The aim of this study was to compare--clinically and ultrasonographically--the therapeutic effects of physical therapy modalities (hot pack, ultrasound therapy, and friction massage), local corticosteroid injection, and extracorporeal shock wave treatment (ESWT) in lateral epicondylitis (LE). Fifty-nine elbows of 59 patients with LE were randomized into three treatment groups receiving either physical therapy, a single corticosteroid injection, or ESWT. Visual analogue scale (VAS) was used to assess pain intensity, Jamar hydraulic dynamometer for grip strength, finger dynamometer for pinch strength (before treatment, on the first, third, and sixth months of treatment). All subjects were also evaluated with ultrasonography before and 6 months after treatment. In all groups, VAS scores of the patients were found to decrease significantly on the first, third, and sixth months of treatment. With respect to grip strength evaluations, the increase after treatment was significant only on the first month in group II; on the first and third months in group I; and on the first, third, and sixth months of treatment in group III. Pinch strength and ultrasonographical findings did not change during follow-up in any group. We imply that physical therapy modalities, corticosteroid injection, and ESWT have favorable effects on pain and grip strength in the early period of LE treatment. The increase in grip strength lasts longer with ESWT. On the other hand, ultrasonographic findings do not change in the first six months of these treatment methods.

Objective: The aim of this study was to determine the frequency of fibromyalgia (FM) in patients on Peritoneal Dialysis (PD) and to investigate its impact on the quality of life of that population. Methods: A hundred and twenty four patients with end stage renal disease who had undergone PD, and a control group of 54 age and sex-matched healthy volunteers were included to the study. Demographic characteristics including age, sex, disease and dialysis duration were recorded. Fibromyalgia Impact Questionnaire (FIQ) and Nottingham Health Profile (NHP) were also measured. Results: The mean age of the patients (68 female, 56 male) and control subjects (36 female, 18 male) were 43.5 ± 13.4 and 41.2 ± 9.2 years respectively. The prevalence of FM in the PD patients and controls were determined as 9.7% (12 patients) and 11.1% (6 controls) respectively and were found to be similar (p = 0.983). The mean score of subgroups of NHP except pain and emotion subgroups, were significantly higher in PD patients than in the control group. The mean FIQ levels, the scores of all the subgroups of NHP except the social subgroup were significantly higher in PD patients with FM than in those without FM. Conclusion: In conclusion although the prevalence of FM appears to be similar in PD patients and control subjects, the functional disability is common and quality of life is worse in PD patients with FM than in patients without FM. Detection and treatment of FM may lead to improvement in the quality of life of PD patients with this syndrome.

The aim of this study was to determine autonomic nervous system (ANS) functions by using clinical and electrophysiological tests in patients with ankylosing spondylitis (AS). Twenty AS and 20 healthy control subjects were recruited. Demographic data, symptoms related with ANS, and neurological findings were recorded. Clinical measurements including the heart rate variation with deep breathing (HRV), heart rate response to standing (HRS), systolic blood pressure response to standing, and diastolic blood pressure response to isometric exercise were obtained to assess parasympathetic and sympathetic functions of the subjects. The electrophysiological assessments of ANS were performed by sympathetic skin response (SSR) and R-R interval variation (RRIV) measurements for the sympathetic and parasympathetic functions, respectively. Patients with AS were subdivided into two groups depending on the activity of disease. The difference between the groups and relationship between ANS variables and clinical entities were determined. Fifteen male and five female AS patients with a mean age of 38+/-8.05 years and 14 male and six female healthy control subjects with a mean age of 40+/-9.8 years were included in the study. All the subjects were totally symptom free for ANS involvement and had normal neurological examination findings. The levels of HRV, HRS, and the mean RRIV values were significantly lower in AS patients than in control subjects. The clinical ANS parameters of the patients having more active disease were lower than in subjects with mild disease in regard to HRV values and SSR amplitudes and higher in regard to SSR latencies. The HRV values were found to be correlated with the mean scores of Bath ankylosing spondylitis disease activity index (BASDAI) and C-reactive protein (CRP) levels, and the mean latencies of SSR were correlated with BASDAI scores and CRP levels. In conclusion, our study indicates a subclinical mainly parasympathetic dysfunction of ANS in patients with AS which can be related with disease activity.

Our study comparing a standardized treatment protocol for incorporating local corticosteroid injection and iontophoresis of dexamethasone sodium phosphate in carpal tunnel syndrome revealed success of both iontophoresis of dexamethasone sodium phosphate and injection of corticosteroids, but symptom relief was greater at 2 and 8 wks with injection of corticosteroids.

According to the results of this study, it was asserted that trace elements, vitamins may play an important role in the pathophysiology of MPS and psychological factors may also have additional effect.