ABSTRACT
Nowadays, it is considered that viral or bacterial infections can influence atherosclerosis development rate. One of them is infection by Chlamydia pneumoniae. The aim of the study was to assess the occurrence of anti-Chlamydia pneumoniae antibodies (AChPA) and their relationship with biochemical and clinical atherosclerosis risk factors in haemodialysed patients. There were 38 patients (24M, 14F) at the mean age 63.3 +/- 14.5 years, haemodialysed for 30.9 +/- 26.1 months. Previous Ch. Pneumoniae infection was assessed based on AchPA IgA and IgG concentrations determined using SIMPLE INDEX. The following risk factors for atherosclerosis were checked in the study group: total cholesterol. CRP and iPTH. AChPA indicative for Ch. pneumoniae infection in the past were detected in 28 patients (74%). The study group was divided into two subgroups; A- (n = 28 patients) with serological features of previous Ch. pneumoniae infection and B- (n = 10 patients) without serological features of Ch. pneumoniae infection. We found no statistical difference between the groups in the studied biochemical factors. We found no correlation between AChPA and other atherosclerosis risk factors. Our preliminary report does not confirm the prognostic value of AChPA presence as an atherosclerosis risk factor in haemodialysed patients.
Subject(s)
Antibodies, Bacterial/blood , Chlamydophila Infections/microbiology , Chlamydophila pneumoniae/immunology , Coronary Artery Disease/microbiology , Renal Dialysis , Adult , Aged , Chlamydophila Infections/complications , Chlamydophila Infections/immunology , Coronary Artery Disease/immunology , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunoglobulin A/blood , Immunoglobulin G/blood , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Male , Middle Aged , Risk FactorsABSTRACT
Failure of arteriovenous fistula (AVFf) still remains the "Achilles'heel" of chronic haemodialysis (HD) programme. Therefore, early, potentially non-invasive diagnosis and prompt surgical correction of AVFf are needed. For these purposes spiral computed tomographic angiography (SCTA) was used for evaluation of clinically suspected AVFf in 19 patients (10M/9F, aged 58.6 +/- 14.6 years, on HD for 34.4 +/- 29.3 months). SCTA was performed using Marconi MX8000 scanner covering whole AVF. After intravenous administration to the peripheral vein of the other leg of 100 ml of non-ionic lomeron 350 contrast (3 ml/s), axial CT images were obtained helically covering whole surface of AVF. Time delay was measured by Trigger function. Maximum Intensity Projections (MIP), 4D-Angio and virtual endoscopy (VE) techniques were used for reconstruction. MIP images demonstrated contrast-enhanced vascular structures and other high-density tissues (calcifications). VE enabled non-invasive simulation of endoscopic procedures and interactive intravascular navigation. Total number of 24 SCTA were performed. We found normal patency of AVF in 5 patients. In the remaining 14 subjects, the following abnormalities were found: stenosis of AVF at the site of anastomosis or in distal segment of efferent vein in 6 SCTA examinations, dilatation in 7 SCTA, acute or chronic thrombosis of AVF in 9 SCTA procedures including total occlusion of AVF in 2 cases. In 2 cases pseudoaneurysms of AVF were found. In 7 SCTA examinations more than one reason of AVFf was found. Photographs of every AVF complication are presented. We noted only one complication of SCTA-rupture of venous vessel on the opposite arm during contrast injection. There were no hypersensitivity reactions to the contrast.
Subject(s)
Arteriovenous Shunt, Surgical , Brachial Artery/diagnostic imaging , Radial Artery/diagnostic imaging , Renal Dialysis , Tomography, Spiral Computed , Adult , Aged , Female , Humans , Image Processing, Computer-Assisted , Kidney Failure, Chronic/diagnostic imaging , Kidney Failure, Chronic/therapy , Male , Middle Aged , Sensitivity and Specificity , Time Factors , Tomography, Spiral Computed/instrumentation , Tomography, Spiral Computed/methodsABSTRACT
On the basis of two cases of haemodialysed patients we present the usefulness of spiral computed tomography in the diagnosis of pseudoaneurysm as a complication of arteriovenous fistula for haemodialysis.
Subject(s)
Aneurysm, False/diagnostic imaging , Aneurysm, False/etiology , Arteriovenous Shunt, Surgical/adverse effects , Renal Dialysis/methods , Tomography, X-Ray Computed , Aged , Female , Humans , Kidney Failure, Chronic/therapy , Male , Sensitivity and SpecificityABSTRACT
Peritonitis complicating peritoneal dialysis (PD) may represent a difficult diagnostic and therapeutic problem if it coexists with surgical pathology of intra-abdominal organs defined as "abdominal catastrophe". The illustration of this problem is the case of 70-year-old patient treated with automated PD, in whom recurrent episodes of peritonitis (Escherichia coli) were typical of "abdominal catastrophe" and were probably caused by microperforations of the colon in the course of diverticulosis.
Subject(s)
Abdomen, Acute/etiology , Catastrophic Illness , Diverticulum, Colon/complications , Intestinal Perforation/complications , Peritoneal Dialysis/adverse effects , Peritonitis/etiology , Abdomen, Acute/microbiology , Aged , Escherichia coli , Female , Humans , Intestinal Perforation/etiology , Peritonitis/microbiology , RecurrenceABSTRACT
Haematuria present in 4% of adult population is not always connected with clinical symptoms. This article presents the current state of the art of using phase-contrast microscopy in examination of urinary sediment in differential diagnosis of haematuria.
