Reliability and validity of the Turkish language version of the Core Lower Urinary Tract Symptom Score.

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.

[Sjögren's syndrome extraglandular expressions]. / Manifestazioni extraghiandolari della sindrome di Sjogren: implicazioni in ginecologia e ostetricia.

The Sjögren's syndrome (SS) is an autoimmune disease which causes injury to lacrimal and salivar glands and is characterized by a potential systemic involvement. The present review will treat mainly of SS extraglandular expressions, focusing on scientific literature articles regarding SS implications in gynecology and obstetrics.

[Clinical effects of hormone replacement therapy with estradiol valerate and cyproterone acetate in perimenopausal women]. / Effetti di un trattamento ormonale sostitutivo con estradiolo valerato e ciproterone acetato in donne in perimenopausa.

BACKGROUND: In perimenopause many women complain of psychogenic and organic disorders often connected with initial and increasing levels of hypoestrogenism. In this study we evaluated the effects of hormone replacement therapy (HRT) in symptomatic women in perimenopause. METHODS: We enrolled 100 healthy and symptomatic women who were randomly distributed to two groups for a 12-month study. Group A: 50 patients received HRT with estradiol valerate and cyproterone acetate (Pausene(R)); Group B: 50 patients were used as a control group (treated with Cacit Vitamin D30(R)). A number of clinical and instrumental tests were performed at 0, 6 and 12 months to evaluate any changes in vasomotor and urogenital symptoms, bone and serum homeostasis and possible sexual disorders. The statistical analysis was performed using the c2 test. RESULTS: The group of women receiving HRT showed a significant reduction in vasomotor clinical symptoms (p<0.001) and sexual disorders (p<0.002); this was not reflected in the control group where libido decreased steadily with apparent slight improvements only at the end of the study. The urogenital disorders disappeared almost completely in Group A, whereas they diminished in Group B. HRT patients also showed a slight increase (p<0.001) in the initial value of BMD (bone mineral density), a reduction in the marker for bone turnover and an improved lipid profile (p<0.05). These changes were unfortunately not noted in Group B. CONCLUSIONS: On the basis of these results we conclude that HRT appeared to have a beneficial effect on perimenopausal clinical symptoms over the 12-month period, leading to marked improvements in the psychophysical wellbeing of symptomatic women in perimenopause.

Transdermal hormone replacement therapy in postmenopausal women with uterine leiomyomas.

OBJECTIVE: To evaluate the effects of transdermal hormone replacement therapy (HRT) on uterine and leiomyoma size and on uterine bleeding patterns in postmenopausal women with uterine leiomyomas. METHODS: The required sample size was calculated to be 30 subjects per group to detect an effect on the size of one standard deviation (SD) with an alpha value of 0.05 (two-sided) and a power 1 - delta = 0.8. At the end of the study, the power analysis showed a value of beta = 0.826. Seventy postmenopausal women with uterine leiomyomas were enrolled and treated for 12 cycles of 28 days each with transdermal 17 beta-estradiol (E(2)) patches plus oral medroxyprogesterone acetate continuously added (group A) or with calcium carbonate (group B). At entry and every three cycles, uterine and leiomyoma dimensions were measured by transvaginal ultrasonography. To evaluate the effect of transdermal HRT on the characteristics of uterine bleeding, 35 healthy postmenopausal women without uterine leiomyomas (group C) were enrolled and treated with the same regimen as group A. A daily diary was used to record the abnormal uterine bleeding episodes, and a rank scale was used to assess the severity of bleeding. RESULTS: There were no significant changes in mean uterine or leiomyoma size between groups A and B, or in each group compared with basal values. No significant difference was detected between groups A and C in uterine bleeding patterns. CONCLUSION: Transdermal HRT did not increase the size of uterine leiomyomas or affect uterine bleeding patterns in postmenopausal women.

Natural gas inflation injury of the upper extremity: a case report.

High-pressure injection injury is well known to hand surgeons. We present a case of low-pressure inflation injury to the upper extremity. Our experience with this injury, its treatment, and the eventual outcome are discussed.

Laryngeal myxoma.

Myxoma is a rare mesenchymal tumor that is especially uncommon in the head and neck. We report a case of a myxoma of the larynx in a 70-year-old man, which, to our knowledge, is the second case reported in the English-language literature. Although benign, myxomas have a propensity for local recurrence due to their tendency to infiltrate surrounding tissues. They commonly appear encapsulated, but simple enucleation is not adequate treatment; excision should include a margin of normal tissue around the tumor.