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  • Husted Moran posted an update 1 day, 5 hours ago

    Growth hormone deficiency, central diabetes insipidus, and panhypopituitarism were more prevalent in childhood-onset adamantinomatous CP (aCP) and least prevalent in adult-onset papillary CP (pCP). At follow-up, metabolic syndrome (MetS) was diagnosed in 80% of childhood-onset and 68% of adult-onset patients (p = 0.411). In the latter group, it tended to be more frequent in the aCP than pCP subtype (80 vs. 50%, p = 0.110). Conclusions Long-term endocrine and metabolic complications are very frequent in childhood- and adult-onset CP patients of both histological subtypes. The prevalence of MetS was higher compared to the largest cohort previously reported.Introduction The significance of N-terminal pro-B type natriuretic peptide (NT-proBNP) to detect heart failure in patients with end-stage kidney diseases on dialysis is controversial. Objective To assess whether serial measurements of NT-proBNP can predict worsening cardiac function in dialysis patients. Methods In this prospective, longitudinal, observational cohort study, the relationship between changes in monthly plasma NT-proBNP concentrations and changes in echocardiographic indices (left ventricular global longitudinal strain [GLS] and ejection fraction [LVEF]) were analyzed in dialysis patients without symptoms of heart failure over 24 months using multilevel mixed effects models. Results The study included 40 dialysis patients who were followed for a median period of 24 months. Logarithmically transformed baseline plasma NT-proBNP levels were correlated positively with GLS (r = 0.48, p = 0.002) and negatively with LVEF (r = -0.44, p = 0.005). Time-averaged and maximum NT-proBNP values during the echocardiogram intervals were significantly correlated with GLS and LVEF over time. Every 1-unit increase in average NT-proBNP level during the echocardiogram interval was associated with a 0.99 (95% confidence interval, 0.41-1.56) higher GLS (%) and 2.90 (1.22-4.57) lower LVEF (%). Every 1-unit increase in maximum NT-proBNP level was associated with a 0.90 (0.35-1.45) higher GLS (%) and 2.67 (1.03-4.30) lower LVEF (%). This increase in GLS indicates a reduction in systolic performance. Conclusions Our cohort study demonstrated that serial plasma NT-proBNP concentrations may be useful for early identification of individuals with worsening cardiac function over time.We aimed to investigate whether the severity of fatigue and the incidences of depression and anxiety of patients with beta thalassemia minor (BTm) are different than healthy individuals using Fatigue Severity Scale (FSS) and Hospital Anxiety and Depression Scale (HADS) BTm patients who were followed in University of Health Sciences Istanbul Training and Research Hospital Hematology Clinic between 2016 and 2017, who had normal biochemical parameters, thyroid function tests and C-reactive protein (CRP) levels, and didn’t use any medications, consume alcohol or tobacco, have any chronic diseases or sleep disturbances were included in the study. Healthy control subjects who were matched with age, sex, marital status, educational status and body mass index (BMI), were also included for comparison. Thirty-nine BTm patients and 25 healthy controls were included in the study. The BTm and the control groups were comparable in terms of gender, age, BMI, educational status and marital status (p= 0.368, 0.755, 0.851, 0.785, 0.709 respectively). Fatigue Severity Scale score was ≥4 in 23 (59.0%) BTm subjects and in 15 (60%) control subjects (p=1.0). HADS anxiety score was ≥10 in 20 (51.3%) BTm subjects and in 5 (20.0%) control subjects (p=0.018) and HADS depression score was ≥ 7 in 20 (51.3%) BTm subjects and 6 (24.0%) healthy control subjects (p=0.039) .There was no correlation of hemoglobin with FSS score (p=0.526, r= -0.105), HADS anxiety score (p=0.703, r= -0.063) or HADS depression score (p=0.718, r= -0.06) in BTm group. We found that both depression and anxiety were higher in BTm patients than healthy individuals, but this difference was not feasible for fatigue.Objectives In this study we describe several cases of ocular dirofilariasis in Bulgaria. Materials and methods In the period 2010-2019, we studied 7 patients with subconjunctival or periorbital form of Dirofilaria repens infection. Morphological, serological and paraclinical diagnostic methods were used. Results The patients were aged between 23 and 72, 6 females and 1 male. In 3 patients, subcutaneous nodules were detected in the area of the upper eyelid, in one patient the location was suborbital. In 3 other patients, subconjunctival location was found. All patients were cured definitively by removal of the larva, without etiologic treatment. Conclusion The most reliable and easily accessible diagnostic method is morphological analysis by microscopy of histological preparations of the parasite. E6446 In dirofilariasis, ocular location is one of the most common cases in humans, and it deserves special attention of clinicians.Objective To compare the efficacy and safety of transurethral laser surgery and transurethral resection of a bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC). Material and methods A research was carried out in Medline via PubMed, EMBASE, the Cochrane Library, and Web of Science up to October 20, 2019, to identify articles related to transurethral laser surgery and TURBT for NMIBC. All analyses were done using RevMan5.3 and Stata14. Results A total of 17 studies involving 2,439 participants were included. The analysis showed no significant difference in operation times (mean difference = -0.2; 95% CI -2.29 to 1.89; p = 0.85) or occurrences of urethral stricture (OR = 0.7; 95% CI 0.24-2.06; p = 0.52). Transurethral laser surgery was associated with a lower incidence of obturator nerve reflex (OR = 0.04; 95% CI 0.02-0.09; p less then 0.00001) and bladder perforation (OR = 0.09; 95% CI 0.04-0.23; p less then 0.00001), a higher rate of detrusor muscle acquisition (OR = 5.28; 95% CI 2.42-11.49; p less then 0.0001), shorter catheterization (mean difference = -1.05; 95% CI -1.41 to -0.68; p less then 0.00001) and hospitalization times (mean difference = -0.96; 95% CI -1.59 to -0.33; p = 0.003), and lower rates of bladder irrigation (OR = 0.21; 95% CI 0.13-0.35; p less then 0.00001) and recurrence both at 12 months (OR = 0.66; 95% CI 0.48-0.9, p = 0.008) and at 24 months (OR = 0.6; 95% CI 0.41-0.86; p = 0.005). Conclusions Transurethral laser surgery for NMIBC, as compared to TURBT, is associated with a lower incidence of complications, a lower recurrence rate, and faster postoperative recovery.

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