Pathways to a more peaceful and sustainable world:The transformative power of children in families

This article provides an overview of selected ongoing international efforts that have been inspired by Edward Zigler’s vision to improve programs and policies for young children and families in the United States. The efforts presented are in close alignment with three strategies articulated by Edward Zigler: (a) conduct research that will inform policy advocacy; (b) design, implement, and revise quality early child- hood development (ECD) programs; and (c) invest in building the next generation of scholars and advocates in child development. The intergenerational legacy left by Edward Zigler has had an impact on young children not only in the United States, but also across the globe. More needs to be done. We need to work together with a full commitment to ensure the optimal development of each child

The relationship between serum estrogen concentration and post-dural puncture headache: a retrospective study

OBJECTIVE: Post-Dural puncture headache (PDPH) is a severe and undesirable complication for the patient and anesthesiologist. PDPH is more common in female patients. However, its relationship with plasma estrogen levels has not been demonstrated. This study aimed to investigate the relationship between estrogen levels and PDPH in patients who underwent spinal anesthesia for in vitro fertilization (IVF) with supraphysiological estrogen levels. PATIENTS AND METHODS: In this retrospective study, the data of patients between the ages of 18-45 with the following characteristics were included in the study: those who underwent IVF procedure between January 2021 and August 2022, in the ASA I-II risk group, and who underwent spinal anesthesia using a 25 G Quinke-tipped spinal needle at the L3-L4 or L4-L5 vertebra levels. The 48 patients in the study were in two groups according to their estradiol values: ‘Supra physiological estradiol levels’ (Group I=24 patients) and ‘Normal estradiol levels’ (Group C=24 patients). The relationship between PDPH and estrogen, progesterone, spinal needle diameter, and patient demographic characteristics were evaluated. RESULTS: The estrogen and progesterone levels of patients in Group I were higher than in Group C (p0.05). CONCLUSIONS: Since there is no relationship between the supraphysiological estrogen level and PDPH, high serum estrogen level should not be considered as an additional risk factor for PDPH in the decision of anesthesia type for IVF procedure

Prognostic factors in glomerular diseases with crescents

INTRODUCTION: More than 50% of glomerular crescent formation is required for a diagnosis of crescentic glomerulonephritis in a kidney biopsy. Although treatment protocols have been established for diffuse crescentic glomerulonephritis, there is no standard treatment for patients with fewer crescents in renal biopsies. In this study the importance of crescent percentage and clinical features on renal survival independent of underlying disease was investigated. METHODS: This retrospective observational study was conducted between 2013 and 2017. Forty-nine patients with crescent formation in their kidney biopsies were evaluated. We compared clinicopathological features and renal survival. We evaluated the factors affecting the course of end stage renal disease (ESRD). RESULTS: A total of 49 patients (57% male and median age 49 years) were enrolled in this study. 39% of patients developed ESRD at follow-up. Logistic regression analysis showed that the requirement for renal replacement treatment on admission (p < 0.001), serum creatinine level above 2.7 mg/dL (p < 0.001), the presence of more than 50% glomerulosclerosis (p = 0.04) and more than 34% crescent formation (p = 0.002) were significantly associated with ESRD. Kaplan-Meier survival analysis revealed that patients with less than 34% crescent in kidney biopsy and a serum creatinine level less than 2.7 mg/dL had increased kidney survival (log-rank test p: 0.01 and p: 0.002). CONCLUSION: Patients with crescent formation in kidney biopsy more than 34% should be evaluated for more aggressive treatment modalities regardless of the underlying disease, especially if the serum creatinine level is above 2.7 mg/dL

Frequency of anemia in chronic psychiatry patients

Sevda Korkmaz,1 Sevler Yildiz,1 Tuba Korucu,1 Burcu Gundogan,1 Zehra Emine Sunbul,1 Hasan Korkmaz,2 Murad Atmaca1 1Department of Psychiatry, 2Department of Cardiology, Faculty of Medicine, Firat University, Elazig, Turkey Purpose: Anemia could cause psychiatric symptoms such as cognitive function disorders and depression or could deteriorate an existing psychiatric condition when it is untreated. The objective of this study is to scrutinize the frequency of anemia in chronic psychiatric patients and the clinical and sociodemographic factors that could affect this frequency.Methods: All inpatients in our clinic who satisfied the study criteria and received treatment between April 2014 and April 2015 were included in this cross-sectional study. Sociodemographic data for 378 patients included in the study and hemoglobin (Hb) and hematocrit values observed during their admission to the hospital were recorded in the forms. Male patients with an Hb level of &lt;13&nbsp;g/dL and nonpregnant female patients with an Hb level of &lt;12&nbsp;g/dL were considered as anemic.Findings: Axis 1 diagnoses demonstrated that 172 patients had depressive disorder, 51 patients had bipolar disorder, 54 patients had psychotic disorder, 33 patients had conversion disorder, 19 patients had obsessive-compulsive disorder, 25 patients had generalized anxiety disorder, and 24 patients had other psychiatric conditions. It was also determined that 25.4% of the patients suffered from anemia. Thirty-five percent of females and 10% of males were considered as anemic. The frequency of anemia was the highest among psychotic disorder patients (35%), followed by generalized anxiety disorder patients (32%), and obsessive-compulsive disorder patients (26%). Anemia was diagnosed in 22% of depressive disorder patients, 25% of bipolar disorder patients, and 24% of conversion disorder patients.Results: The prevalence of anemia among chronic psychiatry patients is more frequent than the general population. Thus, the study concluded that it would be beneficial to consider the physical symptoms and to conduct the required examinations to determine anemia among this patient group. Keywords: anemia, hemoglobin, physical diseas

Quantitative assessment of finger-tapping performance in patients with parkinson's disease [Parkinson hastalarında parmakvuru performansının kantitatif degerlendirilmesi özet]

Objective: The objective, quantitative assessment of patients with Parkinson's disease (PD) is essential for both the diagnosis and follow-up. To be of value in clinical trials and daily clinical practice, the method should be simple and easy, with minimal inter-rater observer variation. The finger-tapping (FT) test is an informative measure of upper-extremity motor skills as a part of the neurological assessment of patients with PD. Therefore, this study evaluated the motor skills of patients with PD by using a computer-based system that quantifies FT performance. Method: Software to measure FT performance was assessed in 25 patients with PD and 25 normal controls by using two FT testing procedures: single FT (SFT) and alternate FT (AFT). Confounding factors that had the potential to affect the performance were considered, including age, sex, education, and cognition. Results: The SFT and AFT scores for the affected side of patients with PD were significantly lower than the corresponding scores for the dominant side of control subjects. In PD patients, our method appeared to be adequate for evaluating bradykinesia independent of age, cognition and education. AFT was a more sensitive tool for determining the disease severity. Conclusion: This method is a sensitive, practical, and objective tool for evaluating upperextremity motor skills in patients with PD. It also reflects the disease severity. We hope that this method might be useful in both daily practice and clinical studies