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A septic pulmonary embolism develops with nonspecific pulmonary symptoms, including pulmonary infiltrations, fever, chest pain and cough as a secondary effect of any infectious focus, leading to the hematogenous spread of coagulated blood containing microorganisms from the right heart to the lungs. The condition can lead to the formation of infarctions and abscesses in patients with such predisposing conditions as congenital heart disease, intravenous drug use and long-term catheter use. We present here a case of septic pulmonary embolism resulting from the use of a dialysis catheter. [ABSTRACT FROM AUTHOR]

Amaç: Diyaliz fistül trombozlarının perkütan tedavisinde kullanılan standart doz ile tromboze segment uzunluğuna göre ayarlanan doz yaklaşımlarının başarısını karşılaştırmak amaçlandı. Gereç-Yöntem: Çalışmaya merkezimizde fistül trombozu nedeniyle anjioplasti yapılan 42 hasta dahil edildi. Hastaların 24’ü erkek (%57,1), 18’i kadın (%42,9) hastaydı. 21 hastaya (%50) standart 5 mg dozda, 21 hastaya ise (%50) tromboze segmentin uzunluğuna göre cm’ye 1 mg olacak şekilde değişen dozlarda (ortanca 7 mg, 4-10 mg arası) trombolitik ajan ultrason eşliğinde kontrollü bir şekilde enjekte edildi. Sonrasında uygun boyut ve uzunlukta balon kateterler yardımıyla anjioplasti yapıldı. Bulgular: İki grup arasında yaş (p=0,633), cinsiyet (p=0,674), tromboze segment uzunluğu (p=0,484), tromboz süresi(p=0,911), primer (p=0,618) ve sekonder (p=0,608) patensi ile teknik (p=0,145) ve klinik (p=0,145) başarı bakımından anlamlı farklılık saptanmadı. Tartışma: Diyaliz fistül trombozlarının perkütan tedavisinde kullanılan standart doz ile tromboze segment uzunluğuna göre ayarlanan doz yaklaşımları arasında teknik ve klinik başarı ile patensi anlamında farklılık saptanmamıştır.

Copyright of Van Health Sciences Journal / Van Sağlık Bilimleri Dergisi is the property of Van Yuzuncu Yil University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Sakarya Tıp Dergisi is the property of Sakarya Tip Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ahi Evran Medical Journal is the property of Ahi Evran University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Van Tip Dergisi is the property of Yuzuncu Yil University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Van Tip Dergisi is the property of Yuzuncu Yil University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Sosyal Güvence Dergisi is the property of Sosyal Guvenlik Uzmanlari Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: COVID-19 has been a stressful experience for healthcare providers (HCPs) and created additional distress for dialysis HCPs due to patients’ higher risk of infection, symptom severity, and death. This study aims to investigate Turkish dialysis HCPs’ levels of psychological difficulties during COVID-19’s initial outbreak. Materials and Methods: The study has recruited physicians, nurses, and healthcare workers in dialysis centers. The participants completed an online survey that includes the screening questionnaire, Depression Anxiety Stress Scale-21 (DASS21), and Multidimensional Scale of Perceived Social Support (MSPSS). The study conducts the chi-square test, Fisher’s exact test, Mann-Whitney U test, Kruskal Wallis H test, Spearman correlation, and linear regression analyses. Results: The study involves 953 respondents, with nurses making up the majority (n=465, 48.8%), followed by healthcare workers (n=402; 42.2%) and physicians (n=86; 9%). HCPs’ most significant concerns were getting infected with COVID-19 and transmitting the disease to their loved ones. Single participants, those without children, those who had trouble finding equipment, and those worried about being able to find equipment in the future, being in contact with COVID-19 (+) people, those whose tobacco and alcohol use increased, and those who declared sleep, appetite, and/or somatic problems had higher DASS-21 scores. When compared respectively to healthcare workers and physicians, nurses were found to be more worried about getting COVID-19 (94.6% compared to 90.6% and 84.7%; p < 0.001), experience equipment shortages (52.9% compared to 29.4% and 26.3%; p<0.001), have sleep (62.2% compared to 43.5% and 34%; p<0.001) and somatic problems (58.4% compared to 50% and 28.2%; p<0.001), and higher DASS-21 scores (Range=5-21 compared to 3-15 and 0-12; p<0.001). Conclusion: Worries and lifestyle changes associated with the outbreak are seen to have been be related to psychological difficulties. An adequate level of knowledge, self-protection, and social support are essential issues for HCPs. While this study recommends that HCPs express and share their worries, institutions should also focus on the psychological status of their staff and provide immediate interventions. [ABSTRACT FROM AUTHOR]

Copyright of Karya Journal of Health Science is the property of Karya Journal of Health Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of this study was to compare the effects of dialysis type on right heart functions with two-dimensional speckle tracking echocardiography (2D-STE). Material and Methods: A total of 53 patients who have peritoneal dialysis and hemodialysis, applied to cardiology and nephrology outpatient clinics, were included in the study. Those with left heart failure, coronary artery disease, primary and secondary pulmonary hypertension, pulmonary embolism, deep vein thrombosis, moderate and severe heart valve failure and stenosis were excluded from the study. Sociodemographic characteristics and biochemical parameters of the patients were recorded. Right heart functions of the patients were evaluated using 2D-STE. Results: There was no difference between groups with respect to age (p=0.496), the rate of male was higher in hemodialysis group (p=0.006). In comparison of 2D-STE measurements; right atrium (RA) maximum volume and RA minimum volume were significantly higher in hemodialysis patients (p=0.006, p=0.007, respectively). There were no difference between the groups in RA maximum volume index, RA minimum volume index and tricuspid annular plane systolic excursion (TAPSE). RAS strain and RAA strain were significantly lower in hemodialysis patients (p=0.001, p=0.012, respectively). A positive correlation was found between TAPSE and RA maximum volume in hemodialysis patients (r=0.484, p=0.036), and between TAPSE and RA minimum volume in peritoneal dialysis patients (r=0.486, p=0.025). Conclusion: Right ventricular functions were found to be similar in peritoneal dialysis and hemodialysis patients. It was observed that right atrial functions were better protected in peritoneal dialysis patients than hemodialysis patients.

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç Kronik böbrek yetmezliği ile takipli hastalarda gelişen plevral efüzyonun değerlendirilmesini amaçladık. Gereç ve Yöntem İç hastalıkları polikliniğine başvuran kronik böbrek yetmezliği nedeniyle takipli ve transüdatif vasıflı plevral efüzyonu olan hastalar çalışmaya dahil edildi. Hastalar yaş, cinsiyet, KBY evresi, kaç yıldır tanılı olduğu, periferik ödem varlığı, diyalize girip girmediği, ek patoloji varlığı, diüretik kullanımı, tedavi yanıtı açısından değerlendirildi. Bulgular Çalışmamıza katılan 57'si erkek, 57'si kadın toplam 114 hastanın yaş ortalaması 65 idi. Hastalar ortalama 7,4 yıldır kronik böbrek yetmezliği tanısı ile takip edilmekteydi. Hastaların %60,5'inde ek patoloji saptanmazken en sık rastlanan ek patoloji kardiyak hastalıklardı. Komorbidite varlığı, diyalize girme dururmu, diüretik kullanma durumu, perikardiyal efüzyon varlığı, periferik ödem varlığı ve tedaviye yanıt ile plevral efüzyon varlığı arasında istatistiksel olarak anlamlı fark olduğu saptandı. Hastaların tamamında diyaliz ve medikal tedavi ile plevral sıvıda belirgin iyileşme izlendi. Sonuç Plevral efüzyon gelişen hastalarda çoğu zaman etkin tedavi ile tam iyileşme sağlandığından özellikle transüda vasfındaki sıvılarda mümkün olduğunca cerrahi tedavi yöntemlerinden kaçınılmalıdır. Objective We aimed to evaluate the development of pleural effusion in patients with chronic renal failure. Material and Methods Patients with chronic renal failure who were admitted to the internal diseases outpatient clinic and who had transudative pleural effusion were included in the study. The patients were evaluated according to age, gender, stage, diagnosis of peripheral edema, presence of dialysis, presence of additional pathology, use of diuretics and treatment response. Results The mean age of the 114 patients (57 male, 57 female) was 65 years in our study. The patients were followed up with a diagnosis of chronic renal failure for an average of 7.4 years. While 60.5% of the patients had no additional pathology, the most common additional pathology was cardiac diseases. There was a statistically significant difference between the presence of comorbidity, the presence of dialysis, the use of diuretics, the presence of pericardial effusion, the presence of peripheral edema and the presence of pleural effusion with response to treatment. All of the patients showed significant improvement in the pleural fluid with dialysis and medical treatment. Conclusion In patients with pleural effusions, surgical treatment methods should be avoided as much as possible, especially in fluids having transudative properties, as full recovery is achieved with effective treatment. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Anesthesiology Reanimation is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of this study was to compare the effects of dialysis type on right heart functions with two-dimensional speckle tracking echocardiography (2D-STE). Material and Methods: A total of 53 patients who have peritoneal dialysis and hemodialysis, applied to cardiology and nephrology outpatient clinics, were included in the study. Those with left heart failure, coronary artery disease, primary and secondary pulmonary hypertension, pulmonary embolism, deep vein thrombosis, moderate and severe heart valve failure and stenosis were excluded from the study. Sociodemographic characteristics and biochemical parameters of the patients were recorded. Right heart functions of the patients were evaluated using 2D-STE. Results: There was no difference between groups with respect to age (p=0.496), the rate of male was higher in hemodialysis group (p=0.006). In comparison of 2D-STE measurements; right atrium (RA) maximum volume and RA minimum volume were significantly higher in hemodialysis patients (p=0.006, p=0.007, respectively). There were no difference between the groups in RA maximum volume index, RA minimum volume index and tricuspid annular plane systolic excursion (TAPSE). RAS strain and RAA strain were significantly lower in hemodialysis patients (p=0.001, p=0.012, respectively). A positive correlation was found between TAPSE and RA maximum volume in hemodialysis patients (r=0.484, p=0.036), and between TAPSE and RA minimum volume in peritoneal dialysis patients (r=0.486, p=0.025). Conclusion: Right ventricular functions were found to be similar in peritoneal dialysis and hemodialysis patients. It was observed that right atrial functions were better protected in peritoneal dialysis patients than hemodialysis patients. [ABSTRACT FROM AUTHOR]

Schmallenberg virus (SBV) infection, discovered in 2011, was reported in Europe including Turkey, Africa and recently in some Asian countries. Commercial enzyme-linked immunosorbent assay (ELISA) kits were widely used by researchers in many epidemiological studies and SBV diagnosis. The aim of this study was to optimise indirect in-house ELISA that is based on different antigen preparations of cell-culture derived whole SBV particle. Antigen preparations were maintained with various methods: PEG precipitation, ultracentrifugation, dialysis, and antigen inactivation. Following antigen optimisation, steps of antigen coating, blocking, conjugate and stop solution were optimised and in-house ELISA was compared to commercial indirect SBV ELISA kit. The best result in ELISA antigen preparation for SBV was gained by 30% PEG purification method followed by formaldehyde inactivation. Although results of this study demonstrated that in-house ELISA for detection of SBV specific antibodies was equally sensitive and specific as commercial kit, purified SBV antigen based in-house ELISA development could increase S/P ratios. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Surgery & Medicine (JOSAM) is the property of Journal of Surgery & Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Kronik böbrek yetmezliği KBY çeşitli nedenlere bağlı olarak böbrek fonksiyonlarının tam olarak yerine getirilemediği bir hastalıktır. Günümüzde böbrek hastalıklarının sıklığı oldukça artmış olup, bu hastalar dişhekimleri açısından önemli bir hasta grubunu oluşturmaktadır. Kullanılan ilaçlar, diyaliz tedavisi intraoral dokuları etkileyebilir. Bu olgu sunumunda amaç kronik böbrek yetmezliğinin intraoral dokular üzerindeki etkisini ve dişhekimleri açısından önemini vurgulamaktır

Copyright of Turkiye Klinikleri Journal of Internal Medicine / Türkiye Klinikleri İç Hastalıkları Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Surgery & Medicine (JOSAM) is the property of Journal of Surgery & Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Chronic kidney disease (CKD) is an inflammatory process. Serum proinflammatory cytokines are known to be ten times higher in patients with CKD when compared to normal population. Monocyte/High density lipoprotein (HDL) cholesterol ratio (MHR) have been shown to be a new marker of inflammation and claimed that, it may be used to predict cardiovascular events in patients with CKD. This cross-sectional study aimed to compare monocyte / HDL cholesterol ratio in patients treated with hemodialysis and peritoneal dialysis. Methods: Files of patients who have been followed up with end stage renal disease (ESRD) and have peritoneal dialysis or hemodialysis therapy in Nephrology Clinic of our hospital have been retrospectively examined. Patients were divided into two groups regarding renal replacement treatment type. Monocyte / HDL cholesterol ratio was compared between groups. IBM SPSS Statistics 22.0 (IBM Corp., NY, USA) packaged software and appropriate statistical methods were used to analyse data. Results: Monocyte / HDL cholesterol ratio was significantly higher in patients treated with hemodialysis (p= 0.028). HDL cholesterol levels were significantly higher in peritoneal dialysis group (p= 0.046). Total cholesterol, LDL cholesterol, triglyceride and VLDL cholesterol have been ascertained to be similar in both patient groups (p> 0.05). The high sensitivity CRP and sedimentation levels have been detected to be similar within the groups (p> 0.05). Conclusion: This is the first study evaluating the monocyte/HDL cholesterol ratio among renal replacement therapy modalities in our literature review. In this study, it has been shown that; monocyte/HDL cholesterol ratio were statistically higher in patients having hemodialysis than in the ones followed up with peritoneal dialysis. According to these results, it may be considered that; peritoneal dialysis may be associated with less systemic inflammation than hemodialysis. [ABSTRACT FROM AUTHOR]

Giriş: Enfektif endokardit (İE), kalbin endokardiyal yüzeyinin bakteriyel enfeksiyonundan kaynaklanan multisistemik bir hastalıktır. Nadir olarak görülür ancak gelişen tanı ve tedavi seçeneklerine rağmen yüksek mortalite oranına sahiptir. Hastalığın erken tanınması, yönetimi açısından son derece önemlidir. Olgu: Altmış üç yaşındaki erkek hasta halsizlik, ateş yüksekliği ile acil servisimize başvurdu. Bu şikayetiyle tekrarlayan hastane başvuruları vardı ve şikayetlerine göğüs ağrısı eklenmesi nedeniyle üç gün önce başvurduğu dış merkezde akut koroner sendrom tanısıyla anjiografi yapılmış, koroner stent takılmış ve sonrasında taburcu edilmişti. Kronik böbrek yetmezliği nedeniyle haftada 3 kez hemodiyaliz uygulanmaktaydı. Diabetes mellitus nedenli insülin almaktaydı. Hastanın ilk değerlendirmesinde; vücut sıcaklığı 39,1 °C, nabız sayısı 115/dakika (sinüs taşikardisi), solunum sayısı 22/dakika ve arteriyel kan basıncı 110/80 mmHg olarak tespit edildi. Kardiyak üfürüm duyulmadı. Diğer sistemik muayeneler doğaldı. Lökosit sayısı 8600/mm, trombosit sayısı 305,000/mm, alanin aminotransferaz değeri 25 Ü/lt, aspartat aminotransferaz değeri 10 Ü/lt, glukoz: 120 mg/dl, kreatinin değeri 4,7 mg/dl, C-reaktif protein değeri 146 mg/lt, prokalsitonin değeri 0,4 ng/ml idi. Tam idrar tetkikinde patoloji yoktu. Kardiyoloji Kliniği hastayı İE açısından transtorasik ekokardiyografi ile değerlendirdi; EF %65, triküspit kapakta 1,3 cm x 1,5 cm vegetasyon tespit edildi. Alınan iki set kan kültüründe metisiline dirençli Staphylococcus aureus üremesi oldu. Hastaya İE tanısı konuldu; tedavisi vankomisin intravenöz (IV) böbrek yetmezliği dozunda başlandı. Hastanın antibiyotiğe karşı alerji gelişmesi ile daptomisin IV'ye geçildi. Kardiyovasküler Cerrahi Kliniği tarafından değerlendirilen hastaya acil cerrahi girişim düşünülmedi. Alınan kontrol kan kültürlerinde üreme olmadı. Doğal kapak endokardit tedavisi tamamlanarak şifa ile taburcu edildi. Sonuç: İE'de erken tanı ve tedavi, prognozu iyileştirmek ve mortaliteyi azaltmak için önemlidir. [ABSTRACT FROM AUTHOR]

Aim: Within this study, we aim to research whether there is a relation between smoking addiction of dialysis patients and their social tendencies. Method: 106 patients, who were being treated in Ankara Training and Research Hospital Nephrology Clinic, were included in the study. Cases included in the study were evaluated in terms of age, gender, educational background, settlement, Financial situation, smoking habits and social tendencies. Results: It is seen that gender, income level, Social tendency and drug avoidance scores of Fatih Social Tendencies Scales are efficient over smoking addiction.Conclusion: In our study, we have put forward smoking condition and its risks for dialysis patients.

INTRODUCTION: Patients with chronic renal failure may tend to bleed in relation to the severity and duration of uremia. Currently, effective dialysis procedures and the removal of uremic toxins that cause platelet dysfunction partially alleviate bleeding disorders. In this study, our aim was to evaluate bleeding, platelet dysfunction, and factors that were effective on platelet dysfunction in patients with chronic renal failure. METHODS: This study was a prospective evaluation of patients who were followed by the Nephrology Clinic of Behçet Uz Children's Diseases and Pediatric Surgery Training and Research Hospital with a diagnosis of chronic renal failure. The study group consisted of 57 patients and 31 healthy controls. Platelet surface fibrinogen (GP IIb-IIa) and von Willebrand Factor (vWF) receptors (GP Ib-IX) were measured by flow cytometry. In vitro bleeding time was measured by the platelet function analyzer method (PFA 100). RESULTS: PFA 100 analysis showed that median closure time was significantly higher among hemodialysis patients in terms of collagen/epinephrine, collagen/ADP comparisons (p=0.000, p=0.000); however, these values returned to normal after hemodialysis (p= 0.018, p = 0.028). The in vitro bleeding time of patients undergoing peritoneal dialysis was found to be in the normal range. The in vitro bleeding time improvements were better in peritoneal dialysis compared to hemodialysis. Analysis with flow cytometry showed that; GP Ib (CD42b mAb) levels in dialysis patients were significantly higher than control group and predialysis patients (p=0.037). The fibrinogen receptor (GPIIb) level decreased significantly in hemodialysis patients,after hemodialysis (p = 0.018). DISCUSSION and CONCLUSION: The PFA 100 method, which is easier than the flow cytometry method for the evaluation of primary hemostasis due to platelet dysfunction in uremic patients, may prove to be an ideal method for the general evaluation of primary hemostasis in the event of bleeding in uremic patients. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The aim of this study was to clarify the etiology, clinical presentation, treatment of peritonitis, peritonitis rate, and to analyze the microbiologic profile of peritonitis in our pediatric dialysis unit. METHODS: This study was performed with children treated with chronic peritoneal dialysis and diagnosed for peritonitis during the period from January 2004 to December 2011 at the Peritoneal Dialysis Unit of our Pediatric Nephrology Department. RESULTS: The patient cohort comprised 55 patients (30 males, 25 females) who were treated for peritoneal dialysis related peritonitis. The total number of peritonitis episodes was 157. The mean peritonitis rate was one episode per 23.9 patient-months; one episode per 26.8 patient-months for continuous ambulatory peritoneal dialysis and one episode per 20.1 patient-months for automated peritoneal dialysis. The yield of culture positivity was 69.5% with %42.6 gram-positive, 19.7% gramnegative, 3.8% polymicrobial gram-positive, 0.6% polymicrobial gram-negative, 0.6% polymicrobial mixed, 1.3% fungal and 0.6% anaerobic organisms. Coagulase-negative staphylococcus was the most common cause, accounting for 17.1% of all episodes. The mean number of peritonitis episodes was 3±2.3 in 42 patients with double-cuffed swan neck catheter whereas the number of peritonitis episodes was 2.3±1.6 in 13 patients with double-cuffed tenckhoff catheter. There was no relation between catheter type and the number of peritonitis episodes (p>0.05). DISCUSSION and CONCLUSION: In conclusion, neither the dialysis modality, catheter type, nor the catheter insertion techniques have a definite effect on the development of a perionitis episode. This directs us to consider the importantance of the training program given to the caregivers. [ABSTRACT FROM AUTHOR]

Objective: Asymmetric dimethylarginine (ADMA) is known as a non-traditional risk factor for cardiovascular disease. Considering the increased prevalence of hypervolemia and heart failure in patients with peritoneal dialysis (PD), we aimed to investigate the relationship of ADMA with other biochemical parameters, echocardiographic findings, and results of bioimpedance analysis, which is a method for the determination of body fluid distribution in detail. Methods: The study was conducted on 21 patients with chronic PD. Bioimpedance was evaluated by Body Composition Monitor H02.201.1®. ADMA level was analyzed by an ELISA kit. Results: The mean ADMA level was 87.6±58.2 (18.54-247.34) μmol/L. The mean ADMA level in patients with hypertension was significantly higher than those with normal blood pressure (95.8±58.8 μmol/L and 41.0±27.9 μmol/L, respectively; p=0.045). In univariate analysis, the parameters associated with serum ADMA levels were uric acid (r=0.681, p=0.001), left ventricular end-systolic diameter (LVESD) (r=0.509, p=0.019), intracellular water (ICW) (r=0.606, p=0.004), extracellular water (r=0.471, p=0.031), dialysate-to-plasma (D/P) creatinine ratio (r=0.452, p=0.04), body surface area (r=0.52, p=0.016), total body water (r=0.581, p=0.006), and lean tissue mass (r=0.528, p=0.014). In multivariate analysis, only uric acid level, ICW, LVESD, and D/P creatinine were found to be significantly associated with ADMA. Conclusion: Serum ADMA level may be a useful marker to detect cardiovascular risk in patients with PD. Serum uric acid and LVESD are important parameters related to ADMA levels in patients with PD. Bioimpedance spectroscopy findings support the association of ADMA with body fluid volume. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Internal Medicine / Türkiye Klinikleri İç Hastalıkları Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: Hemolysis is one of the rare and occasionally fatal complications of hemodialysis. The cause of hemolysis should be found for the prevention of further hemolysis and deaths. The checklist for the cause of hemolysis requires every detail of dialysis process to be reviewed, though clinical experience and the literature are still insufficient to guide medical professionals in solving the problem. The aim of this article was to increase awareness regarding the failure of the current evidence to solve the problem of hemolysis in hemodialysis. MATERIAL and METHODS: Clinical, procedural and technical data regarding 11 episodes of hemolysis in 9 patients on 5 machines from two hemodialysis centers were investigated. The cause for hemolysis was investigated step by step based on the available evidence and instructions of the respective hemodialysis machines. RESULTS: Both the frequent and rare causes of hemolysis in hemodialysis such as blood tubing sets, dialysis membranes, needles, water system and machine contamination, chloramines, high temperature dialysis, and hypo-osmolar dialysis were excluded. Technical investigations of the hemodialysis machines by the authorized services were also of no help. Lastly, replacement of the 5 suspected hemodialysis machines resulted in permanent cessation of the hemolysis episodes. CONCLUSION: The current evidence for the causes of hemolysis in hemodialysis may be insufficient, and replacement of the suspected hemodialysis machines may be the last resort. [ABSTRACT FROM AUTHOR]

Protein-C (PC) is a vitamin-K-dependent anticoagulant proenzyme produced by the liver. PC deficiency may cause both venous and arterial thromboses. In patients with PC deficiency, warfarin further decreases PC activity and causes thrombosis of skin arterioles leading to skin necrosis. A 59-year-old female was admitted with dyspnea, cough, hoarseness and edema in her neck and arms. She had chronic kidney disease for 20 years. She had been on hemodialysis for 8 years but had been switched to peritoneal dialysis due to vascular access problems caused by multiple venous thromboses. With a pre-diagnosis of Superior Vena Cava (SVC) syndrome, cavography was performed and neartotal occlusion of the SVC was detected. Balloon dilatation was performed and warfarin 5 mg and enoxoparin 40 mg were started. Within a day, necrotic and well-demarcated lesions 4x5 cm in size appeared on the arm. Warfarin was stopped and enoxoparin was continued. After 2 weeks, plasma PC activity was found to be significantly low (40% of normal). The diagnosis of "warfarin-induced skin necrosis in a patient with PC deficiency" was established. Skin lesions promptly and completely recovered after the treatment. PC deficiency should be considered in dialysis patients with multiple thromboses, vascular access problems and warfarin-induced skin necrosis. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chronic renal failure is a disease characterized by renal disfunction related to various reasons. Nowadays, the incidence of renal disease considerably increases and these patients constitutes the important patient group for dentists. The used drugs and dialysis may affect the intraoral tissues. The aim of this case report is to lay emphasis on intraoral effects of renal failure for dentists. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Occult hepatitis B (OHB) virus infection is defined as the presence of hepatitis B virus (HBV) DNA in the liver tissue or serum of subjects seronegative for hepatitis B surface antigen. OHB leads to the potential risk of transmission in dialysis service. Routine HBV vaccine in dialysis patients is recommended. However, HBV vaccine response rates are lower than the community. The aim of this study was to determine the prevalence of OHB in hepatitis B vaccinated dialysis patients. MATERIAL and METHODS: This study was performed at the Nephrology Department, Faculty of Medicine, Cumhuriyet University, between st January - 3st December 2014. Sera from 200 dialysis patients with negative HbsAg were investigated for HBV DNA using the polymerase chain reaction (PCR). RESULTS: The mean age of the patients was 59.57±14.89 (18-91) years; 179 of them were on hemodialysis and 21 were on peritoneal dialysis. Of the patients included in the study, anti-HBs positivity was present in 135 (67.5%) and anti-HBs negativity in 65 (32.5%). The OHB prevalence was 1.5% (n=3). CONCLUSION: In our study, the OHB prevalence was 1.5%. We assume that HBV infection would be reduced further by routinely applying HBV PCR tests for all patients who start dialysis and by taking precautions against transmission. [ABSTRACT FROM AUTHOR]

Amaç: SARS-CoV-2 virüsü, özellikle solunum yolları ve akciğerde hasar oluşturmakla beraber böbrek, kalp, sindirim ve sinir sistemi gibi birden fazla organı da etkilemektedir. Kardiyak tutulum, akut böbrek hasarı, pıhtılaşma bozuklukları ve trombotik komplikasyonlar gibi bazı solunumsal olmayan belirtilerin kötü prognozla ilişkili olduğu düşünülmektedir. COVID-19 enfeksiyonlu hastaların idrarlarında viral RNA izolasyonu, SARS-CoV-2’nin böbreklere potansiyel viral afinite gösterdiğini desteklemektedir. SARS-CoV-2 ile enfekte hastaların renal tübül hücrelerinde SARS-CoV-2’ye ait nükleokapsid proteinlerinin bulunması, virüsün insan böbrek hücrelerini de hedef aldığını kanıtlamaktadır. Yapılan son çalışmalarda, böbrek glomerüllerinde bulunan podositlerde ve proksimal kıvrımlı tübüllerde, virüsün hücre içine alımı için gerekli olan anjiyotensin dönüştürücü enzim-2 (ACE-2), serin proteaz ailesinin üyeleri ve TMPRSS2 (transmembrane protease serine 2) genlerinin ekspresyonunun olması böbrekleri SARS-CoV-2 için potansiyel bir konak haline getirmektedir). Bu sunuda biz de, 21 yataklı, SARS-CoV-2 enfekte hastaların takip edildiği yoğun bakım ünitemizde 01 Mayıs 2021-01 Ocak 2022 tarihleri arasında diyalize giren hastaları ve prognozlarını incelemeyi amaçladık. Gereç ve Yöntem: Hasta elektronik ortam dosyaları, e-nabız kayıtları geriye yönelik incelendi. Bulgular: Bu tarihler arasında toplam 494 SARS-CoV-2 PCR (+)/klinik veya radyolojik olarak COVID-19 düşünülen hasta takip edilmiştir. Hastaların APACHE skorları ortalaması 32. hastaların 51 (%10,3) tanesi diyalize alınmıştır. COVID-19’dan önce 01 Mayıs 2019-01 Ocak 2020 tarihleri arasında toplamda 370 hasta tedavi görürken, 25 (%6,75) hasta diyalize alınmıştır. Diyalize girme oranında %3,55 artış saptanmıştır. Diyalize alınan 51 hastadan 12 (%23,5) tanesi önceden KBY tanısı ile diyalize girmekte iken 39 (%76,5) tanesinin tedavi sürecinde diyaliz ihtiyacı olmuştur. Otuz günlük mortalite oranı diyalize giren hastalarda %80,39 olarak saptanmıştır. Bu dönem içinde yoğun bakımda yatan hastaların 30 günlük mortalite oranları %42,8 olarak tesbit edilmiştir. Sonuç: SARS-CoV-2 enfekte hastaların yoğun bakım tedavileri esnasında diyaliz ihtiyacı daha fazla olmakta ve diyaliz alan hastaların mortalite oranları yüksek seyretmektedir. Diyaliz ihtiyacı kötü prognoz belirteçi olarak değerlendirilmelidir [ABSTRACT FROM AUTHOR]

Objectives: Hemolytic uremic syndrome (HUS) is defined by the presence of hemolytic anemia, thrombocytopenia, and acute renal failure. Atypical HUS (aHUS) is characterized by a relapsing course, high risk of permanent renal damage, and dysregulation in the complement pathway. Plasma exchange/infusions may temporarily correct hematologic variables, but as the underlying complement dysregulation persists, end stage renal disease or death occurs in 33-40% of patients. In recent years, eculizumab has been used in the treatment of aHUS with high success rates. In this study we report seven pediatric cases with aHUS successfully treated with eculizumab. Methods: From January 2012 to December 2015, we investigated seven pediatric patients who had been diagnosed as aHUS and treated with eculizumab. Age, gender, presenting symptoms, presence of diarrhea, laboratory data on admission and follow-up, need for dialysis, response to plasma exchange, response to eculizumab, and outcome were recorded. Results: Diarrhea was present in four cases but the investigation about Enterohemorrhagic Echerichia coli (EHEC) was negative in stool specimens. Oliguria/anuria was present in six cases. Four of the seven children received plasma exchange. Five children needed dialysis. Despite vaccination, one patient had severe sepsis and meningitis as a complication of eculizumab. All had full recovery of hematologic parameters. Except one children none had erythrocyte transfusion after treatment. On the last follow up, none of the patients were on dialysis. Conclusion: Our results showed that eculizumab is a life-saving and successful treatment for use in cases of aHUS. However severe complications such as meningitis should be kept in mind before treatment. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Sudden cardiac death and risk of arrhythmia are higher in patients with ESRD. Tp-e/ QT, and Tp-e/QTc are novel and more reliable indexes of ventricular arrhythmogenesis and sudden cardiac death than QTc. The aim of this study was to assess ventricular repolarization in patients with hemodialysis and peritoneal dialysis by using the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio. MATERIAL and METHODS: A total of 35 healthy controls, 92 hemodialysis patients, and 104 peritoneal dialysis patients were enrolled in the study. The Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio were calculated from the ECGs of the individuals and compared among groups. RESULTS: QT value was significantly higher in hemodialysis group compared with peritoneal dialysis group (p<0.001) and control group (p<0.001). However a difference was not found comparing QT values between peritoneal dialysis and control groups. Tp-e, Tp-e/QTc, Tp-e/QT, and QTc values were significantly higher in hemodialysis and peritoneal dialysis group comparing to control group. However a statistically significant difference was not found while comparing QTc values between peritoneal dialysis and control groups (p:0.081). When all patients of ESRD without DM were compared with the control group, Tp-e, Tp-e/QTc, Tp-e/QT, and QTc values were found significantly higher than the healthy control group. The values of Tp-e/QT (p<0.001 r:0.314) and Tp-e/QTc (p:0.018 r:0,187) in all patients with kidney disease were found to show positive correlation with duration of dialysis (month). CONCLUSION: This is the first known study that shows Tp-e/Q, and Tp-e/QTc are higher in hemodialysis and peritoneal dialysis patients. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aims of this study were to assess the incidence, risk factors and complications of falls in the hemodialysis (HD) population. MATERIAL and METHODS: Using a prospective study design, chronic HD patients aged ≥50 years were recruited. The baseline characteristics and laboratory markers of all study participants were recorded. Participants were followed prospectively for 12 weeks. Patients were questioned thrice weekly about fall incidents. RESULTS: A total of 34 patients (mean age 69.1 year) participated in this study. 16 falls occurred in nine (26.5%) patients over 12 weeks of follow-up with an incidence rate of 1.30 falls/patient-year. By applying univariate logistic regression analysis, previous fall history (odds ratio 10.5, P-value= 0.008), high parathyroid hormone level (odds ratio 1.032, P-value= 0.016) and impaired balance (odds ratio 9.00, P-value=0.017) were identified as significant risk factors for falls. CONCLUSION: We concluded that high parathyroid hormone levels might be an important predictor of falls in HD patients in addition to impaired balance and previous fall history. As such, parathyroid hormone is a crucial factor to target for future intervention strategies aimed at reducing the fall incidence in the HD population. [ABSTRACT FROM AUTHOR]

Objectives: To determine the affective temperament profile of patients with chronic renal failure (CRF) in comparison to healthy subjects and to evaluate depression and anxiety status of patients. Methods: This was a case-control study into which 122 CRF patients (63 males, 59 females) and 100 healthy age- and gender-matched controls (66 females, 34 males) were included. The affective temperament profile was determined by Turkish version of Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A). For the assessment of depression and anxiety, the Hospital Anxiety and Depression Scale (HADS) was used. Results: Of the 122 patients, 28 (23%) were in predialysis, 22 (18%) periton dialysis, 30 (24.6%) hemodialysis and 42 (34.4%) transplantation. The majority of participants (n=169, 76.1%) had no dominant affective temperament according to TEMPS-A. For the remaining participants, the most common dominant affective temperament was depressive temperament (8.6%) followed by mixed temperament (7.7%) and anxious temperament (2.7%). There was no signifcantly difference in terms of affective temperament traits between patients and controls. Patient group had significantly higher depression and anxiety scores than healthy controls. There was no correlation between laboratory results and affective temperaments, anxiety, depression scores of patients. There was no significant difference between predialysis, periton dialysis, hemodialysis, and transplantation subgroups in terms of anxiety, depression or affective temperament traits (p>0.05 for all). Conclusion: There is no affective temperament profile specific to patients with CRF. However, considering the high rate of depression and anxiety among patients with CRF, knowing affective temperament profile of patients will guide clinicians through management of psychiatric disorders and CRF itself, thus will improve disease outcome and patients' quality of life. [ABSTRACT FROM AUTHOR]

Treatment of secondary hyperparathyroidism is a major problem in hemodialysis patients. Medical treatment is commonly inadequate in these patients. Parathyroid surgery should be considered in appropriate patients. In this review, we evaluate the techniques, features, results and complications of parathyroid surgery procedures. [ABSTRACT FROM AUTHOR]

We report in this paper a case had continuous venovenous hemodiafiltration (CVVHDF) with the diagnosis of meningococcemia - multiple organ failure (MOF) and without permanent damage development although it took more than 4 weeks of loss of kidney function. Three-yearold female patient was hospitalized for unconsciousness, no spontaneous respiration, blood pressure 50/30 mmHg, and widely echimotic- purpuric rash. In her laboratory. there were 19.600 / mm³ white blood cells, 5.7 g / dL hemoglobin, 76,000 / mm³ platelets, prothrombin time was 23.9 seconds, aPTT was higher than measurable values, creatinine was 7.2 mg / dL, ALT / AST were 378/714 / L, and she was anuric. She underwent CVVHDF treatment with the diagnosis of meningococcemia and MOF. On the 48 hours of treatment, her vital signs were improved, on 55 hours MOF was revealed except for renal functions and CVVHDF treatment was discontinued. Because of the damage to the kidneys continue, she had 3 hours/ day dose of hemodialysis. At the end of hospitalization for 1 week, her hemodialysis need was declined to 3 days/ week, on 5th week to 2 days / week and on the beginning of 6 weeks, there was entirely no need for dialysis and she had been seen in services in one more week without dialysis need. On the last visit, she had normal blood pressure, creatinine clearance, urine osmolarity and protein excretion. She was followed up for 4.5 years with no abnormality. [ABSTRACT FROM AUTHOR]