Do MEFV mutations influence arterial stiffness in FMF patients?

Background: Pulse wave velocity (PWV) is the most used technique to evaluate the arterial elasticity, which is an early indicator of atherosclerosis. We aimed to evaluate if MEFV Mutations influence arterial stiffness in patients with Familial Mediterranean fever (FMF) Methods: 70 patients diagnosed with FMF and 50 age-and sex-matched controls were included in the study. Genetic analysis of the patients was performed. After the measurement of PWV; the presence of AS was determined. Results: Mean PWV value and arterial stiffness frequency of FMF patients were significantly higher than the control group (p <0.001, p <0.001) respectively. In addition, FMF patients with M694Vmutations had higher PWV values and arterial stiffness frequency than those with other mutations. (p=0.045), (p=0.001). There were no differences within all genetic mutation types in terms of arterial stiffness frequency.Conclusions: As a result, due to subclinical inflammation in FMF patients, they have risk for cardiovascular complications. These patients especially those with M694Vmutations have to be followed more closely because of increased cardiovascular risk and PWV measurements may be a good tool to detect early development of atherosclerosis.

Spontaneous Perforation of Cirrhotic Acid After Observed Interesting Development: Case Report

Sirotik asit tedavisinde kullanılan parasentez, yüksek volümle yapıldığında dolaşım disfonksiyonu ve buna sekonder böbrek fonksiyon bozukluklarına neden olabilir. Kliniğimizde, masif asit ve hepatorenal sendrom nedeniyle takip ettiğimiz hastamızda spontan perforasyon gelişmesi takibinde, kreatinin değerlerinde dramatik bir düşme ve normal değerlerine gerileme gözlendi. Sonuç olarak; parasentez ile kreatinin değerlerinde yükselme olmadan da fazla miktarda asit mayisi direne edilebileceği, hastaların hemodinamik durumu da göz önüne alınarak, tedavi planlanırken akılda bulundurulmalıdır.Paracentesis which is used for cirrhotic acid treatment may cause renal dysfunction secondary to circulatory dysfunction when performed with high volume. In our clinic, spontaneous ascites perforation has developed in a patient hospitalized due to massive ascites and hepatorenal syndrome. In the follow-up period, dramatical decline was observed in creatinine values. In conclusion; it should be kept in mind that, a large amount of ascites drainage may be performed without increase in creatinine values during paracentesis taking into account the hemodynamic status of the patient

Spontaneous Perforation of Cirrhotic Acid After Observed Interesting Development: Case Report

Paracentesis which is used for cirrhotic acid treatment may cause renal dysfunction secondary to circulatory dysfunction when performed with high volume. In our clinic, spontaneous ascites perforation has developed in a patient hospitalized due to massive ascites and hepatorenal syndrome. In the follow-up period, dramatical decline was observed in creatinine values. In conclusion; it should be kept in mind that, a large amount of ascites drainage may be performed without increase in creatinine values during paracentesis taking into account the hemodynamic status of the patient

The Protective Effects of Kefir in Aspirin-Induced Gastric Mucosal Damage: An Experimental Study

Aims: Aspirin has a side effect of mucosal damage even at low doses. The aim of the present study was to investigate the efficacy of kefir in the prevention of gastric damage produced by aspirin. Materials and methods: In the present study, 32 male Wistar-Albino rats were divided into four equal groups. First group (Control) and 2nd group (Aspirin) were administered 2 ml serum physiologic for seven days. Third group (Kefir) and 4th group (Kefir + Aspirin) were administered 2 ml kefir solution instead of serum physiologic. On the eight day, aspirin and Kefir + Aspirin groups were administered 200 mg/kg aspirin, three hours before being sacrificed. All stomach mucosa was examined and mucosal damage scores were evaluated. Results: In Kefir + Aspirin group, macroscopic damage score was higher than Control (P=0.002) and Kefir (P=0.028) groups, and lower than Aspirin group (P=0.005). Histological damage scores in Kefir + Aspirin group were similar to those in control and kefir groups and significantly lower than Aspirin group (P<0.001). Conclusion: It was established that kefir prevents aspirin-induced gastric damage in experimental model

Evaluation Of The Diagnostic Criteria Of Restless Leg Syndrome In Hemodialysis Patients

Aim: In diagnosis of restless leg syndrome (RLS), seen frequently in hemodialysis patients, minimal criteria of International RLS Study Group have been commonly used. Our purpose is to investigate the significance of minimal criteria of International RLS Study Group for the diagnosis of RLS in hemodialysis patients in our district. Methods: We investigated the criteria of International RLS Study Group in 68 hemodialysis patients in three dialysis units of Afyonkarahisar city center. Twenty four patients were excluded due to absence of first criteria. Forty four patients answered positively to first question were evaluated for the diagnosis of RLS according to minimal criteria including 4 questions and neurological examination. Results: Among 44 (20 men, 24 women) hemodialysis patients mean age was 51+/-16.1 years and dialysis period was 25 (3-190) months. According to minimal criteria for diagnosis of RLS number of patients considered as positively responded to all four questions was 15 (%34.1); however number of real patients determined on neurological examination was 31 (%70.5). In the same group difference between RLS prevalence determined according to these two criteria was statistically significant (P = 0.001). Conclusion: All patients answered positively to at least first question for diagnosis of RLS, which affects quality of life, morbidity and mortality in HD patients through sleep disorders, should be evaluated in detail

Analysis of patients hospitalized in our clinic with the diagnosis of acute renal failure

Amaç: Akut böbrek yetmezliği, böbrek fonksiyonlarında hızlı bir azalmayla karakterize ve yüksek mortalite oranına sahip önemli bir klinik sendromdur. Akut böbrek yetmezliğinde mortalite, son yıllardaki yoğun bakım ve renal replasman tedavilerindeki gelişmeye rağmen yüksek kalmaya devam etmektedir. Bu çalışmada kliniğimizde ABY tanısıyla yatan hastaları değerlendirdik. Gereç ve Yöntem: Ocak 2011 ve Aralık 2012 arasında hastanemize Akut böbrek yetmezliği tanısıyla başvuran 145 hastayı retrospektif olarak inceledik. Hastaların kayıtlarından yaşı, Akut böbrek yetmezliği tipi, başvuru şekli, başvurudaki temel bulguları, etyolojisi, zeminde eşlik eden hastalıklar, uygulanan tedavi ve laboratuvar değerleri kaydedildi. Bulgular: Olguların etiyolojisi incelendiğinde en sık nedenler prerenal azotemi (%38,6) ve nefrotoksik ajan kullanımıydı (%30,3). Hastaların %72,6’sı nonoligürik %27,4’ü oligürik idi. Olguların %65,5’ine medikal tedavi uygulanırken %34,5’ine medikal tedaviye ek olarak hemodiyaliz tedavisi uygulandı. Hastaların %86,9’u tedavi sonucu iyileşirken, %13,1’i kaybedildi. Ölen hastaların %63,2’si medikal tedaviye ek olarak hemodiyaliz tedavisi alırken %36,8’i sadece medikal tedavi almıştı. Oligürik hastaların %67,5’i medikal tedavi ve hemodiyaliz, %32,5’i sadece medikal tedavi alırken nonoligürik hastaların %21,9’u medikal tedavi ve hemodiyaliz, %78,1’i sadece medikal tedavi aldı. Sonuç: Akut böbrek yetmezliği etiyolojisinde 40 yıl öncesine göre medikal nedenler ön plana çıkmaktadır. Ayrıca oligoanürik Akut böbrek yetmezliği hastalarında diyaliz gereksiniminin arttığı ve diyaliz tedavisi gereken hastalarda prognozun daha kötü olduğu gözlenmiştir. Bu yüzden bu hastaların daha yakından izlenmesi gerekmektedir.Objective: Acute renal failure, which is characterized by a speedy decrease in renal function, is an important clinical syndrome with a high mortality rate. In spite of advanced intensive care and renal replacement therapies in recent years, Acute renal failure mortality continues to remaining high . In this study, we evaluated patients hospitalized with ARF. Material and Methods: We reviewed 145 patients with a diagnosis of Acute renal failure between January 2011 and December 2012 in our hospital, retrospectively. From the records of the patients, age, Acute renal failure type, application form, application of the basic findings, etiology, concomitant diseases, treatment, and laboratory values were recorded. Results: The most common causes of Acute renal failure etiology in our hospital were prerenal azotemia (38.6%) and nephrotoxic agents (30.3%) . The 72.6%of patients were nonoliguric, while 27.4%were oliguric. Medical treatment was applied to 65.5%of patients and medical management together with hemodialysis therapy was administered to the rest of the patients. The improvement rate of patients was 869% while 13.1%of the patients were lost. The 63.2%of dying patients were treated with hemodialysis treatment in addition to medical treatment, while 36.8%had received medical treatment only. The 21.9%of nonoliguric patients had received hemodialysis and medical treat ment and 78.1%of them received only medical treatment. Conclusion: According to the etiology of Acute renal failure, medical reasons come to the forefront compared with 40 years ago. It is also observed that the need for dialysis in Acute renal failure patients with oligoanuria increased and the patients who require dialysis have worse prognosis. Therefore, these patients should be monitored more closely

Severe Hyperkalemia: A Retrospective Analysis

Aim: To investigate the effect of hemodialysis on blood pressure by monitoring ambulatory blood pressure during the interdialysis period and to evaluate the relationship between hypertension and the percentage of total body water calculated via bioelectrical impedance analysis. Methods: Twenty five patients with end stage renal disease who were in the hemodialysis program were included in the study. But only fifteen patients had been able to stay in the required criteria till the end. Pre- and post-dialysis blood pressures of the patients were measured manually and ambulatory blood pressure measurements were obtained during the interdialysis period. Measurements of total body water were performed with bioelectrical impedance method following the hemodialysis procedure. The patients were evaluated for daily course of blood pressure, use of anti-hypertensive medications, incidence of the falling rate of blood pressure at night, amount of total body water and interdialysis weight gain. Results: Manual pre- and post-dialysis measurements and mean values of 44 hours&apos; ambulatory blood pressure monitoring were found to be similar. Blood pressures were found to be significantly low until the 24th hour and they were increased at the 2nd day, then returned to initial levels at the 44th hour. There was uncontrolled hypertension in 7 of the 11 hypertensive patients (63.6 %). Mean percentage of total body water was higher in patients with hypertension (61.1 ±9.8 vs. 57.9±7.0, p>0.05). Conclusion: In our study, the reducing effect of hemodialysis on blood pressure was observed and this effect has continued nearly 24 hours after the dialysis. The fact that total body water is more in hypertensive patients supports the idea that volume excess is an important factor responsible from hypertension

Analysis of patients hospitalized in our clinic with the diagnosis of acute renal failure

Amaç: Akut böbrek yetmezliği, böbrek fonksiyonlarında hızlı bir azalmayla karakterize ve yüksek mortalite oranına sahip önemli bir klinik sendromdur. Akut böbrek yetmezliğinde mortalite, son yıllardaki yoğun bakım ve renal replasman tedavilerindeki gelişmeye rağmen yüksek kalmaya devam etmektedir. Bu çalışmada kliniğimizde ABY tanısıyla yatan hastaları değerlendirdik. Gereç ve Yöntem: Ocak 2011 ve Aralık 2012 arasında hastanemize Akut böbrek yetmezliği tanısıyla başvuran 145 hastayı retrospektif olarak inceledik. Hastaların kayıtlarından yaşı, Akut böbrek yetmezliği tipi, başvuru şekli, başvurudaki temel bulguları, etyolojisi, zeminde eşlik eden hastalıklar, uygulanan tedavi ve laboratuvar değerleri kaydedildi. Bulgular: Olguların etiyolojisi incelendiğinde en sık nedenler prerenal azotemi (%38,6) ve nefrotoksik ajan kullanımıydı (%30,3). Hastaların %72,6’sı nonoligürik %27,4’ü oligürik idi. Olguların %65,5’ine medikal tedavi uygulanırken %34,5’ine medikal tedaviye ek olarak hemodiyaliz tedavisi uygulandı. Hastaların %86,9’u tedavi sonucu iyileşirken, %13,1’i kaybedildi. Ölen hastaların %63,2’si medikal tedaviye ek olarak hemodiyaliz tedavisi alırken %36,8’i sadece medikal tedavi almıştı. Oligürik hastaların %67,5’i medikal tedavi ve hemodiyaliz, %32,5’i sadece medikal tedavi alırken nonoligürik hastaların %21,9’u medikal tedavi ve hemodiyaliz, %78,1’i sadece medikal tedavi aldı. Sonuç: Akut böbrek yetmezliği etiyolojisinde 40 yıl öncesine göre medikal nedenler ön plana çıkmaktadır. Ayrıca oligoanürik Akut böbrek yetmezliği hastalarında diyaliz gereksiniminin arttığı ve diyaliz tedavisi gereken hastalarda prognozun daha kötü olduğu gözlenmiştir. Bu yüzden bu hastaların daha yakından izlenmesi gerekmektedir.Objective: Acute renal failure, which is characterized by a speedy decrease in renal function, is an important clinical syndrome with a high mortality rate. In spite of advanced intensive care and renal replacement therapies in recent years, Acute renal failure mortality continues to remaining high . In this study, we evaluated patients hospitalized with ARF. Material and Methods: We reviewed 145 patients with a diagnosis of Acute renal failure between January 2011 and December 2012 in our hospital, retrospectively. From the records of the patients, age, Acute renal failure type, application form, application of the basic findings, etiology, concomitant diseases, treatment, and laboratory values were recorded. Results: The most common causes of Acute renal failure etiology in our hospital were prerenal azotemia (38.6%) and nephrotoxic agents (30.3%) . The 72.6%of patients were nonoliguric, while 27.4%were oliguric. Medical treatment was applied to 65.5%of patients and medical management together with hemodialysis therapy was administered to the rest of the patients. The improvement rate of patients was 869% while 13.1%of the patients were lost. The 63.2%of dying patients were treated with hemodialysis treatment in addition to medical treatment, while 36.8%had received medical treatment only. The 21.9%of nonoliguric patients had received hemodialysis and medical treat ment and 78.1%of them received only medical treatment. Conclusion: According to the etiology of Acute renal failure, medical reasons come to the forefront compared with 40 years ago. It is also observed that the need for dialysis in Acute renal failure patients with oligoanuria increased and the patients who require dialysis have worse prognosis. Therefore, these patients should be monitored more closely