Volume control associated with better cardiac function in long-term peritoneal dialysis patients.

BACKGROUND: This study was undertaken to investigate the effect of long-term blood pressure (BP) reduction, achieved with salt restriction and strict volume control, on frequency and regression of left ventricular hypertrophy (LVH) in long-term peritoneal dialysis (PD) patients. METHODS: 56 patients who had been treated for more than 2 years under our care were enrolled. After echocardiographic (Echo) evaluation, 46 patients were included in the follow-up study. In our unit, we aim to keep patients' BP below 130/85 mmHg and cardiothoracic index below 0.50. To reach these targets, moderate salt restriction is advised, and if necessary, hypertonic PD solutions are used. Echo was performed at the beginning of the study (after a mean period of 36 months on PD) and at the end of the prospective follow-up period (24 months later). RESULTS: At the time of the first Echo, LVH was detected in only 8 (21%) patients. Residual urine volume was significantly decreased compared to data taken when they first started PD (658 +/- 795 vs 236 +/- 307 mL/day). Mean left ventricular mass index (LVMI) was 107 +/- 26.5 g/m2. LVMI was significantly decreased at the end of the follow-up in patients who had LVH at baseline. No LVH developed in patients who had normal LVMI at baseline. CONCLUSION: Our results indicate that control of hypertension is possible when extracellular fluid volume is kept under control using hypertonic PD solutions in case of recruitment in addition to salt restriction in long-term PD patients. Sustained normovolemia is associated with low incidence and regression of LVH.     

Effects of gamma-hydroxybutyrate on cerebrospinal fluid lactate and glucose levels after spinal cord trauma.

This study aims to evaluate the effects of gamma-hydroxybutyrate (GHB) after spinal cord trauma (SCT). Twenty rabbits were divided equally into four groups: group I was the sham-operated group, group II suffered from SCT but received no treatment, group III was given a dose of 400 mg/kg of GHB intravenously before SCT and group IV received the same dose after SCT. Cerebrospinal fluid (CSF) samples were obtained 30 min before SCT (T(0)), at 60 (T(1)) and 120 min (T(2)) after SCT. There was a threefold increase in lactate levels from baseline value at T(2) in group II, while statistically significant elevation of the lactate levels were not observed in groups III and IV. Glucose levels at T(1) and T(2) were significantly lower in groups III and IV compared with the control group. The findings of this study demonstrate that GHB can control the increase of CSF lactate and glucose levels following SCT and that this metabolic effect may be associated with neuroprotective physiological changes.     

ASO Visual Abstract: Robotic Posterior Retroperitoneal Adrenalectomy: Patient Selection and Long-Term Outcomes

Annals of Surgical Oncology -     

Examination of the relationship between technology use of 5–6 year-old children and their social skills and social status*

The primary objective of this study is to determine the predictive effect of technology use durations of 5–6 year-old children on their social skill levels and social status. In this study, children’s technology usage is restricted to the use of television, portable computers, tablets and smartphones. The sample group of the study consisted of 162 children aged 5 and 6 years old who are actively enrolled in seven kindergartens. The data required for the study were obtained from children, parents and teachers. The ‘Determination of Use of Technology by Children–Parent Form’, the ‘Social Skills Evaluation Scale’, ‘The Picture Sociometry Scale’ and ‘The Personal Information Form’ were used. The results revealed that the use of mobile technologies had no predictive effect on the social skill level, whereas, some mobile devices have predictive effects on the social preference and social impact.     

Comparison between tensile characteristics of various suture materials with two suture techniques: an in vitro study

Clinical Oral Investigations - The first objective of the present study was to evaluate the tensile strength and elongation to failure of commonly used suture materials in oral surgery. As a...     

Immunoglobulin D lambda multiple myeloma and amyloidosis with predominant soft tissue involvement.

Multiple myeloma (MM) is associated with amyloidosis in approximately 15% of the patients. The most frequent presenting signs of such an association are nephrotic syndrome, cardiomyopathy and peripheral neuropathy. Amyloid arthropathy is not a frequent feature. We report a patient with immunoglobulin D (IgD) lambda type MM with presenting symptoms related to mucocutaneous amyloidosis and also amyloid arthropathy. He had no clinical and laboratory involvement due to nephrotic syndrome or cardiomyopathy. IgD myeloma is a rare form of MM and therefore much of the information about the disease is derived from case reports describing patients with associated symptoms. Our case also shows an unusual organ distribution of amyloid.     

The combination of cytological smears and cell blocks on endobronchial ultrasound-guided transbronchial needle aspirates allows a higher diagnostic yield

We compared the diagnostic performances of conventional smears and cell block preparations of tissue samples obtained with endobronchial ultrasound-guided transbronchial needle aspiration. We retrospectively analysed 451 patients (926 lymph nodes) who had undergone endobronchial ultrasound and for whom both smears and cell blocks were available and compared the diagnostic performances of these techniques when used alone and combined. Cell block preparations showed higher diagnostic performance over smears, but the combination was superior to either alone. The combination of smear and cell block techniques achieved a sensitivity, specificity and positive and negative predictive values of 92.5, 100, 100, 97.7 and 99.4, 95.0, 98.6, and 97.9 % for malignant and benign diseases, respectively. We recommend cell block preparations during endobronchial ultrasound-guided transbronchial needle aspiration.     

Successful treatment with anti-tumor necrosis factor (anti-TNF)-alpha of proteinuria in a patient with familial mediterranean fever (FMF) resistant to colchicine: anti-TNF drugs and FMF

Familial mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent attacks of fever, peritonitis, pleuritis, and genetically by autosomal recessive inheritance. The major renal involvement in FMF is the occurrence of amyloidosis that can be prevented by a daily regimen of colchicine. About 5–10% of cases with familial mediterranean fever may be resistant to colchicine. In literature, there is a controversy about the treatment of FMF patients resistant to colchicine. We describe a case with FMF, proteinuria, and bilateral sacroiliitis, which responded to anti-TNF (tumor necrosis factor)-alpha therapy with infliximab and etanercept.