Biomedical subjects

N Aksu

Publications and source records attributed to N Aksu.

4 recordsLinked to original sources

PubMed1998

Does immunologic status predict peritonitis in children treated with CAPD?

The purpose of this study was to evaluate whether immunologic status could predict the development of peritonitis in children on continuous ambulatory peritoneal dialysis (CAPD). Twenty-one patients (12 boys, 9 girls) aged 10.1 +/- 4.32 years (range: 23 months to 14 years) were studied. The mean duration of CAPD treatment was 12.88 +/- 6.69 months (range: 2-22 months). Twelve healthy children (mean age 11.5 years) were selected as a control group. Lymphocyte subpopulations (CD3, CD4, CD8, CD19, NK, and IL-2R) were determined by double-color flow cytometry (Becton-Dickinson). Statistical evaluation was made by Student's t-test. CD4 (38.4 +/- 7.1% vs. 28.0 +/- 5.4%), CD4/CD8 ratio (1.30 +/- 0.4 vs. 0.96 +/- 0.3), and B lymphocyte (19.9 +/- 8.9% vs. 12.0 +/- 3.2%) levels were significantly higher in CAPD patients compared with controls. CAPD patients showed significantly lower natural killer (NK) cell values than controls (12.7 +/- 7.0% vs. 27.3 +/- 8.3%). Apart from CD19 values (21.9 +/- 10.4% vs. 12.0 +/- 3.2%) there were no significant differences between CAPD patients without infection and the control group in the laboratory parameters studied. On the other hand, CD3 (66.3 +/- 7.9% vs. 55.9 +/- 9.7%), CD4 (38.4 +/- 7.1% vs. 28.0 +/- 5.4%), and CD19 (6.3 +/- 3.3% vs. 12.0 +/- 3.2%) levels were significantly higher in CAPD patients with infection compared with the controls. CAPD patients with infection showed significantly lower NK activity (12.7 +/- 7.1% vs. 27.3 +/- 8.3%) than those in the control group. In conclusion, these results can explain the increased vulnerability to peritonitis in CAPD patients compared with healthy subjects. Additionally, immunologic status can predict the development of peritonitis in children treated with CAPD.

Adolescent↗

PubMed1998

Echocardiographic evaluation in children treated with CAPD.

The aim of this study was to evaluate systolic and diastolic cardiac functions in children treated with continuous ambulatory peritoneal dialysis (CAPD). This study included a total of 21 patients (12 boys, 9 girls), aged 23 months to 14 years (average age: 10.1 +/- 4.32 years). The mean duration on CAPD was 12.88 +/- 6.69 months (range: 2-22 months). Twenty age- and sex-matched healthy subjects served as controls. Evaluation was made at the beginning of CAPD treatment in these 21 patients. Tests were repeated in 9 of 21 patients who had completed a 1-year follow-up period. We measured systolic functions [ejection fraction (EF), and fractional shortening (FS)], and diastolic functions [early (E) and late (A) diastolic peak inflow velocities, and E/A ratio, as well as early diastolic flow deceleration velocity (EF slope) and time (dt) functions] using two-dimensional, M-mode, color Doppler echocardiography. Interventricular septum thickness was also recorded. Blood pressure (BP) levels were monitored serially in all patients. Statistical evaluation was made using Student's t-test. Compared with control subjects, systolic and diastolic parameters were significantly inversely affected in patients on CAPD (P < 0.05). The mean BP levels did not differ significantly between CAPD patients and controls. In 9 patients with a second measurement on CAPD, systolic and diastolic cardiac functions tended to have deteriorated. However, these changes were not statistically significant (P > 0.05). In conclusion, CAPD is the preferable option in children with end-stage renal disease to maintain stable cardiac functions. However, systolic and diastolic dysfunctions tend to progress in children on CAPD.

Adolescent↗

PubMedDate not supplied

Surgical treatment of pulmonary arteriovenous malformation: report of two cases and review of the literature.

Pulmonary arteriovenous malformations (PAVMs) are rare anomalies. The degree of right-to-left shunting, which can lead to cyanosis and paradoxical embolism causing neurological complications, determines the prognosis. We report two cases of PAVM and review the literature. A 45-year-old woman with clinical signs and symptoms of PAVM was examined using several different scanning techniques, which showed a large PAVM in the lower lobe of her right lung. A lobectomy was performed, which revealed a 5 cm diameter PAVM with one feeding artery and multiple veins. Intravenous angiography of a 7-year-old girl with symptoms of fatigue and acro-cyanosis confirmed the presence of a large PAVM in her right lower lobe. The PAVM had two major arteries arising from the aorta, which were ligated during a lobectomy. Both patients recovered well following surgery. Although PAVMs are rare, their neurological and haemodynamic consequences may be fatal. Interventional treatment techniques, including surgery, are usually curative.

Angiography↗

PubMedDate not supplied

Cyclosporin A plus prednisone treatment of steroid-sensitive frequently relapsing nephrotic syndrome in children.

Recently, there have been numerous reports on the use of cyclosporin A (CyA) in children with nephrotic syndrome (NS). In this prospective study, we wanted to evaluate the efficacy of CyA together with prednisone therapy in children with steroid-sensitive frequently relapsing NS. A total of 11 children (7 boys, 4 girls) with steroid-sensitive NS were included in this study. The patients ranged in age from 3.5 to 15 years (average 8.45 +/- 4.26 years). Renal biopsy showed minimal change disease in five, mesangial proliferation in four, focal glomerulosclerosis in one and membranous glomerulonephritis in one. The NS had lasted from 13 to 113 months (average 50.27 +/- 38.60 months). The number of relapses varied from three to 10 episodes with an average of 5.9 +/- 3.3 episodes. Patients received 5 mg/kg CyA daily in two divided doses for five months and prednisone for a total of eight weeks (30 mg/m2 daily for 4 weeks followed by 30 mg/m2 on alternate days for 4 weeks). After the completion of the treatment protocol, no therapy was given unless a relapse was observed. Mean follow-up period was 14.9 +/- 5.99 months with a range from six to 26 months. Before this combined treatment, there was a mean relapse rate of 0.144 +/- 0.05 relapses month with a range from 0.088 to 0.238. After discontinuation of therapy, the relapse rate dropped to a mean of 0.0179 +/- 0.031 with a range of 0 to 0.083. In conclusion, it would appear that a combination of CyA and prednisone is effective, sustaining the remission in steroid-sensitive NS. Corticosteroids in combination with CyA may be a better approach than conventional steroid treatment in such patients.

Adolescent↗