Background: Skinfold thickness (SFT) and bioelectrical impedance (BIA) are readily available and commonly used techniques in patient monitoring for body composition analysis (BCA) in clinical practise. Another one, dual-energy X-ray absorptiometry (DEXA) method became popular in body composition analysis (BCA) in recent years. Its results have been reported to be quite accurate and precise, in comparison with in vivo or in vitro multiple component reference methods. The aim of the present study was to assess the degree of agreement between SFT and DEXA, and BIA and DEXA methods, in obese and nonobese patients. Methods: Body fat mass (FM) was measured in 16 nonobese (mean body mass index; BMI = 22.2 ± 2.2 kg/m2) and in 21 obese (BMI = 34.5 ± 6.1 kg/m2) women with DEXA, SFT, and BIA in the same morning. Results: Mean (± SD) FM (kg) was 16.3 ± 5.5, 15.0 ± 5.1, 14.7 ± 4.9 in nonobese subjects and 38.8 ± 10.1, 36.3 ± 10.0, 37.1 ± 12.0 in obese patients, by DEXA, SFT and BIA, respectively. Comparison of the DEXA-BIA and DEXA-STF methods showed high correlation in regression line analysis in nonobese subjects as, r2 = 0.93 and 0.89, respectively. Regression coefficents were 0.84 and 0.75 in obese patients. However, reanalysis of the data by the Bland and Altman method revealed an obvious lack of agreement between the DEXA-BIA and DEXA-SFT methods in obese patients. In addition, FM was underestimated by BIA and SFT as compared to DEXA in both of the study groups. Besides, better precision was obtained by DEXA method among the others. Conclusion: The SFT or BIA method would be preferred to monitor BCA in non-obese subjects in clinical routine. However, DEXA should be considered as the method of choice in obese patient monitoring, since reproducibility gains special importance, other than the accuracy in the context.
Incidence of cardiovascular diseases in the patients having chronic kidney disease (CKD) is between 25% and 60%. This increased rate is proposed to be associated with "accelerated atherosclerosis." Increased carotid intima-media thickness (CIMT) is a subclinical atherosclerosis marker. Small-dense low-density lipoprotein particles are a strong risk factor for atherosclerosis. It was shown that atherogenic index of plasma (AIP = log(TG/HDL-c)) is correlated with size of the lipoprotein particles. We investigated the correlation between AIP and CIMT which is a subclinical atherosclerosis marker, in hemodialysis (HD) patients. A total of 62 persons with 31 patients under HD therapy and 31 volunteers were included in the study. In all the participants, CIMT was measured and AIP were calculated. AIP and CIMT values of the participants were compared with blood pressures, lipid profiles and the other risk factors. AIP (0.39 ± 0.32) and CIMT (0.57 ± 0.13) were found significantly higher in the patient group than in the controls (0.04 ± 0.36 and 0.45 ± 0.119, respectively); (P = 0.0001 and 0.0001, respectively). There was a significant correlation between AIP and increased CIMT in the patient group (P = 0.0001, r = 0.430). Among the lipid parameters, the strongest correlation was found between CIMT and AIP. We demonstrated the significant increase of AIP and CIMT in HD patients. A correlation was found between AIP and CIMT. AIP was found to show a correlation with a greater number of risk factors, both classical and CKD specific, than CIMT. These data suggest that AIP might be a method which can be used both in diagnosis of subclinical atherosclerosis and in deceleration processes of its progression.
The Familial Mediterranean Fever (FMF) shows an autosomal recessive pattern of inheritance and affects certain ethnic groups. Disease is caused by mutations in MEFV gene and more than 180 mutations have been defined in affected individuals. Current study aimed to determine the frequency-type of the mutations for MEFV gene in Sivas-middle Anatolian city. The cohort was composed of 3340 patients. MEFV gene mutations were studied by multiplex PCR based reverse hybridization stripAssay method. Patients' clinical features were; family history: 68%, erysipelas-like erythema: 17.6%, fever: 89.9%, abdominal pain: 84.2%, peritonitis: 90.2%, arthritis: 33%, pleuritis: 14.2%, parental consanguinity: 21.2%. Current results revealed that M694V is the most frequent mutation (43.12%), followed by E148Q (20.18), M680I(G/C) (15.00%) and V726A (11.32%). The study population has a high rate of carriers and the E148Q mutation frequency was found to be highest when compared to the other regions of Turkey and other Mediterranean groups.
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are among the most devastating health problems in the world, including Turkey. The route of transmission of HBV and HCV is mainly parenteral, a small number of epidemiological studies demonstrating that perinatal, sexual, household and occupational transmission occurs. Contact of a patient's blood or bodily fluids with non-intact skin is another mode of HBV and HCV transmission. Barbers in Turkey may often be exposed accidentally to the blood and bodily fluids of their customers. The aim of this study was to determine the prevalence of HBV and HCV infection in barbers. We conducted a study to determine the prevalence of antibodies against HBV and HCV among 176 barbers and 180 control subjects in the Sivas region of Turkey. The prevalence of HBV and HCV was found to be higher in barbers (39.8 and 2.8%, respectively) than in a comparison group (28.3 and 1.1%, respectively). No significant relationship was found with the duration of occupation. Among the seropositive subjects, it was found that most had been exposed to needle pricks or scissor cuts. Our data suggest that both HBV and HCV infections may constitute occupational hazards for barbers. The sources of infection could be not only such personal risk factors as 'sharps' injuries and scissor cuts, but may also include other unknown factors.
Peroxidation of the membrane lipid structure of red blood cell leads to haemolysis and anaemia in haemodialysis patients. Dietary constituents of antioxidant vitamins and trace elements may play an important role in protecting against oxidant damage. In this study, the effects of supplementation of vitamin C and zinc on osmotic fragility and lipid peroxidation of erythrocytes were investigated in 34 zinc-deficient haemodialysis patients. Sixteen sex- and age-matched normal volunteers acted as controls. Patients were randomized to receive vitamin C (250 mg day(-1)), zinc (20 mg day(-1)) or a placebo treatment for 3 months. The levels of vitamin C, zinc, malondialdehyde (MDA) and osmotic fragility were measured initially and 3 months after supplementation. Mean serum concentration of vitamin C and zinc increased significantly in the groups at the end of the respective study periods. Supplementation with vitamin C and zinc improved osmotic fragility, and decreased the level of MDA in the groups, but some side-effects (i.e. nausea, vomiting, fever, muscle pain, weakness) were observed during the zinc treatment. The results showed that the supplementation of both treatments decreased osmotic fragilty and MDA in zinc-deficient haemodialysis patients. However, vitamin C treatment was found to be safer than zinc supplementation.
OBJECTIVE: Studies comparing ultrafiltration and diuretics in management of ADHF have shown controversial results. In this study, we compared the efficacy and safety of intravenous diuretic therapy and ultrafiltration in patients admitted with acute decompensated heart failure (ADHF) who had right ventricular dysfunction superimposed on left ventricular systolic dysfunction. MATERIAL and METHODs:A total of 30 patients of whom 10 were in the ultrafiltration group and 20 were in the diuretic group were enrolled in this study and followed for 3 months.REsULTs: At discharge, there were no significant differences between the ultrafiltration and diuretic groups in terms of weight loss , total fluid loss, and changes in serum creatinine. The clinical decongestion rates were similar in the two groups. Moreover, echocardiographic and biochemical parameters and alterations in renin and aldosterone levels, as measured to assess neurohormonal activation, had overlapping results between the two groups. When unwanted events were analyzed, transition to hemodialysis was seen in 20% of the patients in the ultrafiltration group and 5% of the patients in the diuretic group. The frequency of cardiac arrest and death were 40% in the ultrafiltration group and 10% in the diuretic group. Weight change, creatinine, and electrolyte levels of the patients at 1 and 3 months were also similar. CONCLUsION:Despite the high frequency of hemodialysis transition, cardiac arrest, and death in the ultrafiltration group, safety of ultrafiltration could not be assessed because of inability to perform statistical analyses. Further studies are needed to investigate the practical uses of ultrafiltration in routine clinical practice.
There is an increased risk of AV fistula thrombosis in individuals carrying the VEGF-936C/C genotype. The other renal replacement modalities should be considered in patients with this genotype. As a result, it will be possible to prevent the morbidity and mortality due to fistula failure.
Background: In this study, we investigated the relationship between early arteriovenous fistula (AVF) thrombosis with angiotensin-converting enzyme (ACE) gene and thrombophilic factor gene polymorphisms. Methods: Thirty-five patients who suffered from three or more fistula thrombosis episodes in the early period after AVF operation and 33 control patients with no history of thrombosis for at least 3 years were enrolled in this study. Results: Factor V G1691A Leiden, factor V H1299R (R2), prothrombin G20210A, factor XIIIV34L, b-fibrinogen-455 G-A, glycoprotein IIIa L33P human platelet antigens (HPA-1), methylenetetrahydrofolate reductase C677T, and methylenetetrahydrofolate reductase A1298C gene polymorphisms were similar in both groups (p > 0.05). Plasminogen activator inhibitor 1 (PAI-1) 4G/5G genotype in the study group and 4G/4G genotype in the control group were significantly higher (p = 0.014). No significant difference was detected in terms of the 5G/5G genotype. With regard to the ACE gene polymorphism, the control group showed more ID genotype (19/33, 57.6%), whereas the study group showed more DD genotype (17/35, 48.6%). II genotype was similar in both groups (x 2 = 7.40, p = 0.025). The rate of ACE inhibitor-angiotensin II receptor blockers use was 5/35 in the study group (14.3%) and 5/33 in the control group (15.2%). Individuals with PAI-1 4G/5G genotype showed 5.03 times more risk of thrombosis when compared with 4G/4G and 5G/5G genotypes [p = 0.008, OR = 5.03, 95% confidence interval (1.44:17.64)]. Individuals with ACE DD genotype showed 4.25 times more risk of thrombosis when compared with II and ID [p = 0.008, OR = 4.25, 95% confidence interval (1.404:12.83)]. Conclusion: PAI-1 4G/5G and ACE DD genotypes are associated with increased risk for early AVF thrombosis.
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