No abstract

Coronavirus disease 2019 (COVID-19) is a contagious infection disease, which may cause respiratory, physical, psychological, and generalized systemic dysfunction. The severity of disease ranges from an asymptomatic infection or mild illness to mild or severe pneumonia with respiratory failure and/or death. COVID-19 dramatically affects the pulmonary system. This clinical practice guideline includes pulmonary rehabilitation (PR) recommendations for adult COVID-19 patients and has been developed in the light of the guidelines on the diagnosis and treatment of COVID-19 provided by the World Health Organization and Republic of Turkey, Ministry of Health, recently published scientific literature, and PR recommendations for COVID-19 regarding basic principles of PR. This national guideline provides suggestions regarding the PR methods during the clinical stages of COVID-19 and post-COVID-19 with its possible benefits, contraindications, and disadvantages.

Purpose: This randomized, placebo-controlled study examined the effect of vitamin D replacement therapy on neuropathic symptoms and balance in patients with diabetic neuropathic pain and low vitamin D levels. Patients and Methods: Among the 258 patients, the results in a total of 57 volunteers (32 in the treatment and 25 in the control arm) meeting the inclusion criteria are reported. Symptoms of neuropathic pain were assessed using Douleur Neuropathique 4 (DN4) questionnaire, and presence of polyneuropathy (PNP) was determined by performing electromyography (EMG). Balance was assessed using Berg balance test (BBT). After undergoing these examinations, the patients in the treatment group were intramuscularly (IM) injected with 300,000 IU vitamin D in a liquid formulation and those in the placebo group were IM injected with physiological saline. The DN4 and BBT were repeated after 12 weeks, and the results were compared. Results: The patients in the treatment group showed a significant decrease in total DN4 scores from baseline to the study endpoint compared with the patients in the placebo group (p=0.008). The patients in the treatment group also showed a significant increase in BBT scores from baseline to the study endpoint compared with the patients in the placebo group (p=0.001). Furthermore, in subgroup analysis, these patients showed a significant decrease in electric shock and burning sensation scores from baseline to the study endpoint compared with the patients in the placebo group (p=0.006, p=0.001, respectively). Conclusion: In patients with diabetic neuropathic pain, vitamin D levels should be measured and vitamin D replacement therapy should be administered as required to resolve neuropathic symptoms and to improve balance.

Aim: Investigating reliability and validity of the Turkish version of short form-36 (SF-36) in patients with rheumatoid arthritis Methods: Demographic data of the patients with rheumatoid arthritis were recorded. Health Assessment Questionnaire (HAQ) and Short Form 36 (SF-36) were filled out. Disease activities were computed using Disease Activity Score 28 (DAS-28). Patients were recalled after three months and were asked to state how they felt compared to their first visit, and the same tests were repeated. Results: 141 patients were admitted (9.9% male, 90.1% female). In the reliability study of SF-36, the Cronbach alpha value of the subscales varied in the range 0.792-0.992, hence SF-36 was found to be highly reliable. The item total score correlations were computed for each subscale and were found to be in the ranges: 0.436-0.840 for physical functioning, 0.887-0.895 for role function (physical), 0.861-0.958 for pain, 0.564-0.892 for general health perception, 0.702-0.841 for vitality (energy/fatigue), 0.949-0.952 for social functioning, 0.396-0.473 for role function (emotional) and 0.456-0.824 for mental health. The SF-36 scores from two consecutive visits spaced 3 months apart were compared and the p values were found to be greater than 0.05. The validity study was conducted for the 63 patients whose reported conditions did not change between two visits. The test-retest relation was evaluated using intra-class correlation coefficients, which ranged from 0.51 to 0.78 and the correlations of the two tests were found to be statistically significant. The comparison of SF-36 scores from two consecutive visits, all with p>0.05, showed no statistically significant changes. Conclusion: The Turkish version of SF-36 was found to be reliable and valid in patients with rheumatoid arthritis.

Brachioradial pruritus (BRP) is a rare type of chronic pruritus that usually localized at the dorsolateral part of the forearms. Itching, burning, or pain are common symptoms at the involved areas. The etiological factors are still unknown but sun exposure and/or cervical spine lesions seem to be trigerring or precipiting factors. Neuropathogenic mechanism plays role in etiopathogenesis of BRP, therefore, antiepileptic drugs such as gabapentin, oxcarbazepine. and pregabalin are suggested medications for BRP. Herein, we report three cases with BRP successfully treated with pregabaline.