The evaluation of MTA and Biodentine as a pulpotomy materials for carious exposures in primary teeth

Clinical Oral Investigations - This study examined the effects of MTA and Biodentine on the clinical and radiographic success rates of pulpotomies performed on primary teeth with carious pulp...     

Renal sarcoidosis with normal serum vitamin D and refractory hypercalcemia

Introduction

Sarcoidosis is a multi-system disorder characterized by non-caseating epithelioid granulomas in multiple organs. Renal involvement may usually occur as granulomatous interstitial nephritis, but renal failure is uncommon. We report a case of renal-limited sarcoidosis diagnosed by renal biopsy, associated with abnormal calcium metabolism.

Case presentation

A 30-year-old Caucasian male presented with unexplained renal function impairment and hypercalcemia. The patient did not have any history of kidney disease, cough, skin rash, dysuria, hematuria or any other symptoms. Physical examination was unremarkable. Serum creatinine was 2.2 mg/dl and serum calcium was 11.5 mg/dl. Serum intact parathyroid hormone level (12 pg/mL) was decreased. Serum angiotensin-converting enzyme (ACE), 1,25-dihydroxyvitamin D (1,alpha-25 vit D) and pre-proparathyroid hormone (PTHrP) levels and urinary calcium excretion were all in normal range. The renal biopsy showed severe interstitial nephritis with non-caseating granuloma. The patient was treated with prednisone with starting dose of 1 mg/kg. After 2 months of prednisone therapy, serum creatinine decreased. However, because of continued of hypercalcemia unresponsive to low calcium diet and prednisone, chloroquine was prescribed. Six months after the onset, the patient's serum creatinine is stable at 1.30 mg/dl, serum calcium is 10.8 mg/dl, and serum ACE and 1,alpha-25 vit D levels are in normal range. He does not have any signs of extra-renal relapse.

Conclusion

The mechanisms of abnormal calcium metabolism in this patient with renal-limited sarcoidosis are unclear.     

Simple Renal Cyst Prevalence in Internal Medicine Department and Concomitant Diseases

A total of 684 patients who had not been diagnosed with renal cyst but had undergone abdominal ultrasonography for various reasons were evaluated. Patients with and without renal cyst were classified into two groups and were compared in terms of hypertension (HT), hyperlipidemia (HL), diabetes mellitus (DM) and obesity (body mass index: ≥30 kg/m²) prevalence. Although 94 patients (13.7%) were established with a renal cyst, 590 patients (86.3%) did not have a renal cyst. The mean age of the patients established with a simple renal cyst was 67.3 ± 12.1 years (range: 28–82 years); 54 (57.4%) of them were women and 40 (42.6%) were men. Of the patients established with a simple renal cyst, 64 (68.1%) had HT, 40 (42.6%) had DM, 20 (21.3%) had HL, 42 (44.7%) were obese, 18 (19.1%) had nephrolithiasis, and 6 (6.4%) had urinary tract infection. Of the patients without a cyst, 272 (46.1%) had DM, 212 (35.9%) had HT, 122 (20.7%) had HL, and 96 (16.3%) were obese. HT and obesity were significantly higher in patients with a renal cyst when compared with those without a cyst. However, although HL incidence was higher in patients with a cyst, the difference was not significant statistically. HT, HL, and obesity are more prevalent in patients with a renal cyst when compared with patients without. Consequently, patients with a simple renal cyst should be evaluated and followed up in terms of atherosclerotic risk factors.     

Waist circumference is associated with carotid intima media thickness in peritoneal dialysis patients

Purpose

Atherosclerosis is responsible for the high mortality rate in end-stage renal disease patients. Defining risk factors for atherosclerosis may lead to reduction in cardiovascular disease through modification of these factors. Peritoneal dialysis (PD) patients are subjected to high glucose loads on a daily basis, which results in considerable weight gain and an increase in waist circumference (WC). WC as an indicator of abdominal obesity is a risk factor for atherosclerosis in the general population. Carotid artery intima media thickness (CIMT) measurement is a reliable method for the detection of early atherosclerosis. The aim of this study was to investigate the relationship between WC and CIMT and to define risk factors associated with CIMT in PD patients.

Methods

Fifty-five PD patients and 40 healthy controls were included. Atherosclerosis was assessed using measurement of CIMT. Fasting blood was collected for analysis. Anthropometric parameters (age, weight, BMI, and WC) were measured.

Results

Peritoneal dialysis patients had higher WC (93.9 ± 1.7 vs. 87.3 ± 1.2 cm, p < 0.05) and CIMT (0.70 ± 0.02 vs. 0.57 ± 0.01 mm, p < 0.01) than the control group. On univariate analysis, age, WC, plaque formation, and D/P creatinine were positively correlated with CIMT, whereas residual renal function, albumin, ultrafiltration volume, and D/D0 glucose were negatively correlated. On multivariate analysis, only age, WC, and plaque formation showed correlation (p < 0.001).

Conclusions

Carotid artery intima media thickness is associated with age, plaque formation, and WC in PD patients. WC measurement is a simple, inexpensive, reproducible, and reliable method of evaluating atherosclerosis risk in PD patients and should be assessed at every visit. Appropriate counsel should be provided to patients with greater WC who are deemed to be at risk for atherosclerosis.     

Association of cholesterol 7α-hydroxylase (CYP7A1) promoter polymorphism (rs3808607) and cholesterol 24S-hydroxylase (CYP46A1) intron 2 polymorphism (rs754203) with serum lipids,vitamin D levels,and multiple sclerosis risk in the Turkish population

Neurological Sciences - Patients with multiple sclerosis (MS) have significantly lower vitamin D levels. Cholesterol is known to be the precursor for vitamin D synthesis, and cholesterol removal is...