bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of cardiac output, IVC diameters and lactate levels in prediction of mortality in patients in emergency department; An observational study
Authors: Shahsavarinia Kavous , Taqizadieh Ali , Moharramzadeh Payman , Amirchoupani Ramin , Mahmoodpoor Ata
Published: April 2020

Objective: Fluid overload is an independent marker for mortality in critically ill patients. Assessment of fluid status and fluid responsiveness is crucial for the management of these patients. In this study, we compared the lactate level, inferior vena cava (IVC) diameter and non-invasive cardiac output (CO) monitoring in prediction of mortality in emergency department.

Methods: This was a cross sectional observational study which comprised of 68 patients and was performed in ED of Tabriz University of Medical Sciences, Iran, from Sept 2016 until Sept 2017. IVC diameter was measured before the P-wave on ECG to avoid interference with a-wave and v-wave on the venous pressure curve, and during maximal inspiration and expiration to avoid Valsalva-like maneuvers. An arterial lactate sample was taken from all patients before performing the initial resuscitation. All patients underwent non-invasive CO monitoring by CO2 rebreathing technique. Mortality was noted on day 28.

Results: Deceased patients had a significantly low level of IVC diameters, less CO values and more lactate levels. However, based on ROC curve analysis, the prediction accuracy and validity of both CO values obtained by rebreathing CO2 and IVC diameter was poor and the highest accuracy was obtained by lactate level assessment.

Conclusion: Initial lactate value is a reliable parameter for prediction of mortality in non-traumatic critically ill patients. IVC diameter changes during spontaneous ventilation and non-invasive CO monitoring does not possess acceptable accuracy for prediction of mortality in these patients.

doi: https://doi.org/10.12669/pjms.36.4.2032

How to cite this:Shahsavarinia K, Taqizadieh A, Moharramzadeh P, Amirchoupani R, Mahmoodpoor A. Comparison of cardiac output, IVC diameters and lactate levels in prediction of mortality in patients in emergency department; An observational study. Pak J Med Sci. 2020;36(4):788-792. doi: https://doi.org/10.12669/pjms.36.4.2032

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Representations of the psychological work units of the Ministry of Internal Affairs of Russia about their professional preparedness to provide psychological assistance in maintaining of the optimum of professional activity
Authors: Maltseva Tatyana
Published: April 2020

The article discusses the problem of the need to change the approach both to mental and physical health, and to the psychological culture of employees of internal affairs bodies as a whole. The new approach should be based on a person’s natural desire for psychological well-being. Today, numerous psychological studies around the world indicate a high level of professional stress among law enforcement officials, which leads to chronic fatigue, professional destruction, psychosomatic disorders, diseases, alcohol abuse, divorces, etc. Stressfulness of the profession also causes personnel problems.

Based on the relevance of the role of the phenomenon of subjective vitality in the professional activities of employees of internal affairs bodies, in maintaining their mental and physical health, in increasing the level of psychological well-being, this article analyzes the need for employees of internal affairs bodies and their leaders in psychological assistance to optimize the level of subjective vitality and actualization of their internal resources as subjects of labor, as well as the readiness of psychologists of the internal affairs bodies of the Russian Federation tion (hereinafter referred to as departmental psychologists) to provide such assistance.

The article analyzes the results of five focused group interviews with 45 employees of the psychological work units of the Russian Ministry of Internal Affairs. When processing the obtained data, a framework and qualitative-quantitative data analysis was used.

The results of the study showed several problem areas in the professional activities of departmental psychologists, which are interdependent and interdependent.
Psychological features of military personnell with different specifications of negative consequences of staying in extreme conditions of military situation
Authors: Kovaleva Marina
Published: April 2020

The article presents the results of an empirical study devoted to identifying and describing averaged typical psychological features of categories of military personnel performing combat missions in extreme combat conditions, predisposed to the formation of various forms of deviant behavior as negative consequences of a collision with stressful environmental factors. The results of a comparative analysis of respondents prone to such forms of behavioral deviations as victimization, gambling addiction, procrastination, psychological abuse and violation of official discipline are presented. It was shown that there are statistically significant differences between the psychological structure of these groups of respondents.
Psychological features of family members (wives) of military personnel performing combat missions outside the borders of the Russian Federation, with different levels of satisfaction with marriage
Authors: Gudkova Irina
Published: April 2020

The article describes the results of a comparative analysis of the psychological characteristics of family members (wives) of military personnel performing combat missions outside the borders of the Russian Federation. The urgency of carrying out psychological work not only with military personnel, but also with members of their families is proved. The results of the comparative analysis are clearly presented and described. The unique features of each group of respondents that distinguish it from other groups are given. The information obtained can be used to build a line of psychological support for each of the categories of respondents, depending on their level of satisfaction with marriage.
The level of pedagogical culture as the basis of professional activity of the head of the internal Affairs body of the Russian Federation
Authors: Sumina Ekaterina , Dobrynina Oksana
Published: April 2020

the article deals with the management activities of the head of the internal affairs bodies of the Russian Federation. The main professionally important qualities of the head influencing his professional activity are highlighted. An ideal model of the pedagogically cultural personality of the head of the internal affairs body of the Russian Federation is proposed, which is a set of those properties that must be formed by the head. This model consists of a number of subsystems that are the main dialectically interconnected and interdependent structural elements; pedagogical skills, active life position, knowledge and understanding of pedagogical phenomena, pedagogical conviction. The article discusses the views of a number of scientists regarding the pedagogical culture of the leader. The pedagogical culture is considered as an integral element of the set of professionally important qualities of the head of the internal affairs body of the Russian Federation. The authors conclude that the mere presence of professionally important qualities in a person cannot ensure the high efficiency of managerial activity if, in the process of training and preparation for managerial activity, they were not developed to the highest level - professionalism.
Sharing experience: how to prevent and correct mistakes when teaching english at university
Authors: Dyundik Yuliya , Kalish Elena
Published: April 2020

In the article the authors analyze a mistake as an integral part of any studying process on the example of studying English at University. The authors point out that making mistakes is quite natural, moreover it helps reveal major problems in terms of both studying and teaching. Thanks to students’ mistakes the teacher has an opportunity to understand how to work with a definite group, what aspects and methods need more attention and activity. The article considers basic reasons which lead to mistakes and ideas how to deal with them based on the authors’ experience. It is pointed out that the teacher has to decide how to prevent and work with mistakes in every occasion as every student and every lesson are unique and require individual approach and attention.
Is the third sector an extension of public administration? Reflections on the Gipuzkoan case
Authors: Arrieta Felix , Izaguirre Ainhoa , Zuñiga Martín
Published: April 2020

The role of the third sector in the provision of welfare and its relationship with public administration have been gaining importance in political debates because of the difficulties that welfare states have in responding to emerging social needs. The ‘Gipuzkoan model’, based on a public–private collaboration between third sector organisations and the public administration in Gipuzkoa in the Basque Country in Spain, has been drawing attention over the past 40 years. However, there is a debate concerning the role that each actor should play in the implementation of welfare policies. This article analyses, from a qualitative point of view, the role of the third sector in designing and providing public policy tools for the region within the context promoted by the Gipuzkoan model of public–private collaboration. The results obtained illustrate a multifaceted scenario in which different visions converge around the same question: How should this collaboration be developed and what future awaits the third sector?
Energy adjustment pulse shaping algorithm part I: accuracy improvement of phase retrieval IFTA
Authors: Watanabe Koyo , Inoue Takashi
Published: April 2020

Techniques to generate a targeted temporal waveform with high accuracy are desirable to extend the application range for pulse shapers. In this study, a target energy adjustment mechanism is applied to the input-output iterative Fourier transform algorithm (IFTA). It is numerically demonstrated that, considering multi-pulse temporal waveforms, the developed algorithm provides a suitable spectral phase modulation pattern and improves the shape of the temporal waveform compared to that of the input-output IFTA.
Energy adjustment pulse shaping algorithm part II: realization of a spectral intensity design
Authors: Watanabe Koyo , Inoue Takashi
Published: April 2020

An accurately controlled arbitrary temporal waveform is required for many applications. To realize accurate pulse shaping, many optimization algorithms have been proposed to design spectral phase modulation patterns. However, as far as the authors know, no intensity optimization algorithm has been proposed. Therefore, in this paper, an algorithm is proposed to design an optimal spectral intensity modulation pattern for shaping short laser pulses. Consequently, it is numerically demonstrated that the proposed algorithm provides suitable spectral intensity modulation patterns, which create more accurate shapes of temporal waveform than those of spectral phase-only modulation.
Broadband optical response of layered nickel ditelluride towards the mid-infrared regime
Authors: Yang Lingling , Liu Dongyang , Li Jie , Yi Qian , Yi Jun , Huang Bin , Miao Lili , Wu Man , Zhao Chujun
Published: April 2020

The broadband nonlinear optical material towards the mid-infrared spectral range is highly needed for civil and military applications. Here, we have investigated the nonlinear optical response of the nickel ditelluride (NiTe2) single crystal prepared by the chemical vapor deposition (CVD) method, and found that the layered NiTe2 exhibits attractive broadband nonlinear optical absorption performance towards the mid-infrared regime. We further explored the nonlinear optical response of the layered NiTe2 in the erbium-doped fluoride fiber laser, and have realized the stable Q-switched fiber laser with a pulse width of 708 ns and a repetition rate of 81 kHz around 2.8 µm wavelength. The experimental results may not only make inroads towards the understanding the nonlinear optical response of the topological materials, but also explore their broadband applications in mid-infrared photonics.
Genetic Variants of the MGAT5 Gene Are Functionally Implicated in the Modulation of T Cells Glycosylation and Plasma IgG Glycome Composition in Ulcerative Colitis
Authors: Pereira Márcia S. , Durães Cecília , Catarino Telmo A. , Costa José L. , Cleynen Isabelle , Novokmet Mislav , Krištić Jasminka , Štambuk Jerko , Conceição-Neto Nádia , Machado José C. , Marcos-Pinto Ricardo , Magro Fernando , Vermeire Séverine , Lauc Gordan , Lago Paula , Pinho Salomé S.
Published: April 2020

OBJECTIVES:

The impact of genetic variants (single nucleotide polymorphisms [SNPs]) in the clinical heterogeneity of ulcerative colitis (UC) remains unclear. We showed that patients with UC exhibit a deficiency inMGAT5glycogene transcription in intestinal T cells associated with a hyperimmune response. Herein, we evaluated whetherMGAT5SNPs might functionally impact on T cells glycosylation and plasma IgG glycome in patients with UC, as well as in UC clinical outcomes.

METHODS:

Three selectedMGAT5SNPs (rs3814022, rs4953911, and rs1257220), previously associated with severity of autoimmune disease or with plasma glycome composition in healthy individuals, were functionally evaluated in patients with UC through analysis ofMGAT5mRNA levels in colonic (n = 14) and circulating (n = 24) T cells and through profiling the plasma IgG Fc glycosylation (n = 152).MGAT5SNPs were genotyped in 931 patients with UC from 2 European cohorts and further associated with patients' prognosis. Targeted next-generation sequencing forMGAT5coding and regulatory regions was also performed.

RESULTS:

MGAT5SNPs were shown to be functionally associated with low transcription levels ofMGAT5in colonic and circulating T cells from patients with UC and with agalactosylation of IgGs, often associated with a proinflammatory phenotype. The SNPs rs3814022 and rs4953911 were further associated with the need of biologics. Next-generation sequencing data further revealed a combination ofMGAT5SNPs that stratify patients with UC according to their severity.

DISCUSSION:

Our results revealed thatMGAT5SNPs have a phenotypic impact on T cells glycosylation and in plasma IgG glycome composition associated with UC pathogenesis.MGAT5SNPs display a tendency in the association with a worse disease course in patients with UC.
The Association Between Cholecystectomy, Metabolic Syndrome, and Nonalcoholic Fatty Liver Disease: A Population-Based Study
Authors: Latenstein Carmen S. S. , Alferink Louise J. M. , Darwish Murad Sarwa , Drenth Joost P. H. , van Laarhoven Cornelis J. H. M. , de Reuver Philip R.
Published: April 2020

OBJECTIVES:

Obesity is a risk factor for several phenotypes such as gallstones, metabolic syndrome (MS), and nonalcoholic fatty liver disease (NAFLD). It has been suggested that cholecystectomy is a risk factor for metabolic abnormalities and NAFLD. We aimed to determine whether cholecystectomy is associated with MS or NAFLD in a Dutch population-based study.

METHODS:

The Rotterdam Study is an ongoing prospective population-based cohort. We included participants who underwent a liver ultrasound between 2009 and 2014 to assess steatosis. The prevalence of MS and NAFLD was calculated, and we performed regression analyses relating cholecystectomy with MS and NAFLD and adjusted for age, sex, study cohort, education level, physical activity, energy intake, time since cholecystectomy, body mass index, presence of hypertension, diabetes mellitus, and steatosis/MS.

RESULTS:

We included 4,307 participants (57.5% women, median age 66.0 years [interquartile range 58–74]). In total, 265 participants (6.2%) underwent a cholecystectomy. The median age at the time of cholecystectomy was 57.0 years (47.5–66.5), and the median time from cholecystectomy to imaging of the liver was 10.0 years (0.5–19.5). The prevalence of MS in participants with cholecystectomy was 67.2% and 51.9% in participants without cholecystectomy (P < 0.001). Ultrasound diagnosed moderate/severe NAFLD was present in, respectively, 42.7% and 34.2% of the participants (P = 0.008). After multivariable adjustments for metabolic factors, cholecystectomy was no longer associated with the presence of MS or NAFLD.

DISCUSSION:

The prevalence of MS and NAFLD is higher in participants after cholecystectomy. However, our trial shows that cholecystectomy may not be independently associated with the presence of MS and NAFLD after correction for metabolic factors.
Current Situation. Attack on the Humanities and Social Sciences in Brazil
Authors: Chalhoub Sidney , Corde Marie , Facundo Navia Angela , Mavrot Céline , Tiquet Romain
Published: April 2020

In the wake of President Jair Bolsonaro's recent attacks on philosophy and sociology in the higher education system, Émulations is pleased to welcome three experts for a cross-interview on the situation of human and social sciences in Brazil in light of the current political situation. This interview was conducted by Céline Mavrot and Romain Tiquet.

Dans le cadre des attaques récentes du président Jair Bolsonaro à l’encontre de la philosophie et de la sociologie au sein du système d’éducation supérieure, Émulations reçoit trois spécialistes – Sidney Chalhoub, Marine Corde, Angela Facundo Navia – pour un entretien croisé sur la situation des sciences humaines et sociales au Brésil à la lumière de l’actualité politique du pays. Cet entretien a été réalisé par Céline Mavrot et Romain Tiquet.
Developing improved methods for cost effective viability monitoring of Aeschynomene abyssinica and A. americana
Authors: Sartie Alieu Mortuwah , Woldemariam Yeshi , Hanson Jean , Ndiwa Nicholas
Published: April 2020

Aeschynomene americana and A. abyssinica are forage legumes that are highly valuable as livestock feed and for soil fertility improvement. Hard-seededness is a form of physical dormancy imposed by a hard seed coat and is a common phenomenon in legume seeds. We assessed
dormancy breaking treatments in relation to the time and cost of performing the assessments with the objective of developing improved methods for cost effective viability monitoring in these species. Results show that scarification of seeds with a hot wire, incubating them at 25 or 30°C,
and germinating them on top of paper were the most reliable and cost-effective methods for overcoming seed dormancy for viability monitoring in Aeschynomene abyssinica and A. americana. However, the species differed in their response to the dormancy breaking treatments, with
no significant differences in A. americana for all the factors except accession, suggesting that efficient dormancy breaking methods in Aeschynomere is species-specific.
Introducing the Non-Religious in Alcoholics Anonymous
Authors: Munro Zachary A
Published: April 2020

The religious dimensions of Alcoholics Anonymous (AA) have long caused tensions for the non-religious involved in the fellowship. In response to these challenges, an increasing number of secular meeting groups have begun emerging, offering non-religious approaches to AA's Twelve Step model of recovery. Drawing on qualitative interview and observational data with members of secular groups located in Toronto, Canada, this article explores how non-religion manifests as meaningful difference in the lives of the non-religious navigating AA. As religion is encountered, participants describe how their non-religious identities became problematized, characterized as active impediments to recovery, and how non-religion is often experienced as a source of struggle and conflict. Despite such challenges, as the non-religious persist in active engagement with AA they participate in new labours of nonreligion, producing new agential spaces and new interpretations and expressions of AA's Twelve Step model of recovery. In recognizing non-religion as meaningful difference and attending to the ways it manifests and operates within AA, this article argues that attention to non-religion in AA provides new opportunities for both research into the substantial features of non-religion and integrative paths for the non-religious in AA and Twelve Step fellowships more broadly.
In/visible Recoveries
Authors: Sharp Ethan
Published: April 2020

Based on ethnographic research in Northern Mexico, this article describes the efforts of men within a therapeutic community closely tied to Alcoholics Anonymous (AA) to manage perceptions of AA recovery pathways, and to define for themselves and the larger public the nature of the spirituality that they acquired in recovery. Through an analysis informed by discourse studies and linguistic anthropology, the article shows that through discourse and symbolic actions in public display events, the men reinforced a belief in the effectiveness of AA recovery pathways by affirming their stigmatized identities as “addicts,” and by framing experiences such as rejection by family, an arrest or an encounter with death as possibilities for demonstrating honesty and authenticity, and for developing a sense of spirituality and the confidence needed to do the work of recovery. The men’s spirituality did not rely on any kind of consistent religious or spiritual practice; rather, it involved recognizing God as a force in their lives and remaining open to new discoveries and insights.
A Qualitative and Critical Religion Analysis of the Category of Spirituality within The Visible Recovery Advocacy Movement
Authors: Metcalf-White Liam
Published: April 2020

Critiques of the category "spirituality" argue that it functions to anesthetise affiliates to inequalities such as the suffering caused by capitalism. Furthermore, spirituality is regarded as both a superficial consequence of late-modernity and reifying the neoliberal agenda of an "individual" as narcissistic and morally responsible. While these critiques of spirituality are useful, they are totalising and only partially examine the complexities of such varied discourses. This article qualitatively examines the category of spirituality within the Visible Recovery Advocacy Movement (VRAM). Alongside "faithbased," "non-religious," and allegedly "secular" recovery modalities, many individuals and groups identifying within this movement utilise the language of spirituality. This article does not suggest that discourses on spirituality among people within the VRAM are immune to the tropes of neoliberalism, or that the formation of that category in contemporary usage, is not reliant upon specific cultural, economic, and political trends. Rather, I demonstrate that motivations among VRAM participants for engaging with this classification are far more complicated and dependant on a range of intersecting circumstances than critical evaluations acknowledge. Moreover, utilising study of religion and spirituality literature, I critically examine participants' construction of the category of spirituality, and what they report as the outworkings of that classification, especially in terms of addiction recovery, identity formation, making meaning, and community.
Klesas and Pretas
Authors: Dossett Wendy
Published: April 2020

This article offers an analysis of Buddhist approaches to addiction recovery in the terms of some of the key debates in addiction/recovery studies. Buddhist recovery teachings are analysed for the extent to which they embody models of addiction which construe the problem as a disease, as a moral problem, as a problem of powerlessness, as a problem of control, as a choice, as a social or a personal problem, and as continuous (or not) with putative samsaric experience. They are also analysed for the extent to which recovery is modelled as a change of identity or of practices, and how far ‘recovery ideals' align with Buddhist soteriology. The article exposes philosophical and epistemological diversity across Buddhist recovery pathways, and argues that the therapeutization of Buddhism (Metcalf 2002) is inadequate as a categorical frame
HER2-pozitif lokal ileri meme kanserinde neoadjuvan trastuzumab sıralamasının patolojik tam yanıt üzerine etkisi
Authors: ERGÜN Yakup , YILDIRIM ÖZDEMİR Nuriye , YAZICI Ozan , UÇAR Gökhan , AÇIKGÖZ Yusuf , BAL Öznur , UNCU Doğan
Published: April 2020

Amaç: Trastuzumabın meme kanserinde neoadjuvan
tedaviye eklenmesiyle patolojik tam yanıt (PTY) oranını arttırdığı
bilinmektedir ancak trastuzumabın kullanım sırasıyla ilgili kısıtlı veri
bulunmaktadır. HER2 pozitif lokal ileri meme kanserinde neoadjuvan trastuzumab
uygulama sırasının PTY üzerine etkisi olup olmadığını incelemeyi amaçladık.

Materyal
ve metod: 2010-2018 yılları
arasında HER2 pozitif evre 2 ve 3 meme kanseri nedeniyle neoadjuvan trastuzumab
kullanan hastaların verileri retrospektif incelenmiş olup antrasiklin bazlı
tedavi sonrası trastuzumab alan 30 hasta ile tam tersi sıralama ile tedavi alan
16 hasta çalışmaya alındı.

Bulgular: Çalışmaya toplam 46 hasta alınmış olup
ortanca takip süresi 31 aydı (7-98). Hastaların ortanca yaşı 51 yıldı (19-72).
Tüm hastaların %52 si postmenopozal, %67'si hormon reseptör pozitifti. Tüm
hastalarda klinik nod pozitifliği olup %54'ü cN1 idi. Hastalar trastuzumab
sıralamasına göre gruplandırıldığında bazal özellikler açısından anlamlı fark
yoktu. PTY oranları trastuzumab ile tedaviye başlayanlarda %63 olup diğer
grupta %37 (p=0.1) olup 3 yıllık kümülatif hastalıksız sağ kalım oranları ise
sırasıyla %100 ve %80’di (p=0.2). Tek değişkenli analizde evre 2 ve VKI <25
kg/m² olan grupta PTY oranı anlamlı olarak daha yüksekti, çok değişkenli
analizde ise sadece VKI<25 kg/m² olmasının bağımsız prediktif faktör olduğu
bulundu (Odds oranı: 18.1 %95 Güven aralığı 1.39–36.0, p=0.03).

Sonuç: Neoadjuvan tedaviye trastuzumab ile
başlanması PTY oranını nümerik olarak arttırmış olsa da fark istatistiksel
olarak anlamlı değildi. Farkın istatistiksel olarak anlamlı olmamasının nedeni
hasta sayımızın az olması olabilir. Trastuzumab sıralamasının PTY ile
ilişkisine yönelik daha büyük hasta popülasyonuna sahip güçlü çalışmalara
ihtiyaç vardır.
Akrep Sokması Nedeniyle Başvuran Çocuk Olguların Değerlendirilmesi: Bir Üniversite Hastanesi Deneyimi
Authors: ÇELİK Elif , DURSUN Adem
Published: April 2020

Amaç: Bu
çalışmanın amacı akrep tarafından sokulan çocukların demografik, klinik ve
laboratuvar özelliklerini değerlendirerek; özellikle ağır olgular için öngörü
olabilecek özellikleri tanımlayabilmektir.

Gereç
ve yöntemler: Akrep sokması nedeniyle hastanemize
başvuran toplam 37 çocuk geriye dönük incelendi. Olgular klinik şiddetlerine göre
gruplandırıldı. Evrelerine göre klinik ve laboratuvar özellikleri
karşılaştırıldı.

Bulgular:
Yaş ortalamaları 8±4.6 yıl olan 37 olgu retrospektif olarak değerlendirildi.
24’ü (%65) erkek, 13’ü (%35) kızdı. Olguların %83,7’si hafif-orta klinik
şiddete sahipti. Lokal ağrı (%60) ve lokal eritem (%30) başvuru anındaki en sık
bulgulardı. En fazla sokma olayı yaz mevsiminde (%75.6), evde (%81) ve gece saatlerinde
(%54) gerçekleşmişti. Hiçbir olgu da otonomik fırtına, kalp yetersizliğine
bağlı veya kalp dışı nedenle akciğer ödemi ve kalp yetersizliği gelişmedi. Hiçbir
olgu mekanik ventilatöre bağlanmadı ve ölmedi. Yoğun bakıma yatırılan ve
antivenom uygulanan şiddetli olguların hiçbirinde alerjik reaksiyon gözlenmedi.

Sonuç: Akrep sokması ülkemizde ve bölgemizde halen önemli bir sorundur.
Her ne kadar bölgemizde buna bağlı mortalite oranı düşük olsa da, mortalite ve
morbiditeyi etkileyen en önemli faktör erken başvuru ve uygun tedavidir. Bu
nedenle halka öncelikle korunma tedbirleri öğretilmeli, en kısa sürede sağlık
kuruluşlarına başvurmaları sağlanmalıdır.
Maternal Serum D Vitamini Seviyesinin Gebelik Sonuçlarına Etkisi
Authors: ONAT Taylan , BAŞER Emre , DEMİR ÇALTEKİN Melike , AYDOĞAN KIRMIZI Demet , KARA Mustafa , YALVAÇ Ethem Serdar
Published: April 2020

Amaç:  D
vitamini kalsiyum dengesi ve kemik sağlığının sağlanmasında önemli bir yağda
çözünen vitamindir. D vitamini eksikliği tüm dünyayı etkileyen önemli bir halk
sağlığı sorunudur. Bu çalışmanın amacı; bölgemizdeki gebelerin D vitamini
seviyesini saptamak ve olası gebelik komplikasyonları ile olan ilişkisini
değerlendirmektir.

Materyal ve Metod: Kesitsel
tipte yapılan bu çalışmaya kadın hastalıkları ve doğum
polikliniğine rutin gebelik muayenesi için başvuran 175 gebe dahil edildi. Çalışmaya
katılan gebelerin demografik özellikleri ve obstetrik hikayeleri kayıt edildi.
Maternal serum D vitamini seviyeleri ile gebelik sonuçları karşılaştırıldı.

Bulgular: Çalışmaya
katılan gebelerin ortalama serum D vitamini değeri 11,16±7,15 ng/ml olarak
saptandı ve gebelerin % 57.7’sinde ciddi D vitamini eksikliği (< 10 ng/ml) vardı.
Gebelik sonuçları ile maternal D vitamini seviyeleri arasında ilişki
saptanmadı.

Sonuç:
Çalışmamızda ciddi D vitamini eksikliğinin % 57.7 olarak saptanmasına rağmen maternal
D vitamini seviyeleri ile gebelik sonuçları arasında herhangi bir ilişki
saptanmadı.
Európa Kulturális Fővárosai Kelet-Közép-Európában
Authors: Morvay Szabolcs , Rechnitzer János , Fekete Dávid
Published: April 2020

Az Európai Unió kiváló és sikeres kulturális kezdeményezése az Európa Kulturális Fővárosa projekt. Az ezredforduló utáni két évtizedben a programsorozat Kelet-Közép-Európában is grandiózus módon megvalósult kilenc városban, mely városokban megújulást, ismertséget, kulturális felvirágzást hozott magával. Az első Európa Kulturális Főváros Kelet-Közép-Európában Nagyszeben volt, 2007-ben. Példáját Vilnius követte 2009-ben, a következő években pedig rendre Európa Kulturális Fővárosa volt Pécs, Tallinn, Maribor, Kassa, Riga, Plzen és Wroclaw. Izgalmas kérdés, hogy a programsorozat milyen hatásokat generált ezekben a városokban, milyen hozadéka származott a megvalósított projekteknek, hozzájárult-e - ha igen, miként - a városok fejlődéséhez az Európa Kulturális Fővárosa kezdeményezés? Tudni kell azonban, hogy a projekt jelentős forrásokat igényel, mely olyan felelősséget ró a városokra, hogy a programsorozat képes legyen hosszú távon előremutató városfejlődési eredményeket produkálni. E tanulmányban a kilenc kelet-közép-európai Európa Kulturális Főváros projektjeivel foglalkozunk, megvizsgálva a városok kulturális vízióit, a projektek kézzel fogható eredményeit, illetve összehasonlításra kerülnek a programok költségvetései, valamint a projektévben városokba látogatók száma. Ez utóbbi indikátort az Európa Kulturális Fővárosa projekt kiemelt sikerességi faktorának tekintjük, hiszen kifejezi, hogy milyen mértékben sikerült megszólítani a kultúra iránt érzékeny európai polgárokat. Az eredményesség értékelése kapcsán ugyanakkor eredendően úgy véljük, hogy a kezdeményezés soha nem lesz sikertelen egy városban sem, hiszen a kultúra virágzásáért tett legkisebb erőfeszítés is nagyrabecsülendő.
Health technology assessment in obstetrics: advantage of tailored conservative strategy vs surgical therapies of monochorionic twin complicated by TRAP-sequence
Authors: Tsibizova V. I. , Govorov I. E. , Averkin I. I. , Khamani N. M. , Blinov D. V.
Published: April 2020

Introduction.Twin reversed arterial perfusion (TRAP) syndrome is one of the types of complications of monochorial twins (MT) with a frequency of occurrence of 1:35000 births. It is characterized by the presence of the main vessel instead of a normal 4 chambers heart and intrauterine developmental abnormalities. This pregnancy requires monitoring using dynamic ultrasound diagnostics every 7 days, in accordance with current recommendations. The treatment is intrauterine laser coagulation of blood vessels of the “acardial fetus” (AP) in order to prevent the development of a threatening condition for the “fetal pump” (PP). 

Aim: to demonstrate the possibilities of comprehensive conservative management of monochorial pregnancy complicated by TRAP.

Materials and methods. An ultrasound examinations were performed on a weekly basis in monochorionic pregnancy, complicated by TRAP within the period 12-38 weeks. Serum concentrations of biochemical markers PAPP-A (pregnancy-associated plasma protein-A) and β-hGC (β-subunit of human chorionic gonadotropin) were studied in the first trimester to predict adverse perinatal outcomes.

Results. The possibility of prolonging a pregnancy complicated by TRAP without performing intrauterine surgical intervention, during which quite serious complications can occur in this category of pregnancies, has been demonstrated. In a patient with monochorionic twins complicated by TRAP, totally 27 ultrasound examinations were performed within the period 12-38 weeks. This approach made it possible to dynamically monitor the condition of a pregnant and healthy fetus and to prolong pregnancy without surgery until the full term.

Conclusions.Following the existing guidelines, without tailoring for individual risk, may lead to an unreasonable increase in surgical interventions. In turn, surgery is not only accompanied by a high risk of complications (up to 15%), but also constitute a certain financial burden on the budget, determined by the state on the level of 208,000 rubles. Performing routine ultrasound examinations according to the examination protocol for monochorionic pregnancy will contribute to avoiding the complications associated with surgery and better selection for surgery as well as reducing the government costs.
COVID-19 in Moscow: prognoses and scenarios
Authors: Tamm M. V.
Published: April 2020

Aim:to present a mathematical model of the development of COVID-19 in Moscow along with the analysis of some scenarios of epidemic control and possible epidemic consequences.

Materials and Methods.The modeling of the epidemics was based on the extended SEIR model proposed lately in the group of Prof. R. Neher and realized as a freely available software program. The authors based the choice of the parameters of modeling on published data on the epidemiological properties of the novel coronavirus SARS-CoV-2 and open access data on the registered cases of COVID-19 in Moscow for 8-27 March 2020.

Results.Five potential scenarios of the development of COVID-19 epidemics are studied. The scenarios are differed by the levels of the control measures: Null Scenario corresponded to the lack of protective measures, Scenario A – mild measures of the epidemic control (closing of schools and universities, recommendations for senior citizens to stay inside), Scenario B – medium level of control (closing of all public places, recommendation for the citizens to stay inside), Scenarios C and D – complete lockdown (from the beginning of May 2020 within Scenario C and from the beginning of April 2020 within Scenario D). It was shown that within the Null Scenario, the lethality from the novel coronavirus in Moscow will exceed 100 thousand people, and the number of critically ill patients on the peak of the epidemics will exceed the capacities of the system of healthcare. Scenarios A and B did not provide for a radical decrease in the fatality rate, and the number of critically ill patients at the peak of epidemics will still exceed the capacities of the system of healthcare. Besides, within Scenario B, the epidemics will last for more than a year. Scenarios C and D will allow for the control of epidemics and a significant decrease in the rate of letha lity (by 30 and 400 times, respectively). At the same time, these two scenarios prevent the population from developing herd immunity, which would result in the population susceptibility to repeated epidemics outbreaks.

Conclusion. The scenarios intended for the slow development of herd immunity in the conditions of epidemic control would not bring sufficient results: the lethality would remain unacceptably high, the capacities of the system of healthcare would be overloaded, and the time of limiting measures would be unacceptably long. Such measures as complete lockdown would stop the present epidemics. The earlier they are introduced, the more efficient will be the results. To prevent further repeated outbreaks of the epidemics, it is necessary to establish a system of available, quick, and efficient testing in combination with point isolation of the infected patients and their contacts.
Interregional research and practical conference with international attendance “Epilepsy and Paroxysmal Conditions as an Interdisciplinary Problem”(19 February 2020)
Authors: Petrenko D. A.
Published: April 2020

The annual Interregional research and practical conference “Epilepsy and Paroxysmal Conditions as an Interdisciplinary Problem” was held in Moscow 19/02/2020, bringing together neurologists and epileptologists from Russia. The event was dedicated to the memory of Gagik N. Avakyan, who was President of Russian League Against Epilepsy (RLAE) for many years. The paper contains key messages of the plenary session.
Length-Weight Relationships of 17 Teleost Fishes in the Marmara Sea, Turkey
Authors: ARSLAN İHSANOĞLU Mukadder , DABAN İsmail Burak , İŞMEN Ali , İNCEOĞLU Haşim
Published: April 2020

Length weight relationship parameters were determined for 17 fish (Arnoglossus kessleri, Blennius ocellaris, Callionymus lyra, Cepola macrophthalma, Citharus linguatula, Lesueurigobius friesii, Merluccius merluccius, Lophius piscatorius, Merlangius merlangus, Gobius niger, Mullus barbatus, Solea solea, Spicara maena, Serranus hepatus, Trachurus trachurus, Trachurus mediterraneus, Uranoscopus scober) species in the Marmara Sea. Fish samples were collected monthly bases between September of 2011 and July of 2014 with a beam trawl. The growth type of each species were determined and the calculated b values changed in range from 1.2565 to 3.4018.
Correlation between QoTc and serum as well as ionised calcium in sick neonates
Authors: T. Yashoda H. , C. Kavya , E. Nithya , Gowda Laghna
Published: April 2020

Background: Hypocalcemia is a frequently observed clinical and laboratory abnormality in neonates with risk factors such as prematurity, infant of diabetic mothers and perinatal asphyxia. Hypocalcemia can be asymptomatic or can cause apnoea, seizures, jitteriness, stridor, cardiac abnormalities. Clinically as calcium levels are maintained within narrow ranges. It is therefore imperative to measure and correct any deficit at the earliest. Unfortunately, total serum calcium level correlates poorly with ionized calcium level. Measurement of ionized calcium is both time consuming and expensive and therefore the need for more rapid, inexpensive and non-invasive method for screening at risk-neonates. Serum calcium levels are known to affect the duration of the QoTc interval. Therefore establishing a good correlation between serum/ionized calcium levels and QoTc will validate ECG as a reliable marker of hypocalcemia. Objective was to find correlation between QoTc interval and serum calcium levels in sick neonates.Methods: Total 730 infants were for serum total calcium and ionized calcium levels. Off these 142 infants with hypocalcemia, 29 infants were excluded based on exclusion criteria. The remaining 113 neonates were subjected to three cycles of ECG measurement before correction of calcium and were taken as cases. QoTc intervals were measured and were correlated with corresponding serum total calcium and ionized calcium levels.Results: In this study, a moderate negative or downhill correlation was found between total serum calcium QoT (r = -0.694 and p = <0.001) and QoTc (r = -0.680 and p = <0.001). The ionized calcium levels were found to have strong negative or downhill correlation with QoT (r = -0.837 and p = <0.001), QoTc (r = -0.819 and p = <0.001). All these correlations were found to be statistically significant with p<0.05.Conclusions: QoTc interval can be used as a surrogate marker for blood total or ionized calcium levels.
Clinical and demographic profile of paediatric patients presenting with acute diarrhea
Authors: Shah Apurva C. , Sareen Devendra , Goyal Dileep Kumar
Published: April 2020

Background: Diarrhea is a public health problem globally, being the 2nd leading cause of death in children under 5 years. Dehydration as well as malnutrition are also serious consequences of diarrhea. This study was carried out with an aim to focus on the clinical and demographic profile of diarrheal patients of pediatric age.Methods: Infants and children aged 6 months to 5 years were analysed for age and gender distribution, chief complaints, feeding practices, nutritional status and assessment of dehydration; from January 2018 to June 2019 in the Department of Pediatrics of a Tertiary Care Teaching Hospital.Results: Total 150 patients were analysed. Almost 50.67% group A and 41.34% group B patients belonged to toddlerhood. Male preponderance was also noted. Along with diarrhea, vomiting was noted in 22 group A and 21 group B and fever in 19 group A and 29 group B patients. Approximately 41-45% patients had no malnutrition and 55-60% had no dehydration in both the study groups.Conclusions: There is lack of awareness regarding dog bite and its management among the rural people fever and vomiting were most frequently associated with diarrhea. A little less than half of the study participants had some-dehydration. Nearly half of the patients belonged to toddler age group. Majority of the patients were exclusively breast-fed for six months.
Utility of reticulocyte hemoglobin in diagnosing latent iron deficiency and iron deficiency anemia
Authors: Chandrashekar Kavya , T. Yashoda H. , Reddy Varsha Monica
Published: April 2020

Background: Iron deficiency is the most common cause of anemia and studies have shown poor cognition, psychomotor and social/emotional development in children who are deficient in iron, even with normal hemoglobin levels, the so-called Latent phase of Iron deficiency. It is therefore crucial to identify LID, as well as IDA at the earliest stage, in order to initiate treatment.  Many tests like serum ferritin and soluble transferring receptor(sTfR) have been described collectively as a panel to detect iron deficiency; however no single test is specific enough to be used independently. Also during treatment it takes weeks to observe changes in Hb, hematocrit or RBC indices, hence the need for a more sensitive and reliable test. Objective was to evaluate effectiveness of CHr in diagnosing LID and IDA.Methods: Samples were collected from 180 children, clinically suspected to be anemic. Complete hemogram and Iron profile were measured. Three groups were defined, LID (Tfsat <20%, Hb >11g/dL; n=52), IDA (Tfsat <20%, Hb <11g/dL; (n=84) and controls (Tfsat >20%, Hb >11g/dL; n=44). The mean values of RBC indices, Iron profile and CHr was compared across the groups. A cut off value of <26 pg CHr was taken to represent Iron deficiency state.Results: Comparison between anemic group and control found that all RBC indices were found to be significantly lower including Reticulocyte hemoglobin. All of the variables in anemic group were lower compared to latent iron deficient group except MCHC and reticulocyte count. CHr was found to be statistically lower in LID and IDA group in comparison to control group.Conclusions: CHr can be used as a valuable indicator in diagnosis as well as follow-up of LID and IDA, which is easily available and inexpensive.
Clinical profile and outcome of infant of diabetic mother in a tertiary care sick newborn care units
Authors: Senthilkumar K. M. , Shanthi R.
Published: April 2020

Background: Diabetes mellitus is the most common metabolic disorder complicating pregnancy. The incidence of pre-gestational (type 1 and type 2) and gestational diabetes mellitus is on the rise in India. Authors aimed to study the clinical profile and outcome of the infant of diabetic mothers.Methods: The study was conducted in the Sick Newborn Care Unit attached to Stanley Medical College in Chennai over a period of 6 months. All infants born to diabetic mothers during the study period were included in the study.Results: Among the total of 6236 babies delivered in total during the study period, 566 (9.07%) were born to diabetic mothers. 16.25% were pre-gestational diabetic mothers and 83.75% were GDM Mothers. The incidence of prematurity was 15.2% and LGA was 7.9%. The majority were AGA (495 out of 566). Symptomatic Hypoglycemia was observed in 16 babies and asymptomatic hypoglycemia in 35 babies with total occurrence of hypoglycemia in 9% of babies. Hyper-bilirubinemia is the most common problem encountered in 29% of babies, congenital heart disease and renal problems were the most common congenital anomalies noted in IDM 44 out of 566 babies (7.8%).Conclusions: There is lack of awareness regarding dog bite and its management among the rural populatEarly detection and optimal management of diabetic status during the antenatal period along with anticipation, early recognition and management of postnatal complications will reduce the mortality of infants of diabetic mothersion.
A study to assess the prevalence of atypical organisms in pneumonia in children aged 1 month to 3 years by serum polymerase chain reaction in KIMS Hospital, Bangalore, India
Authors: Ramya H. S. , Gopi Anjana , Elango Vivetha
Published: April 2020

Background: Atypical organisms are a common causative agent of pneumonia in children more than 3 years of age. Though atypical pathogens are said to cause relatively milder form of pneumonia severe manifestations can also occur.  Very few studies are available on the prevalence of atypical pneumonia in children less than 3 years. Hence in this study the prevalence of atypical organisms in pneumonia was identified by using serum Polymerase chain reaction (PCR).Methods: This is a prospective observational study conducted in children between 1 month to 3 years of age with clinical diagnosis of pneumonia admitted in wards and PICU in KIMS hospital. Authors excluded Immuno compromised children. Detailed history and clinical examination was done. Investigations - complete hemogram, Chest X-ray, blood Culture and sensitivity and serum PCR was done for a sample size of 50 children.Results: Among the three atypical organisms, Legionella pneumoniae was identified in 4% (2/50) cases by serum PCR.Conclusions: In this study it was found that the prevalence of 4%. Legionella pneumonia can be fatal in 10% of cases. Hence atypical pathogens like Legionella should be kept in mind even in children less than 3 years when pneumonia is not responding to beta lactam antibiotics, in such cases macrolides to be considered.
Predictors of mortality in children hospitalized with severe acute malnutrition
Authors: Baskaran Vinnamangalam Mani , Naaraayan Sridevi A. , Priyadharishini Dorairaj
Published: April 2020

Background: Severe acute malnutrition (SAM) is a leading cause of morbidity and mortality in children worldwide. Identification of factors contributing to mortality is crucial to decrease the mortality due to SAM. This study aims at identification of factors affecting mortality in hospitalized SAM children.Methods: This study was done in general pediatric wards of a Government tertiary care center from July 2015 to June 2016. Total 200 children admitted to the hospital with Severe Acute Malnutrition (SAM) as per World Health Organization (WHO) criteria were enrolled. Demographic and clinical data were recorded in structured proforma. These children were followed up till death or discharge and their progress and outcome were noted. The risk factors considered were younger age (infancy), female sex and presence of systemic illness, sepsis, retroviral positivity, severe anaemia, pneumonia and diarrhea and these were compared between those who died and survivors.  Univariate analysis and logistic regression analysis were performed to determine the significant risk factors.Results: The mortality rate was 10.5%. Presence of systemic illness, sepsis and retroviral positivity were significant risk factors at the end of univariate analysis and multivariate logistic regression, while the others were insignificant.Conclusions: Systemic diseases, sepsis and retroviral disease are poor prognostic features and are risk factors of mortality in hospitalized SAM children.