Hand functions in type 1 and type 2 diabetes mellitus

Introduction/Objective. Hand functions have an enormous impact on activities of daily living in patients with diabetes mellitus (DM), such as self-care, administering insulin injections, and preparing and eating meals. The aim of the study was to evaluate hand functions and grip strength in patients with type 1 and type 2 DM. Methods. This was an observational case-control study investigating the hand functions and grip strength in patients with type 1 and type 2 DM. The study comprised 41 patients with type 1 DM aged 25–50 years sex- and age-matched, 40 non-diabetic controls, and 91 patients with type 2 DM aged 40–65 years sex- and age-matched 60 non-diabetic controls. Patients with documented history of diabetic sensorimotor neuropathy and adhesive capsulitis were excluded. The Duruoz Hand Index was used to assess the functional hand disability. Grip strength was tested with a calibrated Jamar dynamometer. Results. The Duruoz Hand Index scores in patients with type 2 DM were significantly higher than in persons in the control group (p 0.05). Grip strength values of patients with type 1 DM were significantly lower compared to those in the control group (p < 0.05), whereas there was no significant difference between patients with type 2 DM and their control group. There was a negatively significant correlation between grip strength and the Duruoz Hand Index scores in patients with both type 1 and type 2 DM (p < 0.05). Conclusion. Patients with type 1 DM and type 2 DM have different degrees of hand disability as compared to healthy control groups

Inflammatory arthritis mimicking Complex Regional Pain Syndrome (CRPS) in a child: A case report

Joint complaints in childhood are seen frequently and differential diagnosis can be difficult. Juvenile idiopathic arthritis (JIA) is the most common rheumatological disease of childhood. It involves peripheral joint arthritis, chronic synovitis, and extra-articular manifestations. Accurate diagnosis can take a long time and sometimes multiple diagnoses are used while following the patient until a final diagnosis can be reached. Arthritis may be triggered by trauma and confused with other diseases like complex regional pain syndrome (CRPS), in which trauma plays a role in the etiology. In the present case, ankle pain in an 8-year-old girl was misdiagnosed as CRPS

Pregabalin Treatment of a Patient With Complex Regional Pain Syndrome

BACKGROUND: Complex regional pain syndrome (CRPS) is a painful and disabling neurovascular condition. There is no consensus on the etiopathogenesis or the treatment. We present a patient with CRPS type 1 accompanied by a psychiatric disorder to discuss the relationship between CRPS and Psychiatric disease and to emphasize the response of this case to treatment with pregabalin. PATIENT DESCRIPTION: A 15-year-old girl presented with swelling, severe pain, edema, hyperesthesia, allodynia, and sweating changes in the left arm and was diagnosed as CRPS type 1. The presence of disturbed family relations was revealed on psychiatric examination, and a diagnosis of major depression was made. Her symptoms did not respond to selective serotonin reuptake inhibitors and noradrenergic and specific serotonergic antidepressives, gabapentin, or stellate ganglion blockage, but the patient's pain resolved with pregabalin. Symptom-oriented measures and psychiatric support enabled ongoing treatment. A social services evaluation led to her being placed in the care of social services to protect her from the chaotic and traumatic family life. CONCLUSION: Detailed psycological and psychiatric evaluation is recommended in individuals with CRPS because psychiatric support and improvement of associated psychosocial concerns in addition to pregabalin seems to facilitate treatments in some patients

Pregabalin Treatment of a Patient With Complex Regional Pain Syndrome

BACKGROUND: Complex regional pain syndrome (CRPS) is a painful and disabling neurovascular condition. There is no consensus on the etiopathogenesis or the treatment. We present a patient with CRPS type 1 accompanied by a psychiatric disorder to discuss the relationship between CRPS and Psychiatric disease and to emphasize the response of this case to treatment with pregabalin. PATIENT DESCRIPTION: A 15-year-old girl presented with swelling, severe pain, edema, hyperesthesia, allodynia, and sweating changes in the left arm and was diagnosed as CRPS type 1. The presence of disturbed family relations was revealed on psychiatric examination, and a diagnosis of major depression was made. Her symptoms did not respond to selective serotonin reuptake inhibitors and noradrenergic and specific serotonergic antidepressives, gabapentin, or stellate ganglion blockage, but the patient's pain resolved with pregabalin. Symptom-oriented measures and psychiatric support enabled ongoing treatment. A social services evaluation led to her being placed in the care of social services to protect her from the chaotic and traumatic family life. CONCLUSION: Detailed psycological and psychiatric evaluation is recommended in individuals with CRPS because psychiatric support and improvement of associated psychosocial concerns in addition to pregabalin seems to facilitate treatments in some patients

Burden of Chronic Low Back Pain in the Turkish Population

WOS: 000353480500011Objective: Chronic low back pain (CLBP) is a great economic burden to the society mainly in terms of the large number of the lost work days and disability, and it appears to be growing. The economic burden of LBP in Turkey is not known. This study aims to analyze the health care resource use, work and productivity loss, and health-related economics of CLBP in Turkey. Material and Methods: The study was designed as a multi-centered cross-sectional survey of patients in physical therapy and rehabilitation clinics from eight different regions of Turkey and 662 patients with CLBP over 18 years of age were included. Data on patient sociodemographics, disease-related healthcare resource use during the previous 6 months, inability to work during the last 3 months, Roland Morris Disability Index for the functional status, and psychological health with Beck Depression Scale were collected. Direct costs included medical visits, investigations, medications, hospitalizations, orthopedic aids, and physical therapy. Indirect costs were evaluated mostly with productivity loss. Results: The total annual direct costs for CLBP per patient were estimated at 1080 TL. The indirect costs were estimated at 5511 TL per patient. Direct cost was correlated with disease severity, duration, and age. Indirect cost was higher in women. Conclusion: The indirect costs for CLBP were significantly higher than the direct costs

Impact of the Training on the Compliance and Persistence of Weekly Bisphosphonate Treatment in Postmenopausal Osteoporosis: A Randomized Controlled Study

Long-term patient adherence to osteoporosis treatment is poor despite proven efficacy. In this study, we aimed to assess the impact of active patient training on treatment compliance and persistence in patients with postmenopausal osteoporosis. In the present national, multicenter, randomized controlled study, postmenopausal osteoporosis patients (45-75 years) who were on weekly bisphosphonate treatment were randomized to active training (AT) and passive training (PT) groups and followed-up by 4 visits after the initial visit at 3 months interval during 12 months of the treatment. Both groups received a bisphosphonate usage guide and osteoporosis training booklets. Additionally, AT group received four phone calls (at 2nd, 5th, 8th, and 11th months) and participated to four interactive social/training meetings held in groups of 10 patients (at 3rd, 6th, 9th, and 12th months). The primary evaluation criteria were self-reported persistence and compliance to the treatment and the secondary evaluation criteria was quality life of the patients assessed by 41-item Quality of Life European Foundation for Osteoporosis (QUALEFFO-41) questionnaire.. Of 448 patients (mean age 62.4 +/- 7.7 years), 226 were randomized to AT group and 222 were randomized to PT group. Among the study visits, the most common reason for not receiving treatment regularly was forgetfulness (54.9% for visit 2, 44.3% for visit 3, 51.6% for visit 4, and 43.8% for visit 5), the majority of the patients always used their drugs regularly on recommended days and dosages (63.8% for visit 2, 60.9% for visit 3, 72.1% for visit 4, and 70.8% for visit 5), and most of the patients were highly satisfied with the treatment (63.4% for visit 2, 68.9% for visit 3, 72.4% for visit 4, and 65.2% for visit 5) and wanted to continue to the treatment (96.5% for visit 2, 96.5% for visit 3, 96.9% for visit 4, and 94.4% for visit 5). QUALEFFO scores of the patients in visit 1 significantly improved in visit 5 (37.7 +/- 25.4 vs. 34.0 +/- 14.6, p<0.001); however, the difference was not significant between AT and PT groups both in visit 1 and visit 5. In conclusion, in addition to active training, passive training provided at the 1st visit did not improve the persistence and compliance of the patients for bisphosphonate treatment

Burden of Chronic Low Back Pain in the Turkish Population

Objective: Chronic low back pain (CLBP) is a great economic burden to the society mainly in terms of the large number of the lost work days and disability, and it appears to be growing. The economic burden of LBP in Turkey is not known. This study aims to analyze the health care resource use, work and productivity loss, and health-related economics of CLBP in Turkey. Material and Methods: The study was designed as a multi-centered cross-sectional survey of patients in physical therapy and rehabilitation clinics from eight different regions of Turkey and 662 patients with CLBP over 18 years of age were included. Data on patient sociodemographics, disease-related healthcare resource use during the previous 6 months, inability to work during the last 3 months, Roland Morris Disability Index for the functional status, and psychological health with Beck Depression Scale were collected. Direct costs included medical visits, investigations, medications, hospitalizations, orthopedic aids, and physical therapy. Indirect costs were evaluated mostly with productivity loss. Results: The total annual direct costs for CLBP per patient were estimated at 1080 TL. The indirect costs were estimated at 5511 TL per patient. Direct cost was correlated with disease severity, duration, and age. Indirect cost was higher in women. Conclusion: The indirect costs for CLBP were significantly higher than the direct costs

Demographic and Clinical Findings of Cerebral Palsy Patients in Istanbul: A Multicenter Study

Objective: The objective of this study is to identify epidemiological characteristics of patients with cerebral palsy (CP) in Istanbul, including demographic information, clinical types, risk factors, and some clinical features

Assessment of the Relationship Between Vitamin D Level and Non-specific Musculoskeletal System Pain: A Multicenter Retrospective Study (Stroke Study Group)

Objective: In this study, it was aimed to evaluate the relationship between vitamin D level and pain severity, localization and duration in patients with non-specific musculoskeletal pain