Pain types and risk factors in post-COVID-19.

Objectives: This study aims to accurately evaluate pain lasting longer than three months and falls under the category of chronic pain and to determine the risk factors to follow up and treat properly and to develop appropriate diagnostic and treatment algorithms. Patients and methods: Between March 2021 and December 2021, a total of 437 patients (162 males, 275 females; mean age: 44±14.6 years; range, 12 to 82 years) who were referred to the participating centers due to pain complaints and were diagnosed with post-COVID-19 condition according to the criteria defined by the World Health Organization (WHO) were included in the study. The patients were divided into three groups as nociceptive pain, neuropathic pain, and central sensitization, based on the physician's clinical evaluation and the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Central Sensitization Inventory scores. Results: The most common diagnosis was nociceptive pain followed by central sensitization. Patients with nociceptive pain had less pain. It was found that not exercising regularly, having a chronic disease and being a woman were risk factors for central sensitization, having thyroid disease before COVID-19, and defining the current pain as very severe were risk factors for neuropathic pain. Conclusion: In the evaluation of post-COVID-19 pain, neuropathic pain and central sensitization should be also considered in addition to nociceptive pain and the severity of pain, systemic diseases and physical activity should be questioned.

Urinary system complications and long-term treatment compliance in chronic traumatic spinal cord injury patients with neurogenic lower urinary tract dysfunction.

Objectives: The aim of this study was to evaluate upper and lower urinary tract complications and the compliance of long-term treatment in patients with spinal cord injury (SCI) by urodynamic examination. Patients and methods: Between January 1997 and May 2007, a total of 89 patients with SCI (79 males, 19 females; mean age: 39.8±12.2 years; range, 19 to 72 years) who were admitted to physical medicine and rehabilitation clinic were retrospectively analyzed. Demographic, neurological, and urodynamic data of the patients with the diagnosis of neurogenic lower urinary tract dysfunction (NLUTD) in their initial urodynamic examination and without regular follow-up were recorded. Results: The mean time to the first urodynamic examination was 8.6±5.4 months. Sixty-seven patients who had neurogenic detrusor overactivity (NDO) in their first urodynamic tests were recommended anticholinergics. Clean intermittent catheterization (CIC) was recommended after initial urodynamic examination in all patients. Thirty-nine patients of 67 who had NDO were taking medications, while 28 were not. In the patients who continued anticholinergic treatment, bladder capacity was found to statistically significantly increase, compared to the initial measurement values and detrusor pressures significantly decreased (p<0.001). The compliance rate with CIC and anticholinergic treatment was 79.8% and 58.2%, respectively. Sixteen of the patients had calculus in the urinary system. Forty-two patients had infections more than once a year and used antibiotics. Conclusion: Neurogenic bladder should be evaluated at the beginning of SCI and, then, followed on a regular basis. Urodynamic tests should be performed immediately after spinal shock and can be repeated, as indicated.

Effect of body mass index on functional recovery after total knee arthroplasty in ambulatory overweight or obese women with osteoarthritis.

OBJECTIVE: The aim of this study was to evaluate the relationship between body mass index (BMI) and functional status after total knee arthroplasty (TKA) in ambulatory overweight or obese women with knee osteoarthritis (OA). METHODS: The study included 78 women who underwent elective primary TKA for osteoarthritis. Age, height, body weight and BMI were recorded. Functional status was evaluated using the Turkish version of the Knee Injury and Osteoarthritis Outcome Score (KOOS). The Timed Up and Go (TUG) test was used to evaluate performance-based functional assessment. RESULTS: Mean age of the patients was 66.5 ± 5.8 (range: 56 to 79) years and mean duration of symptoms was 9.56 ± 7.1 years. Body mass index was 30 or higher in 47 patients (60%) and between 25 and 29 in 31 (40%). Body mass index did not correlate with the KOOS or TUG test. Postoperative KOOS scores showed a statistically significant increase (p<0.01). Postoperative TUG test values showed significant improvement (p<0.01). CONCLUSION: Body mass index had no negative effect on functional recovery and mobility in the ambulatory overweight or obese women undergoing TKA. Physical function improved significantly after knee arthroplasty.

Frequency, features, and factors for falls in a group of subacute stroke patients hospitalized for rehabilitation in Istanbul.

Falling is a major complication seen in stroke patients. The purpose of this study was to investigate the frequency, features, and factors for falls affecting subacute stroke patients hospitalized for rehabilitation. Ninety-nine subacute stroke patients, hospitalized for rehabilitation were evaluated prospectively in this study. All patients were evaluated using the functional independence measurement (FIM), the Barthel index (BI), the Berg balance scale (BBS), the mini mental state examination (MMSE), the hospital anxiety depression scale (HADS), and the Downton index (DI), performed by the same physician. Proximal femur bone mineral density (BMD) measurements were performed using the dual-energy X-ray absorbtiometry (DXA). During the period of hospitalization, 17 patients (17.2%) reported falling once. The calculated incidence rate for falls was 6.3/1000 hospital days (95% confidence interval, CI=3.7-10.1). Furthermore, 41% of the falls occurred in patients' rooms, 82% between the hours 06:00- 20:00, 47% while walking and 65% on the side affected from the stroke. Despite the fact that 30% of the patients had osteoporosis, no fractures were observed after these falls, 88% had only soft tissue injury. Overall, 88% of the patients reported they had a fear for falling. Admission DI scores were significantly lower in the group of patients with no falls compared to the group with falls (p<0.05). Falls occurred most frequently during daytime, while subacute stroke patients were walking. DI is useful in stroke patients that are to be hospitalized for rehabilitation and accordingly, preventive action taken on those patients with a high risk for falls.