Purpose: To determine the effect of foot arch structure on ankle muscle strength. Methods: Forty-seven young female volunteers (94 feet) were classified in to low (LA), high (HA) and normal (NA) arch groups according to their arch ratio (AR) and Chip
Study objective: We aimed to study the effects of perineural tramadol on both sensory and motor conduction of ulnar nerve by electroneurography (ENG).Design: Prospective.Setting: Physical Medicine and Rehabilitation Electrophysiology Laboratory.Patients: Eight healthy volunteers.Intervention: Either 3-mL of saline or 50 mg of tramadol in 3-mL saline was initially administered perineurally to ulnar nerve of nondominant extremity. After two weeks, volunteers who received tramadol were given saline, whereas the ones who received saline were given tramadol.Measurements: Baseline sensory and motor responses of ulnar nerve were recorded by ENG prior to injection of study solutions. Perineural injections were realized by means of a teflon-coated needle and a nerve stimulator. Following injections, sensory and motor responses were monitored every five minutes in the first hour and then every 10 minutes until the sensory and motor amplitudes reached at least 80 percent of the baseline value.Main Results: Perineural tramadol administration showed a significant decrease from baseline measurement in the sensory response amplitude with respect to saline administration (65.9 percent vs 12.7 percent, p < 0.05). Decrease in the motor response amplitudes from baseline versus saline was insignificant (32.9 percent vs 15.2 percent). Sensory block was observed in all of the subjects after tramadol injection when compared with saline administration and lasted 25 minutes (p < 0.05). The duration of motor block lasted 12.5 minutes, and motor block developed in four out of eight subjects when compared with saline administration (p < 0.05). Time to reach maximum sensory and motor block were 15 and 10 minutes, respectively, after tramadol injection.Conclusions: Tramadol has a brief local anesthetic-like action when administered to ulnar nerve perineurally.
In this study the effects of agonist acting drugs (morphine sulphate, fentanyl citrate and meperidine hydrochloride) on nerve conduction were studied in 43 healthy young volunteers divided into four groups randomly. According to analgesic equivalent doses, the first group received 2 mg morphine sulphate, the second group 0.02 mg fentanyl citrate, the third group 20 mg meperidine hydrochloride, and as control the fourth group received 2 ml of saline. The latencies, amplitudes of the responses and nerve conduction velocities were obtained immediately before and every 5 min after injections up to 30 min. No significant change was observed within or among the morphine sulphate, fentanyl citrate and saline groups whereas in the meperidine hydrochloride group the amplitudes diminished significantly and this finding was still apparent at 30 min. Four of the cases displayed complete blocks. Nerve conduction velocity did not change in the other 6 cases. The significant decrement of the amplitude of the compound nerve action potential in the meperidine hydrochloride group is probably due to local anesthetic-like action of this drug. Morphine sulphate, fentanyl citrate or saline did not show this effect.
Autonomic nervous system involvement with peripheral neuropathy is a well known complication of rheumatoid arthritis (RA). In the assessment of autonomic function of patients with rheumatoid arthritis, we performed sympathetic skin response (SSR) and R-R interval variation (RRIV) tests in 30 patients and in 30 normal controls. Of 30 patients, 5 had complaints of clinical dysautonomic symptoms. SSRs were abnormal in 6 of 30 patients, whereas 8 showed abnormal RRIVs during deep breathing. Nine of 30 patients also showed electrophysiologic evidence of peripheral neuropathy. All 5 of the patients with clinical dysautonomic symptoms showed abnormal SSR and RRIV test results. No patient with normal results on both tests had clinical dysautonomia. This study showed that there are frequent abnormalities in SSR and RRIV tests in patients with rheumatoid arthritis whether there is a clinical symptom of autonomic dysfunction or not.
Multicentric reticulohistiocytosis is a rare systemic illness which primarily affects joints and skin. The illness has a female predominance and usually begins during the fourth decade.1
Objectives
We describe a patient with multicentric reticulohistiocytosis whose manifestations have started at a much younger age than mentioned in the literature.
Methods
Results
18-year-old female patient presented with a complaint of arthralgia at her wrists, knees and ankles. Her complaints had started 6 months before admission with arthralgia and painful swellings at the wrists and kness. On admission she had active symmetric arthritis at the shoulders, elbows, wrists and knees. Synovial hypertrophy was prominent at the wrists, knees and MCP joints. Cutaneous examination showed a single 0.5 × 0.5 cm erythematous nodular structure at her 3 MCP joint. There were orange coloured hypertrophic lesions at her nail-folds. Her systemic examination was not remarkable. Her ESR was 29 mm/h, CRP 96 mg/dl, RF(-), Hb: 11.5, WBC: 10.300, platelets 289.000. Liver and kidney functions were normal. x-rays of the hands showed periarticular osteopenia, there were no erosions. Arthrosyntesis showed the characteristics of an inflammatory synovial fluid. She was thought to have active rheumatoid arthritis and was started on 7.5 mg prednisolone and sulphasalazine 2 g/day. The dosage of prednisolone was gradually increased to 30 mg/day as there was no improvement in her active arthritis. Methotrexate 7.5 mg/week was added. During her follow-up she developed orange papulonodular lesions on her forehead and pinnae. Biopsy taken from the 3MCP joint revealed reticulohistiocytoma. 10 months after the diagnosis she is still under close surveillence as the disease can be associated with malignancy in 25% of patients. She is currently on methotrexate 12.5 mg/week and prednisolone 20 mg/day. The active arthritis at the shoulders and knees has resolved but she still has active arthritis at the wrists.
Conclusion
Although multicentric reticulohistiocytosis affects predominantly middle-aged women the disease should be kept in mind in the differential diagnosis of active arthritis for younger age groups as well.
Sum maryAim: The aim of this study was to define the demographic and clinical characteristics of geriatric patients who referred to physical medicine and rehabilitation (PMR) outpatient clinics and to detect the differences between these characteristics in regard to age, sex and education level.Materials and Methods: 820 patients over 65 years old who attended 20 outpatient clinics were included in the study.In addition to demographic data, the complaints, comorbid diseases, pain levels, drugs being used, exercise and medical status of the patients were recorded.The effects of age, sex and education level on complaints, comorbid diseases and exercise habits were investigated.Results: The mean age of the patients was 71.7±5.5 years.16.7% were living alone, 61.7% were housewives.86% of the patients had one or more Özet Amaç: Bu çalışmada amaç, Fiziksel Tıp ve Rehabilitasyon (FTR) polikliniklerine başvuran geriatrik hastaların demografik ve klinik özelliklerini belirlemek, bu klinik ve demografik özelliklerin, yaş, cinsiyet ve öğrenim düzeylerine göre farklılıklarını ortaya çıkarmaktı.Gereç ve Yöntem: Çok merkezli
