Predictors of acute kidney injury (AKI) in high-risk ST-elevation myocardial infarction (STEMI) patients: A single-center retrospective observational study

Acute kidney injury (AKI) is a frequent complication in ST-elevation myocardial infarction (STEMI) patients. Factors other than contrast exposure have been suggested as major contributors to renal dysfunction in patients undergoing primary percutaneous coronary intervention (PPCI). Our aim was to assess the incidence and risk factors of AKI in high-risk STEMI patients, mostly treated by PPCI with implemented measures to prevent contrast-induced AKI. We retrospectively analyzed data of 245 STEMI patients (165 men, mean age 63.9 ± 11.9 years) admitted to the Department of Medical Intensive Care Unit. Demographic, clinical, and mortality data were compared between AKI and non-AKI group. AKI was defined as a 1.5-fold increase in serum creatinine from baseline level within 24–48 hours. AKI developed in 34/245 (13.9%) patients. PPCI was performed in 226/245 (92.2%) of all STEMI cases, with no difference between AKI and non-AKI group. There were significant differences between AKI and non-AKI group in diabetes mellitus (41.2% vs. 20.9%), prior MI (26.5% vs. 11.8%), prior resuscitation (38.2% vs. 12.4%), admission acute heart failure [AHF] (44.1% vs. 12.8%), in-hospital AHF (70.6% vs. 17.5%), and hospital-acquired infection [HAI] (79.4% vs. 18.0%). Significantly more AKI patients had increased admission CRP ≥25 mg/L (38.2% vs. 11.8%), peak CRP ≥50 mg/L (91.2% vs. 36%), admission troponin I ≥10 mg/L (44.1% vs. 24.6%), peak troponin I ≥50 mg/L (64.7% vs. 44.1%), peak NT-proBNP ≥400 pmol/L (82.4% vs. 27.5%), and ejection fraction <45% (76.5% vs. 33.6%). Mortality was significantly increased in AKI group, including in-hospital (52.9% vs. 7.1%), 30-day (64.7% vs. 10.7%) and 6-month mortality (70.6% vs. 13.7%). Significant independent predictors of AKI were prior resuscitation (OR 4.171, 95% CI 1.088–15.998), HAI (OR 7.974, 95% CI 1.992–31.912), and peak NT-proBNP (OR 21.261, 95% CI 2.357–191.795). To reduce the risk of AKI in STEMI patients, early diagnosis and treatment of AHF and HAIs are advisable

Remote Reference in U.S. Public Library Practice and LIS Education

This article submitted to IUPUI ScholarWorks as part of the OASIS Project. Article reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Permission granted through posted policies on copyright owner’s website or through direct contact with copyright owner.The state of remote reference services in the United States was assessed by surveying remote reference availability at 100 U.S. public libraries, examining remote reference in the syllabi of American Library Association (ALA)-accredited library and information science (LIS) courses in the U.S., and analyzing national competencies and guidelines. Findings indicated that the telephone was the most common medium in use for remote reference services at public libraries, followed by e-mail and chat. In teaching, however, syllabi at LIS programs addressed digital remote reference media far more often than the telephone. Reference standards and guidelines primarily focused on general practices applicable to both remote and face-to-face reference work, rather than on specifics relevant to differing remote reference media types. Included in this study are recommendations to address this apparent disconnect among reference practices, teaching, and professional guidelines

The use of multiple inteligences theory in learning and teaching english in the 5th grade of primary school

In the theoretical part of the thesis I present the background to the concept of intelligence and identified it in relation to the existing definitions. The second part of the chapter shows a historical review of concepts of intelligence by authors: Gall, Galton, Binet, Stern, Wechsler, Piaget, Spearman, Thurston, Cattell and Horn. In the following chapter I focused on describing Gardner’s theory of multiple intelligences. The starting point of the theory and the criteria on which the theory is based follows, and is expanded by describing each of the intelligences. After explaining the basics of the subject, there is a part dedicated to learning a foreign language. This part is presented from the perspectives of developmental stages of pupils, a personalized approach, motivation for learning and linguistic abilities of an individual in the process of learning a foreign language. The last chapters of the theoretical part contain a few paragraphs dedicated to the integration of multiple intelligences theory in foreign language teaching. Within the chapter on foreign language teaching, I focused on the integration of the theory of multiple intelligences into foreign language teaching together with the presentation of some examples of good practice. The theoretical part is concluded with the presentation of criticism of Gardner’s theory. In the empirical part I identified the methods and techniques that develop the multiple intelligences, according to some pupils involved in the survey, teachers use in teaching English and which are the methods and techniques which help students learn more easily. For this matter students were given a questionnaire, which they had to fill out. I also took an interview with the teachers who are teaching these same students and wanted to find out if they were familiar with the theory of multiple intelligence and if their lessons include activities that promote the development of all intelligences

Individual protection of employees in Czech and Slovak labor law

The work deals with individual protection of employees in the Czech and Slovak labor law. Given that still have not been made any implementation of EU directives, including their respective transpositions into labor law is the difference in labor codes in both State concerned. Diferencema topics in the field of protection of individual employees This thesis deals, analyzes it, and not only from the aspect of substantive legislation but also in terms of process, because different jurisprudence us completes a comprehensive overview of the application practice. This work also provides the reader with the necessary insight to the new concept of flexicurity in the labor law in both countries. Finally, we This thesis presents a comparison of the two labor codes from the perspective of an individual employee protection under the influence of flexicurity

Zaleznosci miedzy wystepowaniem jaj Toxocara w kale psow i w glebie

Infection with Trichinella spiralis in mice generates Th-2 mediated response, which controls effector mechanism operating in the intestine. It is associated with a pronounced intestinal mastocytosis, eosinophilia and destruction of intestinal epithelial layer during expulsion of parasite from the gut. It is believed that protection is dependent on non-specific inflammatory reaction mediated by mast cells. Furthermore, the higher serum levels of parasite specific IgG1 and IgG2a and also mucosal IgA response were related to the course of infection. Inhibition of humoral and cellular immune responses using ketotifen as anti-allergic compound, resulted in the greater worm burden and worm size, but not in the significant prolongation of intestinal phase. Moreover, in treated mice epithelial layer of the gut was protected from destruction provoked by the nematode. As interaction between effector leukocytes and antibodies were not effective it was proposed that other mechanisms, not related to hypersensitivity or conventional inflammatory response regulated the level of infection. The immunological and physiological phenomenons are discussed in terms of events associated with protection to the parasite. Possibly, immunoregulatory capasity of the nematode is involved in the induction of multiple mechanisms operated during infection