This study indicates that pulmonary rehabilitation can prevent loss of muscle strength in ICU. Nevertheless, we consider that further studies with larger populations are needed to examine the impact of NMES and/or active and passive muscle training in bedridden ICU patients who are mechanically ventilated.

Platelet indices, MPV and PDW, can be used for the determination of disease severity, and lead to therapeutic strategies for PE patients.

The purpose of this study was to determine the accuracy of detecting knee effusion with clinical examination and to evaluate whether the amount of effusion, patient obesity, and the clinicians' experience affect the clinicians' decisions in patients with knee osteoarthritis. Patients presenting with knee pain were examined by two residents with different levels of experience and underwent ultrasonographic examination, including measurement of effusion in the medial, mid, and lateral aspects of the suprapatellar bursa. One hundred seventy-two knees of 86 patients were examined. Of the knees investigated, 127 (73.8 %) had effusion. The consistency between ultrasonographic and resident examination were weak (κ = 0.193, p = 0.007 and κ = 0.349, p < 0.001), although the more experienced senior resident had a stronger agreement. The overall inter-rater agreement between the two residents was low (κ = 0.254). The senior resident had a significantly higher accuracy ratio (p = 0.036). In the knees without effusion, the two examiners had no agreement (κ = -0.028, p = 0.856); however, the ratios of the true decisions were similar (p = 1.0). The accuracy of the less experienced resident's decisions was affected by effusion depth (p = 0.005). Clinicians' decisions and their accuracy in detecting knee effusion during clinical examination were different, especially in the absence of effusion. The consistency between ultrasonography and residents was low. The accuracy of clinical examination was affected by effusion depth and experience, but not by patient obesity.

Grisel's syndrome is a nontraumatic atlantoaxial subluxation which is usually secondary of an infection or an inflammation at the head and neck region. It can be observed after surgery of head and neck region. Etiopathogenesis has not been clearly described yet, but increased looseness of paraspinal ligament is thought to be responsible. Patients typically present with painful torticollis. Diagnosis of Grisel's syndrome is largely based on suspicion of the patient who has recently underwent surgery or history of infection in head and neck region. Physical examination and imaging techniques assist in diagnosis. Therefore, clinicians should be aware of acute nontraumatic torticollis after recently applied the head and neck surgery or undergone upper respiratory tract infection. In this paper, a case of an eight-year-old male patient who had Grisel's syndrome after adenotonsillectomy is discussed with review of the literature.

There are many factors affecting arterial stiffness in CAPD patients. In our study, higher levels of OS status, hepcidin and FGF-21 were independent determinants of arterial stiffness in PD patients. Therefore, definition and improvement of these new parameters will be helpful to reduce the cardiovascular disease risk and mortality in CAPD patients.