Objective: This study aims to investigate the efficacy of therapeutic pulsed ultrasound on pain, function, synovial sac and femoral cartilage in knee osteoarthritis. Design: Randomized, double-blind, controlled study Setting: Dokuz Eylul University, Department of Physical Medicine and Rehabilitation Subjects: A total of 96 patients with knee osteoarthritis Interventions: Participants were randomized into two groups; Group I ( n = 48, pulsed ultrasound) and Group II ( n = 48, sham ultrasound). The sessions were held three times a week for 8 weeks. The study continued for 12 weeks (with 4 weeks follow-up). All participants performed exercises at home for 12 weeks. Main measures: Knee pain (at rest and ADLs) was assessed using the visual analog scale (VAS). Functionality was assessed using the Timed Up and Go test and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire. Femoral cartilage and synovial sac thickness was measured using ultrasonography. All evaluations were performed at the baseline, at the 8 and 12 weeks after baseline. Results: The study was completed with a total of 75 patients ( n = 39 in group I and n = 36 in group II). The mean (SD) pain at ADLs score at baseline and week 12 was 7.2 (2.1), with 3.6 (2.9) in the group I, and 6.7 (2.0) and 4.3 (2.2) in the group II, respectively. Both groups presented significant improvements in terms of pain and function ( P < 0.001). There was no difference between groups for any parameters. Conclusion: Treatment of pulsed ultrasound has no positive effect on knee pain, function, femoral cartilage and synovial sac thickness in knee osteoarthritis.

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P armak ucu yaralanmaları çocuklarda sıktır, çeşitli çalışmalarda çocuk acil servis başvurularından %1.8-2'sini el yaralanmalarının oluşturduğu bildirilmiştir ve bunların %21-46'sı parmak ucu yaralanmalarıdır. [1][2][3] Erişkin hastaların parmak ucu yaralanmaları değerlendirildiğinde daha çok iş kazaları etyolojik neden olmakla birlikte çocuk hastalarda bu nedenler daha çok ev ve dış ortamda gerçekleşen kazalar olarak karşımıza çıkar. Başka bir çalışmada da tüm acil başvurularının %2'sini kapıya sıkışma ile olan parmak ucu yaralanmaları oluşturmaktadır. [4] Amerika'da yapılan ülke geneli bir çalışmada parmak amputasyonlarının tüm pediatrik travmatik amputasyonların %91,6'sını oluşturduğu bildirilmiştir. [5] Ülkemizde çocuk popülasyonunun hızlı artışına rağmen bu tarz yaralanmaların epidemiyolojisine ilişkin yeterli bilgi bulunmamaktadır. Bu yaralanmalar yapılan aktivitelere ve bölgelere bağlı değişiklik gösterdiği için Amaç: Bu çalışmada 4 yıllık süreçte parmak ucu yaralanması nedeniyle acil serviste değerlendirerek tedavi ettiğimiz 354 pediatrik olgu etiyoloji, demografik bilgiler, tedavi ve komplikasyonlar açısından incelenmiştir. Çalışmanın amacı çocuk hastalarda sık görülen parmak ucu yaralanmalarına dikkat çekmek ve önleyici stratejiler geliştirilmesine yardımcı olmaktır. Yöntem: Çalışmaya dahil edilen 354 hastalanın 191 tanesi erkek çocuk 163 tanesi kız çocuktu. Yaşları 6 ay ile 17 yaş arasında değişmekteydi. Bu hastalar cinsiyete, yaralanan el ve parmaklara, yaralanma mekanizmasına, yaralanma bölgesine, seçilen tedavi yöntemlerine ve komplikasyonlara gore sınıflandırılarak incelendi. Ameliyatların tamamında lokal anestezi altında çalışıldı. Hastaların tamamına acil serviste girişim yapılarak hastalar aynı gün taburcu edildi. Bulgular: Çalışmamızda incelenen hasta grubunda erkek çocukların (%54) kız çocuklara göre (%46) daha fazla yaralndığı görüldü. Sağ elin (%65.3), sol ele (%34.7) göre çok daha fazla yaralandığı görüldü. En fazla yaralanmanın 136(%38.4) hastada orta parmakta olduğu, bunu 120(%33.9) hastada yüzük parmağın takip ettiği gözlendi. Bu yaralanmaların en sık görüldüğü yaş 5 olarak belirlendi. En sık yaralanma tipi %83.3 oranla ezilme tipi yaralanma olarak görülmüşken, bunun da en sık nedeninin kapıya sıkışma tarzı yaralanmalar olduğu görüldü. Bu yaralanmaların çoğuna cerrahi müdahale gerekmişken, uygun hastalarda yara bakımı ile sekonder iyileşme ile tedavi yapıldı. Tartışma: Çocukluk çağında oldukça el yaralanmaları oldukça sıktır ve parmak ucu yaralanmaları bunların arasında çoğunluğu oluşturur. Çocukluk çağında olan bu yaralanmalar ileri dönemde bu hastalarda önemli fonksiyonel, estetik ve psikolojik sekellere yol açmaktadır. Bu yaralanmaların etiyolojisi, dağılımı ve mekanizmaları hakkında bilgi sahibi olmak, bu konuda önleyici tedbirlerin geliştirilmesine imkan verecektir. Anahtar Sözcükler: Amputasyon; kompozit greft; rekonstrüksiyon; parmak ucu.Please cite this article as "

Background:Osteoarthritis (OA) is a progressive rheumatic disease which is the most common cause of musculoskeletal pain and functional impairment, particularly in the elderly group. Ultrasound therapy is one of the most commonly used physical modalities in the OA treatment. It has deep heating effect and increases tissue regeneration, blood flow and metabolic effects while reducing the inflammation. In addition, it increases the cartilage regeneration according to certain in vivo and in vitro studies (1).Objectives:To research the effect of pulsed ultrasound treatment on pain, functionality, synovial fluid and cartilage thickness in knee osteoarthritis.Methods:This study was a randomised-controlled and parallel group study. 96 patients (79 females and 17 males) were included to study who had knee pain, aged between 45-75 years. They also have diagnosed as knee osteoarthritis according to ACR diagnostic criteria and their Kellgren-Lawrence grades were ≤3. These patients were divided in two groups randomly: Treatment group (exercise + US), (9 male, 39 female), control group (exercise + Sham US), (8 male, 40 female). The patients in the treatment group were treated with a 1 MHz probe and a density of 1w/cm², 1: 4 for 10 minutes, and 3 sessions a week for 8 weeks. Sham US treatment was applied to each group at the same time. Both groups received a home exercise program including knee range of motion and isometric strengthening exercises. All patients were evaluated by ultrasonographic measurements and quality of life tests; VAS (Visuel Analog Scale) rest, VAS walking, Timed Up and Go Test, WOMAC Questionnaire scores (before treatment, after treatment, 3 months after treatment).Results:9 out of 48 patients in the treatment group and 12 out of 48 patients in the control group were excluded from the study because they did not continue treatment or come to the control. The distribution of groups was similar (Table-1). VAS rest, VAS walking, Timed up and go test, WOMAC questionnaire scores, were improved statistically significant in both groups (P<0.05), but group effect could not be demonstrated (P>0.05) There were no statistically significant results in terms of both synovial fluid and femoral cartilage thickness measurements (P>0.05) (Table 2).Abstract THU0435 –Table 1Conclusion:Therapeutic ultrasound treatment in addition to home exercise program has not been shown to be effective rest and walking pain, functionality, synovial fluid and femoral cartilage thickness in the treatment of knee osteoarthritis. This is the first study to evaluate the effect of therapeutic intermittent ultrasound on synovial fluid and cartilage thickness by ultrasonography. International collaborative studies and randomized clinical trials will help in clarifying these areas of uncertainty.References:[1] -Loyola-Sánchez, A. 2012.” Effect of low-intensity pulsed ultrasound on the cartilage repair in people with mild to moderate knee osteoarthritis: a double blinded, randomized, placebo-controlled pilot study”, Archives of Physical Medicine and...

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Vasculitis may rarely be seen in the course of myeloproliferative neoplasms (MPN). In vasculitis associated with hematological diseases, mostly small‐ and medium‐vessel involvement is expected, aortitis is very rare. It is not exactly known whether large‐vessel vasculitis associated with MPN is a paraneoplastic phenomenon or coincidental. We aimed to present an uncommon case diagnosed with chronic myeloid leukemia and Takayasu arteritis concurrently.

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Introduction: We aimed to investigate the effects of the coronavirus disease 2019 (COVID-19) pandemic on the course and treatment of patients with inflammatory rheumatic musculoskeletal disease (iRMD) using biologic or targeted synthetic disease modifying and rheumatic drugs (b/tsDMARDs). Methodology: The study was carried out in two stages: in the first stage we investigated the delay of b/tsDMARD treatment in the first 3 months of the pandemic; in the second stage, we investigated all patients who decided to continue treatment after interruption in the 12-month period. Results: A total of 521 patients were included in the study. The iRMD diagnosis was listed as spondyloarthritis (SpA) (54.3%), rheumatoid arthritis (RA) (25.7%), psoriatic arthritis (PsA) (8.4%), vasculitis (6.1%), and others (5.4%). Concurrent use of hydroxychloroquine (hazard ratio [HR] = 1.49), iv bDMARD use (HR = 1.34), and a history of discontinuation of drug in the first 3 months of the pandemic (HR = 1.19) were determined as factors that reduced 12-month drug retention rates. The use of glucocorticoid (HR = 3.81) and having a diagnosis of interstitial lung disease/chronic obstructive lung disease (HR = 4.96) were found to increase the risk of being infected by SARS coronavirus 2 (SARS-CoV-2). Conclusions: It was shown that approximately 1/5 of iRMD patients using b/tsDMARDs delayed their treatment due to the fear of COVID-19 in the first three months of the pandemic process. However, with good communication with the patients, b/tsDMARD treatment was restarted and the 12-month drug retention status was quite high.