In this study, the bladder emptying methods at different stages of the post-stroke period along with the effects of demographic and clinical parameters on spontaneous voiding frequency were investigated. The frequencies of bladder emptying methods at admission to the rehabilitation clinic, after neurourological and urodynamic assessment and at home after discharge were spontaneous voiding (SV) 51/99 (51.5 %), 62/99 (62.6 %), 73/99 (73.7 %), emptying without a urinary catheter + an external collector system (EWUC + ECS) 24/99 (24.2 %), 18/99 (18.2 %), 17/99 (17.2 %), intermittent catheterization (IC) 1/99 (1.0 %), 15/99 (15.2 %), 6/99 (6.1 %), indwelling urethral catheter (IUC) 23/99 (23.2 %), 4/99 (4.0 %) and 3/99 (3.0 %), respectively. Lower spontaneous voiding frequencies were observed in single-divorced and geriatric individuals (p < 0.05). The number of patients who modified the method at home was 2/62 for SV, 5/18 for EWUC + ECS, 9/15 for IC, and 2/4 for IUC. The majority of stroke patients were able to void spontaneously and the spontaneous voiding frequency increased at follow-up. The spontaneous voiding frequency was low in geriatric and single-divorced subgroups. The method in which the most changes occurred was IC.

Early signs of brain infarction can be detected by modern CCT technology even within the first 6 h after stroke. Little is known about the prognostic significance of early infarction signs in CCT. We prospectively evaluated clinical and CCT findings of 95 consecutive patients with an acute ischemia in the territory of the middle cerebral artery. All patients were admitted to our stroke unit within 6 h after stroke. In 55 patients CCT was performed within 3 h, and in 40 cases between 3 and 6 h. In all patients the clinical findings were assessed by the Scandinavian Stroke Scale (SSS). The disability due to stroke was evaluated after 4 weeks by use of the modified Rankin Scale. We could demonstrate the following early signs of cerebral infarction: focal hypodensity (23.2%), obscuration of basal ganglia (12.6%), focal brain swelling (22.1%), hyperdense middle cerebral artery sign (HMCA; 11.5%). In 3 patients early edema led to ventricular compression, in 1 patient to midline shift. The occurrence of early infarction signs did not depend on the etiology of ischemia but was significantly associated with a severe neurological deficit at admission and an unfavourable disability status 4 weeks after stroke. Focal brain swelling and HMCA were often followed by extensive infarction lesions on the follow‐up CCT. In conclusion, early signs of hemispheric brain infarction visible on CCT scans performed within 6 h after stroke are correlated with severe stroke and an unfavourable functional outcome. However, a substantial part of our patients had a benign course of the disease in spite of early CCT pathology. Decisions on therapy in individual patients therefore should not depend on early CCT findings exclusively.

Objectives:This study aims to analyze the demographic and clinical properties of patients with spinal cord injury (SCI) and to investigate the functional outcomes after rehabilitation. Patients and methods:In this retrospective and descriptive study, we investigated a total of 118 SCI patients (74 males, 44 females; mean age 41±16 years; range 13 to 74 years) with full records who were admitted to our rehabilitation program between January 2005 and December 2010. Demographic characteristics of the patients, etiological factors, time since injury, length of hospital stay, level of injury, as assessed by the American Spinal Injury Association (ASIA) Impairment Scale and functional status, as assessed by the Functional Independence Measure (FIM TM ) on admission and discharge were analyzed. Complications related to SCI were also noted. Characteristic features of the patients', frequency of complications, and functional and neurological recovery were evaluated. Results:Of the patients, 70% were tetraplegic. The median time since injury was four months (IQR: 1 to 15 months), while the median length of stay was 76 days (IQR: 46 to 104 days). Four of 47 patients (8%) with Grade A (complete) according to the ASIA Impairment Scale on admission progressed to Grade B on discharge. Functional independence measure motor scores showed significant improvements at discharge (p<0.0001). The most common complications were urinary tract infections (70%), pressure ulcers (31%), and pain (28%). Conclusion:Inpatient rehabilitation in a tertiary referral hospital appears to provide substantial functional and motor gains in patients with SCI. Based on our study results, considerable improvement in the activities of daily living, as assessed by FIM motor scores, can be achieved with rehabilitation.Keywords: Function; outcome; rehabilitation; spinal cord injury.Omurilik hasarlı hastaların demografik ve klinik özellikleri ve rehabilitasyon sonrası fonksiyonel sonuçları Sonuç: Üçüncü basamak bir hastanede yatarak rehabilitasyon OY'li hastalarda önemli fonksiyonel ve motor kazanımlar sağlamaktadır. Çalışma sonuçlarımıza göre, FIM motor skorları ile değerlendirilen günlük yaşam aktivitelerinde rehabilitasyon sonrasında önemli düzeyde iyileşme elde edilebilir.

In patients with coronary artery disease, the distinction between scar and viable myocardium by means of myocardial perfusion imaging (MPI) sometimes can be difficult because of the equivocal meaning of fixed perfusion defects. In this study we examined whether addition of a 99mTc-sestamibi infusion study to the standard MPI could provide extra information regarding the fixed defects. Thirty-seven patients underwent standard MPI and an extra SPECT study in which 99mTc-sestamibi was given as a prolonged constant infusion. Of 324 myocardial segments available for analysis, 134 had fixed or resting perfusion abnormalities on standard MPI studies, of which 25% (33/134) in 12 patients showed partial improvement in the perfusion pattern whereas in 6% (8/134) the improvement was very significant in infusion studies. In 19 patients who were also examined with dobutamine echocardiography, 13 showed concordance between echocardiography and infusion MPI. This study suggests that infusion MPI may provide complementary information to the conventional scintigraphy with regard to interpretation of standard myocardial perfusion scans with fixed defects.

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