Objective The aim of this study was to evaluate the presence and incidence of neuropathic pain (NP) in patients with rheumatoid arthritis (RA) and to determine the relationship between neuropathic pain scores, quality of life and functional status. Methods 119 patients with RA and 45 control subjects with acute non-inflammatory pain were recruited for the study. Disease activity with DAS28 (Disease Activity Score-28), pain visual analog scale, functional status and quality of life were recorded. Quality of life was evaluated with the Rheumatoid Arthritis Quality of Life Scale (RAQoL), and functional status was assessed with the Health Assessment Questionnaire (HAQ). The presence of NP was evaluated with the LANSS (Leeds Assessment of Neuropathic Symptoms and Signs), Douleur Neuropathique 4 (DN4) and painDETECT questionnaires (PDQ). Results The prevalence of NP according to LANSS, DN4 and PDQ was 63.9%, 58.8% and 51.3% in the RA group and 6.7%, 4.4% and 4.4% in the control group, respectively. NP scores were significantly higher in the RA group (p<0.001). LANSS, DN4 and PDQ scores correlated with VAS, HAQ and RAQoL scores. Conclusion The NP evaluated with different pain questionnaires is not rare in patients with RA and is related to functional status and quality of life.

Objectives: This study aims to investigate the incidence and associated risk factors of clavicle and humerus fractures and brachial plexus injuries (BPIs) secondary to birth trauma. Patients and methods: Between October 2019 and May 2023, a total of 556 newborns (300 males, 256 females; median age: 5 days; range, 0 to 5 days) with clavicle, humerus fractures, and BPIs secondary to birth trauma were retrospectively analyzed. The sex, Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores at 1 and 5 min, need for resuscitation, gestational week, mode of delivery, birth weight, birth length, and head circumference of the neonates were recorded. Concomitant BPI, evaluation specialty, and maternal characteristics were also noted. Results: A larger head circumference was associated with an increased risk of clavicle fractures (p<0.001, odds ratio [OR]=1.681). High birth weight (p<0.01, OR=1.001), larger head circumference (p<0.001, OR=1.523), and lower APGAR score at 1 min (p=0.018, OR=0.605) were associated with BPI risk. Fractures were mainly evaluated by orthopedists, while BPI was primarily assessed by physical medicine and rehabilitation and pediatric neurology specialists (p<0.001). Neonatal physicians most frequently requested consultations from orthopedics for fractures and rehabilitation or neurology for BPI (p<0.001). Conclusion: Our study results show that larger head circumference increases the risk of clavicle fractures and BPI. Higher birth weight and lower APGAR scores at 1 min also raise BPI incidence. Newborns with these risk factors should undergo a thorough evaluation.

Aim We aimed to evaluate systemic inflammation in patients with postmenopausal osteoporosis using C-reactive protein (CRP)/albumin ratio, blood neutrophil/lymphocyte ratio (NLR) and prognostic nutritional index (PNI) and to determine its relationship with bone mineral density (BMD). Methods Our study has a retrospective design. A total of 363 postmenopausal female patients admitted to physical medicine and rehabilitation outpatient clinics were evaluated. Patients were divided into three groups as osteoporosis, osteopenia and normal BMD. Demographic data, femoral neck and lumbar total T scores, BMD values, complete blood count parameters, CRP and albumin results were recorded. CRP/albumin ratio, NLR and PNI were calculated. Results Osteoporosis was found in 102, osteopenia in 167 and normal BMD in 94 patients. In the osteoporosis group, albumin, CRP and CRP/albumin ratio were lower than the normal BMD group (p = 0.017; p < 0.001; p = 0.032, respectively). In the osteoporosis group, PNI was lower than the other groups (p < 0.001). NLR was higher in the osteoporosis group than the other groups, but not statistically significant (p = 0.723). We found a positive correlation between BMD with albumin and PNI. Conclusion The effect of inflammatory response in postmenopausal osteoporosis is not prominent. CRP/albumin ratio does not seem to be an appropriate index for osteoporosis. In the light of our data, nutritional factors seem to be more effective on osteoporosis.

Fibromyalgia syndrome (FMS) is a multifactorial condition characterized by chronic widespread pain, fatigue, and sleep disturbances, often accompanied by biochemical and psychosocial alterations. Sleep quality plays a critical role in disease severity and patient functionality. Recent evidence suggests that magnesium may influence both pain and sleep regulation. This observational cross-sectional study aimed to investigate the relationship between sleep quality and serum magnesium levels in patients with FMS and to explore their associations with clinical characteristics such as pain severity and functional status. Eighty-two patients diagnosed with FMS were grouped based on their Pittsburgh Sleep Quality Index (PSQI) scores: PSQI ≤ 5 (n = 27) and PSQI > 5 (n = 55). Demographic and clinical parameters, including age, body mass index, tender points, Fibromyalgia Impact Questionnaire (FIQ), and serum magnesium levels, were compared between the groups. Correlation analyses were performed to assess associations between magnesium levels and clinical variables. No significant differences were found between the groups in terms of age and body mass index (P > .05 for all). The PSQI > 5 group demonstrated significantly higher tender points (P = .035), visual analog scale scores (P = .002), FIQ scores (P < .001), and lower serum magnesium levels (P = .038) compared to the PSQI ≤ 5 group. Significant negative correlations were observed between magnesium levels and tender points (ρ = −0.293, P = .008), visual analog scale score (ρ = −0.252, P = .023), FIQ scores (ρ = −0.242, P = .028), PSQI scores (ρ = −0.324, P = .003). The findings indicate that lower serum magnesium levels are associated with poorer sleep quality, higher pain severity, and greater functional impairment in patients with FMS. These findings suggest a potential link between magnesium levels and the pathophysiology of sleep disturbances in FMS. However, due to the cross-sectional nature of the study and possible confounding influences, further longitudinal and interventional research is required to determine whether magnesium supplementation could offer clinical benefits in this population.

Objectives. The aim of this study was to investigate the frequency of work-related musculoskeletal system disorders (WRMSDs) in health personnel working in the operating room, the factors affecting WRMSDs, and the relationship between work-related sleep disturbance and musculoskeletal system problems. Methods. The study included 315 health personnel working in the operating room for at least 1 year. Musculoskeletal disorders (MSDs) were investigated with the Cornell musculoskeletal discomfort questionnaire (CMDQ), and sleep disorders were assessed with the Jenkins sleep scale. Results. In total, 57.5% of the operating room personnel had chronic MSDs. CMDQ scores were statistically significantly higher in women than in men (p < 0.01). CMDQ scores were statistically significantly higher in employees with sleep problems (p < 0.01). No statistically significant correlation was found between CMDQ scores and smoking, shift working periods and regular exercise (p = 0.63, p = 0.29 and p = 0.543, respectively). Jenkins sleep scale and Visual analog scale values were statistically positively correlated with CMDQ values (p < 0.01). Conclusion. Women and people with sleep disorders were potentially more at risk for WMRSDs in this study. More comprehensive studies with large populations are needed to determine the risk factors for WMRSDs in operating room personnel and to develop preventive methods to prevent WMRSDs.

Objective: The aim of this study was to research the frequency of Human Leukocyte Antigen (HLA)-B27 antigen positivity and relationship between HLA-B27 positivity and other autoantibodies and between HLA-B27 positivity and treatment in patients diagnosed with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Material and Method: The study is a retrospective study. Patients diagnosed with RA and AS as a result of the examinations performed at Physical Medicine and Rehabilitation outpatient clinic between January 2017 and September 2022 were retrospectively screened, and patients whose HLA-B27 antigen was tested were included in study. Results: A total of 569 patients, 199 with RA and 370 with AS were included in study. While HLA-B27 was positive in 11% of patients with RA, it was 37.5% in patients with AS and there was a significant difference between the groups. When we analyzed the correlation of autoantibodies with HLA-B27, we found that HLA-B27 was not correlated with RF, Anti-cyclic citrullinated peptides (Anti-CCP) or Anti-nuclear antibody (ANA). When we analyzed the relationship between HLA-B27 and the treatment method, there was no significant relationship between HLA-B27 and treatment method. Conclusion: While HLA-B27 was found to be 5% positive in the general population in the literature, we found 11% in 199 patients with RA. This study is important because it shows that HLA-B27 positivity is not very common in patients diagnosed with AS recently contrary to popular belief. More studies are needed to evaluate HLA-B27 frequency in RA and AS.