Carotid intima-media thickness in maintenance hemodialysis patients: role of cardiovascular risk factor.

INTRODUCTION: Carotid intima-media thickness (CIMT) has been introduced as a cardiovascular disease predictor which may increase in hamodialysis patients. As there are many risk factors in the uremic state that theoretically lead to increase in CIMT, this study was aimed to determine risk factors of CIMT increase in a group of hemodialysis patients. MATERIALS AND METHODS: Seventy-two hemodialysis patients with a mean age of 61.3 ± 15.0 years and 49 individuals with no history of chronic disease (control group) underwent ultrasonography for measurement of CIMT. Correlation of demographic, clinical, and laboratory factors with CIMT was studied. Carotid intima-media thickness was measured by one radiologist in the bilateral common carotid artery, and the mean value of the two sides was reported. RESULTS: The mean duration on dialysis was 82.4 ± 78.0 months. The mean CIMT was 0.96 ± 0.25 mm (range, 0.4 to 1.7 mm) in hemodialysis patients and 0.76 ± 0.06 mm (range, 0.58 to 0.91 mm) in the control group (P < .001). The mean CIMT was significantly higher in men compared to women on dialysis and in diabetic compared to nondiabetics patients. There was a positive correlation between CIMT and age (r = 0.266, P = .02) and serum cholesterol (r = 0.375, P = .002). No correlation was found between CIMT and other studied variables. CONCLUSIONS: Carotid intima-media thickness was greater in hemodialysis patients compared to the control group. It was mainly affected by traditional cardiovascular risk factors and uremic risk factors did not specifically affect CIMT.

Value of ultrasound-guided irrigation and drainage of refractory pyocysts in ADPKD.

BACKGROUND: Cyst infections is not common in the patients with autosomal dominant polycystic kidney disease (ADPKD) however it may pose major problems to the clinicians because the diagnosis is hampered by lack of reliable imaging techniques for identification of the infected cysts and treatment may be difficult due to poor penetration of antibiotics into the cysts. CASE PRESENTATION: We present a case of ADPKD and intractable pyocysts that did not respond to standard antibiotic therapy but successfully treated by using ultrasound-guided cyst puncture, and repeated irrigation and drainage. CONCLUSION: Where the experienced interventional radiologists are available, this method can rescue these patients from nephrectomy.

Hydatid cyst of the parotid gland.

Primary hydatid cyst of the parotid gland is extremely rare, even in the endemic areas. A 23-year-old woman presented with slowly progressive swelling in the right periauricular region. Computed tomography (CT) scan of the head and neck revealed a round, well-demarcated water-density mass in the right parotid gland. At the operation, the cystic mass replacing most of the superficial part of right parotid gland was demonstrated. Superficial parotidectomy was carried out. Histopathological examination confirmed the diagnosis of hydatid disease. CT scan is a valuable imaging method for diagnosis of parotid cystic lesions; however, other acquired and congenital cystic lesions of parotid gland may have similar appearance and should be differentiated. Where the incidence of the disease is high, hydatid cyst of parotid gland should be considered in the differential diagnosis of lesions causing swelling of the parotid area.

Hydatidosis of the pelvic cavity: a big masquerade.

We report and discuss a case of primary hydatidosis of the pelvic cavity in a woman who presented with severe weight loss and abdominal pain. This unusual presentation was initially considered as a tumor process until surgical exploration and microscopic studies confirmed the diagnosis. The gynecologists should be aware of possibility of primary hydatid cyst of the pelvic cavity and should be considered in the differential diagnosis of cystic pelvic masses, especially in areas where the disease is endemic.

Liver: an alarm for the heart?

BACKGROUND/AIMS: Fatty liver (FL) and coronary artery disease (CAD) have several risk factors in common, which are usually considered to account for their frequent coexistence. The independent association between FL and angiographic CAD was assessed in this case-control study by considering the contribution of their shared risk factors. METHODS: Three hundred and seventeen adult patients who underwent elective coronary angiography (CAG) were recruited immediately after CAG and classified into either of the two groups A (normal or mildly abnormal CAG; n=85) or B (clinically relevant CAD; n=232). A liver sonography was performed on the same day as CAG. RESULTS: The groups were significantly different in terms of gender, fasting blood glucose, low-density lipoproteins, diabetes (DM), hypertension and FL. In binary logistic regression, FL was the strongest independent predictor of CAD [P<0.001, odds ratio (OR)=8.48%, 95% confidence interval (CI)=4.39-16.40], followed by DM (P=0.002, OR=2.94) and male gender (P=0.014, OR=2.31). This pattern of associations did not change after clinically significant variables (waist-to-hip ratio, body mass index, triglycerides and high-density lipoproteins) were added to analysis. CONCLUSION: Fatty liver seems to be a strong independent alarm for the presence of significant CAD.