Impact of Neuropathic Pain on Health-Related Quality of Life and Disability in Patients with Chronic Low Back Pain

Objective:Low back pain (LBP) is the most common chronic pain disorder worldwide. Chronic LBP is a mixed pain syndrome associated with nociceptive and neuropathic pain mechanisms. Investigation and early treatment of neuropathic pain is important in the management of chronic LBP. The aim of this study is to investigate the frequency of neuropathic pain and determine its impact on health-related quality of life and disability in patients with chronic LBP.Materials and Methods:A total of 120 patients with chronic LBP participated in the study. The presence of neuropathic pain was assessed using Leeds Assessment of Neuropathic Symptoms and Signs pain scale. 10-cm visual analogue scale (VAS) pain score, Oswestry Disability index (ODI) and short form-36 (SF-36) measurements were performed. Predictors for the presence of neuropathic pain were also investigated.Results:Neuropathic pain was detected in 49 (40.8%) of the patients with chronic LBP. ODI score and VAS pain score in patients with neuropathic pain were higher than that in those without neuropathic pain (p<0.001 and p=0.035, respectively). Physical function, body pain, general health and physical component subscales of SF-36 were lower in patients with neuropathic pain (p=0.043, p<0.001, p=0.012, p<0.001, respectively). Advanced age and radicular LBP were found as predictors for neuropathic pain (p=0.016 and p<0.001, respectively).Conclusion:The presence of neuropathic pain in chronic LBP was found relevant with poor health-related quality of life and disability. Advanced age and presence of radicular pain were associated with neuropathic involvement

Cerebellar Herniation after Lumbar Puncture in Galactosemic Newborn

Cerebral edema resulting in elevated intracranial pressure is a well-known complication of galactosemia. Lumbar puncture was performed for the diagnosis of clinically suspected bacterial meningitis. Herniation of cerebral tissue through the foramen magnum is not a common problem in neonatal intensive care units because of the open fontanelle in infants. We present the case of a 3-week-old infant with galactosemia who presented with signs of cerebellar herniation after lumbar puncture

Octreotide treatment in a neonate with non-chylous pleural effusion

Fetal pleural effusion is a rare condition. While it may regress spontaneously, it may also continue up to the post-natal period. This condition may be treated by thoracentesis, thoracoabdominal shunt application and pleurodesis in the intrauterine period while thoracentesis or tube thoracostomy may be used in the post-natal period. In cases where the fluid is defined to represent chylothorax, octreotide, a somatostatin analogue, may be administered for treatment. In this case report, we discussed the outcomes of treatment with octreotide administered in a neonatal case under follow-up due to fetal pleural effusion and with non-chylous ascites detected in the post-natal period

Hypermobility Frequency in School Children: Relationship With Idiopathic Scoliosis, Age, Sex and Musculoskeletal Problems.

This study aims to assess the prevalence of generalized joint hypermobility (GJH) in school children in relation to scoliosis and to identify musculoskeletal problems

Hypermobility Frequency in School Children: Relationship With Idiopathic Scoliosis, Age, Sex, and Musculoskeletal Problems

Objectives: This study aims to assess the prevalence of generalized joint hypermobility (GJH) in school children in relation to scoliosis and to identify musculoskeletal problems. Patients and methods: This cross-sectional study included 822 school children (413 males, 409 females; mean age 12.2 +/- 1.3 years; range, 10 and 15 years). Demographic characteristics of all children were recorded. The presence of GJH was assessed by the Beighton score (>= 4 was considered joint hypermobility). Scoliosis screening consisted of forward bend test (FBT) and measurement of angle of trunk rotation (ATR). Positive FBT or ATR was >= 5 degrees referred to a portable X-ray device. The presence of musculoskeletal complaints was determined by a questionnaire. Results: Children's body mass index (BMI) was 19.6 +/- 4.1. GJH was diagnosed in 151 subjects (18.4\%). No significant association was detected between sex and hypermobility. Joint hypermobility was inversely correlated with age and BMI. Scoliosis was found in 43 subjects (5.2\%) and all of them except one girl had mild scoliosis. The most common scoliosis pattern was a single left thoracolumbar curve. Seventy-three subjects (8.9\%) had Cobb angle under 10 degrees, with a potential for progression. Among subjects having GJH, the most common clinical finding was pes planus (34.3\%) and the most common clinical symptom was ankle sprain 31.3\%). Conclusion: Similar to that found in children from many countries, GJH is a common clinical condition in Turkish children. GJH should be assessed in the differential diagnosis of adolescents with musculoskeletal complaints for effective treatment and reducing morbidity. GJH should be considered in adolescents with scoliosis, which may be an important aspect treatment

Neonatal Screening for Congenital Adrenal Hyperplasia in Turkey

Objective: Congenital adrenal hyperplasia (CAH) is the most common form of primary adrenal insufficiency in children. Neonatal screening for CAH is effective in detecting the salt-wasting (SW) form and in reducing mortality. In this study, our aim was to estimate the incidence of CAH in Turkey and to assess the characteristics and efficacy of the adopted newborn CAH screening strategy. Methods: A pilot newborn CAH screening study was carried out under the authority of the Turkish Directorate of Public Health. Newborn babies of ≥32 gestational weeks and ≥1500 gr birth weight from four cities, born between March 27-September 15, 2017 were included in the study. Screening protocol included one sample two-tier testing. In the first step, 17α-hydroxyprogesterone (17-OHP) was measured by fluoroimmunoassay in dried blood spots (DBS) obtained at 3-5 days of life. The cases with positive initial screening were tested by steroid profiling in DBS using a liquid chromatography-tandem mass spectrometry method to measure 17-OHP, 21-deoxycortisol (21-S), cortisol (F), 11-deoxycortisol and androstenedione as a second-tier test. The babies with a steroid ratio (21-S+17-OHP)/F of ≥0.5 were referred to pediatric endocrinology clinics for diagnostic assessment. Results: 38,935 infants were tested, 2265 (5.82%) required second-tier testing and 212 (0.54%) were referred for clinical assessment, six of whom were diagnosed with CAH (four males, two females). Four cases were identified as SW 21-hydroxylase deficiency (21-OHD) (two males, two females). One male baby had simple virilizing 21-OHD and one male baby had 11-OHD CAH. The incidence of classical 21-OHD in the screened population was 1:7,787. Conclusion: The incidence of CAH due to classical 21-OHD is higher in Turkey compared to previous reports. We, therefore, suggest that CAH be added to the newborn screening panel in Turkey. The use of steroid profiling as a second-tier test was found to improve the efficacy of the screening and reduce the number of false-positives.PubMedWoSScopu