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    THE EFFECTS OF THE LEVEL OF SPINAL CORD INJURY ON LIFE SATISFACTION AND DISABILITY
    (Literatura Medica, 2020) Karatas, Gulsah; Metli, Neslihan; Yalcin, Elif; Gunduz, Ramazan; Karatas, Fatih; Akyuz, Mufit
    Introduction - Spinal Cord Injury (SCI) may often lead to significant disability in affected individuals and reduce life satisfaction. Herein we aimed to investigate the effects of the level of injury on disability and life satisfaction as well as the relation between life satisfaction and disability. Methods - Patients with at least one-year history of SCI were included. Demographic-clinical data of patients were recorded. The Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) was used for quantifying the degree of patients' disability. Life satisfaction was assessed by the Satisfaction with Life Scale (SWLS). Results - Of the 76 patients, 21 (27.6%) were tetraplegic and 55 (72.4%) were paraplegic. SWLS was found to be similar in tetraplegic vs. paraplegic patients (P=0.59), whereas CHART parameters such as physical independence, mobility, occupation, and total CHART value were significantly higher in paraplegic patients (P=0.04, P=0.04, P=0.001 and P=0.01, respectively). Social integration was found similarly high in both groups. There was a positive correlation between elapsed time after the injury and CHART physical independence, occupation and the level of economic sufficiency (P<0.01, P<0.01, P=0.01). Excluding the economic sufficiency (P=0.02), there was not any other association between the rest of CHART parameters and SWLS. Conclusions - According to our findings, although the level of injury seems to be influential on disability, it seems to have no significant effect on life satisfaction. Since the only thing that positively affects life satisfaction is economic sufficiency, more emphasis should be placed on regulations that increase the return to work in patients.
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    Midodrine treatment in a patient with orthostatic hypotension associated with spinal cord injury
    (2018) Karataş, Hatice Gülsah; Metli, Neslihan; Yalçın, Elif; Akyüz, Müfit; Kaymaz, Tuğba İkiz
    Orthostatic hypotension (OH) is an important clinical issue that may adversely affectthe rehabilitation process in patients with spinal cord injury (SCI). In some clinical situations whereOH is nonresponsive to non-pharmacological approaches, it may be beneficial to use midodrine forthe treatment of OH, which is a potent vasoconstrictive agent. A 62-year-old male patients with C4AIS C chronic spinal cord injury, he have OH associated with spinal cord injury admitted to hospitalfor the long term rehabilitative care. Rehabilitation program couldn’t be maintained as a resultof OH. Midodrine therapy was started to remove the OH. OH was completely improved withmidodrine therapy and the patient was finally able to sit. During the treatment, rate of AutonomicDysreflexia (AD) was increased, hence, the midodrin dosage was lowered to the level at which theAD was at least seen, and the treatment continued. The patient then was discharged from the hospitalat a wheelchair-dependent level. The midodrine was observed to be effective for the treatmentof OH in patients with SCI. AD, however, should be kept in mind that its frequency may increasesas a side effect of midodrine therapy.