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Abstract
Background There is a strong relationship between arterial stiffness and endothelial dysfunction and hypertension. How arterial stiffness is affected in elevated PRL conditions is uncertain. Biological action of prolactin contributing to the atherosclerotic process is a new research area. Aims We aimed at investigating cardiovascular risk predictability by conducting arterial stiffness measurement in patients with idiopathic hyperprolactinemia. Subjects and Methods The biochemical parameters and arterial stiffness analyses of 54 patients with idiopathic hyperprolactinemia, who had applied to our polyclinic in 2017 and 2018, and 55 healthy volunteers having similar characteristics with regard to age, sex and body mass index. Results The median prolactin level of the idiopathic hyperprolactinemia patients with a median age of 31 was found to be 45 ng/mL. The peripheral and central blood pressures and pulse wave velocities (PWV) of both the patient group and the control group were found to be similar. Any relations between prolactin levels and blood pressure and arterial stiffness could not be found. Discussion Our study showed that arterial stiffness did not increase in young patients with idiopathic mild hyperprolactinemia. However, the long-term effects of mildly elevated prolactin levels are unknown. Prospective randomized studies are required, that could reveal more clearly the prolactin-cardiovascular risk relation, and the clinical effects of extra-pituitary hyperprolactinemia.
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The easy way of evaluating exocrine pancreatic insufficiency in type 2 diabetes : listen to the patients' complaints and look in their eyes! Acta Gastroenterol Belg 2020; 83:407-412. [PMID: 33094587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND STUDY AIMS The objective of this study is to determine the prevalence of exocrine pancreatic insufficiency (EPI) in diabetic patients, and to investigate whether there is a relationship between EPI and diabetes period, gastrointestinal complaints and other diabetic microvascular complications. PATIENTS AND METHODS A total of 93 participants, consisting of 57 type 2 diabetes patients and 36 healthy volunteers have been included in our cross-sectional study. Participants were questioned for abdominal complaints and weight loss. Fecal elastase-1 (FE-1) was determined in fecal spot samples received from participants. The relationship between EPI and blood glucose, HbA1c, and duration and complications of diabetes were investigated. RESULTS FE-1 levels were significantly lower in diabetic group compared to control group (p=0.007). The number of patients with FE-1 levels of <200μg/g were significantly higher in diabetic group (p=0.002). A statistically significant negative correlation was determined between FE-1 levels and the duration of diabetes (r= -0.453 p<0.001). FE-1 levels were significantly lower in patients with retinopathy (p= 0.014). In the post-hoc analysis, this difference was due to patients in the proliferative retinopathy group. A significant negative correlation was determined between the presence of retinopathy and FE-1 levels (r=-0.32, p=0.02). Abdominal pain and distension complaints were independent predictive factors that estimate EPI. CONCLUSIONS An important part of type 2 diabetes patients has EPI and it should be considered in diabetes patients upon abdominal pain and distension. Determination of proliferative retinopathy in the eye examination may also suggest an idea on the possible presence of EPI.
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Alternate-day calcium dosing may be an effective treatment option for chronic hypoparathyroidism. J Endocrinol Invest 2020; 43:853-858. [PMID: 31900832 DOI: 10.1007/s40618-019-01173-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 12/22/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE Conventional treatment of chronic hypoparathyroidism consists of oral calcium supplements and active vitamin D analogs; however, some patients are unable to meet treatment goals despite the high dosage of oral calcium supplementation. We aimed to investigate the effectiveness of alternate-day oral calcium intake in patients with uncontrolled chronic hypoparathyroidism. METHODS In this retrospective cohort study, we evaluated 66 patients with chronic hypoparathyroidism who were admitted to our hospital between January 2017 and January 2019. Fourteen patients receiving ≥ 2000 mg/day oral elemental calcium and who were admitted to emergency department or our outpatient clinic at least once in the last 3 months for hypocalcemia requiring intravenous calcium replacement were switched to the alternate-day dosing regimen in which patients took calcium orally every other day. We collected and analyzed patients' medical history information, serum and urinary parameters over a 3-month period prior to and following the treatment. RESULTS Before alternate-day dosing regimen, median oral calcium intake was 3750 mg/day, oral calcitriol intake was 0.88 mcg/day, serum calcium levels were 7.71 mg/dL, serum phosphate levels were 5.35 mg/dL, and 24-h urine calcium levels were 165 mg/day. Following alternate-day dosing regimen, median oral calcium intake was 1500 mg/day, oral calcitriol intake was 0.88 mcg/day, serum calcium levels were 8.25 mg/dL, serum phosphate levels were 5 mg/dL, and 24-h urine calcium levels were 210.5 mg/day. After alternate-day dosing regimen, oral calcium intake decreased and serum calcium levels increased. The number of emergency visits dropped from 21 to 3 after alternate-day dosing regimen. CONCLUSION Patients with uncontrolled chronic hypoparathyroidism could be controlled more effectively with alternate-day dosing regimen.
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P386Comparison of whether a beginner can be close to an expert with an artificial neural network in myocardial perfusion imaging. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez149.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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The Effect of Preoperative Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio on Predicting Rupture Risk in Tubal Ectopic Pregnancies. Gynecol Obstet Invest 2019; 84:378-382. [DOI: 10.1159/000496543] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/02/2019] [Indexed: 11/19/2022]
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Template-promoted self-replication in dynamic combinatorial libraries made from a simple building block. Chem Commun (Camb) 2018; 54:13096-13098. [PMID: 30395138 DOI: 10.1039/c8cc06253f] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We report dynamic combinatorial libraries made from a simple building block that is on the verge of enabling self-assembly driven self-replication. Adding a template provides a sufficient additional push yielding self-replication. Self-assembly and self-replication can emerge with building blocks that are considerably smaller than those reported thus far.
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Serum betatrophin/angiopoietin-like protein 8 (ANGPTL8) levels in pregnancies affected by hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 2018; 225:221-227. [PMID: 29754072 DOI: 10.1016/j.ejogrb.2018.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/09/2018] [Accepted: 04/23/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The association between serum betatrophin levels and hyperemesis gravidarum (HEG) remains unknown. The aim of this study was to determine and understand the alterations in serum betatrophin levels in pregnancies complicated by HEG compared with unaffected normal pregnancies. STUDY DESIGN A cohort study was carried out to evaluate serum betatrophin levels in patients with HEG. Serum betatrophin concentrations were measured with other metabolic markers for lipids and glucose metabolism in 40 singleton pregnancies affected by HEG and 40 gestational age- and body mass index-matched controls. RESULTS The serum betatrophin concentrations were significantly higher in pregnant women with HEG than in the controls (1000 [600-1100] vs. 900 [500-1000] pg/ml, p = 0.003). The serum total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) levels were significantly higher in patients with HEG than in the healthy counterparts at the first trimester of pregnancy (158.5 ± 29.4 vs. 143.8 ± 29.7 mg/dl and 47.3 ± 14.2 vs. 40.1 ± 8.6 mg/dl, p = 0.031 and p = 0.007, respectively). Receiver operating characteristic (ROC) analyses demonstrated that the area under the curve (AUC) indicative of the betatrophin value for discriminating HEG patients was 0.690 (95% CI: 0.574-0.806, p = 0.003). The optimal cutoff value was 976 pg/ml with a sensitivity of 50% (95% CI: 33.80-66.20%) and a specificity of 82.5% (95% CI: 67.22-92.66%). We also found a positive correlation between betatrophin levels and HDL-C (r = 0.311; p = 0.005). Logistic regression analyses demonstrated that increased levels of betatrophin and HDL-C were risk factors for HEG with odds ratios (95% confidence interval) of 4.884 (1.589-15.009) and 5.346 (1.044-27.366), respectively. CONCLUSION We conclude that serum betatrophin concentrations were increased in pregnancies affected by HEG. Furthermore, HDL-C levels seem to be associated with alterations in serum betatrophin levels.
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Study of the influence of tonsillitis on other organs based on biophysical properties of skin biologically active points. INTERNATIONAL JOURNAL OF BIOLOGY AND CHEMISTRY 2018. [DOI: 10.26577/ijbch-2018-1-313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Molar pregnancy in cesarean section scar: A case report. Turk J Obstet Gynecol 2017; 14:249-251. [PMID: 29379669 PMCID: PMC5780570 DOI: 10.4274/tjod.26878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 11/05/2017] [Indexed: 12/13/2022] Open
Abstract
Cesarean scar ectopic pregnancies and molar pregnancies are two very rare obstetric pathologies. In both cases, serious morbidities are involved that require careful management. The coexistence of the two clinical conditions is far less common and there are a limited number of cases in the literature. In this case report, a 34-year-old patient with previous cesarean section was diagnosed as having a molar pregnancy in a cesarean scar through ultrasonography. The patient was asymptomatic at that time. Ultrasonography revealed a protruding mass at the cesarean section and her human chorionic gonadotropin level was measured as 59.705 mIU/mL. Due to the risk of severe bleeding, cesarean section scar excision and revision were performed via laparotomy after counselling the patient. Removal of all trophoblastic tissue was observed as a result of the frozen pathology and the operation was terminated. After the definite pathology result came as a complete molar pregnancy, the patient was followed up according to molar pregnancy follow-up protocols and cured completely. Despite the alternative treatment options (methotrexate application, curettage, uterine artery embolization) in such patients, the decision for surgery was made after counselling the patient. In this very rare clinical condition, patients should be closely monitored and the appropriate treatment option should be applied as soon as possible, taking into consideration the bleeding risks of both pathologies.
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First Trimester Ultrasonographic Diagnosis of Unruptured Rudimentary Horn Pregnancies in Two Cases. HASEKI TIP BÜLTENI 2016. [DOI: 10.4274/haseki.2890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Postpartum Depression and Associated Factors in Patients Who Admitted to Our Clinic to Make Child Birth. HASEKI TIP BÜLTENI 2016. [DOI: 10.4274/haseki.2856] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Maternal serum ferritin as a clinical tool at 34-36 weeks' gestation for distinguishing subgroups of fetal growth restriction. J Matern Fetal Neonatal Med 2016; 30:452-456. [PMID: 27049175 DOI: 10.1080/14767058.2016.1174997] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To compare maternal ferritin levels across pregnancies with fetal growth restriction including SGA and IUGR compared to appropriate for gestational age (AGA). METHODS Three groups were enrolled: AGA, SGA (birth weight below 10th percentile for gestational age with no placental insufficiency findings), and IUGR (birth weight below 5th percentile for gestational age accompanied by abnormal umbilical artery Doppler waveforms and/or oligohydramnios). Maternal serum ferritin samples were obtained at gestational weeks 34 through 36, and delivery occurred at or beyond 36 weeks. RESULTS A total of 126 pregnancies with AGA (36%), SGA (40%), and IUGR (24%) were enrolled. The mean maternal serum ferritin level was higher in the IUGR group than in the AGA group (59 μg/l versus 32.5 μg/l, p < 0.001). A maternal serum ferritin cutoff of 48 μg/l was found to be optimal for distinguishing between IUGR and AGA with a sensitivity of 67.7%, specificity of 92%, PPV of 84%, NPV of 82%, diagnostic accuracy of 82.7%, LR + of 8 and LR- of 0.3, respectively. CONCLUSION Maternal serum ferritin levels differ in pregnancies with IUGR. The role of maternal serum ferritin measurements as a clinical tool for distinguishing different forms of fetal growth restriction warrants further investigation.
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Success rates of single-dose methotrexate and additional dose requirements among women with first and previous ectopic pregnancies. Int J Gynaecol Obstet 2015; 133:49-52. [PMID: 26873120 DOI: 10.1016/j.ijgo.2015.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 08/09/2015] [Accepted: 12/08/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To compare the success of the single-dose methotrexate regimen and the requirement for a second or third dose of methotrexate between women with their first ectopic pregnancy (EP) and those with previous EP. METHODS In a retrospective cohort study, data were analyzed from women treated for EP by single-dose methotrexate at a Turkish tertiary referral center between January 2010 and December 2013. Data were compared between women with at least one previous EP and those with their first EP. RESULTS The success rate of the protocol in the first and previous EP groups was similar: 93.0% (320/344) and 87.3% (48/55), respectively. History of previous EP was not a predictor of treatment failure. However, the requirement for additional methotrexate doses was significantly higher in the previous EP group (16/48 [33.4%]) than in the first EP group (55/320 [17.2%]; P=0.03). Multivariate analysis showed that history of tubal surgery (P=0.006) and initial levels of the β-subunit of human chorionic gonadotropin (P=0.001) were significant predictors of treatment failure. CONCLUSION Although the single-dose regimen had similar success rates in the previous EP and first EP groups, additional doses of methotrexate were more frequently required in the previous EP group.
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Tubal rupture in ectopic pregnancy: is it predictable? MINERVA GINECOLOGICA 2015; 67:13-19. [PMID: 25660430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Ectopic pregnancies account for 10-15% of all maternal deaths. Rupture of an ectopic pregnancy is an urgent medical situation, therefore prediction of any tubal rupture before its occurrence is extremely important. The aim of this study was to evaluate the tubal rupture rate in different treatment modalities in EP cases and to find a hCG level on admission and/or size of ectopic mass predictive for tubal rupture. METHODS Demographic data and medical data were extracted from patient charts for 211 cases who had diagnosis of tubal ectopic pregnancy. Women with tubal rupture were compared to those without rupture. RESULTS Expectant management, single dose methotrexate and primary surgical treatment were applied to 83 cases (39%), 93 cases (44%) and 35 cases (17%), respectively. The tubal rupture occurred in 14.7% of the study population. If the EP mass diameter is <2 cm, no tubal rupture was found. hCG values at admission were found to be predictive for rupture. On admission, hCG level of 1855 IU/L had 93.5%, sensitivity and 29% positive predictive value for tubal rupture. CONCLUSION In tubal ectopic pregnancy cases, hCG level on admission and size of ectopic pregnancy mass can predict tubal rupture.
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Early prediction for the requirement of second or third dose methotrexate in women with ectopic pregnancy, treated with single-dose regimen. Arch Gynecol Obstet 2014; 291:1327-32. [DOI: 10.1007/s00404-014-3593-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 12/09/2014] [Indexed: 10/24/2022]
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Second trimester serum alpha-fetoprotein level is a significant positive predictor for intrauterine growth restriction in pregnant women with hyperemesis gravidarum. J Turk Ger Gynecol Assoc 2011; 12:220-4. [PMID: 24591998 DOI: 10.5152/jtgga.2011.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 09/07/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine the association between three parameters of second trimester serum secreening and preterm labor and intrauterine growth restriction (IUGR) in patients with hyperemesis gravidarum (HG). MATERIAL AND METHODS A prospective study on 429 pregnancies with HG was designed to determine the association between alpha-fetoprotein (AFP), unconjugated estriol (uE3), human chorionic gonadotropin (HCG) and pregnancy prognosis in terms of preterm labor, IUGR and birth weight. RESULTS In our study group the mean age of patients was 25.4±3.8 years. Mean birth weight was 3180±555 g. Mean AFP, uE3, hCG levels in the study group were 1.44±0.65 MoM, 0.91±0.38 MoM, 1.09±0.64 MoM, respectively. Twenty nine (6.8%) patients delivered before 37 weeks of gestation and 52 (12.1%) patients developed IUGR. Mean MoM values of AFP among patients with preterm labor, IUGR and normal delivery were 1.35±0.45, 1.97±0.81, 1.34±0.58 MoM, respectively (p<0.001). Mean MoM values of hCG among patients with preterm labor, IUGR and normal delivery were 1.46±0.90, 1.35±0.89, 1±0.5 MoM respectively (p<0.001). Mean MoM values of uE3 among patients with preterm labor, IUGR and normal delivery were 0.75±0.25, 0.80±0.30, 0.95±0.40 MoM, respectively (p=0.003). Odds ratio of AFP>1.55 was 3.73 (95% CI, 1.99-6.98, p<0.001) for IUGR after adjustment for HCG. CONCLUSION Our study suggests that AFP levels of the second trimester screening test higher than 1.55 MoM is significantly associated with IUGR in hyperemesis gravidarum. The second trimester screening test can predict poor outcome in HG.
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Significance of subchorionic haemorrhage and pregnancy outcome in threatened miscarriage to predict miscarriage, pre-term labour and intrauterine growth restriction. J OBSTET GYNAECOL 2011; 31:210-2. [PMID: 21417641 DOI: 10.3109/01443615.2010.545899] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Subchorionic haemorrhage in the 1st trimester of pregnancy can be seen in some patients and the significance of it is controversial. In this study, subchorionic haemorrhage was found to be significantly associated with increased risk of miscarriage and IUGR. On the other hand, we did not see a significant relation between pre-term labour and subchorionic haemorrhage. We hope these findings will help clinicians in their practice about pregnancy follow-up.
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Reply. Nephrol Dial Transplant 2010. [DOI: 10.1093/ndt/gfq584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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An unusual cause of acute renal failure: hypothyroidism. Clin Kidney J 2010; 3:386-7. [PMID: 25949438 PMCID: PMC4421523 DOI: 10.1093/ndtplus/sfq021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 02/16/2010] [Indexed: 11/15/2022] Open
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Peritonitis Due to Pseudomonas stutzeri, an Organism That May Be Difficult to Culture. Perit Dial Int 2010; 30:484-6. [DOI: 10.3747/pdi.2009.00210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Among the different cardiovascular risk factors, lipid abnormalities dominate the high mortality in chronic ambulatory peritoneal dialysis patients. So far, no data comparing the effect of standard glucose-containing, amino acid-containing, and icodextrin-containing peritoneal dialysis solutions on serum lipid concentrations in a chronic ambulatory peritoneal dialysis population are available. To determine the effect of peritoneal dialysis solutions on parameters of lipid metabolism, 67 subjects who had continued their usual dialysis for the last six months were enrolled in the study. Group A consisted of 18 patients who were receiving only glucose-based peritoneal dialysis solutions, group B consisted of 18 patients who were receiving glucose and amino acid-based peritoneal dialysis solutions, and group C consisted of 31 patients who were receiving glucose and icodextrin-based peritoneal dialysis solutions. Serum lipid parameters including total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride, and lipoprotein (a) were determined in all groups. No significant difference in serum lipid parameters was found between groups A, B, and C. These results demonstrate the lack of the effect of amino acid or icodextrin-based peritoneal solutions on dyslipidemia of CAPD patients.
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A novel agent of peritoneal dialysis-related peritonitis: Granulicatella adiacens. Perit Dial Int 2008; 28:96-97. [PMID: 18178954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
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A rare case: full-term delivery in a lupus patient on CAPD. Perit Dial Int 2007; 27:711-712. [PMID: 17984439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
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Abstract
BACKGROUND Mature cystic teratomas, often referred to as dermoid cysts, are the most common germ cell tumors of the ovary. In the recent years, transvaginal sonographic diagnosis of ovarian dermoid cysts together with laparoscopic approach have greatly improved the treatment of this benign lesion. We retrospectively reviewed the outcome of laparoscopic surgery for suspected ovarian dermoid cysts. PATIENTS AND METHODS The preoperative findings, operative techniques and postoperative complications were retrospectively reviewed in women who underwent laparoscopic surgery for dermoid cysts, between January 2000 and May 2003. RESULTS In 47 women aged 21 to 53 years (median, 38.8 years), 93.6% had a unilateral cyst with a diameter of 17 to 108 mm (median, 51 mm). Clinical presentations were pain (62%), abnormal vaginal bleeding (21%) and ovarian torsion (2%), whilst 17% were diagnosed incidentally during routine examination. Surgery included cystectomy (57%), total (36%) or partial oophorectomy (6.4%) and laparoscopy-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy (2%). During the cyst extraction, minimal spillage occurred in 42.5% of the cases and none developed chemical peritonitis. In 2 patients, conversion to laparotomy (4.3%) was required, one for sigmoid colon injury and one for malignant ovarian tumor detected via frozen section. The median operating time was 80 minutes (range, 35-180 minutes). CONCLUSION Using strict adherence to guidelines for preoperative clinical assessment and intra-operative management, laparoscopic treatment of dermoid cysts appears to be a safe procedure.
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Subtransverse process wiring: a new technique of segmental spinal fixation of the thoracic spine or in the treatment of adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2001; 26:2392-6. [PMID: 11679827 DOI: 10.1097/00007632-200111010-00018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Segmental fixation is the preferred technique for the surgical treatment of adolescent idiopathic scoliosis. Sublaminar wiring is a widely used, strong type of segmental fixation. The most common drawback of the sublaminar wiring is the risk of neurologic injury. The authors have applied subtransverse wiring for 3 years, and the technique seems promising. OBJECTIVES To show that subtransverse wiring is a technique strong enough to correct scoliosis curves and does not carry neurologic injury risks. SUMMARY OF BACKGROUND DATA Sublaminar wiring is a commonly used fixation method for posterior fusion in the treatment of scoliosis. Because of its associated risk of neurologic injury, it is mostly recommended for long neuromuscular curves. METHODS The authors used the subtransverse wiring technique in 12 cases of adolescent idiopathic scoliosis and followed them for an average of 22 months. RESULTS The average correction rate was 65%, and correction loss at the end of the follow-up period was 5 degrees. No neurologic complications were encountered. CONCLUSIONS Subtransverse wiring is strong enough to correct scoliotic curves. It requires less operative time and skill and is neurologically safe.
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The use of polymethylmethacrylate in the management of hydatid disease of bone. THE JOURNAL OF BONE AND JOINT SURGERY. BRITISH VOLUME 2001; 83:1005-8. [PMID: 11603512 DOI: 10.1302/0301-620x.83b7.12105] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
Hydatid disease of bone is rare. It probably represents between 0.5% and 4% of all human hydatid disease and, in about 60% of patients, affects the spine or pelvis. Between 1986 and 1998, we treated 15 cases of bone hydatidosis. Curettage, swabbing with povidone iodine and filling the defect with polymethylmethacrylate (PMMA) were carried out in ten patients. Three of these had a recurrence after five years, but seven had no signs of relapse during a mean follow-up of 52 months. We believe that the combination of antihelminthic therapy, wide resection and the use of PMMA gives the best outcome in the treatment of bone hydatidosis.
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Abstract
Hydatid disease of bone is rare. It probably represents between 0.5% and 4% of all human shydatid disease and, in about 60% of patients, affects the spine or pelvis. Between 1986 and 1998, we treated 15 cases of bone hydatidosis. Curettage, swabbing with povidone iodine and filling the defect with polymethylmethacrylate (PMMA) were carried out in ten patients. Three of these had a recurrence after five years, but seven had no signs of relapse during a mean follow-up of 52 months. We believe that the combination of antihelminthic therapy, wide resection and the use of PMMA gives the best outcome in the treatment of bone hydatidosis.
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Abstract
Primary malignant lymphoma of bone (PLB) is an uncommon tumour. A survey of 278 primary malignant cases in our clinic showed that 20 cases of PLB were registered between 1986 and 1997. Fourteen of the 20 cases underwent surgical excision. The mean follow-up time was 36.3 months. The rate of response to treatment was 65% with a rate of complete recovery of 55%. The clinical stage of tumours correlated well with the prognosis. Our results seem worse than most of the series in the literature. A high proportion of stage IV disease and pathological fractures at presentation may be a factor.
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Abstract
Between 1987 and 1999 we diagnosed and treated 110 patients with osteoid osteoma. Sixty patients were younger than 20 years. One hundred and four patients had characteristic pain at night. The mean duration of symptoms before surgery was 16 months. One hundred and four symptomatic patients were treated operatively with either wide resection or curettage. Ninety-one patients had immediate and complete relief of pain. The average follow-up was 2.5 years.
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