Therapeutic approach to FSGS in children

Therapy of primary focal segmental glomerulosclerosis (FSGS) in children incorporates conservative management and immunosuppression regimens to control proteinuria and preserve kidney function. In long-term cohort studies in adults and children with primary FSGS, renal survival has been directly associated with degree of proteinuria control. This educational article reviews the current therapeutic approach toward children with primary FSGS

Peritoneal ultrafiltration failure

5th Congress of the Balkin-Cities-Association-for-Nephrology-Dialysis-Transplantation-and-Artificial-Organs (BANTAO) -- SEP 30-OCT 03, 2001 -- THESSALONIKI, GREECEWOS: 000171605400042PubMed ID: 11568264Balkin Cities Assoc Nephrol Dialysis Transplantat Artificial Organ

Diuretic effects of intravenous albumin (A), furosemide (F) and their combination (A + F) in the nephrotic syndrome (NS).

[No abstract available

Internal medicine residency training in Turkey

Medical school entrance depends on passing a central examination that is given annually by the National Selection and Placement Center. Undergraduate medical education takes 6 years. About 5000 students graduate from medical faculties annually. The central exam necessary for residency training is given by the National Selection and Placement Center. A Specialist Training Regulation regulates residency training. Internal medicine residency training takes 4 years and includes inpatient and outpatient care in wards and rotations. Residents prepare a dissertation that is used in the evaluation of residency competency. At the end of the residency period, residents who have been successful in previous evaluations take an oral exam followed by a written exam, which lead to their certification in internal medicine. Residents' scientific knowledge and skills are assessed by a jury consisting of five people, four from the same department and one from the equivalent department in another training institution. The title of specialist is granted after a certification exam given by training institutions and approved by the Ministry of Health. Internists are mainly employed in state hospitals, which are under the Ministry of Health. Subspecialty areas in internal medicine include gastroenterology, geriatrics, endocrinology, nephrology, hematology, rheumatology, immunology, allergology, and oncology. The training period for a subspecialty is 2 years. A substantial effort is being made all over the country to improve regulations and health care service delivery. These changes will also affect the residency training and manpower planning and employment of internists. © 2005 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved

Cardiovascular Disturbances In Hemodialysis-Patients - the Importance of Volume Overload

WOS: A1995QV62800004This review concentrates on the pathophysiology of cardiovascular changes in hemodialysis and attempts to identify regions deserving more attention. Some of the links constituting the volume/blood pressure relationship still await further elucidation. Whether volume retention is an independent risk factor has not yet been completely analysed. The existence of a specific toxic cardiomyopathy is debated, since a similar picture can result from long-standing hypertension and volume expansion. The relative contribution of plasma renin to the hypertension of many HD patients is still unknown. Consequently the place of converting enzyme inhibition in the treatment of these patients has yet to be established. Taken together the evidence available indicates that better volume control could considerably improve cardiovascular morbidity in a large part of the HD population

Cardiovascular disturbances in hemodialysis patients: The importance of volume overload

This review concentrates on the pathophysiology of cardiovascular changes in hemodialysis and attempts to identify regions deserving more attention. Some of the links constituting the volume/blood pressure relationship still await further elucidation. Whether volume retention is an independent risk factor has not yet been completely analysed. The existence of a specific toxic cardiomyopathy is debated, since a similar picture can result from long-standing hypertension and volume expansion. The relative contribution of plasma renin to the hypertension of many HD patients is still unknown. Consequently the place of converting enzyme inhibition in the treatment of these patients has yet to be established. Taken together the evidence available indicates that better volume control could considerably improve cardiovascular morbidity in a large part of the HD population

POLYMORPHISMS IN HETEROZYGOUS AND HOMOZYGOUS PERILIPIN GENE, C.1113T > C AND C.1119C > T, ARE INCREASED IN OBESE WOMEN

WOS: 000312679100005Background. Obesity involves both genetic and environmental influences, but the mechanisms of the genetic effects are not well understood. Objective. The aims of the study were to investigate the frequency of perilipin gene polymorphism in order to identify the relationship between insulin resistance and gene polymorphism in obese women. Subjects and methods. Study population included 31 obese women and 10 women with normal weight as a control group. All of the entire coding exons of PLIN gene were amplified by polymerase chain reaction (PCR). Insulin resistance (IR) was estimated using the homeostasis model assessment (HOMA-IR). Results. In the obese group, 29 (93.6%) patients were homozygous and 1 patient (3.2%) was heterozygous for the c.580C>.G (p.Pro194A1a) (rs.6496589) mutation and I patient (3.2%) was Pro194A1a. Homozygous.Val156Leu. heterozygous mutation at exon 5 at PLIN gene (p=0.072). As for exon 8 at PLIN gene in obese group, 6 patients (19.3%) had heterozygous for the c.1113T>C (Pro371Pro) (rs2304796) mutation, and 12 patients (38.7%) had heterozygous for the c.1113T>C and c.1119C>T (p.Val373Val) (rs2304795) mutation, and 4 patients (12.9%) had homozygous for the c.1113T>C and c.1119C>T mutations (p=0.009). In obese patients with no nucleotide substitution at exon 8, mean levels of systolic and diastolic blood pressures were higher than those of obese subjects with gene polymorphism. However, there were no statistically significant differences for HOMA-IR levels between obese women with and without perilipin gene polymorphism. Conclusions: Perilipin gene polymorphisms such as heterozygous and homozygous for the c.1113T>C and c.1119C>T (rs2304795) at exon 8 were associated with obesity risk. However, no relationship was found between insulin resistance and polymorphisms of perilipin gene in obese women