Bazal Ürik Asid Düzeyi, Sepsiste Akut Böbrek Hasarının Önceden Belirlenmesi İçin Bir Kılavuz Olabilir

Amaç: Sepsis, yoğun bakım ünitesinde (YBÜ), akut böbrek hasarının (ABH) en önemli nedeni olup %15-20’sinde renal replasman tedavisi ihtiyacı olmaktadır. Ürik asit, hipertansiyon, dislipidemi, yağlı karaciğer, böbrek hastalıkları ve kardiyovasüler hastalıklarla ilişkilidir. Ürik asit seviyelerinin ABH riskinin artması ile bağlantılı olduğu gösterilmiştir. Biz de artmış ürik asit düzeyinin ABH'yı önceden belirlemede rolü olup olmadığını incelemeyi amaçladık. Gereç ve Yöntem: Bu retrospektif çalışmada, Eylül 2015-Aralık 2017 arasında sepsis nedeni ile YBÜ kabul edilen 105 ardışık hastayı dahil ettik. Kabul esnasındaki klinik laboratuvar testleri ve basitleştirilmiş akut fizyoloji skoru (SAPSII) kaydedildi ve 7 gün boyunca böbrek fonksiyonlarının izlemi yapıldı. Bulgular: 7 gün içindeki ABH oluşum oranı %47.6 idi. Bazal ürik asit düzeyi ABH gelişen grupta ABH gelişmeyen gruba göre daha yüksekti. Multivariate lojistik regresyon analizinde, serum ürik acid, albumin ve SAPSII; ABH ile bağımsız olarak bağlantılıydı. Serum ürik asit 6.85 mg/dl eşik noktasında sepsis hastalarında ABH'yı belirlemede oldukça etkiliydi ve %72 duyarlılık ve %85.5 özgüllüğe sahipti. Sonuç: Artmış ürik asit düzeyi sepsiste ABH'nın önceden belirlenmesinde yardımcı olabilir

Corruption and shadow economy in transition economies of European Union countries: a panel cointegration and causality analysis

Corruption and shadow economy are two critical problems which feed each other and pose an obstacle against the economic development of countries, especially those with weak fundamentals. Central and Eastern European countries have experienced an absolute political and economic transformation after the downfall of the Berlin Wall. This study researches the effect of corruption and rule of law on shadow economy in 11 transition economies of Central and Eastern Europe over the 2003–2015 term with panel cointegration and causality tests considering heterogeneity and cross-sectional dependence. The cointegration coefficients revealed a complementary interplay between size of shadow economy and corruption. Furthermore, the causality analysis indicated that there was a bilateral causality between control of corruption and shadow economy in all the cross-section units. However, there was a two-way causality between rule of law and shadow economy only in Bulgaria, Czech Republic, Poland and Romania. Furthermore, there was one-way causality from rule of law to shadow economy in Croatia, Estonia, Hungary, Slovakia and Slovenia

How Fiscal Policies Affect Credit Rates: Probit Analysis of Three Main Credit Rating Agencies’ Sovereign Credit Notes

The aim of this study is to identify the relationship between fiscal policy and sovereign credit ratings within a comparative framework for the post-2000 period. In this study, indicators affecting credit notes of three rating agencies through domestic savings, growth, inflation, unemployment, current account balance and public revenues, public expenditures, primary deficits, budget deficits and public debt data for selected countries for the period between 2001 and 2016 are evaluated by using probit analysis under four scenarios.The study reveals that growth, unemployment, savings, current account deficit and public debt have come to the forefront in the realizations and far estimates, while the main indicators in the public sector, namely the impact of expenditure, deficit, primary balance and debt on rating decisions, are more dominant in the near estimates. These results show that the factors that are differentiating the credit rating evaluation period are the indicators of public finance. It seems that models used by the credit institutions are more likely to show short-term outcomes in the sense of public finance parameters mainly reflecting the macroeconomic responsibility level of the ruling governments.</p

P Wave Duration And Dispersion In Patients With Hyperthyroidism And The Short-term Effects Of Antithyroid Treatment

Background: Prolonged P wave duration and P wave dispersion (PWD) have been associated with an increased risk for atrial fibrillation (AF). Hyperthytodism is a frequent cause of atrial fibrillation (AF). Methods: Forty-two patients with newly diagnosed overt hyperthyroidism and 20 healthy people were enrolled in the study. Transthoracic echocardiography, 12 lead surface ECG and thyroid hormone levels were studied at the time of enrollment and after achievement of euthyroid state with propylthiouracil treatment. Results: Maximum P wave duration (Pmax) (97.4±14.6 vs. 84.2±9.5 msec, p<0.001), PWD (42.9±10.7 vs. 31.0±6.2 msec, p<0.001), deceleration (DT) (190.7±22.6 vs. 177.0±10.2 msec, p=0.013) and isovolumetric relaxation times (IVRT) (90.9±11.2 vs. 79.6±10.5 msec, p<0.001) were significantly higher in hyperthyroid patients compared to control group. Pmax and PWD were significantly correlated with the presence of hyperthyroidism. Pmax (97.4±14.6 to 84.3±8.6 msec, p<0,001) Pmin (54.1±8.6 to 48.1±8.5 msec, p=0.002), PWD (42.9±10.7 to 35.9±8.1 msec, p=0.002) and DT (190.7±22.6 to 185.5±18.3, p=0.036) were significantly decreased after achievement of euthyroid state in patients with hyperthyroidism. Diastolic dyfunction was seen in 5 patients at hyperthroid state but only in one patient at euthyroid state. Conclusions: Hyperthyroidism is associated with prolonged P wave duration and dispersion. Achievement of euthyroid state with propylthiouracil treatment results in shortening of P wave variables. Diastolic function may have a partial effect for the increased Pmax and PWD. Shortening of Pmax and PWD may be a marker for the prevention of AF with the anti-thyroid treatment

The effects of iron deficiency anemia on p wave duration and dispersion

OBJECTIVES: The association between P wave dispersion and iron deficiency anemia has not been documented in the literature. In this study, we evaluated P wave dispersion in patients with iron deficiency anemia and the possible relationships between P wave dispersion and other echocardiographic parameters. INTRODUCTION: The iron status of an individual may play an important role in cardiovascular health. Anemia is an independent risk factor for adverse cardiovascular outcomes. P wave dispersion is a simple electrocardiographic marker that has a predictive value for the development of atrial fibrillation. Apart from cardiovascular diseases, several conditions, such as seasonal variation, alcohol intake and caffeine ingestion, have been demonstrated to affect P wave dispersion. METHODS: The study included 97 patients who had iron deficiency anemia and 50 healthy subjects. The cases were evaluated with a clinical examination and diagnostic tests that included 12-lead electrocardiography and transthoracic echocardiography. RESULTS: Compared to the control group, patients with iron deficiency anemia showed significantly longer maximum P wave duration (Pmax) (91.1±18.0 vs. 85.8±6.7 msec, p=0.054), P wave dispersion (PWD) (48.1±7.7 vs. 40.9±5.6 msec,

A rule based prosody model for Turkish text-to-speech synthesis

Ovaj članak predstavlja naš novi prozodijski model u sustavu za sintezu turskog teksta u govor (TTS). Nakon razvijanja TTS sustava vođenog parametrijskim osobinama koje se sastoje od promjena trajanja, visine i jačine glasa, pokušavamo postaviti neka prozodijska pravila kako bi se povećala prirodnost našeg sintetizatora. Budući da u turskom jeziku glagoli koji se sprežu mogu biti samostalne rečenice uz sufikse koji im se dodaju, sastavljamo perceptualni prozodijski model definiranjem pravila o obrascima naglasaka kod sprezanja glagola. Sistematski su se proučavali potvrdni, negativni i upitni (i potvrdni i negativni) oblici mnogih glagola. Nisu se proučavali samo glagoli već, na isti način, i neke fraze kako bi se postigla ispravna prozodija. Prema rezultatima testova slušanja, definirana pravila zasnovana na promjenama trajanja, visine i jačine glasa, dovode do perceptualno bolje govorne sinteze, naime u prosjeku do 1,78/5,0 poboljšanja u CMSO testu (Comparative Mean Opinion Score). To poboljšanje predstavlja uspjeh našeg novog prozodijskog modela.This paper presents our novel prosody model in a Turkish text-to-speech synthesis (TTS) system. After developing a TTS system driven by parametric features consisting of duration, pitch and energy modifications, we try to figure out some prosody rules in order to increase the naturalness of our synthesizer. Since the inflected verbs in Turkish can be stand-alone sentences with the suffixes they take, we build a perceptual prosody model by defining rules on the stress patterns of verb inflections. Affirmative, negative and interrogative (both positive and negative) forms of many verbs were examined in a systematic way. Not only verbs, but in the same way, some phrases were examined for obtaining a proper prosody. According to the results of listening tests, the defined rules based on duration, pitch and energy modification weights, result in perceptually better speech synthesis, namely about 1,78/5,0 improvement in average in the CMOS (Comparative Mean Opinion Score) test. This improvement shows the success of our novel prosody model

Trace Elements, Heavy Metals and Vitamin Levels in Patients with Coronary Artery Disease

Aim: In the present study, we aimed to assess serum concentrations of zinc (Zn), copper (Cu), iron (Fe), cadmium (Cd), lead (Pb), manganese (Mn), vitamins A (retinol), D (cholecalciferol) and E (α-tocopherol) in patients with coronary artery disease (CAD) and to compare with healthy controls