Hearing Loss and the Affecting Factors in Patients with Fibromyalgia.

OBJECTIVE: To find the frequency of hearing loss in newly diagnosed patients with fibromyalgia (FM), and the factors affecting it. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Physical Medicine and Rehabilitation and Department of Otorhinolaryngology Head and Neck Surgery, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Turkey, from March 2021 to November 2022. METHODOLOGY: Patients with FM and gender/age matched controls were compared with pure-tone audiometric (PTA), and transient evoked otoacoustic emissions (TEOE) tests after standardised otorhinolaryngologic assessment The subjects were questioned for NSAID uptake and scored with ASAS-NSAID score. RESULTS: There were 33 patients with FM and 32 healthy volunteers. Subjective tinnitus, dizziness, and hearing loss rate in the FM group were 12%, 18%, and 15%, respectively. PTA air and bone conduction studies yielded significant differences between the control and FM group (p<0.05). The statistical difference was pronounced in higher frequencies. TEOE tests showed the FM group had significantly lower scores when compared to the control group at 3000 Hz and 4000 Hz (p<0.05). The median ASAS-NSAID scores were 0 for the control group and 7.78 for the FM group (p <0.001). CONCLUSION: Patients with FM had high rate of audiometric hearing loss of the sensorineural type. The abnormalities were more prominent in the high frequencies but also present in the low frequencies. KEY WORDS: Fibromyalgia syndrome, Hearing loss, Audiometry, Ototoxicity, Central sensitisation.

Lower Urinary Tract Symptoms in Patients With Chronic Low Back Pain: A Cross-Sectional Study.

INTRODUCTION:  This study aimed to determine the extent of lower urinary tract symptoms (LUTS) in patients with chronic low back pain (CLBP) and the relationship between LUTS and patients' clinical and functional factors. METHODS: Patients aged 40 to 80 who were admitted with CLBP were included. Demographic data and the duration of CLBP and LUTS were noted. Anteroposterior and lateral lumbar radiographs and lumbar MRI findings were recorded. Short Form 36 (SF-36) and the Oswestry Disability Index (ODI) were used for functional status assessment. For the LUTS evaluation, patients were asked to tick the symptoms from the list of LUTS prepared. RESULTS: We included 90 patients with CLBP. The frequency of urinary incontinence was 81.1%. The mean number of LUTS was 2.81±3.22. The LUTS rates were higher in patients with vertebral height loss (p = 0.03), with central (p = 0.02) and lateral spinal narrow canals (p = 0.03), and with facet hypertrophy (p = 0.04). The rates of LUTS were lower in patients with decreased lumbar lordosis (p = 0.02). The ODI and LUTS were found to be related (p = 0.01). The role limitations due to physical problems of the SF-36 subgroups and LUTS were significantly correlated (p = 0.01). CONCLUSION: The incidence of the coexistence of CLBP and LUTS is high. Patients cannot match and report LUTS among their complaints, so physicians should inquire about LUTS in patients with CLBP and carry out the appropriate diagnosis and treatment.

Hearing loss can also be seen in patients with nonradiographic axial spondyloarthropathies as well as radiographic axial spondyloarthropathies.

Objectives: Hearing loss has been described in patients with radiographic axial spondyloarthropathies (R-AxSpA) but has not been studied in patients with non-radiographic axial spondyloarthropathies (NR-AxSpA); accordingly, the aim of the study was to compare hearing loss in patients with NR-AxSpA, R-AxSpA, and healthy individuals. Patients and methods: This cross-sectional observational study was conducted with 68 participants (30 males, 38 females; mean age: 39.8±7.4 years) between March 2021 and March 2022. Of the participants, 16 were patients with NR-AxSpA, 15 were patients with R-AxSpA, and 37 were healthy controls. Disease activity and radiological and audiological features were analyzed. The audiological assessment included pure-tone audiometric tests at octave frequencies of 250 to 8000 Hz and transient evoked otoacoustic emissions. Results: Hearing loss was found in three (8%) in the healthy group, five (31.3%) in the NR-AxSpA group, and 10 (66.7%) in the R-AxSpA group. The chi-square analysis showed a statistical significance (p=0.001). Values of audiometric tests yielded significant differences between the control and R-AxSpA group and also the control and NR-AxSpA group. For the air conduction studies, the statistical significance began at 1000 Hz in the R-AxSpA group. It was found that in the NR-AxSpA group, the statistical difference started in higher frequencies. The bone conduction audiometric studies were similar to air conduction studies. Transient evoked otoacoustic emission studies showed that the R-AxSpA group was significantly affected compared to the control and NR-AxSpA groups. There was no statistical difference between the control and NR-AxSpA groups. Conclusion: Both NR-AxSpA and R-AxSpA patients had hearing loss; however, in pure-tone audiometric tests, the abnormalities began in lower frequencies in the R-AxSpA group than in the NR-AxSpA group.

Comparison of shock wave therapy and corticosteroid injection in the treatment of greater trochanteric pain syndrome: A single-blind, randomized study.

Objectives: The aim of this study was to compare the efficacy of the corticosteroid (CS) injection and shock wave therapy (SWT) in the treatment of greater trochanteric pain syndrome (GTPS). Patients and methods: Between 2020 September and 2021 October, a total of 60 patients with GTPS (12 males, 48 females; mean age: 50.8±8.5 years; range, 34 to 65 years) were included. The patients were randomly assigned to two groups as the SWT group (n=32) receiving one session of SWT per week for a total of three weeks and CS injection group (n=28) receiving CS and local anesthetic. Both groups were evaluated using the Short Form-36 (SF-36) at baseline and three months and using the Visual Analog Scale (VAS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) at baseline, three weeks, and three months. Results: The mean VAS, greater trochanter tenderness, and WOMAC scores of both groups were similar at baseline, while the third-week and three-month scores were significantly lower in both groups compared to baseline (p<0.05). There was no significant difference in the treatment efficacy between the groups (p>0.05). There was a similar improvement in SF-36 physical function, physical role difficulty, and pain subscales in both groups (p<0.05). Conclusion: Our study results show that both CS injection and SWT are effective modalities and none of the treatments is superior to each other.

Evaluation of the physical and emotional effects of the COVID-19 pandemic on patients with fibromyalgia and chronic low back pain: A multicenter cross-sectional controlled study.

Objectives: This study aimed to investigate the physical and emotional effects of the coronavirus disease 2019 pandemic in patients with fibromyalgia syndrome (FMS) and chronic low back pain (CLBP) patients. Patients and methods: The cross-sectional controlled study was performed with 1,360 participants (332 males, 1,028 females; mean age: 42.3±12.5 years; range, 18 to 65 years) between September 2020 and February 2021. The participants were evaluated in three groups: the FMS group (n=465), the CLBP group (n=455), and the healthy control group (n=440). Physical activity, pain levels, and general health status before and during the pandemic were evaluated in all participants. Stress levels were analyzed with the perceived stress scale (PSS) in all groups, and disease activity was analyzed with the fibromyalgia impact questionnaire (FIQ) in patients with FMS. Results: Patients with FMS had worsened general health status and pain levels during the pandemic compared to the other groups (p<0.01). The FMS group showed significantly higher PSS scores than those in other groups (p<0.01). There was a weak-positive correlation between FIQ and PSS parameters in patients with FMS (p<0.05, r=0.385). Conclusion: The general health status, pain, and stress levels of the patients with FMS and CLBP tended to worsen during the pandemic. This high-stress level appeared to affect disease activity in patients with FMS.

Top 100 cited articles on fibromyalgia syndrome: A bibliometric and altmetric analyses study.

OBJECTIVES: Fibromyalgia syndrome is a global health problem. The aim of this study was to analyze the top 100 cited articles. METHODS: Web of Science database was scanned for the period between 1990 and 2020 using the search term, 'fibromyalgia,' and the 100 most cited articles were determined. For the bibliometric analysis, a record was made of the article title, year of publication, number of authors and names, number of citations, citation index, name of the journal in which it was published, impact factor, type of article, and source of funding. The altmetric attention score was recorded from the automatic software calculation. RESULTS: The total number of citations of the articles in the top 100 list varied between 203 and 6254. The majority of articles were published in arthritis and rheumatism (n=24) and pain (n=15) journals. The country producing the most articles was the US and the most cited author was Russel IJ. Case-controlled studies constituted the largest part of the top 100 (n=36). When the number of citations was examined, studies evaluating classification criteria, diagnostic criteria, and epidemiologic study were at the forefront. In terms of altmetric attention score, treatment studies, especially exercise, were in the first orders. CONCLUSION: This study presents a view on the subject of the level of interest shown by the scientific world and on social platforms to the most cited articles on the subject of fibromyalgia. There is a need for further studies which would use more wide-scale databases and offer interactions between countries.

The effects of COVID-19 on Physical Medicine and Rehabilitation in Turkey in the first month of pandemic.

OBJECTIVES: The outbreak of novel coronavirus-2019 (COVID-19) has affected Turkey very seriously, as well as all around the world. Many urgent and radical measures were taken due to the high contagious risk and mortality rate of the outbreak. It is noteworthy that isolation recommendations and the provision of health services for pandemic have a negative impact on Physical Medicine and Rehabilitation (PMR) services. In this study, we aimed to evaluate the effects of COVID-19 on the PMR services and physiatrists immediately after the first month of pandemic in Turkey. PATIENTS AND METHODS: An online survey consisting of 45 items was sent to the members of the Turkish Society of Physical Medicine and Rehabilitation. The main goal of the survey was to evaluate the changes in the provided service of PMR and conditions of physiatrists one month after the first reported COVID-19 case in Turkey. RESULTS: A total of 606 PMR specialists and residents responded to the survey. The mean number of the patients visited the outpatient clinics was 148.2±128.5 per week before the pandemic, it significantly decreased to 23.4±33.1 per week after the first month of the reported first COVID-19 case. Similarly, the mean number of the patients of inpatient service significantly decreased from 21.7±39.3 per week to 2.5±10.0 per week after the first month of the pandemic. Most of the residents (69%) reported that their training was seriously affected due to pandemic. From the economic aspect, 69.2% of the participants who were working at private hospitals reported a decrease in their monthly salary, and 21% of them were sent to an unpaid vacation. A total of 21.9% of private-practice institutions paused their services. During the first month, 46.9% of the participants were assigned to the different services such as COVID-19 inpatient service, emergency or COVID-19 outpatient clinics. According to the Republic of Turkey, Ministry of Health guideline and algorithm, 15.7% of the physicians were in the category of healthcare workers with suspected COVID-19. CONCLUSION: The COVID-19 pandemic affected seriously both the services and the PMR physicians as early as the first month. This effect is expected to become worse, when the duration of pandemic prolongs. Proper arrangements and measures should be planned to ameliorate the negative effects of the pandemic on the patients and PMR physicians.

Safety and efficacy of ultrasound-guided intra-articular hylan G-F 20 injection in osteoarthritis of the hip: a pilot study.

OBJECTIVE: The aim of this study was to determine the efficacy and safety of viscosupplementation applied to the hip joint with the lateral approach and ultrasound guidance and to show whether this can be an alternative treatment model in hip osteoarthritis (OA). METHODS: We performed three hylan G-F injections each to 14 patients with hip OA. We evaluated visual analog score (VAS), Lequesne hip OA severity index, 15-meter walking time before injections and 30 and 90 days after injections, and patient satisfaction. RESULTS: We established that after 30 respectively 90 days of treatment, VAS, Lequesne hip OA severity index, and 15-meter walking time were statistically significantly lower than before the treatment. This decrease continued after the 30th day. No side effects or complications were observed. CONCLUSIONS: Viscosupplementation performed under ultrasound guidance with the lateral approach is an effective and safe method and can be an alternative treatment of hip OA.