Occupation in spinal cord injury patients in Turkey.

STUDY DESIGN: A cross-sectional survey. OBJECTIVES: To investigate the changes in the occupation of patients after spinal cord injury (SCI) and the factors that cause this change. SUBJECTS: The study involved 192 Turkish patients (41 female, 151 male) who had suffered SCI. The mean age of patients was 36.1+/-12.0 years. The mean follow-up time was 43.4+/-38.0 months. Before injury, 138 patients were employed in gainful occupations, 26 patients were housewives, 10 were retired, 7 were students and 11 patients were unemployed. Only 15 patients (7.8%) returned to their original occupations after injury. Thirteen patients (6.8%) are currently working in another job; 1 patient (0.5%) is a student; 10 (5.2%) are retired as was earlier; 40 (20.8%) are retired on grounds of disability; 26 (13.5%) are housewives; and 87 patients (45.3%) are currently unemployed. METHODS: Prospective data collection through a face-to-face interview on an established SCI Turkish sample. RESULTS: In our study, the rate of returning to work was found to be 14.6%. In the evaluation of factors affecting return to work after injury, educational level (P=0.00), pre-injury employment (P=0.01) and bladder-emptying method (P=0.03) were statistically significantly correlated with return to work. CONCLUSION: In this study, education, pre-injury employment and bladder-emptying method were found to be important factors in returning to work after SCI.

[The staged medical rehabilitation of patients with secondary chronic pyelonephritis in infravesical obstructions]. / Etapnaia meditsinskaia reabilitatsiia bol'nykh vtorichnym khronicheskim pielonefritom pri infravezikal'nykh obstruktsiiakh.

The authors believe that chronic pyelonephritis patients operated for infravesical obstructions need staged postoperative rehabilitation. In antibacterial postoperative treatment, a significant response was seen in 7.9%, a partial response in 18.4% and no response in 73.7% of patients. After combined physiotherapy--in 38%, 41.7% and 20.3% of patients, respectively.

Posterior ledge at the bladder neck: crucial diagnostic role of ultrasonography.

A posterior ledge at the bladder neck was seen in 158 patients (107 of whom were undergoing intermittent catheterization) on a sonographic voiding cystourethrogram. In 117 patients, the ledge was 0.5 cm or longer; 66 patients were on intermittent catheterization, and 51 experienced difficulty with catheterization, including vigorous bleeding in 4. Ledges less than 0.5 cm were discovered in 41 patients, all on intermittent catheterization, none of whom had difficulty with this procedure. The duration of intermittent catheterization and of detrusor-sphincter dyssynergia was shown statistically to be an important factor leading to the formation of the longer obstructing ledges (P less than 0.0005, Mann-Whitney test). Sphincterotomies were performed in 74 patients through the periurethral striated sphincter at 10 and 2 o'clock and extended to the bladder neck. The operation was a success in 73 (98%), all of whom were catheter-free, and in all of whom sonography revealed that the ledge had receded and the catheter was no longer obstructed.