Sedef Ersoy

Background: Nail technicians face significant risks of musculoskeletal disorders due to ergonomic challenges. Nail technicians’ working conditions and health risks can be evaluated to develop strategies that enhance their well-being. Objective: This study assesses the working conditions, occupational symptoms, and potential risk factors for musculoskeletal disorders among nail technicians. Methods: This cross-sectional study involved 35 female nail technicians. Data were collected through interviews, pain assessments, occupational details, the Nordic Musculoskeletal Questionnaire, and the Quick Exposure Check (QEC) for ergonomic risks. Results: A significant proportion of technicians reported respiratory issues (37.1%), skin problems (14.2%), and musculoskeletal pain, particularly in the neck (51%), upper back (57%), and lower back (31%). QEC levels showed that back static positions and neck and wrist/hand exposures were in the “very high risk” category, while shoulder/arm exposures were classified as “high risk”. Neck and static back QEC scores were significantly correlated with weekly working hours and years of experience (r = 0.828, p < 0.001), and reported pain was strongly linked to QEC risk scores for these areas (r = 0.944, p < 0.001). Conclusions: The findings regarding nail technicians’ working conditions and health risks underscore the necessity for ergonomic training and workplace modifications to mitigate these risks. Early intervention is essential to prevent chronic work-related disorders and improve technicians’ health and quality of life.

To compare central sensitization (CS), pressure pain threshold (PPT), and psychosocial factors between women with lipedema and healthy controls and to identify variables associated with CS in lipedema. In this cross-sectional study, 30 women with clinically diagnosed lipedema and 30 age-matched healthy controls were assessed.CS was measured with the Central Sensitization Inventory (CSI), and PPT was recorded bilaterally at the deltoid, lateral thigh, and medial knee using an algometer, pain-related cognitions with the Pain Catastrophizing Scale (PCS), and mood with the Hospital Anxiety and Depression Scale (HADS). Compared with controls, the lipedema group had lower PPTs at all sites (all p ≤ 0.001) and higher CSI scores (p ≤ 0.001). CS prevalence (CSI ≥ 40) was 70.0% in lipedema versus 23.3% in controls (p≤ 0.001). HADS-Depression (p = 0.001), HADS-Anxiety (p = 0.017), and PCS helplessness, magnification, rumination, and total scores (all p ≤ 0.006) were higher in lipedema. In the total sample, CSI correlated negatively with all PPT values (all p ≤ 0.003) and positively with HADS-Depression/Anxiety and PCS scores (all p < 0.001). In multivariable analysis among patients with lipedema, higher CSI was associated with greater BMI (β = 1.117, p=0.018), hypertension (β = 15.918, p = 0.009), diabetes mellitus (β = 16.663, p = 0.002), higher VAS pain (β = 0.368, p = 0.002), lower right medial knee PPT (β = - 3.891, p = 0.011), and higher HADS-Depression (β = 1.307, p = 0.038). Lipedema is associated with lower pain thresholds and higher CS, alongside greater depressive and anxiety symptoms and pain catastrophizing. CS in lipedema appears linked to pain intensity, depressive symptoms, and cardiometabolic comorbidities. These findings suggest that management should complement peripheral approaches with strategies targeting central pain mechanisms and psychosocial factors. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Objective: This study aimed to investigate the relationship between nutritional status, assessed by the Controlling Nutritional Status (CONUT) score, and functional recovery in patients with stroke undergoing inpatient rehabilitation. Methods: A total of 113 patients diagnosed with stroke were included in this observational study. Nutritional status was evaluated using the CONUT score, and functional independence and baseline disability were assessed with the Modified Barthel Index (mBI) and the Modified Rankin Scale (mRS) at admission. Functional independence was reassessed with the mBI at discharge. Patients were divided into four groups based on their CONUT score: normal, mild, moderate, and severe malnutrition risk. Results: According to CONUT classification, 37.2% of patients were normal, 46.0% were at mild, 13.3% at moderate, and 3.5% at severe risk of malnutrition. A weak positive correlation was found between CONUT score and age (r = 0.186, p = 0.049). CONUT score was negatively correlated with vitamin D (r = –0.212, p = 0.024), albumin (r = –0.636, p < 0.001), total protein (r = –0.387, p < 0.001), LDL (r = –0.445, p < 0.001), and total cholesterol (r = –0.444, p < 0.001). Within-group comparisons showed significant improvement in mBI scores from admission to discharge in the normal (p < 0.001), mild (p < 0.001), and moderate (p = 0.024) groups, but not in the severe malnutrition group (p = 0.317). Conclusions: Although no statistically significant association was found between the CONUT score and mBI outcomes, patients with better nutritional status showed a clinical trend toward greater functional improvement during rehabilitation, whereas those with severe malnutrition demonstrated limited gains. These findings should be interpreted cautiously due to the very small number of patients in the severe malnutrition group. Early screening and appropriate nutritional management using objective tools such as the CONUT score may still support rehabilitation planning in stroke patients.

Quality of Life Outcomes in Lower Extremity Lymphedema After Manual Lymphatic Drainage Therapy - Bagcilar Medical Bulletin

SUMMARY OBJECTIVE: Chronic edema in the lower extremities leads to significant negative effects on the quality of life, body image perception, satisfaction, self-confidence, and self-esteem of affected individuals. The aim of this study was to evaluate body image, quality of life, and related factors in patients with chronic lower extremity edema due to lymphedema and lipedema. METHODS: This cross-sectional study included 14 lymphedema and 12 lipedema patients receiving treatment at the lymphedema unit. Individuals aged 18–65 years with a confirmed diagnosis were enrolled; those with active infections, malignancies, or systemic diseases were excluded. Body image, dysfunctional thoughts about appearance, and quality of life were evaluated using the Body Cathexis Scale, Beliefs About Appearance Scale, and Lymphedema Quality of Life scale. Circumference measurements of the lower extremities were taken before and after 20 sessions of manual lymphatic drainage therapy. Quantitative data were analyzed to compare the two groups and assess correlations between clinical and psychosocial parameters. RESULTS: No significant differences were observed between the lymphedema and lipedema groups in terms of age, body mass index, or pre-treatment Body Cathexis Scale, Beliefs About Appearance Scale, and Lymphedema Quality of Life scale scores (p>0.05). After 20 sessions of manual lymphatic drainage therapy, both groups showed reductions in limb circumference measurements (p<0.05). Reductions in limb size were moderately associated with improvements in Body Cathexis Scale and Lymphedema Quality of Life scale scores (p<0.05). Post-treatment improvements in body image and quality of life scores were observed in both groups. CONCLUSIONS: This study highlights that patients with lower extremity lymphedema and lipedema experience significant body image disturbances and reduced quality of life. Manual lymphatic drainage therapy improves limb circumference, body image, and quality of life.

This study aimed to adapt the Rehabilitation Complexity Scale-Extended (RCS-E) for use in Turkish and assess its validity and reliability in patients with hemiplegia due to vascular stroke. We reviewed the medical records of 102 patients hospitalized for rehabilitation following ischemic or hemorrhagic stroke. The complexity of rehabilitation needs was assessed using the RCS-E. Validity was determined by analyzing correlations between RCS-E scores and the mBarthel Index, mRankin Scale, and Functional Independence Measure (FIM) scores. Intrarater and interrater reliability were evaluated using the intraclass correlation coefficient (ICC) and Cronbach’s alpha. Two experienced rehabilitation specialists performed assessments one week apart. The ICC values for the RCS-E subscales ranged from 0.960 to 0.985, with a total score ICC of 0.987, indicating excellent intra-rater reliability. The inter-rater reliability ICCfor the total score was 0.858, reflecting high reliability. The Cronbach’s alpha value for the total score was 0.870, signifying high internal consistency. Significant positive correlations were found between the RCS-E scores and mBarthel Index (r = -0.611), motor FIM (r = 0.659), cognitive FIM (r =-0.481), and total FIM (r =-0.661) scores, while a negative correlation was observed with the mRankin Scale (r = 0.647; p < 0.001 for all).The Turkish version of the RCS-E is a valid and reliable tool for assessing rehabilitation needs in stroke patients with hemiplegia. It effectively guides rehabilitation planning and improves service quality. Keywords: Rehabilitation; Stroke; Hemiplegia;Validation Study

SUMMARY OBJECTIVE: The aim of the study was to investigate the prevalence of insomnia in postmenopausal osteoporotic women. It also evaluated the relationship between insomnia, fatigue, and mood disorders. METHODS: This cross-sectional study was conducted with 200 postmenopausal osteoporotic women aged 50–75 years. Insomnia severity was assessed using the Insomnia Severity Index, while fatigue and mood disorders were measured using the Fatigue Severity Scale and the Hospital Anxiety and Depression Scale, respectively. The participants were divided into two groups based on the Insomnia Severity Index scores, using a cutoff of 15. We then analyzed the clinical characteristics of these two groups, focusing on the relationship between insomnia severity and factors such as fatigue, anxiety, depression, and bone mineral density. RESULTS: Among the participants, 20.5% were clinically diagnosed with insomnia (Insomnia Severity Index≥15). Sleep initiation difficulties were reported by 73.5%, sleep maintenance difficulties by 57.5%, and early awakening by 45%. Insomnia severity was significantly correlated with higher levels of fatigue (r=0.342, p<0.001), depression (r=0.297, p<0.001), and anxiety (r=0.323, p<0.001). There was no significant correlation between insomnia and bone mineral density or T-scores. CONCLUSION: Insomnia is common in postmenopausal osteoporotic women and is closely linked to higher fatigue, anxiety, and depression levels. Early detection and management of insomnia in this population are essential to reduce fall risk and prevent fractures.

The Effect of Smoking on the Functional Gain After Inpatient Rehabilitation in People with Spinal Cord Injury - Medical Journal of Bakirkoy