Mehmet Adam

Quality of Life After Burn Injury: The Impact of Joint Contracture

We sought to investigate quality of life, and to specifically assess how joint contracture affects it, in patients with burn injuries. The study is involved 22 adults with burn injuries. Patients were divided into two groups according to the presence (n = 11) or absence (n = 11) of any joint contracture. Patient age, sex, date of burn injury, burn type, location, and extent of burn (TBSA) were recorded for each case. Each individual underwent a thorough musculoskeletal system examination, with special focus on range of motion of the joints. Quality of life was evaluated using the Short Form 36 (SF-36). Eight (36.4%) of the patients were women, and 14 (63.6%) were men, and their mean age (± SE) was 24.7 ± 4.68 years. The mean interval from injury to the study assessment was 21.45 ± 14.69 months. Eleven patients (50%) had at least one joint contracture. The patients with one or more contractures had significantly lower scores for the SF-36 subscales of physical functioning, physical role limitations, bodily pain, and vitality (P = .05, P = .01, P = .04, and P = .02, respectively). In the 22 patients overall, TBSA was negatively correlated with the scores for the SF-36 subscales vitality and emotional role limitations (r = −.586 and r = −.805, respectively). Joint contracture does impact burn patients’ quality of life, especially with respect to physical functioning, physical role limitations, bodily pain, and vitality. In addition, the amount of BSA burned is correlated with psychosocial problems and poorer quality of life, regardless of whether joint contractures develop.

Clinical and epidemiologic evaluation of pressure ulcers in patients at a university hospital in Turkey.

Objective We sought to measure the incidence of pressure ulcer development at a university health center in Turkey, and to determine whether the Waterlow Pressure Sore Risk (PSR) Scale score predicted pressure ulcer development, stage, or number of ulcers. Design We prospectively evaluated patients who were hospitalized at our university-based medical center. Setting and subjects We analyzed data from 22,834 patients hospitalized at the Baskent University Adana Teaching and Medical Research Center in Ankara, Turkey from January 1, 2004 to December 31, 2004, including 360 patients who developed pressure ulcers. Instruments The Waterlow PSR Scale was used to assess pressure ulcer risk. In addition, age, sex, the ward or unit in which the patient was hospitalized, reason for hospitalization, and location and stage of ulcers were collected on a data form designed specifically for this study. Methods A single nurse physiotherapist assessed all patients daily during their hospitalization. When a pressure ulcer was diagnosed by the nurse physiotherapist, a physician staged the pressure ulcers based on the US National Pressure Ulcer Advisory Panel (NPUAP) staging system. Results Three hundred sixty out of 22,834 patients developed 1 or more pressure ulcers, resulting in an incidence rate of 1.6%. Most ulcers (59.2%) occurred in patients hospitalized in the intensive care unit (n = 213). A positive correlation between the Waterlow PSR Scale score and number of ulcers per patient (r: 0.178, P < .01) was identified. No significant correlation was found linking Waterlow PSR Scale score and ulcer stage or the development of a single ulcer. Conclusion We found significantly lower pressure ulcer incidence rates than those commonly reported in the literature, which we believe is principally attributable to short hospital stays and a strong emphasis on preventive nursing care. While high Waterlow PSR scale Scores correlated positively with development of multiple ulcers, this did not predict ulcer stage or the presence of a single pressure ulcer.

Validation of a Turkish version of the burn-specific health scale.

The abbreviated Burn-Specific Health Scale (BSHS) is an instrument that measures physical, mental, social, and general health in burn survivors. This scale is composed of 80 items. The aim of this study was to determine the reliability and validity of a Turkish version of the BSHS (the BSHS-Turkish). The BSHS-abbreviated was translated and adapted for Turkish persons according to standard procedures. After a telephone interview with all eligible patients, the BSHS-Turkish was mailed to 103 burn patients. Fifty-three patients (51.46%) filled out both questionnaires; the second one was completed within 15 days of the first one. The mean time that it took to complete the questionnaire was 31.06 ± 15.2 minutes (range, 3–60 minutes). The test–retest, internal reliability, and construct validity of the BSHS-Turkish were satisfactory according to intraclass correlation coefficient, Cronbachs alpha, and the Mann Whitney U test. The BSHS-Turkish is a reliable and valid instrument for determining the health status of Turkish patients with burns.

Effects of therapeutic ultrasound and exercise on pain, function, and isokinetic shoulder rotator strength of patients with rotator cuff disease.

[Purpose] The aim of this prospective, double-blind, randomized, placebo-controlled study was to evaluate the effects of therapeutic continuous ultrasound (US) on patients with rotator cuff disease. [Subjects and Methods] Twenty-two patients were treated with a standard physiotherapy program consisting of a hot-pack, transcutaneous electrical nerve stimulation (TENS), exercises, and US that was supervised by the same physiotherapist. The patients were randomly assigned to either a group that received true US (n=11) or one that received sham US (n=11). [Results] There were significant differences between the pre- and post-intervention UCLA Shoulder Rating Scale and Constant-Murley Shoulder Outcome scores, VAS, and external rotation (ER) peak torque 60°/second values for both the true and sham US groups. However, the between-group differences were not statistically significant. [Conclusion] In patients with rotator cuff disease, physiotherapy interventions effectively treat the pain, improve the clinical status, and increase the muscle strength of the shoulder ER at a low constant angular velocity, with functional improvement being seen immediately after treatment. However, at the end of the intervention, the US had yielded no additional efficacy to the physiotherapy treatment regimen of the patients with rotator cuff disease.

Autosomal Dominant Osteopetrosis Type II

Osteopetrosis is a rare genetic disorder caused by osteoclast failure. Dominant negative mutations of the ClCN7 gene cause the so-called, autosomal dominant osteopetrosis type II, which represents the most frequent and heterogeneous form of osteopetrosis, ranging from asymptomatic to intermediate-severe, thus suggesting additional genetic and environmental determinants affecting penetrance. Here, we present a case a 46 year-old woman complained low back pain for 15 years. The patient lacked any history of direct trauma and her pain was radiating to her left leg, increasing with physical activity, she had no pain at nights. The patient was diagnosed with autosomal dominant osteopetrosis on the basis of the presence of typical radiological appearance. Were present a case report of osteopetrosis type II (an autosomal dominantly inherited disease) as a cause for low back pain without any familial penetrance of the disease.

The effect of physician experience on the measurement reliability of the Reimers' hip migration percentage in children with cerebral palsy.

[Purpose] Reimers’ hip migration percentage (MP) is commonly used to document the extent of hip displacement in children with cerebral palsy (CP). However, factors such as poor administration of pelvic radiographs, a lack of concentration, inexperience, or a busy clinical environment may result in variations in the MP measurements. The aim of this study was to compare the differences in the MP results of two physiatrists with varying levels of experience to determine the role of experience in the measurement’s accuracy. [Subjects and Methods] This retrospective study included 62 hip radiographs of 31 children with spastic CP. Two physiatrists with different experience levels calculated the baseline MP on two occasions six weeks apart. Correlations, intra- and inter-rater reliabilities, and differences in the MPs were compared. [Results] Correlations and inter- and intra-rater reliabilities of the measurements were excellent. There were no statistically significant intra- or inter-rater differences for either of the two measurement points. Inter-rater correlations for each session were 0.94. [Conclusion] Experience does not appear to be a factor in the evaluation of MP, and inter-rater differences do not cause problems regarding patient follow-up. Therefore, repeated pelvic radiographs are not necessary in the evaluation of MP in children with CP unless indicated.

Çocuk Hastada Ağrısız Diskoid Lateral Menisküs ve Meniskal Yırtık

Ya z›fl ma Ad re si/Ad dress for Cor res pon den ce: Dr. Mehmet Adam, Başkent Üniversitesi Adana Araştırma ve Uygulama Merkezi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Adana, Türkiye Tel.: +90 322 344 44 44/1095 E-pos ta: mehmetadam@baskent-adn.edu.tr Ge liş Ta ri hi/Re cei ved: Ağustos/August 2011 Ka bul Ta ri hi/Ac cep ted: Mart/March 2012