Objectives: The aim of the present study was to examine the presence of fibromyalgia (FM) in elderly adults and to evaluate the impact of the severity of FM on quality of life.
Methods: A total of 100 patients between 65 and 80 years of age were included. The main admission diagnosis of the patients was recorded. Presence of FM was evaluated based on 1990 American College of Rheumatology (ACR) diagnostic criteria. The FM group was comprised of 31 patients fulfilling these criteria, and the remaining 69 patients composed the non-FM group. Tender point count (TPC) and common symptoms were recorded. FM disease severity was assessed using Fibromyalgia Impact Questionnaire (FIQ). Nottingham Health Profile (NHP) was used to evaluate quality of life. Pain severity was measured using Visual Analog Scale (VAS).
Results: Rate of FM was found to be 31%. FM patients scored significantly higher on pain, sleep, social isolation, and emotional reactions subgroups of NHP when compared to controls (p<0.05). TPC and FIQ were not affected by gender difference (p>0.05), but reduced with increasing age (p<0.01). FIQ and TPC were found to be correlated with only the pain and emotional reactions subgroups of NHP (p<0.01). There was no statistically significant correlation between FIQ and TPC and the physical mobility, sleep, energy, and social isolation subgroups of NHP (p>0.05).
Conclusion: Although FM is known as a disease of young and middle-aged women, our study indicates that its prevalence increases with age. FM is associated with poor quality of life in terms of pain, sleep, social, and emotional functions.

Objectives: Pain is one of the most important symptoms in palliative care, and has a major impact on the quality of life of cancer patients. In developing countries, difficult access to opioids and the lack of well-established palliative care organizations result in undertreatment of pain. Turkey is one of the countries with statistical evidence of inadequate morphine consumption per capita. In 2010, the adequacy of opioid analgesic consumption was only 7%, based on a per capita consumption of 14.31 mg morphine equivalents. The present study analyzed and described patterns of opioid use among cancer patients in the palliative care clinic.
Methods: The data of 418 cancer patients who received palliative care at the palliative care clinic in 2014 were evaluated retrospectively.
Results: Of the total, 183 (44%) of the patients studied were female and 235 (56%) were male. Age ranged from 18 to 93 years (61±15 years). No opioids had been prescribed for 9% of patients, 26% of patients were using weak opioids, and 65% were using strong opioids. Daily oral morphine equivalent dosage per patient was 172±58 mg (range: 40–328 mg). Indications for opioid use were pain (61%), dyspnea (19%), and both dyspnea and pain (20%).
Conclusion: Although there is a limited variety of opioids currently available in this country, it is thought that a more effective and adequate level of pain management can be obtained through education of health practitioners about pain management and opioid use. The relatively high incidence of weak opioid use may be associated with the lack of available rapid release opioids in the country.

Objectives: This study sought to evaluate pain severity and pain management methods of patients with carpal tunnel syndrome.
Methods: This descriptive study was conducted with patients who were diagnosed with carpal tunnel syndrome (n=99) in the neurology clinic of the university hospital between August 2014 and December 2015. Patient data form, visual analog scale (VAS) and a pain management inventory were used to collect data.
Results: Of the total, 64.6% of the patients experienced pain. Patients used prescription medication, massage, and exercise to control pain, and reported that the most useful method was exercise, followed by massage and, finally, prescription medication.
Conclusion: Healthcare professionals may share the findings of relative benefit according to method of pain management and encourage patients to use non-pharmacological methods.

Objectives: The present study sought to compare the analgesic efficacy and adverse effects of intravenous (IV) lornoxicam and tramadol to investigate if lornoxicam is a reasonable alternative to a weak opioid for post-thyroidectomy pain.
Methods: Fifty patients of American Society of Anesthesiologists class I or II, 18 to 65 years of age, and who underwent thyroidectomy were assigned to 2 groups in a randomized manner. Group L received 8 mg of lornoxicam IV and Group T received 1 mg/kg of tramadol IV at conclusion of the operation. Pain intensity of patients was recorded at 15 and 30 minutes, and at 1, 2, 3, 4, 6, 12, and 24 hours after the initial dose with Numerical Rating Scale (NRS) and Ramsey Sedation Scale. Electrocardiogram, heart rate, systolic/diastolic and average artery pressure and peripheral oxygen saturations were monitored continuously during this period. Patients completed satisfaction questionnaires at 24th hour.
Results: Both drugs produced acceptable analgesia; however, significantly fewer patients reported 1 or more adverse events with lornoxicam than with tramadol. Most commonly seen in Group T was nausea/vomiting. NRS scores at 15 minutes, 30 minutes, and 1 hour were lower in Group L than in Group T (p<0.05), but there was no significant difference between groups after postoperative first hour. First analgesic requirement time was significantly longer in Group L compared to Group T (p<0.001). No serious complications were seen in either group.
Conclusion: Lornoxicam is a safe and effective analgesic that may be used with fewer complications than low-dose tramadol for treatment of moderate to severe postoperative pain.

In recent years, brachial plexus anesthesia techniques for upper limb surgery have been used more and more commonly on children; however, the patient is typically under deep sedation or general anesthesia. For eligible, cooperative children, surgery can also be performed using regional blocks while the patient is awake. We present 5 cases in which Ultrasound (US)-guided infraclavicular brachial plexus blocks (ICB) were used on children for hand or forearm surgery. Surgical anesthesia was achieved in all patients and surgery was completed uneventfully using brachial plexus anesthesia, without need for deep sedation.

Cancer is frequently seen in women of reproductive age. Diagnosis, management of treatment, and safety of the therapeutic approach are particularly important for these patients. Presently described is pain management in a case of pregnancy with malignant mesenchymal tumor. A 23-year-old woman in 30th gestational week presented with severe pain in right hip and back of the right thigh. Piriformis block successfully decreased pain and was followed by pulsed radiofrequency (PRF) to the piriformis muscle. PRF, as a non-neurodestructive method, is a safe and effective method to treat cancer pain in a pregnant patient.

The syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL), is a rare, benign, self-limiting syndrome that is not well known. Cerebrospinal fluid examination (CSF) on clinical suspicion has diagnostic value for this syndrome, which has a rich neurological symptomatology that can mimic many diseases causing mortality and morbidity. Although the ethiopathogenesis of this syndrome is not fully known, autoimmunity is thought to be in the foreground. Described in this article is a HaNDL case that on first clinic presentation appeared to be a transient ischemic attack (TIA) with temporary but recurring neurological findings and normal CSF pressure accompanied by papilledema. Clinical features, epidemiology, ethiopathogenesis, differential diagnosis, and treatment of this syndrome are reviewed according to the literature.

This is a letter to editor and it does not require an abstract.