Correlation of neutrophil-lymphocyte ratio and risk scores in non-muscle invasive bladder cancer. / Correlación entre el índice neutrófilo/linfocito y las puntuaciones de riesgo en el cáncer de vejiga no músculo-invasivo.

OBJECTIVES: Aim of this study is to evaluate the correlation between European Organization for Research and Treatment of Cancer (EORTC) risk score and neutrophil-lymphocyte ratio (NLR) in patients with non-muscle invasive bladder cancer and the relationship between NLR and risk groups. METHODS: We retrospectively reviewed data of 212 patients with non-muscle invasive bladder cancer were included in the study. The tumors were graded according to the 1973 World Health Organization grading system and the tumor node metastasis (TNM) 2012 staging system. Patients were categorized low, intermediate and high risk for recurrence and progression, according to European Association of Urology guidelines. Serum values for the NLR were measured on the day before the operation to ascertain the baseline value for neutrophil and lymphocyte counts and statistically analyzed. RESULTS: Of the 212 patients, 193 were male and 19 were female. Mean age was 66.7. Mean NLR score was 3.04±2.11. T1 tumors, G3 tumors, multiple tumors and>3cm tumors seen mostly in patients with NLR>2.41. Low, intermediate and high risk groups compared and NLR rates were significantly higher in high risk group patients (P<.001). When the correlation between NLR and EORTC recurrence and progression scores was evaluated, it was observed that as NLR value increased, recurrence (r=0.252, P<.001) and progression (r=0.145, P=.034) scores increased significantly. CONCLUSIONS: This study demonstrated the association of high NLR value with T1 tumor, high grade, multiple tumor,>3cm tumor and EORTC high risk group in non-muscle invasive bladder cancer patients. There was also a positive correlation between NLR and EORTC recurrence and progression scores.

Therapeutic effect of N- acetyl cysteine as an antioxidant on rainbow trout's brain in cypermethrin toxicity.

The aim of this study was to investigate the therapeutic effect of N-acetylcystein (NAC) against oxidative stress induced by Cypermethrin pesticide in rainbow trout (Oncorhynchus mykiss). The experiment was designed as 5 groups (A, B, C, D, and E). Group A was organized as control group and had no treatment. The other groups were treated with Cypermethrin for 14 days. At the end of this period, Groups B (1.0 mM NAC) and D (0.5 mM NAC) was performed with NAC for 96 h. Group C was not administered NAC, the recovery process was evaluated with this group. Group E was exposed to cypermethrin during 14 days and sampled. Acetylcholinesterase (AChE), malondialdehyde (MDA), glutathione peroxidase (GPx), superoxide dismutase (SOD), catalase (CAT), paraoxonase (PON), arylesterase (AR), myeloperoxidase (MPO) activities, oxidative DNA damage (8-hydroxy-2'-deoxyguanosine (8-OHdG)), caspase-3 levels, and trace elements contents analyses were performed in all fish brains. According to the results, MDA, MPO, 8-OHdG and caspase-3 levels were significantly decreased compared to the other groups (pesticide and recovery) (p < 0.05), AChE, SOD, CAT, GPx, PON, and AR activities increased (p < 0.05). In brain tissue, no statistically significant difference was observed in trace element analysis of all application groups. According to the obtained data, the positive effect of N-acetylcysteine on protein synthesis, detoxification, and diverse metabolic functions against cypermethrin toxicity has been more effective in 1.0 mM NAC. NAC has important therapeutic effect on pesticide-induced neurotoxicity for fish in terms of all data. It was concluded that NAC has an antioxidant effect against pesticide-induced oxidative stress and the selected biochemical markers are useful for such studies.

Pedicled Vascularized Lymph Node Transfer Treats Lymphedema in Rat Hind Limb: A Simple Experimental Study Design.

Vascularized lymph node transfer is a new and promising technique for the physiologic treatment of lymphedema and several clinical and experimental studies have been conducted in recent years. However, the exact mechanism of vascularized lymph node transfer is still unknown. In this study, we aimed to investigate treatment efficacy through the design of a simple and feasible experimental lymphedema model for testing a vascularized lymph node transfer technique. After a pilot study, 30 male Sprague-Dawley rats were divided into two groups and lymphedema was induced in the hindlimb of both groups. In Group 1 (control, n=15) no treatment was applied while pedicled lymph node transfer was applied in Group 2 (experimental, n=15). Model dynamics were assessed with lymphoscintigraphy, limb measurement, and histological analysis. A statistically significant limb circumference reduction at the ankle was seen on days 30 and 90 in Group 2 as compared to Group 1, p<0.05, and lymphatic tracer transport improved in 13 out of the 15 animals in Group 2. A statistically significant reduction in histological scores was achieved in Group 2, p<0.05. In this rat hindlimb lymphedema model, our vascularized lymph node transfer technique is an effective physiologic surgical treatment and represents a feasible experimental model for future studies.

Active surveillance or radical prostatectomy? Which treatment is best?

OBJECTIVE: We evaluated the patients who are candidates for active surveillance and treated with radical prostatectomy. These patients were compared with other patients who had not met the criteria of active surveillance. METHODS: In total, 135 patients were included in the study. The patients were divided into two groups. The patients in Group 1 had less than three positive cores, Gleason 6 (3 + 3) and PSA level equal to or less than 10 ng/ml. Patients in Group 2 had three or more positive cores, Gleason 6 (3 + 3) and PSA level equal to or higher than 10 ng/ml. Pathological results of each groups were compared. RESULTS: The patients' ages were between 52 and 76, and 50 and 77 in groups 1 and 2, retrospectively. There were 69 and 66 patients in groups 1 and 2, retrospectively. The mean age of patients, PSA levels, PSA density, and prostate volumes were 63.89 ± 5.89 years, 5.82 ± 1.84 ng/ml, 0.14 ± 0.07 and 51.21 ± 31.75 cc (Group 1) and 65.77 ± 6.36 years, 13.65 ± 17.11 ng/ml, 0.63 ± 1.03 and 45.44 ± 26.77 cc (Group 2). T2a, T2c, T3a and T3b were reported in 28 patients, 36 patients, 3 patients and 2 patients after pathological evaluation in Group 1,respectively. T2a, T2c, T3a and T3b were reported in 13 patients, 47 patients, 5 patients and 1 patient in the other group, respectively. CONCLUSION: The final pathology showed that there is no difference in the positive surgical margin, proportion of insignificant prostate cancer and Gleason upgrading between groups. The clinicians must be aware of the fact that active surveillance can be misdiagnosed in some patients (Tab. 2, Ref. 20).

Non-contrast-enhanced imaging of haemodialysis fistulas using quiescent-interval single-shot (QISS) MRA: a feasibility study.

AIM: To assess the efficiency of a novel quiescent-interval single-shot (QISS) technique for non-contrast-enhanced magnetic resonance angiography (MRA) of haemodialysis fistulas. MATERIALS AND METHODS: QISS MRA and colour Doppler ultrasound (CDU) images were obtained from 22 haemodialysis patients with end-stage renal disease (ESRD). A radiologist with extensive experience in vascular imaging initially assessed the fistulas using CDU. Two observers analysed each QISS MRA data set in terms of image quality, using a five-point scale ranging from 0 (non-diagnostic) to 4 (excellent), and lumen diameters of all segments were measured. RESULTS: One hundred vascular segments were analysed for QISS MRA. Two anastomosis segments were considered non-diagnostic. None of the arterial or venous segments were evaluated as non-diagnostic. The image quality was poorer for the anastomosis level compared to the other segments (p<0.001 for arterial segments, and p<0.05 for venous segments), while no significant difference was determined for other vascular segments. CONCLUSION: QISS MRA has the potential to provide valuable complementary information to CDU regarding the imaging of haemodialysis fistulas. In addition, QISS non-enhanced MRA represents an alternative for assessment of haemodialysis fistulas, in which the administration of iodinated or gadolinium-based contrast agents is contraindicated.

Effect of Kidney Transplantation on Smoking Habits of Kidney Donors.

INTRODUCTION: Smoking increases the risk for cardiovascular disease in kidney donors, as is the case with normal individuals; it may also result in the development and progression of chronic renal failure. The present study aimed to investigate the effect of kidney transplant on smoking habits of kidney donors. METHOD: The study included 98 donors in total (54 female, 44 male). A questionnaire was administered to donors about smoking status. Smoking status was asked about before surgery and 12 months postoperatively, and the preoperative and postoperative values were compared. The Fagerstörm test for nicotine dependence was administered to individuals who were still smokers and those who had smoked but quit. RESULTS: The mean age of the participants was 48.27 ± 10.8 years. The preoperative smoking status was 47% (n = 46), whereas the postoperative rate decreased to 29% (n = 28). This reduction in smoking rate was significant (P = .001). There was no difference in Fagerström levels between donors who continued smoking and those who quit smoking after the surgery (P = .583). CONCLUSIONS: A person who becomes a kidney transplant donor has the chance to quit smoking, which is a cardiovascular risk factor. In addition to the psychosocial benefits of being a donor, it should be noted that it might also provide some medical benefits. However, some patients continue smoking after surgery. Smoking should be questioned in the postoperative follow-ups of donors and the support required for smoking cessation should be provided.

Kidney Transplantation Is Superior to Hemodialysis and Peritoneal Dialysis in Terms of Cognitive Function, Anxiety, and Depression Symptoms in Chronic Kidney Disease.

BACKGROUND: Cognitive impairment, anxiety and depression are important problems for patients with chronic kidney failure. Cognitive impairment, anxiety, and depression may be related to various factors, such as complications of hemo/peritoneal dialysis, uremic encephalopathy, psychosocial burden of the disease, and various comorbidities in patients with chronic kidney failure. Successful kidney transplantation (KT) improves kidney, endocrine, metabolic, and vascular systems, mental functions, and the quality of life of the patients. METHODS: A total of 181 patients with chronic kidney failure were studied: 54 currently on hemodialysis, 58 on peritoneal dialysis, and 69 with KT. All participants were given a detailed sociodemographic form, including data about the reason of kidney failure, duration of treatment (hemodialysis, peritoneal dialysis, and KT), and comorbid illnesses. Participants were evaluated with the use of the Hospital Anxiety and Depression Scale (HADS) for evaluating depressive and anxiety symptoms and the Brief Cognitive State Examination (BCSE) for detecting possible cognitive impairment. RESULTS: Patients with KT had lower levels of anxiety and depression symptoms than patients with hemodialysis and peritoneal dialysis. The KT group scored better than the hemodialysis and peritoneal dialysis groups on the BCSE. The peritoneal dialysis group scored higher on the BCSE than the hemodialysis group. The hemodialysis group scored higher on the HADS than the peritoneal dialysis group. CONCLUSIONS: In this study it was found that KT patients have better cognitive and mood regulation outcomes than hemodialysis and peritoneal dialysis patients with chronic kidney failure. With this knowledge we suggest that patients with kidney failure should have KT for having better cognitive functions and mood state as soon as possible.

Neutrophil-Lymphocyte Ratio Is Significantly Decreased in Preemptive Renal Transplant Patients.

AIM: Cardiovascular diseases and infections are the leading two causes of morbidity and mortality in end-stage renal disease (ESRD) patients. Kidney transplantation is the preferred method for renal replacement owing to better survival. There are reports of irreversibly damaged immune system in dialysis patients, which did not return to normal even after kidney transplantation. The neutrophil-lymphocyte ratio (NLR) is an easily applicable method for evaluation of inflammation. We hypothesized that preemptive kidney transplantation can improve inflammatory state compared with nonpreemptive recipients. To test our hypothesis, we retrospectively investigated pretransplant and posttransplant NLR and C-reactive protein (CRP) levels of ESRD patients and compared them with values in healthy controls. MATERIALS AND METHODS: We retrospectively analyzed NLR, CRP, and other hematologic parameters of ESRD patients who were transplanted between January 2005 and January 2014 on the day of transplantation and at the end of first year. We grouped the patients as preemptive and nonpreemptive ones. We excluded patients with coronary artery disease, obesity, hypotension, hyperthyroidism, uncontrolled diabetes mellitus, hematologic or solid organ cancers, and active documented infection at any evaluation period. RESULTS: We included 137 ESRD patient and 34 healthy control individual in our study. Of the 137 ESRD patients, 52 (38%) were transplanted preemptively. Of the patients, 85 were already on either hemodialysis or peritoneal dialysis therapy at the time of transplantation. The white blood cell count value of the patient and control group (7246.72 ± 1460.26 and 76661.76 ± 1286.29, respectively; P = .43), NLR of the control group was significantly lower than patient group (1.98 ± 0.94 and 3.47 ± 2.33, respectively; P = .007). The NLR of the preemptive group was decreased substantially at the end of first year posttransplantation, the NLR of the preemptive group was significantly lower than the nonpreemptive group (3.08 ± 1.32 and 3.71 ± 2.33; P = .01). CONCLUSIONS: We showed that all ESRD patients had an increased inflammation rate according to CRP and NLR when compared with healthy controls. We also found that improvement of inflammatory state in preemptive patients is significantly better than nonpreemptive patients at the end of first year evaluation.

High-Grade Inflammation in Renal Failure Patients, According to Mean Platelet Volume, Improves at the End of Two Years After Transplantation.

BACKGROUND: Chronic kidney disease (CKD) is a worldwide disorder which is characterized by the presence of systemic low-grade inflammation. There is also acquired immune deficiency in this patient group which is clinically present with increased incidence of severe infections, poor response to vaccination, and increased risk of virus-associated cancers. Renal transplantation is one of the renal replacement modalities that restore renal functions. Mean platelet volume (MPV) is emerging as a marker of inflammation in many clinical conditions. In this study we aimed to disclose the improvement of paired immune response of ESRF patients after renal transplantation even though they are under immunosuppressive therapy. METHODS: We retrospectively investigated C-reactive protein, MPV, platelets (PLT), and other hematologic parameters on the day of transplantation and at the end of the 1st and 2nd years after transplantation of 58 preemptive and 112 nonpreemptive renal transplant patients. We compared them with a healthy control group. RESULTS: The MPV of the control group was 8.00 ± 0.73. The mean MPV of transplant patients before transplantation and at the end of the 1st and 2nd years after transplantation were 7.66 ± 1.01, 8.06 ± 0.97, and 8.20 ± 0.84, respectively. The initial MPV of the patient group was statistically significantly lower than the control group (P = .04). There was a statistically significant increase of MPV after transplantation. At the end of the 2nd year the difference of MPV between the patient and control groups was gone. CONCLUSIONS: We detected that CKD patients had a decreased MPV compared with normal individuals and that it normalized at the end of the 2nd year after renal transplantation. We speculated that the decreased MPV in CKD patients is related to increased inflammation and uremic toxins owing to uremia which was improved after renal transplantation.

Caregiver Burden, Anxiety, Depression, and Sleep Quality Differences in Caregivers of Hemodialysis Patients Compared With Renal Transplant Patients.

BACKGROUND: We compared the caregivers of hemodialysis (HD) patients and caregivers of patients with renal transplantation (Tx) in terms of anxiety, depression, sleep quality, and caregiver burden. We believe that caregivers of HD have more difficult conditions than caregivers of the patients with Tx. METHODS: This cross-sectional study analyzed the psychological status of caregivers of Tx patients compared with those of HD patients with using the Hospital Anxiety and Depression Scale, Zarit Burden Interview, and Pittsburg Sleep Quality Indexes. We recruited 133 caregivers-65 caregivers in the Tx group and 68 in the HD group. RESULTS: Mean age was 43.1 ± 8.5 years. The age, sex, income level, and education level were similar between the 2 groups. Caregivers in the HD group had significantly higher rates of anxiety and depression compared with the Tx group (P = .007 and P < .001, respectively). Good sleep quality rates for caregivers in the Tx group and caregivers in the HD group were 92% (n = 60) and 63% (n = 43), respectively. Poor sleep quality was significantly higher in caregivers in the HD group compared with caregivers in the Tx group (P < .001). Caregiver burden scores were significantly higher for caregivers in the HD group compared with caregivers in the Tx group (P < .001). CONCLUSIONS: We suggest that Tx is the more appropriate renal replacement therapy for caregivers who undertake the care of patients with end-stage renal disease and chronic kidney disease.

Comparison of Serum Vitamin D Levels Among Patients With Chronic Kidney Disease, Patients in Dialysis, and Renal Transplant Patients.

OBJECTIVE: Vitamin D is a hormone with a variety of functions, and its deficiency and insufficiency are commonly seen both in the general population and in patients with chronic renal disease. The aim of this study was to compare vitamin D levels in patients with chronic renal disease who are on hemodialysis, peritoneal dialysis, or no renal replacement therapy and patients who underwent renal transplantation. METHODS: A total of 169 patients who had not used vitamin D for ≥ 1 year and who had no diabetes mellitus or proteinuria were included in the study. These included: 40 patients with renal transplantation, 40 patients on hemodialysis, 49 patients on peritoneal dialysis, and 40 patients with chronic renal failure stage 1, 2, 3, or 4. 25-Hydroxy vitamin D levels were evaluated in the sera of the patients. RESULTS: 25-Hydroxy vitamin D levels in patients with renal transplantation and in predialysis patients were 12.74 ± 10.24 ng/mL and 11.16 ± 12.25 ng/mL, respectively. The levels were 7.77 ± 6.71 ng/mL and 5.96 ± 4.87 ng/mL in patients on hemodialysis and peritoneal dialysis, respectively. CONCLUSIONS: Vitamin D levels are lower in patients on hemodialysis and peritoneal dialysis compared with the patients with renal transplantation for a variety of reasons. In this study, objective results were obtained supporting the administration of vitamin D supplements without glomerular filtration rate measurement in all patient groups with the diagnosis of chronic renal failure in accordance with the guidelines.

Changes in Exfoliative Cell of Oral Mucosa in Kidney Transplant Patients.

OBJECTIVES: The aim of this study was to investigate quantitative cytologic changes in oral mucosal smears collected from kidney transplant patients by modern stereologic methods. METHODS: We enrolled 32 kidney transplant patients. Smears were obtained from the buccal mucosa transplant patients before and 12 months after kidney transplantation. Smears from each individual were stained using the Papanicolaou method and were analyzed using a stereological method. RESULTS: Statistically, the nuclear volumes and cytoplasmic volumes in the cells of buccal mucosa were markedly higher after kidney transplantation (P < .05). There was a decreased positive cell density in the oral epithelial cells after kidney transplantation compared with before renal transplantation (P < .05). CONCLUSIONS: These findings suggest that there are alterations in the oral epithelial cells after kidney transplantation, which are detectable by microscopy and cytomorphometry.

The osseous and dental changes of patients with chronic renal failure by CBCT.

OBJECTIVES: The aim of the present study was to evaluate the osseous changes of the jaws of patients with chronic renal failure (CRF) by CBCT. METHODS: On CBCT scans obtained from 15 patients with CRF and 15 control patients (7 males and 8 females), the mean was calculated for the antegonial index (AI), mental index (MI), panoramic mandibular index (PMI) and mandibular cortical index (MCI). The MI, AI and PMI, pulp chamber size, number of teeth with pulp calcification and lamina dura loss were compared using the paired t-test, and the MCI values were analysed using the χ(2) test. RESULTS: There were no statistically significant differences in the PMI, MI and AI values in patients with CRF and the control group. With regard to MCI, the cortical margins of the mandible were more porous in patients with CRF than in the control group, and also soft-tissue calcifications, lamina dura loss and radiolucent defects were more common in patients with CRF. There were no statistically significant differences in pulp chamber size and pulp calcifications between patients with CRF and the control group. CONCLUSIONS: Radiographic changes in the jawbones of patients with CRF may be commonly seen. CBCT is a valuable diagnostic tool for the evaluation of osseous findings, pulp chamber, soft-tissue calcifications and MCIs and allows indices measurement in three dimensions without any superposition.

Plasma homocysteine and liver tissue S-adenosylmethionine, S-adenosylhomocysteine status in vitamin B6-deficient rats.

OBJECTIVE: The aim of this study was to evaluate plasma homocysteine (Hcy), malondialdehyde (MDA), glutathione (GSH) levels, glutathione peroxidase (GSH-Px) and glutathione-S-transferase (GST) activities and liver tissue S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) levels in control and vitamin B6-deficient rats. MATERIALS AND METHODS: Thirty-two male rats with a weight of 65-75 g were used for the experiment. The rats were divided into control (n=16) and vitamin B6-deficient groups. At the end of the experiment, the animals were anesthetized with ketamine-HCl (Ketalar, 20 mg/kg, i.p.), and the blood was collected by cardiac puncture after thoracotomy. Plasma Hcy, pyridoxal phosphate (PLP), liver SAM, SAH levels measured by an isocratic system with high performance liquid chromatography. Plasma GSH-Px, GSH activities and GSH, MDA levels were carried out using a spectrophotometer. RESULTS: Plasma Hcy, MDA, liver tissue SAH levels were significantly increased, whereas plasma GSH, PLP, liver tissue SAM levels, plasma GST, GSH-Px activities and SAM/SAH ratio were decreased compared to those of control group. CONCLUSIONS: Vitamin B6 deficiency causes an increase in plasma homocysteine levels. Thus, we think that vitamin B6 supplementation could be used for therapeutic purposes in hyperhomocysteinemia condition.

How fast can a naturopathic medicine cause skin burn? a case report of garlic burn.

This paper presents a case in which a chemical burn resulted from the use of garlic as a naturopathic medicine for knee pain.

Nous présentons une brûlure chimique causée par l'ail utilisé comme une médecine naturopathique antalgique du genou.

[Capsule endoscopy in a supra-regional network corporation: experience in more than 1000 cases]. / Moderne medizinische Versorgungsstrukturen am Beispiel der Videokapselendoskopie: Erfahrungen aus über 1000 Untersuchungen in einem überregionalen Netzwerk.

INTRODUCTION: Capsule endoscopy (CE) is firmly established as a standard procedure in the diagnostic algorithm of mid gastrointestinal (GI) bleeding. Despite its excellent diagnostic yield, missing expertise, reading time and financial expenditure limit an area-wide availability. A multicentric cooperation might compensate these disadvantages. METHODS: The CE device was bought by a centrally located hospital (CH). CE-equipment is transported to the network partner (NP) on request and the procedure performed at the spot. Video reading is exclusively done in the CH. RESULTS: Between January 2002 and July 2013, 1026 CE (548 m, 478f; 64 ±â€Š16, 13 - 93 yrs.) were performed within the network. 744/1026 (73 %) CE were done at 17 NP, 282/1026 (27 %) in the CH. Between 2002 (n = 39) and 2012 (n = 136) the annual number of CE increased threefold. Leading indication for CE was suspected mid GI-bleeding (80 %). Mean latencies between requested date and actual examination were less than 24 h and 2 days between CE performance and report. 95 % of the capital investment in each cooperating hospital could be avoided by sharing one workstation within the network. CONCLUSION: The experience from more than 1000 CE show that long-term multicentric utilization of CE equipment is feasible. Such a network runs at stable procedural quality levels similar to an in-house supply, allows an economic as well as area-wide availability of CE and improves reading expertise by centralized video evaluation.

The effect of carvacrol on healthy neurons and N2a cancer cells: some biochemical, anticancerogenicity and genotoxicity studies.

Carvacrol (CVC) is a phenolic monoterpene present in many essential oils of medicinal and aromatic plants and has attracted attention because of its beneficial biological activities. To date, although various biological activities of CVC have been demonstrated, its neurotoxicity on cultured primary rat neurons and N2a neuroblastoma cells has never been explored. Therefore, in this present study, we aimed to describe in vitro antiproliferative and/or cytotoxic properties (by 3-(4,5 dimetylthiazol -2-yl)-2,5 diphenlytetrazolium bromide (MTT) test), genotoxic damage potentials (by single cell gel electrophoresis (SCGE) or Comet assay) and antioxidant activities (by total antioxidant capacity (TAC) and total oxidative stress (TOS) analysis) of CVC in vitro. Dose (0-400 mg/L) dependent effects of CVC were tested on both cultured primary rat neurons and N2a neuroblastoma cells. Statistical analysis of MTT assay results indicated significant (p < 0.05) decreases of cell proliferation rates in both cell types treated with CVC at 200 and 400 mg/L. On the other hand, the mean values of the total scores of cells showing DNA damage (for comet assay) was not found significantly different from the control values for both cells (p > 0.05). In addition, our results indicated that 10, 25 and 50 mg/L of CVC treatment caused increases of TAC levels in cultured primary rat neurons but not in the N2a cell line. However, CVC treatments led to increases of TOS levels in cultured primary rat neurons at only 400 mg/L while they led to increases of TOS levels in N2a neuroblastoma cells at 200 and 400 mg/L. The present findings demonstrated that CVC could be a source of antioxidant and chemopreventive activities to be studied on cancer diseases.

The effects of serum cholesterol, LDL, and HDL levels on gallstone cholesterol concentration.

OBJECTIVE: Gallbladder stones are common in the Western world, and 70% to 80% of gallstones are cholesterol stones. This study investigates the effects of serum cholesterol, LDL, and HDL levels on gallstone cholesterol concentration. METHODOLOGY: The gallstones of 75 patients with cholelithiasis were examined using spectrophotometry. RESULTS: High serum cholesterol and LDL levels were associated with high cholesterol stone rates (86.7% vs. 40.0%, P < 0.001; 75.0% vs. 48.9%, P < 0.05, respectively). Similarly, high serum cholesterol and LDL levels were correlated with high gallbladder stone cholesterol concentrations (63.6% vs. 44.4%, P < 0.001; 62.3% vs. 46.0%, P < 0.001, respectively). In contrast, low serum HDL levels do not seem to affect the occurrence of gallbladder cholesterol stones (60.0% vs. 58.3%, respectively, P > 0.05) or gallbladder stone cholesterol concentrations (50.8% vs. 52.4%, respectively, P > 0.05). CONCLUSION: The relationship between cholesterol, LDL, and HDL levels and cholesterol gallstone formation is multifactorial and complex and is also dependent on other individual properties.

Psychological and emotional status, and caregiver burden in caregivers of patients with peritoneal dialysis compared with caregivers of patients with renal transplantation.

OBJECTIVES: We sought to examine the relationship between caregivers of continuous ambulatory peritoneal dialysis (CAPD) and of renal transplant (Tx) patients with regard to sleep quality, anxiety, depression, and overall burden. METHODS: This cross-sectional study of prevalent caregivers of CAPD patients and of renal Tx patients used a multidimensional instrument to assess the association of sleep quality, depression and anxiety symptoms, as well as burden using a Zarit Burden Interview. Among the 113 caregivers who participated in this study, 53 were in the Tx and 60 in the CAPD group. RESULTS: The overall mean age was 40.7 ± 13.6 years. The proportions of age, gender, income, and education level were similar between the 2 groups. Caregivers of peritoneal dialysis patients had significantly higher rates of anxiety and depression compared with the Tx group (P = .039 and P = .003, respectively). Good sleep quality rates for caregivers of Tx versus CAPD patients were 88.7% (n = 47) and 61.7% (n = 37), respectively. Poor sleep quality was significantly higher among caregivers of CAPD compared with those for Tx patients (P = .001). Caregiver burden scores were significantly higher in caregivers of CAPD patients compared with Tx patients (P < .001). Upon logistic regression analysis, caregivers of CAPD patients were 2.61 times (95% confidence interval, 1.03-6.59; P = .043) higher than the caregiver burden risk than those for Tx patients. CONCLUSIONS: This study indirectly indicated that renal Tx improves the life quality and decreases psychiatric symptoms among caregivers of ESRD patients.