Comparison of homologous and heterologous inactivated and mRNA vaccination programme against SARS-CoV-2 in dialysis patients.

AIM: To evaluate the vaccine response and the effect of the booster dose on COVID-19 positivity in haemodialysis (HD) and peritoneal dialysis (PD) patients who received and did not receive BNT162b2 as a booster dose after two doses of CoronaVac. METHODS: The study included 80 PD and 163 HD patients, who had been administered two doses of the CoronaVac. Antibody levels were measured on Days 42 and 90 after the first dose. Measurements were repeated on Day 181 after the first dose in the patients that received two vaccine doses and on Day 28 after the third dose in those that also received the booster dose. Antibody levels below 50 AU/mL were considered negative. RESULTS: The seropositivity rate was similar in the HD and PD group on Days 42 and 90 (p = 0.212 and 0.720). All patients were seropositive in the booster group. The antibody level was lower in the patients that received CoronaVac as the booster compared to those administered BNT162b2 in HD and PD groups (p < 0.001 and 0.002). COVID-19 positivity was detected in 11 patients (7 = had not received the booster dose, 4 = had received third dose of CoronaVac). The multivariate analysis revealed that as age increased, COVID-19 positivity also increased (OR: 1.080, 95% CI: 1.017 - 1.146, p = 0.012), while booster dose administration decreased this positivity (OR: 0.113, 95% CI: 0.028 - 0.457, p = 0.002). CONCLUSION: Our results may indicate the need for additional vaccination doses in patients with HD and PD. Our findings indicate a higher antibody response in dialysis patients with heterologous BNT162b2 as a booster dose after two doses of CoronaVac compared to homologous CoronaVac.

Relationship between the prognostic nutritional index and resistant hypertension in patients with essential hypertension.

OBJECTIVES: Immune system activation plays a role in resistant hypertension (RHTN) pathogenesis. The clinical effect of the prognostic nutritional index (PNI) on patients with RHTN remains unclear. The aim of this study investigated the possible correlation between PNI and RHTN. METHODS: In this cross-sectional study, we enrolled 180 adult subjects. In patients were classified into three groups according to their office and ambulatory blood pressure measurements (ABPM): RHTN (n = 60), controlled hypertension (CHTN, n = 60), and normotension-control (NT-C, n = 60). RHTN was defined as BP ≥140/90 mm Hg while taking ≥3 antihypertensive medications or BP <140/90 mm Hg while taking ≥4 medications. The PNI was calculated from the 10 x serum albumin (g/dL) + 0.005 x total lymphocyte count (/µL) formula. RESULTS: Office and ABPM were significantly higher in patients with RHTN. Patients in the RHTN (46.1 ± 5.3) had significantly lower PNI than that in the CHTN (54.9 ± 6.7) (P = .032), and PNIs of both hypertensive groups were significantly lower than the NT-C group (P = .019, for both). The ROC curve analysis performed to assess the predictive value of PNI for RHTN and using 50.9 optimal cutoff value of PNI for RHTN gave a sensitivity of 77% and a specificity of 68.5% (AUC = 0.73, 95% CI 0.69-0.96).Multivariate analysis indicated diabetes, 24-h ABPM SBP, CRP, pill burden, and PNI (<51.6) as independent predictors of RHTN. CONCLUSION: This study showed that the level of PNI was significantly lower in patients with RHTN compared to patients with CHTN. PNI is independently related to RHTN.

Frequency of masked hypertension in patients with nonfunctioning adrenal incidentalomas with normal and high normal blood pressure.

OBJECTIVES: Nonfunctioning adrenal incidentalomas (NFAIs) are associated with increased cardiovascular risk, but the frequency of masked hypertension (MH) is uncertain in these patients. This study aimed to evaluate the prevalence of MH by ambulatory blood pressure monitoring in patients with NFAIs. METHODS: The study included a total of 85 individuals: 43 patients with NFAIs and 42 controls of similar age, gender, BMI, smoking, and diabetes. The office BP and ABPM parameters of the NFAI and controls were measured. Biochemical, hormonal, and radiological data were obtained retrospectively in the NFAI group. RESULTS: There were no statistically significant difference between the NFAI and control groups in relation to the office SBP (134.4 ± 37.2 mmHg vs 133.1 ± 35.8 mmHg, p = 0.273) and office DBP (87.4 ± 14.5 mmHg vs 86.8 ± 13.7 mmHg, p = 0.318). Besides, normal (28% vs 28.6%, p = 0.176) and high normal blood pressure (72% vs 71.4%, p = 0.332) rates were similar. The prevalence of MH was significantly higher in patients with NFAI than in controls (25.5% vs 9.5%, p = 0.037). MH was significantly associated with diabetes odds ratio (OR) = 2.07, p = 0.044, office SBP (OR = 1.41, p = 0.046), smoking (OR = 1.46, p = 0.031), BMI (OR = 1.17, p = 0.037), and morning cortisol (OR = 1.21, p = 0.039). CONCLUSION: The prevalence of MH in the NFAI patient's was higher than in the control group. Patients with NFAI with high normal blood pressure should be evaluated for MH.

Familial mediterranean fever and immunoglobulin A nephropathy: A case report and review of the literature.

Familial Mediterranean fever (FMF) is an autosomal recessive disease charac-terized by recurrent fever episodes and polyserositis. The most important complication is amyloidosis. Nonamyloidotic nephropathy in FMF is poorly documented. Besides amyloidosis, different types of glomerulonephritis may rarely be seen in FMF patients. A 24-year-old male patient followed up due to FMF was evaluated for macroscopic hematuria and acute kidney injury. The patient was diagnosed as immunoglobulin A nephropathy with renal biopsy. The patient gave a good response to colchicine and steroid treatment. The case reports in the literature about the treatment of the patients with association of FMF and glomerulonephritis are insufficient, and there are no satisfactory epidemiological and treatment outcome reports.

Thiocolchicoside associated with epileptic seizures in a chronic hemodialysis patient.

Thiocolchicoside (TCC) is a widely used centrally acting muscle relaxant. Epileptic seizures from the use of TCC are rarely reported. A 67-year-old male patient with endstage renal disease that was caused by hypertension was on maintenance hemodialysis (HD) for 22 months. He had taken TCC 8 mg capsules twice daily for four days due to painful myofascial spasm in neck and face muscles. At the end of the HD session, he had generalized tonic-clonic seizures. Epileptic seizures were brought under control with sodium valproate, and no recurrence of epileptic seizures was observed.

Prognostic factors in head and neck mucosal malignant melanoma.

OBJECTIVE: Primary mucosal malignant melanoma of the head and neck (HN-PMMM) is an aggressive and uncommon neoplasm. Herein, we present a series of 33 patients and the results of treatment, and aimed to determine prognostic factors in HN-PMMM. METHODS: Patients who were diagnosed as having HN-PMMM in our reference hospital, between 2005 and 2014 were evaluated. Thirty-three of these patients who had follow-up data were included. Surgical margin status was extracted from the original pathology reports. Archived materials were retrieved for the histopathologic findings: ulceration, necrosis, lymphovascular invasion, perineural invasion, pigmentation, and presence of an in situ component. Mitotic activity was evaluated using phosphohistone H3 (PHH3) immunohistochemical staining. RESULTS: We found an association of PHH3 mitotic activity with overall survival in a univariate analysis and to our knowledge, this is the first report among the available case series of HN-PMMM to evaluate mitotic activity using immunohistochemical staining. We also investigated the relationship between multicentricity and locoregional recurrence, which the authors believe is also a first. CONCLUSION: PHH3 mitotic activity can be used a prognostic factor for head and neck mucosal malignant melanoma.

A rare retrovesical hydatid cyst and value of transrectal ultrasonography in diagnosis: a case report and review of the literature.

We present a large hydatid cyst located midline and posterior to prostatic gland and seminal vesicles in an asymptomatic patient. Computed tomography (CT) scan revealed a large retrovesical mass and the transrectal ultrasonography idetified a degenerated hydatid cyst with "ball of wool'' appearance. Although extremely rare, hydatid disease should be kept in mind in the differential diagnosis of pelvic particularly retrovesical midline masses.