Use of Plasmapheresis in Nephrology Practice

WOS: 000374928400002Plasma exchange (plasmapheresis) is a treatment method based on separating the plasma, one of the 4 components, from whole blood removed from the body and giving the remaining part back to the circulation with replacement fluid. The place of plasmapheresis in the management of kidney disease is often controversial. In this article, we aimed to review the use of plasmapheresis in nephrology practice. Plasmapheresis treatment can be used in Goodpasture's disease, small vessel vasculitis (crescentic glomerulonephritis), acute renal failure due to multiple myeloma, paraproteinemia or hyperviscosity syndrome, some cases of systemic lupus erythematosus, adult HUS, and acute humoral rejection in renal transplantation patients in nephrology practice together with other treatments

Alpha-Galactosidase A Activity Levels in Turkish Male Hemodialysis Patients

WOS: 000311856500007PubMed ID: 23190516Fabry disease is an X-linked lysosomal storage disorder due to deficient activity of alpha-galactosidase A (alpha-Gal A) leading to renal insufficiency in males. The aim of present study was to investigate the level of alpha-Gal A activity and to determine the prevalence of Fabry disease in a Turkish male hemodialysis population. The activity of plasma alpha-Gal A was measured in a group of 808 male hemodialysis patients using fluorimetric methods. Patients with low alpha-Gal A activity were evaluated clinically and genetic testing was carried out. A correlation with creatinine, uric acid, urea, white blood cell (WBC), and high sensitivity (hs)CRP and alpha-Gal A activity was also investigated. Plasma a-Gal A activity among this male population undergoing hemodialysis was 7.88 +/- 5.18 mu M/hour/L (0.4055.72), significantly lower when compared to controls. No influence of creatinine, uric acid, WBC, or hsCRP on measured alpha-Gal A activity was reported. Two new Fabry disease patients were identified. Both were previously diagnosed with diabetes mellitus type 2. These findings provide, for the first time, data regarding the prevalence of alpha-Gal A deficiency (0.24%) in Turkish males receiving hemodialysis

Attention Deficit Hyperactivity Disorder Treatment Practice in Turkey

Objective: To determine the factors associated with type of ADHD prescription and re-admission of the cases to the outpatient clinics between January-July 2013. Method: The Ministry of Health prescription database, which included prescriber, region, age and gender data and contained almost 20% of IMS data. Results: A total of 73,189 prescription were prescribed to a total of 41,341 (30,014 males; 72.7%) patients. 38645 (93.5%) of the patients were between 6 and 18 years of age. The most frequently prescribed drug was OROS methylphenidate (MPH, 59.7%) followed by IR MPH, atomoxetine and combination of drugs. There were several regional differences in prescription practice. Treatment choice changed significantly with age and gender. Rate of repeated prescription was highest among 6-18 year-old male subjects receiving combination treatment. Conclusions: ADHD treatment choice seemed to be heavily influenced by official regulations. Age, gender and drug of choice were important factors associated with treatment adherenc

Evaluation of Corneal Topography and Biomechanical Parameters after Use of Systemic Isotretinoin in Acne Vulgaris

Purpose. We report the effect of isotretinoin on corneal topography, corneal thickness, and biomechanical parameters in patients with acne vulgaris. Method. Fifty-four eyes of 54 patients who received oral isotretinoin for treatment of acne vulgaris were evaluated. All patients underwent a corneal topographical evaluation with a Scheimpflug camera combined with Placido-disk (Sirius), ultrasonic pachymetry measurements, and corneal biomechanical evaluation with an ocular response analyzer at baseline, in the 1st, 3rd, and 6th months of treatment, and 6 months after isotretinoin discontinuation. Results. The thinnest corneal thickness measured with Sirius differed significantly in the 1st, 3rd, and 6th months compared with the baseline measurement; there was no significant change in ultrasonic central corneal thickness measurements and biomechanical parameters (corneal hysteresis and corneal resistance factor) throughout the study. Average simulated keratometry and surface asymmetry index increased significantly only in the first month of treatment according to the baseline. All changes disappeared 6 months after the end of treatment. Conclusion. Basal tear secretion and corneal morphologic properties were significantly influenced during the systemic isotretinoin treatment and the changes were reversible after discontinuation. No statistical important biomechanical differences were found to be induced by isotretinoin

Evaluation of Corneal Topography and Biomechanical Parameters after Use of Systemic Isotretinoin in Acne Vulgaris

Purpose. We report the effect of isotretinoin on corneal topography, corneal thickness, and biomechanical parameters in patients with acne vulgaris. Method. Fifty-four eyes of 54 patients who received oral isotretinoin for treatment of acne vulgaris were evaluated. All patients underwent a corneal topographical evaluation with a Scheimpflug camera combined with Placido-disk (Sirius), ultrasonic pachymetry measurements, and corneal biomechanical evaluation with an ocular response analyzer at baseline, in the 1st, 3rd, and 6th months of treatment, and 6 months after isotretinoin discontinuation. Results. The thinnest corneal thickness measured with Sirius differed significantly in the 1st, 3rd, and 6th months compared with the baseline measurement; there was no significant change in ultrasonic central corneal thickness measurements and biomechanical parameters (corneal hysteresis and corneal resistance factor) throughout the study. Average simulated keratometry and surface asymmetry index increased significantly only in the first month of treatment according to the baseline. All changes disappeared 6 months after the end of treatment. Conclusion. Basal tear secretion and corneal morphologic properties were significantly influenced during the systemic isotretinoin treatment and the changes were reversible after discontinuation. No statistical important biomechanical differences were found to be induced by isotretinoin