Course of Encephalopathy in a Cirrhotic Dialysis Patient Treated Sequentially with Peritoneal and Hemodialysis

End-stage kidney disease and advanced cirrhosis are sometimes seen concomitantly. There is no consensus on dialysis modality in terms of determining the optimal way of treating these patients. It has been suggested that peritoneal dialysis is a better choice for these patients, but efficacy of hemodialysis in stable cirrhotic patients has not been evaluated sufficiently. We report a case with advanced cirrhosis and end-stage kidney disease who was faced with hepatic encephalopathy episodes up on starting renal replacement therapy. The case is also interesting in that it reveals effects of hemodialysis and peritoneal dialysis on hepatic encephalopathy episodes and quality of life of the patient

Relationship between psychosocial status, diabetes mellitus, and left ventricular systolic function in patients with stable multivessel coronary artery disease

Background: Negative emotional conditions contribute to the development of coronary artery disease (CAD). Depression and anxiety are prognostic factors in patients with CAD. The aim of our study was to investigate the association between emotional conditions and left ventricular (LV) systolic functions in CAD. Methods: 168 patients (102 men, 66 women, mean age 66.3 &#177; 9.9 years) with stable angina and multivessel disease (MVD) were included in the study. According to the LV ejection fraction (LVEF) in echocardiography, patients were divided into two groups, the preserved group (LVEF > 50%), and the impaired group (LVEF < 50%). The preserved group consisted of 94 patients and the impaired group consisted of 74 patients. Emotional status was evaluated using the Hamilton Depression (HAM-D), Hamilton Anxiety (HAM-A), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) scores. Results: The prevalence of diabetes mellitus (DM) was significantly higher in the impaired group than in the preserved group (29.8% vs 56.8%, p < 0.01). The HAM-D, HAM-A, BAI and BDI scores were higher in the impaired group compared to the preserved group (HAM-D: 12.1 &#177; 3.3 vs 14.5 &#177; 2.3, p = 0.03; HAM-A: 12.7 &#177; 3.4 vs 14.3 &#177; 2.2, p = 0.01; BAI: 18.6 &#177; &#177; 6.4 vs 22.1 &#177; 6.6, p = 0.01 and BDI: 13.9 &#177; 2.5 vs 17.2 &#177; 2.0, p = 0.002, respectively). In multivariate analysis, BDI scores (odds ratio [OR]: 2.197, < 95% confidence interval [CI] 1.101&#8211;4.387; p = 0.026), HAM-A scores (OR: 1.912, < 95% Cl 1.092&#8211;2.974; p = 0.041) and DM (OR: 2.610, < 95% Cl 1.313&#8211;5.183; p = 0.006) were important risk factors for LV dysfunction in stable patients with MVD. Conclusions: This study demonstrated that emotional status and DM are factors associated with impaired LV systolic function in patients with stable CAD

Constraints on the χ_(c1) versus χ_(c2) polarizations in proton-proton collisions at √s = 8 TeV

The polarizations of promptly produced χ_(c1) and χ_(c2) mesons are studied using data collected by the CMS experiment at the LHC, in proton-proton collisions at √s=8  TeV. The χ_c states are reconstructed via their radiative decays χ_c → J/ψγ, with the photons being measured through conversions to e⁺e⁻, which allows the two states to be well resolved. The polarizations are measured in the helicity frame, through the analysis of the χ_(c2) to χ_(c1) yield ratio as a function of the polar or azimuthal angle of the positive muon emitted in the J/ψ → μ⁺μ⁻ decay, in three bins of J/ψ transverse momentum. While no differences are seen between the two states in terms of azimuthal decay angle distributions, they are observed to have significantly different polar anisotropies. The measurement favors a scenario where at least one of the two states is strongly polarized along the helicity quantization axis, in agreement with nonrelativistic quantum chromodynamics predictions. This is the first measurement of significantly polarized quarkonia produced at high transverse momentum