Evaluation of von Willebrand factor and protein/creatinine ratio in idiopathic sudden hearing loss / Evaluación del Factor Von Willebraund y la Relación Proteína/Creatinina en la Hipoacusia Súbita Idiopática

Objective The objective of this study was to evaluate the levels of von Willebraund Factor (vWF) in plasma and the protein/creatinine ratio in urine in patients with idiopathic sudden acute hearing loss, which we think to be caused by epithelial dysfunction. Materials-Methods Thirty patients with a sudden hearing loss and thirty healthy individuals were included in the study. Before the treatment, blood and urine were collected from the patients and the control group to investigate the levels of the protein/creatinine ratio and the levels of vWF. The test results of the patients group were compared with those of the control group. Results We found that the levels of vWF increased in the patient group, which was statistically significant (P<.05). The protein/creatinine ratio in the urine increased in the patient group, but this was not statistically significant (P>.05). In addition, we found that the vWF and urine protein/creatin ratio of the patients who benefited from treatment were lower than those who did not benefit. Conclusions This study showed that sudden sensorineural hearing loss may result from endothelial dysfunction. However, more studies that include more patients are needed in order to support this. (AU)

Objetivo El objetivo de este estudio fue evaluar los niveles de factor de von Willebraund (vWF) en plasma y la relación proteína/creatinina en orina en pacientes con hipoacusia aguda súbita idiopática, que creemos que es causada por una disfunción epitelial. Material-Método Treinta pacientes con hipoacusia súbita y treinta individuos sanos fueron incluidos en el estudio. Antes del tratamiento, se recogieron sangre y orina de los pacientes y del grupo de control para investigar los niveles de relación proteína/creatinina y los niveles de vWF. Los resultados de las pruebas del grupo de pacientes se compararon con el grupo de control. Resultados En la literatura, se sabe que la cantidad de proteína en la orina y las elevaciones en los niveles de vWF en plasma son las consecuencias de la disfunción endotelial. Encontramos que los niveles de vWF aumentaron en el grupo de pacientes y esto fue estadísticamente significativo. Sin embargo, la relación proteína/creatinina en la orina aumentó en el grupo de pacientes, pero esto no fue estadísticamente significativo. Además, encontramos que el vWF y la relación proteína/creatina en orina de los pacientes que se beneficiaron del tratamiento fueron más bajos que los que no se beneficiaron. Conclusiones Este estudio muestra que la pérdida auditiva neurosensorial súbita puede resultar de una disfunción endotelial. Sin embargo, se necesitan más estudios que incluyan más pacientes para respaldar esto. (AU)

The Effect of Serum Calcium Levels on Uremic Encephalopathy in Patients with Acute Kidney Injury in the Emergency Department.

BACKGROUND AND OBJECTIVES: Uremic encephalopathy is the most important complication of renal failure and urgent dialysis treatment is required. Parathormone (PTH) contributes to the etiopathogenesis of uremic encephalopathy. PTH is a hormone that acts in the calcium balance in the organism. The aim of our study was to investigate the effect of serum adjusted and ionized calcium on the development of uremic encephalopathy in patients with acute renal injury (acute kidney injury network (AKIN) stage 3). MATERIALS AND METHODS: Our study was supported by Canakkale Onsekiz Mart University Scientific Research Projects Unit (ID:1278). Three groups were formed for the study. The first group was acute renal failure AKIN stage 3 (N: 23), the second group was AKIN stage 3, and the patients who had emergency hemodialysis (N: 17) and the third group (N: 9) had AKIN stage 3 hemodialysis due to uremic encephalopathy. In these patient groups, 25-hydroxy vitamin D, PTH, calcium, albumin, urea, creatinine, and blood-gas-ionized calcium were observed in their serum during the first application. Calcium, albumin, urea, creatinine, and ionized calcium in blood gas were also examined in serum at 24th and 72th hours. Data were analyzed using SPSS version 19.0. Kruskal-Wallis test and Mann-Whitney U test were applied for the variables that did not comply with normal distribution. p < 0.005 was accepted statistically. RESULTS: A statistically significant difference was found between the measurement creatinine values at the 24th and 72th hours of admission in AKIN stage 3 patients who applied to the emergency department (p = 0.008). A statistically significant difference was found in the measured calcium values (p = 0.013). A statistically significant difference was found in the measured ionized calcium values (p = 0.035). CONCLUSIONS: In our study, the effect of ionized calcium level on uremic encephalopathy in serum creatinine, calcium, and blood gas in patients presenting with acute renal injury, AKIN stage 3, was significant, but studies with new and large groups are needed.

Quantitative Clinical Diagnostic Analysis of Acetone in Human Blood by HPLC: A Metabolomic Search for Acetone as Indicator.

Using high-performance liquid chromatography (HPLC) and 2,4-dinitrophenylhydrazine (2,4-DNPH) as a derivatizing reagent, an analytical method was developed for the quantitative determination of acetone in human blood. The determination was carried out at 365 nm using an ultraviolet-visible (UV-Vis) diode array detector (DAD). For acetone as its 2,4-dinitrophenylhydrazone derivative, a good separation was achieved with a ThermoAcclaim C18 column (15 cm × 4.6 mm × 3 µm) at retention time (t R) 12.10 min and flowrate of 1 mL min(-1) using a (methanol/acetonitrile) water elution gradient. The methodology is simple, rapid, sensitive, and of low cost, exhibits good reproducibility, and allows the analysis of acetone in biological fluids. A calibration curve was obtained for acetone using its standard solutions in acetonitrile. Quantitative analysis of acetone in human blood was successfully carried out using this calibration graph. The applied method was validated in parameters of linearity, limit of detection and quantification, accuracy, and precision. We also present acetone as a useful tool for the HPLC-based metabolomic investigation of endogenous metabolism and quantitative clinical diagnostic analysis.