ABS TRACT Objective: Corticosteroid injections are remarkably effective as a treatment for carpal tunnel syndrome (CTS) in the short term. This study aimed to determine the effects of ultrasound (US)-guided corticosteroid injection with or without hydrodissection on symptom severity, functional status, grip strength, quality of life, and the cross-sectional area (CSA) of the median nerve in CTS. Material and Methods: A prospective cohort of patients with CTS was retrospectively evaluated. A total of 28 patients were randomly selected who received US-guided triamcinolone injection with hydrodissection (3 mL) as the hydrodissection group and US-guided triamcinolone injection (1 mL) as the control group, from the data (case-control ratio 1:1). Outcome measures were the hand grip strength (HGS), CSA of the median nerve, Boston Carpal Tunnel Questionnaire (BCTQ), and Short Form 12. We recorded the assessments at baseline, 1 and 4 weeks after injections. Results: HGS significantly improved, CSA of the median nerve, Symptom Severity Scale, and Functional Status Scale (FSS) scores of BCTQ significantly decreased in both groups throughout the assessment points (p<0.01 for each variable). Percent changes in baseline and 1st-week results between groups showed improvement in the FSS score of BCTQ in the hydrodissection group (-47.46% vs. -13.97%, p=0.016) but this was not available after 4 weeks (-53.25% vs. -33.33%, p=0.053). Conclusion: Corticosteroid injection with hydrodissection did not provide an additional clinical effect except for an improvement in functional scores in 1st week.
ÖZET Amaç: Kronik dönem orta veya ağır travmatik beyin hasarı (TBH) olan erişkin hastalarda ön hipofiz hormon düzeylerini, fonksiyonel, bilişsel ve emosyonel sonuçları karşılaştırmak, bu parametrelerin travma şiddeti ile ilişkisini belirlemek hedeflenmiştir. Gereç ve Yöntemler: Kesitsel olarak planlanan bu çalışmaya en az 6 aydır TBH'li olan 53 hasta dâhil edildi. Travma şiddeti ilk 24 saat içinde kaydedilen Glaskow Koma Skalası (GKS) skoruna göre belirlendi, hastalar orta (n=20) ve ağır TBH (n=33) olarak 2 gruba ayrıldı. Fonksiyonel Bağımsızlık Ölçeği (FBÖ), Mini Mental Durum Testi (MMDT), Ranchos Los Amigos Kognitif Fonksiyon Skalası (RLAS), Beck Depresyon Ölçeği (BDÖ) ve Beck Anksiyete Ölçeği (BAÖ) değerlendirmeler için kullanıldı. Ayrıca tüm hastaların adrenokortikotropik hormon, prolaktin, folikül uyarıcı hormon, luteinize edici hormon, tiroid uyarıcı hormon, insülin benzeri büyüme faktörü-1 ve büyüme hormon bazal seviyeleri ölçüldü. Bulgular: Orta ve ağır TBH olan hastalar arasında FBÖ, MMDT, BDÖ ve BAÖ değerleri bakımından anlamlı farklılık vardı ancak ön hipofiz hormon bazal düzeyleri farklılık göstermedi. GKS ile FBÖ ve MMDT arasında pozitif ilişki, BDÖ ve BAÖ arasında negatif ilişki görülürken ön hipofiz hormon düzeyleri ile ilişki saptanmadı. Sonuç: Kronik TBH olan hastalarda travmanın şiddeti arttıkça günlük yaşam aktivitelerinde bağımlılık, depresif duygudurum, anksiyete ve bilişsel işlevlerde bozulma artmaktadır. Bu nedenle, GKS skorunun kaydedilmesi, sonraki rehabilitasyon sürecinde, özellikle klinik sonuçların belirlenmesi açısından değerlidir. Anah tarKe li me ler: Beyin hasarı; hipofiz hormonları; fonksiyonellik; bilişsel durum; emosyonel durum ABS TRACT Objective: To compare the anterior pituitary hormone levels, functional, cognitive, and emotional outcomes in adult patients with chronic period moderate or severe traumatic brain injury (TBI) and to determine the relationship between these parameters and the severity of trauma. Material and Methods: Fifty-three patients with TBI were included in this cross-sectional study. Trauma severity was determined according to the Glasgow Coma Scale (GCS) score recorded within the first 24 hours, and the patients were divided into 2 groups as moderate (n=20) and severe TBI (n=33). Functional Independence Measure (FIM), Mini Mental State Test (MMST), Ranchos Los Amigos Cognitive Function Scale (RLAS), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used for evaluations.Basal levels of adrenocorticotropic hormone, prolactin, follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, insulin-like growth factor-1 and growth hormone were measured in all patients. Results: There was a significant difference between patients with moderate and severe TBI in terms of FIM, MMST, BDI and BAI values but no difference was found in anterior pituitary hormone basal levels. There was a positive relationship between GCS score and FIM and MMST, and a negative relationship between BDI and BAI while no relationship was noted between...
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