The efficacy of cinacalcet in the treatment of hyperparathyroidism in Turkish hemodialysis patient population

WOS: 000393291900012OBJECTIVE: Cinacalcet reduces parathyroid hormone levels by increasing the sensitivity of the parathyroid gland to calcium. in this study, we firstly aimed to evaluate the efficacy of cinacalcet in Turkish hemodialysis patients. MATERIAL and METHODS: 4483 hemodialysis patients were screened and 469 patients who had used cinacalcet were included in the study. the patients were divided into 4 groups according to drug usage durations (Group 1: 3 months, Group 2: 6 months, Group 3: 9 months and Group 4: 12 months). the patients' Parathormone, Ca, P and CaxP levels at the 3rd, 6th, 9th and 12th months were compared to the start of treatment and previous months. RESULTS: the levels of Parathormone, Ca, P and CaxP significantly decreased compared to their initial levels in all groups (from 1412 pg/ml to 1222 pg/mL for Parathormone, p< 0,001) in the 3rd month. However, this reduction was not continued in the subsequent months (Parathormone: 1381 pg/ml for the 12th month). CONCLUSION: Cinacalcet may not provide adequate benefit in control of hyperparathyroidism in Turkish hemodialysis patient population

Determination of reliability of some tests in evaluating arteriovenous fistul flow rate in hemodialysis patients

Hemodiyalize giren hastalarda vaskuler arteriovenöz fistül fonksiyonunu en doğrugösteren yöntemlerden birisi Doppler ultrason (USG) ile akım hızının ölçümüdür.Amacımız arteriyovenöz fistüllü hemodiyaliz hastalarında vasküler akses akımınınölçümünde Glukoz pompa infüzyon testinin doppler USG tekniği ile karşılaştırılması vegüvenilirliğininin tayin edilmesi, statik basınç ölçümleri ile birlikte değerlendirilmesidir.Gereç ve yöntem: Çalışmaya Konya il merkezinde AV fistülden hemodiyalize giren 93hasta alındı. Fistül akım hızını ölçmek için hastanın hemodiyalize girmediği günlerdenbirinde Doppler USG çalışması ve GPT testi yapıldı. GPT testi farklı zamanlarda her hastada3 kez hemodiyaliz başlamadan hemen önce yapıldı ve ortalamaları alındı. Tüm hastalardavasküler akses takip metodlarından bir diğeri olan statik akses basınç ölçümleri de yapıldı.GPT ve Doppler USG ile ölçülen akses akımları karşılaştırıldı ve bu 2 yöntemin statik basınçölçümleri ile ilişkisi değerlendirildi. Veriler SPSS 13.0 bilgisayar programına girildi. Normaldağılıma uyan verilerde Student-t testi kullanıldı. Normal dağılımauymayan verilerinanalizinde Mann-Whitney U testi kullanıldı. Kategorik verilerin karşılaştırılmasında Ki-Karetesti kullanıldı. Veriler arası ilişkiler Pearson korelasyon analizi ile değerlendirildi.Bulgular: Vasküler akses akım ölçüm yöntemlerinden olan Doppler USG sonuçları ileGlukoz pompa testi bulguları karşılaştırıldı. Her iki yöntemle tespit edilen akses akım hızıortalamaları farklı değildi (t: -0,257, p> 0,05). İki yöntemin birbiriyle korelasyonu da iyi idi(r: 0,49; p 0,05). Doppler USG ve Glukozpompa testi ile ölçülen akses akım hızlarının statik basınç arteryel ve venöz oranlarıarasında iyi bir korelasyon yoktu. Statik basınç oranlarına göre stenozu olan hastalardaakses akımı anlamlı değişiklik göstermiyordu (p>0.05).Sonuç: Hemodiyalize giren hastalarda AV fistül fonksiyonu takip yöntemi olarak kullanılandoppler USG ile AV fistül akım hızı ölçümü yerine ucuz, kolay uygulanabilir, operatörbağımlı olmayan bir test olan Glukoz pompa infüzyon tekniğinin kullanılabileceği fakatstatik basınç oranlarının AV fistül fonksiyonunu takipte başarıyla kullanılamayacağısonucuna varılmıştır.Vascular access flow is the most accurate method measured by Doppler USGshowing AV fistul function in hemodialysis patients. We aimed to compare glıcose pumptest and Doppler US imaging technique in evaluating vascular access flow rate anddetermine reliability of this test with static pressure measurements.Methods and materials: 93 patients from Konya city center were involved to this studyinitiating hemodialysis with AV fistulae. Doppler USG and GPT tests were performed onone of their free days to measure fistul flow rate which they didn?t undergo hemodialysis.Also a static pressure mesurements were performed to all patients which is anothertechnique to follow up vascular access. The vascular access flow results measured withGPT test and Doppler USG were compared and the relationship of these methods withstatic pressure measurements was evaluated. Statistical testing was performed with theuse of SPSS 13.0 software version. Student?s t-test was used in normal dispersial datas tocompare means. In analysing non-dispersial datas we used Mann-Whitney U test.Relation between variables were evaluated with Pearson?s correlation analysis. A p value0,05).Access flow rates which was measured by Doppler USG and GPT was not correlatedwith access flow rates? arterial and venous ratios. According to the static pressure ratiosthe stenosis findings in patients with vascular accesses were not significantly different (p>0,05).Conclusion: In hemodialysis patients, GPT technique was compared with Doppler USG infollow-up of the function of AV fistul which is a more expensive, less operable and moreoperator dependant test. But no significant relevence was found in static pressuremeasurements performed by GPT or Doppler USG which are both used in follow-up ofvascular access, so it was understand that static pressure measurements can not be usedinstead of Doppler USG

Meningitis caused by Neisseria Meningitidis, Hemophilus Influenzae Type B and Streptococcus Pneumoniae during 2005-2012 in Turkey A multicenter prospective surveillance study

Akin, Fatih/0000-0001-5725-3867; Dinleyici, Ener Cagri/0000-0002-0339-0134; Emiroglu, Melike/0000-0003-1307-0246WOS: 000348316800043PubMed: 25483487Successful vaccination policies for protection from bacterial meningitis are dependent on determination of the etiology of bacterial meningitis. Cerebrospinal fluid (CSF) samples were obtained prospectively from children from 1 month to <= 18 years of age hospitalized with suspected meningitis, in order to determine the etiology of meningitis in Turkey. DNA evidence of Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae), and Hemophilus influenzae type b (Hib) was detected using multiplex polymerase chain reaction (PCR). In total, 1452 CSF samples were evaluated and bacterial etiology was determined in 645 (44.4%) cases between 2005 and 2012; N. meningitidis was detected in 333 (51.6%), S. pneumoniae in 195 (30.2%), and Hib in 117 (18.1%) of the PCR positive samples. Of the 333 N. meningitidis positive samples 127 (38.1%) were identified as serogroup W-135, 87 (26.1%) serogroup B, 28 (8.4%) serogroup A and 3 (0.9%) serogroup Y; 88 (26.4%) were non-groupable. As vaccines against the most frequent bacterial isolates in this study are available and licensed, these results highlight the need for broad based protection against meningococcal disease in Turkey.Novartis Vaccines and Diagnostics; GlaxoSmithKlineGlaxoSmithKlineThe study was supported by Novartis Vaccines and Diagnostics (for 5 years) and by GlaxoSmithKline (for 2 years). The authors declare that they have no other conflicts of interest

Elevated Serum Uric Acid to HDL-Cholesterol Ratio is Related to Cardiovascular Risk in Patients Receiving Hemodialysis

Aim: Chronic kidney disease (CKD) is a progressive disease in which frequent cardiovascular (CV) comorbidities. High uric acid to HDL-cholesterol ratio (UHR) results were quite notable in patients receiving peritoneal dialysis. Thus, in this study, we aimed to evaluate the UHR results in dialysis patients. Materials and Methods: This retrospective, multicenter, cross-sectional study was conducted with CKD patients, and the control group consisted of hypertensive patients with a normal glomerular filtration rate (GFR). Patients’ laboratory, ambulatory blood pressure monitoring, and demographic records were obtained from the follow-up cases of two university hospitals’ internal medicine and nephrology departments. The patients' group then were divided into five subsets according to GFR. Results: A total of 124 CKD patients and 127 control participated in this study. All CKD patients were also identified as pre-dialysis and dialysis. The cases of UHR, non-dipper blood pressure pattern, and nocturnal heart rate (HR) were increased in CKD compared to the control group. Per disease progression, the non-dipper HR and nocturnal HR were more significant in patients receiving dialysis with high UHR than in the pre-dialysis subset. In diabetic patients with an on-targeted HbA1c, those with high UHRs still had nocturnal diastolic BP elevations. Finally, there was not an exact stage-specific result for pulse wave velocity. Conclusions: Based on our results, dialysis patients with high UHRs have higher non-dipper PR, nocturnal heart rate, and nocturnal diastole blood pressure, associated with CV risk. Moreover, effective diabetic management might not prevent CV risk in dialysis patients with high UHRs

Meningitis caused by Neisseria Meningitidis, Hemophilus Influenzae Type B and Streptococcus Pneumoniae during 2005–2012 in Turkey

Successful vaccination policies for protection from bacterial meningitis are dependent on determination of the etiology of bacterial meningitis. Cerebrospinal fluid (CSF) samples were obtained prospectively from children from 1 month to ≤ 18 years of age hospitalized with suspected meningitis, in order to determine the etiology of meningitis in Turkey. DNA evidence of Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae), and Hemophilus influenzae type b (Hib) was detected using multiplex polymerase chain reaction (PCR). In total, 1452 CSF samples were evaluated and bacterial etiology was determined in 645 (44.4%) cases between 2005 and 2012; N. meningitidis was detected in 333 (51.6%), S. pneumoniae in 195 (30.2%), and Hib in 117 (18.1%) of the PCR positive samples. Of the 333 N. meningitidis positive samples 127 (38.1%) were identified as serogroup W-135, 87 (26.1%) serogroup B, 28 (8.4%) serogroup A and 3 (0.9%) serogroup Y; 88 (26.4%) were non-groupable. As vaccines against the most frequent bacterial isolates in this study are available and licensed, these results highlight the need for broad based protection against meningococcal disease in Turkey