Aydin Balci

We aimed to evaluate the efficacy and safety of flexible bronchoscopy-guided tracheal intubation during difficult airways. We retrospectively evaluated the hospital records of intubated patients with the assistance of a flexible bronchoscope during 5 years-period, (between January 2015 to 2020). All patients were intubated under general anesthesia. A total of 67 patients were enrolled in the study. The majority of the patients were male (n=42, 62.7%). The mean age was 55.5±15.3 years. Mallampati classification was revealed frequently in class IV in 76.1% of cases. Only one patient with class II is evaluated as having a difficult airway because of obesity. The most frequent 3 indications for endotracheal tube (ETT) insertion (intubation) with the help of a bronchoscope were limitation of the mouth opening (40.3%), obesity (20.9%), and cervical-vertebrate fracture (11.9%). The intubation route was preferred as the oral way in 53 patients and the nasal way in 14 patients. The mean duration for ETT intubation via bronchoscopy guidance was 3.38 minutes. There was no severe complication other than transient oxygen desaturation (SaO2) below 90% (n=8, 11.9%) and epistaxis (n=2, 3%) in the complication records of all patients. Intubation with the help of a flexible bronchoscope is an effective, practical, and safe method in patients with a difficult airway.

Amaç: Bu çalışmanın amacı atletizm atlamalar branşı sporcularında gastrocnemius kasına uygulanan kinezyo bantlama fasilitasyon ve inhibisyon kas tekniklerinin sıçrama yüksekliğine akut etkisinin incelenmesiydi.Yöntem: Araştırmaya 17 atletizm atlamalar branşı sporcusu dâhil edildi. Sporcular rastgele fasilitasyon ve inhibisyon grubuna ayrıldı ve sporcuların her iki gastrocnemius kasına kinezyo bant uygulaması yapıldı. Sporcuların squat, serbest ve aktif sıçrama yükseklikleri Microgate Optojump® ölçüm aleti ile bantlama öncesi ve bantlamadan 24 saat sonra bant çıkarılmadan değerlendirildi.Bulgular: Fasilitasyon ve inhibisyon gruplarının yaş, vücut ağırlığı, boy uzunluğu ve vücut kütle indeksi değerleri arasında istatistiksel olarak anlamlı fark yoktu (p>0,05). Fasilitasyon ve inhibisyon gruplarının bantlama öncesi ve bantlama sonrası squat, serbest ve aktif sıçrama yükseklikleri ve bu sıçramalar sırasında üretilen güç değerlerinin benzer olduğu ve gruplar arasında fark olmadığı belirlendi (p>0,05).Sonuç: Çalışmamızın sonucunda atletizm atlamalar branşı sporcularında gastrocnemius kasına uygulanan kinezyo bantlama fasilitasyon ve inhibisyon kas tekniklerinin dikey sıçrama performansına etkisinin olmadığı belirlendi.

Leg-length discrepancy (LLD) is a common condition that may cause posture changes and clinical consequences. Rasterstereography is a valid and reliable method that analyzes posture without radiation exposure and invasive procedures. This study aimed to assess the immediate effect of artificial LLD on pelvic position and spinal posture in athletes. Twenty-four elite karate athletes (14 men, 10 women) were included in the study. Sagittal imbalance, coronal imbalance, pelvic obliquity, pelvic torsion angle, thoracic kyphosis angle and lumbar lordosis angle were measured at different artificial LLD heights (5 –10 –15 –20 mm). Statistical analysis was performed with One-Way ANOVA with repeated measures or Friedman test. In cases where there were significant differences, pairwise comparisons were performed with least significant differences (LSD) test or Wilcoxon signed rank test. There were statistically significant differences in pelvic obliquity (p = 0.001), pelvic torsion (p = 0.001) and lumbar lordosis (p = 0.001) with varying LLD. However, there was no significant difference in sagittal imbalance, coronal imbalance and thoracic kyphosis angle. It has been observed that even a 5-mm LLD causes pelvic position and spinal posture changes. Future studies detecting these changes in populations with LLD via rastersterography may prevent possible musculoskeletal disorders.

Introduction: Lower extremity injuries may be associated with proximal muscle weakness and decreased motor control. Our study aims to examine knee flexor and extensor muscle strength in athletes with and without trunk muscle strength asymmetry. Materials and methods: This matching control study involved a total of 80 athletes; 40 athletes with asymmetrical trunk muscle strength (asymmetric group) and 40 athletes with symmetrical trunk muscle strength (symmetrical group). Strength measurements of trunk and knee muscles were made with the IsoMed 2000 isokinetic device. Independent Samples T-Test or Mann Whitney-U test was used to compare variables according to their distribution status. The statistical error level was determined as p < 0.05. Results: In the symmetric group, the isokinetic muscle strength of the trunk flexor muscles was stronger than the asymmetric group (p < 0.05) and the trunk extensor muscles were weaker than the asymmetric group (p < 0.05). The Limb Symmetry Index (LSI) value of the two groups at 60°/sec was significantly different (p = 0.032), and the dominant side in the symmetric group and the non-dominant side in the asymmetric group were stronger than the other side. Conclusions: This result may be associated with knee joint injuries which are common in athletes with weak muscle strength, and can be attributed to the literature knowledge that core muscle weakness may increase the frequency of knee injury. Therefore, symmetrical core strengthening training can prevent possible injuries of athletes with asymmetrical trunk muscle strength. However, we think that more studies are needed to reveal this relationship.

Coronavirus disease 2019 (COVID-19) is a fatal and pandemic disease discovered in December 2019 in Wuhan, with lots of asymptomatic cases and a long incubation period. The researchers suggested that high d-dimer levels could predict disease severity, lung complications, and thromboembolic events before they occur. We searched in PubMed, Scopus, and Web of Science using the keywords "D-dimer" and "coronavirus" or "D-dimer" and "COVID-19." We used Standardized Mean Differences (SMD) to build forest plots of continuous data and assess differences in serum D-dimer concentrations between severe and non-severe patients with COVID-19 disease. We evaluated p-value < 0.05 as statistically significant and preferred 95% confidence intervals (CIs). The pooled results of all studies revealed that the D-dimer concentrations were significantly higher in patients with more severe COVID-19 (SMD: 2.32 μg/mL; 95% CI, 0.72 3.92 μg/mL, p< 0.001). We evaluated severe patients with total D-dimer levels. D-dimer concentrations were significantly higher in severe patients against total COVID-19 patients (SMD: 2.01 μg/mL; 95% CI, 0.25 to 3.77 μg/mL, p= 0.08). We do not know the D-dimer increment mechanism in severe patients yet, but we think that these findings will be useful in the early diagnosis of severe disease and the first treatment.

Article: The relationship between isokinetic trunk and upper limb muscle strength and respiratory function and respiratory muscle strength: a cross-sectional study - Medicina dello Sport 2020 December;73(4):635-51 - Minerva Medica - Journals

Introduction: Scapular asymmetry may affect the biomechanics of the shoulder girdle joints and muscles by changing the contraction angles of the muscles. The purpose of this prospective cohort, matched-controlled study was to compare shoulder muscle strength, proprioception sense and internal/external rotation flexibility between adolescent athletes with and without scapular asymmetry. Material and methods: Nineteen athletes of tennis, fencing, shooting, archery, gymnastics, and badminton branches with left side (non-dominant) scapular asymmetry were included in the study as asymmetry group. Nineteen athletes who have similar gender, sports branch, professional experience, physical characteristics with asymmetry group were included in the study as the control group. Scapular asymmetry was measured using a tape measure with the Lateral Scapular Slide Test. Shoulder horizontal abduction/adduction isokinetic muscle strength and shoulder abduction/adduction isometric muscle strength was tested by an isokinetic dynamometer. The proprioception sense of the glenohumeral joint was evaluated with a digital inclinometer, and the flexibility of the internal and external rotation of the shoulder was evaluated by the flexibility test. Results: There was not any significant difference between the groups in isokinetic muscle strength, isometric muscle strength, and proprioception sense of shoulder (p > 0.05). Shoulder internal rotation flexibility of both dominant and non-dominant sides was higher in the asymmetry group than the control group (p < 0.05). Conclusions: It was determined that the flexibility of shoulder internal rotation in adolescent athletes with scapular asymmetry was higher than those without asymmetry.

Different types of stretching exercises are utilized prior to physical exercises as a part of warming-up. The purpose of this study is to investigate the effects of the dynamic and static stretching exercises on ankle muscle strength and single-leg balance. Twenty healthy male participants, who were between 25 and 30 years old and did not have a previous ankle injury, were included in the study. This study is a cross-over designed study. Isokinetic ankle muscle strength tests and single-leg balance tests were applied to the participants after different intervention protocols (two intervention protocols and one control protocol) on 6 different days. With isokinetic testing, peak torque and average power were measured at 60/s and 120/s angular velocities. The tests were performed to the participants after static stretching, dynamic stretching and for a resting period without stretching. The order of stretching intervention was determined randomly. The Peak Torque results of the 120/s angular velocity isokinetic strength test after the dynamic stretching exercises were found significantly improved than those without stretching exercises (p0.05). It was also shown that the dynamic stretching significantly enhanced the balance scores (p<0,05). In the current study, dynamic stretching exercises were found to have positive effects on isokinetic peak torque and balance scores.

Purpose: Balance has a vital role in taekwondo athletes for injury prevention and athletic performance. Many strategies are being investigated to improve balance. The Kinesio Tape (KT) application is one of these methods. The study aimed to investigate the acute effect of the la application to the hip abductor muscle on the single-leg balance in elite taekwondo athletes. Methods: The 53 elite taekwondo athletes with no ankle or lower extremity problems (27 males and 26 females) participated in the study. Athletes were randomly assigned to either the study group (n-28) or the control group (n-25) after the first balance evaluation. Single leg balance was assessed with using a power plate device under different conditions: (1) without taping (for all athletes); (2) the 48 hours after application with the KT for the study group; (3) the 48 hours after the first balance evaluation without KT for the control group. KT was applied to the hip abductor muscle by facilitation technique to the study group. The second measurement of balance was made 48 hours after the KT application. Results: There was no statistically significant difference between the groups in terms of the total score, anteroposterior (A-P) score and mediolateral (M-L) scores between the first and second balance tests (p>0.05). No statistically significant differences were found in total score, A-P score, and M-L scores of the first and the second balance tests of both KT and control groups (p>0.05). Conclusion: It was determined that KT application to hip abductor muscles did not affect single leg balance in healthy elite taekwondo athletes.