Relapse of minimal change disease after inactivated SARS-CoV-2 vaccination: case report

[No Abstract Available

Relationship between serum soluble endothelial protein C receptor level and COVID-19 findings

Coronavirus-related disease-2019 (COVID-19)-associated coagulopathy presents predominantly with thrombosis and leads to complications in close association with inflammatory process. Soluble endothelial protein C receptor (sEPCR), which is the soluble form of EPCR, reduces the anticoagulant and anti-inflammatory activity of activated protein C. The purpose of this study is to investigate the relationship between sEPCR and the laboratory parameters and thorax computed tomography (CT) findings in the course of COVID-19. Twenty-five laboratory-confirmed [reverse transcription-quantitative polimerase chain reaction (RT-qPCR) positive] and 24 clinically diagnosed (RT-qPCR negative) COVID-19 patients were enrolled in the study. Blood specimens were collected for sEPCR and haematological and biochemical parameter measurement. Thorax CT was performed to detect COVID-19 findings. These parameters from RT-qPCR positive and negative patients were then compared. Although there was no difference between the groups in terms of symptoms, the time between the onset of symptoms and the admission time was shorter in RT-qPCR positive group (P?=?0.000). sEPCR levels were significantly higher in the RT-qPCR positive group (P?=?0.011). Patients with ground-glass opacity and bilateral involvement on thorax CT have higher serum sEPCR levels (P?=?0.012 and 0.043, respectively). This study has shown for the first time that serum sEPCR levels, which is a member of coagulation cascade and has also been reported to be associated with inflammation, is higher in patients with positive RT-qPCR test and patients with GGO or bilateral involvement on thorax CT regardless of the PCR result. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved

Management of Nephrology Clinics in COVID-19 Pandemic

SARS-COV2’nin etkeni olduğu COVİD-19 ciddi mortaliteye sebep olan, Dünya Sağlık Örgütü tarafından kısa süre içinde pandemi olarak ilan edilen bir hastalık halini almıştır. Semptomatik olguların büyük kısmında hastalık hafif semptomlarla geçirilse de bazı hastaların mortalite ve morbidite açısından daha yüksek risk grubunda oldukları görülmüştür. Hipertansiyon başta olmak üzere kronikkardiyovasküler hastalığı olan hastalar ve glomerülonefritler, renal tranplantasyon ve diğer sebeplere bağlı kronik böbrek hastalıklarını içeren kronik renal hastalığı olanlar bahsi geçen yüksek risk grubundadır. Öte yandan böbrekler COVİD-19 seyrinde akut biçimde de en sık ve ağır biçimde etkilenen organlar arasında yer almaktadır. Hastalığın kesin bir tedavisinin olmaması, etkilenen organlarda uzunvadedeki etkilerinin bilinmemesi nedeniyle koruyucu önlemler COVİD-19 pandemisinin yönetiminde kilit role sahiptir. Tüm bu özelliklerinden ötürü COVİD-19 pandemisi nefroloji kliniklerinde özel koruyucu önlemler alınmasını, tedavi ve takipte kısa ve uzun vadeli planlamalar yapılmasını gerekli kılmıştır. Bu makalede COVİD-19 pandemisinde nefroloji kliniklerinde yapılması gereken düzenlemeler ve özel hasta gruplarının takibi özetlenecektir.COVID-19, caused by SARS-COV2, has became a disease which is declared as a pandemic by World Health Organization in a short time. Although most symptomatic cases, result in minör symptoms; some patients were found to be at higher risk for mortality and morbidity. Patients with chronic cardiovascular morbidities, especially hypertension, and chronic renal morbidities including glomerulonephritis, renal transplantation and chronic kidney diseases due to other causes are included in the high-risk group. However, kidneys are among the most frequently and severely affected organs acutely in the course of the COVID-19. Preventive measures play a key role in COVID-19 pandemic management, as there is no definitive treatment for the disease and the long-term effects in involved organs are unknown. This has made it necessary to take special protective measures in nephrology clinics and to make short and longterm plans in treatment and follow-up. In this article, the arrangements to be made in nephrology clinics in COVID-19 pandemic and the follow-up of special patient groups will be summarized

Radiotherapy-Related Tumour Lysis Syndrome in a Patient with Metastatic Adenocarcinoma of Unknown Origin

Tumour lysis syndrome (TLS) is a rare but serious complication of cancer treatment. It is generally seen in patients with high tumour load or chemosensitive tumour after chemotherapy and is more common with haematological malignancies like leukaemia and lymphoma when compared to solid tumours. TLS occurring after radiotherapy (RT) in patients with solid tumours is very rare. We aimed to present TLS seen after RT for a vertebral tumoral mass in a patient with metastatic adenocarcinoma of unknown origin. A 78-year-old woman, who was diagnosed with adenocarcinoma of unknown origin, was hospitalized to undergo palliative RT for the vertebral mass. On the 1st day, 4 mg q6hour perioral dexamethasone was started. 300 cGy per session RT started on the 2nd day of hospitalization. After the fifth session of RT (after a total dose of 15 Gy), she developed TLS complicated with acute kidney injury requiring renal replacement therapy and she was successfully treated by haemodialysis. Close monitoring, even in patients with low risk for TLS and early administration of preventive modalities should be kept in mind

The place of infectious markers in predicting culture positivity in patients with renal failure hospitalized with suspected infection

Infectious diseases are an important cause of mortality in patients with renal failure. The markers used to diagnose infection in patients with renal failure have various limitations. Culture positivity is an objective guide in that context. The purpose of this study was to examine the effectiveness of frequently used markers of bacterial infection in predicting culture positivity in renal failure patients with renal failure hospitalized with suspected bacterial infection over an approximately 1.5-year period were included in this prospective observational study. Patients' demographic and laboratory findings were recorded. Demographic and laboratory findings and mortality were compared between patients with and without culture-positivity. Parameters affecting culture positivity were also analyzed. Four hundred twenty-six patients (median age 67.50, 45.5% female) were included in the study. Culture positivity was determined in 54.5% of patients. Hospital stay was longer (p < 0.001) and leukocyte (p < 0.001), neutrophil percentage (p < 0.05) and CRP (p < 0.001) values were significantly higher in culture-positive patients. Mortality was also significantly higher in culture-positive patients than in culture-negative patients (p < 0.05). CRP was determined as a predictor of culture positivity at logistic regression analysis (p = 0.000, exp ß [1.004]). Culture positivity was determined in more than half of the patients hospitalized with suspected bacterial infection. CRP, a longstanding marker, was identified as a parameter predicting culture positivity. We think that the determination in further studies of a cut-off point for CRP in determining culture positivity may be a useful diagnostic guide. © 2021 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy

Serum Calprotectin Level as an Inflammatory Marker in Newly Diagnosed Hypertensive Patients

Background. Hypertension is one of the leading causes of cardiovascular mortality. Although the pathogenetic process involved is not yet fully understood, the disease involves endothelial damage and inflammation. Calprotectin is an inflammatory marker that rises in parallel with disease activity in conditions such as systemic inflammatory diseases, infection, and atherosclerosis. The purpose of this study was to evaluate inflammation through serum calprotectin levels in newly diagnosed primary hypertension patients. Methods. Forty-nine newly diagnosed hypertensive patients and 38 healthy adults were included in the study. Patients' office blood pressure values, biochemical findings, and demographic characteristics were recorded. Serum calprotectin levels were measured using ELISA. Parameters affecting serum calprotectin levels and determinants of hypertension were evaluated. Results. Serum calprotectin levels were 242.8 (72.4-524) ng/mL in the control group and 112.6 (67.4-389.8) ng/mL in the hypertensive patient group, the difference being statistically significant (p=0.001). There was no correlation between serum calprotectin levels and other parameters (blood pressure values, age, gender, serum creatinine, uric acid, and calcium levels) in the hypertensive group. A lower serum calprotectin level was found to be independently related to hypertension (? = -0.009, p=0.005). Serum calprotectin at a cutoff level of 128.6 ng/mL differentiated hypertensives from healthy controls with a sensitivity of 69.4% and specificity of 68.4% (AUC = 0.767). Conclusions. The results of this study were the opposite of our hypothesis that a higher calprotectin level may reflect subclinical endothelial damage in newly diagnosed hypertensive patients. Further comparative studies involving patients at different stages of hypertension may contribute to clarifying the relationship between calprotectin and hypertension. We conclude that molecular studies seem essential for understanding the place of calprotectin in hypertension-associated inflammation, a complex process. © 2022 Nergiz Bayrakci et al

Procollagen C-proteinase enhancer-1 and renal failure in multiple myeloma

Background Renal involvement is present in approximately 50% of multiple myeloma (MM) cases and is associated with a poor prognosis. Procollagen C-Proteinase Enhancer 1 (PCPE-1) is an extracellular matrix glycoprotein that has been shown to increase collagen production by enhancing the activity of Procollagen C-Proteinase (PCP) involved in collagen fibrillogenesis and contribute to the fibrotic process. This study investigates the relationship between PCPE-1 and renal function in myeloma patients. Methods Eighty-one adults, consisting of 61 patients diagnosed with MM and 20 healthy controls, were included in this cross-sectional study. The MM patients with renal injury (RI) were classified as MM-RI( +) and those with no RI as MM-RI(-). Results The median serum PCPE-1 level was 10.7 (5.0-39.4) ng/mL for the entire study population, 9.9 (5.0-13.6) ng/mL for the control group, 10.0 (6.4-22.5) ng/mL for the MM-RI(-) group, and 11.4 (8.1-39.4) ng/mL for the MM-RI( +) group. The difference between the control group and MM-RI( +) group was statistically significant (p < 0.013). PCPE-1 levels negatively correlated with estimated glomerular filtration rate (eGFR), serum albumin, and hemoglobin levels but positively correlated with serum creatinine and CRP levels in the entire study population. Among MM patients, only serum phosphorus and beta-2-microglobulin (beta 2M) were positively correlated with PCPE-1. PCPE-1 levels was not affected by other parameters in the entire study population and in the MM group. Conclusions Although serum PCPE-1 was higher in the MM-RI( +) group, it was thought to be associated with low GFR reflecting non-specific kidney injury rather than myeloma-related kidney injury

MicroRNA 21 and microRNA 155 levels in resistant hypertension, and their relationships with aldosterone

Aim: MicroRNAs (miRNAs) are non-coding RNA molecules that serve as regulators following gene expression transcription. While studies have investigated the role of miRNAs in the pathogenesis of essential hypertension (HT), very few have considered their place in the pathogenesis of resistant hypertension (RH). The purpose of this study was to investigate levels of miRNA 21 and miRNA 155 in RH and their relationships with aldosterone. Method: Thirty-two normotensive patients, 30 newly diagnosed HT patients, and 20 RH patients were included in the study. Patients’ demographic data were recorded, and office blood pressure measurement and 24-h ambulatory blood pressure monitoring (24-h ABPM) were performed. Blood specimens were collected for miRNA 21, miRNA 155 and aldosterone measurement. MiRNA 21 and miRNA 155 levels in the control and patient groups and their relations with other demographic and biochemical parameters were then subjected to analysis. Results: No difference was determined in miRNA 155 levels between the groups, but miRNA 21 and aldosterone levels were significantly higher in the RH group (p < 0.001 and <0.05, respectively). At correlation analysis, miRNA 21 exhibited positive correlation with aldosterone, age, office SBP, 24-h ABPM all-day SBP. A 9.6 copy/uL level for miRNA 21 predicted presence or absence of RH with 95% sensitivity and 71% specificity (AUC:0.823, 95% CI (0.72–0.92). Conclusion: The study results revealed significantly higher miRNA 21 and aldosterone in RH patients than in healthy individuals and newly diagnosed hypertensives. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.This study was supported by the Scientific Researches Fund of Tekirda? Nam?k Kemal University

Advanced Age and Mild Thyrotoxicosis are Associated with Nodular Goiter in Graves Disease

Objective: The primary goal of this study is to evaluate predictors of nodular goiter in Graves Disease (GD).Materials and Methods: A total of 202 consecutive patients (mean age: 45; 145 female, 57 male) were enrolled. All patients were treated with antithyroid drugs as initial therapy. TSH, FT3, FT4, TRAb, ATPO, and ATG were measured. Radioactive iodine uptake and thyroid ultrasonography were performed, and thyroid volume and nodule diameter were assessed. Ultrasound-guided fine needle aspiration was performed on thyroid nodules ≥8mm. Results: Diffuse goiter was detected in 51% of patients. Solitary nodules were detected in 16%, and multi-nodular disease in 33%. Mean nodule diameter was 8.82 mm. Nodular disease was slightly more common in women (p=0.063). Patients with nodular GD were older (p=0.004), had lower levels of FT3 (p=0.016) and TRAB (p=0.002) when compared with subjects with diffuse GD. Age (OR:6.867) was the independent variable predicting nodular GD. Conclusion: Increased prevalence of nodules was associated with advanced age and milder thyrotoxicosis. Apoptosis of thyroid follicular cells due to excess iodine might interfere with nodule formation, and lead to diffuse goiter in severe thyrotoxicosis. Because of increased rate if malignancy in GD, comprehensive evaluation of thyroid nodules of any size is mandatory. Turk Jem 2009; 13: 1-

Relationship between Microfibrillar-Associated Protein 4 Levels and Subclinical Myocardial Damage in Chronic Kidney Disease

Introduction:Chronic kidney disease (CKD) is a widespread health problem, in which mortality is most frequently due to cardiovascular diseases. Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein. MFAP4 is involved in several biological processes, particularly the maintenance of vascular integrity and extracellular matrix remodeling. Our review of the literature revealed no data concerning MFAP4 levels in CKD and its relationship with myocardial functions.Objective:The purpose of this study was therefore to investigate MFAP4 levels in CKD, parameters affecting these, and the relationship with myocardial functions.Materials and Methods:Seventy-nine CKD patients and 30 healthy controls were included in the study. Routine biochemical tests and echocardiography were performed once demographic data had been recorded. Blood specimens were collected for MFAP4 analysis, and the results were subjected to statistical analysis.Results:MFAP4 levels were significantly higher in the patient group than in the control group (p< 0.001). Doppler parameters revealed more frequent LV diastolic impairment in the patient group. Tissue Doppler systolic velocity and global longitudinal strain were significantly impaired, revealing the subclinical LV systolic dysfunction in CKD patients. MFAP4 elevation in the patient group was positively correlated with aortic root (AR), global circumferential strain (GCS), and GCS rate.Conclusion:Our results showed MFAP4 elevation in CKD for the first time in the literature, and that this elevation may be related to GCS and AR dilation. We think that, once supported by further studies, MFAP4 may constitute a marker in the evaluation of myocardial functions in CKD