Hastaların perspektifinden: Periton diyalizinin yaşama ve ruhsal belirtilere etkisi

Amaç: Bu çalışmanın amacı; sürekli ayaktan periton diyalizi (SAPD) uygulayan hastaların kendi ifadeleri ile hastalığı nasıl tanımladıkları ve periton diyalizinin iş, aile, sosyal ve özel yaşamlarına etkisi ile ruhsal belirti sıklığı arasındaki ilişkileri incelemektir. Yöntem: Tanımlayıcı ve ilişki arayıcı olarak yapılan bu çalışma özel bir diyaliz merkezinde takip edilen 153 periton diyalizi hastasıyla yürütülmüştür. Çalışma verileri hasta tanıtım formu ve Kısa Semptom Envanteri (KSE) kullanılarak toplanmıştır. Bulgular: Hastaların yaş ortalaması 49.51±15.44 yıl olup, %53.6’sı erkektir. Hastaların %81.7’si evli ve %51.6’sı ilkokul mezunudur. Hastaların %18.3’ü “hastalığın doğal bir durum” olduğunu ve %46.6’sı “özel yaşamında hiçbir şeyin eskisi gibi olmadığını, daha karmaşık ve zor olduğunu” belirtmiştir. KSE puan ortalaması 49.01±13.21 olarak bulunmuştur. Periton diyalizinin iş yaşamlarını nasıl etkilediğine ilişkin ifadeleri açısından, KSE’nin somatik belirtiler, hostilite ve paranoid düşünceler alt boyutları arasında istatistiksel olarak anlamlı fark bulunmuştur (p<.01, p<.01 ve p<.05). Sonuç: Periton diyalizi hastaları yaş, cinsiyet, hastalıklarını algılayış biçimleri ve hastalığın yaşamlarını etkileme biçimlerine göre değişik sıklıkta ruhsal belirtiler yaşayabilmektedir

Şiddetli amfizemi olan aşiri obez bir hastada anterior yaklaşimli perkütan böbrek biyopsisi: Olgu bildirisi

The most commonly used technique of percutaneous renal biopsy is performed by approaching posteriorly. We had to perform a kidney biopsy with an anterior approach because of an access problem posteriorly. Except for transplanted kidney biopsies we could not find a similar application utilising anterior approach in the literature. Therefore, we are reporting our experience on this case who was extremely obese and had severe emphysema

Safe and Successful Treatment With Agalsidase Beta During Pregnancy in Fabry Disease

WOS: 000363832600010PubMed: 26338166Fabry disease, an X-linked lysosomal storage disorder, is caused by alpha-galactosidase A deficiency and leads to accumulation of glycospinhgolipids in most tissues, with life-theratening consequences in the kidney, heart, and cerebrovascular system. Enzyme replacement therapy is available as 2 different preparations: agalsidase alfa and agalsidase beta. Enzyme replacement therapy is started as soon as the diagnosis is confirmed, but there is no data available in the literature about its safety during preganacy. Herein, we described 2 patients with Fabry disease who received agalsidase beta during their pregnancy. This report is important as the data about enzyme replacement therapy during pregnancy is restricted with case reports

Evaluation of tuberculosis in chronic renal failure

PubMed ID: 22233319[No abstract available

Ochrobactrum anthropi endocarditis and septic shock in a patient with no prosthetic valve or rheumatic heart disease: Case report and review of the literature

WOS: 000240271000012PubMed: 16936348Although Ochrobactrum anthropi is an opportunistic pathogen in immunocompromised patients, it is increasingly being recognized to be a causative agent in healthy hosts. In this paper, we report a case of O. anthropi endocarditis and septic shock in a patient who had no prosthetic valve or rheumatic heart disease, in contrast to previous reports

Quality of life and psychiatric symptom distribution in chronic dialysis patients

Amaç: Son dönem böbrek yetmezliği (SDBY), hastalarda birçok psikososyal sorunlara neden olmakta ve yaşam kalitesini düşürmektedir. Biz çalışmamızda diyaliz hastalarının yaşam kalitesi ve psikiyatrik belirti dağılımını belir-lemeyi amaçladık. Yöntem: Çalışmamıza nefroloji ünitesi tarafından izlenen 54 hemodiyaliz (HD) ve 13 sürekli ayaktan periton diyalizi (SAPD) uygulanan toplam 67 hastayı aldık. Hastalara sosyodemografik bilgi formu, Short Form-36 (SF-36) Yaşam Kalitesi Ölçeği, Hastane Anksiyete ve Depresyon Ölçeği (HAD), Kısa Semptom Envante-ri (KSE) uygulandı. İstatistiksel analizde nonparametrik testlerden Mann Whitney-U uygulandı. Sonuçlar: Hasta-ların 31’i erkek, 36’sı kadındı. HD hastalarının yaş ortalaması 53.5517.26 yıl, SAPD grubunun ise 47.8313.76 idi. SF-36 alt ölçeklerinden hiçbirisinde HD ve SAPD grupları arasında fark yoktu. Psikiyatrik belirti dağılımını ölçen KSE alt ölçeklerinden ise, HD grubunda daha kötü olmak üzere somatizasyon (p0.027) ve depresyonda (p0.045) istatistiksel olarak anlamlı fark vardı. HAD anksiyete ve depresyon puanı eşik üstü olan hastaların yaşam kalitesi (SF-36) alt ölçeklerinin (anksiyete grubunda emosyonel rol alt ölçeği hariç p0.186) tümü ve KSE alt ölçek puanları daha kötüydü ve istatistiksel olarak anlamlı fark vardı. Tartışma: Diyaliz uygulanan SDBY’li hastaların biyolojik değerlendirilmesine koşut olarak psikiyatrik yönden de değerlendirilmesi önemli görülmektedir. Hem yaşam kalitesi, hem de psikiyatrik belirti dağılımı yönünden kötüleşmeye neden olabilen depresyon ve/veya anksiyete kısa sürede ve kolayca uygulanabilen ölçeklerle tanınabilir. Bu sayede hastalara gerekli psikiyatrik destek sağlanarak yaşam kalitelerinin artırılabilmesinin yanı sıra, psikiyatrik belirtiler de daha kolay tanınıp gerekli önlemler alınabilir. Bu grup hastalarda psikiyatrik değerlendirme ve destek ihmal edilmeyecek kadar önemli görülmektedir. Bu sayede bakım verenlerin de tükenme sendromuna girmesi engellenebilir.Objective: End stage kidney failure cause many psychosocial problems and decrease quality of life (QoL). Our aim in this study was to determine QoL and psychiatric symptom distribution in chronic dialysis patients. Methods: Fifty-four chronic hemodialysis (HD) and 13 continuous ambulatory peritoneal dialysis (CAPD) patients (total 67 patients) who have been followed up by our nephrology unit have been included in this study. The tests applied in all patients were as following: Sociodemographic information form, Short Form-36 (SF-36) Quality of Life Scale, Hospital Anxiety and Depression Scale (HAD), Brief Symptom Inventory (BSI). Mann Whitney-U non-parametric test were used for statistical analysis. Results: There were 31 male, 36 female patients. Mean age in the hemodialysis group was 53.55±17.26 in the hemodialysis group and 47.83±13.76 in the CADP group. There no significant difference in the SF-36 sub-scales between two groups. According to the BSI sub-scales, there were significantly more somatization (p0.027) and depression (p0.045) in the HD group. All QoL subscales (except emotional role subscale in the anxiety group (p0.186)) and BSI subscale points were statistically significantly worse among the patients who had over-threshold HAD anxiety and depression points. Conclusion: Psychiatric evaluation of chronic dialysis patients together with nephrologic evaluation seems quite important. Anxiety and/or depression, that cause deterioration in both QoL and psychiatric symptom distribution in these patients, can easily identified by quick and easily performed tests. By this way, psychiatric support can be provided to improve QoL, also psychiatric disorders can be early diagnosed, and thus necessary measures can be taken. Psychiatric evaluation and support seem to be very important and cannot be overlooked. By this means, caregiving &#8220;burn-out&#8221; syndrome can also be prevented

Quality of life and psychiatric symptom distribution in chronic dialysis patients

WOS: 000267350900010Objective: End stage kidney failure cause many psychosocial problems and decrease quality of life (QoL). Our aim in this study was to determine QoL and psychiatric symptom distribution in chronic dialysis patients. Methods: Fifty-four chronic hemodialysis (HD) and 13 continuous ambulatory peritoneal dialysis (CAPD) patients (total 67 patients) who have been followed up by our nephrology unit have been included in this study. The tests applied in all patients were as following: Sociodemographic information form, Short Form-36 (SF-36) Quality of Life Scale, Hospital Anxiety and Depression Scale (HAD), Brief Symptom Inventory (BSI). Mann Whitney-U non-parametric test were used for statistical analysis. Results: There were 31 male, 36 female patients. Mean age in the hemodialysis group was 53.55 +/- 17.26 in the hemodialysis group and 47.83 +/- 13.76 in the CADP group. There no significant difference in the SF-36 sub-scales between two groups. According to the BSI sub-scales, there were significantly more somatization (p=0.027) and depression (p=0.045) in the HD group. All QoL subscales (except emotional role subscale in the anxiety group (p=0.186)) and BSI subscale points were statistically significantly worse among the patients who had over-threshold HAD anxiety and depression points. Conclusion: Psychiatric evaluation of chronic dialysis patients together with nephrologic evaluation seems quite important. Anxiety and/or depression, that cause deterioration in both QoL and psychiatric symptom distribution in these patients, can easily identified by quick and easily performed tests. By this way, psychiatric support can be provided to improve QoL, also psychiatric disorders can be early diagnosed, and thus necessary measures can be taken. Psychiatric evaluation and support seem to be very important and cannot be overlooked. By this means, caregiving "burn-out" syndrome can also be prevented. (Anatolian Journal of Psychiatry 2009; 10: 142-150

Hiportiroidi olgularında antitiroid tedavinin akım-volüm eğrileri üzerindeki etkileri

Astım tanısı bulunmayan 20 hipertiroidi olgusunda anütiroid tedavinin akım-volüm eğrileri üzerindeki etkilerini değerlendirmek üzere prospektif bir çalışma düzenlendi. Antitiroid tedavinin başlangıcında ve üçüncü ayının sonunda hastaların tiroid hormonları (Total T3, Total T4 ve TSH), ultrasonografi ile tiroid bezi volümleri, boyun çevresi ölçümleri ve akım-volüm eğrileri değerlendirildi. Propilüourasil tedavisi ile tiroid bezi volümünde ve boyun çevresi ölçümünde istatistiksel olarak anlamlı azalma görüldü (sırasıyla; p 0.001 ve p 0.001). Çalışmanın en önemli sonucu maksimal ekspirasyon ortası akım hızı (MMEFR) parametresinde üç aylık propiltiourasil tedavisi sonrası görülen düzelme idi. Vital kapasitenin %25'indeki ortalama ekspiratuar akım hızı (FEF_{25}) ve vital kapasitenin %75'indeki ortalama ekspiratuar akım hızı (FEF_{75}) parametrelerinde kaydedilen artışlar tüm ekspiratuar akım parametrelerindeki düzelme ile uyumluydu (sırasıyla; p 0.044 ve p 0.012). Sonuçta hipertiroidi tedavisi için propiltiourasil kullanan hastaların akım-volüm eğrilerinde en erken değişiklik ekspiratuar akım parametrelerindeki düzelme olarak bulundu.This prospective study was designed to evaluate the effects of hyperthyroidism on flow-volume loops in nonasthmatic 20 patients with hyperthyroidism. Thyroid related hormones (Total T3, Total T4 and TSH), thyroid gland volumes with ultrasonography, circumference of neck values and flow-volume loops were obtained at the beginning and after three months of antithyroid treatment. Propylthiouracil treatment was followed by a statistically significant decrease in thyroid gland volume and circumference of neck (p< 0.001 and p< 0.001, respectively). The most significant result was improvement of maximum midexptratory flow rate (MMEFR) after propylthiouracil therapy for three months (p 0.003). Increases in mean forced expiratory flow after 25% of FVC has been exhaled (FEF_{25}), mean forced expiratory flow after 75% of FVC has been exhaled (FEF_{75})values were found consistent with the puerall improuement in expiratory flow parameters (p 0.044, p 0.072 respectively) in conclusion, we speculated that improvement of expiratory flow parameters might be the earlier changes in flow volume loops of patients who were treated with propylthiouracil for hyperthyroidism

Two successive pregnancies after ursodeoxycholic acid therapy in a previously infertile woman with anti mitochondrial antibody-negative primary biliary cirrhosis

20th National Gastroenterology Week Meeting -- SEP, 2003 -- Kusadasi, TURKEYWOS: 000227637600039PubMed: 15749512Objective: To describe the benefit of ursodeoxycholic acid (UDCA) for the initiation and completion of a successful pregnancy in a previously infertile woman with primary biliary cirrhosis. Design: Case report. Setting: A university hospital with relevant departments. Patient(s): A 29-year-old woman with primary biliary cirrhosis and failure to conceive for 6 years. Intervention(s): Establishment of diagnosis with a liver biopsy, pretreatment of patient with UDCA before conception, and continuation of UDCA after first trimester until term. UDCA was used in the second pregnancy again after the first trimester. Main Outcome Measure(S): Achievement of a safe conception and full-term pregnancy. Result(S): Two consecutive successful pregnancies, a healthy 3,250-g male infant and a healthy 3,000-g female infant. The second conception occurred in a period without the use of UDCA, implicating a latent beneficial effect of either UDCA orthe previous pregnancy via some possible immune mechanism. Conclusion(s): Ursodeoxycholic acid could help achieve conception in infertile women with primary biliary cirrhosis. The use of UDCA after the first trimester is shown to be safe in two consecutive pregnancies. Although it cannot be conclusive, the unintentional use of UDCA in the first 20 days after conception did not result in any teratogenicity in the first child. (c) 2005 by American Society for Reproductive Medicine.Turkish Journal Gastroentero