Evaluation Of Insecticide Poisoning And The Cases In Turkey

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Long-term results of endocardial pacing with Autocapture™ threshold tracking pacemakers in children

PubMedID: 16216759Aim: We aimed to evaluate the long-term results of endocardial pacing with Autocapture™ threshold tracking pacemakers in children. Methods and results: Implantation and follow-up data of 20 children with these pacemakers were retrospectively evaluated. The pacemakers were implanted subpectorally in five and subcutaneously in 15 patients. The indication for pacing was high-grade atrioventricular block in 18 cases. The mean age at implantation was 7 ± 4.8 years. Four patients were pacemaker dependant (heart rate < 30 bpm). At implantation, the mean pacing threshold was 0.5 V at 0.5 ms. The mean evoked response (ER) signal was 8.5 ± 3.6 mV, and the polarisation signal (PS) was <1 mV in 15 patients and 1-2 mV in five patients. During the mean follow-up period of 60 months, mean ER signal decreased significantly to 7.7 ± 6.3 mV at 24 months and 6.5 ± 2.5 mV at 60 months (P < 0.05). In four of 15 patients (26.6%), with a predischarge PS value of <1 mV, it increased between 1 and 2 mV over time. During follow-up, autocapture function was deactivated in six (30%) patients; due to inappropriate ER/PS values in four and due to severe muscle twitching in two with subpectoral implants. These problems occurred during a median period of 21 months after implantation. Generators were replaced in three patients with Microny pacemakers because of battery depletion at 54, 66 and 78 months. In two of them autocapture function had been working since implantation. In seven of 10 patients, who completed ?60 months of follow-up, battery impedances were still at the predischarge level. Conclusions: Autocapture function works well in most children at implantation. Mean ER signal significantly decreases over time despite stable pacing parameters. Autocapture function may become nonoperational due to decreased ER signal in some patients. Muscle twitching may be an important problem that may result in discontinuation of autocapture function in children with subpectoral implants. © 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved

The effect of L-carnitine on insulin resistance in hemodialysed patients with chronic renal failure

We investigated the effect of L-carnitine in seven patients, four female and three male (mean age 44.4 +/- 6.0 years) with chronic renal failure. Six patients, four female and two male (mean age 49.3 +/- 2.2 years) with chronic renal failure were given a placebo (0.9% sodium chloride) as control, After the basal data were obtained, patients received a single intravenous dose of L-carnitine (1 g) or placebo and two hours later insulin sensitivity was studied by the intravenous insulin tolerance test. No change was observed in biochemical data and K-itt values in the placebo group, K-itt increased significantly with carnitine (from 2.99 +/- 0.3 to 3.54 +/- 0.2%/min, p < 0.03) compared to the control group (p < 0.02). This result suggests that L-carnitine may improve the insulin resistance common among uremic patients

The effect of L-carnitine on insulin resistance in hemodialysed patients with chronic renal failure

We investigated the effect of L-carnitine in seven patients, four female and three male (mean age 44.4 +/- 6.0 years) with chronic renal failure. Six patients, four female and two male (mean age 49.3 +/- 2.2 years) with chronic renal failure were given a placebo (0.9% sodium chloride) as control, After the basal data were obtained, patients received a single intravenous dose of L-carnitine (1 g) or placebo and two hours later insulin sensitivity was studied by the intravenous insulin tolerance test. No change was observed in biochemical data and K-itt values in the placebo group, K-itt increased significantly with carnitine (from 2.99 +/- 0.3 to 3.54 +/- 0.2%/min, p < 0.03) compared to the control group (p < 0.02). This result suggests that L-carnitine may improve the insulin resistance common among uremic patients

The effect of L-carnitine on insulin resistance in hemodialysed patients with chronic renal failure

We investigated the effect of L-carnitine in seven patients, four female and three male (mean age 44.4 +/- 6.0 years) with chronic renal failure. Six patients, four female and two male (mean age 49.3 +/- 2.2 years) with chronic renal failure were given a placebo (0.9% sodium chloride) as control, After the basal data were obtained, patients received a single intravenous dose of L-carnitine (1 g) or placebo and two hours later insulin sensitivity was studied by the intravenous insulin tolerance test. No change was observed in biochemical data and K-itt values in the placebo group, K-itt increased significantly with carnitine (from 2.99 +/- 0.3 to 3.54 +/- 0.2%/min, p < 0.03) compared to the control group (p < 0.02). This result suggests that L-carnitine may improve the insulin resistance common among uremic patients

Intravenous alfacalcidol improves insulin resistance in hemodialysis patients

We have examined the effect of a four-week intravenous treatment with 1 alpha-hydroxyvitamin D-3 on insulin sensitivity in 14 patients on chronic hemodialysis compared with 10 healthy control subjects by the insulin tolerance test. Compared to controls, the uremic patients have featured increased levels of parathyroid hormone (1085.0 +/- 822.1 vs 74.2 +/- 8.7 pg/ml, p 0.05) and C-peptide concentrations increased from 6.0 +/- 2.1 to 7.5 +/- 2.5 ng/ml (p <0.02). In summary, uremic patients with secondary hyperparathyroidism developed insulin resistance and hyperinsulinemia. Intravenous 1 alpha-hydroxyvitamin D-3 treatment has improved insulin sensitivity directly or by reducing secondary hyperparathyroidism in uremic patients on chronic hemodialysis