INTRODUCTION: This study aimed to compare the effects of general anesthesia (GA) and interscalene brachial plexus block (ISB) on clinical outcomes following arthroscopic single-row or double-row repair of crescentic rotator cuff tears.
METHODS: This retrospective cohort study included 80 patients (46 women, 34 men; mean age, 66.7 years) who underwent arthroscopic repair for crescent-shaped full-thickness rotator cuff tears. Patients were divided into GA (n=40) and ISB (n=40) groups. Tears were classified according to the Cofield classification. Functional outcomes were assessed using Constant-Murley, ASES, and UCLA scores, along with joint range of motion (JROM) and visual analog scale (VAS) pain scores. Evaluations were performed at 6 and 18 months postoperatively.
RESULTS: At 6 months, Constant-Murley, ASES, and UCLA scores were significantly higher in the ISB group than in the GA group. No significant differences were observed between the groups at 18 months. Both groups showed significant improvement over time. JROM and VAS scores were similar between the groups. Demographic variables and repair type had no significant effect on outcomes.
DISCUSSION AND CONCLUSION: ISB was associated with improved short-term functional outcomes following arthroscopic rotator cuff repair. Long-term clinical results were comparable to those achieved with general anesthesia.

INTRODUCTION: Falls in geriatric populations may result in significant injury and subsequent functional decline, thereby diminishing overall quality of life. Therefore, accurate assessment of fall risk and comprehensive identification of contributing factors are of fundamental importance, particularly within geriatric populations.
METHODS: Geriatric patients admitted to the inpatient Physical Therapy and Rehabilitation unit were enrolled in the study. Data were collected on patients’ age, sex, height, weight, educational status, medications potentially associated with falls, and assistive devices used during ambulation. Cognitive function was evaluated using the Hodkinson Abbreviated Mental Test. All participants underwent assessment with the Functional Ambulation Category (FAC), the Berg Balance Scale (BBS), and the Falls Efficacy Scale (FES). Patients were additionally ques-tioned regarding visual impairments; urinary symptoms; nutrition-related risk factors; psychological complaints; and environmental hazards in the home that might elevate fall risk. Observations were also made to identify risky behaviors during mobility and transfers. Participants were subsequently categorized into two groups based on their fall history, and differences in these variables were analyzed between the groups.
RESULTS: A total of 54 patients aged 65 years and older were included in the study. Patients were categorized into two groups: fallers and non-fallers. A significant difference in the female-to-male ratio was observed between the two groups (p=0.002). While no significant differences were observed between the two groups in terms of age, height, weight, cognitive status, FAC, or FES scores, the faller group demonstrated significantly lower BBS scores and a higher frequency of mobility- and transfer-related risky behaviors (p=0.013, p=0.012).
DISCUSSION AND CONCLUSION: This study found that fall risk in geriatric patients was significantly associated with reduced balance and risky behaviors during mobility and transfers. The results underscore the need for systematic fall-risk assessment, close supervision, and balance-focused interventions in inpatient rehabilitation to reduce falls and support prevention strategies after discharge.

INTRODUCTION: In Türkiye, a triage system based on a 3-color code (red: very urgent, yellow: urgent, green: non-urgent) is mandatory in all public hospitals. This study aimed to analyze the triage codes assigned to confirmed COVID-19 patients according to their outcomes to test the reliability of the triage system. Our study provides data on our triage system, whose reliability has not been tested before.
METHODS: Patients with positive PCR tests who were admitted to the emergency department between March 15 and December 31, 2020, were included in the study. Assigned triage codes and outcomes were analyzed retrospectively.
RESULTS: Of the 7040 patients, 4176 (59.3%) were coded as ‘green’ and 333 (4.7%) were coded as ‘red’ at triage. The sensitivity of green triage for recovery was 60.29%, and the specificity was 78.78%. The sensitivity of red triage for critical outcomes and mortality was 57.14%, and the specificity was 96.59%. Being over 58 years old, regardless of gender, was a predictive factor for critical outcomes and mortality.
DISCUSSION AND CONCLUSION: Based on this study, it is possible to state that the ‘Turkish Triage System’ is successful in recognizing patients in critical situations, but its performance in distinguishing cases with recovery is moderate in the COVID-19 patient group.

INTRODUCTION: Shoulder pain is the most common cause of upper extremity pain. This study aimed to comparatively investigate the effects of low-intensity laser and ultrasound therapy on pain and functionality.
METHODS: Our study included 60 patients who presented to our outpatient clinic with shoulder pain and limited range of motion. The study was designed as a randomized, prospective, single-blind trial. Patients were randomly assigned to two groups. Both groups received TENS (transcutaneous electrical nerve stimulation), a hot pack, and medical treatment (diclofenac sodium 75 mg once daily). Ultrasound (US) treatment was administered at a dose of 1.5 W/cm² for 5 minutes, and laser therapy was applied at 2000 Hz, 0.6 J/cm², and 905 nm for 6 minutes. The treatment consisted of 10 sessions over 2 weeks. Evaluations were conducted before treatment, immediately after treatment, and at 3 months. During assessments, VAS (visual analog scale) scores during sleep, movement, and rest and active-passive range of motion (ROM) measurements were used. The Constant and UCLA scoring systems were used for shoulder function assessment.
RESULTS: Both groups demonstrated significant improvements in pain, ROM, and functional scores compared with baseline (p<0.05), with effects maintained at 3 months. No significant between-group differences were observed in VAS pain scores or ROM values (p>0.05). However, the US group showed significantly greater improvement in the Constant score compared with the LLLT group (p<0.05).
DISCUSSION AND CONCLUSION: This study found that both low-level laser therapy and therapeutic ultrasound were effective in reducing pain and improving range of motion in patients with shoulder pain. Therapeutic ultrasound demonstrated superior efficacy compared with laser therapy in restoring shoulder function. Ultrasound therapy can also be considered an effective and reliable treatment method for shoulder pain.

INTRODUCTION: Medication Overuse Headache (MOH) is a secondary headache that develops due to the use of analgesic treatment for more than three months, exceeding 10–15 days per month, depending on the medication used. Patients with MOH are more likely to experience sleep disorders, such as chronic insomnia, compared with those without such disorders, which negatively impacts their quality of life.
METHODS: This study was a retrospective, single-center observational study conducted at the Neurology Clinic involving 23 patients diagnosed with MOH and treated with a greater occipital nerve (GON) block. Patients over 18 years of age who met the ICHD-3 criteria for MOH were included in the study. For each patient, the average monthly headache frequency over the three months following the injection, Epworth Sleepiness Scale (ESS) scores, and subjective sleep quality assessments were recorded.
RESULTS: Among the participants, the number of days with pain decreased in 18, increased in 1, and remained the same in 4. A statistically significant difference was found when comparing the number of painful days before and after the procedure. In 7 participants, the ESS score decreased after the procedure, while in 16, it remained the same. A statistically significant difference was found when comparing the ESS scores before and after the proce-dure.
DISCUSSION AND CONCLUSION: GON block is an effective, low-cost, accessible, and safe procedure that can be used in the treatment of MOH. Our findings demonstrate a reduction in the number of headache days and daytime sleepiness.

Lyme disease is a zoonotic infection caused by the spirochete Borrelia burgdorferi, which can affect multiple organs, including the skin, joints, heart, and central nervous system. Neurological involvement that typically appears within the first few months after a tick bite is referred to as neuroborreliosis. In this paper, we present a case of neurob-orreliosis with concurrent involvement of the trigeminal nerve, peripheral facial nerve, and partial cauda equina. A 32-year-old male patient presented with complaints of facial numbness, difficulty walking, and loss of sensation in the perianal region. Brain and spinal magnetic resonance imaging (MRI) revealed no pathological findings. Cerebrospinal fluid (CSF) analysis showed elevated protein levels, and Borrelia burgdorferi IgM antibodies were positive. After the patient was treated with intravenous ceftriaxone, significant improvement in clinical symptoms was observed. This case is important because it demonstrates that neuroborreliosis can present with rare neurological findings, such as cranial neuropathy and cauda equina syndrome.