Amaç: Amiloidozun koroner arterlere etkisini ortaya koymak ve eğer artmış bir koroner arter hastalığı riski varsa erken tanı ile olguların yaşam süresini artırmada katkı sağlamak ...amaçlanmaktadır.Gereç ve Yöntem: Çalışmaya 6 ay süresince Nefroloji Polikliniğinimize başvuran, kronik böbrek yetmezliğine girmemiş, biyopsi ile tanı almış 20 sekonder amiloidoz olgusu ve sağlıklı 20 gönüllüden oluşan kontrol grubu dahil edildi. Hasta ve kontrol grubuna Toshiba Aquilion 16 dedektörlü çok kesitli bilgisayarlı tomografi cihazı ile koroner arter kalsiyum skorlama tetkiki yapıldı. Öykülerinde koroner arter hastalığı, hipertansiyon, diyabetes mellitus, kronik böbrek yetmezliği, hiperlipidemi, obesite olan olgular çalışma dışı bırakıldı. Bulgular: Hasta grubumuzda koroner arter kalsiyum skoru ortalaması 16,05 ±10,4 kontrol grubunda 6,4±4,36 idi. İki grup arasındaki istatistiksel fark anlamlı bulunmadı p=0,739 . Gruplar arasında yaş, cinsiyet, sigara ve alkol kullanımı, sistolik ve diastolik kan basıncı, açlık kan şekeri ve kan lipid parametreleri, kan üre nitrojen, kreatinin, C reaktif protein ve fosfor düzeyleri açısından anlamlı farklılık saptanmadı. Kan albumin ve total kalsiyum düzeyleri ile idrar protein/kreatinin arasındaki fark ise anlamlı idi p
Hypernatremia is a common electrolyte disorder associated with prolonged hospitalization and death. Severe hypernatremia is defined as a serum sodium (Na
+
) concentration >160 mmol/L. To the best of ...our knowledge, there is little information on patients with severe hypernatremia, Na
+
>160 mmol/L. Therefore, in this study, we aimed to determine the frequency, demographic and clinical characteristics, comorbid conditions and treatment strategies in patients presenting to the emergency department with severe hypernatremia, and also to evaluate the effects of these factors on mortality. A retrospective chart review was performed on patients presenting to the emergency department between January 2011 and June 2014. Patients with Na
+
>160 mmol/L were screened retrospectively via the hospital electronic information management system and patient medical record files. During the 3.5 years of screening, 256 patients (0.04 %) with Na
+
>160 mmol/L presented to the emergency department. The mean age of the patients included in the study was 74.4 ± 15.2 years, mean Na
+
level was 168.7 ± 7.4 mmol/L and, mean mortality was 49.5 % during the hospitalization. Multivariable Cox regression analysis showed that low systolic blood pressure, low pH, Na
+
>166 mmol/L, increased plasma osmolarity, mean sodium reduction rate ≤−0.134 mmol/L/h, dehydration, and, pneumonia to be independently associated with mortality. This study describes the demographic and clinical characteristics of patients with Na
+
>160 mmol/L in a large population along with comorbid conditions, incidence, treatment strategies and, its association with mortality.
We aimed to determine the association between platelet indices including plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and proteinuria associated with ...hypertension (HT) as well as the relative power of each to predict proteinuria.
The study included 223 patients (68 men and 155 women) with primary HT. PCT, MPV, PDW, and proteinuria levels were measured. The patients were divided into two groups according to proteinuria status based on 24-hr urinary protein excretion: proteinuria (+) group (15 men and 40 women) and proteinuria (-) group (53 men and 115 women).
The mean and SD of platelet count, PDW, PCT, and MPV were 278.8±49.6×10⁸/L, 13.5±1.8%, 0.31±0.07%, and 11.3±2.6 fL, respectively. The mean platelet count, PCT, MPV, and PDW were significantly higher in the proteinuria (+) group than in the proteinuria (-) group (P<0.05); there were no significant differences in the other blood parameters between the two groups. The platelet count, PCT, MPV, and PDW were independent risk factors predictive of proteinuria according to a stepwise regression analysis of PDW, PCT, and MPV. PCT was the strongest independent predictor of proteinuria.
The platelet indices PCT, PDW, and MPV were significantly higher in patients with proteinuria than in those without it. Among these three indices, PCT was the strongest predictor of proteinuria.
We aimed to investigate the thiol/disulphide homeostasis in patients with newly diagnosed primary hypertension with a novel and automated method. Blood thiol/disulphide homeostasis, which consists of ...native thiol/disulphide exchanges, was investigated in 45 patients with primary hypertension and 45 healthy controls. The levels of native thiol, total thiol, and native thiol/total thiol ratio were lower while the disulphide level and disulphide/native thiol and disulphide/total thiol ratios were higher in patients with primary hypertension when compared with those in the control group. Positive correlation was detected between 24-hour systolic and diastolic blood pressure levels and disulphide/native thiol ratio. With reference to the stepwise multiple linear regression model; increase in disulphide/native thiol ratio and log(24-hour urine microalbumin) and decrease in native thiol/total thiol ratio are independent predictors of 24-hour systolic and diastolic blood pressure. This study demonstrated that thiol/disulphide homeostasis was shifted toward disulphide formation in patients with primary hypertension.
High dietary salt intake was reported to increase blood pressure by numerous studies, but no study has investigated the effect of dietary salt intake on blood pressure variability (BPV). This study ...aimed to determine if daily salt intake is related to ambulatory BPV. The study included 136 primary hypertensive patients (92 male, 44 female) with a mean age of 50.7±11.1 years. All the patients underwent 24-h ambulatory blood pressure monitoring to determine both the 24-h systolic and 24-h diastolic BPV. 24-h urine sodium was measured. The correlation between BPV and 24-h urinary sodium was investigated. Logarithmic transformation of 24-h urinary sodium log(24-h urinary sodium) was positively correlated with the mean 24-h systolic ARV, and nighttime systolic ARV (r=0.371 and p=0.001, r=0.329 and p=0.028, respectively). Similarly, log(24-h urinary sodium) was positively correlated with mean 24-h diastolic ARV and nighttime diastolic ARV (r=0.381 and p=0.001, r=0.320 and p=0.020 respectively). Log(24-h urinary sodium) was an independent predictor of BPV based on multivariate regression analysis. Dietary salt intake might play a role in the pathogenesis of ambulatory BPV.
En numerosos estudios se ha señalado que el consumo elevado de sal aumenta la presión arterial; no obstante, no se ha investigado el efecto de la ingesta alimenticia de sal sobre la variabilidad de la presión arterial (VPA). El objetivo de este estudio fue determinar si el consumo diario de sal está relacionado con la VPA ambulatoria. En el estudio se incluyeron 136 pacientes hipertensos esenciales (92 hombres y 44 mujeres) con una edad media de 50,7±11,1años. Todos los pacientes se sometieron a una monitorización ambulatoria de la presión arterial de 24h para determinar la VPA sistólica y diastólica de 24h. Se midió la natriuria de 24h y se estudió la correlación de la misma con la VPA. La transformación logarítmica de la natriuria de 24h (log natriuria 24h) se relacionó con certeza con el índice Average Real Variability (ARV) sistólico de 24h y el ARV sistólico nocturno medios (r=0,371 y p=0,001, r=0,329 y p=0,028, respectivamente). De forma parecida, el log natriuria 24h se relacionó con seguridad con el ARV diastólico de 24h y el ARV diastólico nocturno medios (r=0,381 y p=0,001, r=0,320 y p=0,020, respectivamente). El log natriuria 24h fue una variable independiente de la VPA, según el análisis de regresión multivariante. Es posible que el consumo de sal intervenga en la patogénesis de la VPA ambulatoria.
Dynamic thiol/disulphide homeostasis plays a critical role in numerous intracellular enzymatic pathways including antioxidant defence and detoxification. In this study, we sought to investigate ...dynamic thiol/disulphide homeostasis in patients with masked hypertension (MHT) and its relationship with blood pressure. Forty patients (23 men, 17 women) with newly diagnosed MHT and not yet on medical therapy, and 40 healthy volunteers (21 men, 19 women) were enrolled. Blood thiol/disulphide homeostasis was measured in both groups. Serum native and total thiol levels were measured using the novel, fully automated colorimetric method developed by Erel et al. Serum disulphide level was calculated as (serum total thiol − serum native thiol)/2. Native and total thiol levels (p = 0.001) and native thiol/total thiol ratio (p = 0.023) were found to be lower in patients with MHT when compared to those of the control group. Disulphide level and ratios of disulphide/native thiol and disulphide/total thiol were higher in patients with MHT than in the control group (p = 0.001). A positive correlation of systolic blood pressure (SBP) and diastolic blood pressure (DBP) was observed with disulphide/native thiol ratio (p < 0.001). Stepwise multivariable regression analysis showed disulphide/native thiol ratio to be an independent risk factor of SBP and DBP, and SBP to be an independent risk factor of disulphide/thiol ratio (p = 0.001). In this study, we found that dynamic thiol/disulphide homeostasis shifted towards disulphide formation due to thiol oxidation in patients with MHT. Prospective randomised controlled studies are required to elucidate whether abnormal thiol/disulphide status lies in the pathogenesis of MHT or is a consequence of MHT.
The aims of this study were to measure the levels of interleukin-33 (IL-33) and soluble Suppression of Tumorigenicity 2 (sST2) in patients with newly diagnosed primary hypertension (HT) and to ...determine the relationship between carotid intima-media thickness (CIMT) and IL-33/sST2. Eighty-two patients with newly diagnosed primary HT and ninety healthy volunteers were included in the study. CIMT ⩾0.9 mm was considered as significant for subclinical atherosclerosis. The sST2 levels of patients with primary HT were higher than those of the control group, whereas the IL-33 levels of these patients were much lower than those of the control group. The sST2 levels were higher in patients with subclinical atherosclerosis than in control subjects or patients with primary HT but not with subclinical atherosclerosis. In the primary HT group, sST2 had a positive correlation with CIMT, 24-h systolic-diastolic blood pressure, low-density lipoprotein and C-reactive protein, whereas sST2 had a negative correlation with the IL-33 level. A stepwise multivariable logistic regression analysis revealed that sST2 is an independent risk factor for subclinical atherosclerosis. Although the diagnostic predictive value of HT risk was determined as >51.8 pg l(-1) in the receiver operating characteristic curve analysis in respect of the sST2 level, the diagnostic predictive value for subclinical atherosclerosis risk was determined to be >107.2 pg l(-1). The sST2 level displays a positive correlation with atherosclerotic changes, and is an independent risk factor for subclinical atherosclerosis expressed as increased CIMT.
Magnetic poly(2-hydroxyethyl methacrylate) (mPHEMA) beads were used in the removal of anti-dsDNA antibodies from systemic lupus erythematosus (SLE) patient plasma in a magnetically stabilized ...fluidized bed. mPHEMA beads, in the size range of 80–120
μm, were produced by suspension technique. Then, DNA was immobilized onto mPHEMA beads by carbodiimide activation. Magnetic beads were contacted with blood in in vitro systems. Loss of blood cells and clotting times were followed. mPHEMA beads were characterized by scanning electron microscopy (SEM). Important results obtained in this study are as follows: the mPHEMA beads have a spherical shape and porous structure. Loss of cells in the blood contacting with mPHEMA/DNA was negligible. The anti-dsDNA adsorption capacity decreased significantly with the increase of the flow-rate. With increasing anti-dsDNA antibody concentration, the amount of antibody adsorbed per unit mass increased, then reached saturation. Maximum anti-dsDNA antibody adsorption capacity was found to be 97.8
mg/g. Pathogenic antibody molecules could be repeatedly adsorbed and desorbed with these magnetic beads without noticeable loss in their antibody adsorption capacity. Because of the good blood-compatibility, mPHEMA is hopeful for the treatment of SLE by magnetically stabilized fluidized bed systems in the future.
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