Tear Function Alterations and Conjunctival Impression Cytology Findings in Patients With Gout.

OBJECTIVES: The aim of this study was to evaluate the tear functions and conjunctival impression cytology (CIC) findings of patients with gout and compare them with healthy controls. METHODS: Thirty-four patients with gout (group 1) and 32 age-matched and gender-matched healthy individuals (group 2) were included in this cross-sectional study. Schirmer 1 test, tear breakup time (TBUT), Ocular Surface Disease Index (OSDI) score, and CIC grade were evaluated and compared between the groups. RESULTS: There was no significant difference between the groups in gender and age (P=0.923 and P=0.078, respectively). The mean of Schirmer 1 test result was significantly lower in group 1 (9.74±6.03 mm) than that in group 2 (17.16±9.33 mm) (P<0.001). The TBUT was also significantly lower in group 1 (7.00±2.09 seconds) than that in group 2 (12.75±5.25 seconds) (P<0.001). The OSDI score (20.04±12.92) was significantly higher in group 1 than that in group 2 (6.19±10.07) (P<0.001). Although 10 patients (29.4%) in group 1 had the CIC grade of 2 to 3, none of the controls had CIC grade 2 to 3. The mean CIC grade in group 1 (1.15±0.89) was significantly higher than that in group 2 (0.47±0.51) (P<0.001). CONCLUSIONS: The results of this study suggest that ocular surface alterations assessed by CIC and tear function abnormalities are more common in patients with gout.

Thoracic Complications in Behçet's Disease: Imaging Findings.

Behçet's disease (BD) causes vascular inflammation and necrosis in a wide range of organs and tissues. In the thorax, it may cause vascular complications, affecting the aorta, brachiocephalic arteries, bronchial arteries, pulmonary arteries, pulmonary veins, capillaries, and mediastinal and thoracic inlet veins. In BD, chest radiograph is commonly used for the initial assessment of pulmonary symptoms and complications and for follow-up and establishment of the response to treatment. With the advancement of helical or multislice computed tomography (CT) technologies, such noninvasive imaging techniques have been employed for the diagnosis of vascular lesions, vascular complications, and pulmonary parenchymal manifestations of BD. CT scan (especially, CT angiography) has been used to determine the presence and severity of pulmonary complications without resorting to more invasive procedures, in conjunction with gadolinium-enhanced three-dimensional (3D) gradient-echo magnetic resonance (MR) imaging with the subtraction of arterial phase images. These radiologic methods have characteristics that are complementary to each other in diagnosis of the thoracic complications in BD. 3D ultrashort echo time (UTE) MR imaging (MRI) could potentially yield superior image quality for pulmonary vessels and lung parenchyma when compared with breath-hold 3D MR angiography.

The association of decreased testosterone with atherosclerosis and inflammation in male predialysis patients with chronic kidney disease.

PURPOSE: To investigate the frequency of hypogonadism and its relationship to inflammation and carotid intima-media thickness (CIMT) in male patients with predialysis chronic kidney disease (CKD). METHODS: A total of 105 patients with CKD, 55 (52.4%) as stage 3, 33 (31.4%) as stage 4 and 17 (16.2%) as stage 5, were enrolled into the study. Total testosterone (TT) and free testosterone (FT), interleukin 6 (IL-6), C-reactive protein (CRP) levels, and CIMT were measured. RESULTS: According to TT and FT, hypogonadism was detected in 18 (17.1%) and 22 (20.9%) patients, respectively. There was no difference in terms of TT and FT, CIMT, CRP and IL-6 between the stages of CKD. According to TT, the patients with hypogonadism had significantly higher CRP and high-density lipoprotein cholesterol (HDL-cholesterol) levels (p=0.004 and p=0.005, respectively). There was no significant difference in other parameters. According to FT, the patients with hypogonadism had significantly higher CRP (p=0.017), and TT were negatively correlated with body mass index (BMI), waist circumference (WC), hip circumference, and CRP levels. FT was negatively correlated with age, waist circumference, systolic blood pressure, diastolic blood pressure (DBP) and CRP. CONCLUSIONS: The frequency of hypogonadism was found around 17-21% among the patients with CKD. Despite similar IL-6 and CIMT levels, CRP was found to be higher in the patients with hypogonadism. We consider that further studies with larger populations are needed to elucidate the entity.

Sleep quality and risk factors of atherosclerosis in predialysis chronic kidney disease.

INTRODUCTION: Chronic kidney disease (CKD) patients have more frequent sleep disorders and cardiovascular disease than normals. Since arterial stiffness as a risk factor of atherosclerosis can be evaluated with pulse wave velocity (PWV), we aimed to investigate the prevalance of sleep quality (SQ) and the relationship between SQ and risk factors of atherosclerosis and whether there is a relationship between SQ and PWV (the indicator of arterial stiffness) in predialysis CKD patients. METHODS: This cross-sectional study was carried out in CKD patients followed at the Nephrology Department in Konya, Turkey, between November 2014 and March 2015. A total of 484 CKD patients were screened. Of the 484 patients, 285 patients were excluded. The remaining 199 CKD patients without cardiovascular disease at stage 3, 4, and 5 (predialysis) were included in the final study. The SQ of the patients was evaluated by the Pittsburgh Sleep Quality Index (PSQI). PWV was measured by using a single-cuff arteriography device (Mobil-O-Graph PWA, a model pulse wave analysis device; IEM). RESULTS: A total of 199 predialysis CKD patients were included in the study, 73 of whom (36.7 %) were 'poor sleepers' (global PSQI >5). Patients with poor SQ were older than those with good SQ (p = 0.077). SQ was worse in female patients compered to male patients (p = 0.001). SQ was worse in obese patients. As laboratory parameters, serum phosphorus, LDL cholesterol, and triglycerides levels correlated positively with SQ (respectively; r = 0.245, p&0.001; r = 0.142, p = 0.049; r = 0.142, p = 0.048). The indicator of arterial stiffness, PWV, was higher in patients with poor SQ (p = 0.033). Hyperphosphatemia and female gender are determined as risk factors for poor SQ in multivariate analysis (p = 0.049, ExpB = 1.477; p = 0.009, ExpB = 0,429, respectively). CONCLUSIONS: Our study showed for the first time that there is a relationship between SQ and risk factors of atherosclerosis in predialysis CKD patients.

The association of decreased testosterone with atherosclerosis and inflammation in male predialysis patients with chronic kidney disease / Asociación entre el descenso del nivel de testosterona y aterosclerosis e inflamación en varones con insuficiencia renal crónica prediálisis

PURPOSE: To investigate the frequency of hypogonadism and its relationship to inflammation and carotid intima-media thickness (CIMT) in male patients with predialysis chronic kidney disease (CKD). METHODS: A total of 105 patients with CKD, 55 (52.4%) as stage 3, 33 (31.4%) as stage 4 and 17 (16.2%) as stage 5, were enrolled into the study. Total testosterone (TT) and free testosterone (FT), interleukin 6 (IL-6), C-reactive protein (CRP) levels, and CIMT were measured. RESULTS: According to TT and FT, hypogonadism was detected in 18 (17.1%) and 22 (20.9%) patients, respectively. There was no difference in terms of TT and FT, CIMT, CRP and IL-6 between the stages of CKD. According to TT, the patients with hypogonadism had significantly higher CRP and high-density lipoprotein cholesterol (HDL-cholesterol) levels (p = 0.004 and p = 0.005, respectively). There was no significant difference in other parameters. According to FT, the patients with hypogonadism had significantly higher CRP (p = 0.017), and TT were negatively correlated with body mass index (BMI), waist circumference (WC), hip circumference, and CRP levels. FT was negatively correlated with age, waist circumference, systolic blood pressure, diastolic blood pressure (DBP) and CRP. CONCLUSIONS: The frequency of hypogonadism was found around 17-21% among the patients with CKD. Despite similar IL-6 and CIMT levels, CRP was found to be higher in the patients with hypogonadism. We consider that further studies with larger populations are needed to elucidate the entity

OBJETIVO: Investigar la frecuencia de hipogonadismo y su relación con la inflamación y grosor de la íntima-media carotídea (CIMT) en varones con insuficiencia renal crónica (IRC) prediálisis. MÉTODOS: Se incluyó en el estudio a un total de 105 pacientes con IRC, 55 (52,4%) en estadio 3, 33 (31,4%) en estadio 4, y 17 (16,2%) en estadio 5. Se midieron testosterona total (TT) y testosterona libre (TL), interleucina 6 (IL-6), niveles de proteína C reactiva (PCR), y CIMT. RESULTADOS: Con respecto a TT y TL, se detectó hipogonadismo en 18 (17,1%) y 22 (20,9%) pacientes, respectivamente. No se encontraron diferencias en términos de TT y TL, CIMT, PCR e IL-6 entre los diferentes estadios de IRC. Con respecto a TT, los pacientes con hipogonadismo tenían valores significativamente más altos de PCR y colesterol de lipoproteínas de alta densidad (HDL-colesterol) (p = 0,004 y p = 0,005, respectivamente). No se encontraron diferencias significativas en cuanto a otros parámetros. Con respecto a TL, los pacientes con hipogonadismo tenían valores significativamente más altos de PCR (p = 0,017), y TT guardó una correlación negativa con el índice de masa corporal (IMC), perímetro de la cintura, perímetro de la cadera, y niveles de PCR. TL se correlacionó negativamente con la edad, perímetro de cintura, presión arterial sistólica (PAS), presión arterial diastólica (PAD) y PCR. CONCLUSIONES: Se encontró frecuencia de hipogonadismo en cerca del 17-21% de los pacientes con IRC. A pesar de encontrar niveles similares de IL-6 y CIMT, los niveles de PCR fueron más altos en los pacientes con hipogonadismo. Consideramos que son necesarios más estudios, con poblaciones de mayor tamaño, para explicar esta entidad