The aim of this study was to determine the emotional and sociodemographic characteristics of patients with ankylosing spondylitis (AS) and to investigate the impact of the disease on their social life and quality of life (QOL). This study included 101 patients with the diagnosis of AS. All patients filled in a questionnaire comprising their sociodemographic and emotional status and their self-rating on the disease and completed the 36-item Short Form Health Survey (SF-36). The impact of the disease on work status, sexuality, and family relations was measured on a Likert scale. The impact of the disease on employment, family and sexual relations, work life as well as SF-36 was investigated. Therefore, the effect of educational level, employment, social security, and sexual relations with spouse, etc. on QOL were assessed. More than half of the patients had no knowledge about the disease and half of them were not under a physician's control. Thirty-two percent of the previously working patients quit their jobs because of the disease. Quitting a job due to the disease was more frequent in the first 10 years of the disease. The most affected domains of the SF-36 were physical role power, general health, and pain. Patients unemployed due to the disease had lower SF-36 scores compared with employed ones. Unemployed patients without social insurance had lower values on SF-36 subscales (p<0.05). A higher education level had positive influences on disease impact. The level of anxiety was high and was associated with sexual relations (p<0.05). Our results show that the disease affects patients' work and social life. Work disability affects QOL. Educating the patients about the disease may play an important role in improving his/her life quality and coping with the disease. Thus, the socioeconomic burden of the disease on the person and on society can be diminished.

The objective of this study is to investigate the efficacy of manual lymphatic drainage (MLD) therapy in edema secondary to the reflex sympathetic dystrophy (RSD). A total of 34 patients were allocated randomly into two groups. All of the patients undertook nonstreoidal anti-inflammatory drug, physical therapy and therapeutic exercise program for 3 weeks. Patients in study group undertook MLD therapy additionally. Then the patients continued 2-month maintenance period with recommended home programs. Volumetric measurements pain scores and functional measurements were assessed at baseline, after treatment and 2 months after the treatment. After treatment, improvement in edema was statistically significant in the study group but not in the control group. At follow-up, with respect to baseline, improvements were not significant in both of the groups. Between the groups, difference of the percentage improvements in edema was statistically significant with superiority of MLD group after treatment, but not significant at follow-up. In this pilot study, MLD therapy was found to be beneficial in the management of edema resulted from RSD. Although the long-term results showed tendency towards improvement, the difference was not significant.

No abstract

Bier block with methylprednisolone and lidocaine in CRPS type I does not provide long-term benefit in CRPS, and its short-term benefit is not superior to placebo.

This is a retrospective epidemiological study. The objective is to determine the epidemiological characteristics including the patient demographics, etiological factors, duration of symptoms, treatment modalities applied and clinical outcome of the treatment in reflex sympathetic dystrophy (RSD). Medical records of the 168 patients managed in two tertiary hospitals with the diagnosis of RSD that was made according to both IASP criteria and three-phase bone scan were reviewed. The upper limb was affected 1.5 times as commonly as the lower limb. Of the 168 cases, 10.7% were non-traumatic. In 89.3% of the patients, RSD developed after a traumatic inciting event with a predominance of fracture. In 75.6% of the patients, RSD developed due to job-related injuries. The percentage of successful clinical outcome was 72%. The percentage of the patients that did not respond to therapy was 28%. The management period is long and this causes higher therapeutic costs in addition to loss of productive effort. However, response to therapy is good. On the other hand, in approximately one third of the patients, RSD does not improve despite all therapeutic interventions. In addition to compensation costs, this potentially debilitating feature causes RSD to appear as a socioeconomic problem.