Hypertension is common in renal transplant recipients (RTRs). Ambulatory blood pressure (BP) monitoring (ABPM) is important in diagnosing hypertension and diurnal BP variation. The authors set out to compare office BP and ABPM measurements to determine diurnal pattern and to evaluate echocardiographic findings in RTRs. ABPM and office BP measurements were compared in 87 RTRs. Echocardiographic evaluation was performed for each patient. The correlations between office and 24-hour ABPM were 0.275 for mean systolic BP (P=.011) and 0.260 for mean diastolic BP (P=.017). Only 36.8% had concordant hypertension between office BP and ABPM, with a masked hypertension rate of 16.1% and white-coat effect rate of 24.1%. Circadian BP patterns showed a higher proportion of nondippers (67.8%). Left ventricular mass index was increased in 21.8% of all recipients. There was a significant but weak correlation between office BP and ABPM. J Clin Hypertens (Greenwich). 2016;18:766-771. ª 2015 Wiley Periodicals, Inc.Hypertension (HTN) is a prevalent disorder in renal transplant recipients (RTRs) and is considered one of the major risk factors for the development of cardiovascular disease (CVD).1 CVD represents the single most frequent cause of death in RTRs, accounting for approximately 40% of all-cause mortality. 2Diagnosis of HTN has traditionally been based on measurements of blood pressure (BP) in the office or clinic. However, inadequate BP control may occur when office BP is used as the only method to monitor BP and drug adjustment.3 Ambulatory BP monitoring (ABPM) has recently gained popularity in more accurately diagnosing HTN and predicting outcome in hypertensive patients and those with chronic kidney disease.4 It has been shown that ABPM can predict left ventricular hypertrophy (LVH), mortality and morbidity, and progression toward end-stage renal disease better than BP in patients with CKD. 5,6 In addition to accurate BP measurement, one of the variables measured by ABPM is diurnal BP variation. However, the optimal method for monitoring BP in RTRs remains unclear.In our study, we compared office and ABPM measurements to determine the diurnal BP pattern and to assess the relationship between BP parameters and echocardiographic findings in RTRs. MATERIALS AND METHODS Study PatientsWe examined 498 consecutive adult RTRs (age ≥18 years) in whom the duration of transplantation was more than 1 year. The following exclusion criteria were used: history of diabetes mellitus, heart failure, ischemic heart disease, cardiomyopathy, or significant valvular heart disease; active infection; a serum creatinine level >1.5 mg/dL; or hemoglobin level <10 g/dL. Of the remaining 150 RTRs, 60 refused to participate in the study and three did not show up for the echocardiography appointment. Thus, 87 patients completed the study. Study ProtocolDemographic (age and sex) and clinical (etiology of previous renal disease, date of transplant, donor type, height, and weight) data and previous renal replacement therapy (type and duration) records were...

No abstract

Increased secretion of growth hormone and insulin-like growth factor-1 in acromegaly has various effects on multiple organs. However, the ocular effects of acromegaly have yet to be investigated in detail. The aim of the present study was to compare retina ganglion cell/inner plexiform layer (GCIPL) and peripapillary nerve fiber layer thickness (pRNFL) between patients with acromegaly and healthy control subjects using spectral domain optical coherence tomography (SD-OCT). This cross-sectional, comparative study included 18 patients with acromegaly and 20 control subjects. All participants underwent SD-OCT to measure pRNFL (in the seven peripapillary areas), GCIPL (in the nine ETDRS areas), and central macular thickness (CMT). Visual field (VF) examinations were performed using a Humphrey field analyzer in acromegalic patients. Measurements were compared between patients with acromegaly and control subjects. A total of 33 eyes of 18 patients with acromegaly and 40 eyes of 20 control subjects met the inclusion criteria of the present study. The overall calculated average pRNFL thickness was significantly lower in patients with acromegaly than in control subjects (P = 0.01), with pRNFL thickness significantly lower in the temporal superior and temporal inferior quadrants. Contrary to our expectations, pRNFL thickness in the nasal quadrant was similar between acromegalic and control subjects. The mean overall pRNFL thickness and superonasal, nasal, inferonasal, and inferotemporal quadrant pRNFL thicknesses were found to correlate with the mean deviation (MD) according to Spearman's correlation. However, other quadrants were not correlated with VF sensitivity. No significant difference in CMT values was observed (P = 0.6). GCIPL thickness was significantly lower in all quadrants of the inner and outer macula, except for central and inferior outer quadrants, in the acromegaly group than that in the control group (P< 0.05). GCIPL thicknesses of the inferior inner and outer macula quadrants were found to correlate with MD, whereas no correlation was observed between other quadrants and VF sensitivity. We demonstrated that GCIPL thickness decreased in patients with acromegaly compared with that in control subjects. However, the nasal quadrant pRNFL thickness was similar in acromegaly, in contrast to our expectations. SD-OCT may have utility in the assessment of the effects of acromegaly on retinal structures.

No abstract

Infections due to Chryseobacterium indologenes (C. indologenes) are rare and generally associated with immunosupression and indwelling catheters. We report a recurrent port infection caused by C. indologenes. In the first bacteremia episode we did not remove the port and only applied antibiotherapy. However, the patient presented with bacteremia with the same bacteria and successfully treated with antibiotherapy and removal of the port. Key Words: Chryseobacterium indologenes, Port infection ÖzetChryseobacterium indologenes ile enfeksiyon gelişimi nadirdir ve genellikle immün baskılanma ve kalıcı kateterler ile ilişkilidir. Bu yazı-mızda C. indologenes'e bağlı gelişen port enfeksiyonu sunmaktayız. İlk bakteremi atağında port çıkarılmadı ve sadece antibiyotik tedavisi verildi. Ancak, hasta aynı mikroorganizma ile yeni bir bakteremi atağı geçirdi ve portun çıkarılması ve uygun antibiyoterapi ile başarılı bir şekilde tedavi edildi.