165 research outputs found

    A case of primary hypoparathyroidism presenting with acute kidney injury secondary to rhabdomyolysis

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    Hypoparathyroidism is the most common cause of symmetric calcification of the basal ganglia. Herein, a case of primary hypoparathyroidism with severe tetany, rhabdomyolysis, and acute kidney injury is presented. A 26-year-old male was admitted to the emergency clinic with leg pain and cramps, nausea, vomiting, and decreased amount of urine. He had been treated for epilepsy for the last 10 years. He was admitted to the emergency department for leg pain, cramping in the hands and legs, and agitation multiple times within the last six months. He was prescribed antidepressant and antipsychotic medications. He had a blood pressure of 150/90 mmHg, diffuse abdominal tenderness, and abdominal muscle rigidity on physical examination. Pathological laboratory findings were as follows: creatinine, 7.5 mg/dL, calcium, 3.7 mg/dL, alanine transaminase, 4349 U/L, aspartate transaminase, 5237 U/L, creatine phosphokinase, 262.000 U/L, and parathyroid hormone, 0 pg/mL.There were bilateral symmetrical calcifications in basal ganglia and the cerebellum on computerized tomography. He was diagnosed as primary hypoparathyroidism and acute kidney injury secondary to severe rhabdomyolysis. Brain calcifications, although rare, should be considered in dealing with patients with neurological symptoms, symmetrical cranial calcifications, and calcium metabolism abnormalities

    Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

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    Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

    stairs and fire

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    Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

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    A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

    Examination of the relationship between students' basic physchological needs and their commitment to school at secondary schools

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    YÖK Tez No: 674112Bu araştırmada taşımalı eğitim kapsamında olan ve olmayan öğrencilerin okuldaki temel psikolojik ihtiyaçları ile okula bağlanmaları arasındaki ilişkinin incelenmesi amaçlanmıştır. Betimsel bir araştırma olan bu çalışmada ilişkisel tarama modeli kullanılmıştır. Bu araştırmanın çalışma grubunu 2020-2021 eğitim öğretim yılı Karaman il Merkez ve ilçelerinde öğrenimlerine devam etmekte olan 467 (%61,3)'si kız ve 295 (%38,7)'i erkek, toplamda 762 ortaokul öğrencisi oluşturmaktadır. Bu öğrencilerin 342 (%44,9)'si taşımalı eğitim, 420 (%55,1)'si taşımalı eğitim kapsamında olmayan bir okulda öğrenim görmektedir. Veri toplama aracı olarak Kişisel Bilgi Formu, Ergen Öğrencilerin Okulda Temel Psikolojik Gereksinimleri Ölçeği ve Çocuk ve Ergenler için Okula Bağlanma Ölçeği kullanılmıştır. Verilerin analizinde taşımalı eğitim kapsamında olan ve olmayan öğrencilerin okuldaki temel psikolojik ihtiyaçları ve okula bağlanma düzeylerinin demografik özelliklerine göre farklılaşıp farklılaşmadığına bağımsız gruplar için iki yönlü ANOVA analizi uygulanmıştır. Öğrencilerin okuldaki temel psikolojik ihtiyaçları, okul türü (taşımalı kapsamında olmayan bir okulda öğrenim görmek) ve okula bağlanma düzeyi arasında anlamlı düzeyde ilişki olup olmadığını belirlemek için Pearson korelasyon analizi ve son olarak okuldaki temel psikolojik ihtiyaçlar ve okul türünün okula bağlanmayı anlamlı düzeyde yordayıp yordamadığını belirlemek için çoklu Regresyon analizi yapılmıştır. Bulgulara göre taşımalı eğitim kapsamında olan öğrencilerin okuldaki temel psikolojik ihtiyaç düzeyleri taşımalı eğitim kapsamında olmayan öğrencilerinkinden anlamlı düzeyde düşük bulunmuştur. Dahası okuldaki temel psikolojik ihtiyaçlar öğrencilerin cinsiyetine göre kızların lehine, sınıf düzeyine göre 8. Sınıfta olanlara göre 6.sınıfta olanların lehine, yılsonu başarı düşük olanlarınkine göre yılsonu başarı puanı yüksek olanların lehine anlamlı düzeyde bulgular elde edilmiştir. Ancak öğrencilerin okuldaki temel psikolojik ihtiyaçları yaş, anne eğitim düzeyi ve baba eğitim düzeyine göre anlamlı düzeyde farklılaşmamaktadır. Taşımalı eğitim kapsamında olan öğrencilerin okula bağlanma düzeyleri taşımalı eğitim kapsamında olmayan öğrencilerinkinden anlamlı düzeyde düşük bulunmuştur. Öğrencilerin okula bağlanma düzeyleri cinsiyetine göre kızların lehine, yaşına göre 13 ve 14 yaşında olanlarınkine göre 11 yaşında olanların lehine, 14 yaşında olanlarınkine göre 13 yaşında olanların lehine, sınıf düzeyine göre 7 ve 8. sınıfta olanlarınkine göre 6.sınıfta olanların lehine, yılsonu başarı puanı düşük olanlarınkine göre yılsonu başarı puanı yüksek olanların lehine anlamlı düzeyde bulgular elde edilmiştir. Ancak öğrencilerin okula bağlanma düzeyleri anne eğitim düzeyi ve baba eğitim düzeyine göre anlamlı düzeyde farklılaşmamaktadır. Öğrencilerin okuldaki temel psikolojik ihtiyaçları, okul türü ve okula bağlanmaları arasında pozitif yönde anlamlı düzeyde ilişkiler bulunmuştur. Son olarak öğrencilerin okuldaki temel psikolojik ihtiyaçları ve okul türü okula bağlanmalarının toplam varyansının yaklaşık %20'sini açıklamıştır. Sonuçlara göre öğrencilerin taşımalı eğitim kapsamında olmaması ve okuldaki temel psikolojik ihtiyaçlarının karşılanması okula bağlılıklarını arttıracak etmenler arasında sayılabilir. Politika yapıcıların taşımalı eğitim yerine yerinde eğitimi yaygınlaştırıcı çözümler üretmesi ve okuldaki psikolojik ihtiyaçlarını karşılayacak şekilde okul ortamlarını düzenlemeleri önerilmektedir.The study aims to examine the relationship between students' basic psychological needs at schools and their commitment to schools within the bussed to school and non-bussed to school. The sample consists of 467 (61.3%) girls and 295 (38.7 %) boys in Karaman in 2020-2021 academic year. 342 (44.9 %) of these students are from the bussed to school, 420 (55.1 %) of these students attend are from non-bussed to school. Personal Information Form, Adolescent Students' Basic Psychological Needs at School Scale and Students' Commitment to School were given to these students. Two-way ANOVA was used to see the significant differences between students' basic psychological needs at schools and their commitment to school according to their demographic variables. Additionally, Pearson Correlation Analysis was conducted whether there is a significant relationship between students' basic psychological needs, school type (attending a non-bussed to school) and their commitment to school. Regression analysis was also done to find out whether their basic psychological needs at school, school type predict and commitment to school. Findings indicated that students' basic psychological needs at school are significantly lower than their commitment to non-bussed to schools. Moreover, basic psychological needs at school are found in favor of girls according to the gender of the students, in favor of 6th grade students in comparison with 8th grade students according to their class level and in favor of students who have higher year-end success grade than students who have lower year-end success grade. However, students' basic psychological needs at school are not differentiated significant according to mothers' education level and fathers' education level. There are positive relationships among students' school type, their commitment to school and their basic psychological needs. Regression results show that students' basic psychological needs at school and school type are the significant predictors of their commitment to school and these variables explained nearly 20% of total variance of commitment to school. According to the results being students within non-bussed to school and meeting students' basic psychological needs at school are the factors to increase their commitment to school. It is recommended that policy makers should find solutions to extend on-site education instead of bussed to school and they should develop policies to arrange schools' environment, meeting students' basic psychological needs at school

    Acute Kidney Injury and Chronic Kidney Disease: A Bidirectional Road

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    Acute kidney injury (AKI) and chronic kidney disease (CKD) have many common points regarding risk factors, etiology, clinical and laboratory factors. We aimed in this review to discuss the outcome, the risk of CKD, cardiovascular and overall mortality risk after AKI, and the mechanisms underlying the relationship between AKI and CKD

    Male pseudohermaphroditism as a cause of secondary hypertension: a case report

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    Seventeen alpha-hydroxylase deficiency (17OHD) syndrome is a rare genetic disorder of steroid biosynthesis causing decreased production of glucocorticoids and sex steroids and increased synthesis of mineralocorticoid precursors. There are only 130 cases reported worldwide with documented severe 17OHD. Here, we describe the clinical, hormonal, and molecular genetic characteristics of a Turkish patient with 17OHD, who presented to our clinic due to high blood pressure. A 29-year-old girl with 46,XY genotype was admitted to our nephrology clinic due to uncontrolled hypertension and hypokalemia. The diagnosis was suspected because of primary amenorrhea, absence of sexual maturation, hypertension, and hypokalemia. Endocrine investigation revealed low basal levels of all steroid hormones which require 17-hydroxylation for biosynthesis. Plasma concentrations of ACTH, FSH, and LH were elevated. Imaging did not reveal uterus or adnexial structures. The patient's hypertension and hypokalemia resolved after glucocorticoid replacement and treatment with potassium-sparing diuretics. 17OHD is a rare form of congenital adrenal hyperplasia in which defects in the biosynthesis of cortisol and sex steroids result in mineralocorticoid excess, hypokalemic hypertension, and sexual abnormalities such as pseudohermaphroditism in males, and sexual infantilism in females. 17OHD should be suspected in patients with hypokalemic hypertension and lack of secondary sexual development so that appropriate therapy can be implemented

    Morphological and molecular diversity in Turkish sesame germplasm and core set selection

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    The conservation of plant germplasm is essential to ensure future breeding gains and crop bio-diversity. To be truly useful, such germplasm must be characterized for morphological traits and genetic diversity. In this work, agro-morphological diversity was assessed in 137 Turkish sesame (Sesamum indicum L.) genotypes (129 accessions and eight cultivars) by examination of eight qualitative and nine quantitative traits. As expected, morphological variability in the cultivars was low with broader diversity present in sesame accessions. However, some accessions were identified with interesting features, such as increased number of capsules and seed yield, which could be employed in future cultivar development. The sesame genotypes were analyzed for molecular genetic diversity with 140 amplified fragment length polymorphism (AFLP) loci. The results indicated a relatively low level of variability with an average dissimilarity value of 0.33 for all genotypes. Population structure was also examined and indicated that the material fell into two subpopulations. As most of the accessions (82%) were obtained from the U.S. Department of Agriculture (USDA) and are not yet housed in the Turkish national sesame germplasm collection, the data were used to identify a core set of 22 accessions that should be preserved in Turkey. The importance of using both molecular and morphological data for core selection is highlighted with a focus on germplasm preservation and breeding. © Crop Science Society of AmericaScientific and Technological Research Council of Turkey (108O478

    Factors effective on peritoneal phosphorus transport and clearance in peritoneal dialysis patients

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    Aims: Transport characteristics of phosphorus are different from other small solutes that are evaluated in routine peritoneal equilibration test ( PET) in peritoneal dialysis (PD) patients. We aimed to evaluate peritoneal phosphorus clearance and permeability, and their relationship with peritoneal membrane transport type and creatinine clearance as well as factors affecting peritoneal phosphorus clearance. Methods: 70 adult patients on a PD program were included in our study. Phosphorus transport status was classified according to dialysate/plasma (D/P) phosphorus at the 4th hour of PET as slow transporter ( 0.67). We evaluated the relationship of peritoneal phosphorus clearance and transport type with PD regime, phosphorus level, and presence of residual renal function in addition to investigating factors that are effective on peritoneal phosphorus clearance. Results: D/P phosphorus and peritoneal phosphorus clearance were positively correlated with D/ P creatinine and peritoneal creatinine clearance, respectively. Automated PD and continuous ambulatory PD patients were similar regarding phosphorus and creatinine clearances and transport status based on D/ P phosphorus. The major determinant of peritoneal phosphorus clearance was anuria status. Anuric patients had higher dialysate volume (11.6 +/- 3.0 L vs. 8.4 +/- 2.1 L, p < 0.001) and therefore higher peritoneal phosphorus clearance (61.7 +/- 15.1 L/week/1.73 m(2) vs. 48.4 +/- 14.0 L/week/1.73 m(2), p = 0.001). Hyperphosphatemia was present in 40% and 11% of anuric patients and those with residual renal function, respectively (p = 0.005). Conclusions: Peritoneal phosphorus transport characteristics are similar to that of creatinine. Although increased dialysis dose may increase peritoneal phosphorus clearance, it may be insufficient to prevent hyperphosphatemia in anuric patients
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