Barin Selcuk

Effect of temperature on electrophysiological parameters of swallowing.

The effect of three different temperature ranges on the triggering of voluntary-induced swallowing and on the duration of the pharyngeal phase of oropharyngeal swallowing was studied electrophysiologically. The relationship between volume and temperature of liquids swallowed was also explored. This study included 40 nondisabled volunteers (23 male and 17 female). Laryngeal vertical movements and submental electromyographic activity were recorded as each subject swallowed water at three different temperature ranges: normal (23-25 degrees C), cold (8-10 degrees C), and hot (58-60 degrees C). The time for triggering of the pharyngeal phase of swallowing was found to be shorter for cold and hot water than for normal temperature water (p < 0.01). The duration of the pharyngeal phase of oropharyngeal swallowing was also shorter for cold and hot water than for normal temperature water (p < 0.05). The maximum capacity of a single bolus (dysphagia limit) was >20 mL of water in all nondisabled subjects for different temperatures. However, the capacity was significantly less for hot water relative to normal temperature water and cold water (p < 0.05). In conclusion, the temperature ranges used in this study were found to be effective in triggering voluntary-induced swallowing.

Association of anti-CCP positivity with serum ferritin and DAS-28

Antibodies to cyclic citrullinated peptides (anti-CCP) are highly specific for the diagnosis of rheumatoid arthritis (RA) with a marginal increased prediction of the disease. In this study, we aimed to investigate the relation of the presence of anti-CCP with clinical manifestations and disease activity in a cohort of RA patients. A total of 61 RA patients were included in this study. Data of disease-related parameters such as duration of disease, medications, degree of pain (visual analog scale, VAS), disease activity score 28 (DAS-28) and health assessment questionnaire (HAQ) were recorded. Laboratory workup included erythrocyte sedimentation rate (ESR), plasma C-reactive protein (CRP), rheumatoid factor (RF), anti-CCP, complete blood count and anemia parameters. Anti-CCP positivity was associated with higher scores of DAS-28, longer duration of morning stiffness, serum RF positivity and low levels of serum ferritin, while it was not associated with disease duration, VAS, HAQ, ESR, CRP and hemoglobin.

Extremity Shortness in Obstetric Brachial Plexus Lesion and Its Relationship to Root Avulsion

A total of 73 patients with obstetric brachial plexus palsy and extremity shortness were evaluated clinically, electrophysiologically, and with cervical magnetic resonance imaging. Patients were separated into groups according to age and the level of lesion. The differences of the length of the humerus, ulna, radius, and the second and fifth metacarpal bones were significant between the involved and uninvolved extremities. The difference in shortness increased in relation to the age of the groups and stabilized to approximately 10% in the groups aged 4 to 8 years and 8+ years. A significant relationship was observed between bone length differences and lesion levels. Differences in bone lengths were statistically significant in patients with avulsion in the group aged 8+ years. Extremity shortness appears to be related to avulsion and the level of lesion. The effect of avulsion on extremity shortness gradually increases with age. Finally, root avulsion can be an important factor in extremity shortness of obstetric brachial plexus palsy patients.

Autonomic dysreflexia after intramuscular injection in traumatic tetraplegia: a case report.

Autonomic dysreflexia is a syndrome of massive imbalance of reflex sympathetic discharge occurring in patients with spinal cord lesion above the splanchnic outflow (T6). It is characterized by a sudden onset and severe increase in blood pressure and is potentially life threatening. The most common causes are bladder and rectum distention. In this case study, we report an autonomic dysreflexia case that developed after intramuscular injection in a 29-yr-old tetraplegic patient with C5 American Spinal Injury Association grade A lesion. After careful scrutiny of English literature, this clinical manifestation seems to be an unusual event.

The development of dysphagia and dysphonia due to anterior cervical osteophytes

Cervical osteophytes may cause dysphagia by compressing the esophagus and may cause dysphonia by compressing the larynx and inferior laryngeal nerve. The occurrence of dysphagia and dysphonia due to cervical osteophytes has rarely been reported in literature. In this article, a case, in which the multiple cervical osteophytes were found to be the cause of dysphagia and dysphonia, was evaluated by imaging methods and electrophysiological evaluation of swallowing and the case was discussed in the light of relevant literatures.

Electromyography and Ultrasonography in the Diagnosis of A Rare Double-Crush Ulnar Nerve Injury

Reported here is a 46-year-old man who was seen for pain, numbness, and weakness in his left upper limb and hand. Electromyographic studies demonstrated denervation of ulnar-innervated muscle groups except for the flexor carpi ulnaris. A localized nerve conduction block could not be depicted because of severe axonal loss. Ultrasonographic evaluation showed enlargement of the ulnar nerve at 2 sites: at the level of the epicondylar groove and the inside of the flexor carpi ulnaris muscle. Herein, we would like to emphasize the complementary role of an ultrasound in peripheral nerve pathologies, not only does it confirm the entrapment but it also displays the underlying cause(s).

A rarely seen syndrome in rehabilitation of hemiplegia: antiphospholipid antibody-negative Sneddon's syndrome.

Sneddon’s syndrome is a rarely seen disorder and it is characterized by livedo reticularis (LR) and neurologic findings. Some systematic findings may also be seen with neurologic and cutaneous findings. In this case, we aimed to present a 28-year-old female patient with diffuse LR, cardiac valve disease and migraine-type headache who had a right hemiplegic attack.

Isolated fibrosis/contracture of the rectus femoris muscle: Diagnosis and follow-up with sonography

Reported here is a 21-year-old female with isolated contracture of the rectus femoris muscle. Its possible relation to breech positioning, and the role of sonography for its diagnosis and close follow-up are discussed in the light of the relevant literature.

Rehabilitation outcomes in patients with early and two-stage reconstruction of flexor tendon injuries.

[Purpose] The primary aim of this study was to assess rehabilitation outcomes for early and two-stage repair of hand flexor tendon injuries. The secondary purpose of this study was to compare the findings between treatment groups. [Subjects and Methods] Twenty-three patients were included in this study. Early repair (n=14) and two-stage repair (n=9) groups were included in a rehabilitation program that used hand splints. This retrospective evaluated patients according to their demographic characteristics, including age, gender, injured hand, dominant hand, cause of injury, zone of injury, number of affected fingers, and accompanying injuries. Pain, range of motion, and grip strength were evaluated using a visual analog scale, goniometer, and dynamometer, respectively. [Results] Both groups showed significant improvements in pain and finger flexion after treatment compared with baseline measurements. However, no significant differences were observed between the two treatment groups. Similar results were obtained for grip strength and pinch grip, whereas gross grip was better in the early tendon repair group. [Conclusion] Early and two-stage reconstruction of patients with flexor tendon injuries can be performed with similarly favorable responses and effective rehabilitation programs.

A Cause of Misdiagnosis: Cervical Syringomyelia Occurring in a Patient With Poliomyelitis Sequelae

Study Design:This was a case report. Objective:The aim of this study was to present a case of cervical syringomyelia occurring in a patient with polio sequelae in line with the literature data. Setting:This study was carried out at the Ankara Physical Medicine and Rehabilitation Training and Research Hospital of Ministry of Health, Turkey. Case Report:In this case report, we discuss a case of cervical syringomyelia leading to clinical deterioration (pain in the waist, neck, and left arm and weakness in the left arm, hypoesthesia in the left C5-6-7 dermatoma) in a 38-year-old female patient with polio sequelae, and we also present the relevant literature data. Conclusions:Patients with polio sequelae may exhibit clinical deterioration in the late stage. Although the primary reason for this is postpolio syndrome, the other causes like syringomyelia, cervical spondylosis–associated radiculopathy, and/or myelopathy are also kept in mind.