International Instrument on Permitted Uses in Copyright Law

Funder: Max Planck Institute for Innovation and Competition (IMPRS-CI, IP MPG) (2

Neurogenic bladder in patients with traumatic spinal cord injury: Treatment and follow-up

Study design:Multi-center, cross-sectional study.Objectives:Our aim was to evaluate the treatment methods and follow-up of neurogenic bladder in patients with traumatic spinal cord injury retrospectively using a questionnaire.Setting: Turkey.Methods:Three hundred and thirty-seven patients who had spinal cord injury for at least 2 years were enrolled from six centers in the neurogenic bladder study group. They were asked to fill-out a questionnaire about treatments they received and techniques they used for bladder management.Results:The study included 246 male and 91 female patients with a mean age of 42±14 years. Intermittent catheterization ( IC) was performed in 77.9% of the patients, 3.8% had indwelling catheters, 13.8% had normal spontaneous micturition, 2.6% performed voiding maneuvers, 1.3% used diapers and 0.6% used condom catheters. No gender difference was found regarding the techniques used in bladder rehabilitation ( P>0.05). Overall, 63.2% of patients used anticholinergic drugs; anticholinergic drug use was similar between genders ( P>0.05). The most common anticholinergic drug used was oxybutynin ( 40.3%), followed by trospium ( 32.6%), tolterodine ( 19.3%) darifenacin ( 3.3%), propiverine ( 3.3%) and solifenacin ( 1.1%). The specialties of the physicians who first prescribed the anticholinergic drug were physiatrists ( 76.2%), urologists ( 22.1%) and neurologists ( 1.7%). Only four patients had previously received injections of botulinum-toxin-A into the detrusor muscle and three of them stated that their symptoms showed improvement. Most of the patients ( 77%) had regular follow-up examinations, including urine cultures, urinary system ultrasound and urodynamic tests, when necessary; the reasons for not having regular control visits were living distant from hospital ( 15.3%) and monetary problems ( 7.7%). Of the patients, 42.7% did not experience urinary tract infections ( UTI), 36.4% had bacteriuria but no UTI episodes with fever, 15.9% had 1-2 clinical UTI episodes per year and 5% had ≥3 clinical UTIs. The clinical characteristics of patients with and without UTI ( at least one symptomatic UTI during 1 year) were similar ( P>0.05). The frequency of symptomatic UTI was similar in patients using different bladder management techniques ( P>0.05).Conclusion:The most frequently used technique for bladder rehabilitation in patients with SCI was IC ( 77.9%). In all, 63.2% of patients used anticholinergic drugs, oxybutynin being the most commonly used drug. Also, 77% of patients had regular control visits for neurogenic bladder; 42.7% did not experience any UTIs. © 2014 International Spinal Cord Society

Intermittent catheterization in patients with traumatic spinal cord injury: Obstacles, worries, level of satisfaction

Objectives: The aim of this study is to examine the obstacles in people with traumatic spinal cord injury (SCI) face performing intermittent catheterization (IC), also their worries and level of satisfaction. Methods: Two hundred sixty-nine patients performing IC for at least 3 months were asked to fill-out a questionnaire about their opinions on IC. Results: In total, 69.5% of patients performed IC themselves, 10.4% had performed by their mothers, 7.8% by another caregiver and 7.4% by their spouse. For the 72 (26%) patients unable to apply IC, reasons were insufficient hand function (56.1%), being unable to sit appropriately (35.4%) and spasticity (8.5%). In all, 70% of male patients had insufficient hand function, 20% could not sit and 10% had spasticity while 56.3% of female patients could not sit, 37.5% had insufficient hand function and 63% had spasticity. Difference between sexes was found to be statistically significant (P<0.05). Worries patients had when starting IC were fear of being dependent on IC (50.2%), accidentally injuring self (43.8%), embarrassment (43.2%), causing an infection (40.2%), bleeding (32.7%), fear of feeling pain (30.2%) and hygiene (24.7%). More women felt embarrassment; other items were similar in both sexes. In all, 46.9% of patients had urinary incontinence in intervals. Conclusion: In total, 69.5% of patients performed IC themselves. Men's most common obstacle was insufficient hand function while women's was being unable to sit appropriately. Patients' most common worries were being dependent on IC for life. In all, 46.9% had incontinence in intervals; 47.9% said IC improved their life quality; and 97.4% preferred IC over continuous catheterization. © 2014 International Spinal Cord Society All rights reserved

Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience

Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population.Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed.Results: SVR12 was achieved in 92.8% of the patients (4,040/4,352) according to intention-to-treat and in 98.3% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2%-100%) and genotypes (95.6%-100%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.22-2.38; p=0.023]), higher hepatitis C virus (HCV) RNA levels (OR: 1.44, 95% CI: 1.31-2.28; p=0.038), and higher serum ALT levels (OR: 1.38, 95% CI: 1.21-1.83; p=0.042) were associated with poor SVR12. The most common adverse events were fatigue (12.6%), pruritis (7.3%), increased serum ALT (4.7%) and bilirubin (3.8%) levels, and anemia (3.1%).Conclusion: LDV/SOF or PrOD +/- RBV were effective and tolerable treatments for patients with CHC and with or without advanced liver disease before and after liver transplantation. Although HCV eradication improves the liver function, there is a risk of developing HCC.Turkish Association for the Study of The Liver (TASL

How Public Is the Public Domain? The Perpetual Protection of Inventions, Designs and Works by Trademarks

There are plenty of trademarks consisting of product shapes that effectively deter competition, although the original work or the invention giving the shape to the product (and to the trademark) is already in the public domain and should be free to be used by anyone. Trademark laws typically contain provisions declaring certain kinds of trademarks not protectable on the basis of absolute grounds for refusal. However, the legal practice reveals that these mechanisms within the trademark laws are not sufficient to safeguard the public domain. Companies frequently try to deter free competition by registering trademarks consisting of the shape of a product after they lose the exclusivity in the patent, industrial design or work that gave its value to the product and meanwhile belongs to the public domain. This problem occurs in particular in relation to popular inventions, but also to designs or characters of works that are of high commercial value. Not only in developing countries, courts seem to hesitate assessing an invention, design or work to be part of the public domain if the popularity and value of the product are significant. The most appropriate approach to solve this problem is to introduce an international mandatory regulation that overarches all intellectual property rights and explicitly safeguards the public domain. Such general principle in international law should particularly ensure that the free use of inventions, designs or works is not affected by trademarks once the underlying intellectual property right expires

Experimental study on cylindrical grinding with helical grooves wheels

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Zulässige Formen der Nutzung verwaister Werke

The Max Planck Institute for Intellectual Property and Competition Law comments on the Commission's proposal for a new directive on certain permitted uses of orphan works - COM(2011)289. In principle,the Institute welcomes the proposal of the Commission, which, after years of discussion, is now attempting to create a legal framework allowing libraries in particular both to digitise their archives and to make such archives available in an online library or archive. Instead of addressing the digitisation of public collections or collections as such, the Commission limits itself to orphan works. From the Institute's point of view, this approach raises several - to some extent fundamental - concerns