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Thyrotoxicosis in children and adolescents : diagnostic and therapeutic dilemmas
Get PDFCilj istraživanja: Utvrditi incidenciju tirotoksikoze u populaciji djece i adolescenata lijeĉenih na podruĉju Splitsko-dalmatinske ţupanije. Ispitati postoji li razlika u pojavnosti tirotoksikoze s obzirom na spol i dob pacijenta. Ispitati postotak remisije i relapsa tireotoksikoze u pacijenata mlaĊih od 18. godina. Odrediti indikacije i vrijeme za zbrinjavanje hipertireoze radiojodnom terapijom ili operacijskim zahvatom.
Materijali i metode: Za izradu ovog diplomskog rada su korišteni podatci koji su prikupljeni iz Klinike za pedijatriju KBC Split. Dijagnoza tirotksikoze je postavljena na temelju anamneze, fizikalnog pregleda, ultrazvuka štitnjaĉe, serumskih koncetracija hormona štitnjaĉe (T3 ,T4, TSH) i protutijela na TSH receptore (TRAb). PronaĊeno je ukupno 80 bolesnika s dijagnozom hipertireoze. Podaci o pacijentima su uneseni u tablicu (Microsoft Excel 2010 ) te je napravljena je deskriptivna statistiĉka analiza podataka.
Rezultati: U razdoblju od 2002.- 2019.godine imali smo 80 pacijenta s dijagnozom tirotoksikoze.Omjer djevojĉica prema djeĉacima je 4:1, što odgovara podatcima iz drugih literatura. Incidencija Gravesove bolesti na podruĉju Splitsko-dalmatinske ţupanije iznosi 3,2/100 000. Dijagnozu Gravesove bolesti(GB) postavljena je u 70% bolesnika, a Hashimotov tireoiditis u njih 26%. Dijagnoza je postavljena na temelju anamneze, kliniĉkog pregleda,ultrazvuka i analize protutijela TRAb-a. Sva djeca s GB lijeĉena su tireostaticima (TS) te blokatorima adrenergiĉkih receptora. Od bolesnika s Hashimotovim tireoditisom njih 18,4% je dobilo terapiju TS, a 38% je dobilo i simptomatsku terapiju beta blokatorima. Remisiju smo postigli u 26,7% bolesnika s GB-om nakon šest do 63 mjeseca lijeĉenja tireostaticima. Ti podatci odgovaraju iskustvima iz drugih centara.Tako u studiji iz Argentine na 113 bolesnika nakon 10 godina uzimanja TS-a, njih 33% doţivjelo je remisiju (32), a u studiji iz Japana na 723 bolesnika s GB-om njih 46,2% je postiglo remisiju prosjeĉno nakon 3,8 godina uzimanja TS-a (33). Relaps GB-a u naših bolesnika uoĉen je u 40% sluĉajeva,što je nešto manje u odnosu na objavljene rezultate.Research goals: The aim of this research is to determine the incidence of thyrotoxicosis in the population of children and adolescents treated in the County of Split-Dalmatia. Another goal is to analyze and determine if there is a distinction in the prevalence of thyrotoxicosis, considering the patient’s age and gender. Also there is a need to inspect the remission and relapse percentage of thyrotoxicosis among the patients younger than 18 years. At last, the goal is to define the indications and period for the medical treatment of hyperthyroidism with a radioiodine therapy or a surgical procedure.
Materials and methods: All the data used for this diploma thesis are collected from the Clinic for Pediatric Medicine of CHC Split. The medical diagnosis for thyrotoxicosis is based upon the anamnesis, physical examination, thyroid ultrasound, serum concentrations of thyroid hormones (T3, T4, TSH) and TSH receptor antibodies (TRAb). At least 80 patients were detected with the diagnosis of hyperthyroidism. The patient data are presented in tables (Excel, version, city, country) and in addition, the descriptive statistical analysis of collected data has been conducted and displayed
Results: During the period between 2002 and 2019 there were 80 patients with the diagnosis of thyrotoxicosis. The female to male ratio is 4:1, which corresponds to the information from other literature sources. The incidence of Graves disease in the County of Split-Dalmatia is estimated of 3.2/100 000. Around 70% of patients were diagnosed with Graves disease (GD), while 26% of them with Hashimoto disease. The diagnosis is based upon the anamnesis, clinical examination, ultrasound and analysis of TRAb antibodies. All the children with GD were treated with thyrostatic drugs (TS) and adrenergic blocking agents. Looking at patients with Hashimoto disease, 18.4% of them were treated with TS therapy, while 38% were treated with adrenergic blocking agents as well. The remission was attained in 26.7% of patients with GD after 6 to 63 months of treatment with tyrostatic drugs. That data corresponds to the clinical experience from other hospital centers. For example, a study conducted in Argentina shows that from 113 patients that had TS therapy for 10 years, 33% of them were in remission (32), while in Japan, out of 723 patients with GD, 46.2% of them were in remission approximately after 3.8 years of taking TS drugs (33). Relapse of GD in 38 Croatian patients was recognized in 40% of the cases, which is a slight decrease compared to published study results.
Conclusion: We demonstrated that female children are 4 to 5 times more likely to have hyperthyroidism than boys. Also, we proved that the remission of Graves disease depends on multiple factors such as the thyroid size, level of TRAb and age, thus the youngest patients are less likely to be in remission compared to adults. Thyrostatic drugs (TS) should be used as the drug of choice, but if we decide for the definite treatment, a surgical procedure should be chosen over the radioiodine therapy, since the latter causing the higher risk of development of a malignant disease. To conclude, it is important to encourage the parents of the patients with little probability to be in remission to decide faster
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
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