The Association of Fibroblast Growth Factor 23 with Arterial Stiffness and Atherosclerosis in Patients with Autosomal Dominant Polycystic Kidney Disease

Background/Aims: In patients with autosomal dominant polycystic kidney disease (ADPKD), cardiovascular events are the most frequent cause of mortality and morbidity. The aim of our study is to investigate the association between serum fibroblast growth factor-23 (FGF-23) and arterial stiffness (AS) as determined with brachial-ankle pulse wave velocity (baPWV) and atherosclerosis development as determined with carotid artery intima-media thickness (CA- IMT). Methods: This cross-sectional study was conducted with totally 86 ADPKD patients, 50 (58.1%) female and 36 (41.9%) male, with a mean age of 49.5 ± 13.9 years. Patients were compared with healthy control group with similar distribution of age and gender. AS was assessed with baPWW, and atherosclerosis development was assessed with CA-IMT. CA-IMT > 9 mm was considered as increased atherosclerosis. Serum FGF-23 and soluble klotho (s-KL) levels were measured with enzyme-linked immunosorbent assay. Due to skewed distribution of variables, statistical calculations of FGF-23 and s-KL were performed with log10. Results: According to the CKD stages, 46 (53.5%) patients had stage 1-2, 32 (37.2%) had stage 3-4, and 8 (9.3%) had predialysis stage 5 disease. Mean log10FGF-23 was 2.43 ± 0.41 pg/mL, and mean log10s-KL was 1.28 ± 0.09 ng/mL. Mean baPWV was 7.48 ± 1.68 m/sec, and mean CA-IMT was 0.63 ± 0.14 mm. Among patients at various stages of CKD, systolic blood pressure (SBP) (p = 0.003), diastolic blood pressure (DBP) (p = 0.002), creatinine, 1.25hydroxy(OH)2VitaminD3, log10FGF-23, baPWV, CA-IMT were higher (p < 0.001)andlog10s-KL were lower (p < 0.001) in comparison to healthy individuals. FGF-23 was positively correlated with creatinine, 1.25(OH)2VitD3 (p < 0.001), baPWV (p = 0.002) and CA-IMT (p = 0.005), and negatively correlated with eGFR (p < 0.001). Conclusion: In patients with ADPKD, as the disease stage advanced, serum FGF-23 levels increased while s-KL decreased. In ADPKD patients, AS and atherosclerosis development increased as compared to healthy subjects, and as CKD advanced. In ADPKD patients, the effect of serum FGF-23 on the development of AS and atherosclerosis in peripheral vessels is independent of s-KL

Adsorption of ciprofloxacin hydrochloride on multiwall carbon nanotube

Ciprofloxacin hydrochloride is an important pharmaceutical ingredient. It is used for many bacterial infection treatment. It can present in water sources due to incomplete metabolism in humans and coming from the pharmaceutical factory effluents. In this work, the adsorption of ciprofloxacin hydrochloride by multiwall carbon nanotube (MWCNT) was investigated. The effects of equilibrium of adsorption time and initial ciprofloxacin hydrochloride concentration on adsorption were determined. Langmuir and Freundlich isotherm models were utilized to express to the adsorption mechanism of ciprofloxacin hydrochloride by MWCNT. In addition, pseudo-first order, pseudo-second order and Elovich kinetic models were applied. This study showed that MWCNT absorbent is highly effective adsorbent for the removal of ciprofloxacin hydrochloride from aqueous solutions. Equilibrium data for adsorption of ciprofloxacin hydrochloride on MWCNT were best exemplified by Freundlich isotherm with a value of R square 0.9993. The most favorable kinetic model was obtained as pseudo-second order kinetic model with a value of R square 1.000. (C) 2020 Elsevier B.V. All rights reserved

Making decisions about cancer treatment

Oncology, driven by new discoveries in pharmacology, technology and information technology, is advancing at an unprecedented rate. However, the most basic process that is at the core of applied oncology is the process of making efficient oncology decisions. Decision making influences the choice of available treatment, patient satisfaction and oncological outcome. The decision is multidisciplinary and is based on the knowledge, experience and personality of many experts who make up the dream team of the health organization they serve. The clinical decision-making process is the quintessence of daily clinical practice. Medical decision-making for cancer patients can be highly complex and multifaceted, involving diagnostic and therapeutic uncertainties, patient preferences and values, and certainly includes healthcare environment

Skin tags associated with obesity and diabetes mellitus in patients with chronic kidney disease

Introduction/Objective. Both chronic kidney disease and skin tags are associated with similar cardiovascular risk factors such as obesity, diabetes mellitus, dyslipidemia, hypertension, etc. The aim of this study was to determine the prevalence of skin tags in patients with chronic kidney disease, and to assess the relationship between skin tags and cardiovascular risk factors such as diabetes, hypertension, dyslipidemia, obesity, and metabolic syndrome. Methods. We evaluated 358 patients [149 (41.6%) female and 209 (58.1%) male, 197 (55%) predialytic and 161 (45%) dialytic] with chronic kidney disease. All the patients were examined for skin tags by the same clinician, and evaluated for body mass index, diabetes mellitus, hypertension, and dyslipidemia. Results. Skin tags were detected in 199 (55%) patients. Prevalence of skin tags was higher in males than in females (p = 0.041) and was also higher in diabetic patients than in nondiabetic ones (p = 0.013). Body mass index was higher in patients with skin tags when compared to patients without skin tags (p = 0.047). Skin tags were detected in 48.3% of normal, in 58% of overweight, and in 66% of obese patients (p = 0.029). Conclusion. The presence of skin tags is merely related to male sex, obesity, and diabetes mellitus in patients with chronic kidney disease

SEASONAL VARIATION OF TURKEY: A CONSENSUS CLUSTERING APPROACH

A "consensus clustering" methodology is applied to long-term (1950-2010) Turkey's meteorological data (temperature, humidity and precipitation) in order to analyze the seasonal variations. The consensus clustering analysis applied is based on the methodology of disturbing the original data using resampling techniques, proposed by Monti et al [2]. We employed four different clustering algorithms (Agglomerative Nesting, Divisive Analysis, Partitioning Around Medoids and K-means) in order to form a consensus solution among different algorithms. Results indicated that Turkey is experiencing longer winter and summer, and rather short spring and fall seasons than usual

The Validity of Malnutrition Universal Screening Tool (MUST) for Nutritional Screening in Hemodialysis Patients

Objective: Wasting and malnutrition are problems frequently encountered in patients undergoing hemodialysis that may increase morbidity and mortality. The malnutrition universal screening tool (MUST) is a quick and easy-to-use nutritional screening tool. The aim of this study was to determine the validity of MUST by comparing two accepted nutritional screening methods in hemodialysis patients