Optimal duration of medical expulsive therapy for lower ureteral stones: a critical evaluation.

To evaluate the optimal duration of Medical Expulsive Therapy (MET) application for distal ureteric stones on a time period based manner. 89 patients with 5-10 mm distal ureter stones received tamsulosin (0.4 mg) for MET and diclofenac sodium (75 mg) for analgesia. Patients were evaluated once a week for 4 weeks. Radiologic stone passage was evaluated by kidney ureter bladder (KUB) and ultasonography where non-contrast computed tomography (NCCT) was also performed if needed. While 23 cases (28.4%) were SF after first week, 23 were SF (28.4%) after 2 weeks, 9 cases (11.1%) after 3 and lastly 7 cases (8.6%) became SF after four weeks. Nineteen (23.5%) cases were not SF after 4 weeks. A positive relationship was found between the time period elapsed for stone passage and ureteral wall thickness (UWT) along with the degree of hydronephrosis. In addition, mean number of renal colics and emergency department (ED) visits were found to be higher in patients passing stones in the 4th week along with the ones who could not despite MET. SFR for distal ureteric stones sizing 5-10 mm was higher within the first 3 weeks under MET application. Thus, waiting for a longer period of time may result in increased analgesic and unnecessary MET treatment with increased risk of emergency department visits and additional costs as well. We believe that other options could be considered in such cases who are not SF at the end of the first 3 weeks.

Attachment Styles of Parents with Alcohol Use Disorder and the Relation of Their Parenting Perception to Their Parenting Attitudes.

Objective: Many neurobiological, genetic, environmental, and spiritual factors are involved in addiction etiology. This study aims to examine parental perceptions, attachment styles, and parental attitudes. Methods: This is a cross-sectional study. Patients diagnosed with alcohol use disorder (AUD) were enrolled in the Addiction Clinic of the Erenköy Mental Hospital. The structured clinical interview for DSM-5 (SCID-5) was applied, and the sociodemographic data form, Adult Attachment Style, Family Life and Child Rearing Attitude Scale, and Parent Attachment Scale were administered to the participants. Results: It was determined that 21.5% of participants had depressive episode and anxiety disorder diagnoses; 15.4% of participants had children with a history of psychiatric treatment; 16.9% had children with a history of alcohol/substance use. The avoidant attachment score average of individuals with APD was found to be higher. The positive perception of parents participating in terms of care and protection toward their own parents was significant in all subdimensions with secure attachment. When the child-rearing attitudes of parents with secure attachment were examined, the dimensions of democratic attitude and recognition of equality were statistically significantly higher. Conclusion: Parenting and attachment are associated with many steps of addiction. In the fight against addiction, it is very important to treat addiction as a family problem. The education and interventions to be made can be protective in terms of psychopathology and addiction issues, which may provide early intervention for these problems. In addition, constructive interventions related to family relationships are important in increasing the social support of people who are being treated for AUD.