A home exercise program could be an effective preventive method for improving ROM for foot joints and plantar pressure distribution in diabetic patients independent of the presence of neuropathy.
Objectives: This study aims to evaluate the relationship between serum angiogenic factor levels and disease activity in patients with rheumatoid arthritis (RA) using both clinical and dynamic wrist magnetic resonance imaging (MRI) data. Patients and methods: Simultaneous serum angiogenesis markers [vascular endothelial growth factor (VEGF), angiopoietin-1 (ANG1), ANG2, and tyrosine-protein kinase receptor for angiopoietin (Tie-2)] were studied in 40 patients with RA (13 males, 27 females; mean age 51.1±10.8 years; range, 23 to 69 years) and 20 healthy controls (11 males, 9 females; mean age 47.3±12.8 years; range, 29 to 69 years) and dynamic contrast-enhanced wrist MRI was performed in 40 RA patients and seven controls. Rate of early in 55 th second (REE) and Relative enhancement (REt) values were calculated from the signal time curve values obtained from the analysis of images. In clinical assessment, duration of morning stiffness, patient pain assessment [visual analog scale (VAS)], physician and patient global assessments (VAS) were recorded. The number of tender joints and swollen joints were determined. Disease activity score 28 and Ritchie scores were calculated. Health assessment questionnaire was used for functional evaluation. Anti-cyclic citrullinated peptide, rheumatoid factor, erythrocyte sedimentation rate and high sensitive C-reactive protein analyses were performed. Results: Serum VEGF, REE and REt values were significantly higher in RA patients than healthy controls (p=0.002, p=0.00, p=0.00, respectively). There was no significant correlation between serum angiogenesis markers and clinical parameters or REE and REt (p>0.05). VEGF value correlated positively with disease duration (p=0.024). Conclusion: Serum VEGF was higher in RA patients. While its level was associated with disease duration, no significant correlation was found with disease activity. As a diagnostic test, dynamic contrast-enhanced MRI was a valuable method for showing disease activity.
Brown-Sequard syndrome (BSS) is an incomplete spinal cord lesion that reflects the spinal cord's hemi-compression or hemisection, characterized by the loss of ipsilateral motor function resulting from corticospinal tract dysfunction and also contralateral pain and temperature sensation loss due to spinothalamic system dysfunction. The most common causes of this syndrome are traumatic injuries and spinal cord neoplasms. 1,2 In addition, other etiologies, including ischemia, epidural hematoma, multiple sclerosis have been described. 3 Cervical disc herniation is an exceptional cause of this syndrome. Considering the severity of neurological deficits in BSS, it is important to raise awareness about this syndrome and early diagnosis. The aim of this case report is to emphasize the consideration of BSS as a rare diagnosis in the patients with cervical disc herniation exhibiting atypical clinical findings. CASE REPORT A 31-year-old male patient presented with weakness on the left side for 1 month, loss of the pain and temperature sensation on the right upper and lower extremities. He was having urinating difficulty for a month. He was admitted to another center with these complaints and his brain magnetic resonance imaging
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