Leptin and bone mineral density in haemodialysis patients

<p><b>INTRODUCTION</b>There are very few data about relations between leptin and bone mineral density (BMD) in regular haemodialysed patients. We aimed to examine the relationship of serum leptin levels with BMD values in dialysed patients. We also assessed whether leptin is a significant predictor of BMD in haemodialysed patients.</p><p><b>MATERIALS AND METHODS</b>Leptin levels were studied using commercially available kits and BMD values were calculated using dual energy X-ray absorptiometry (DEXA) at femoral neck and distal radius in 74 (30 men and 44 women ) haemodialysis patients.</p><p><b>RESULTS</b>BMD values at the femoral neck and distal radius did not differ significantly between the 2 genders. BMD at the distal radius correlated positively with bone alkaline phosphatase (BAP) (r = 0.503, P = 0.005) in male patients and correlated positively with phosphorus (r = 0.343, P = 0.02) in female patients. The time ondialysis treatment was longer in men (59 +/- 48 vs 44 +/- 41) but the difference was not statistically significant. Leptin levels were negatively correlated with BMD at the distal radius (r = -0.250 and P = 0.03) in all patients. Serum leptin levels were also correlated with body mass index (BMI) in all the patients (r = 0.749 and P = 0.001) and in both genders (r = 0.653 and P = 0.001 in women, r = 0.704 and P = 0.001 in men). In multivariate regression analysis, it was found that leptin level was not an independent determinant of BMD at all skeleton sites measured.</p><p><b>CONCLUSIONS</b>There was significant difference between the 2 genders with reference to leptin levels, BMI, phosphorus and creatinine. Serum leptin levels are not significant predictors of BMD in the current study.</p>

Emergency room cases of mushroom poisoning

To describe the pattern of mushroom poisoning in adults. We investigated patients presenting at the Emergency Room, Medical School Hospital, Cumhuriyet University, Turkey between 1999 and 2003 with complaints of mushroom poisoning. They were kept under observation in the emergency unit and Anesthesia Department intensive care unit. We evaluated the demographical features of the patients, laboratory data, vital signs, and applied treatment and results. Seventy-eight patients aged between 19-72 [40.27 +/- 16.09] were studied, 52 were females [67%], and 26 were males [33%]. It was established that 90% [70] of the patients had picked wild mushrooms, and 67.9% [53] had done so in springtime. Methods of cooking were as follows: 30 patients [38.4%] grilled the mushrooms, 28 patients [35.8%] stir fried, and 20 patients [25.6%] consumed mushrooms uncooked. Onset of symptoms was mostly [43.5%] within the first hour of consumption. The most common [42.3%] symptoms were gastrointestinal complaints. Upon examining laboratory results, 17.9% revealed variations in hematological parameters, impairment in renal functions in 6 patients [7.6%], hematuria in 10 patients [12.8%] and 15.3% had primarily elevated liver enzymes. Seventy-four patients [97%] completely recovered and were discharged. However, 2 patients [2.8%] who consumed raw mushrooms died due to acute hepatic failure. There was a 20-year-old patient at week 31 of her first pregnancy who had consumed uncooked wild mushrooms. She developed gastrointestinal symptoms and mild loss of consciousness within the first half hour. She received quadruple therapy and completely recovered. The results of the study indicated that the public, as well as the cultivators, were rather unconcerned and uneducated regarding this issue. Efforts aimed at overcoming this problem will decrease the number of mushroom poisoning cases, will help to save on treatment costs, and more importantly, reduce patient mortality