Management of small bowel volvulus in a patient with simultaneous pancreas-kidney transplantation (SPKT): a case report

There are several surgical complications which can occur following simultaneous pancreas-kidney transplantation (SPKT). Although intestinal obstruction is known to be a common complication after any type of abdominal surgery, the occurrence of small bowel volvulus, which is one of the rare causes of intestinal obstruction, following SPKT has not been published before. A 24-year-old woman suffering from type I diabetes mellitus with complications of nephropathy resulting in end stage renal disease (ESRD), neuropathy and retinopathy underwent SPKT. On the postoperative month 5, she was brought to the emergency service due to abdominal distention with mild abdominal pain. After laboratory research and diagnostic radiological tests had been carried out, she underwent exploratory laparotomy to determine the pathology for acute abdominal symptoms. Intra-operative observation revealed the presence of an almost totally ischemic small bowel which had occurred due to clockwise rotation of the mesentery. Initially, simple derotation was performed to avoid intestinal resection because of her risky condition, particularly for short bowel syndrome, and subsequent intestinal response was favorable. Thus, surgical treatment was successfully employed to solve the problem without any resection procedure. The patient's postoperative follow-up was uneventful and she was discharged from hospital on postoperative day 7. According to our clinical viewpoint, this study emphasizes that if there is even just a suspicion of acute abdominal problem in a patient with SPKT, surgical intervention should be promptly performed to avoid any irreversible result and to achieve a positive outcome

Paraoxonase 1, atherosclerosis and arterial stiffness in renal patients

WOS: 000316333600021PubMed ID: 22669508Atherosclerosis is an important contributor to increased cardiovascular burden in populations with and without renal disease. Paraoxonases (PON) are a group of enzymes that hydrolyse organophosphates. Recent evidence indicates a protective role for PON in patients with coronary artery disease and atherosclerosis. Although data are limited, the low enzyme activity found in patients with chronic kidney disease and renal transplants has been linked to atherosclerosis and arterial stiffness. In this paper, we review the emerging role of PON1 in the pathophysiology of atherosclerosis and arterial stiffness in patients with chronic kidney disease

NEW ONSET HYPERCALCEMIA AFTER RENAL TRANSPLANTATION: AN INFECTIOUS ETIOLOGY BEYOND PERSISTENT HYPERPARATHYROIDISM

[No Abstract Available

New-Onset Hypercalcemia After Renal Transplant: An Infectious Etiology Beyond Persistent Hyperparathyroidism

Pneumocystis jirovecii pneumonia is an opportunistic infection in kidney transplant recipients. It may be complicated by hypercalcemia. Here, we discuss a 59-year-old man who presented with respiratory symptoms and hypercalcemia. He had undergone a deceased donor kidney transplant 2 years previously. The patient had persistent hyperparathyroidism, but his serum calcium level was normal. At the time of admission, his serum calcium level had increased and his parathyroid hormone level was suppressed. He was diagnosed with Pneumocystis jirovecii pneumonia. Serum calcium and parathyroid hormone levels returned to baseline values after treatment. Pneumocystis jirovecii pneumonia is an important infection that can present with hypercalcemia among kidney transplant recipients

Two Different Causes of Decreased Activity on Ipsilateral Iliac Artery in Renal Transplant Scintigraphy

WOS: 000435346400033PubMed ID: 2974260

Comparison of Renal Transplant Scintigraphy With Renal Resistance Index for Prediction of Early Graft Dysfunction and Evaluation of Acute Tubular Necrosis and Acute Rejection

WOS: 000330356100010PubMed ID: 24152633Purpose: We discuss whether resistance index (RI) and renal scintigraphy obtained within 48 hours after operation could predict the early graft dysfunction. We also aimed to assess the uses of scintigraphy and RI in diagnosis of acute rejection (AR) and acute tubular necrosis (ATN). Methods: A total of 153 studies were performed in 109 patients. T-1/2 of perfusion peak, perfusion curve grades, and accumulation index (R20/3) were used as scintigraphic parameters. Baseline studies obtained within 48 hours after transplantation were evaluated for prediction of early graft dysfunction. All data were then assessed for specific diagnosis. Results: Scintigraphic parameters were significantly higher in patients with delayed graft function (DGF) and slow graft function (SGF) than in patients with immediate graft function. These parameters in DGF were also considerably different from those in SGF. The mean RI was significantly high in DGF, but there was no difference between SGF and immediate graft function. In diagnostic groups, the mean values of all tests were significantly different between normal functioning grafts and pathological grafts (ATN + AR). There was no significant difference between AR and ATN. However, renal scintigraphy has higher sensitivity and specificity for AR as compared with RI of Doppler ultrasonography (US). Conclusions: In predicting graft dysfunction and separating normal functioning graft from pathological graft (ATN + AR), renal scintigraphy provides more accurate information than Doppler US. Even though it is superior to Doppler US, renal scintigraphy also cannot reliably separate ATN from AR. The major advantage of renal scintigraphy is the early detection of reduced renal function

Analysis of morphological variations of three Adlerius (Diptera: Psychodidae) species collected in two cutaneous leishmaniasis endemic foci of Turkey

Leishmaniasis, transmitted to human by sand flies, is a neglected vector-borne diseases and has two clinical forms: cutaneous (CL) and visceral leishmaniasis (VL) in Turkey. Subgenus of Adlerius are known as probable vectors of both forms of leishmaniasis in Turkey. Examined three species belonging to Adlerius are difficult to distinguish morphologically and have similar taxonomic characters. The aim of this study was to analyse and identify the possible morphological variations, of wild-caught sand fly specimens belonging to Adlerius subgenus. Six and seven morphological characters for female and male specimens were used, respectively. ANOVA, principal component analysis (PCA) and discriminant function analysis (DFA) test were performed to determine the significant morphometric variables of the three species. Univariate and multivariate analyses of 13 morphometric variables via ANOVA, DFA and PCA showed that eight (six for females, two for males) morphometric variables had an accuracy of 100% for discriminating three Adlerius subgenus specimens. The analyses revealed significant differences on several morphological structures of Adlerius specimens. These results suggested that morphological and morphometrical features can be used to discriminate three Adlerius species, in which one of them is proven vector Leishmania (L.) tropica in two foci of Turkey.We thank Scientifc Research Projects Coordination Unit of Ege University, which supported our study with a project ID of `2009 TIP 32'.Scientifc Research Projects Coordination Unit of Ege Universit

THE ASSOCIATION BETWEEN INFLAMMATION MARKERS, MALNUTRITION AND QUALITY OF LIFE WITH VOLUME STATUS IN THE PRE-POST TRANSPLANT PERIOD

WOS: 00032823200153