The Relationship Between Dietary Intakes and Total Kidney Volume in Patients with Autosomal Dominant Polycystic Kidney Disease Dietary Intake and Polycystic Kidney Volume

Aim: There is a need to understand autosomal dominant polycystic kidney disease (ADPKD) patients’ dietary habits since dietary interventions may have potential effects on ADPKD. In this study, we aimed to analyze the relationship between dietary nutrient intake and total kidney volume (TKV). Methods: This cross-sectional study was conducted on 54 ADPKD patients recruited from the Nephrology outpatient clinic between June and July 2014. TKV was determined by magnetic-resonance imaging and general characteristics, biochemical and urinary parameters were determined. The nutrient intakes of patients were calculated using the three-day dietary records obtained on three consecutive days. Results: The total kidney-volume median was found to be 1407 mL. Patients’ total dietary energy and protein intakes were 25.8±9.4 kcal/kg, 0.9±0.3 g/kg, respectively. The percentage of carbohydrates, protein, and fat in energy was 49±7%, 14±3%, 37±7%, respectively. The mean intakes of thiamin, riboflavin, B6, calcium, magnesium, and zinc were sufficient, the mean dietary potassium intake was insufficient; and sodium intake was excessive in both sexes. In females, there was a negative but weak correlation between dietary vitamin C intake and TKV. In males, a negative but weak correlation was found between TKV and dietary intake of fiber, water, vitamin B6, vitamin K, magnesium, and iron. Conclusions: Dietary micronutrient intake may affect TKV according to sex. © 2022, Galenos Publishing House. All rights reserved

Delamination technique together with longitudinal incisions for treatment of Chiari I/syringomyelia complex: a prospective clinical study

<p>Abstract</p> <p>Background</p> <p>Treatment modalities in Chiari malformation type 1(CMI) accompanied by syringomyelia have not yet been standardized. Pathologies such as a small posterior fossa and thickened dura mater have been discussed previously. Various techniques have been explored to enlarge the foramen magnum and to expand the dura. The aim of this clinical study was to explore a new technique of excision of the external dura accompanied by widening the cisterna magna and making longitudinal incisions in the internal dura, without disturbing the arachnoid.</p> <p>Methods</p> <p>Ten patients with CMI and syringomyelia, operated between 2004 and 2006, formed this prospective series. All cases underwent foramen magnum decompression of 3 × 3 cm area with C1–C2 (partial) laminectomy, resection of foramen magnum fibrous band, excision of external dura, delamination and widening of internal dura with longitudinal incisions.</p> <p>Results</p> <p>Patients were aged between 25 and 58 years and occipital headache was the most common complaint. The mean duration of preoperative symptoms was 4 years and the follow-up time was 25 months. Clinical progression was halted for all patients; eight patients completely recovered and two reported no change. In one patient, there was a transient cerebrospinal fluid (CSF) fistula that was treated with tissue adhesive. While syringomyelia persisted radiologically with radiological stability in five patients; for three patients the syringomyelic cavity decreased in size, and for the remaining two it regressed completely.</p> <p>Conclusion</p> <p>Removal of the fibrous band and the outer dural layer, at level of foramen magnum, together with the incision of inner dural layer appears to be good technique in adult CMI patients. The advantages are short operation time, no need for duraplasty, sufficient posterior fossa decompression, absence of CSF fistulas as a result of extra arachnoidal surgery, and short duration of hospitalization. Hence this surgical technique has advantages compared to other techniques.</p

The feasibility of anthropometric measurements for evaluation of abdominal obesity in patients with autosomal dominant polycystic kidney disease: a cross-sectional study

Introduction: total kidney volume (TKV) increases in patients with autosomal dominant polycystic kidney disease (ADPKD), which perturbs anthropometric measurements. Objectives: the primary objectives were to investigate the accuracy of waist circumference (WC) and waist-to-hip ratio (WHR) for determining abdominal obesity in patients with ADPKD by comparison with magnetic resonance images. The secondary objectives were to investigate the associations of energy/macronutrient intake with WC and WHR. Methods: sixty patients with ADPKD were recruited from a nephrology outpatient clinic in this cross-sectional study. Main outcome measures were: TKV, total subcutaneous fat (TSF), total intraperitoneal fat (TIF), WC, WHR, body mass index (BMI), skinfold thickness (SFT), and energy/ macronutrient intake. Results: mean age was 48.6 ± 11.3 years, 38 of 60 were women, median TKV was 1486 (IQR, 981-2847) mL. The patients classed as obese by the BMI had higher WC, TSF, TIF, and SFT than did non-obese; however, WHR was similar in obese and non-obese men. In the all-patients group, the WHR of obese and non-obese patients were also similar. TKV was positively correlated with WC and WHR in women, but not in men. In the multivariate analysis, TKV was an independent factor affecting WC and WHR in women. Dietary fat intake was similar in groups with and without abdominal obesity according to WC and WHR. Conclusions: in women with ADPKD, WC and WHR may not be accurate anthropometric measurements for evaluation of abdominal obesity; however, they may be associated with TKV. © 2022 SENPE y Arán Ediciones S.L

Effectiveness of Using Dual-source CT and the Upshot it creates on Both Heart Rate and Image Quality

Background: Early detection of coronary artery disease (CAD) is important because of the high morbidity and mortality rates. As invasive coronary angiography (ICA) is an invasive procedure, an alternative diagnostic method; coronary computed tomography angiography (CTA), has become more widely used by the improvements in detector technology

Effectiveness of Using Dual-source CT and the Upshot it creates on Both Heart Rate and Image Quality

Background: Early detection of coronary artery disease (CAD) is important because of the high morbidity and mortality rates. As invasive coronary angiography (ICA) is an invasive procedure, an alternative diagnostic method; coronary computed tomography angiography (CTA), has become more widely used by the improvements in detector technology

The role of ultrasonography in the imaging of body packers comparison with CT: a prospective study

This study investigated the sonographic properties of drug packets containing narcotic drugs and the diagnostic role of ultrasonography in detecting body packing in comparison with CT

The Relation between Sarcopenia and Mortality in Patients at Intensive Care Unit

Background and Aim. Psoas muscle area (PMA) can reflect the status of skeletal muscle in the whole body. It has been also reported that decreased PMA was associated with postoperative mortality or morbidity after several surgical procedures. In this study, we aimed to investigate the relation between PMA and mortality in all age groups in intensive care unit (UNIT). Materials and Method. The study consists of 362 consecutive patients. The demographic characteristics of patients, indications for ICU hospitalization, laboratory parameters, and clinical parameters consist of mortality and length of stay, and surgery history was obtained from intensive care archive records. Results. The mean age was 61.2±18.2 years, and the percentage of female was 33.3%. The mean duration of stay was 10.3±24.4 days. Exitus ratio, partial healing, and healing were 25%, 70%, and 5%, respectively. The mean right, left, and total PMA were 8.7±3.6, 8.9±3.4, and 17.6±6.9, respectively. The left and total PMA averages of the nonoperation patients were statistically significantly lower (p=0.021  p=0.043). The mean PMA between the ex and recovered patients were statistically significantly lower (p=0.001, p=0.001, p<0.001). Dyspnoea, renal insufficiency, COPD, transfusion rate, operation rate, ventilator needy, and mean duration of hospitalization were statistically significant higher in patients with exitus. There is a significant difference in operation types, anesthesia type, and clinic rates. Conclusion. Our data suggest that sarcopenia can be used to risk stratification in ICU patients. Future studies may use this technique to individualize postoperative interventions that may reduce the risk for an adverse discharge disposition related to critical illness, such as early mobilization, optimized nutritional support, and reduction of sedation and opioid dose

Perforation of the Left Brachiocephalic Vein Secondary to Central Venous Catheterization

Vascular access has prime importance in patients on hemodialysis. Vascular accesses may become unusable due to various complications in patients with multiple vascular problems

Anastomoses of the Vestibular, Cochlear, and Facial Nerves

The internal auditory canal (IAC) is 10 to 17 mm in length, and the facial nerve and vestibulocochlear nerve, which consist of the cochlear nerve, the superior vestibular nerve, and the inferior vestibular nerve, run together in the IAC packaged in dura mater. Oort first described the vestibulocochlear anastomoses in 1918, which is important for the understanding of the pathogenesis and pathophysiology of otologic disorders. The current study documents the existence of vestibulofacial and vestibulocochlear neural connections and topographical relationship of the nerves as part of a radiologic evaluation of 73 human temporal bones from brainstem to the lateral portion of IAC