Knowledge, Attitudes and Behaviors of Medical School Students about HPV, HPV Vaccine and Cervical Cancer: A Survey Study in a Medical School

Objective: This study aimed to determine the knowledge, attitudes and behaviors of students in a medical school about HPV, HPV vaccine and cervical cancer. Methods: The research was carried out in the students of Selcuk University Faculty of Medicine in April 2022. The universe of the study consisted of all medical school students and it was conducted with 125 volunteers who accepted the study. Participants were asked questions about HPV, HPV vaccine and cervical cancer. Results: One-hundred twenty five students participated in the study. The mean age was 20,89±2,339 (range 18-31). Of the 125 participants, 50,4% (n: 63) were female and 49,6% (n: 62) were male, and 74,4% (n: 93) were preclinical (1-2-3th year) students, and 25,6% (n = 32) were clinical (4-5-6th year) students. Majority of the respondents [ 86.4% (n=108)] reported that they did not have enough knowledge about HPV, HPV vaccine and diseases caused by HPV. Conclusion: As the result of the study, even medical school students were not fully informed about HPV, HPV vaccine, and cervical cancer. It is extremely important for more healty generation that medical students, who will be the pioneers of healthcare of the future and will educate the public on health and guide health policies, are given adequate training on HPV and HPV vaccine

Discontinuation of RAAS Inhibition in Children with Advanced CKD

Background and objectives Although renin-angiotensin-aldosterone system inhibition (RAASi) is a cornerstone in the treatment of children with CKD, it is sometimes discontinued when kidney function declines. We studied the reasons of RAASi discontinuation and associations between RAASi discontinuation and important risk markers of CKD progression and on eGFR decline in the Cardiovascular Comorbidity in Children with CKD study. Design, setting, participants,& measurements In this study, 69 children with CKD(67% male, mean age 13.7 years, mean eGFR 27 ml/min per 1.73m(2)) who discontinued RAASi during prospective follow-up were included. Initial change in BP, albuminuria, and potassium after discontinuation were assessed (median time 6 months). Rate of eGFR decline (eGFR slope) during a median of 1.9 years before and 1.2 years after discontinuation were estimated using linear mixed effects modeling. Results Physician-reported reasons for RAASi discontinuation were increase in serum creatinine, hyperkalemia, and symptomatic hypotension. After discontinuation of RAASi, BP and albuminuria increased, whereas potassium decreased. eGFR declined more rapidly after discontinuation of RAASi (23.9 ml/min per 1.73m2 per year; 95% confidence interval, 25.1 to 22.6) compared with the slope during RAASi treatment (21.5 ml/min per 1.73 m(2) per year; 95% confidence interval, 22.4 to 20.6; P=0.005). In contrast, no change in eGFR slope was observed in a matched control cohort of patients in whom RAASi was continued. Conclusions Discontinuation of RAASi in children with CKD is associated with an acceleration of kidney function decline, even in advanced CKD

Serum indoxyl sulfate concentrations associate with progression of chronic kidney disease in children

The uremic toxins indoxyl sulfate (IS) and p-cresyl sulfate (pCS) accumulate in patients with chronic kidney disease (CKD) as a consequence of altered gut microbiota metabolism and a decline in renal excretion. Despite of solid experimental evidence for nephrotoxic effects, the impact of uremic toxins on the progression of CKD has not been investigated in representative patient cohorts. In this analysis, IS and pCS serum concentrations were measured in 604 pediatric participants (mean eGFR of 27 ± 11 ml/min/1.73m2) at enrolment into the prospective Cardiovascular Comorbidity in Children with CKD study. Associations with progression of CKD were analyzed by Kaplan-Meier analyses and Cox proportional hazard models. During a median follow up time of 2.2 years (IQR 4.3-0.8 years), the composite renal survival endpoint, defined as 50% loss of eGFR, or eGFR <10ml/min/1.73m2 or start of renal replacement therapy, was reached by 360 patients (60%). Median survival time was shorter in patients with IS and pCS levels in the highest versus lowest quartile for both IS (1.5 years, 95%CI [1.1,2.0] versus 6.0 years, 95%CI [5.0,8.4]) and pCS (1.8 years, 95%CI [1.5,2.8] versus 4.4 years, 95%CI [3.4,6.0]). Multivariable Cox regression disclosed a significant association of IS, but not pCS, with renal survival, which was independent of other risk factors including baseline eGFR, proteinuria and blood pressure. In this exploratory analysis we provide the first data showing a significant association of IS, but not pCS serum concentrations with the progression of CKD in children, independent of other known risk factors. In the absence of comorbidities, which interfere with serum levels of uremic toxins, such as diabetes, obesity and metabolic syndrome, these results highlight the important role of uremic toxins and accentuate the unmet need of effective elimination strategies to lower the uremic toxin burden and abate progression of CKD

CDH12 as a Candidate Gene for Kidney Injury in Posterior Urethral Valve Cases:A Genome-wide Association Study Among Patients with Obstructive Uropathies

Background: Posterior urethral valves (PUVs) and ureteropelvic junction obstruction (UPJO) are congenital obstructive uropathies that may impair kidney development. Objective: To identify genetic variants associated with kidney injury in patients with obstructive uropathy. Design, setting, and participants: We included 487 patients born in 1981 or later who underwent pyeloplasty or valve resection before 18 yr of age in the discovery phase, 102 PUV patients in a first replication phase, and 102 in a second replication phase

HOSPITALIZATION BURDEN IN CHILDREN WITH CHRONIC KIDNEY DISEASE (CKD): FINDINGS FROM THE 4C STUDY

WOS: 000408418900455

CORRELATION OF ACOUSTIC RADIATION FORCE IMPULSE (ARFI) ELASTOGRAPHY WITH HISTOLOGICAL FINDINGS IN PEDIATRIC RENAL TRANSPLANT PATIENTS

WOS: 000408418900055

SOLUBLE UROKINASE PLASMINOGEN ACTIVATOR RECEPTOR (SUPAR) SERUM LEVELS PREDICT PROGRESSION OF KIDNEY DISEASE IN CHILDREN

WOS: 000408418900043

Hemophagocytic Syndrome and Acute Liver Failure Associated with Ethylene Glycol Ingestion: A Case Report

The authors describe a case of accidental ethylene glycol poisoning in an 18-month-old boy who developed hemophagocytic syndrome (HPS). Ethylene glycol is a common substance in various antifreeze preparations. Acute ethylene glycol intoxication is a medical emergency that, if not diagnosed correctly and treated aggressively, will lead to serious neurological, cardiopulmonary, and renal dysfunction, and may result in death. The taking of a detailed history, physical examination, and laboratory testing are essential for diagnosis. To the best of the authors' knowledge this is the first case in the literature of a subject who developed HPS after ethylene glycol intoxication.Wo