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    General approach to diabetic neuropathy
    (2020) Uzuner, Bora; Ketenci, Sertaç; Salbaş, Ender
    Diabetic neuropathy is the most common complication of diabetes mellitus. It causes microvascular and macrovascular damage and diagnosis can easily be overlooked by most physicians. Generally, the diagnosis of DN can be omitted by physicians dealing with diabetes treatment since it starts with non-specific findings, shows slow progression and can be confused with complaints in many diseases. It is estimated that there will be 578 million people diagnosed with DM in the world in 2030. Chronic hyperglycemia, microvascular insufficiency, oxidative and nitrosative stress, impaired neurotropism and autoimmunity are some of the factors that cause nerve destruction. Paresthesias such as tingling, burning, electrical shock-like sensations, numbness, throbbing, compression, pinpricks to the skin, complaints are the most common symptoms. There is no treatment for pathogenetic mechanisms in diabetic neuropathy that eliminates neuronal damage. The purposes of treatment are slowing down the progression of the disease, controlling the pain, preventing complications, quick and adequate treatment of occurred complications, maintaining the functional capacity of the patient. In this review, we aimed to comprehensively address the general approach to diabetic neuropathy, diagnosis and treatment.
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    The attitudes of Turkish physicians in the treatment of fibromyalgia; is Pregabalinophobia the new reality of pain medicine?
    (Kare Publ, 2022) Ketenci, Sertac; Golboyu, Birzat Emre; Salbas, Ender; Uzuner, Bora; Ciftci, Bahadir
    Objectives: This study aims to determine the treatment preferences of physicians interested in fibromyalgia treatment and to investigate their hesitations about prescribing pregabalin. Methods: Our survey study was conducted between February 5 and 20, 2021. The survey forms were sent to the known email addresses and phone numbers of 1569 physical medicine and rehabilitation (PMR), algology, and rheumatology physicians. The replies to the surveys were checked for possible resubmissions. The pooled data were evaluated with the SPSS 22.0 statistical package program. Frequency distributions were calculated and presented as n, %. Results: Four hundred and six PMR, rheumatology, and algology specialists fulfilled the study forms. About 59.0% of physicians stated that they prefer duloxetine as the first-line agent of fibromyalgia syndrome (FMS) treatment. Pregabalin was only 6.0% of the physicians' first choice for FMS. About 35.0% of the participating physicians stated that the PMR department should follow up FMS patients. About 44.3% of the participants noted that they refer FMS patients to other departments which interested in FMS treatment and do not want to follow-up FMS patients. About 81% agreed that pregabalin causes addiction. About 36.7% stated that at least 20% of the patients could abuse pregabalin and 97.8% of physicians stated that they were prejudiced about prescribing pregabalin to prisoners. Approximately two of the three physicians experienced an act of violence in their hospital regarding pregabalin prescribing. Conclusion: These data showed that the Pregabalinophobia should be accepted. This condition is associated with life safety concerns of the physician not only from unreliability of the drug. It seems that the doctors have valid reasons to develop this prejudice.