Healing refractory livedoid vasculopathy-related skin ulcers by ozone therapy: a case-based review.

Chronic skin wounds represent a prominent etiological factor in the occurrence of non-traumatic foot amputations on a global scale and pose a substantial threat to the patient's well-being and mortality in the absence of effective treatment strategies. There exists a subset of patients that exhibit an insufficient response to different treatment options, comprising antibiotics, dressings, gauze bandages, debridement, rehabilitation, collagen patch, and vacuum-assisted closure. In this patient group, distinct treatment strategies emerge before surgery and amputation. Ozone therapy is one of them. Ozone exhibits a wide variety of effects such as antimicrobial, anti-inflammatory, antioxidant, and trophic. Its trophic effect is mediated by disinfection, stimulation of granulation tissue, acceleration of the angiogenesis process, and detoxification mechanisms. In this article, we presented the beneficial effect of ozone therapy in a case of chronic skin ulcer associated with livedoid vasculopathy. In this context, we aimed to discuss the role of ozone therapy in the management of chronic skin ulcers. Finally, we focused on ozone therapy as a promising method in inflammatory rheumatic diseases.

Diagnosis, monitoring, and management of axial spondyloarthritis.

Axial spondyloarthritis (axSpA) is a chronic condition predominantly affecting the spine and sacroiliac joints. This article provides an in-depth overview of the current approaches to diagnosing, monitoring, and managing axSpA, including insights into developing terminology and diagnostic difficulties. A substantial portion of the debate focuses on the challenging diagnostic procedure, noting the difficulty of detecting axSpA early, particularly before the appearance of radiologic structural changes. Despite normal laboratory parameters, more than half of axSpA patients experience symptoms. X-ray and magnetic resonance imaging (MRI) are essential for evaluating structural damage and inflammation. MRI can be beneficial when there is no visible structural damage on X-ray as it can help unravel bone marrow edema (BME) as a sign of ongoing inflammation. The management covers both non-pharmacological and pharmacological approaches. Lifestyle modifications, physical activity, and patient education are essential components of the management. Pharmacological therapy, including nonsteroidal anti-inflammatory drugs (NSAIDs) and biologic disease-modifying anti-rheumatic drugs (bDMARDs), are explored, emphasizing individualized treatment. To effectively manage axSpA, a comprehensive and well-coordinated approach is necessary, emphasizing the significance of a multidisciplinary team. Telehealth applications play a growing role in axSpA management, notably in reducing diagnostic delays and facilitating remote monitoring. In conclusion, this article underlines diagnostic complexities and emphasizes the changing strategy of axSpA treatment. The nuanced understanding offered here is designed to guide clinicians, researchers, and healthcare providers toward a more comprehensive approach to axSpA diagnosis and care.

SARS-CoV-2 as a trigger of IgA vasculitis: a clinical case and literature review.

Coronavirus Disease 2019 (COVID-19), caused by SARS-CoV-2, has negatively affected global health. COVID-19 has been associated with a variety of autoimmune and inflammatory disorders, complicating its respiratory manifestations. SARS-CoV-2 triggers inflammatory reactions which may involve multiple organs and systems. The proof for IgA involvement in the immune reactions to coronavirus infection is growing, particularly in the case of IgA immune complex deposition diseases such as IgA vasculitis (IgAV) and IgA nephropathy.This report presents a case of IgAV caused by SARS-CoV-2 in a 53-year-old man. His symptoms included papillomatous, bright red rashes, urticaria throughout the body, aphthous stomatitis, pain in all joints and muscles, weakness, malaise, abdominal pain, face swelling, and arterial hypertension (160/100 mmHg). He received intravenous methylprednisolone (250 mg) and then oral methylprednisolone (16 mg) treatment, which improved his condition. This improvement included the disappearance of abdominal and joint pain and skin rashes.This article also provides an overview of published cases of IgAV after SARS-CoV-2. It may alert rheumatologists and allied specialists of clinical features of IgAV and guide them how to diagnose and treat this disease.

The positive effect of pulse electromagnetic field therapy on pain and disability in chronic low back pain: a comparative study.

BACKGROUND: Low back pain that lasts longer than three months is called chronic low back pain. Chronic low back pain is among the most common problems in the world, causing severe disability and loss of employment in patients. OBJECTIVE: To investigate the effect of pulse electromagnetic field therapy (PEMFT) added to routine physical therapy on pain and functional status in patients with chronic low back pain. METHODS: This retrospective comparative study included 69 patients with chronic low back pain. The patients were divided into two groups: those who received lumbar transcutaneous electrical nerve stimulation, infrared, and ultrasound treatments, and those who additionally received PEMFT. The files of patients with chronic low back pain were reviewed, and those who had been evaluated using the Quebec Back Pain Disability Scale (QBPDS) in terms of functional capacity and effects of low back pain and the Visual Analogue Scale (VAS) for pain both before and after treatment were included in the study. RESULTS: No significant difference was detected between the two groups' pretreatment VAS and QBPDS scores (p > 0.05). The second-and-third measurement scores of both groups were significantly lower than their first-measurement VAS and QBPDS scores (p ˂ 0.001), but there was no significant difference between their second- and third-measurement scores (p > 0.05). According to the inter-group comparison of the VAS and QBPDS scores, the second and third-measurement scores of the PEMFT group were significantly lower than those of the control group (p ˂ 0.001). CONCLUSIONS: PEMFT seems to be able to alleviate pain intensity and ameliorate disability in patients with chronic low back pain. PEMFT can be considered an effective and safe option that can be added to routine physical therapy modalities for relieving chronic low back pain frequently encountered in clinical practice. Further studies validating the effectiveness of PEMFT could strengthen its position in the management of chronic low back pain.

Emergencies in inflammatory rheumatic diseases.

Inflammatory rheumatic diseases (IRDs), encompassing a broad spectrum of chronic disorders, typically necessitate prolonged therapeutic intervention. Nevertheless, these diseases can sometimes manifest as severe emergencies requiring prompt and extensive medical intervention. Urgent intervention is essential for effectively recognizing and managing these situations, as they have the potential to be life-threatening and can result in severe morbidity and mortality. Emergencies in IRDs can occur with different frequencies and manifestations, including nervous system issues, severe infections, thrombosis-emboli, renal crises, gastrointestinal issues, and cardiovascular events. The fact that these events can occur across different IRDs underscores the necessity for heightened awareness and readiness among healthcare professionals. The pathophysiologic mechanisms that cause rheumatic emergencies are complex and involve multiple factors. These emergencies frequently arise due to the interplay between the inflammatory characteristics of rheumatic diseases and different systemic triggers. Early detection and treatment can have a substantial impact on an individual's prognosis in cases of severe and life-threatening disorders that require prompt recognition. Rapid decision-making and urgent care are required to effectively address rheumatic emergencies, as well as the implementation of a diagnostic flowchart. This article provides an overview of the emergencies linked to IRDs, classifying and assessing them individually. This article aims to enhance healthcare professionals' knowledge and awareness of critical situations by examining current recommendations and pathophysiological information. Implementing standardized diagnostic and treatment methods, providing patient education, and conducting continuing research into the underlying mechanisms are essential for enhancing the management of these critical situations and improving patient outcomes.

Telerehabilitation: lessons from the COVID-19 pandemic and future perspectives.

The coronavirus disease 2019 (COVID-19) pandemic has had an enormous effect on healthcare, notably rehabilitation for neurological, rheumatological, musculoskeletal, and cognitive diseases. Telerehabilitation provides rehabilitation services via multiple modalities, such as real-time chats, computerized consultations, and distant evaluations, emphasizing assessment, diagnosis, and intervention. While the use of telerehabilitation had restrictions before COVID-19, regulatory changes have accelerated its adoption, broadening therapy provision beyond traditional healthcare settings. Telerehabilitation has been examined for its effectiveness in a variety of health concerns, including stroke, traumatic brain injury, Parkinson's disease, musculoskeletal disorders, and rheumatic diseases. Despite the constraints of the COVID-19 environment, telerehabilitation settings, which include patient and therapist aspects, have emerged to ensure optimal treatment delivery. Key themes include home-based rehabilitation initiatives, wearable gadgets, and the integration of analytics and artificial intelligence. The growing acceptance of telehealth and telerehabilitation is expected to drive further progress in this discipline.

Potential role of camel, mare milk, and their products in inflammatory rheumatic diseases.

Milk and dairy products serve as a significant dietary component for people all over the world. Milk is a source of essential nutrients such as carbohydrates, protein, fats, and water that support newborns' growth, development, and physiological processes. Milk contains various essential biological compounds that contribute to overall health and well-being. These compounds are crucial in immune system regulation, bone health, and gut microbiota. Milk and dairy products are primarily from cows, buffalos, goats, and sheep. Recently, there has been a notable increase in camel and mare milk consumption and its associated products due to an increasing attraction to ethnic cuisines and a greater awareness of food biodiversity. Camel and mare milk possess diverse nutritional and therapeutic properties, displaying potential functional foods. Camel milk has been linked to various health advantages, encompassing antihypertensive, antidiabetic, antiallergic, anticarcinogenic, antioxidant, and immunomodulatory properties. Camel milk has exhibited notable efficacy in mitigating inflammation and oxidative stress, potentially offering therapeutic benefits for inflammatory disorders. Nevertheless, although extensively recorded, the potential health benefits of mare's milk have yet to be investigated, including its impact on inflammatory conditions. This article highlights the therapeutic potential of camel and mare milk and its derived products in treating inflammatory rheumatic disorders, specifically focusing on their anti-inflammatory and immune-regulatory capabilities. These alternative types of milk, which do not come from cows, offer potential avenues for investigating innovative strategies to regulate and reduce inflammatory conditions.

Vagus nerve stimulation as a therapeutic option in inflammatory rheumatic diseases.

The vagus nerve forms intricate neural connections with an extensive number of organs, particularly the digestive system. The vagus nerve has a pivotal role as a fundamental component of the autonomic nervous system, exhibiting an essential effect. It establishes a direct link with the parasympathetic system, consequently eliciting the synaptic release of acetylcholine. Recent studies have revealed the potential anti-inflammatory function of the vagus nerve. The activation of the hypothalamic system through the stimulation of vagal afferents is fundamentally involved in regulating inflammation. This activation process leads to the production of cortisol. The other mechanism, defined as the cholinergic anti-inflammatory pathway, is characterized by the involvement of vagal efferents. These fibers release the neurotransmitter acetylcholine at particular synaptic connections, involving interactions with macrophages and enteric neurons. The mechanism under consideration is ascribed to the α-7-nicotinic acetylcholine receptors. The fusion of acetylcholine receptors is responsible for the restricted secretion of inflammatory mediators by macrophages. A potential mechanism for anti-inflammatory effects involves the stimulation of the sympathetic system through the vagus nerve, leading to the control of immunological responses within the spleen. This article offers an extensive summary of the present knowledge regarding the therapeutic effectiveness of stimulating the vagus nerve in managing inflammatory rheumatic conditions based on the relationship of inflammation with the vagus nerve. Furthermore, the objective is to present alternatives that may be preferred while applying vagus nerve stimulation approaches.

The effect of earthquake on fibromyalgia: a comparison of patients on medication and without medication.

INTRODUCTION / OBJECTIVES: Stressful events like earthquakes might worsen the symptoms of fibromyalgia, although the influence of medications on these consequences is yet uncertain. The objective of this study was to examine the influence of an earthquake on the symptoms of fibromyalgia and evaluate the impacts of medications used to treat fibromyalgia on the clinical picture. METHOD: Ninety-five fibromyalgia patients were enrolled in a comparative study and divided into two groups: medication and non-medication. Three subcategories of medication groups were established: selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and gabapentinoid drugs (GDs). Before and after the earthquake, clinical evaluations were conducted using the Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Scale (HADS), and Jenkins Sleep Rating Scale (JSS). Statistical analyses were conducted to compare the scores before and after the earthquake and evaluate the differences between the groups. RESULTS: Statistically significant increases were observed in FIQ, HADS-anxiety, HADS-depression, and JSS scores in the medication and non-medication groups before and after the earthquake comparisons (p < 0.05). Non-medication group reported significantly higher post-earthquake changes in FIQ, HADS-anxiety, HADS-depression, and JSS compared to the medication group (p < 0.05). While HADS-anxiety, HADS-depression, and JSS changes after the earthquake differed according to the drug subgroups (p < 0.05), no statistically significant difference was observed in FIQ values (p > 0.05). The highest scores were detected in the GD subgroup. CONCLUSIONS: This study highlights the substantial impact of earthquakes on fibromyalgia patients. Medication use may assist in reducing the detrimental effects of stresses like earthquakes on fibromyalgia symptomatology. Future research with larger sample sizes and more extended follow-up periods is needed to explain these findings and optimize treatment regimens for fibromyalgia patients experiencing significant stressors.

Uncovering the link between inflammatory rheumatic diseases and male reproductive health: a perspective on male infertility and sexual dysfunction.

Inflammatory rheumatic diseases (IRDs) refer to a range of persistent disorders that have a major influence on several physiological systems. Although there is much evidence connecting IRDs to sexual dysfunction and fertility problems, research specifically focusing on male infertility in relation to these diseases is sparse. This review addresses the complicated connection between IRDs and male infertility, emphasising the physiological, psychological, and pharmacological aspects that influence reproductive health outcomes in men with rheumatic conditions. We explore the effects of IRDs and their treatments on many facets of male reproductive well-being, encompassing sexual functionality, semen characteristics, and hormonal balance. Additionally, we present a comprehensive analysis of the present knowledge on the impact of several categories of anti-rheumatic drugs on male reproductive function. Although there is an increasing awareness of the need of addressing reproductive concerns in individuals IRDs, there is a noticeable lack of research especially dedicated to male infertility. Moving forward, more comprehensive research is needed to determine the prevalence, risk factors, and mechanisms driving reproductive difficulties in males with IRDs. We can better assist the reproductive health requirements of male IRD patients by expanding our understanding of male infertility in the setting of rheumatic disorders and implementing holistic methods to care.

Evaluation of ophthalmic vascular and neuroretinal alterations in fibromyalgia syndrome: a cross-sectional comparative study.

INTRODUCTION: Fibromyalgia syndrome (FMS) is a prevalent rheumatic disorder, and its pathogenesis includes genetic, neuroendocrine, and autonomic abnormalities, which may impact ocular structures. The aim was to conduct a comparative analysis of the ophthalmic vasculature and the retinal nerve fiber layer (RNFL) thickness between FMS and control groups using optical coherence tomography (OCT) and OCT angiography (OCTA). METHODS: This cross-sectional comparative study included 43 FMS patients and 40 healthy controls recruited from a tertiary education and research hospital between January 2024 and May 2024. All patients satisfied the 2016 American College of Rheumatology criteria for FMS and consented. OCT and OCTA were used to assess the RNFL thickness and the retinal microvasculature structure. The Fibromyalgia Impact Questionnaire (FIQ) was performed to evaluate disease severity. RESULTS: The study found significantly higher total retinal parafoveal thickness and foveal density in FMS patients (p = 0.017 and p = 0.044, respectively). Nevertheless, there were no significant differences among the groups concerning total retinal foveal thickness, foveal avascular zone characteristics, superficial and deep capillary plexus densities, choriocapillaris flow area, and outer retinal flow area values (p > 0.05). The RNFL thickness in all quadrants did not reveal significant differences between the groups (p > 0.05). Furthermore, there was no significant correlation between FIQ scores and OCTA parameters or RNFL thickness values (p > 0.05). CONCLUSION: The study revealed slight differences in retinal parafoveal thickness and foveal density in FMS patients, but no substantial vascular or neurodegenerative alterations were observed compared to healthy controls. These data indicate that FMS may not substantially affect ocular structures, contrary to earlier hypotheses.

Exploring complex links: inflammatory rheumatic diseases and men's health.

This article examines the complex interactions between inflammatory rheumatic diseases (IRDs) and men's health. It delves into the effects of IRDs on reproductive health, erectile dysfunction, prostate involvement, male osteoporosis, body composition, physical activity, and coping mechanisms. The findings show that the prevalence of sexual dysfunction varies among different diseases, underscoring the necessity for comprehensive counseling. The link between IRDs and prostate health, with a substantial rise in benign prostatic hyperplasia among IRD patients, demonstrates the condition's importance. In contrast to popular belief, osteoporosis mostly affects women; the current study highlights the growing identification of male osteoporosis, particularly in the setting of IRDs. Male RA patients had a significant loss in bone mineral density, highlighting the importance of increasing awareness and tailored therapy to address osteoporosis in men. IRDs affect body composition, with male RA patients showing imbalances characterized by decreased lean body mass and increased fat mass. Given the dynamic nature of these conditions, coping with IRDs necessitates thorough and individualized diversified approaches. The complex link between IRDs and men's health demands continuing research, including longitudinal studies and tailored therapies. The essay promotes a patient-centered approach, recognizing the unique obstacles that males with IRDs confront.

Comparative analysis of the therapeutic effects of extracorporeal shock wave therapy and high-intensity laser therapy in lateral epicondylitis: a randomised clinical trial.

Lateral epicondylitis (LE) presents a substantial obstacle due to the pain and functional decline, frequently requiring non-surgical treatments. This study contrasts the efficacy of high-intensity laser therapy (HILT) and extracorporeal shock wave therapy (ESWT) in managing LE. A prospective, randomized comparative trial was conducted with 50 participants assigned to either HILT or ESWT groups. Both groups received standard physiotherapy (exercise program and LE bandages), and outcomes, including tenderness, Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder, and Hand scale (Q-DASH), and grip strength, were assessed at baseline, 3rd weeks, and 12th weeks. The baseline features of the groups exhibited similarities (p > 0.05). In intra-group comparisons, both HILT and ESWT groups exhibited significant enhancements in tenderness, VAS, Q-DASH, and grip strength (p < 0.05). In inter-group comparisons, the HILT group exhibited superior outcomes in tenderness reduction, pain alleviation, and disability improvement compared to the ESWT group (p < 0.05). Grip strength did not differ significantly across the groups (p > 0.05). Both HILT and ESWT, when combined with standard physiotherapy, showed effectiveness in treating LE. However, HILT demonstrated greater efficacy in terms of tenderness reduction, pain relief, and disability improvement. This study suggests that non-invasive techniques, particularly HILT, can be preferable for managing LE.

Post-stroke rehabilitation in the peri-pandemic COVID-19 era.

The coronavirus disease 2019 (COVID-19), which arose in late 2019, caused extensive destruction, impacting a substantial proportion of the worldwide population and leading to millions of deaths. Although COVID-19 is mainly linked to respiratory and pulmonary complications, it has the potential to affect neurologic structures as well. Neurological involvement may manifest as minimal and reversible; however, a notable proportion of cases have exhibited pronounced neurological consequences, such as strokes. Endothelial inflammation, hypercoagulation, renin-angiotensin-aldosterone system alterations, and cardiogenic embolism are the pathophysiological mechanisms of stroke under COVID-19 circumstances. Physical activity and exercise have improved several aspects of post-stroke recovery, including cardiovascular health, walking capacity, and upper limb strength. They are commonly used to assist stroke survivors in overcoming their motor restrictions. Furthermore, stroke rehabilitation can incorporate a range of specific techniques, including body-weight-supported treadmill applications, constraint-induced movement therapy, robotic rehabilitation interventions, transcranial direct current stimulation, transcranial magnetic stimulation, and prism adaptation training. Under pandemic conditions, there were several barriers to neurological rehabilitation. The most significant of these were individual's fear of infection, which caused them to postpone their rehabilitation applications and rehabilitation areas being converted into COVID-19 units. The primary emphasis had turned to COVID-19 treatment. Several valuable data and views were gained in reorganizing rehabilitation during the pandemic, contributing to establishing future views in this regard.

Nurses' roles, interventions, and implications for management of rheumatic diseases.

Nurses have become integral members of multidisciplinary teams in managing rheumatic diseases, departing from their traditional patient care roles. This article provides a comprehensive review of nurses' roles, interventions, and impacts in several rheumatic diseases, including rheumatoid arthritis, osteoarthritis, spondyloarthritis, gout, systemic lupus erythematosus, and polymyalgia rheumatica. It has been demonstrated that care under nursing supervision is effective and safe, with benefits including disease management, quality of life, and treatment adherence. In addition, nurses play a crucial role in promoting health, educating patients, and administering biological disease-modifying anti-rheumatic drugs. The COVID-19 pandemic has highlighted the significance of telehealth services and nurses' role in delivering remote care. However, nursing education and training challenges persist, particularly in standardization and access to postgraduate education. Efforts to enhance the role of nurses in rheumatology care are necessary to optimize patient outcomes and meet the evolving needs of individuals with rheumatic diseases. Collaboration across healthcare institutions, professional groups, and educational facilities is necessary for promoting the continual growth and advancement of rheumatology nurse practice. By equipping nurses with the requisite knowledge, expertise, and resources to deliver top-notch care, we can enhance the well-being of individuals with rheumatic diseases and foster improved overall health outcomes.

Knowledge, perceptions, and practices of axial spondyloarthritis diagnosis and management among healthcare professionals: an online cross-sectional survey.

Spondyloarthritis (SpA) is a group of inflammatory disorders, including axial SpA (axSpA), characterized by inflammation in the spine and sacroiliac joints. Healthcare professionals have a crucial role in diagnosing and managing axSpA. Assessing their knowledge, perceptions, and practices is essential to enhance patient care. The objective of this study is to evaluate these factors by conducting an online survey. This online survey was performed using SurveyMonkey.com to assess healthcare professionals' knowledge, perceptions, and practices related to axSpA diagnosis, management, and monitoring. The questionnaire included questions about definitions, management strategies, monitoring approaches, treatment options, and barriers to care. Convenience sampling was used, and the data were analyzed descriptively by Microsoft Excel. One hundred sixty-four healthcare professionals participated; most respondents were rheumatologists from various geographic locations (27 countries). Most participants were familiar with axSpA definitions and diagnostic criteria, demonstrating high expertise. Variations were seen in follow-up intervals and diagnostic preferences, reflecting clinical heterogeneity. Seventy-two (43.9%) individuals had a multidisciplinary team, frequently including rheumatologists, physiotherapists, and radiologists. Of the participants, 73 (44.5%) had online/telephone follow-up sessions. The pharmacological and non-pharmacological treatment approaches varied, pointing to the importance of personalized care. Glucocorticoid use varied among countries. Recognizing inflammatory back pain, interpreting radiographs, and diagnosing early was essential to medical education. This study provides beneficial data on healthcare professionals' knowledge, perceptions, and practices regarding axSpA. While diagnostic familiarity and multidisciplinary approach are positives, there is a potential to standardize management, improve telemedicine services, remove barriers to physical activity, and optimize treatment options.

YouTube as a Source of Information on Public Health Ethics.

BACKGROUND: Public health ethics (PHE) is a dynamic area within bioethics that addresses the complex moral implications of public health measures in the face of growing health threats. YouTube is a powerful and widely used platform for disseminating health-related information. The primary objective of this study is to assess videos related to PHE on YouTube. The aim is to gauge the extent of misinformation in collecting PHE videos on the platform. METHODS: On October 25, 2023, a thorough investigation on YouTube was undertaken, employing pre-determined search phrases involving 'public health,' 'healthcare,' 'health services administration,' and 'health policy and ethics.' The research encompassed a total of 137 videos that were selected according to strict inclusion and exclusion criteria. The videos were evaluated using the Global Quality Scale to measure quality and the modified DISCERN tool to evaluate reliability. The researchers identified video sources and compared several video attributes across different quality groups. RESULTS: A total of 137 videos were analyzed, and 65 (47.45%) were classified as high quality, 52 (37.23%) as moderate quality, and 21 (15.32%) as low quality. In high-quality videos, academic, government, physician, and university-hospital sources predominated, whereas Internet users and news sources were connected with low-quality videos. Significant differences in DISCERN score, per day views, likes, and comments were seen across the quality groups (P = 0.001 for views per day and P = 0.001 for other characteristics). According to the findings, low-quality videos had higher median values for daily views, likes, and comments. CONCLUSION: Although nearly half of the videos were high-quality, low-quality videos attracted greater attention. Critical contributors to high-quality videos included academic, government, physician, and university-hospital sources. The findings highlight the importance of quality control methods on social media platforms and strategies to direct users to trustworthy health information. Authors should prioritize appropriate citations and evaluate YouTube and other comparable platforms for potential promotional low-quality information.

Neuropathic arthropathy of the shoulder secondary to operated syringomyelia: a case-based review.

Neuropathic arthropathy (NA) is a long-term progressive disorder that causes joint destruction in the existence of a neurologic deficit. Minor injuries and fractures are commonly overlooked until the visible joint deterioration becomes persistent. Syringomyelia is one of the important causes of NA. The appearance of clinical signs in syringomyelia is caused by longitudinal cysts formed in the cervical and cervicothoracic regions of the spinal cord. Depending on the existence of the underlying disorder, the number and localization of the syrinxes, a range of symptoms, involving pain, sensation deficit, loss of motor function, and deep tendon reflex abnormality, emerge. The case is here described of a 68-year-old female patient with shoulder NA following syringomyelia, who partially responded to the rehabilitation program. Furthermore, the available case reports were comprehensively reviewed on Web of Science, Scopus, and PubMed/Medline. Furthermore, the available case reports were comprehensively evaluated on Web of Science, Scopus, and PubMed/Medline. Thus, we aimed to present the demographic characteristics, symptoms, physical examination signs, treatment, and follow-up parameters of syringomyelia-related shoulder NA cases.

The effectiveness of yoga as a form of exercise in the management of rheumatic diseases.

Yoga, a long-standing Indian tradition, has gained popularity globally, inspiring many different disciplines to employ it as a complementary treatment for various diseases. Yoga is primarily composed of numerous physical poses and positions that are coupled with breathing techniques, profound relaxation, and meditation. There are many types of yoga with varying levels of difficulty. Yoga, consisting of various poses and postures with distinct postural mechanics, is frequently highlighted as an exercise that improves both physical and mental health. Applying the proper techniques to yoga poses can boost balance, strength, and flexibility while also improving general health and quality of life. In addition to its physical benefits, it is recognized that yoga enhances an individual's mood, anxiety, and depression levels and their ability to deal with stress. Rheumatic diseases affect many different organs, particularly the musculoskeletal structures, and negatively impact patients' quality of life. Maintaining a sufficient level of exercise is essential to preserve and enhance physical function in addition to pharmaceutical therapy, the mainstay of rheumatic disease treatment. In treatment guidelines for many rheumatic diseases, exercise, and physiotherapy techniques are stressed as the most substantial component of non-pharmacological treatment. This review considered yoga a form of exercise outside of traditional practices. From this perspective, we aimed to summarize the efficacy of yoga practices on various rheumatic diseases. Additionally, we aimed to highlight possible mechanisms of action.

Evaluating the efficacy of hippotherapy: a promising intervention in rheumatology, pain medicine, and geriatrics.

Using animals for medical care has a long history. Animals have long been recognized for their ability to improve human health and well-being throughout nations and civilizations. Animal-assisted therapy is a concept that incorporates intentional and regulated interactions between individuals and animals to achieve therapeutic aims. Hippotherapy is an animal-assisted therapy consisting of medical procedures and practices that use horses to restore and enhance physical and mental health. The effectiveness of hippotherapy is evidenced by its ability to have a favorable influence on various domains, encompassing physical, psychosocial, and educational aspects. This multifaceted method entails the active involvement of the sensory, musculoskeletal, vestibular, and visual systems. Hippotherapy is an unconventional modality, leveraging horses' cyclic and repetitive motions to activate the postural reflex structures of individuals. Various studies have mostly focused on determining the efficacy of hippotherapy in the context of neurological conditions, neuro-rehabilitation, and psychiatric disorders. The primary objective of this study was to present the effectiveness of hippotherapy in the fields of rheumatology, pain medicine, and geriatrics. In addition, we provided a summary of the potential underlying mechanisms of hippotherapy. Finally, we conducted a comparison of hippotherapy and horse riding simulator interventions to provide their respective strengths and restrictions.