Objective Lower urinary tract dysfunction (LUTD) are quite commonly seen in Multiple Sclerosis (MS). In this study we aimed to show the relationship between the LUTD symptoms and disease related parameters including the severity, duration, subtypes and the lesion localization of MS. Material and MethodIn a prospective study, we recorded demographic information, MS subtypes, disease duration, disease severity, neurological examinations, scores of Expanded Disability Status Scale (EDSS), lower urinary tract symptoms (LUTS), duration of the symptoms, urinary tract examination, urinary function tests (Overactive Bladder Symptom Score (OABSS), International Prostate Symptom Score (IPSS)), urodynamic evaluation results of 42 MS patients whom admitted to our neurology department during the last 3 months. Statistical analysis was performed by using ANOVA, Mann Whitney-U test and non-parametric Pearson test. p<0.05 was considered statistically significant.Results 42 patients (13 male, 29 female) who were diagnosed with MS according to the 2010 revised McDonald criteria included in our study while patients with history of diabetes mellitus, urinary tract infections, and urological surgery were excluded. There was no significant relationship between the presence of LUTS, and age, gender, EDSS, MS subtypes, duration of illness (p>0,05). A statistically significant difference was found between the genders, EDSS and irritative symptoms (p<0,05) while no significance was found between obstructive symptoms (p>0,05). There was no statistically significant difference between the localization of the lesion and presence of the irritative and obstructive symptoms (p>0,05).Conclusion Our study indicates that, disease severity is an important determinant factor of irritative urinary symptoms in MS patients. ( Sakarya Med J 2016, 6(4):190-195 )Keywords Multiple Sclerosis, urinary system, questionnaire Öz Amaç Multipl Sklerozda (MS), alt üriner sistem fonksiyon bozuklukları oldukça sık görülmektedir. Çalışmamızda, MS hastalarında alt üriner sistem disfonksiyon semptomları ile hastalığın şiddeti, süresi, alt tipi ve lezyon lokalizasyonu arasındaki ilişkiyi göstermeyi amaçladık. Materyal ve Metod

IntroductionThe relationships between plasma levels of brain natriuretic peptide (BNP) and severity and location of stroke, prognosis, and infarct volume were investigated in acute ischemic stroke patients who presented within the first 24 hours (h) of stroke.Material and methodsBrain natriuretic peptide levels were tested in 40 patients and 30 healthy controls. Infarct volume was automatically calculated by multi-slice computed tomography. Disease severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) at presentation, 24 h, 72 h and the 28th day. Progression was defined as an increase of more than two points in the NIHSS scores.ResultsThe mean BNP levels were 284.16 ±382.79 at presentation and 273.78 ±451.91 at 72 h in the patient group, whereas the mean BNP level was 25.29 ±13.47 in controls. There was a statistically significant difference between the two groups (p < 0.001). Differences in BNP levels among patient subgroups according to the TOAST and OCSP classifications were not statistically significant (p = 0.534, p = 0.943, respectively). There was no significant correlation between plasma BNP level and infarct volume or NIHSS scores (p = 0.5, p = 0.07). A positive correlation was found between BNP levels and the length of the hospitalization period (p = 0.03 and r = 0.33). There was no statistically significant relationship between elevated plasma BNP levels and progression of disease (p = 0.08).ConclusionsPlasma BNP levels were increased in the acute phase of stroke; therefore, BNP could be used as a biomarker for morbidity and mortality, even in patients without cardiac failure.

Fat embolism syndrome is a rarely seen complication of skeletal trauma, and it is seen at a rate of 2-5% after fractures of the long bones of the lower extremities. Its classic triad-+consists of hypoxemia, petechial bleedings on the skin and neurological findings. These neurological findings are highly variable and non-specific, and they can present with lethargy, irritability, delirium, stupor, convulsion or coma. In this report, a male case is presented who was diagnosed with cerebral embolism due to acute cognitive disorder after a segmental tibial fracture.Key Words: Cerebral fat embolism, tibial fracture, acute cognitive disorder, diffusion-weighted MRI ÖzetYağ embolizmi sendromu, iskelet travmalarının nadir komplikasyonudur, alt ekstremite uzun kemik kırıkları sonrasında %2-5 oranında görülür. Klasik triadı; hipoksemi, ciltte peteşial kanamalar ve nörolojik bulgulardır. Nörolojik bulgular oldukça değişken ve nonspesifik olup baş ağrısı, letarji, irritabilite, deliryum, stupor, konvülzyon veya koma ile prezente olabilir. Bu yazıda, parçalı tibiya fraktürü sonrası akut kognitif bozukluk ile serebral embolizm tanısı alan erkek bir olgu sunulmuştur.Anahtar Kelimeler: Serebral yağ embolisi, tibiyal fraktür, akut kognitif bozukluk, difüzyon ağırlıklı MRG

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