Background/Aims: Anorectal diseases, including fecal incontinence, are prevalent and have an enormous impact on the quality of life. Therefore, investigating their etiological factors may help to reduce the incidence and/or the severity of the underlying diseases. Materials and Methods: Referral complaints (constipation, strained defecation, and incontinence) and medical and anorectal manometry records of 883 (562 female/321 male, ages 45.17±1.00 and 48.41±0.63 years, respectively) patients were evaluated retrospectively. Maximal resting pressure (MRP) and maximal squeeze pressure (MSP) measured by stationary pull-through technique, volume of rectoanal inhibitory reflex, and sensory threshold to rectal balloon distention (ST) were obtained by water perfusion system. Data were compared according to referral complaints, age, gender, parity, and underlying diseases. Results: Incontinence was the most frequent referral complaint in 61.2% of females and 67.6% of males. MRP and MSP were significantly lower in incontinent females than in the other groups. In incontinent males, MSP was lower than the strained defecation group, and ST was higher than the constipation group. Age was negatively correlated with MRP for both of the genders and in all groups. Obstetric trauma (85%) and number of parity (3.40±2.59) were significantly higher in incontinent females. Moreover, the most prevalent underlying disease was diabetes in incontinent females (13.7%) and neurological diseases, including traumas, in incontinent males (41.5%). Conclusion:Increasing awareness of labor safety, controlling diabetes mellitus, and preventing obstetric traumas may reduce the prevalence of fecal incontinence.
Objective: Cardiac dysfunction has been reported in both cirrhotic and alcoholic patients. Our aim was to determine the relation of serum N-terminal pro-B-type natriuretic peptide (Nt-proBNP) levels to myocardial performance index (MPI) and disease severity in nonalcoholic cirrhotic patients. Patients and Methods: In this prospective study including 25 cirrhotic patients and 27 healthy controls, MPI was assessed by pulsedwave tissue Doppler imaging (PW-TDI). The disease severity was determined by Child-Turcotte-Pugh (CTP ) and model for endstage liver disease (MELD) scores. Results: There were no statistically significant differences in MPI levels between patients and controls (p< 0.246). Nt-proBNP levels (p< 0.0003), cardiac output (CO) (p< 0.0002), left ventricular end-systolic (LVES) volume (p< 0.031) and QT interval (p< 0.0001) increased and left ventricular systolic function was normal in all cirrhotic patients when compared to controls. Nt-proBNP levels were positively correlated with MELD scores (p< 0.0001, r= 0.59), QT duration (p< 0.0001, r= 0.59), CO (p= 0,001, r= 0.44), right atrial (RA) area (p= 0.026, r= 0.31) and negatively correlated with diastolic BP (p= 0.015, r= -0.34). Conclusion: We conclude that in nonalcoholic cirrhotic patients, left ventricular MPI and systolic function were normal. Nt-proBNP levels were correlated with the disease severity and hyperdynamic circulation.
Objectives The purpose of this study was to develop the Turkish version of the Core Lower Urinary Tract Symptom Score (CLSS) and determine its psychometric properties in Turkish subjects. Methods A total of 428 subjects, 259 with lower urinary tract symptoms (LUTS) and 169 without any complaints, were included in the study. In addition, 40 subjects were included in the study for test‐retest analysis. After the Turkish version of the CLSS was created, all patients underwent medical history, physical examination, complete urinalysis, urinary ultrasonography, and filled out a CLSS. In addition, men were asked to fill in International Prostate Symptom Score (IPSS), International Consultation on Incontinence Questionnaire‐Male LUTS and National Institutes of Health Chronic Prostatitis Symptom Index. Women completed the Bristol Female LUTS‐Short Form and IPSS. The patients from the test‐retest group were asked to fill out the CLSS two times at 2‐week intervals. Results CLSS showed high internal consistency (Cronbach's α for men and women was 0.909 and 0.767, respectively). The test‐retest reliability of CLSS was high for subdomains (intraclass correlation coefficient was 0.739‐0.962). Scores of CLSS were significantly higher in the study group than the control group (P < 0.001). In men and women, it showed very strong convergent validity (P < 0.0001) with subdomain related to other questionnaires. In our confirmatory factor analysis, the original model of CLSS was found to be compatible. Conclusions The Turkish version of CLSS is a valid and reliable questionnaire to evaluate the symptoms and disorders of patients with LUTS.
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