Comparison of effectiveness of extracorporeal shock wave therapy and peloidotherapy in patients with plantar fasciitis: a prospective, randomized, controlled study.

Although peloidotherapy and ESWT are effective treatments for plantar fasciitis, there is no comprehensive research that directly compares their effectiveness. Our study aimed to compare the effectiveness of ESWT and peloidotherapy on pain, quality of life and functional status in individuals diagnosed with plantar fasciitis (PF). A total of 78 patients, aged between 18 and 65 years, diagnosed with PF after a thorough anamnesis and physical examination and experiencing heel pain for at least 3 months or longer and who presented to the Clinic between January 2021 and January 2023, were included in the study. Patients were randomly allocated to two groups. The peloidotherapy group received 15 sessions of peloid therapy five days a week for three weeks, while the ESWT group received three sessions of radial-type ESWT once a week for three weeks. Additionally, all patients were given a home exercise program. All patients were evaluated three times for treatment efficacy. Pain levels were assessed using the Visual Analog Scale (VAS) and Heel Tenderness Index (HTI), functional status and quality of life were assessed using the Foot Ankle Outcome Score (FAOS) and Short Form 36 (SF-36), respectively. In both treatment groups, there was a statistically significant improvement in VAS, HTI, FAOS and SF-36 scores at the end of treatment and during the one-month follow-up, compared to the initial baseline values. A statistically significant difference in favor of peloidotherapy was observed in post-treatment symptom and pain scores (p = 0.046). However, this difference did not persist at the one-month follow-up. Both active treatment methods were similarly effective and no superiority was observed between them (p > 0.05). Peloidotherapy and ESWT treatments, along with a home exercise program, were found to be effective for patients with plantar fasciitis. In the conservative treatment of PF, both peloidotherapy and ESWT can be recommended as effective and reliable options.

Comparison of the efficacy of 2 different botulinum toxin injection techniques in gastrocnemius muscle spasticity in hemiplegic patients: A randomized double-blind controlled study.

OBJECTIVE: To compare the efficacy of the innervation zone-targeted injection technique (EUROMUSCULUS/USPRM spasticity approach) and the injection technique along the muscle length. DESIGN: A double-blind randomized controlled trial SETTING: Department of rehabilitation medicine of a medical center PARTICIPANTS: One hundred stroke patients with ankle plantar flexor spasticity. MAIN OUTCOME MEASURES: Modified Ashwort Scale, Modified Tardiue Scale, ankle range of motion measurement and 10 Meter Walk Test were used before and one month after injection. INTERVENTIONS: In addition to conventional rehabilitation, eligible patients were randomly assigned to two groups. The experimental group was injected with botulinum toxin along the length of the muscle, while the control group was injected with the same dose and volume of botulinum toxin 25-35% proximal to the medial head and 20-30% proximal to the lateral head of the gastrocnemius muscle. RESULTS: The study was completed by 60 participants with a mean age of 59.96±12.15 years. Both injection methods were found to be effective on range of motion, spasticity level, ambulation and walking speed. There was no statistically significant difference between injection methods CONCLUSION: Both injection methods of botulinum toxin A produce similar clinical effects.

The Effect of In-Ear and Behind-Ear Transcutaneous Auricular Vagus Nerve Stimulation on Autonomic Function: A Randomized, Single-Blind, Sham-Controlled Study.

Background/Objectives: Transcutaneous auricular vagus nerve stimulation (TaVNS) is a non-invasive method of electrical stimulation used to autonomic neuromodulation. Position and form of the electrodes are important for the effectiveness of autonomic modulation. This study was aimed to investigate the effect of TaVNS in-ear and behind-ear on autonomic variables. Methods: A total of 76 healthy participants (male: 40, female: 36) were randomized into four groups as in-ear TaVNS, behind-ear TaVNS, in-ear sham, and behind-ear sham. The TaVNS protocol included bilateral auricular stimulation for 20 min, 25 hertz frequency, a pulse width of 250 µs, and a suprathreshold current (0.13-50 mA). Heart rate (HR), systolic and diastolic blood pressure (SBP and DBP), and heart rate variability (HRV) were measured baseline and after stimulation. The parameters RMSSD (root mean square of consecutive differences between normal heartbeats), LF power (low-frequency), and HF power (high-frequency) were assessed in the HRV analysis. Results: HR decreased in the in-ear TaVNS after intervention (p < 0.05), but did not change in behind-ear TaVNS and sham groups compared to baseline (p > 0.05). SBP and DBP decreased and RMSSD increased in the in-ear and behind-ear TaVNS groups (p < 0.05), but did not change in sham groups compared to baseline (p > 0.05). There was no significant difference in LF and HF power after TaVNS compared to baseline in all groups (p > 0.05). SBP was lower and RMSSD was higher in-ear TaVNS than behind-ear TaVNS after intervention (p < 0.05). Conclusions: In-ear TaVNS appears to be more effective than behind-ear TaVNS in modulating SBP and RMSSD, but this needs to be studied in larger populations.

The Effect of Laughter Yoga Applied to Intensive Care Nurses on Their Perceived Stress, Job Motivation, and Mental Well-being: Randomized Controlled Study.

AIM: The aim of this study was to examine the effect of laughter yoga applied to intensive care nurses on perceived stress, job motivation, and mental well-being. DESIGN: This study was a randomized controlled trial. METHODS: The study was conducted with nurses working at the university hospital's surgical intensive care and anesthesia intensive care units of the third-level intensive care unit in Turkey. Data obtained from 30 participants in the intervention group and 33 participants in the control group were analyzed. The Nurse Introduction Form, Nurse Job Motivation Scale, Perceived Stress Scale, and Warwick-Edinburgh Mental Well-being Scale were used to collect data. Data obtained from the study were evaluated using the SPSS 22.0 package. RESULTS: It was determined that there was no statistically significant difference in the average scores of the pretest/posttest 1/posttest 2 of the Perceived Stress Scale (13.70 ± 3.33 to 14.57 ± 4.57, P > .05; 13.50 ± 3.15 to 13.48 ± 4.59, P > .05; and 13.56 ± 3.15 to 13.15 ± 3.49, P > .05, respectively) and Work Motivation Scale (59.70 ± 7.58 to 59.69 ± 7.98, P > .05; 60.30 ± 8.07 to 58.48 ± 8.94, P > .05; and 60.56 ± 7.86 to 57.93 ± 9.54, P > .05, respectively) for both the intervention and control groups of nurses. A statistically significant difference was found in the average scores of the Warwick-Edinburgh Mental Well-Being Scale pretest/posttest 1/posttest 2 for the intervention group of nurses (50.90 ± 7.60, 51.50 ± 7.80, and 53.70 ± 7.08, respectively; F = 3.330, P = .043). However, the difference was found to be insignificant in pairwise comparisons in the further analysis (a = b = c). It was determined that there was no statistically significant difference in the average scores of the Warwick-Edinburgh Mental Well-Being Scale pretest/posttest 1/posttest 2 for the control group of nurses (52.21 ± 9.89, 51.93 ± 10.45, and 51.03 ± 9.63, respectively; P > .05). CONCLUSIONS: The application of laughter yoga on intensive care nurses did not result in a significant change in perceived stress levels and work motivation. However, statistically significant differences were observed in the average mental well-being scores among the intervention group.

Comparison of the efficacy of low intensity laser and peloid therapy in patients with subacromial impingement syndrome.

The objective of this study was to compare the impact of peloid and low-level laser (LLLT) treatment in conjunction with a home exercise programme on short-term symptomatic pain, functional status and quality of life in individuals diagnosed with subacromial impingement syndrome (SIS). A total of 168 patients diagnosed with SIS were included in the study, with 56 receiving LLLT + exercise, 56 receiving peloidotherapy + exercise, and 56 receiving exercise only. Patients underwent clinical evaluations prior to treatment (first measurement), after treatment completion (second measurement), and one month post-treatment (third measurement). Pain was evaluated using the Visual Analog Scale (VAS). Functional status was evaluated using the Shoulder Pain and Disability Index (SPADI), and quality of life was evaluated using the Short Form 36 (SF-36). Active range of motion of the shoulder was measured by the same investigator using a goniometer. Statistically significant improvements in VAS, SPADI, SF-36, and ROM parameters were achieved after treatment and at 1 month follow-up compared to pretreatment in both active treatment groups (p < .05). The third group showed significant improvements in ROM and SF-36 physical components after treatment and 1 month later (p < .05). Low-level laser therapy or peloid therapy given in addition to home exercise therapy for SIS were found to have similar short-term effects on pain, functional status, quality of life and ROM.

Comparison of the effectiveness of peloid therapy and kinesiotaping in patients with unilateral plantar fasciitis: A prospective, randomized controlled study.

Objectives: This study aimed to compare the efficacy of peloid therapy and kinesiotaping for unilateral plantar fasciitis (PF). Patients and methods: In the randomized controlled study, a total of 114 patients (89 females, 25 males; mean age: 45.1±8.3 years; range, 27 to 65 years) diagnosed with unilateral PF between January 2021 and March 2023 were randomly divided into three equal groups: the peloid group (peloid therapy and home-based exercise + heel pad), the kinesiotaping group (kinesiotaping and home-based exercise + heel pad), and the control group (home-based exercise + heel pad). Peloid therapy was performed over two weeks for a total of 10 sessions. Kinesiotaping was applied four times over two weeks. Plantar fascia, calf, and Achilles stretching exercises and foot strengthening exercises were performed, and prefabricated silicone heel insoles were used daily for six weeks. Patients were evaluated three times with clinical assessment scales for pain, the Heel Tenderness Index, and the Foot and Ankle Outcome Score before treatment, at the end of treatment, and in the first month after treatment. Results: Statistically significant improvements were observed for all parameters at the end of treatment and in the first month after treatment compared to the baseline in every group (p<0.001). No superiority was found between the groups. Conclusion: Peloid therapy or kinesiotaping, given as adjuncts to home-based exercise therapy and shoe insoles in patients with unilateral PF, did not result in additional benefits.

The Effect of Frequency of Sexual Intercourse on Symptoms in Women with Fibromyalgia.

Objectives: Fibromyalgia is known to affect sexual function, but the effect of frequency of sexual intercourse on fibromyalgia symptom severity is unclear. This study investigated how frequently women with fibromyalgia engaged in sexual activity affected how severe the disease was. Methods: The depression status of the participants was evaluated with the Beck Depression Inventory (BDI) and the mean monthly frequency of sexual intercourse in the last 3 months was noted. Pain levels of fibromyalgia patients were evaluated with Visual Analog Scale (VAS), pain prevalence Widespread Pain Index (WPI), symptom level Symptom Severity Scale (SSS), and fibromyalgia exposure status with Fibromyalgia Impact Questionnaire (FIQ). Results: A hundred women with fibromyalgia with a mean age of 37.11±6.2 years and 100 healthy female controls with a mean age of 36.53 ± 5.85 years participated in the study. Female patients with fibromyalgia had higher BDI and VAS scores and lower frequency of sexual intercourse (p<0.001). While no significant relationship was observed between the frequency of sexual intercourse and VAS, FIQ, SSS and WPI scores, it was found that BDI was lower in those with an average monthly frequency of 8 or more sexual intercourses (p=0.02). Conclusion: This study revealed that the frequency of sexual intercourse is low in female patients with FM and that depression is less common in women with FM who have a higher frequency of sexual intercourse.

Comparison of the efficiency of peloidotherapy and extracorporeal shock wave therapies in patients diagnosed with lateral epicondylitis: a prospective, randomized, controlled study.

Various treatment methods are used in the management of lateral epicondylitis (LE); however, there is no universally accepted standard treatment approach. The aim of this study is to compare the effects of peloidotherapy and extracorporeal shock wave therapy (ESWT) on pain, functional status, and quality of life in the treatment of LE. The study was designed as a hospital-based, prospective randomized controlled trial. Ninety patients, with a mean age of 47.30±7.95 (range, 18 to 65 years), diagnosed with chronic (3 months) unilateral LE were included in the study. The patients were randomly divided into two groups. The peloidotherapy group received 15 sessions of peloid therapy for 3 weeks, 5 days a week, while the ESWT group received three sessions of ESWT (1.8 bar, 10.0 Hz, 2000 impulses) for 3 weeks, once a week. The patients were evaluated before treatment, at the end of the treatment, and one month after the treatment. The groups were compared in terms of pain, quality of life, functional status, and handgrip strength. At the end of the treatment and one-month follow-up, statistically significant improvements were observed in all parameters. This study is the first randomized trial comparing peloidotherapy to ESWT as an adjunct to exercise therapy in LE. Both ESWT and peloidotherapy, when added to exercise therapy, showed positive short-term effects on pain, quality of life, functional status, and handgrip strength in primary conservative treatment of chronic LE (p<0.001), and no superiority was found between them in terms of efficacy. Peloidotherapy or ESWT may be preferred in the treatment of lateral epicondylitis, depending on the patient's condition. Peloidotherapy appears to be more advantageous due to its lower side effects and painless nature. ClinicalTrials.gov ID: NCT04748406.

Efficiency of therapeutic underwater ultrasound therapy in mild-to-moderate carpal tunnel syndrome: A randomized sham-controlled study.

Objectives: This study aimed to evaluate the efficiency of therapeutic pulsed ultrasound (US) applied underwater in mild-to-moderate carpal tunnel syndrome (CTS). Patients and methods: This randomized, placebo-controlled study included 75 patients (114 hands; 7 males, 68 females; mean age: 46.7±9.9 years; range, 24 to 64 years) diagnosed with CTS through clinical evaluation and electroneuromyography (ENMG) results between March 2012 and January 2013. Patients were randomized into three groups. Group 1 received underwater pulsed US, Group 2 received sham US, and Group 3 was the control group. All groups were given night splints. Patients were evaluated at baseline, at the end of treatment (two weeks), and 12 weeks after the treatment using clinical examination tests (Tinel, Phalen, and hand elevation test), hand grip strength, Visual Analog Scale (VAS) for pain, Pain Quality Assessment Scale (PQAS), and ENMG. Results: In all groups, a significant improvement was detected in the clinical assessment parameters, including the pain VAS, PQAS scores, physical examination outcomes, and hand grip strength. The decrease in VAS score and PQAS was found to be superior in the pulsed US group at both two weeks after the treatment and at the 12th week after the treatment compared to the sham US and control groups (p<0.001). Improvement in ENMG parameters, such as median motor latency, median sensorial velocity, and median sensory latency, was observed only in the underwater pulsed US group (p<0.001). Conclusion: Therapeutic underwater pulsed US is an effective, safe, and easy-to-apply treatment option in the conservative treatment of mild-to-moderate CTS.

Efficacy and safety of single or consecutive double high-dose oral cholecalciferol supplementation in adult patients with vitamin D deficiency.

BACKGROUND AND AIM: Enhancing vitamin D levels as a crucial modifiable risk factor may provide a critical contribution to prevent susceptibility to various diseases, including musculoskeletal, autoimmune, and inflammatory rheumatic diseases as well as promoting overall health. However, adherence to daily vitamin D supplementation is generally poor, and there are some concerns regarding the high-dose vitamin D supplementation's safety. We aimed to investigate whether a single oral dose of 300,000 IU or consecutive two-day dosing of 300,000 IU each day of cholecalciferol could sufficiently and safely elevate vitamin D levels. METHODS: This cross-sectional study was conducted on 160 inpatients with vitamin D deficiency and various musculoskeletal diseases.Subjects with serum 25(OH)D levels between 10 and 20 ng/mL (mild to moderate deficiency) received a single oral dose of 300,000 IU cholecalciferol, while those with severe vitamin D deficiency (<10 ng/mL) were supplemented with consecutive two-day doses of 300,000 IU cholecalciferol (a total of 600,000 IU). RESULTS: After one week of replacement therapy, the 25(OH)D levels increased from 6.3 (4.0-9.9) ng/mL to 53.3 (8.3-84.4) ng/mL and from 15.0 (10.1-19.6) ng/mL to 38.4 (16.3-67.7) in the group with severe and those with the mild-to-moderate vitamin D deficiency, respectively. Except for three patients, nearly all patients (98%) achieved levels above 20 ng/mL. No signs of toxicity were observed in any of the patients. During the 6-month follow-up, falls were observed in 3 patients (2.8%), but no fractures were reported. CONCLUSION: A single dose of 300,000 IU of oral cholecalciferol or two consecutive doses with a total dose of 600,000 IU cholecalciferol can effectively and reliably increase the 25(OH)D serum levels within one week in nearly all patients. The results may contribute to optimizing treatment strategies for vitamin D deficiency and re-evaluating the potential negative impact of high-dose vitamin D supplementation.

Evaluation of sexual dysfunction in females with neck and upper back myofascial pain syndrome: a cross-sectional study.

Myofascial pain syndrome (MPS) is a prevalent chronic musculoskeletal pain disorder that is frequently encountered in clinical practice and can cause sexual dysfunction in women. While there have been studies examining sexual function in various painful rheumatic conditions, particularly fibromyalgia, no studies have been conducted specifically on primary MPS. In this context, we aimed to investigate the frequency of sexual intercourse and the factors associated with it in women diagnosed with MPS. The study was designed as a cross-sectional study at a tertiary rehabilitation center between May 2022 and April 2023. Forty-five consecutive sexually active women (mean age: 38.1 ± 6.8 years) diagnosed with primary MPS were included in the study. They were compared to 45 healthy women of similar ages. The participants were interviewed regarding their weekly frequency of sexual intercourse and the importance of sexual life. Also, the Beck Depression Inventory (BDI) and the Visual Analog Scale (VAS) were assessed. The importance of sexual life score (p = 0.008), BDI (p < 0.001), VAS pain (p < 0.001), and VAS fatigue (p < 0.001) values were found to be lower in the patient group compared to the control group. The frequency of sexual intercourse was lower in the patient group, although this difference did not reach statistical significance (p = 0.083). In patients with a higher BDI score (≥ 17), the number of sexual intercourse was lower (p = 0.044), and the severity of fatigue was higher (p = 0.013). Significant associations were observed in MPS patients between the weekly frequency of sexual intercourse and VAS pain, VAS fatigue, BDI, and the importance of the sexual life score. A positive correlation was observed between the number of weekly sexual intercourses and the importance of the sexual life score (r = 0.577, p < 0.001), and negative correlations were found between BDI (r = - 0.478, p < 0.001), VAS pain (r = - 0.409, p < 0.001), and VAS fatigue (r = - 0.439, p < 0.001). Patients with MPS should be assessed for depressive mood and fatigue, as these factors may contribute to sexual dysfunction. These results may also emphasize the importance of adopting a multidisciplinary approach in the management of MPS patients with concurrent sexual dysfunction. Clinicaltrials.gov identifier: NCT05727566.

Evaluation of temporomandibular joint dysfunction in traumatic brain injury patients.

BACKGROUND: The aim of this study was to evaluate the frequency of temporomandibular joint dysfunction and related factors in patients with traumatic brain injury. METHODS: A total of 60 participants, 30 patients with traumatic brain injury and 30 healthy volunteers of similar age, have been included in this study, which was designed as a hospital-based cross sectional study. Fonseca questionnaire was used to evaluate and classify the temporomandibular joint dysfunction. Temporomandibular joint range of motion was evaluated with a digital calliper, and masticatory muscles pressure pain threshold was evaluated with an algometer. Labial commissure angle measurement was used to evaluate the severity of facial paralysis. Complications related to traumatic brain injury were recorded in patients with traumatic brain injury. RESULTS: According to Fonseca questionnaire score, 80% of traumatic brain injury patients and 16.7% of the control group had temporomandibular dysfunction (p < .001). In the intergroup comparison, a significant decrease was found in all temporomandibular range of motion and masticatory muscles pressure pain threshold parameters in favour of the traumatic brain injury group (p < .001). Labial commissure angle and Fonseca questionnaire scores were higher in the traumatic brain injury group (p < .001). The frequency of temporomandibular dysfunction was more common in traumatic brain injury patients with headache than in those without headache, as shown by the results of the Fonseca questionnaire (p = .044). CONCLUSION: Compared to healthy controls, patients with traumatic brain injury experienced issues with the temporomandibular joint more frequently. Additionally, TBI patients with headaches had a greater frequency of temporomandibular joint dysfunction. Therefore, it is advised to check for temporomandibular joint dysfunction in traumatic brain injury patients during follow-up. In addition, the presence of headache in traumatic brain injury patients may be a stimulant for temporomandibular joint dysfunction.

Problematic Internet use in Adults: The Role of Happiness, Psychological Resilience, Dispositional Hope, and Self-control and Self-management.

There is increasing literature examining the use of problematic internet in the context of psychological factors. Most of these studies are focused on the young population. On the other hand, the prolongation of human life and the increasing rate of adult individuals in society's population cannot be ignored. It is seen that the number of research examining the use of problematic internet in the context of psychological factors is quite limited. In this current study, the problematic internet usage of primary and secondary school students' parents was examined in happiness, psychological resilience, dispositional hope, self-control and self-management. The research was conducted on 1123 parents. Path analysis was performed to discover the relations between the structures. As a result of the path analysis, it was determined that there is a significant negative relationship between problematic internet use and happiness, problematic internet use and psychological resilience, problematic internet use, and dispositional hope. According to these findings, adults' high happiness levels, psychological resilience, and hope levels will reduce their problematic internet use. It has been determined that there is a significant indirect relationship between self-control and self-management and problematic internet use. Happiness, psychological resilience, and dispositional hope mediating role in this relationship. Increasing parents' happiness levels, developing psychological resilience, increasing dispositional hope levels, and developing self-control and self-management skills will reduce problematic internet use. In line with the findings, what can be done to reduce the use of problematic internet has been discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s10942-022-00482-y.

Comparison of the effectiveness of peloid and paraffin treatment for symptomatic hand osteoarthritis in women: a single-blind randomized controlled study.

Although peloid and paraffin treatments may have a positive effect in the short term on pain, functional status, hand grip strength, and quality of life in patients with hand osteoarthritis (HOA), there are no comprehensive and comparative studies of these therapies for HOA. The aim of our study was to evaluate the short-term effects of peloid and paraffin treatments in symptomatic HOA patients. Eighty female patients diagnosed with HOA were randomly divided into two equal groups: peloid group (peloid therapy and home exercise) and paraffin group (paraffin therapy and home exercise). Peloid and paraffin applications were performed over 3 weeks for a total of 15 sessions. Patients were evaluated with visual analog scale (VAS)-rest, -activity, and -handgrip for pain, Jamar hand dynamometer for grip strength, Australian/Canadian (AUSCAN) Osteoarthritis Hand Index for function, health assessment questionnaire (HAQ) for physical activity, Beck depression inventory (BDI) for depression, and short form-36 (SF-36) for quality of life. Evaluations were performed before treatment, in the 3rd week, and 1 month after treatment. For all parameters except SF-36, statistically significant improvements were observed in short-term evaluations compared to the baseline in both groups (p = .000). Reductions in HAQ scores in the 3rd week and 1st month (p = .001 and p = .003), and the decrease in BDI scores in the 3rd week (p = .005) was statistically significantly higher in the peloid group. Improvements in some subparameters of the SF-36 were statistically significant in favor of the peloid group. In female patients with HOA, both groups experienced similar positive effects on pain, functional status, and hand grip strength for up to one month, but the peloid group was found to be superior in the short term in terms of physical activity and some quality of life parameters. Peloid therapy can be preferred as a natural and reliable method for symptomatic HOA.

Comparison of the efficacies of peloid therapy and paraffin treatment given as an adjuncts to exercise therapy in patients with hallux rigidus: a randomized, uncontrolled, prospective study.

Although it is thought that peloid and paraffin treatments may have positive effect on pain, functional status, and quality of life in patients with hallux rigidus (HR), there are no comprehensive and comparative studies with a high level of evidence. We aimed to compare peloid and paraffin treatments in symptomatic hallux rigidus patients. A total of 113 patients diagnosed with HR between May 2019 and June 2021 were included in the study. After exclusion criteria, the remaining 90 patients were randomly divided into two groups: the peloid therapy group (peloid therapy + home exercise) and the paraffin therapy group (paraffin therapy + home exercise). Peloid and paraffin treatments were applied for 2 weeks (5 days a week for a total of 10 sessions). Patients were evaluated before treatment, at the end of treatment, and one month after treatment. The groups were compared in terms of pain, functional status, quality of life, and joint range of motion. In the final analysis, 40 patients in each treatment group were compared. Statistically significant improvements were achieved for all parameters at the end of treatment and at follow-up, and the treatments were found to be highly effective. As a result of the comparison, the methods were not found to be superior to each other. The present study is the first randomized study comparing peloid therapy and paraffin therapy given as an adjuncts to exercise therapy. Exercise therapy plus peloid and exercise therapy plus paraffin treatments seem to have similar effects on HR; however, controlled trials are necessary for confirmation of our results.

The role of loneliness and aggression on smartphone addiction among university students.

The COVID-19 pandemic has become a major health problem worldwide. In addition to the physical effects of COVID-19 on individuals, it has caused psychological and social problems on individuals. One of these problems is related to feelings of loneliness they experienced during the pandemic process and the increase in aggression and smartphone addiction levels, which are thought to be related. The main goal of current research is to explore the effects of loneliness and aggression behaviors on smartphone addiction. The data of the study were obtained from 843 university students (565 female and 278 male; 17-54 age range) who voluntarily participated in the research from 68 of 81 provinces in Turkey. Research data were obtained based on participants' self-reports through an online questionnaire. Personal information form, Smartphone Addiction Scale, UCLA Loneliness Scale, and Buss-Perry Aggression Questionnaire were used as data collection tools. Research findings show that the feeling of loneliness affects aggression behaviors and smartphone addiction, and aggression behaviors also affect smartphone addiction. Therefore, it can be said that loneliness and aggression are variables in predicting university students' smartphone addiction.

Relationship between prevalence and severity of restless legs syndrome and anemia in patients with systemic lupus erythematosus.

AIM: Our aim was to evaluate the relationship between the prevalence and severity of restless legs syndrome (RLS) and the anemia in patients with systemic lupus erythematosus (SLE). METHODS: This was a case-control study which was conducted at the rheumatology clinic of a university affiliated hospital, including 62 patients with SLE and 62 age- and sex-matched healthy controls. The patients were divided into two groups in terms of their hemoglobin levels. The criterion for anemia was hemoglobin level lower than 12 g/dL in females and 13 g/dL in males. RESULTS: Nineteen patients (30.6%) in the patient group were diagnosed with RLS, and International RLS Study Group Rating Scale (IRLSSG-RS) score was 10.7 ± 9.5 (median:10.0 [range:0.0-30.0]). Three subjects (4.8%) in the control group had RLS, and the IRLSSG-RS score was 0.7 ± 3.3 (median:0.0 [range:0.0-18.0]). The prevalence of RLS and the IRLSSG-RS score were higher in the patient group than those in the control group (P < 0.001). Ten SLE patients (50%) with anemia had RLS, and their IRLSSG-RS score was 14.5 ± 9.9 (median:21.0 [range:11.0-30.0]). Nine SLE patients (21.4%) without anemia had RLS and their IRLSSG-RS was 9.0 ± 8.9 (median:21.0 [range:11.0-24.0]). Significant differences were present in the prevalence of RLS and the IRLSSG-RS score between SLE patients with and without anemia (P = 0.024, P = 0.044, respectively). CONCLUSION: The present study demonstrated that the prevalence of RLS was higher in patients with SLE than that of the normal population. Results of this study also suggested that anemia was associated with higher frequency of and more severe RLS in patients with lupus.

Efficacy of vitamin D replacement therapy on patients with chronic nonspecific widespread musculoskeletal pain with vitamin D deficiency.

AIM: The objective of this study is the evaluation of the effect of vitamin D replacement treatment on musculoskeletal symptoms and quality of life in patients with chronic widespread musculoskeletal pain (CWP) including fibromyalgia (FM) and vitamin D deficiency. METHOD: Patients with nonspecific CWP and vitamin D deficiency (25-OH D3 < 25 ng/mL) were included into the study. Replacement treatments of 50 000 IU/week oral vitamin D3 for 3 months were given to the patients. Patients were assessed pre- and post-treatment in terms of serum levels of Ca, P, alkaline phosphatase, 25-OH D3, severity of pain (visual analogue scale [VAS]-pain), severity of asthenia (VAS-asthenia), Beck Depression Inventory (BDI), quality of life scale (Short Form [SF]-36), tender point count (TPC), severity of waking unrefreshed, headache, tenderness on tibia, meeting the criteria of FM, and level of patient satisfaction. RESULTS: Fifty-eight patients with a mean age of 36.9 ± 9.2 years were included into the study. 25-OH D3 levels of patients elevated from 10.6 ± 5.1 ng/mL to 46.5 ± 24.0 ng/mL after replacement treatment (P < 0.001). Marked decrease in VAS-pain, VAS-asthenia, severity of waking unrefreshed, TPC, and BDI and an evident increase in subgroups of SF-36 were established in patients after treatment (P < 0.001). The number of FM+ patients was 30 (52%) before treatment and regressed to 20 (34%) after treatment (P = 0.013); 85% of patients stated satisfaction with the treatment. CONCLUSIONS: Vitamin D replacement treatment in patients with nonspecific CWP has provided improvements in musculoskeletal symptoms, level of depression and quality of life of patients. Patients with CWP should be investigated for vitamin D deficiency.

Ischemia-Modified Albumin and Atherosclerosis in Patients With Familial Mediterranean Fever.

The constriction of vessels due to atherosclerotic lesions causes hypoxia/ischemia and oxidative changes resulting in transformation of free albumin to ischemia-modified albumin (IMA) in the circulation and increased carotid intima-media thickness (cIMT). We investigated the reliability of IMA increase in evaluating atherosclerosis in patients with familial Mediterranean fever (FMF) compared with cIMT. Patients with FMF (n = 58) diagnosed by the Tel-Hashomer criteria in attack-free period and 38 healthy people were included in the study. Patient demographics as well as the clinical and laboratory characteristics of the healthy controls and patients with FMF were noted. The IMA levels and cIMT in patients with FMF were 0.30 ± 0.09 absorbance units (ABSUs) and 1.12 ± 0.27 mm, respectively, and in the control group, IMA levels and cIMT were 0.25 ± 0.07 ABSU and 0.74 ± 0.26 mm, respectively. The IMA levels and cIMT were significantly higher in patients with FMF than in controls (P= .020 andP< .0001, respectively). The IMA values showed positive correlation with cIMT in patients with FMF(r= .302,P= .041). Our results reveal that IMA--an oxidative stress marker--may be an indicator of atherosclerosis in patients with FMF. This finding deserves further investigation.

Two new inflammatory markers associated with Disease Activity Score-28 in patients with rheumatoid arthritis: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio.

AIM: Rheumatoid arthritis (RA) is an inflammatory autoimmune disease with unknown etiology and systemic involvement. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are two new inflammatory markers used in the assessment of systemic inflammation. The aim here is to study NLR and PLR in patients with RA to investigate their relation with Disease Activity Score of 28 joints (DAS-28). METHODS: The study included 104 patients with RA and a control group of 51 age- and gender-matched healthy subjects. We divided the patients into two groups according to the DAS-28 score. Group 1 included patients with a score of lower than 2.6 by the DAS-28 (patients in remission) and Group 2 included patients with a score of 2.6 and higher (patients with active disease). RESULTS: NLR was 2.12 ± 0.83 in the patient group and 1.58 ± 0.57 in the control group. PLR was 136.50 ± 53.52 in the patient group and 114.84 ± 29.41 in the control group. There was a statistically significant difference in NLR and PLR between the patient and control groups (P ≤ 0.0001 and P = 0.001, respectively). Patients in Group 1 had an NLR of 1.84 ± 0.61 and a PLR of 119.25 ± 41.77. Patients in Group 2 had an NLR of 2.29 ± 0.90 and a PLR of 147.28 ± 56.96. There was a statistically significant difference in NLR and PLR between the two groups (P = 0.003 and P = 0.005 respectively). A correlation was observed between NLR and PLR by DAS-28 (r = 0.345, P ≤ 0.0001 and r = 0.352, P ≤ 0.0001, respectively). CONCLUSIONS: The present study showed us that NLR and PLR were two new inflammatory markers which could be used to assess disease activity in patients with RA.