Objective: To determine the frequency and severity as well as the diagnosis and treatment of overactive bladder problems in patients with multiple sclerosis (MS) followed up at five centers in Turkey. Design: Survey study. Setting: Outpatient tertiary clinics of physical medicine and rehabilitation and neurology. Participants: Consecutive MS patients scheduled for outpatient follow-up (n = 309). Intervention: MS patients were asked to complete a questionnaire regarding the frequency and severity, as well as the diagnosis and treatment of their overactive bladder problems. Results: The mean age ± SD was 39.3 ± 10.6 years. Urinary urgency was the most common urinary symptom (62%), followed by frequency (50.4%), urge incontinence (44.7%) and nocturia (33%). Residual urine volume was measured using a portable ultrasound instrument in 13.3% of the patients and by catheterization in 16.2% of them. Urodynamic investigations and urinary tract ultrasound were performed on 26.5% and 35.3% of the patients, respectively. Anticholinergic medications were prescribed for 27.5% of the patients. Intermittent catheterization and indwelling catheterization were used on 8.1% and 1.9% of the patients, respectively. The overactive bladder symptom score (OABSS) was significantly higher in patients who had had residual urine measurement (P < 0.001), upper urinary tract assessment by ultrasound (P < 0.001), urodynamic assessment (P < 0.001), admitted to a doctor for urinary symptoms (P < 0.001), and current or past catheter use (P = 0.002). Conclusion: Urgency was the most common urinary symptom followed by frequency, urge incontinence and nocturia in MS patients. The patients with lower OABSS had detailed urological assessments less frequently than the patients with higher OABSS.
To identify any structural differences in macular choroidal thickness in migraine patients and compare them with that of control subjects by using spectral domain optic coherence tomography (SD-OCT). In this prospective study, choroidal thicknesses of 32 migraine patients during migraine attack-free period and 32 age- and sex-matched healthy subjects were measured using SD-OCT. All patients underwent a complete ophthalmic examination before the measurements. The migraine patients were classified into the migraine with aura group or the migraine without aura group. Migraine severity was assessed by visual analog scale (VAS), migraine disability questionnaire (Migraine Disability Assessment Score (MIDAS), and Wong-Baker faces pain rating scale. Thirty eyes of 32 subjects (31 female and 1 male) in the migraine group and 32 eyes of 32 subjects (31 female and 1 male) in control group were evaluated. In the study group, 16 patients suffered migraine without aura (MWA) and 16 patients were diagnosed as migraine with aura (MA). The mean subfoveal choroidal thickness (SFCT) was 353.3 ± 66.5 μm in the control group versus 304.3 ± 72.9 μm and 276.1 ± 61.4 μm in MWA and MA groups, respectively. The difference in SFCT between the migraine patients and the controls was significant (p < 0.001). Additionally, a moderate correlation was found between SFCT and the VAS score and W baker score (r = 0.48, p = 0.008 and r = 0.43, p = 0.02, respectively). The choroidal thickness was found to decrease significantly not only in migraine patients with aura but also in those without aura during the attack-free period.
Brainstem inhibitory and excitatory interneuronal activity is altered in ALS, possibly brought about by physiological and morphological changes at the cortical or bulbar levels. Muscle Nerve 56: 925-929, 2017.
It is required to determine the factors that are dangerous in terms of occupational health and safety in hazardous waste disposal facilities, which is an area where multidisciplinary work is required. It is also needed to find solutions for preventing risks that may cause. In this study; probability, severity and frequency criteria were used as decision criteria and the importance weights of these criteria were determined with fuzzy analytical hierarchy process. Then, 46 risks identified for the five main processes such as entry of waste to the plant, waste analysis, intermediate storage of hazardous waste, disposal of hazardous waste, and auxiliary facilities; were evaluated by fuzzy TOPSIS method according to decision criteria and prioritized according to their level. It is found that the highest priority risks for all sub-process are “fire and explosion”.
Bu çalışmada engelli bireylerin toplumsal hayata entegrasyonunda kent yapılanmasının ve çevre düzenlemesinin rolü incelenmiştir. Araştırma Konya ilinde gerçekleştirilmiştir. Toplam yirmi engelli bireyle görüşülmüştür. Araştırma nitel desenli yapılmıştır. Ayrıntılı literatür taramasından sonra yarı yapılandırılmış on üç sorudan oluşan yarı yapılandırılmış soru formu hazırlanmıştır. Araştırmada görüşmecilere büyük oranda Konya Ortopedik Engelliler Derneği ve Konya Görme Engelliler Derneğinde ulaşılmıştır. Katılımcılardan 7'si Kadın 13'ü Erkektir. Araştırmaya katılanlarla derinlemesine görüşme yapılmış ve onların kent deneyimleri incelenmişti., Görüşmeler izin alınarak kayıt altına alınmıştır, kayıtlar deşifre edilmiş N-vivo programıyla temalara ve alt temalara ayrılarak analiz edilmiştir. Araştırmada engelli bireylerin yeterince sosyalleşememeleri onların engel durumundan kaynaklanmadığı, şehir düzenlemelerinin onları göz ardı ederek yapılanmasından kaynaklandığı verilerine ulaşılmıştır. Modern dönemin tanımlamış olduğu "normal birey" göz önünde bulundurularak şehir düzenlemelerinin yapıldığı bu "normalin" dışında kalan engelli bireylerin göz ardı edildiği görüşü yapılan görüşmelerle desteklenmiştir Engelli bireylerin yaşadıkları sıkıntılar büyük oranda kent düzenlemelerine dair kanunların yetersiz olması ve çevre düzenlemeleri ile ilgili mevcut kanunların uygulanmasının yetersiz olmasıdır. Engelli bireylerin sosyal adalet ve sosyal eşitlik düzleminde haklarından haberdar olmamaları ya da haklarını savunamamaları da kanunların engellileri gözeterek düzenlenmesini ve de uygulanmasını zorlaştırmaktadır. Engelli bireylerin kent düzenlemelerine dair ihtiyaç duydukları unsurlar engel türlerine göre çeşitlilik göstermektedir.
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