Türkiye Romatizma Araştırma ve Savaş Derneği ankilozan spondilit ulusal tedavi önerileri

Objectives: To develop Turkish League Against Rheumatism (TLAR) National Recommendations for the management of ankylosing spondylitis (AS). Materials and methods: A scientific committee of 25 experts consisting of six rheumatologists and 19 physical medicine and rehabilitation specialists was formed by TLAR. Recommendations were based on the 2006 ASsessment in Ankylosing Spondylitis International Working Group(ASAS)/European League Against Rheumatism (EULAR) recommendations and a systematic review of associated publications between January 2005 and September 2010. A Delphi process was used to develop the recommendations. Twelve major recommendations were constructed for the management of AS. Voting using a numerical rating scale assessed the strength of each recommendation. Results: The 12 recommendations include patient assessment, patient follow-up along with pharmacological and non-pharmacological methods. Some minor additions and changes have been made to the ASAS/EULAR recommendations. All of the recommendations had sufficient strength. Conclusion: National recommendations for the management of AS were developed based on scientific evidence and consensus expert opinion. These recommendations will be updated regularly in accordance with recent developments.Türkiye Romatizma Araştırma ve Savaş Derneği᾽nin (TRASD) Ankilozan Spondilit (AS) için ulusal tedavi önerilerinin oluşturulmasıdır. Gereç ve yöntemler: TRASD tarafından altı Romatoloji ve 19 Fiziksel Tıp ve Rehabilitasyon uzmanı olmak üzere toplam 25 kişiden oluşan bir bilimsel kurul oluşturuldu. Önerilerde 2006 yılında yayınlanan Ankilozan Spondilit Değerlendirme Uluslararası Çalışma Grubu (ASAS)/Romatizmaya karşı Avrupa Ligi (EULAR) önerileri ve Ocak 2005 - Eylül 2010 arasında yayınlanmış olan ilişkili yayınlar konusundaki sistematik bir inceleme temel alındı. Öneriler oluşturulurken Delphi süreci kullanıldı. Ankilozan spondilit tedavisi ile ilgili 12 ana öneri oluşturuldu. Oylama yapılarak önerilerin güçlülük düzeyi bir nümerik derecelendirme skalası ile belirlendi. Bulgular: On iki öneri hasta değerlendirilmesini, hasta takibini ve farmakolojik ve non-farmakolojik yöntemleri içermektedir. ASAS/EULAR önerilerine bazı ilaveler ve önerilerde bazı küçük değişiklikler yapılmıştır. Tüm öneriler yeterli kuvvete sahipti. Sonuç: Bilimsel kanıtlar ve uzmanların görüş birliği ile AS tedavisine yönelik ulusal öneriler oluşturulmuştur. Bu öneriler, yeni gelişmeler doğrultusunda düzenli olarak güncellenmelidi

Hızlı Periton Eşitleme Testi İle Standart Periton Eşitleme Testi Uygulamalarının Karşılaştırılması

Amaç: Hızlı Periton Eşitleme Testi (PET) ve Standart PET uygulamalarının periton zarıgeçirgenliğine etkisini belirlemektir.Metot: Deneysel nitelikte tasarlanan bu çalışma İstanbul’da periton diyaliz (PD) ünitesi olaniki farklı hastanede 30 periton diyaliz hastası ile çaprazlama yöntemi kullanılarakgerçekleştirildi Birinci gruba (n=15) ilk hafta Hızlı PET, ikinci hafta Standart PETuygulaması; ikinci gruba (n=15) ise önce Standart PET, takiben Hızlı PET uygulamasıyapıldı. Veriler Hasta Tanılama Formu, PET Kayıt Formu kullanılarak elde edildi. Peritongeçirgenliğinin değerlendirilmesinde PD Adequest (Baxter Healthcare, Deerfield, USA) veçalışmanın istatistiksel analizinde SPSS 17.0 bilgisayar programları kullanıldı. Verilertanımlayıcı istatistikler ve non-parametrik testler ile analiz edildi.Bulgular: Hastaların periton geçirgenlik özelliğinin her iki test yönteminde de benzer olduğutespit edildi ve hastaların bir sonraki PET tercihlerinin Hızlı PET olduğu saptandı.Sonuç: Hızlı PET periton geçirgenliğini değerlendirme kullanılabilir

ASSESSMENT OF SATISFACTION IN PERITONEAL EQUILIBRATION TEST: A STUDY ON THE VALIDITY AND RELIABILITY OF THE PERITONEAL EQUILIBRATION SATISFACTION SCALE

Aim: This study has been designed to develop an assessment tool to be used in determining the patients' satisfaction level with the peritoneal equilibration test (PET) procedure. Materials and Methods: The development and validation of the peritoneal equilibration test Satisfaction Scale (PETSS) was completed in two phases. Phase I focused on instrument construction and included item development and establishment of concurrent validity. Phase II included the factor analysis and psychometric assessment of the scale. In statistical evaluation of the data descriptive statistics and non-paratmetric tests were used. Results: The first version of the scale that has 3.62 Content Validity Index value was composed of 20 items. It was found that the latest version of the scale that has 14 items explained 46% of the variance. It was found that the Cronbach alfa value of this scale, which has 0.52-0.89 coefficient of item-total correlation was 0.96. Psychometric assessment of the scale revealed that except for type of the PET application, none of the demographic and clinical characteristics effect patients level of satisfaction during the PET application. Conclusion: This preliminary study showed that PETSS was a valid and reliable scale that can be used for determining satisfaction level of patients during PET application

MO919: Persistence of Antibodies After SARS-COV-2 Vaccines in Haemodialysis Patients: A 6 Months Follow-Up

Abstract BACKGROUND AND AIMS As COVID-19 related mortality is higher in haemodialysis patients than in the general population, proper vaccination strategies against the SARS-CoV-2 virus have utmost importance. It has been previously shown that mRNA vaccines (e.g. BNT162b2) can generate &amp;gt;95% of seropositivity in haemodialysis patients [1]. On the other hand, the seropositivity rate reached by the inactivated vaccine (CoronaVac®) was around 80%. In this study, we aimed to analyse the persistence of SARS-CoV-2 antibodies in haemodialysis patients for 6 months and compare it with the healthy controls. METHOD Haemodialysis patients who were vaccinated either by BNT162b2 or CoronaVac® and who continued their regular controls for 6 months were involved in the study. Those who had previous or active SARS-CoV-2 infection, who had malignancies and those who had received immunosuppressive drugs in the previous 12 month were excluded from the study. SARS-CoV-2 IgG levels were measured by a commercial test after the first doses of the vaccines and at the end of the sixth month. Healthy healthcare workers who were vaccinated with similar vaccine schemes were taken as the control group. RESULTS We recruited 85 haemodialysis patients who had received their first doses of either vaccine. Of them, 4 patients died; 3 patients were hospitalized because of COVID-19 infection during the follow-up; 9 patients missed at least one of their regular controls; and 2 patients were diagnosed with malignancy. A total of 26 patients experienced asymptomatic or mild COVID-19 infection during the follow-up period. SARS-CoV-2 IgG levels were measured at the end of the sixth month for the remaining 41 patients. Sero-positivity significantly decreased at the end of the sixth month for both vaccines, but the BNT162b2 group (n = 22) still had better seropositivity than CoronaVac® (n = 19) group (81% versus 50%; P = .03). In contrast, the seropositivity of healthy controls, even with the inactivated vaccine, was 96%. When one booster dose was applied, 90% of seropositivity could be maintained in the BNT162b2 group at the sixth month. CONCLUSION BNT162b2 vaccine generates more persistent antibodies than inactivated vaccines in haemodialysis patients. However, when compared with the healthy controls at the end of the sixth month, antibody titers decrease more profoundly in haemodialysis patients. The booster dose can maintain the antibody levels and should be applied at least every 6 months. </jats:sec

PERSISTENCE OF ANTIBODIES AFTER SARS-COV-2 VACCINES IN HAEMODIALYSIS PATIENTS: A 6 MONTHS FOLLOW-UP

BACKGROUND AND AIMS: As COVID-19 related mortality is higher in haemodialysis patients than in the general population, proper vaccination strategies against the SARS-CoV-2 virus have utmost importance. It has been previously shown that mRNA vaccines (e.g. BNT162b2) can generate >95% of seropositivity in haemodialysis patients [1]. On the other hand, the seropositivity rate reached by the inactivated vaccine (CoronaVac®) was around 80%. In this study, we aimed to analyse the persistence of SARS-CoV-2 antibodies in haemodialysis patients for 6 months and compare it with the healthy controls. METHOD: Haemodialysis patients who were vaccinated either by BNT162b2 or CoronaVac® and who continued their regular controls for 6 months were involved in the study. Those who had previous or active SARS-CoV-2 infection, who had malignancies and those who had received immunosuppressive drugs in the previous 12 month were excluded from the study. SARS-CoV-2 IgG levels were measured by a commercial test after the first doses of the vaccines and at the end of the sixth month. Healthy healthcare workers who were vaccinated with similar vaccine schemes were taken as the control group. RESULTS: We recruited 85 haemodialysis patients who had received their first doses of either vaccine. Of them, 4 patients died; 3 patients were hospitalized because of COVID-19 infection during the follow-up; 9 patients missed at least one of their regular controls; and 2 patients were diagnosed with malignancy. A total of 26 patients experienced asymptomatic or mild COVID-19 infection during the follow-up period. SARS-CoV-2 IgG levels were measured at the end of the sixth month for the remaining 41 patients. Sero-positivity significantly decreased at the end of the sixth month for both vaccines, but the BNT162b2 group (n = 22) still had better seropositivity than CoronaVac® (n = 19) group (81% versus 50%; P = .03). In contrast, the seropositivity of healthy controls, even with the inactivated vaccine, was 96%. When one booster dose was applied, 90% of seropositivity could be maintained in the BNT162b2 group at the sixth month. CONCLUSION: BNT162b2 vaccine generates more persistent antibodies than inactivated vaccines in haemodialysis patients. However, when compared with the healthy controls at the end of the sixth month, antibody titers decrease more profoundly in haemodialysis patients. The booster dose can maintain the antibody levels and should be applied at least every 6 months

Toxic Shock Syndrome in Two CAPD Patients with <i>Staphylococcus Aureus</i> Exit-Site Infection

Toxic shock syndrome (TSS) is an illness defined by the occurrence of fever, rash, hypotension, multiple organ system dysfunction, and desquamation. Nonmenstrual TSS is often associated with surgical or nonsurgical cutaneous infections, which are rarely purulent or inflamed (Reingold AL, et al. Nonmenstrual toxic shock syndrome: a review of 130 cases. Ann Intern Med 1982; 96:871–4). Toxic shock syndrome associated with peritoneal exit-site infection but without peritonitis is extremely unusual (Sherbotie JR, et al. Toxic shock syndrome with Staphylococcus aureus exit-site infection in a patient on peritoneal dialysis. Am J Kidney Dis 1990; 15:80–3). We describe 2 patients that met the Centers for Disease Control case definition of TSS secondary to a peritoneal dialysis catheter exit-site infection with signs of mild inflammation and growth of Staphylococcus aureus, but with no evidence of peritonitis. </jats:p

Homozygous factor V Leiden mutation and disseminated thrombosis in a patient with nephrotic syndrome

We report the case of a young male patient with nephrotic syndrome and multiple venous thromboses. The patient presented various aggregated thrombophilic risk factors. He was found to be homozygous for factor V Leiden mutation and his anticardiolipin antibody and homocysteine levels were high