Extracorporeal shock wave therapy versus corticosteroid injection in the treatment of trigger finger: a randomized controlled study.

The purpose of this study was to compare the efficacies of extracorporeal shock wave therapy and corticosteroid injection for the management of trigger finger. In this prospective randomized clinical trial, 40 patients with actively correctable trigger fingers were randomly assigned to extracorporeal shock wave therapy (1000 impulses and 2.1 bar) or injection groups. The effectiveness of the treatment was assessed using cure rates, a visual analogue scale, the frequency of triggering, the severity of triggering, the functional impact of triggering, and the Quick-Disabilities of the Arm, Shoulder, and Hand questionnaire at 1, 3, and 6 months after treatment. An intention-to- treat analysis was used in this study. Both groups demonstrated statistically significant improvements in all outcome measures after treatment. The intention-to-treat analyses showed no between-group differences for cure rates, pain, and functional status at follow-up. We conclude that extracorporeal shock wave therapy could be a non-invasive option for treating trigger finger, especially for those patients who wish to avoid steroid injections. LEVEL OF EVIDENCE: Level II.

Impact of exercises administered to stroke patients with balance trainer on rehabilitation results: a randomized controlled study.

OBJECTIVE: The objective of this study was to determine the efficacy of the exercises administered to stroke patients with the balance trainer (BALANCE-trainer, art.nr. 07001-001(TM)) on balance, level of independence and ambulation parameters. MATERIAL AND METHOD: Fifty patients with hemiplegia were randomized into either study group or control group. Patients in the control group received 30 sessions of conventional rehabilitation program and patients in the study group were trained with balance trainer in addition to conventional rehabilitation program. Balance level and postural control were evaluated with Berg Balance Scale (BBS) and Timed-Up and Go Test (TUG). Their functional statuses were evaluated using Functional Independence Measure (FIM). Evaluations were repeated following the six-week rehabilitation program. RESULTS: Of the 50 participants, 19 were women (38%) and 31 were men (62%). The mean age was 57.1 ± 9.2 years. The time that elapsed after stroke was 87.3 ± 26.3 days. Statistically significant improvements were noted in BBS, TUG and FIM in intra-group evaluations for both groups. Statistically significant improvements were documented in BBS and TUG levels for inter-group evaluation (respectively p =0.038, p =0.025), while the difference in FIM levels was not statistically significant (p >0.05). CONCLUSION: Positive impact of balance trainer on balance and postural control was demonstrated in stroke patients in the current study. Hippokratia 2015; 19 (2):125-130.

Neutrophil-to-lymphocyte ratio is involved in the severity of ankylosing spondylitis.

OBJECTIVE: Ankylosing spondylitis (AS) is a progressive chronic inflammatory disease mainly characterized by axial skeleton and sacroiliac joint involvement. We aimed to investigate the relation between neutrophil-to-lymphocyte ratio (NLR) and disease severity of AS and to explore its availability in clinical practice. METHODS: A total of 102 AS patients and 60 individuals who were age- and gender-compatible with the control group were included into the study. Patients were divided into 2 groups according to Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores. Patients with BASDAI scores < 4 were considered to be having mild disease activity, whereas those with scores ≥ 4 were considered to be displaying severe disease activity. Hemogram test during the diagnosis, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and other laboratory values of the control group were recorded. RESULTS: NLR was observed to be higher in AS patients compared to the controls (2.47 ± 1.33 and 1.72 ± 0.47; respectively; p<0.0001). NLR was observed to be significantly higher in severe AS disease activity compared to the mild AS disease activity (2.72 ± 1.41, 2.20 ± 1.19; respectively; p = 0.001). NLR had statistical significant differences between mild disease activity compared to the controls (2.20 ± 1.19 and 1.72 ± 0.47, respectively; p = 0.263). There was a positive correlation between NLR and BASDAI (r = 0.193, p = 0.041). The performance of NLR evaluating the disease severity by Roc analysis had sensitivity of 69%, specificity of 54% (cut-off value 1.91), and AUC of 0.652 (95% Cl, 0.549-0.755) (p = 0.006). CONCLUSIONS: NLR may be a simple and inexpensive marker to indicate disease activity in patients with AS in daily clinical practice (Tab. 3, Fig. 3, Ref. 25).