Renal and suprarenal insufficiency secondary to familial Mediterranean fever associated with amyloidosis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Familial Mediterranean fever is an autosomal recessive disease that predominantly affects people of the Mediterranean coast. One of the most frequent complications of the disease is amyloidosis. This clinical entity is known as secondary (also called AA) amyloidosis.</p> <p>Case presentation</p> <p>In this report, we describe the case of a 33-year-old Turkish man with familial Mediterranean fever and chronic renal insufficiency. He was admitted to our clinic with symptoms of suprarenal insufficiency. The patient died three months later as a result of cardiac arrest.</p> <p>Conclusion</p> <p>Our aim is to make a contribution to the literature by reporting a case of combined insufficiency due to the accumulation of renal and adrenal amyloid in a patient with familial Mediterranean fever, which has very rarely been described in the literature. We hope that adrenal insufficiency, which becomes fatal if not diagnosed and treated rapidly, will come to mind as easily as chronic renal failure in clinical practice.</p

Steinert's syndrome presenting as anal incontinence: a case report

<p>Abstract</p> <p>Introduction</p> <p>Myotonic dystrophy (MD) or Steinert's syndrome is a rare cause of chronic diarrhea and anal incontinence. In the presence of chronic diarrhea and fecal incontinence with muscle weakness, neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis.</p> <p>Case Presentation</p> <p>We present the case of a 45-year-old Turkish man with Steinert's syndrome, who was not diagnosed until the age of 45.</p> <p>Conclusions</p> <p>In clinical practice, the persistence of diarrhea and fecal incontinence with muscle weakness should suggest that the physician perform an anal manometric study and electromyography. Neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis.</p

Serum Neurotrophic Factor Levels in Patients with Type 2 Diabetes Mellitus: Relationship to Metabolic Syndrome Components

Background: It has been thought that neurotrophins have metabotrophic effects and take part in the carbohydrate and lipid metabolism. The aim of the present study is to examine the levels of neurotrophins in type 2 diabetes mellitus (T2DM) and whether the levels are linked to the components of metabolic syndrome

The Impact of Obesity and Insulin Resistance on Iron and Red Blood Cell Parameters: A Single Center, Cross-Sectional Study

Objective: Obesity and iron deficiency (ID) are the 2 most common nutritional disorders worldwide causing significant public health implications. Obesity is characterized by the presence of low-grade inflammation, which may lead to a number of diseases including insulin resistance (IR) and type 2 diabetes. Increased levels of acute-phase proteins such as C-reactive protein (CRP) have been reported in obesity-related inflammation. The aim of this study was to investigate the impact of obesity/IR on iron and red blood cell related parameters

The cardiac effects of Formaterol in mild to moderate asthma and COPD patients

Cardiac side effects of beta 2 agonists have been evaluated in many studies. The most important factors were hypoxia and hypokalemia. We searched for the cardiac side effects of formaterol in asthma and COPD patients with Pa 02> 60 mm Hg, FEV1 > %50 and without any other cardiac disease. Patients after a period of withdrawal of bronc-hodilatator therapy were applied placebo, Formaterol 12 microgram and 24 microgram on days 0, 1 and 2 respectively. Their arterial blood gases, serum electrolytes and cardiac rithyms by Holter moniterisation were evaluatedfor three days. Serum potassium levels significantly decreased in correlation with formaterol dose. 12 microgram formoterol did not change Pa 02 levels compared with placebo though 24 microgram decreased Pa 02 significantly. Also 24 microgram caused a significant decrease of Pa 02 compared with 12 microgram (p<0.05). 24 microgram formaterol decreased serum potassium levels more than 12 microgram; but neither doses caused difference in atrial and ventricular arrythmia pruduction. We conclude that in mild to moderate stable asthma and COPD patients without hypoxemia both 12 and 24 microgram of formaterol did not cause significant arrythmia although they gave rise a decrease in potassium levels inaccordance with dose

The effects of renal replacement therapy on plasma, asymmetric dimethylarginine, nitric oxide and C-reactive protein levels

Purpose: Asymmetric dimethylarginine (ADMA), nitric oxide (NOx), and C-reactive protein (CRP) are important risk factors for endothelial dysfunction and mortality in the end stage renal diseases population. The aim of the study was to investigate the relationship between renal replacement therapy and endothelial dysfunction. Methods: Plasma NOx, ADMA and CRP levels were examined in randomized selected 30 patients with chronic kidney diseases (CKD), 28 patients receiving continuous ambulatory peritoneal dialysis (PD) and 30 patients receiving regular hemodialysis (HD) and age-matched 20 healthy controls. The duration of dialysis was from 4, 5 to 11, and 6 years, respectively. Results: CKD patients had higher plasma ADMA (1.26±0.53?mol/L) and CRP levels (1.02±025mg/L) and lower NOx levels (28.6±5.4?mol/L) than controls (0.45±0.20; 0.65± 0.45; 32.5±37 respectively, P < 0.001).Plasma NOx and CRP levels were higher in HD patients (32.9±5.5?mol/L, P < 0.05 and 4.59±3.18mg/L, P < 0.001) and plasma ADMA and CRP levels were higher in PD patients (1.82±0.98?mol/L, P < 0.001 and 2.40±1.53mg/L, P < 0.001) than in CKD patients. PD patients had higher plasma ADMA levels (P < 0.05) and lower plasma NOx and CRP levels than HD patients (P < 0.001 and P < 0.001). Plasma ADMA levels were negatively correlated with NOx levels in all patient groups (P < 0.001). Plasma CRP levels in CKD and HD patients were positively correlated with plasma urea levels (r:0,437, P < 0,001) and duration of dialysis (r:0,370, P < 0.01), respectively. Conclusion: CRP and ADMA may be emerging as important risk factors for atherosclerosis in dialysis patients. Reduced NO elaboration secondary to accumulation of ADMA and elevated inflammation may be important pathogenic factors for endothelial dysfunction in both dialysis treatment strategies

DEVELOPMENT AND EVALUTION OF A TURKISH "RHINITIS QUALITY OF LIFE SCALE"

WOS: 000307988400007Objective: Questioning the quality of life in patients with chronic diseases is important. However questionnaires should be suitable to the structure and habits of the community studied as well as it should be easily understood. Considering the fact that rhinitis adversely affect the quality of life, we developed a rhinitis scale of quality of life, which suits the life style and habits of our population in patients with rhinitis. Material and Method: Scale includes the 28 parameters that are needed to be graded and scored about daily activities, nasal symptoms, and eye complaints, sleep disorders in addition to social and emotional assessment. A total of 163 patients with allergic rhinitis, that applied to Allergy division of Internal Medicine Department of Istanbul Medical School have been included into the study Symptoms scoring has been performed with short form 36 (SF-36) and novel scale at week 0, week 1 and 1 month after treatment. The results of newly developed rhinitis quality of life scale were compared with statistical methods for language validity, reliability, repeatability, reproducibility and sensitivity. Results: Language validity of scale was shown (n=20). Intraclass correlation coefficient (ICC) is 0.8877, Cronbach cilia is 0.94; these values are high and represent the reliability of new scale (control at 1. week without treatment n=38). Although there is a weak correlation between the results of new scale and SF-36 sub parameter scores, these correlations were significant in statistical analysis (n=.103) (validation). New scale was significantly sensitive for determining the pre and post treatment changes (n=103) (z=-7.452, p=0.000). Conclusion: This newly developed scale is practical, easy to be administrated in short periods; also it has sufficient reliability, reproducibility, validity and sensitivity characteristics. We concluded that this scale is suitable for both determining the clinical status and response to treatment in patients with allergic rhinitis

Oxidative lipid, protein, and DNA damage as oxidative stress markers in vascular complications of diabetes mellitus

Purpose: The purpose of this study was to determine the effects of diabetic complications on oxidation of proteins, lipids, and DNA and to investigate the relationship between oxidative damage markers and clinical parameters. Methods: The study group consisted of 69 type 2 diabetic patients (20 patients without complication, 49 patients with complication) who attended internal medicine outpatient clinics of Istanbul Education and Research Hospital and 19 healthy control subjects. In serum samples of both diabetic patients and healthy subjects, 8-hydroxy-2’deoxyguanosine (8-OHdG), as a marker of oxidative DNA damage, Nε-(hexanoyl)lysine (HEL) and 15-F2t-iso-prostaglandin (15-F2t-IsoP). as products of lipooxidative damage, advanced oxidation protein products (AOPP), as markers of protein damage, and paraoxonase1 (PON1) as antioxidant were studied. Results: 15-F2t-IsoP (p < 0.005) and AOPP (p < 0.001) levels were significantly higher in diabetic group than control group while there were no significant differences in levels of 8-OHdG and HEL between the two groups. AOPP (p < 0.001) and 8-OHdG (p < 0.001) were significantly higher in diabetic group with complications compared to diabetic group without complications. Conclusions: Increased formation of free radicals and oxidative stress, under conditions of hyperglycaemia, is one of the probable causes for evolution of complications in diabetes mellitus. Our study supports the hypothesis that oxidant/antioxidant balance is disturbed in diabetic patients