Peritonitis (P) is the main complication and primary limiting factor in the extension of continuous ambulatory peritoneal dialysis(CAPD) in developing countries, because of exposure to potential external contamination, especially in people with unsatisfactory hygiene habits. We will present a case of peritonitis in 62 years old woman after the first three months of CAPD treatment. The peritoneal infection is confirmed by a cloudy fluid with increased WBC in the dialysis solution (2300..1300..1100 cells/mm; polymorphonuclears between 60% to 80%), augmented fluid protein content(cca.2.4 g/l), presence of microorganisms and symptoms of acute peritoneal infection(isolated Enterobacteria species, abdominal pain and diarrhoea). The peritonitis was treated following the Oreopoulos group’s recommendations and after a report of the sensitivity of the isolated Enterobacteria, with an appropriate antibiotic (Amikacine) in recommended intraperitoneal dose. Three days after successful treatment of peritonitis, the definite deafness is developed.
Background: End Stage Renal disease (ESRD) as it was historically termed is a term that encompasses all degrees of decreased renal function, from damaged-at risk through mild, moderate, and severe chronic kidney failure. ESRD is a worldwide public health problem. In the United States, there is a rising incidence and prevalence of kidney failure, with poor outcomes and high cost (see Epidemiology). Material and Methods: The blood sample for routine analysis (lipidogram) and specific analysis was taken at 08 o'clock in the morning with the room temperature that variated from 19 to 24°C, before the hemodialysis session, minimum 12 hours of fasting -with tendency to avoid the absorption effect of food by the intestine as well as avoid absorption of lipids and formation of chilomicrones. In all samples regardless of their group, the concentration of ApoC-II and lipids were analyzed in a period of 12 months in a period of 12 months (the measurements were made every three months, it means we totally made 3 measurements in 9 months). Results: The results from patients and controlling group for Apo-C3 and lipid profile (ChT, TG, HDL-ch, LDL-ch) are given in table number 3. A significant statistical difference with p<0.0001 is found from the results of the lipidic profile and ApoC-III of patients with ESRD treated with HD compared with the results of the controlling group for the same parameters. Conclusion: In this study patients with ESRD treated with HD have high parameters of ApoC-III, TG, LDL-ch but low concentrations of HDL-ch due to impaired catabolism of apolipoproteins in this specific group of patients. In all patients symptoms of CDV (myocardial infarction, angina pectoris, ischemia), acute coronary syndrome were noticed.
Background: Homocystinuria is a rare autosomal recessive disease complicated by early and aggressive occlusive arterial disease. This may be related to the grossly increased homocysteine concentrations seen in this disease. More recently, milder hyperhomocysteinemia has been proposed as an independent risk factor for coronary artery disease. Cardiovascular disease (CVD) is among the diseases with multiple contributing factors, hence making it difficult to pinpoint a particular factor alone. The main factor that is of relevance to this study is homocysteine. Coronary artery disease is the narrowing or blockage of the arteries and vessels that supply oxygen and nutrients to the heart (1, 2). CVD is the major cause of morbidity and mortality worldwide. Obesity, HTA, Diabetes mellitus, hypercholesterolemia, and smoking have been recognized as major risk factors for CVD. Aim: Aim of this paper is to examine concentrations of Hcyt and lipid profiles in patients with CVD and positive personal history for CVD, comparing them with the control group composed of healthy individuals. Our study aimed to verify the role of Homocysteine as a new independent risk factor on the onset of early atherosclerosis and atheromatous processes in coronary arteries in patients with CVD. Materials and methods: The results obtained represent the average value earned once every three months in the 3 year period. 5ccm serum with a few heparin spots was sent to the Clinical Laboratory of the University Clinic of Skopje. Results: The results obtained from patients with CVD and control groups are presented in the following text, where a statistically significant difference was observed for p <0.0001 between the parameters obtained by patients with CVD compared to the control group. Concentrations of homocysteine and lipids in patients with CVD compared to the control group showed statistically significant difference with p<0.0001, expected results, and verified in many other multicentric studies. These facts show that raised Hcyt has more impact on the onset of CVD. When Hcy levels are in the blood, the activity of the cystathionine-synthetase enzyme is raised. It is believed that this enzyme plays a vital role in the metabolism of Hcyt. In recent years a lot of studies have been made on the effect of hyperhomocysteinemia and its impact on the onset of coronary and all have verified that hyperhomocysteinemia is a significant parameter for the onset of early atherosclerosis of coronary and CVD(6,7,8). Conclusions: In the above-mentioned cases, it is recommended substitutive therapy with folic acid, pyridoxine, vitamin B12, vitamin E and other antioxidants which are found that have an effect on the prevention of premature atherosclerosis in patients with CVD and raised Hcyt: acute myocardial infarction, CARB, angina pectoris. PTCA, Stenting, and prevention of stroke.
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