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Renovasküler hipertansiyon şüphesi olan hastalarda klinik ipuçlarının değerlendirilmesi
Full text linkRenovasküler hipertansiyon (RVH), renal arter(ler) darlığının neden olduğu yüksek kan
basıncı ile karekterize klinik bir durumdur. Kronik böbrek yetmezliğine neden olabilen
önemli bir hastalıktır ve erken teşhis edildiğinde sekonder hipertansiyonun en sık
düzeltilebilme ihtimali olan nedenlerinden biridir. Renal arter stenozu (RAS) teşhisinde
altın standart invaziv ve pahalı olan renal anjiografidir. RAS’nun göstergesi olarak sıklıkla
kullanılan bazı risk faktörleri vardır.
Prospektif çalışmamızın amacı, RVH tanısında, klinik ve labratuvar bulgulardan
hangilerinin daha belirleyici olduğunu bulmaktır. Nihai hedefimiz ise renal anjiografi gibi
invaziv bir işleme sadece bu belirleyici faktörleri taşıyan hastaların maruz kalmasını
sağlamaktır.
Çalışmaya hipertansiyon nedeni ile başvuran ve RVH için risk faktörü taşıyan 184 hasta
dahil edildi. Hastaların 77’si erkek (%42), 107’si kadındı (%58)(ortalama yaş:53.5 ± 14).
Tüm hastalara üç boyutlu kontrastlı manyetik rezonans anjiografi (MRA) uygulandı.
Hastalar RAS olanlar ve olmayanlar şeklinde iki gruba ayrıldı. Hastaların demografik
verileri, medikal öyküsü, labratuvar bulguları ve RVH düşündüren risk faktörleri
istatistiksel olarak analiz edildi.
Hipertansiyonlu hastalarımızın %32’sinde RAS saptandı. İleri yaş, düşük vücut kitle
indeksi, yüksek serum kreatinin seviyesi, proteinüri, diabetes mellitus ve kronik böbrek
hastalığı varlığı, RVH için önemli risk faktörleri olarak bulundu. Logistik regresyon analizi
ile RVH için bağımsız risk faktörü olarak sadece korener arter hastalığı öyküsü ile renal
asimetri varlığı saptandı.
Sonuç olarak, ayrıntılı öykü alınması ve böbrek boyutunun değerlendirilmesi hipertansiyon
hastaları için büyük önem taşımaktadır. Koroner arter hastalığı ve böbrek boyutları
arasında 1.5 cm’den büyük fark, RVH’nun güçlü birer göstergesi olabilir.
Renovascular hypertension (RVH) is a clinical situation characterized by high blood
pressure in the presence of the renal artery(ies) stenosis (RAS). It is a very important
disorder that could cause chronic renal failure and is also the most common yet correctable
cause of secondary hypertension if diagnosed early. The gold standard for diagnosing RAS
is renal angiography which is invasive and costly. There are numerous, commonly used
risk that are factors indicative of RAS.
The aim of our prospective study is to find which clinical and laboratory signs are more
determinant in the diagnosis of RVH. The end goal is to have only the patients presenting
these determinant factors go through the invasive procedure of renal angiography.
The study included 184 patients who were admitted due to hypertension and presented risk
factor(s) for RVH. Of these patients, 77 were male (42%), 107 were female (58%) (mean
age ± SD: 53.5 ± 14). All patients were performed three-dimensional time-of-flight
Magnetic Resonance Angiography (MRA) with phase-contrast. Patients were divided into
two groups as with or without stenosis. Statistical analysis was performed on the following
study attributes: patient demographics, medical history, laboratory values, and risk factors
for RAS.
RVH was found in 32% of patients with hypertension. The following were found as
significant risk factors for RVH; advenced age, low body mass index, high serum
creatinine level, presence of proteinuria, in patients with diabetes mellitus, and chronic
renal disease. Only the presence of renal asimetry and the history of coronary artery
disease were found to be independent clinical predictors of RVH based on logistic
regression anaylysis.
In conclusion, detailed patient history and kidney size evaluation hold a great deal of
importance for hypertension patients, as coronary artery disease and a difference in renal
size more than 1.5 cm could be strong indications of RVH
Eritropoetin tedavisi alan kronik hemodiyaliz hastalarında hemoglobin stabilitesinin değelendirilmesi ve hemoglobin stabilitesinin kardiyovasküler hastalık riski üzerine etkisi
No full textAnemi hemodiyaliz tedavisi gören son dönem böbrek yetmezlikli hastalarda hayat kalitesini düşüren en önemli etkenlerden biridir. Bu hastalarda anemi tedavisinde eritropoezi uyaran ilaçlar (ESA) kullanılmaktadır. Kronik böbrek yetmezliğinde hedef hemoglobin (Hb) değeri 11-12 gr/dl olmasına rağmen hastaların büyük çoğunluğunda hemoglobin değerleri normal, yüksek ve düşük değerler arasında dalgalanma göstermekte olup bu dalgalanmanın mortaliteyi artırdığı, kardiyovasküler yapısal değişikliklere yol açtığı öne sürülmektedir. Bu çalışmada ESA tedavisi alan kronik hemodiyaliz hastalarında hemoglobin dalgalanmaları ve bunun kardiyovasküler hastalık riski üzerine etkisini araştırdık. 181 hastanın 12 aylık hemoglobin değerleri incelendi. Hedef Hb düzeyi 11-12 gr/dl aralığı olarak kabul edilip hastalar hemoglobin değerlerine göre sürekli düşük, düşük normal, hedef, normal yüksek, düşük yüksek ve sürekli yüksek olmak üzere göre 6 gruba ayrıldı. Hemoglobin düzeyindeki değişkenliğe göre gruplar, demografik, laboratuar özellikler, kullandığı tedaviler, kardiyovasküler hastalık riski, hospitalizasyon ve ölüm sıklığı ve nedenleri açısından karşılaştırıldı. Toplam 181 hasta 12 aylık ortalama Hb düzeylerine göre sınıflandırıldığında 22 (%12,2) hasta sürekli düşük, 72 (%39,8) hasta düşük-normal, 10 (%5,5) hasta normal-yüksek, 77 (%42,5) hasta düşük-yüksek Hb grubuna dahil oldu. 12 aylık takip süresince Hb değeri sürekli hedefte ve sürekli yüksek olan grupta hasta yoktu. Gruplar diyabet, hipertansiyon, koroner arter hastalığı gibi yandaş hastalıkların varlığı ve diğer demografik özellikler bakımından benzer olup, gruplar arasında mortalite ve kardiyovasküler hastalık gelişimi açısından fark saptanmadı. Yalnızca sürekli düşük Hb grubunda ESA dozları ve kan transfüzyon sayısı diğer gruplara göre anlamlı derecede yüksek saptandı. Bu çalışmada kronik hemodiyaliz (HD) hastalarında yüksek oranda anemi ve hemoglobin değişkenliği gösterilmiş olup bu etkenlerin kardiyovasküler hastalık riski ve mortalite gibi muhtemel olumsuz sonuçları istatistiksel olarak anlamlı saptanmamıştır. Hb değişkenliği ve kardiyovasküler risk arasındaki ilişkinin araştırılması için daha büyük HD hasta grubunda ileriye dönük çalışmalara ihtiyaç vardır.
Anemia is one of the most important problems that reduce the quality of life for end-stage renal disease patients undergoing hemodialysis. Erythropoietin stimulating agents (ESAs) are used for treatment of anemia in these patients. Although target Hb value is 11-12 g/dl in patients with chronic kidney disease, these values show fluctuations in the majority of patients. It has been proposed that these fluctuations increase mortality and cause cardiovascular structural changes. In this study we investigated the effect of fluctuations of hemoglobin for the development of cardiovascular risk in chronic hemodialysis patients under treatment of ESA. 181 patients’ hemoglobin values were examined in the last 12 months. Target hemoglobin level was accepted as 11-12 g/dl. Patients were divided into 6 groups according to the level of hemoglobin as; persistently low, low-normal, target, high-normal, low-high, and persistently high. According to the variability in hemoglobin levels groups were compared in terms of the risk of cardiovascular diseases, frequency of hospitalizations and mortality, and demographics, laboratory data, and treatments used. A total of 181 patients were classified according to Hb levels. 22 patients (12,2%) were in persistently low, 72 were (39.8%) in low-normal, 10 were (5.5%) in normal-high, and 77 were (42.5%) in low-high Hb group. During the 12-month follow-up, there were no patients in target and high Hb group. Groups are distributed uniformly in terms of diabetes, hypertension, coronary artery disease, and in terms of other demographic characteristics. There was no difference in terms of mortality and cardiovascular disease development. Only in persistently low Hb group, the ESA doses and the number of blood transfusion were significantly higher than the other groups.
In this study, high rates of anemia and hemoglobin variability has been shown in chronic hemodialysis (HD) patients. But the potential adverse consequences, such as the development of cardiovascular diseases and mortality were not statistically related to Hb variability. To determine the relationship between hemoglobin variability and cardiovascular risk factors, prospective studies are needed in the larger HD population
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
Full text link“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
Full text linkWe 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
Full text linkWe 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
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