The report entitled "PP-116 vortex keratopathy associated with long term use of amiadarone," written by Altun et al and published in a recent issue of American Journal of Cardiology, was quite ...interesting.1 Here, we would like to emphasize some relevant points.
Aims. Cardiovascular diseases are the primary cause of premature morbidity and mortality in early breast cancer patients after treatment with cardiotoxic chemotherapeutic agents. Arterial stiffness ...is an independent risk factor for future cardiovascular diseases and can be used as a predictive marker of subclinical cardiac damage. The aim of this study is to analyze the arterial stiffness in breast cancer patients who are in the follow-up period after receiving anthracycline-based chemotherapy regimens with trastuzumab. Methods and Material. We enrolled 45 HER2-positive breast cancer patients who are on follow-up at least for six months after completion of adjuvant chemotherapy with trastuzumab, and cardiovascular risk matched 30 control volunteers. The measurements were done with pulse wave analyzing machine. Results. Mean pulse wave velocity was higher in breast cancer patients compared to controls. The pulse wave velocity was significantly higher in patients receiving aromatase inhibitors compared to patients under tamoxifen. It was also significantly higher in postmenopausal breast cancer patients than postmenopausal controls. Conclusions. Arterial stiffness measurements may predict the breast cancer survivors with higher risk for cardiovascular events earlier in the follow-up period, and necessary preventive approaches and/or treatments can be applied.
Continuous renal replacement therapy (CRRT) is an increasingly preferred treatment that is easier to use in patients with hemodynamic impairment and can be applied in critical care settings. There ...are various subtypes of CRRT, one of which is continuous venovenous hemodiafiltration (CVVHDF). In this study, we examined the general characteristics of intensive care patients who underwent CVVHDF.
Methods. The clinical and biochemical data of 123 patients who underwent CVVHDF in the intensive care units of our center between February 2012 and November 2014 were analyzed retrospectively. Patients who died during the course of therapy were compared with those who survived.
Results. The study included 123 patients, 73 males (59.3%) and 50 females (40.7%). The mean age was 64.4 years. Eighty-eight patients (71.5%) died during CVVHDF while 35 patients survived (28.5%). Hemodynamic parameters such as systolic and diastolic arterial blood pressure, mean arterial pressure, and pulse pressure were significantly lower in patients who died compared to survivors (p<0.001). Mean lactic acid level was significantly higher in the deceased group than in the surviving group (8.54 mmol/L vs. 3.68 mmol/L, p<0.001, chi-square test).
Conclusions. Low bicarbonate level, low systolic arterial blood pressure, and older age were significant independent predictors of mortality in this study. Mortality rates were significantly higher among patients with lactic acidosis and those over 66 years of age. Lactic acid levels can be used to predict mortality in patients undergoing CVVHDF.
Objective
The aim of this article is to assess and compare the rate of primary patency achieved by drug-eluting balloon angioplasty (DEBA) and conventional balloon angioplasty (CBA) in hemodialysis ...arteriovenous fistula stenoses.
Methods
This retrospective study consists of 52 patients with significant arteriovenous fistulas stenoses who were treated with DEBA (
n
= 26) or CBA (
n
= 26) between January 2013 and January 2015. Only those patients with postprocedural technical and clinical success of 100 % were selected from the database. Primary patency rates of fistulas at 6 and 12 months were evaluated with Doppler ultrasonography as well as clinically. The Kaplan-Meier method was used to compare the primary assisted patency rates for the two groups.
Results
The type of AVFs were 41 (78.8 %) radiocephalic and 11 (21.2 %) brachiocephalic. Primary patency rates between the DEBA and CBA group had a statistically significant difference at 12 months (
p
< 0.05). However there was no statistically significant difference at the 6-month follow-up period (
p
= 0.449). There was no statistically significant difference among the patient age, patient gender and fistula type of the two groups (
p
> 0.05).
Conclusion
Drug-eluting balloon angioplasty proved to be an effective treatment of hemodialysis AVFs stenosis, with a high primary patency rate at 12 months.
Introduction: The endothelial damage, changes in vascular permeability and plaque formation are caused by the effects of cytokines and chemokines that plays role in chronic inflammation in rheumatoid ...arthritis (RA) and ankylosing spondylitis (AS). It has been reported that arterial stiffness and the level of cell adhesion molecules are affected by inflammation. In this study, we aimed to determine the relationship between vascular endothelial growth factor (VEGF), E-selectin, arterial stiffness and disease activity in patients with rheumatic diseases. Methods: Thirteen patients diagnosed with AS, 28 patients diagnosed with RA and 30 healthy controls were included in the study. Arterial stiffness, VEGF, E-selectin, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were evaluated in all patients and healthy controls. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Disease Activity Score-28 (DAS-28) were calculated in patients with rheumatic diseases. The level of serum VEGF and E-selectin were determined by ELISA, and arterial stiffness was measured by oscillometric method. The data were statistically evaluated by using Student t-test, Mann-Whitney U Test and Wilcoxon test. Results: DAS-28, BASDAI, ESR and CRP levels were significantly decreased on the 3rd month of treatment in all patients (p<0.001). VEGF and E-selectin levels increased, and pulse wave velocity (PWV) and augmentation index (Alx) parameters decreased with treatment. While the level of PWV did not change, Alx decreased on the 3rd month of non- tumor necrosis factor treatment in RA patients. Conclusion: DAS, ESR and CRP were decreased with the reduction of inflammation in RA and AS patients with treatment. PWV and Alx of arterial stiffness parameters decreased after 3 months of treatment, but it did not reach statistical significance. Arterial stiffness and cardiovascular risk are expected to reduce significantly with ongoing treatment process.
Microscopic polyangiitis is an important and common component of cytoplasmic antibody–associated vasculitides that can lead to serious morbidity and even death. A clear causative etiology has not ...been identified. Although silica is well known to produce lung damage, the negative renal effects of silica exposure should not be overlooked. We present a case of renal dysfunction associated with silica exposure, its diagnosis by renal biopsy, and the treatment method used. Environmental or occupational silica exposure can cause microscopic polyangiitis. Working in occupations with increased risk of silica exposure may result in serious medical problems.
Acute Phosphate Nephropathy is a clinical and pathological finding characterized by acute and subsequent chronic renal failure following the use of intestinal cleansers containing sodium phosphate. ...The pathophysiology of Acute Phosphate Nephropathy occurs due to the increase of sodium and water absorption in the proximal tubules due to hypovolemia, and the accumulation of calcium phosphate load in the distal tubules in the collector and distal canals. Renal biopsy findings include acute and chronic tubular damage with tubular and interstitial calcium phosphate deposits. Prevention of Acute Phosphate Nephropathy can be achieved by hydration before and after the use of calcium phosphate in risky patients, minimizing the sodium phosphate dose, and having 12-hour intervals between sodium phosphate applications. In this article, we aimed to present the patients who used sodium phosphate for colonoscopy and developed Acute Phosphate Nephropathy.
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