RESUMO
BACKGROUND: The preoperative prediction of intraperitoneal adhesion (IPA) before repeated cesarean deliveries (CD), which are becoming more prevalent, is crucial for maternal health. AIM: The aim of the study was to preoperatively predict IPA in repeated CD with the stria gravidarum (SG) scoring system. METHODS: A total of 167 patients with at least one previous CD at or beyond 37 weeks of gestation were analyzed. Preoperative SG was calculated according to the Davey scoring system: 0-2 score were defined as mild SG (Group 1; n: 94, 56.2%), and 3-8 score were defined as severe SG (Group 2; n = 73, 43.8%). Preoperative previous cesarean incision features were evaluated according to the Vancouver scar scale. IPA was evaluated according to the Nair's and modified Nair's scoring systems. RESULTS: Parity, younger age at first pregnancy, higher body mass index, number of previous CDs, rate of scar symptoms, Nair's and the modified Nair's scores were statistically significant in Group 2 (P = 0.01; P = 0.04; P = 0.007; P = 0.004; P < 0.001; P = 0.007; P = 0.02, respectively). Davey score ≥3 and Vancouver score ≥4.5 were determined as the cut-off value to predict IPA (P = 0.1 and 0.07, respectively). According to multivariate analysis, both Davey and Vancouver scores are independent factors in predicting IPA (P = 0.02 and 0.04, respectively). CONCLUSION: Evaluating the SG score through the Davey score in women with a history of previous CD may assist in predicting IPA status before the planning of a subsequent surgery.
Assuntos
Recesariana , Humanos , Feminino , Gravidez , Adulto , Aderências Teciduais , Estudos Transversais , Recesariana/estatística & dados numéricos , Fatores de Risco , Doenças Peritoneais/diagnóstico , Índice de Gravidade de Doença , Valor Preditivo dos Testes , Cesárea/efeitos adversos , Paridade , Adulto JovemRESUMO
PURPOSE: The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children. METHODS: This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014-2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years. RESULTS: The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis. CONCLUSION: Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment.
Assuntos
Transtornos de Ansiedade , Transtorno do Deficit de Atenção com Hiperatividade , Criança , Adolescente , Humanos , Prevalência , Turquia/epidemiologia , Transtornos de Ansiedade/psicologia , Transtornos do Humor/epidemiologia , Comorbidade , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Estudos EpidemiológicosRESUMO
PURPOSE: To investigate the changes in refractive status of amblyopic patients with partially refractive esotropia (PAET). MATERIALS AND METHODS: Amblyopic patients with PAET were enrolled. Non-amblyopic patients with full refractive accommodative esotropia (RAET) were included in the study as a control group. Preoperative and postoperative best-corrected visual acuity (BCVA), spherical equivalent (SE), astigmatism, stereoacuity, and deviations at near and distance were evaluated and statistically compared within the study group. Mean BCVA, SE, astigmatism were compared between the two groups. RESULTS: The patient and the control groups were composed of 58 eyes of 29 patients per group. There were statistically significant differences between pre- and postoperative mean astigmatism and SE between the patient and control groups. The mean astigmatism was higher in amblyopic eyes when compared with the eyes in the control group (P:0.009). During the follow-up period, changes in SE and astigmatism were not different between groups. CONCLUSION: The mean SE and astigmatism were changed in both amblyopic patients with PAET and non-amblyopic patients with RAET during the follow-up period. This suggested that neither amblyopia nor strabismus surgery has an effect on refractive status in patients with PAET.
Assuntos
Ambliopia , Esotropia , Ambliopia/complicações , Ambliopia/epidemiologia , Esotropia/complicações , Esotropia/epidemiologia , Humanos , Refração Ocular , Estudos Retrospectivos , Testes Visuais , Acuidade VisualRESUMO
OBJECTIVES: NLR (neutrophil-lymphocyte ratio) and PLR (platelet-lymphocyte ratio) are prognostic markers of differentiated thyroid cancers. In our study, we evaluated NLR, PLR and C-reactive protein (CRP) for predicting the occurence of differentiated thyroid cancer. This is the first study that compares NLR and PLR to C-reactive protein indifferantiated thyroid cancer not only papillary cancer but also folliculer cancer. METHODS: This study includes 51 papillary carcinoma, 42 papillary microcarcinoma and 31 folliculer carcinoma patients attending to our outpatient Endocrinology Clinic at Erzurum Region Training and Research Hospital between 2009 and 2014. The control group include 50 age, sex and body mass index matched healty subjects. Blood counts and CRP were measured at the day before surgery. Thyroglobulin was measured after 6 months of operation. RESULTS: There were positive correlations between tumor diameter, age, white blood cell (WBC) and thyroglobulin levels. There were also positive correlation between NLR, PLR and CRP levels. CONCLUSION: In our study, we found out that higher NLR and PLR was associated with higher levels of thyroglobulin which indicates worse survival. CRP levels were also associated with poorer tumor profile but the determining rate was lower according to ROC analysis.
Assuntos
Adenocarcinoma Folicular/diagnóstico , Plaquetas , Proteína C-Reativa/análise , Linfócitos , Neutrófilos , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Adenocarcinoma Folicular/sangue , Adolescente , Adulto , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Prognóstico , Estudos Retrospectivos , Câncer Papilífero da Tireoide/sangue , Neoplasias da Glândula Tireoide/sangue , Adulto JovemRESUMO
BACKGROUND AND PURPOSE: People with epilepsy are at increased risk of accidents and injuries but, despite several studies on this subject, data regarding preventable causes are still contradictory. The aim of this study was to investigate the relationship between injuries, side effects of antiepileptic drugs (AEDs) and depression. METHODS: Data from a consecutive sample of adult patients with epilepsy attending the outpatient clinics at St George's University Hospital in London were included. All patients were asked if they had had any injury since the last clinic appointment and completed the Liverpool Adverse Event Profile (LAEP) and Neurological Disorders Depression Inventory for Epilepsy. RESULTS: Among 407 patients (243 females, mean age 43.1 years), 71 (17.4%) reported injuries since the last appointment. A two-step cluster analysis revealed two clusters with the major cluster (53.5% of the injured group) showing a total score for LAEP ≥45, a positive Neurological Disorders Depression Inventory for Epilepsy screening and presence of AED polytherapy. A total score for LAEP ≥45 was the most important predictor. CONCLUSIONS: Antiepileptic drug treatment should be reviewed in patients reporting injuries in order to evaluate the potential contribution and burden of AED side effects.
Assuntos
Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/uso terapêutico , Depressão/complicações , Epilepsia/complicações , Epilepsia/tratamento farmacológico , Ferimentos e Lesões/epidemiologia , Adulto , Idoso , Análise por Conglomerados , Depressão/psicologia , Interações Medicamentosas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polimedicação , Escalas de Graduação PsiquiátricaRESUMO
Adams-Oliver syndrome is a rare disorder with varying degrees of scalp and cranial bone defects as well as limb anomalies, which can range from mild to more pronounced manifestations. In mild cases, closure of these defects can be achieved with a conservative approach. However, surgical closure is recommended in cases where the defect is extensive and includes cranial involvement. Several complicated cases of Adams-Oliver syndrome have been reported, in which flap failures were encountered and other alternatives had to be used to close critical scalp defects. Here, the case of a 4-year-old child with Adams-Oliver syndrome and a complex cranial defect with exposed titanium mesh is described. The patient was successfully treated with epidermal growth factor (EGF) infused foam dressings and subsequent split-thickness skin grafting. The EGF has been highlighted for its essential role in dermal wound repair through the stimulation of the proliferation and migration of keratinocytes, and showed accelerated wound healing when used in partial or full-thickness skin wounds.
Assuntos
Bandagens , Displasia Ectodérmica/terapia , Fator de Crescimento Epidérmico/uso terapêutico , Deformidades Congênitas dos Membros/terapia , Dermatoses do Couro Cabeludo/congênito , Couro Cabeludo/cirurgia , Crânio/cirurgia , Retalhos Cirúrgicos , Pré-Escolar , Humanos , Imageamento Tridimensional , Couro Cabeludo/anormalidades , Dermatoses do Couro Cabeludo/terapia , Crânio/anormalidades , Telas Cirúrgicas , Titânio , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: Autism spectrum disorders (ASDs) are a severe group of neurodevelopmental disorders that are characterized by impairment in social communication, and imagination and social interaction. The aetiology of autism is complex, but some studies suggest autoimmunity to the central nervous system in the pathogenesis. The aim of this study is to investigate the positivity of antineuronal antibodies including anti-glutamic acid decarboxylase antibodies (anti-GAD), anti-glutamate receptor (anti-GluR) antibodies and seven types of anti-ganglioside antibodies, in children with autism. METHODS: We conducted the study over a period of one year from May 2012 to December 2013. Human anti-GAD in serum were investigated with ELISA; human autoantibodies against the N-methyl-D-aspartate subtype of GluR were investigated with indirect immunofluorescence test; class IgG antibodies against the seven gangliosides were investigated with immunoblot assay. RESULTS: Serum antineuronal antibodies were measured in 42 children (24 male, 18 female) with autism in comparison to 21 (13 male, 8 female) healthy-matched children aged between 2-12 years. There was no seropositivity of antineuronal antibodies in either of the groups. CONCLUSION: There is no evidence to support an association between autism and antibodies positivity of anti-GAD, anti-GluR and anti-gangliosides (Ref. 26).
Assuntos
Transtorno Autístico/imunologia , Autoanticorpos/sangue , Sistema Nervoso Central/imunologia , Gangliosídeos/imunologia , Glutamato Descarboxilase/imunologia , Receptores de Glutamato/imunologia , Transtorno Autístico/diagnóstico , Criança , Pré-Escolar , Manual Diagnóstico e Estatístico de Transtornos Mentais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Estatística como Assunto , Transmissão Sináptica/imunologia , Ácido gama-Aminobutírico/imunologiaRESUMO
BACKGROUND AND OBJECTIVE: Although potato is greatly consumed all over the world, adverse reactions to potato are uncommon. Our aim is to describe the clinical features of potato sensitivity in allergic children. MATERIALS AND METHODS: Forty children with sensitivity to potato were followed up in the Pediatric Immunology and Allergy Clinic of our hospital were included in the study. These patients were retrospectively evaluated from January 2012 to December 2013. RESULTS: Forty children aged between 6 months and 10 years (mean 2.9±3.2, median:1.5 years) were enrolled of whom 26 were male (65%). Thirty three of these children had presented eczema, nine wheezing, seven urticaria and/or angioedema, six rhinitis, four subjects had experienced anaphylaxis, and two vomiting or other gastrointestinal complaints. In 38 (95%) patients, skin prick tests detected sensitivity to other allergens besides potato. The most frequently identified sensitivities were to food sensitivities (82.5%). In addition sensitivity to house dust mite, cat dander, pollens, A. Alternata and cockroaches in skin prick tests were documented in nine, six, five, four and four patients, respectively. Latex sensitivity was not detected in any patient. Five (38.5%) out of 13 patients over the age of three showed sensitivity to pollen. CONCLUSIONS: Potatoes sensitivity is mostly seen in children with atopic dermatitis. In children with atopic eczema should be asked whether the increase in complaints with potatoes. Mostly potato sensitivity is combined with other food allergies. Therefore potato should be included in the test in patients with atopic eczema and food allergy.
Assuntos
Dermatite Atópica/classificação , Dermatite Atópica/imunologia , Hipersensibilidade Alimentar/classificação , Hipersensibilidade Alimentar/imunologia , Solanum tuberosum , Alérgenos/imunologia , Criança , Pré-Escolar , Dermatite Atópica/diagnóstico , Feminino , Hipersensibilidade Alimentar/diagnóstico , Humanos , Lactente , Masculino , Prognóstico , Estudos Retrospectivos , Testes CutâneosRESUMO
BACKGROUND: Preeclampsia is characterized by increased extracellular fluid which manifests as generalized edema due to endothelial injury and subsequent capillary leak. Therefore, preeclampsia may lead to increased skin to subarachnoid distance (SSD) which may influence daily clinical practice in this particular gravid population. METHODS: Age- and height-matched gravidas with and without preeclampsia were enrolled prospectively at an allocation ratio of 1:4. Spinal anesthesia (SA) was performed in a sitting position by a mid-line approach at the L3-L4 interspace using a 25-gauge Quincke spinal needle. An internal pilot study was performed to determine the sample size. When the protocol violations were excluded, 146 gravidas were included in the study (25 preeclamptics and 121 normotensive controls) for final analysis. RESULTS: On average, SSD was 0.89 cm greater in preeclamptics compared to normotensive controls. Mean values of the SSD in preeclamptic and normotensive control group patients at the L3-L4 interspace were 6.187 ± 0.967 and 5.301 ± 0.834 cm, respectively. SSD was significantly correlated with body weight and body mass index (BMI). The regression formula for the estimation of SSD in preeclamptic gravidas with BMI during SA was SSD = 3.696 + 0.075×BMI. The regression formula for the estimation of SSD in the normotensive control group with BMI during SA was SSD = 3.144 + 0.067×BMI - 0.0001×BMI×BMI. CONCLUSION: Knowing that the SSD is increased in preeclamptics compared to normotensive gravidas may be of value in terms of selecting needle, and providing safe and comfortable anesthesia.
Assuntos
Raquianestesia/métodos , Pré-Eclâmpsia/fisiopatologia , Pele/metabolismo , Adulto , Pressão Sanguínea , Índice de Massa Corporal , Peso Corporal , Estudos de Coortes , Feminino , Humanos , Agulhas , Projetos Piloto , Gravidez , Estudos Prospectivos , Adulto JovemRESUMO
In this study, the levels of the natural and artificial radioactivity in soil samples collected from surrounding of Karaman in Turkey were measured. Activity concentrations of the concerned radionuclides were determined by gamma-ray spectrometry using a high-purity germanium detector with a relative efficiency of 40 % at 1.332 MeV. The results obtained for the (238)U series ((226)Ra, (214)Pb and (214)Bi), (232)Th series ((228)Ac), (40)K and fission product (137)Cs are discussed. To evaluate the radiological hazard of radioactivity in samples, the radium equivalent activity (Raeq), the absorbed dose rate (D), the annual effective dose and the external (Hex) and internal hazard index (Hin) were calculated and presented in comparison with the data collected from different areas in the world and Turkey.
Assuntos
Radioisótopos/efeitos adversos , Radioisótopos/análise , Poluentes Radioativos do Solo/efeitos adversos , Poluentes Radioativos do Solo/análise , Radioisótopos de Césio/efeitos adversos , Radioisótopos de Césio/análise , Humanos , Radioisótopos de Potássio/efeitos adversos , Radioisótopos de Potássio/análise , Doses de Radiação , Monitoramento de Radiação , Radônio/efeitos adversos , Radônio/análise , Gestão da Segurança , Espectrometria gama , Tório/efeitos adversos , Tório/análise , Turquia , Urânio/efeitos adversos , Urânio/análiseRESUMO
In this study several soil samples were collected from the Büyükeceli district where Turkey's first nuclear power plant will be built and radioactivity concentrations of (226)Ra, (232)Th, (40)K and (137)Cs were determined by gamma spectrometry using a high-purity germanium detector. The measured activity concentrations in soil samples ranged from 9.8 ± 0.7 to 258.6 ± 15.8, 11.7 ± 0.9 to 85.6 ± 5.0, 173.8 ± 2.1 to 1949.5 ± 14.7 and 0.4 ± 0.1 to 72.2 ± 2.2 Bq kg(-1) for (226)Ra, (232)Th, (40)K and (137)Cs, respectively. Findings are in good agreement with the published results of neighbouring areas. The absorbed gamma dose rate (D) in air and the annual effective dose of soil samples were calculated to be 80.2 nGy h(-1) and 98.3 mSv y(-1), respectively. The results show that the radiation hazard in the Büyükeceli district is insignificant. The data presented in this study would be very useful to determine the future effects of the nuclear power plant to the environment.
Assuntos
Radiação de Fundo , Radioisótopos de Potássio/análise , Monitoramento de Radiação/métodos , Poluentes Radioativos do Solo/análise , Espectrometria gama/métodos , Tório/análise , Raios gama , Geografia , Centrais Nucleares , Doses de Radiação , Solo , TurquiaRESUMO
INTRODUCTION: The reliability and validity of Turkish version of Childhood Asthma Control Test (C-ACT). PURPOSE: The management of asthma is an important as well as difficult issue of physician's daily practice particularly in busy clinical settings. C-ACT was created to identify asthma control levels in children aged 4-11 years. Our aim was to evaluate the reliability, validity and responsiveness of C-ACT in a Turkish sample of children with asthma. METHOD: In this multicenter study, 368 children were enrolled. C-ACT was completed every month by parents and patients who were evaluated in 3 visits within 2 month intervals. At each visit, physicians interpret the control level and decided for the treatment step as established in GINA guidelines. RESULTS: The internal consistency reliability of the Turkish version of C-ACT (C-ACT1 to C-ACT5) was found to be 0.82, 0.83, 0.82, 0.82 and 0.80, respectively (reliability statistics, Cronbach's alpha). Test-retest reliability was 0.71. There was significant correlation between C-ACT and physician's assessment of asthma control at visit 1 (r = 0.65, P < 0.001). CONCLUSIONS: Turkish version of C-ACT is an accurate and reliable tool to evaluate asthma control in children aged 4-11 years. Its widespread use may facilitate appropriate assessment of asthma control and may lead to decrease the number of uncontrolled patients.
Assuntos
Asma/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Criança , Feminino , Humanos , Masculino , TurquiaRESUMO
BACKGROUND: In recent years, laryngopharyngeal reflux (LPR) in children has been taken into consideration. OBJECTIVE: The aim of this study was to assess the laryngoscopic findings in children diagnosed LPR and/or gastro-oesophageal reflux (GERD). METHODS: The findings of 49 patients with at least one or more respiratory complaint such as chronic cough, wheezing, hoarseness, recurrent laryngitis, and throat clearing/postnasal discharge suggesting LPR were evaluated retrospectively. The diagnosis of LPR+GERD or GERD was done by the clinical history and 24 h double-probe pH monitoring and/or scintigraphy. RESULTS: Thirty eight out of 49 patients examined by laryngoscopy underwent 24 h double-probe pH monitoring and/or scintigraphy. Thirty of them were diagnosed as LPR+GERD or GERD by any test positivity. Twelve of 30 patients diagnosed with LPR+GERD or GERD had a positive laryngeal finding on the examination of fibre optic laryngoscopy. The most common finding with eight cases was arytenoid erythema A sensitivity of 40% and specificity of 50% for the laryngoscopy in the diagnosis of LPR/GERD were found. CONCLUSION: In children with unexplained respiratory symptoms, laryngopharyngeal reflux should be suspected. Therefore, until enough data on this issue in the literature accumulates, the history and the laboratory findings of the patients obtained from various techniques to document paediatric LPR should be evaluated together.
Assuntos
Refluxo Gastroesofágico/diagnóstico , Refluxo Laringofaríngeo/diagnóstico , Transtornos Respiratórios/diagnóstico , Adolescente , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/fisiopatologia , Humanos , Lactente , Refluxo Laringofaríngeo/complicações , Refluxo Laringofaríngeo/fisiopatologia , Laringoscopia , Masculino , Prognóstico , Transtornos Respiratórios/complicações , Transtornos Respiratórios/fisiopatologia , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
Zinc deficiency may be suspected to play a role in the pathogenesis, control, and severity of asthma because of its antioxidant, antiapoptotic, and anti-inflammatory effects. We aimed to investigate whether there was any relationship between erythrocyte zinc levels and childhood asthma. The erythrocyte zinc levels of 67 asthmatic and 45 healthy children were analyzed in this case-control study. The mean concentrations of erythrocyte zinc were 1215.8 ± 145.1 µg/dl in asthma patients and 1206.9 ± 119.5 µg/dl in controls with no significant difference (P = 0.472). The erythrocyte zinc level was below 1,000 µg/dl in 6 asthmatic patients (8.9%) and 2 control group patients (4.4%). There was no relationship between erythrocyte zinc levels and duration of follow-up, severity, and control of the asthma (P > 0.05). On the other hand, patients hospitalized for an asthma attack had significantly lower erythrocyte zinc levels compared with nonhospitalized patients and the control group (P = 0.000 and P = 0.004 respectively). This study's findings indicate that asthmatic children are not a risk group for zinc deficiency. We emphasize that checking zinc levels in children who are hospitalized for an asthma attack may be useful.
Assuntos
Asma/sangue , Asma/metabolismo , Eritrócitos/química , Zinco/análise , Zinco/deficiência , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , TurquiaAssuntos
Alérgenos/efeitos adversos , Eosinófilos/patologia , Hipersensibilidade/diagnóstico , Hipersensibilidade/imunologia , Proteínas de Insetos/efeitos adversos , Alérgenos/imunologia , Animais , Criança , Baratas/imunologia , Humanos , Síndrome Hipereosinofílica/etiologia , Síndrome Hipereosinofílica/prevenção & controle , Hipersensibilidade/fisiopatologia , Imunoglobulina E/sangue , Proteínas de Insetos/imunologia , Síndrome de Job/etiologia , Síndrome de Job/prevenção & controle , Masculino , Controle de Pragas , Testes de Função Respiratória , Testes CutâneosRESUMO
BACKGROUND: Inhaled corticosteroids (ICS) are the first-line therapy in the treatment of persistent asthma. At medium to high doses and prolonged usage, ICS can supresss the hypothalamic-pituitary-adrenal axis. Dehydroepiandrosterone sulphate (DHEA-S) is a corticotropin-dependent adrenal androgen precursor that is supressible in patients treated with ICS. OBJECTIVES: To evaluate the adrenal axis in asthmatic children treated with moderate doses of fluticasone propionate and to evaluate the DHEA-S as a possible marker for adrenal axis in preadrenarchal children. METHODS: Twenty-eight children with persistent asthma with a mean age of 4.4 years (median 4.2; range 2.5-7.1) on long term treatment (mean 6.16; median 6; range 4.5-9 months) with moderate doses (mean 250; median 253; range 158-347 (g/m(2)/day) of inhaled fluticasone propionate were evaluated with low-dose ACTH stimulation test to assess adrenal function, and DHEA-S levels were compared with the results. RESULTS: One out of 28 patients (3.57%) demonstrated an abnormal cortisol response to low-dose ACTH test. There was no correlation between DHEA-S and peak cortisol, morning cortisol and fasting blood glucose levels. However, mean inhaled corticosteroid dosages were inversely correlated with the DHEA-S. CONCLUSIONS: In most of the children with persistent asthma, mild to moderate fluticazone propionate doses supress the hypothalamic-pituitary-adrenal axis rarely. Chronic moderate doses of ICS may suppress adrenal androgen levels without supression of cortisol production. DHEA-S levels may be used as a practical method to follow adrenal functions and may be an earlier indicator of adrenal dysfunction in children.
Assuntos
Androstadienos/efeitos adversos , Asma/tratamento farmacológico , Broncodilatadores/efeitos adversos , Sulfato de Desidroepiandrosterona/sangue , Sistema Hipotálamo-Hipofisário/efeitos dos fármacos , Sistema Hipófise-Suprarrenal/efeitos dos fármacos , Asma/sangue , Biomarcadores/sangue , Criança , Pré-Escolar , Feminino , Fluticasona , Humanos , Imunoensaio , MasculinoRESUMO
BACKGROUND/AIMS: Several conflicting results are presently reported regarding raised IgG and IgM-anticardiolipin antibodies (ACA) titers in hemodialysis (HD) patients and their role in vascular access dysfunction. We aimed to determine the prevalence of both IgM and IgG-ACA titers and to analyze retrospectively their role in primary and secondary arteriovenous fistula (AVF) failure in a homogeneous group of HD patients with chronic hepatitis C. METHODS: This study included 103 adults on maintenance hemodialysis with chronic hepatitis C infection. All participants had blood samples drawn predialysis and after an overnight fast. Analysis included biochemistry, IgG and IgM ACA, Anti-HCV, HBsAg, serum HCV RNA and HCV genotyping. RESULTS: The prevalence of IgG-ACA was 14.6% (15/103). No patient had a positive value of the IgM-ACA test. HCV replication was detected in 52 of 76 patients. The most common HCV genotype was genotype 1 (90%). The percentage of females was higher in ACA(+) group (p = 0.038). There were no significant differences between subjects with and without ACA-IgG regarding other parameters studied. No difference in regard to AVF survival was detected between ACA(+) and ACA(-) groups (p > 0.05). CONCLUSION: We found no significant differences in primary or secondary AVF failure between patients with elevated and normal ACA. Therefore, we conclude that AVFF may be caused by factors other than ACA in these patients. More prospective studies are needed to confirm this observation.