Assessment of pain, stiffness, fatigue, and lower-extremity involvement as well as asking for a history of falls will highlight those at high risk for further falls. In addition to the general exercise program adopted for all patients, we suggest that a balance rehabilitation program should be valuable for the patients with risk factors for fall. Exercise may improve fear of falling and BASFI and BASMI scores. However, further study is needed to investigate these hypotheses. We believe that clinicians should train and support the patients via reducing fear of falls and maintaining good posture and functional capacity.
The results of the study showed that low back pain occurred in 78.0% of Turkish coal miners. Although the nature of the occupation may have influenced coal miners' lumbar spinal curvature, lumbar angles are not a determinant for low back pain in this population. Further extensive studies involving ergonomic measurements are needed to validate our results for Turkish coal mining industry.
A home-based exercise program can have an effect on some measures respiratory muscle and functional status. Greater emphasis should be placed on maintaining cardiorespiratory fitness as well as spinal mobility to encourage patients with AS.
The case of a previously healthy 24-year-old man diagnosed with extradural thoracic granulocytic sarcoma with no evidence of bone marrow or other hematological involvement is described. The tumor was removed totally by microsurgery. The histopathological examination was consistent with granulocytic sarcoma. Granulocytic sarcomas are most commonly found in the context of an acute myelogenous leukemia or in chronic myelogenous leukemia. They rarely have been reported in otherwise healthy patients without any evidence of systemic disease. A review of the literature revealed only 14 more nonleukaemic cases with granulocytic sarcoma causing thoracic spinal cord compression.
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.
Ankylosing spondylitis (AS) is a multisystemic disease and extra-articular features may develop as pleuropulmonary involvement. We aimed to show and compare the early and late pleuropulmonary findings of AS and its effects on patients' daily life by causing dyspnea. The study consisted of 38 patients (33 male, 5 female). All patients met the New York criteria for AS. Patients were divided into two groups for comparison of early (disease duration <10 years and normal chest X-ray, 18 patients) and late (disease duration >/=10 years and normal or abnormal chest X-ray, 20 patients) manifestations. All patients underwent high-resolution computed tomography (HRCT) and pulmonary function tests. A questionnaire was completed to measure perceived shortness of breath (dyspnea score) with activities of daily living such as dressing, shaving or walking. HRCT findings were abnormal in 27 of the 38 patients (73%). Pulmonary involvement was high in early AS (61.1%). The number of findings in early and late AS found were as follows: mosaic pattern (9/10), parenchymal micronodules (2/3), parenchymal bands (5/9), bronchial wall thickening (2/10), ground-glass opacity (7/7), and interlobular septal thickening (6/10). A moderate correlation was obtained between presence of mosaic pattern and forced midexpiratory flow rate (FEF(25-75)) values indicating small airway obstruction (r=0.346, p=0.019). The dyspnea score was statistically higher in patients with AS having pulmonary involvement than those without involvement. Pulmonary involvement is common in early AS compared to late AS. The involvement of small airways was found frequently as interstitial lung disease in early and late AS. This study also suggests that AS with pulmonary involvement may affect patients' daily life by causing dyspnea, which is why early detection of pulmonary lesions may have clinical importance and should be studied in a large cohort.
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