RESUMO
Behçet's Syndrome (BS) is a chronic vasculitis of unknown etiology. Arterial involvement occurring in the pulmonary artery is associated with poor prognosis. It may cause pulmonary thrombus (PTE) and aneurysm (PAA) which may also lead to a rare complication, intracardiac thrombus. PAA and PTE can be complications of BS and are associated with high morbidity and mortality. A 30-year-old male patient had a fever of 38.4°C, recurrent oral-genital ulcers, shortness of breath, cough, and sputum. In this case report, medical history, clinical and laboratory examinations, radiography, echocardiography, and computer tomography imaging examinations were performed. PAA, PTE, intracardiac and left popliteal vein thrombosis, and infective endocarditis were present. The patient was diagnosed with BS according to the International Study Group criteria. Surgery was performed for intracardiac thrombus. Vegetation within the thrombus was demonstrated histopathologically. The patient's clinical condition and laboratory tests improved with intervention and medical treatments. The patient with BS, PAA, PTE, intracardiac thrombus, and infective endocarditis was successfully treated with pulmonary embolization, antibiotics, and systemic immunosuppression, despite its rarity, poor prognosis, and high morbidity and mortality rates.
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BACKGROUND: Haemophilic arthropathy is likely to influence posture and muscle stiffness in adolescent male haemophilia patients (HP). OBJECTIVE: This study aimed to investigate the possible change in upright standing posture and stiffness of the superficial postural muscles in HP. METHODS: Twenty-two HP aged between 12 and 19 years and twenty-two healthy peers were included in the study. The photogrammetry was used to assess the upright standing posture from sagittal and frontal planes. Also, stiffness of the superficial postural muscles was evaluated using the myotonometry. RESULTS: A significant difference was found in the craniovertebral, lumbar lordosis, knee flexion-valgus, and ankle plantar flexion angles between the groups (p< 0.05). Craniovertebral, knee flexion, and knee valgus angles were lower; whereas lumbar lordosis and ankle plantar flexion angles were higher in HP compared to the healthy peers. Stiffness of the rectus femoris muscle was lower in HP (p< 0.001). CONCLUSION: This study revealed that the ankle, knee, lumbar, and craniovertebral segments' posture angles were changed and the stiffness of the rectus femoris muscle decreased in HP. Postural alterations and reduced rectus femoris stiffness should be considered in management of the musculoskeletal complications of haemophilia.
Assuntos
Hemofilia A , Postura , Humanos , Masculino , Hemofilia A/fisiopatologia , Hemofilia A/complicações , Adolescente , Postura/fisiologia , Criança , Adulto Jovem , Estudos de Casos e Controles , Músculo Quadríceps/fisiopatologia , Músculo Quadríceps/fisiologia , Amplitude de Movimento Articular/fisiologiaRESUMO
Objectives: This study aimed to evaluate the frequency of fibromyalgianess, fibromyalgia syndrome (FS), and widespread pain in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and their relationship with clinical and demographic parameters. Patients and methods: This cross-sectional multicenter trial was performed in 14 centers across Türkiye between June 2018 and November 2019. Out of 685 patients recruited from the accessible population, 661 patients (342 RA, 319 AS; 264 males, 397 females; mean age: 48.1±12.9 years; range, 17 to 88 years) met the selection criteria. In these cohorts, those who did not meet the criteria for FS and had widespread pain (widespread pain index ≥7) were evaluated as a separate group. Clinical status and demographic parameters of patients in both cohorts were evaluated as well as the evaluations of RA and AS patients with widespread pain (widespread pain index ≥7) and RA and AS patients with FS groups. In addition, correlations between polysymptomatic distress scale (PSD) scores and Visual Analog Scale (VAS), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), and Disease Activity Score using 28 joint counts for RA patients and VAS, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Ankylosing Spondylitis Disease Activity Score (ASDAS) for AS patients were analyzed. Results: Frequencies of patients with FS and patients who had PSD scores ≥12 were 34.1% and 44.4% in all RA patients, respectively. Moreover, FS and PSD scores ≥12 were found in 29.2% and 36.9% of all AS patients, respectively. PSD scores of RA patients with FS were higher than all RA patients and RA patients with widespread pain. SDAI and CDAI scores of RA patients with FS were higher than all RA patients and RA patients with widespread pain. Similarly, PSD scores of AS patients with FS were higher than all AS patients and AS patients with widespread pain. ASDAS-erythrocyte sedimentation rate and BASDAI scores of AS patients with FS were found higher than all AS patients and AS patients with widespread pain. Conclusion: Disease activity scores, including pain in RA and AS, were higher in the presence of FS or fibromyalgianess. It may be related to clinical parameters, but cohort studies with long-term follow-up are needed to reveal causality. Additionally, to avoid overtreatment, coexistence of fibromyalgianess should be kept in mind in patients who have inflammatory diseases such as RA and AS, particularly with intractable widespread pain.
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SUMMARY: Health professionals especially nurses have ongoing contact with patients and they may have a high incidence of musculoskeletal problems. For this reason, grip strength and carrying angle are important parameters for all health professionals to succeed in their job and avoid injuries. It was aimed to determine the effects of the hand grip, and pinch strength, carrying angle of dominant, and non-dominant hands as well as the association of the hand functional index with morphometric measurements in 193 nursing students. The means of the carrying angle of dominant and non-dominant sides were 169.11±4.21° and 168.16±4.30°, respectively. The means of the dominant and, non-dominant sides of hand grip strength were 45.99±11.24 kg and 45.89±11.34 kg, respectively. The lateral pinch strength means were measured as 19.55±3.75 kg and 19.31±3.45 kg, respectively. This paper's findings may be important for some experts such as anatomists, clinicians, surgeons, forensic scientists, anthropologists, and nurses- healthcare professionals keep in touch with patients. Also, we believe that appropriate and effective knowledge of carrying angle, hand grip and lateral pinch strength has created an opportunity to research in terms of reducing work-related risk factors.
Los profesionales de la salud, especialmente las enfermeras, se mantienen en contacto con los pacientes y pueden tener una alta incidencia de problemas musculo-esqueléticos. En consecuencia, la fuerza de agarre y el ángulo de carga son parámetros importantes para que todos los profesionales de la salud tengan éxito en su trabajo y eviten las lesiones. El objetivo de este estudio fue determinar los efectos de la fuerza de prensión y pinzamiento de la mano, el ángulo de carga de las manos dominantes y no dominantes, así como la asociación del índice funcional de la mano con medidas morfométricas en 193 estudiantes de enfermería. Las medias del ángulo de carga de los lados dominante y no dominante fueron 169,11±4,21° y 168,16±4,30°, respectivamente. Las medias de los lados dominante y no dominante de la fuerza de prensión manual fueron 45,99 ± 11,24 kg y 45,89 ± 11,34 kg, respectivamente. La media de la fuerza de pellizco lateral se midió como 19,55 ± 3,75 kg y 19,31 ± 3,45 kg, respectivamente. Los hallazgos de este artículo pueden ser importantes para algunos expertos, como anatomistas, médicos clínicos, cirujanos, científicos forenses, antropólogos y enfermeras y profesionales de la salud que se mantienen en contacto con los pacientes. Además, creemos que el conocimiento apropiado y efectivo del ángulo de carga, el agarre de la mano y la fuerza de pellizco lateral ha creado una oportunidad para investigar en términos de reducción de los factores de riesgo relacionados con el trabajo.