Effect of an early supervised rehabilitation programme compared with home-based exercise after temporomandibular joint condylar discopexy: a randomized controlled trial.

The goal of rehabilitation after temporomandibular joint (TMJ) surgery is to achieve a normal range of motion. The aim of this study was to compare the impact of a comprehensive and early supervised rehabilitation programme with home-based exercise after TMJ condylar discopexy. Patients diagnosed with disc displacement without reduction were randomized to the study and control groups. After baseline assessments, the same surgical condylar discopexy procedure was applied to both groups. Following surgery, the study group patients underwent a supervised exercise programme conducted by a physiotherapist in the outpatient clinic. This comprised 30-min sessions 3 days per week for 8 weeks in the hospital. The control group patients performed the same exercise programme at home. Maximum mouth opening (MMO), protrusion, and right and left lateral movements were measured. Based on the results, the supervised rehabilitation programme yielded significantly better outcomes for pain at rest and with activity, MMO, and protrusion compared with the home-based exercise programme. Also certain parameters of quality of life improved significantly in the study group. In conclusion, exercise therapy is the cornerstone of rehabilitation of the TMJ, and a supervised rehabilitation programme after TMJ surgery is effective in improving functional parameters.

Malignity-like peritoneal tuberculosis associated with abdominal mass, ascites and elevated serum Ca125 level.

Peritoneal tuberculosis (TB) is similar to ovarian cancers with respect to clinical, radiological laboratory findings. In this report, we present 10 TB cases with malignity pre-diagnosis based on the presence of ascites, pelvic mass, abdominal lymph nodes and elevated Ca125. The mean age of the cases was 29 +/- 14.4 years (18-63). Eight cases were associated with ascites, and the mean adenosine deaminase (ADA) value in ascitic fluid was 130.37 +/- 92.2. All cases had elevated levels of serum Ca125. In 6 cases, we identified lung pathologies based on chest radiography. Diagnoses were made based on diagnostic laparotomy in four cases, laparoscopy in two cases, percutaneous needle biopsy in two cases, and clinical evaluation in two cases. Anti-TB treatments lasted 12 months. Serum Ca125 levels normalised in the 3rd month of treatment. In the differential diagnosis of ascites and high serum Ca125 levels, tuberculosis should be considered in patients from developing countries.

Factors influencing sputum smear and culture conversion time among patients with new case pulmonary tuberculosis.

Sputum smear and culture conversion are important indicators for the effectiveness of treatment and the infectivity of the patient. The aim of this study was to identify the factors influencing both sputum smear and culture conversion time among patients with new case pulmonary tuberculosis (TB). The study was conducted in a reference hospital in Turkey in which 737 patients with pulmonary TB were hospitalised between January 2000 and 2005. We evaluated 306 (193 men and 113 women) human immunodeficiency virus-negative patients diagnosed with new case pulmonary TB. Factors associated with both sputum smear and culture conversion time (days) were investigated. Patients with diabetes mellitus (DM), cavitary disease, radiologically extensive disease had longer sputum smear and culture conversion time than the other groups. In addition, old age, male sex, smoking and thrombocytosis were found to be significantly associated with sputum smear conversion time. In the logistic regression analysis, the presence of DM and extensive disease were determined as independent factors associated with persistent sputum smear and culture positivity at the end of 2 months. The presence of DM and extensive disease were found to be independent risk factors influencing both sputum smear and culture conversion time in pulmonary TB. Sputum smear and culture examinations should be considered together to assess the poor prognosis.

Pulmonary alterations in patients with chronic HCV infection.

BACKGROUND: Chronic hepatitis C virus infection has been reported in association with several extrahepatic manifestations. Included in this list is interstitial lung involvement. AIMS: The aim of the present study was to evaluate pulmonary alterations in patients with chronic hepatitis C virus infection. PATIENTS: Twenty-one patients with chronic hepatitis C virus infection were enrolled into a prospective study. One patient has been excluded because of underlying tuberculosis. METHODS: All patients underwent pulmonary function tests, diffusion capacity for carbon monoxide and high-resolution computed tomography of the chest. RESULTS: Forced vital capacity, forced expiratory volume in first second/forced vital capacity and forced expiratory volume in first second values were reduced to less than 80% of predicted values in 3, 11 and 5 patients, respectively. Diffusion capacity for carbon monoxide was low in 12 patients (60%), 8 of whom had simultaneous decrease in diffusion capacity for carbon monoxide/VA values. Thorax high-resolution computed tomography revealed abnormal findings in eight patients (40%). Fifteen patients with chronic hepatitis C virus infection (75%) had at least one pulmonary alteration as evidenced by abnormal pulmonary function tests, diffusion capacity for carbon monoxide and/or high-resolution computed tomography results. CONCLUSION: In spite of a limited study population, these findings may implicate that pulmonary manifestations of chronic hepatitis C virus infection are frequently underdiagnosed.

Diffuse panbronchiolitis observed in a white man in Turkey.

Diffuse panbronchiolitis (DPB) is a distinct clinicopathological entity which is characterized by chronic recurrent sinopulmonary infection and inflammation. It is prevalent in the Far East, but extremely rare in western countries. In this report, we described the first Turkish case of DPB and also evaluated demographic and diagnostic characteristics of 18 patients with DPB, previously reported from non-Asian countries. We believe that DPB patients described from these countries may also increase if this disease is taken into consideration in differential diagnosis of sinopulmonary diseases. Another consideration is that, since the treatment and prognosis of DPB are different from other obstructive pulmonary diseases, it should not be mistaken for others.