Restless legs syndrome in patients with chronic low back pain.

Background: Based on studies showing that both chronic low back pain (LBP) and restless legs syndrome (RLS) have similar pathophysiological mechanisms, we aimed to investigate the prevalence of RLS in patients with chronic LBP and to define which demographic and clinical features are prominent in those with LBP accompanied by RLS. Methods: One hundred and two eligible, volunteer participants with chronic LBP were enrolled in this study. Visual analog scale (VAS), the Oswestry Disability Index (ODI), Pittsburgh Sleep Quality Index, Beck Depression Inventory, and Short Form-36 scales were applied to the patients. All patients were evaluated face-to-face for RLS using the International RLS study group diagnostic criteria. Results: Most of our patients were women (52%). The mean age was 40.96±13.34 years and the mean disease duration was 46.16±41.98 months. RLS was detected in 36 (35.3%) of the patients with LBP. It was found that the female gender was more dominant in patients with RLS and the difference was statistically significant (p < 0.001). The amount of coffee intake was significantly higher in patients with RLS compared to those without RLS (p = 0.001). The disease duration for LBP was significantly higher in the patients with RLS (p = 0.003). VAS score, ODI score, PUKI score, and Beck depression score were significantly higher in the RLS group (p value were 0.048, 0.040, 0.007, and 0.043, respectively). In the evaluation of quality of life, all parameters except role emotional limitations and mental health were found to be significantly worse in the RLS group.

The effect of cardiac rehabilitation on kinesiophobia in patients with coronary artery disease.

OBJECTIVES: The aim of this study was to define the level of kinesiophobia in cardiac patients, to determine whether there was a positive change in kinesiophobia after an exercise based cardiac rehabilitation (CR), and to define the associated variables with the change in kinesiophobia. PATIENTS AND METHODS: Between September 2017 and December 2018, a total of 98 patients (63 males, 35 females; mean age: 58±10.4 years; range, 36 to 78 years) diagnosed with coronary artery disease (CAD) were included in the study. The Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) was used to measure kinesiophobia. The short form of the International Physical Activity Questionnaire (IPAQ) was applied to measure physical activity level. The Short Form 36 (SF-36) was used to measure health-related quality of life (HRQoL). After CR, kinesiophobia was reevaluated. RESULTS: A high level of kinesiophobia was present in 74.5% of the patients. The mean TSK-SV heart score was 41.4±6.2. After CR, 34.6% of the patients had a high level of kinesiophobia (p<0.001). The patients with a high level of kinesiophobia were physically more inactive than those with a low level of kinesiophobia (p=0.001) and HRQoL scores were significantly lower (p<0.05). CONCLUSION: Kinesiophobia is quite common in patients with CAD. Aerobic exercise capacity and physical activity levels are lower in patients with a high level of kinesiophobia, compared to those with a low level of kinesiophobia. After an exercise-based CR program, kinesiophobia significantly reduces.

The prevalence of sacroiliitis in patients with acne vulgaris using isotretinoin.

BACKGROUND/OBJECTIVE: Acne vulgaris is a chronic inflammatory disease affecting the pilosebaceous unit in the skin. Isotretinoin is a synthetic vitamin A derivative regarded as the most effective agent in the treatment of acne. There have recently been increasing reports of adverse effects of isotretinoin on the skeletal system. Our aim in this study was to evaluate the rheumatic side-effects triggered by this drug, and particularly the prevalence of sacroiliitis. MATERIALS AND METHODS: A total of 73 patients receiving isotretinoin due to moderate or severe acne vulgaris were included. All patients were questioned about inflammatory low back pain and musculoskeletal pains during the treatment process. Inflammatory low back pain was evaluated using Assessment of Spondyloarthritis International Society (ASAS) criteria. Patients meeting ASAS criteria were evaluated with radiography and when necessary with sacroiliac magnetic resonance. RESULTS: The dose range for isotretinoin was between 0.4 and 0.8 mg/kg/day (mean 0.53 mg/kg/day). Treatment lasted for 6-8 months (mean 6.8 months). Lethargy was determined in 37 (50.7%) patients, myalgia in 31 (42.5%) and low back pain in 36 (49.3%). Mechanical low back pain symptoms were present in 20 of the patients describing low back pain and inflammatory low back pain in 16. Acute sacroiliitis was determined in six patients (8.2%) following a sacroiliac magnetic resonance imaging (MRI). Five (83.3%) of the patients with sacroiliitis were female and one (16.7%) was male. No statistically significant difference was determined between male and female patients in terms of prevalence of sacroiliitis (p = 0.392). CONCLUSION: The incidence of sacroiliitis in patients using isotretinoin is quite high. Patients using isotretinoin must be questioned about sacroiliitis findings and must be subjected to advanced assessment when necessary. Further studies regarding the development of sacroiliitis under isotretinoin therapy are now needed.