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Monkman H, Mir S, Bond J, Borycki EM, Courtney KL, Kushniruk AW. Canadian employers' perspectives on a new framework for health informatics competencies. Int J Med Inform 2024; 183:105324. [PMID: 38218130 DOI: 10.1016/j.ijmedinf.2023.105324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/26/2023] [Accepted: 12/23/2023] [Indexed: 01/15/2024]
Abstract
Competencies are the knowledge, skills, and abilities needed to operate and perform successfully in the workplace. Due to the evolving nature of health informatics, it is important continuously examine and refine competencies in this field. In this study, we administered a questionnaire to Canadian employers (N = 29) of health informatics cooperative education (co-op) students to garner their feedback on competencies within a New Health Informatics Professional Competencies Framework. Overall, the findings supported this new framework. An average of ratings within each of the four competency categories revealed that participants perceived Management Science to be the most important, followed by Information & Computer Science, then Health Science and finally Data Science. Further, at least 20 (69 %) respondents rated nine of the 12 competencies as important. Of the 12 competencies, Biological and Clinical Science was rated the lowest. Findings from this study can potentially be used to inform curricula, career progression, and hiring practices in health informatics. Future work includes refining the questionnaire to assess the competencies more comprehensively and potentially exploring the importance of more transferable skills or general competencies (e.g., communication, problem-solving). Additionally, we want to survey a broader sample of health informatics professionals and integrate recent national and international work on health informatics competencies. Future work is also recommended towards the development of a maturity model for competencies of more experienced health informatics professionals.
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Affiliation(s)
- Helen Monkman
- School of Health Information Science, University of Victoria, Victoria, BC, Canada.
| | - Samiha Mir
- School of Health Information Science, University of Victoria, Victoria, BC, Canada
| | - Jason Bond
- School of Health Information Science, University of Victoria, Victoria, BC, Canada
| | - Elizabeth M Borycki
- School of Health Information Science, University of Victoria, Victoria, BC, Canada
| | - Karen L Courtney
- School of Health Information Science, University of Victoria, Victoria, BC, Canada
| | - Andre W Kushniruk
- School of Health Information Science, University of Victoria, Victoria, BC, Canada
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Monkman H, Mir S, Borycki EM, Courtney KL, Bond J, Kushniruk AW. Updating professional competencies in health informatics: A scoping review and consultation with subject matter experts. Int J Med Inform 2023; 170:104969. [PMID: 36572000 DOI: 10.1016/j.ijmedinf.2022.104969] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/05/2022] [Accepted: 12/16/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The discipline of health informatics emerged to address the need for uniquely skilled professionals to design, develop, implement, and evaluate health information technology. Core competencies are an essential pre-requisite for establishing a professional discipline such as health informatics. In 2012, Digital Health Canada released a framework (DHC Framework) for Canadian health informatics competencies. Multiple perspectives on health informatics competencies have evolved to reflect global and unique country contexts. In this paper, we will describe a two-phase study in which we ultimately developed a new framework for health informatics competencies. METHODS In Phase 1, we conducted a scoping review of to identify health informatics competencies from research articles and grey literature from professional associations. Of 1038 articles identified in the search, ultimately 38 met our inclusion criteria and were subject to in-depth analysis. We summarized our findings from this phase into a preliminary framework of health informatics competencies and then in Phase 2, we shared these findings with subject matter experts (SMEs; N = 5) to garner their feedback. The SMEs were all instructors in health informatics in Canada and held various roles (director, professor, advisor, and co-operative education coordinator). We used their insights into the current and forecasted Canadian health informatics landscape to iteratively develop a new framework until we achieved consensus amongst the subject matter experts. RESULTS In Phase 1, all competencies of the DHC Framework were supported by the literature. However, we also identified two emergent competencies: Human Factors and Data Science. In Phase 2, consultations with SMEs guided the introduction of one new competency category and seven new competencies. One competency was renamed and two were removed from the DHC Framework. Additionally, we added new terms that encompass the framework and labelled the core of the framework Health Informatics Professionalism. DISCUSSION We found that the DHC Framework did not capture all necessary competencies required by health informatics professionals. Based on the literature and consultations with SMEs, we extended the DHC Framework to better reflect the current Canadian context and propose a new Health Informatics Core Competencies Framework. The new framework can be used to inform Canadian health informatics programs to ensure graduates are equipped for careers in health informatics. Future work includes validating the new framework with Canadian health informatics employers to assess whether this new framework adequately reflects their needs, and more detail may be required to define specific skills necessary in each competency.
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Affiliation(s)
- Helen Monkman
- School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada.
| | - Samiha Mir
- School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
| | - Elizabeth M Borycki
- School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
| | - Karen L Courtney
- School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
| | - Jason Bond
- School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
| | - Andre W Kushniruk
- School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
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Mir S, Wegener K, Gorressen S, Twarock S, Haendeler J, Altschmied J, Sak A, Stuschke M, Jendrossek V, Fischer JW, Floegel U, Grandoch M. Impact of whole thorax irradiation on cardiac remodeling and outcome after ischemia/reperfusion. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Thoracic irradiation is a fundamental treatment of several malignancies and has contributed to significant rise in long-term survival of cancer patients. However, a potentially increased risk of cardiac late effects, such as accelerated atherosclerosis, coronary heart disease or myocardial fibrosis, may partially diminish the therapeutic benefit and increase the risk of cardiovascular events, e.g. ischemia/reperfusion (I/R). The purpose of this project was to unravel the impact of whole thorax irradiation (WTI) on the outcome and cardiac remodeling after I/R.
Method
11-week-old male C57BL/6J mice were either exposed to WTI with a single dose (12.5 Gy) or sham-irradiation only (0 Gy) and subsequently observed over four weeks. Blood samples were taken to monitor early changes in circulating leukocytes (flow cytometry) and RNA was isolated from cardiac tissue to observe damage to mitochondria by analysis of different mitochondrial markers.
To study the impact of WTI on cardiac remodeling and outcome after I/R, mice were subjected to ischemia by occlusion of the left anterior descending artery (for 45 minutes) four weeks after WTI or sham-irradiation, followed by reperfusion for up to three weeks.
During early timepoints of cardiac remodeling, circulating immune cells and the immune cell influx in the heart were analysed (flow cytometry), ischemic area and cardiac inflammation were assessed by magnetic resonance imaging (MRI) and multiple cytokines were measured in the plasma (immunoassay).
Results
After WTI, a downregulation of leukocyte numbers was observed three days after irradiation, which recovered over four weeks. In addition, WTI resulted in a decrease in relative mRNA expression of mitochondrial fission factor (MFF) and a decrease in relative ATP levels in irradiated mice, suggesting damage of cardiac mitochondria.
The combined setup of WTI and I/R led to enhanced plasma concentration of IL-12(p70), IL-13, MCP-1 or MIP-1β and an increased ischemic area one day after I/R. Further, cardiac inflammation was increased three days post I/R in irradiated mice. Flow cytometric analysis revealed, increased amounts of circulating Ly6Chigh monocytes (% of all monocytes) and cardiac myeloid cells, specifically macrophages. Survival of irradiated mice was impaired already after one week post I/R; therefore, when analysing scar size three weeks later, no changes could be observed in the surviving mice.
Conclusion
Our data show that WTI causes early damage to cardiac mitochondrial network. While WTI also led acutely to a decrease in circulating immune cells, upon I/R, the preexisting irradiation-induced cardiac damage impacts on circulating and cardiac macrophages and monocytes resulting in increased cardiac inflammation and plasma concentration of cytokines in irradiated mice. In sum, irradiation-induced cardiac damage and subsequently altered immune response are likely contributing to the impaired survival of irradiated mice after I/R.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): DFG - GRK 1739
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Affiliation(s)
- S Mir
- University Hospital Duesseldorf, Pharmacology and Clinical Pharmacology , Duesseldorf , Germany
| | - K Wegener
- University Hospital Duesseldorf, Pharmacology and Clinical Pharmacology , Duesseldorf , Germany
| | - S Gorressen
- University Hospital Duesseldorf, Pharmacology and Clinical Pharmacology , Duesseldorf , Germany
| | - S Twarock
- University Hospital Duesseldorf, Pharmacology and Clinical Pharmacology , Duesseldorf , Germany
| | - J Haendeler
- Heinrich Heine University, Core Unit Biosafety Level 2 Laboratory , Duesseldorf , Germany
| | - J Altschmied
- Heinrich Heine University, Heisenberg-Group - Environmentally-induced cardiovascular degeneration , Duesseldorf , Germany
| | - A Sak
- University Hospital of Essen (Ruhr), Clinic for Radiation Therapy , Essen , Germany
| | - M Stuschke
- University Hospital of Essen (Ruhr), Clinic for Radiation Therapy , Essen , Germany
| | - V Jendrossek
- University Hospital of Essen (Ruhr), Institute of Cell Biology (Cancer Research), Dept. of Molecular Cell Biology , Essen , Germany
| | - J W Fischer
- University Hospital Duesseldorf, Pharmacology and Clinical Pharmacology , Duesseldorf , Germany
| | - U Floegel
- University Hospital Duesseldorf, Molecular Cardiology , Duesseldorf , Germany
| | - M Grandoch
- University Hospital Duesseldorf, Pharmacology and Clinical Pharmacology , Duesseldorf , Germany
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Lin E, Lantos JE, Strauss SB, Phillips CD, Campion TR, Navi BB, Parikh NS, Merkler AE, Mir S, Zhang C, Kamel H, Cusick M, Goyal P, Gupta A. Brain Imaging of Patients with COVID-19: Findings at an Academic Institution during the Height of the Outbreak in New York City. AJNR Am J Neuroradiol 2020; 41:2001-2008. [PMID: 32819899 DOI: 10.3174/ajnr.a6793] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/17/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE A large spectrum of neurologic disease has been reported in patients with coronavirus disease 2019 (COVID-19) infection. Our aim was to investigate the yield of neuroimaging in patients with COVID-19 undergoing CT or MR imaging of the brain and to describe associated imaging findings. MATERIALS AND METHODS We performed a retrospective cohort study involving 2054 patients with laboratory-confirmed COVID-19 presenting to 2 hospitals in New York City between March 4 and May 9, 2020, of whom 278 (14%) underwent either CT or MR imaging of the brain. All images initially received a formal interpretation from a neuroradiologist within the institution and were subsequently reviewed by 2 neuroradiologists in consensus, with disputes resolved by a third neuroradiologist. RESULTS The median age of these patients was 64 years (interquartile range, 50-75 years), and 43% were women. Among imaged patients, 58 (21%) demonstrated acute or subacute neuroimaging findings, the most common including cerebral infarctions (11%), parenchymal hematomas (3.6%), and posterior reversible encephalopathy syndrome (1.1%). Among the 51 patients with MR imaging examinations, 26 (51%) demonstrated acute or subacute findings; notable findings included 6 cases of cranial nerve abnormalities (including 4 patients with olfactory bulb abnormalities) and 3 patients with a microhemorrhage pattern compatible with critical illness-associated microbleeds. CONCLUSIONS Our experience confirms the wide range of neurologic imaging findings in patients with COVID-19 and suggests the need for further studies to optimize management for these patients.
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Affiliation(s)
- E Lin
- From the Department of Radiology (E.L., J.E.L., S.B.S., C.D.P., A.G.)
| | - J E Lantos
- From the Department of Radiology (E.L., J.E.L., S.B.S., C.D.P., A.G.)
| | - S B Strauss
- From the Department of Radiology (E.L., J.E.L., S.B.S., C.D.P., A.G.)
| | - C D Phillips
- From the Department of Radiology (E.L., J.E.L., S.B.S., C.D.P., A.G.)
| | - T R Campion
- Department of Population Health Sciences (T.R.C., M.C.)
| | - B B Navi
- Clinical and Translational Neuroscience Unit (B.B.N., N.S.P., A.E.M., S.M., C.Z., A.G.)
| | - N S Parikh
- Clinical and Translational Neuroscience Unit (B.B.N., N.S.P., A.E.M., S.M., C.Z., A.G.)
| | - A E Merkler
- Clinical and Translational Neuroscience Unit (B.B.N., N.S.P., A.E.M., S.M., C.Z., A.G.)
| | - S Mir
- Clinical and Translational Neuroscience Unit (B.B.N., N.S.P., A.E.M., S.M., C.Z., A.G.)
| | - C Zhang
- Clinical and Translational Neuroscience Unit (B.B.N., N.S.P., A.E.M., S.M., C.Z., A.G.)
| | | | - M Cusick
- Department of Population Health Sciences (T.R.C., M.C.)
| | - P Goyal
- Feil Family Brain and Mind Research Institute and Department of Neurology, and Department of Medicine (P.G.), Weill Cornell Medicine, New York, New York
| | - A Gupta
- From the Department of Radiology (E.L., J.E.L., S.B.S., C.D.P., A.G.)
- Clinical and Translational Neuroscience Unit (B.B.N., N.S.P., A.E.M., S.M., C.Z., A.G.)
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Dhar A, Dangroo NA, Mir S, Dar BA. THE EXPEDITIOUS OXIDATION OF ARYLBORONIC ACIDS TO PHENOLS BY TERTIARY BUTYL HYDROPEROXIDE IN GREEN AQUEOUS ETHANOL. ECB 2020. [DOI: 10.17628/ecb.2020.9.193-195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Mir S, Bishop J, Swaroop S, Viswanath A. A Comparison of Opioids and Non-Opioids in Management of Postoperative Pain Following Third Molar Extraction. J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.joms.2019.06.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Alhajj MN, Khader Y, Murad AH, Celebic A, Halboub E, Márquez JR, Macizo CC, Khan S, Basnet BB, Makzoumé JE, de Sousa-Neto MD, Camargo R, Prasad DA, Faheemuddin M, Mir S, Elkholy S, Abdullah AG, Ibrahim AA, Al-Anesi MS, Al-Basmi AA. Perceived sources of stress amongst dental students: A multicountry study. Eur J Dent Educ 2018; 22:258-271. [PMID: 29607584 DOI: 10.1111/eje.12350] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 06/08/2023]
Abstract
AIMS The aim of this study was to explore the perceived sources of stress reported by dental students from fourteen different countries. METHODS A total of 3568 dental students were recruited from 14 different dental schools. The dental environmental stress (DES) questionnaire was used including 7 domains. Responses to the DES were scored in 4-point Likert scale. Comparison between students was performed according to the study variables. The top 5 stress-provoking questions were identified amongst dental schools. Data were analysed using SPSS software program. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Logistic regression analysis was also conducted to determine the effect of the studied variables on the stress domains. The level of statistical significance was set at <.05. RESULTS Internal consistency of the scale was excellent (0.927). Female students formed the majority of the total student population. The percentage of married students was 4.8%. Numbers of students in pre-clinical and clinical stages were close together. The most stress-provoking domain was "workload" with a score of 2.05 ± 0.56. Female students scored higher stress than male students did in most of the domains. Significant differences were found between participating countries in all stress-provoking domains. Dental students from Egypt scored the highest level of stress whilst dental students from Jordan scored the lowest level of stress. CONCLUSION The self-reported stress in the dental environment is still high and the stressors seem to be comparable amongst the participating countries. Effective management programmes are needed to minimise dental environment stress.
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Affiliation(s)
- M N Alhajj
- Department of Prosthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - Y Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - A H Murad
- Department of Oral Diagnosis, College of Dentistry, Al-Qadisiyah University, Al-Diwaniya, Iraq
| | - A Celebic
- Department of Removable Prosthodontics, Faculty of Dentistry, University of Zagreb, Zagreb, Croatia
| | - E Halboub
- Division of Oral Medicine, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - J R Márquez
- Department of Oral Rehabilitation, Faculty of Dentistry, University of San Martín de Porres, Lima, Peru
| | - C C Macizo
- Department of Oral Rehabilitation, Faculty of Dentistry, University of San Martín de Porres, Lima, Peru
| | - S Khan
- Department of Restorative Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | - B B Basnet
- Department of Prosthodontics and Crown-Bridge, College of Dental Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - J E Makzoumé
- Department of Removable Prosthodontics, Faculty of Dentistry, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - M D de Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - R Camargo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - D A Prasad
- Department of Prosthodontics and Crown-Bridge, A.B. Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, India
| | - M Faheemuddin
- Department of Prosthodontics, University College of Medicine and Dentistry, University of Lahore, Punjab, Pakistan
| | - S Mir
- Private Dental Clinic, Punjab, Pakistan
| | - S Elkholy
- Department of Implants and Removable Prosthodontics, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
| | - A G Abdullah
- Department of Basic Sciences, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - A A Ibrahim
- Department of Prosthodontics, Faculty of Dentistry, Al-Gazira University, Wad Medani, Sudan
| | - M S Al-Anesi
- Conservative Department, Faculty of Dentistry, Thamar University, Dhamar, Yemen
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Taylor D, Mir S, Mace S, Whiskey E. Co-prescribing of atypical and typical antipsychotics – prescribing sequence and documented outcome. Psychiatr bull 2018. [DOI: 10.1192/pb.26.5.170] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND METHODTo evaluate patterns of antipsychotic co-prescription and to establish documented outcome, we reviewed 1441 in-patient and community prescriptions written in a large mental health trust. For patients co-prescribed regular atypical and typical antipsychotics for longer than 6 weeks, medication histories were taken and case notes examined to determine sequence of prescribing, documented outcome and reasons for co-prescription.RESULTSFifty-three patients had been co-prescribed aytpical and typical antipsychotics for more than 6 weeks. In 62% of cases the atypical drug had been prescribed first and a typical drug added later. The most frequently documented reason for co-prescription was that symptoms persisted when prescribed a single antipsychotic. Clinical outcome was documented for 64% of patients: 45% of the total number treated showed some improvement, with seven of 53 patients noted to have shown improvements in psychotic symptoms.CLINICAL IMPLICATIONSCo-prescription of aytpical and typical antipsychotics often occurs as a consequence of poor outcome with single drug treatment. In this study there was minimal evidence to suggest that co-prescription improved outcome to an important extent. There remains little support for co-prescription of antipsychotics but considerable evidence to suggest that such practice worsens adverse effect burden. Co-prescription of atypical and typical antipsychotics should be avoided in all but very exceptional circumstances.
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Conkar S, Mir S, Sözeri B, Bulut K, Çınar C. Evaluation and therapy in four patients with Takayasu′s arteritis. Saudi J Kidney Dis Transpl 2016; 27:164-9. [DOI: 10.4103/1319-2442.174205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Murtaza G, Ullah H, Khan SA, Mir S, Khan AK, Nasir B, Azhar S, Abid MA. Formulation and In vitro Dissolution Characteristics of Sustained-Release Matrix Tablets of Tizanidine Hydrochloride. TROP J PHARM RES 2015. [DOI: 10.4314/tjpr.v14i2.5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ayoub RK, Murtaza G, Imran M, Khan SA, Mir S, Khan AK, Azhar S, Mehmood Z, Sajjad A, Shah SNH. Formulation and Permeation Kinetic Studies of Flurbiprofen Gel. TROP J PHARM RES 2015. [DOI: 10.4314/tjpr.v14i2.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Li T, Murtaza G, Azhar S, Nasir B, Raza H, Shah SH, Farzana K, Khan AK, Mir S, Li Y, Nisa ZU, Xu X. Assessment of the determinant of choice of ‘over the counter’ analgesics among students of a university in Abbottabad, Pakistan. TROP J PHARM RES 2014. [DOI: 10.4314/tjpr.v13i10.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Xu X, Sajid KM, Zhai X, Yao W, Mir S, Mahmood R, Khan AK, Asad MHHB, Farzana K, Murtaza G, Li T. Prevalence of hepatitis B and C virus in euthyroid patients. TROP J PHARM RES 2014. [DOI: 10.4314/tjpr.v13i10.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ullah H, Ullah B, Karim S, Tariq I, Khan AK, Mir S, Baseer A, Azhar S, Murtaza G. Malnutrition amongst Under-Five Years Children in Swat, Pakistan: Prevalence and Risk Factors. TROP J PHARM RES 2014. [DOI: 10.4314/tjpr.v13i8.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sozeri B, Mir S, Ozdemir K, Berdeli A. PReS-FINAL-2205: Vascular risk assesment and MMP-3 gene in FMF. Pediatr Rheumatol Online J 2013. [PMCID: PMC4042596 DOI: 10.1186/1546-0096-11-s2-p195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sozeri B, Yilmaz S, Mir S, Ates H. PReS-FINAL-2313: Clinical experiences of therapy in pediatric patients with Behcet uveitis, singe center study. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044576 DOI: 10.1186/1546-0096-11-s2-p303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Sozeri B, Dincel N, Yilmaz E, Mir S. PW01-017 – Urine MMP-3 level as a biomarker for in FMF attack. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952635 DOI: 10.1186/1546-0096-11-s1-a70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Sozeri B, Yilmaz S, Mir S, Ates H. P03-009 - Experiences of in pediatric Behçet uveitis. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952529 DOI: 10.1186/1546-0096-11-s1-a204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Mir S, Sozeri B, Ozdemir K, Berdeli A. P01-024 – Vascular risk assessment and MMP-3 gene in FMF. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952099 DOI: 10.1186/1546-0096-11-s1-a28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Sood S, Verma R, Mir S, Agarwal M, Singh N, Kar HK, Sharma VK. P2.049 NAATs For Gonorrhoea Diagnosis in Women: Experience of a Tertiary Care Hospital in North India. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Legendre C, Cohen D, Delmas Y, Feldkamp T, Fouque D, Furman R, Gaber O, Greenbaum L, Goodship T, Haller H, Herthelius M, Hourmant M, Licht C, Moulin B, Sheerin N, Trivelli A, Bedrosian CL, Loirat C, Legendre C, Babu S, Cohen D, Delmas Y, Furman R, Gaber O, Greenbaum L, Hourmant M, Jungraithmayr T, Lebranchu Y, Riedl M, Sheerin N, Bedrosian CL, Loirat C, Sheerin N, Legendre C, Greenbaum L, Furman R, Cohen D, Gaber AO, Bedrosian C, Loirat C, Haller H, Licht C, Muus P, Legendre C, Douglas K, Hourmant M, Herthelius M, Trivelli A, Goodship T, Remuzzi G, Bedrosian C, Loirat C, Kourouklaris A, Ioannou K, Athanasiou I, Demetriou K, Panagidou A, Zavros M, Rodriguez C NY, Blasco M, Arcal C, Quintana LF, Rodriguez de Cordoba S, Campistol JM, Bachmann N, Eisenberger T, Decker C, Bolz HJ, Bergmann C, Pesce F, Cox SN, Serino G, De Palma G, Sallustio FP, Schena F, Falchi M, Pieri M, Stefanou C, Zaravinos A, Erguler K, Lapathitis G, Dweep H, Sticht C, Anastasiadou N, Zouvani I, Voskarides K, Gretz N, Deltas CC, Ruiz A, Bonny O, Sallustio F, Serino G, Curci C, Cox S, De Palma G, Schena F, Kemter E, Sklenak S, Aigner B, Wanke R, Kitzler TM, Moskowitz JL, Piret SE, Lhotta K, Tashman A, Velez E, Thakker RV, Kotanko P, Leierer J, Rudnicki M, Perco P, Koppelstaetter C, Mayer G, Sa MJN, Alves S, Storey H, Flinter F, Willems PJ, Carvalho F, Oliveira J, Arsali M, Papazachariou L, Demosthenous P, Lazarou A, Hadjigavriel M, Stavrou C, Yioukkas L, Voskarides K, Deltas C, Zavros M, Pierides A, Arsali M, Demosthenous P, Papazachariou L, Voskarides K, Kkolou M, Hadjigavriel M, Zavros M, Deltas C, Pierides A, Toka HR, Dibartolo S, Lanske B, Brown EM, Pollak MR, Familiari A, Zavan B, Sanna Cherchi S, Fabris A, Cristofaro R, Gambaro G, D'Angelo A, Anglani F, Toka H, Mount D, Pollak M, Curhan G, Sengoge G, Bajari T, Kupczok A, von Haeseler A, Schuster M, Pfaller W, Jennings P, Weltermann A, Blake S, Sunder-Plassmann G, Kerti A, Csohany R, Wagner L, Javorszky E, Maka E, Tulassay T, Tory K, Kingswood J, Nikolskaya N, Mbundi J, Kingswood J, Jozwiak S, Belousova E, Frost M, Kuperman R, Bebin M, Korf B, Flamini R, Kohrman M, Sparagana S, Wu J, Brechenmacher T, Stein K, Bissler J, Franz D, Kingswood J, Zonnenberg B, Frost M, Cheung W, Wang J, Brechenmacher T, Lam D, Bissler J, Budde K, Ivanitskiy L, Sowershaewa E, Krasnova T, Samokhodskaya L, Safarikova M, Jana R, Jitka S, Obeidova L, Kohoutova M, Tesar V, Evrengul H, Ertan P, Serdaroglu E, Yuksel S, Mir S, Yang n Ergon E, Berdeli A, Zawada A, Rogacev K, Rotter B, Winter P, Fliser D, Heine G, Bataille S, Moal V, Berland Y, Daniel L, Rosado C, Bueno E, Fraile P, Lucas C, Garcoa-Cosmes P, Tabernero JM, Gonzalez R, Rosado C, Bueno E, Fraile P, Lucas C, Garcia-Cosmes P, Tabernero JM, Gonzalez R, Silska-Dittmar M, Zaorska K, Malke A, Musielak A, Ostalska-Nowicka D, Zachwieja J, K d r V, Uz E, Yigit A, Altuntas A, Yigit B, Inal S, Uz E, Sezer M, Yilmaz R, Visciano B, Porto C, Acampora E, Russo R, Riccio E, Capuano I, Parenti G, Pisani A, Feriozzi S, Perrin A, West M, Nicholls K, Sunder-Plassmann G, Torras J, Cybulla M, Conti M, Angioi A, Floris M, Melis P, Asunis AM, Piras D, Pani A, Warnock D, Guasch A, Thomas C, Wanner C, Campbell R, Vujkovac B, Okur I, Biberoglu G, Ezgu F, Tumer L, Hasanoglu A, Bicik Z, Akin Y, Mumcuoglu M, Ecder T, Paliouras C, Mattas G, Papagiannis N, Ntetskas G, Lamprianou F, Karvouniaris N, Alivanis P. Genetic diseases and molecular genetics. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Shi H, Wen J, LI Z, Elsayed M, Kamal K, LI Z, Wen J, Shi H, El Shal A, Youssef D, Caubet C, Lacroix C, Benjamin B, Bandin F, Bascands JL, Monsarrat B, Decramer S, Schanstra J, Laetitia DB, Ulinski T, Aoun B, Ozdemir K, Dincel N, Sozeri B, Mir S, Dincel N, Berdeli A, Mir S, Akyigit F, Mizerska-Wasiak M, Panczyk-Tomaszewska M, Szymanik-Grzelak H, Roszkowska-Blaim M, Jamin A, Dehoux L, Monteiro RC, Deschenes G, Bouts A, Davin JC, Dorresteijn E, Schreuder M, Lilien M, Oosterveld M, Kramer S, Gruppen M, Pintos-Morell G, Ramaswami U, Parini R, Rohrbach M, Kalkum G, Beck M, Carter M, Antwi S, Callegari J, Kotanko P, Levin NW, Rumjon A, Macdougall IC, Turner C, Booth CJ, Goldsmith D, Sinha MD, Camilla R, Camilla R, Loiacono E, Donadio ME, Conrieri M, Bianciotto M, Bosetti FM, Peruzzi L, Conti G, Bitto A, Amore A, Coppo R, Mizerska-Wasiak M, Roszkowska-Blaim M, Maldyk J, Chou HH, Chiou YY, Bochniewska V, Jobs K, Jung A, Fallahzadeh Abarghooei MH, Zare J, Sedighi Goorabi V, Derakhshan A, Basiratnia M, Fallahzadeh Abarghooei MA, Hosseini Al-Hashemi G, Fallahzadeh Abarghooei F, Kluska-Jozwiak A, Soltysiak J, Lipkowska K, Silska M, Fichna P, Skowronska B, Stankiewicz W, Ostalska-Nowicka D, Zachwieja J, Girisgen L, Sonmez F, Yenisey C, Kis E, Cseprekal O, Kerti A, Szabo A, Salvi P, Benetos A, Tulassay T, Reusz G, Makulska I, Szczepanska M, Drozdz D, Zwolnska D, Sozeri B, Berdeli A, Mir S, Tolstova E, Anis L, Ulinski T, Alber B, Edouard B, Gerard C, Seni K, Dunia Julienne Hadiza T, Christian S, Benoit T, Francois B, Adama L, Rosenberg A, Munro J, Murray K, Wainstein B, Ziegler J, Singh-Grewal D, Boros C, Adib N, Elliot E, Fahy R, Mackie F, Kainer G, Polak-Jonkisz D, Zwolinska D, Laszki-Szczachor K, Zwolinska D, Janocha A, Rusiecki L, Sobieszczanska M, Garzotto F, Ricci Z, Clementi A, Cena R, Kim JC, Zanella M, Ronco C, Polak-Jonkisz D, Zwolinska D, Purzyc L, Zwolinska D, Makulska I, Szczepanska M, Peco-Antic A, Kotur-Stevuljevic J, Paripovic D, Scekic G, Milosevski-Lomic G, Bogicevic D, Spasojevic-Dimitrijeva B, Hassan R, El-Husseini A, Sobh M, Ghoneim M, Harambat J, Bonthuis M, Van Stralen KJ, Ariceta G, Battelino N, Jahnukainen T, Sandes AR, Combe C, Jager KJ, Verrina E, Schaefer F, Espindola R, Bacchetta J, Cochat P, Stefanis C, Leroy S, Leroy S, Fernandez-Lopez A, Nikfar R, Romanello C, Bouissou F, Gervaix A, Gurgoze M, Bressan S, Smolkin V, Tuerlinkx D, Stefanidis C, Vaos G, Leblond P, Gungor F, Gendrel D, Chalumeau M, Rumjon A, Macdougall IC, Turner C, Rawlins D, Booth CJ, Simpson JM, Sinha MD, Arnaud G, Arnaud G, Anne M, Stephanie T, Flavio B, Veronique FB, Stephane D, Mumford L, Marks S, Ahmad N, Maxwell H, Tizard J, Vidal E, Amigoni A, Varagnolo M, Benetti E, Ghirardo G, Brugnolaro V, Murer L, Aoun B, Christine G, Alber B, Ulinski T, Aoun B, Decramer S, Bandin F, Ulinski T, Degi A, Degi A, Kerti A, Kis E, Cseprekal O, Szabo AJ, Reusz GS, Ghirardo G, Vidoni A, Vidal E, Benetti E, Ramondo G, Miotto D, Murer L. Paediatric nephrology. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Velankar S, Alhroub Y, Best C, Caboche S, Conroy MJ, Dana JM, Fernandez Montecelo MA, van Ginkel G, Golovin A, Gore SP, Gutmanas A, Haslam P, Hendrickx PMS, Heuson E, Hirshberg M, John M, Lagerstedt I, Mir S, Newman LE, Oldfield TJ, Patwardhan A, Rinaldi L, Sahni G, Sanz-García E, Sen S, Slowley R, Suarez-Uruena A, Swaminathan GJ, Symmons MF, Vranken WF, Wainwright M, Kleywegt GJ. PDBe: Protein Data Bank in Europe. Nucleic Acids Res 2011; 40:D445-52. [PMID: 22110033 PMCID: PMC3245096 DOI: 10.1093/nar/gkr998] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The Protein Data Bank in Europe (PDBe; pdbe.org) is a partner in the Worldwide PDB organization (wwPDB; wwpdb.org) and as such actively involved in managing the single global archive of biomacromolecular structure data, the PDB. In addition, PDBe develops tools, services and resources to make structure-related data more accessible to the biomedical community. Here we describe recently developed, extended or improved services, including an animated structure-presentation widget (PDBportfolio), a widget to graphically display the coverage of any UniProt sequence in the PDB (UniPDB), chemistry- and taxonomy-based PDB-archive browsers (PDBeXplore), and a tool for interactive visualization of NMR structures, corresponding experimental data as well as validation and analysis results (Vivaldi).
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Affiliation(s)
- S Velankar
- Protein Data Bank in Europe, EMBL-EBI, Wellcome Trust Genome Campus, Hinxton, Cambridge CB10 1SD, UK
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Musial K, Ciszak L, Kosmaczewska A, Szteblich A, Frydecka I, Zwolinska D, Kilic O, Balat A, Pehlivan S, Kilic BD, Sever T, Buyukcelik M, Kul S, Makulska I, Szczepanska M, Drozdz D, Zwolinska D, Ulmeanu A, Viorela N, Ulmeanu C, Monteverde ML, Chaparro AB, Balbarrey Z, Marcos Y, Ibanez JP, Turconi AF, Diaz M, Harambat J, van Stralen KJ, Verrina E, Schaefer F, Jager KJ, Wikiera-Magott I, Hurkacz M, Kubicki D, Zwolinska D, Sozeri B, Mir S, Dincel N, Kara OD. Paediatric nephrology. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mir S, Yavascan O, Berdeli A, Sozeri B. TRPC6 gene variants in Turkish children with steroid-resistant nephrotic syndrome. Nephrol Dial Transplant 2011; 27:205-9. [DOI: 10.1093/ndt/gfr202] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gurbuz C, Best S, Donnally C, Mir S, Pearle M, Cadeddu J. Intermediate Term Outcomes Associated With the Surveillance of Ureteropelvic Junction Obstruction in Adults. J Urol 2011; 185:926-9. [DOI: 10.1016/j.juro.2010.10.082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Indexed: 10/18/2022]
Affiliation(s)
- C. Gurbuz
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - S.L. Best
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - C. Donnally
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - S. Mir
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - M.S. Pearle
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - J.A. Cadeddu
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas
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Yilmaz E, Mir S, Berdeli A. Endothelial nitric oxide synthase (eNOS) gene polymorphism in early term chronic allograft nephropathy. Transplant Proc 2010; 41:4361-5. [PMID: 20005399 DOI: 10.1016/j.transproceed.2009.09.080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2009] [Accepted: 09/29/2009] [Indexed: 11/20/2022]
Abstract
Chronic allograft nephropathy (CAN) is a complex phenomenon caused by underlying kidney disease with superimposed enviromental and genetic factors. CAN development begins with progressive renal microvascular injury. Endothelial cells play key roles in the regulation of vascular tone, permeability, and remodeling. A reduction in basal nitric oxide (NO) release as a result of genetic variation in endothelial NO synthase (eNOS) function may predispose to hypertension, thrombosis, vasospasm, and atherosclerosis, all contributing to the development of CAN. We analyzed the G894T mutation at exon 7 of the eNOS gene in relationship to CAN among 81 children with renal transplantations. The 20 patients who developed CAN underwent renal biopsies for histological confirmation. Proteinuria and hypertension were observed in CAN. We selected 173 healthy reference subjects. The G894T polymorphism of the eNOS gene was determined by PCR-restriction fragment-length polymorphism analysis. The group included 33 male and 48 female subjects who received 32 living-related grafts and 49 from deceased donors (DD) donors. Donor age (y) was 32.7 +/- 13.7 and the HLA A,B,DR mismatch number of the cadaveric cases was 3.5 +/- 0.79. The distribution of the genotypes were ENOS GG/GT/TT 48%, 33%, 19%, respectively. G-alleles frequency was 64.8%; T-allele frequency was 35.2%. ENOS G894T gene polymorphism did not seem to influence long-term renal allograft outcome. Recipient ENOS G894T gene polymorphism did not alter the risk of chronic allograft failure. Even if NO synthesis and bioactivity are influenced by this polymorphism, many vasoactive factors may have roles to suppress the advantageous effects of NO.
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Affiliation(s)
- E Yilmaz
- Department of Pediatric Nephrology, Ege University, Izmir, Bornova, Turkey.
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Mutlubas F, Mir S, Berdeli A, Ozkayin N, Sozeri B. Association between Toll-like receptors 4 and 2 gene polymorphisms with chronic allograft nephropathy in Turkish children. Transplant Proc 2009; 41:1589-93. [PMID: 19545686 DOI: 10.1016/j.transproceed.2009.02.079] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Accepted: 02/09/2009] [Indexed: 10/20/2022]
Abstract
Toll-like receptor (TLR) gene polymorphism is known to impair intracellular signaling pathways following adaptive immune responses. Our aim was to investigate the distribution of TLR4 and TLR2 gene polymorphisms among pediatric renal transplantation patients in relation to chronic allograft nephropathy (CAN). In addition to 115 healthy controls, we included 69 renal recipients, 19 of whom were identified as CAN by biopsy scored according to the Banff criteria. Polymorphisms at TLR4 Asp299Gly and/or Thr399Ile were present in 11.6% of renal transplant recipients. None of these subjects was identified in cosegregation with the Thr399Ile allele, whereas three had an isolated Asp299Gly and five had an isolated Thr399Ile. Neither renal recipients nor healthy controls were homozygous for both Asp299Gly and Thr399Ile polymorphisms. However, TLR4 Thr399Ile polymorphism and Ile allele was greater among CAN (-) versus CAN (+) recipients (P > .05). The frequency of TLR2 mutant type Gln allele was significantly higher in recipients than among healthy controls (P < .0001). However, the Gln allele frequency was similar between CAN (+) and CAN (-) patients. The results of present study may be speculated to show TLR4 and TLR2 gene polymorphisms as protective factors from CAN development due to impaired immune responses.
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Affiliation(s)
- F Mutlubas
- Department of Pediatric Nephrology, Faculty of Medicine, Ege University, Izmir, Turkey.
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Seth R, Mir S, Dhir JS, Cheeseman C, Singh J. Fitness to fly post craniotomy--a survey of medical advice from long-haul airline carriers. Br J Neurosurg 2009; 23:184-7. [PMID: 19306175 DOI: 10.1080/02688690802669351] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Commercial airline passengers are subject to numerous medical risks while in transit. Seventeen long-haul airline companies were questioned concerning fitness to travel and the case of a patient wishing to travel post craniotomy. Three airline companies gave satisfactory medical information, while the remaining airlines felt it was the decision of the operating surgeon rather than the airline company. A literature review shows that post operative pneumocephalus and the risk of tension pneumocephalus is the major medical concern when transporting patients post craniotomy. Evidence is contradictory with respect to the importance of this potentially life threatening problem. Postoperative 100% oxygen may improve the rate of pneumocephalus absorption. Airline companies have an unstandardised approach to unique medical problems, resulting in increased responsibility for the attending surgeon who may be ill equipped to deal with poorly researched aviation medicine.
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Affiliation(s)
- R Seth
- Microsurgery Research Fellow, Royal Marsden Hospital, London, United Kingdom.
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Soylemezoglu O, Ozkaya O, Ozen S, Bakkaloglu A, Dusunsel R, Peru H, Cetinyurek A, Yildiz N, Donmez O, Buyan N, Mir S, Arisoy N, Gur-Guven A, Alpay H, Ekim M, Aksu N, Soylu A, Gok F, Poyrazoglu H, Sonmez F. Henoch-Schönlein nephritis: a nationwide study. Nephron Clin Pract 2009; 112:c199-204. [PMID: 19439991 DOI: 10.1159/000218109] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Accepted: 11/24/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIM The aim of this retrospective study was to evaluate the presentation, clinical and pathological manifestations and outcome of the Henoch-Schönlein purpura (HSP) nephritis in children. METHODS Clinical and laboratory data of 443 children with HSP nephritis aged between 3 and 16 years from 16 pediatric nephrology reference centers were analyzed retrospectively. The biopsy findings were graded according to the classification developed by the International Study of Kidney Disease in Children (ISKDC). RESULTS Renal biopsy was performed in 179 of the patients with HSP nephritis. The most common presenting clinical finding in patients who were biopsied was nephrotic range proteinuria (25%) which was followed by nephritic-nephrotic syndrome (23.5%). The biopsy findings according to the ISKDC were as follows: class I: 8.3%; II: 44.1%; III: 36.3%; IV: 6.7%; V: 3.3%; VI: 1.1%. All of the patients who developed end-stage renal disease had nephritic-nephrotic syndrome at presentation. Of 443 patients, 87.2% had a favorable outcome and 12.8% had an unfavorable outcome. The overall percentage of children who developed end-stage renal disease at follow-up was 1.1%. Logistic regression analysis did not show any association of initial symptoms and histology with outcome. CONCLUSION In the presented cohort, the presence of crescents in the first biopsy or presenting clinical findings did not seem to predict the outcome of HSP nephritis in children. We conclude that children with HSP nephritis even with isolated microscopic hematuria and/or mild proteinuria should be followed closely.
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Affiliation(s)
- O Soylemezoglu
- Gazi University, Department of Pediatric Nephrology, Ankara, Turkey
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Ozkayin N, Mir S, Afig B. The role of fcgamma receptor gene polymorphism in pediatric renal transplant rejections. Transplant Proc 2009; 40:3367-74. [PMID: 19100392 DOI: 10.1016/j.transproceed.2008.08.137] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Accepted: 08/29/2008] [Indexed: 10/21/2022]
Abstract
The aim of the study reported herein was to determine whether panel-reactive antibody (PRA) and FcgammaR gene polymorphism act in the same way on acute rejection (AR) and chronic rejection (CR) in children who have undergone renal transplantation. The study evaluated 56 children who underwent transplantation and 115 healthy subjects. AR was observed in 13 cases; CR was observed in 7 patients. The assessment for FcgammaR of the groups in which AR was present showed statistical significance only for the FcgammaIIA genotype. There was no statistical significance for either the FcgammaIIIA or FcgammaIIIB genotypes. Assessment of the FcgammaIIA, IIIA, and IIIB genotypes of the groups in whom CR was present did not show statistical significance. As a result, the prediction of graft survival among transplant recipients is possible using molecular biology. The results of our study showed that individuals of the FcgammaRIIA genotype seemed to have a poorer prognosis similar to some autoimmune diseases. These individuals constitute a risk group for AR. If other studies are conducted with more patients to demonstrate the relationship of other FcgammaRs to rejection, the resultant predictive knowledge about the value of genotypes may lead to improved outcomes following renal transplantation.
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Affiliation(s)
- N Ozkayin
- Department of Pediatrics Ege University Faculty of Medicine, Bornova, Izmir, Turkey
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Abstract
The aim of this study is to investigate Arg753Gln allele polymorphisms of toll-like receptor-2 (TLR2) gene distribution, allele frequency in urinary tract infection (UTI) and genotype-phenotype association of TLR2 gene in children with UTI. The polymorphism was investigated in 124 children with UTI (22 boys and 102 girls; mean age 5.81 +/- 3.47 years) with direct DNA sequencing-based method. TLR2 gene Arg753Gln allele frequency was higher in the patient group when compared with control group (OR 3.14, 95%CI 1.53-6.44, P < 0.001). The frequency of the Arg753Gln allele was significantly higher in gram-positive group than in gram-negative group (OR 7.64, 95%CI 2.80-20.81, P < 0.001). The frequency of UTI was found significantly higher in the Arg753Gln allele carriers of TLR2 gene than the non-carriers (OR 4.94, 95%CI 1.09-22.33, P < 0.05). Similarly, the incidence of asymptomatic UTI was also found significantly higher in the group carrying Arg753Gln allele (OR 3.73, 95%Cl 1.54-9.04, P < 0.05). As a result, we suggest that TLR2 gene could be the predisposing factor for urinary tract infection. Additionally, we observed that subjects carrying the TLR2 Arg753Gln allele had higher risk of urinary tract infection with gram-positive pathogens, history of more than two attacks of UTI and asymptomatic UTI.
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Affiliation(s)
- Y Tabel
- Department of Pediatric Nephrology, Inonu University, Malatya, Turkey.
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Schaefer F, Feneberg R, Aksu N, Donmez O, Sadikoglu B, Alexander SR, Mir S, Ha IS, Fischbach M, Simkova E, Watson AR, Möller K, von Baum H, Warady BA. Worldwide variation of dialysis-associated peritonitis in children. Kidney Int 2007; 72:1374-9. [PMID: 17882152 DOI: 10.1038/sj.ki.5002523] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Peritonitis is the most common cause of dialysis failure in children on chronic peritoneal dialysis. We performed a prospective study of 501 peritonitis episodes in 44 pediatric dialysis centers located in 14 countries that examined peritonitis etiology, efficiency of opinion-based management guidelines, and final outcomes. Culture-negative incidence varied significantly from 11% in North America to 67% in Mexico. Argentina and North America had the highest rate of Gram-negative episodes. Pseudomonas-based peritonitis was eightfold more common in the United States than in Europe, and correlated with the frequency of exit site cleansing and topical mupirocin administration. Significant regional variation in antibiotic susceptibility was noted for the first generation cephalosporins and aminoglycosides. Initial response rates to standardized empiric antibiotic treatment did not differ between regions; however, final outcomes were significantly less favorable in Eastern Europe. The wide regional variation in culture-negative peritonitis, and the distribution and antibiotic susceptibilities of causative bacteria needs to be taken into consideration when the guidelines for empiric therapy of pediatric dialysis-associated peritonitis are revised.
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Affiliation(s)
- F Schaefer
- Division of Pediatric Nephrology, University of Heidelberg, Heidelberg, Germany.
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Mutlubas F, Mir S, Ozkayin N, Ozbek SS, Kantar M, Sen S. A late-onset Epstein-Barr virus-related lymphoma completely remitted in a child with renal allograft. Transplant Proc 2007; 39:1679-82. [PMID: 17580218 DOI: 10.1016/j.transproceed.2007.02.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2006] [Revised: 01/03/2007] [Accepted: 02/10/2007] [Indexed: 11/19/2022]
Abstract
Lymphomas are frequently encountered malignancies following renal transplantations. A 17-year-old boy was found to have lymphoma 1.5 years after a the first cadaveric transplantation performed due to reflux nephropathy. Polyclonal anti-thymocyte globulin (induction) with prednisolone (PRD), azathioprine (AZT), and tacrolimus (Tac) regimen had been given after the transplantation. A hypoechoic mass (25 mm) was detected in the upper pole of the allograft by renal Doppler ultrasound performed due to graft dysfunction with a high basal serum creatinine (Cr) (2.2 mg/dL). The renal biopsy revealed a large B-cell lymphoma with CD20 staining in the medulla. The serum displayed a positive Epstein-Barr virus (EBV), immunoglobulin (Ig)G, negative IgM with negative DNA-polymerase chain reaction. However, the biopsy was positive for EBV-LMA. The viral status at the time of transplant was unknown. After withdrawing AZT and Tac therapies, a chemoimmunotherapeutic regimen consisting of PRD, cyclophosphamide, and anti-CD20 monoclonal antibody was administered twice. The patient excreted the necrosed tumor particles over a 2-month interval with hydronephrotic colic attacks. The basal Cr improved at 6 months (to 1.4 mg/dL). A low dose of Tac (0.5 mg/d) was added to PRD. The patient has remained in complete remission for 2.5 years with a well-functioning renal allograft. Although this case was a late-onset lymphoma, the patient displayed a picture like excreting stones from the allograft and remitted completely. This case illustrates that localization of a tumor may play a more important role than the elapsed time from transplant in the diagnosis in EBV-related posttransplant lymphoproliferative disease.
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Affiliation(s)
- F Mutlubas
- Department of Pediatric Nephrology, Ege University, Faculty of Medicine, Pediatrics Clinic Bornova, Ege 35100, Turkey.
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Yavascan O, Sarsik B, Mutlubas F, Mir S, Kabasakal C. Epidermolysis bullosa dystrophica with renal failure due to secondary amyloidosis. Indian J Nephrol 2007. [DOI: 10.4103/0971-4065.39175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Nazir Z, Razaq S, Mir S, Anwar M, Al Mawlawi G, Sajad M, Shehab A, Taylor RS. Revisiting the accuracy of peak flow meters: a double-blind study using formal methods of agreement. Respir Med 2004; 99:592-5. [PMID: 15823456 DOI: 10.1016/j.rmed.2004.10.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2004] [Revised: 06/07/2004] [Accepted: 10/14/2004] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is widespread use of peak flow meters in both hospitals and general practice. Previous studies to assess peak flow meter accuracy have shown significant differences in the values obtained from different meters. However, many of these studies did not use human subjects for peak flow measurements and did not compare meters of varying usage. In this study human subjects have been used with meters of varying usage. METHODS Participants were tested using two new (meters A and C) and one old peak flow meter (meter B) in random order. The study was double-blinded. Participants were recruited from the university campus. RESULTS Four hundred and nine individuals participated. The difference between peak flow means of A and B was -9.93 l/min (95% CI: -12.37 to -7.48, P<0.0001). The difference between peak flow means of B and C was 20.08 l/min (95% CI: 17.85-22.29, P<0.0001). The difference between peak flow means of A and C was 10.15 l/min (95% CI: 7.68-12.61, P<0.0001). CONCLUSION There was a significant difference between the values obtained from the new and old peak flow meters and also between the two new peak flow meters. We conclude that there is need for caution in interchangeably using flow meters in clinical practice.
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Affiliation(s)
- Z Nazir
- School of Medicine, University of Birmingham, UK
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Rivera P, Tagle R, Mir S, González R. [Relationship between serum testosterone levels and prostatic cancer]. Actas Urol Esp 2003; 27:788-92. [PMID: 14735860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
INTRODUCTION The association between testosterone and prostate cancer badly is understood. The testosterone levels are not conclusive to distinguish benign prostate processes of malignant. The objective of our work is to determine the relation between levels of serum testosterone and prostate cancer. MATERIAL AND METHOD 38 patients with prostate cancer and a control group of 32 were studied in prospective form, with ages that fluctuated between the 50 and 80 years. The total and free testosterone was determined by radio-immunoensayo. The statistical analysis was descriptive inferential, with bands of 95% confidence. RESULTS The average values of total and free testosterone, were significantly smaller in patients with prostate cancer. Any correlation between gleason, prostate antigen and stage with testosterone, was not demonstrated. CONCLUSIONS Our work demonstrated that the testosterone is significantly smaller in the patients with prostate cancer that in the controls.
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Affiliation(s)
- P Rivera
- Unidad de Urología, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
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Stover EH, Borthwick KJ, Bavalia C, Eady N, Fritz DM, Rungroj N, Giersch ABS, Morton CC, Axon PR, Akil I, Al-Sabban EA, Baguley DM, Bianca S, Bakkaloglu A, Bircan Z, Chauveau D, Clermont MJ, Guala A, Hulton SA, Kroes H, Li Volti G, Mir S, Mocan H, Nayir A, Ozen S, Rodriguez Soriano J, Sanjad SA, Tasic V, Taylor CM, Topaloglu R, Smith AN, Karet FE. Novel ATP6V1B1 and ATP6V0A4 mutations in autosomal recessive distal renal tubular acidosis with new evidence for hearing loss. J Med Genet 2002; 39:796-803. [PMID: 12414817 PMCID: PMC1735017 DOI: 10.1136/jmg.39.11.796] [Citation(s) in RCA: 197] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Autosomal recessive distal renal tubular acidosis (rdRTA) is characterised by severe hyperchloraemic metabolic acidosis in childhood, hypokalaemia, decreased urinary calcium solubility, and impaired bone physiology and growth. Two types of rdRTA have been differentiated by the presence or absence of sensorineural hearing loss, but appear otherwise clinically similar. Recently, we identified mutations in genes encoding two different subunits of the renal alpha-intercalated cell's apical H(+)-ATPase that cause rdRTA. Defects in the B1 subunit gene ATP6V1B1, and the a4 subunit gene ATP6V0A4, cause rdRTA with deafness and with preserved hearing, respectively. We have investigated 26 new rdRTA kindreds, of which 23 are consanguineous. Linkage analysis of seven novel SNPs and five polymorphic markers in, and tightly linked to, ATP6V1B1 and ATP6V0A4 suggested that four families do not link to either locus, providing strong evidence for additional genetic heterogeneity. In ATP6V1B1, one novel and five previously reported mutations were found in 10 kindreds. In 12 ATP6V0A4 kindreds, seven of 10 mutations were novel. A further nine novel ATP6V0A4 mutations were found in "sporadic" cases. The previously reported association between ATP6V1B1 defects and severe hearing loss in childhood was maintained. However, several patients with ATP6V0A4 mutations have developed hearing loss, usually in young adulthood. We show here that ATP6V0A4 is expressed within the human inner ear. These findings provide further evidence for genetic heterogeneity in rdRTA, extend the spectrum of disease causing mutations in ATP6V1B1 and ATP6V0A4, and show ATP6V0A4 expression within the cochlea for the first time.
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Affiliation(s)
- E H Stover
- Department of Medical Genetics, University of Cambridge, UK
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Abstract
A 17-year-old anuric female patient with end-stage renal failure received a massive overdose of vancomycin and was treated with high-flux hemodiafiltration, as described in this report. The hemodiafiltration procedure with a polysulfone membrane was performed 3 times. The vancomycin concentration was decreased from 101 mg/l to 16.59 mg/l at the end of the procedure. No adverse effects were noted from either vancomycin or hemodiafiltration. Hemodiafiltration with a high-flux polysulfone membrane is a novel and safe treatment modality for vancomycin overdose in pediatric patients.
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Affiliation(s)
- I O Akil
- Department of Pediatric Nephrology, Ege University Medical School, Bornova, full blockzmir, Turkey.
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Abstract
The pathogenesis of edema in nephrotic syndrome has not been entirely understood. We investigated the value of the echographic parameters [inferior vena cava index (IVCI), inferior vena cava collapsibility index (IVCCI), and left atrium diameter (LAD)] to determine the volume load in children with minimal lesion nephrotic syndrome (MLNS). Twelve children with MLNS (seven boys, five girls) were included in this study. The patients were classified into three different stages (stage A: edematous; stage B: 50% decrease in weight gain; stage C: edema free) following measurement of their ideal weights. The ideal weight of patients in stage A was increased 13 +/- 7%. Serum total protein, albumin and urine sodium levels were found to be low in these patients. Plasma renin activity (PRA) and serum aldosterone levels in stage A were significantly different from those of the control group (P<0.05). PRA and serum aldosterone levels were not different from those of the control group in stage B (P>0.05). However, the increase in PRA was significant in stage C. Although a significant weight decrease was found in stages B and C, it had no effect on IVCI, LAD, and cardiothoracic index. We consider IVCI, IVCCI, and LAD measurements by echocardiography (ECHO) to be easy and reliable clinical methods for assessing the intravascular volume load in patients with MLNS.
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Affiliation(s)
- O Dönmez
- Department of Pediatric Nephrology, Uludag University Faculty of Medicine, Bursa, Turkey.
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Abstract
Hyperglycaemia is known occasionally to occur with conventional neuroleptics, but has more recently been associated with atypical antipsychotics especially clozapine and olanzapine. This article examines more closely this association. A review of relevant published literature from 1970 to date was undertaken following Medline and Embase searches in June 2000. Hyperglycaemia with clozapine was widely reported: spontaneous reports of either hyperglycaemia or ketoacidosis were described in a total of 17 people. In a five-year naturalistic study, 30.5% of patients taking clozapine were eventually diagnosed with Type 2 diabetes. With olanzapine, a total of 10 cases of hyperglycaemia and 5 cases of ketoacidosis have been published. Reports of hyperglycaemia with other atypicals are relatively scarce. The association of hyperglycaemia or ketoacidosis with clozapine and olanzapine appears to be a true drug-induced effect. Risk factors may include male gender, age of around 40 years and being non-Caucasian. The management of hyperglycaemia depends on the causative agent. With clozapine, treatment with oral hypoglycaemics has been successful. With olanzapine, other atypical antipsychotics may be considered. Blood glucose monitoring is essential for all patients starting clozapine or olanzapine.
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Affiliation(s)
- S Mir
- Pharmacy Department, Maudsley Hospital, London, UK
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Abstract
Hemodialysis-associated seizure (HAS) is a common complication of hemodialysis. The efficiency of anticonvulsant drugs in treating or preventing seizures is poorly defined. In this study, children on long-term hemodialysis were examined for HAS and the effect of diazepam prophylaxis on HAS was investigated. Nine patients with a mean age of 14.1 + 2.8 years had HAS and 4 with a mean age of 13.0 +/- 4.4 years had never experienced HAS. The patients with HAS had tonic-clonic seizures. Four patients had focal slow-wave paroxysms, especially in the parieto-occipital regions; 2 had subcortical epileptiform discharges by electroencephalography. No correlation was observed between HAS and patient age, primary disease, prior history of seizures, type of dialysis, duration of hemodialysis, anemia, hyperparathyroidism, and administration of erythropoietin. Hypertension due to hypervolemia may also play a role in the development of HAS. Five patients with HAS first treated with phenobarbital (PB) had recurrence of seizures. As a dialyzable antiepileptic PB may be associated with an increased risk for HAS. In a preliminary study, we gave diazepam as a prophylactic therapy to 4 patients with HAS. During 6 months of follow-up, these patients had no seizures. The number of HAS was significantly different between the groups receiving PB and diazepam (z=-2,58, P=0.009). In conclusion, administration of diazepam per os to patients with HAS may be of value for preventing recurrence of HAS.
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Affiliation(s)
- F Sönmez
- Department of Pediatrics, Adnan Menderes University, Aydin, Turkey.
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Aksu N, Keskinoglu A, Erdogan H, Yavascan O, Mir S, Kansoy S. Does immunologic status predict peritonitis in children treated with CAPD? Adv Perit Dial 2000; 14:243-6. [PMID: 10649733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The purpose of this study was to evaluate whether immunologic status could predict the development of peritonitis in children on continuous ambulatory peritoneal dialysis (CAPD). Twenty-one patients (12 boys, 9 girls) aged 10.1 +/- 4.32 years (range: 23 months to 14 years) were studied. The mean duration of CAPD treatment was 12.88 +/- 6.69 months (range: 2-22 months). Twelve healthy children (mean age 11.5 years) were selected as a control group. Lymphocyte subpopulations (CD3, CD4, CD8, CD19, NK, and IL-2R) were determined by double-color flow cytometry (Becton-Dickinson). Statistical evaluation was made by Student's t-test. CD4 (38.4 +/- 7.1% vs. 28.0 +/- 5.4%), CD4/CD8 ratio (1.30 +/- 0.4 vs. 0.96 +/- 0.3), and B lymphocyte (19.9 +/- 8.9% vs. 12.0 +/- 3.2%) levels were significantly higher in CAPD patients compared with controls. CAPD patients showed significantly lower natural killer (NK) cell values than controls (12.7 +/- 7.0% vs. 27.3 +/- 8.3%). Apart from CD19 values (21.9 +/- 10.4% vs. 12.0 +/- 3.2%) there were no significant differences between CAPD patients without infection and the control group in the laboratory parameters studied. On the other hand, CD3 (66.3 +/- 7.9% vs. 55.9 +/- 9.7%), CD4 (38.4 +/- 7.1% vs. 28.0 +/- 5.4%), and CD19 (6.3 +/- 3.3% vs. 12.0 +/- 3.2%) levels were significantly higher in CAPD patients with infection compared with the controls. CAPD patients with infection showed significantly lower NK activity (12.7 +/- 7.1% vs. 27.3 +/- 8.3%) than those in the control group. In conclusion, these results can explain the increased vulnerability to peritonitis in CAPD patients compared with healthy subjects. Additionally, immunologic status can predict the development of peritonitis in children treated with CAPD.
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Affiliation(s)
- N Aksu
- Department of Pediatric Nephrology, SSK Tepecik Teaching Hospital, Yenisehir, Turkey
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Abstract
BACKGROUND In this study, 66 patients with Henoch-Schönlein nephritis (HSN) were investigated clinicopathologically. METHODS The patients were classified according to their initial presentation, histologic findings, recurrences of purpura, type of treatment and clinical outcome. Logistic regression analysis was performed. RESULTS Sixty-eight percent of patients were hospitalized with mild renal disease. Most patients were evaluated as class I and II according to light microscopy. In addition to IgA deposition alone, 33% of patients showed IgA + C3 and 27% had IgA + IgG + C3 depositions. After the follow-up period of 3.3 years, 15 patients had minor urinary findings, 4 had active renal disease and 1 had renal insufficiency. Recurrences occurred in 37.9% of patients and 37.1% of patients with recurrences had persistent pathologic findings. Symptomatic treatment was given to 51.5% of patients, while 27.2% were given corticotherapy. CONCLUSIONS Clinical presentation was found to be correlated with outcome. Recurrence of the disease and the type of the treatment also affected the outcome. It was also thought that mesangial IgG and C3 depositions may have a role in the pathogenesis of renal damage in HSN.
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Affiliation(s)
- F Sönmez
- Division of Pediatric Nephrology, Ege University Faculty of Medicine, Izmir, Turkey.
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Abstract
Elevated urinary calcium and phosphate excretion have been observed in children with insulin-dependent diabetes mellitus (IDDM). This may be related to a defect in tubular reabsorption. It is well known that converting enzyme inhibition decreases microalbuminuria and may prevent or retard diabetic nephropathy. We investigated whether enalapril also improves the defect in calcium and phosphate reabsorption. We studied 16 children and young adults (age 12-21 years) with IDDM and persistent microalbuminuria before and during 12 weeks of enalapril treatment. Before treatment microalbuminuria, urinary calcium excretion, and fractional tubular phosphorus reabsorption (TPR) were 153+/-53 microg/min, 5.5+/-0.9 mg/kg per day, and 71.4+/-3.6%, respectively. At the end of the 12th week, microalbuminuria had decreased to 20.3+/-7.9 microg/min and calcium excretion to 3.3+/-0.4 mg/kg per day (P<0.01), while the TPR increased to 80.1+/-3.8% (NS). The renal threshold phosphate concentration increased from 1.8+/-0.15 to 2.92+/-0.23 mg/dl (P<0.01). The fasting serum glucose and hemoglobin Alc levels did not change significantly during the study. Systolic and diastolic blood pressures were 120.4+/-2.2 / 79.3+/-1.4 mm Hg and 110.5+/-1.8 / 71.3+/-0.9 mm Hg before and after 12 weeks, respectively. We conclude that enalapril treatment improves not only microalbuminuria but also abnormal calcium and phosphate excretion in microalbuminuric children with IDDM.
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Affiliation(s)
- H Yüksel
- Division of Pediatric Nephrology, Ege University Medical Faculty, Bornova, Izmir, Turkey
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Abstract
BACKGROUND Antidepressant therapy is not always effective and is slow to take effect. In theory, these shortfalls may be caused by induction of neuronal negative feedback via pre-synaptic 5-HTIA receptors. Pindolol, an antagonist at somatodentritic pre-synaptic 5-HTIA receptors has been investigated as a potential accelerator and augmentor of antidepressant response. METHOD A Medline search was conducted in November 1997. RESULTS Six open-label studies and six controlled studies were identified for review. CONCLUSIONS Open-label studies strongly suggest that pindolol may accelerate and augment antidepressant response, but controlled studies do not wholly support these findings: only three of six studies clearly demonstrate benefit. Larger, well-designed, controlled trials are needed to determine definitively the effectiveness of pindolol in this context.
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Kabasakal C, Mir S, Gousseinov A, Cura A, Betin N, Coker I. The role of PAF and leukotrienes in bioincompatibility of cuprophane membranes in hemodialysis. Turk J Pediatr 1998; 40:413-20. [PMID: 9763906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Inflammatory lipid mediators, PAF and leukotrienes (LTs), are thought to have an important role in biocompatibility in hemodialysis. PAF, LTB4 and LTC4 were studied both in controls (n: 12) and in 11 children on regular hemodialysis (150 minutes) with cuprophane dialyzers. Blood samples were collected initially (0'-precapillary), at first minute (1'-postcapillary) and at one hour after the hemodialysis sessions (210'-venous). Presence of LTs and high levels of PAF in 0' samples compared to levels in controls and significant increases in 1' samples suggested the alterations in PAF and LTs likely originated from the peripheral leukocyte activation. In 210' samples, PAF and LTs levels were decreased but still higher than the levels in 0' samples. This study suggested that PAF and LTB4 may be the control elements in biocompatibility in hemodialysis with cuprophane membranes, and demonstrated that the effects of activation last until the following session.
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Affiliation(s)
- C Kabasakal
- Department of Pediatrics, Ege University, Faculty of Medicine, Tepecik Social Security Hospital, Izmir
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