Middle Ear Pressure and Factors Affecting It in Intubated Patients Hospitalized in Intensive Care

Objective:To assess the probable agents affecting middle ear pressure in intubated patients hospitalized in intensive care units with various diagnoses.Methods:Middle ear pressure of 38 patients hospitalized in intensive care units within our faculty hospital was measured using portable tympanograms and acoustic reflectometry. The mode of the device to which each patient was attached and patients’ blood pressure, Glasgow Coma Score, and additional disease parameters other than admission diagnosis were recorded. All data collected were subjected to statistical analysis to determine whether or not they affected middle ear pressure.Results:Septal deviation, survey, and mode of automatic respiratory device emerged as factors affecting middle ear pressure (odds coefficient 4.796, 3.745, 2.557, respectively, with 95% CI). Although aged over 60, additional disease and nasogastric tube also compromised middle ear pressure; the levels involved were not statistically significant.Conclusion:Middle ear pressure in patients hospitalized in intensive care units may change, particularly after the seventh day. This may particularly involve septal deviation, survey, and mode of automatic respiratory device, and tympanograms and reflectometry may be added to the patient-monitoring protocol in terms of changes in middle ear pressure

Progress report no. 7

Statement of responsibility on title-page reads: editor: M.J. Driscoll; contributors: D.C. Aldrich, M.J. Driscoll, O.K. Kadiroglu, S. Keyvan, H.U.R. Khan, D.D. Lanning, R. Morton, J. Pasztor, T.J. Reckart, A.A. Salehi, J.I. Shin, A.T. Supple, D.J. Wargo, and S.S. WuIncludes bibliographical referencesProgress report; September 30, 1976U.S. Atomic Energy Commission contracts: E(11-1) 225

The Effect of Periodontal Therapy on Serum CRP, IL-6 Levels and Periodontal Parameters in Patients Having Poorly and Well Controlled Type 2 Diabetes with Chronic Periodontitis: a 3-month evaluation

Aim: To evaluate the effect of nonsurgical periodontal therapy on serum C-reactive protein(CRP), interlökin-6 (IL-6) levels and periodontal parameters in patients with poorly and wellcontrolled type 2 diabetes with chronic periodontitis.Methods: Forty-five patients were included in the study. Of the 45, 30 had type 2 diabetesmellitus with chronic periodontitis (group 1A; poorly controlled group, n = 15, HbA1c ≥ 7%and group 1B; well controlled group, n = 15, HbA1c < 7%) and 15 were systemically healthy(group 2) with chronic periodontitis. Plaque index, gingival index, probing depth, clinicalattachment loss, gingival bleeding index scores, serum CRP and IL-6 concentrations weremeasured at baseline and 3 months after the nonsurgical periodontal therapy. Results: After the nonsurgical periodontal therapy all periodontal parameters and CRP and IL-6 levels decreased significantly by the third month compared to baseline values in all groups.No statistically significant difference was determined among the groups between baseline andthird-month periodontal parameters, or in CRP or IL-6 levels after nonsurgical periodontaltherapy. Conclusion: Improvement in periodontal health is effective on control of systemic infectionvia reducing serum concentrations of CRP and IL-6 in patients with poorly and well controlledtype 2 diabetes with chronic periodontitis. The effects of nonsurgical periodontal treatmentseems to be independent of the degree of diabetic status

The Relationship Between Nt-ProBNP and Volume Overload in Diabetic Nephropathy Progression

Objectives: The early diagnosis of volume overload in chronic kidney disease (CKD) is very important. N-terminal probrain natriuretic peptide (NT-proBNP) is a valuable biomarker for this purpose. Our study aimed to detect the relationship between NT-proBNP and left ventricular hypertrophy (LVH), hypertension (HT), GFR, and proteinuria among diabetic patients with stage 3-4 CKD. Methods: 160 diabetic patients with stage 3-4 CKD [80 patients in stage 3 CKD (group 1) and 80 patients in stage 4 CKD (group 2)] were enrolled. NT-proBNP levels were evaluated in serum, and proteinuria was determined from 24-hour collected urine. Left ventricular hypertrophy was evaluated by M-mode echocardiography. NT-proBNP levels were compared according to their left ventricular hypertrophy, hypertension, and proteinuria levels. Results: NT-proBNP levels was significantly higher, and GFR was lower in group 2 compared to group1 (p < 0.05). NTproBNP was higher in patients with LVH (+) HT (+) and proteinuria ≥ 1gr/d than patients with LVH (-), HT (-), and proteinuria < 1g/d (p < 0.05). We found a significant correlation between NT-proBNP levels and left ventricular posterior wall thickness, diastole (LVPWTd), proteinuria, SBP, and DBP. Proteinuria was the major contributor to increased NTproBNP levels among the independent variables. Conclusion: We detected that NT-proBNP levels are increased during the progression of CKD, and proteinuria is the major cause of increased NT-proBNP levels among the independent variables

A Rare Cause of Secondary Amyloidosis: Common Variable Immunodeficiency Disease

The common variable immunodeficiency disease (CVID) is the most common symptomatic primary antibody deficiency. It is the most frequently observed cause of panhypogammaglobulinemia in adults. Here, we present a case of systemic amyloidosis that developed secondary to the common variable immunodeficiency disease causing recurrent infections in a young female patient. A 24-year-old female patient, who was under treatment at the gynecology and obstetrics clinic for pelvic inflammatory disease, was referred to our clinic when she was observed to have swellings in her legs, hands, and face. She had proteinuria at a rate of 3.5 gr/day, and her serum albumin was 1.5 gr/dl. The levels of immunoglobulins are IgG: 138 mg/dl, IgA: 22,6 mg/dl, and IgM: 16,8 mg/dl. The renal USG revealed that the kidneys were observed to be enlarged. Since the patient had recurrent infections, hypogammaglobulinemia, nephrotic range proteinuria, and enlarged kidneys in the renal USG, she was thought to have type AA amyloidosis and therefore underwent a renal biopsy. The kidney biopsy revealed amyloid (+). So the patient was diagnosed with AA type of amyloidosis secondary to common variable immunodeficiency disease. A treatment regimen (an ACE inhibitor and a statin) with monthly administration of intravenous immunoglobulin was started

The frequency of osteoporosis in hemodialysis and continuous ambulatory peritoneal dialysis patients according to PTH levels after active vitamin D therapy during the two years period

Aim: Osteoporosis is a skeletal disorder that is characterized by low bone mass, micro-structural degeneration of bone and high risk of fracture. In this study our aim was to detect the frequency of osteoporosis in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients according to Parathyroid Hormone (PTH) after vitamin D therapy during the two years period. Materials and method: 18 HD patients (12 male, 6 female) and 12 CAPD patients (8 male, 4 female) undergoing to dialysis therapy in dialysis center of Medicine Faculty Hospital in Dicle University were enrolled to the study. The patients were evaluated with bone mineral density which was measured by left heel quantitative ultrasound before and after the active vitamin D therapy. The blood samples were collected for biochemical analysis in the morning after 12 hours fasting period before and after the active vitamin D therapy. Results: After the therapy T and Z scores bone mineral density and ALP values were increased in the group that PTH values were between 120-250 pg/ml and more than 250 pg/ml. But these parameters were decreased in the group that PTH were lower than 120 pg/ml. Osteoporosis percentage were 23 % in PTH value 250 pg/ml in the initial measurement. After the therapy these were 30 %, 0 % and 20 % relatively. Conclusion: Before the treatment there was not a statistical difference between T score of 3 groups. After the treatment there was a statistically significant difference. Especially T score was better after the therapy in the second group that PTH values were between 120-250 pg/ml. © 2010 Düzce Medical Journal

Evaluation of fluid status related parameters in hemodialysis and peritoneal dialysis patients: Clinical usefulness of bioimpedance analysis

Background and objective: Fluid overload is a common and serious problem that leads to severe complications in dialysis patients. We aimed to compare hydration status as measured with bioimpedance analysis (BIA) method in hemodialysis (HD) and peritoneal dialysis (PD) patients, as well as investigating the association between blood pressure, left ventricular mass index (LVMI) and hydration status. Materials and methods: We examined 43 HD and 33 PD patients. Blood pressure was recorded. In each group, echocardiographic examinations were performed on all patients. Hydration status was assessed using multifrequency bioelectrical impedance analysis. Overhydration was defined as an overhydration (OH)/extracellular water (ECW) ratio of >0.15. Results: The OH/ECW ratio was significantly higher in PD patients compared to post-HD patients. Overhydration was statistically more frequent in PD than in post-HD patients (30.3% vs. 11.6%, P = 0.043). Systolic blood pressure (SBP) in both post-HD and PD groups, and LVMI in the PD group were found to be significantly higher in overhydrated patients than non-overhydrated patients. In multiple linear regression analyses, increased OH/ECW ratio was independently associated with higher SBP and LVMI. Conclusions: Fluid overload may be an even more prevalent and serious problem in PD patients. Overhydration is closely associated with increased blood pressure and LVMI. OH/ECW ratio, a derived parameter of fluid load measured by BIA, was a significant and independent determinant of SBP and LVMI

Frequency and relationship of ABO blood groups in patients with nephrotic syndrome

Aim of the study: To investigate the frequency of ABO blood groups and the relationship between nephrotic syndrome (NS) and blood groups in patients with NS.Material and methods: 199 patients with a diagnosis of NS and 200 healthy individuals, who applied to Dicle University Faculty of Medicine, Department of Nephrology between 2016 and 2020, and whose blood group information was in the records, were included in the study as the control group. This study was carried out retrospectively using data from the file registration system in our hospital.Results: In the study, there were 199 patients: 52.8% (n = 105) male and 47.2% (n = 94) female and 200 healthy individuals: 47.5% male (n = 95) 52.5% female (n = 105). The mean age of the patients was 35.79 ± 12.21 (min-max: 17–71), and the mean proteinuria was 7.08 ± 4.33 (min-max: 3.50–25.50). There was no difference between sick and healthy individuals in terms of age or sex (p &gt; 0.05). It was determined that 43.2% of the patients had blood group A, 26.1% blood group O, 25.1% blood group B, and 5.5% blood group AB. There was no significant difference between blood groups of patients with NS and individuals in the healthy group (p &gt; 0.05). Membranous glomerulonephritis (MGN) (27.9%) was most common in blood group A; FSGS was detected most frequently in blood groups B (46.0%), O (28.8%), and AB (36.4%). The most common cause of NS was focal segmental glomerulosclerosis (FSGS) in 31.2% (n = 62), and MGN was the second common cause in 19.1% (n = 38), blood group B (37.1%) in FSGS, blood group O (46.7%) in systemic lupus erythematosus, MGN (63.2%), IgA nephropathy (50%), and MPGN (52.2%) was found most frequently in blood group A. Conclusions: We did not find a significant relationship between the blood group and NS in our study