Objective Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection might have a higher mortality rate in patients with end-stage renal disease due to immunosuppression. This study investigates the mortality rates of SARS-CoV-2 infection and the factors affecting mortality among patients who were on maintenance hemodialysis and continuous ambulatory peritoneal dialysis. Materials and methods A total of 200 patients, including 157 maintenance hemodialysis and 43 continuous ambulatory peritoneal dialysis patients followed in our hospital, were included in the study. The patients' sociodemographic characteristics, comorbidities, history of SARS-CoV-2 infection in the previous year, death event, source of death (SARS-CoV-2 or not), presence of hospitalization due to SARS-CoV-2 infection, need for intensive care unit, need for ventilatory support in intensive care unit were obtained from the clinical file records. Results 85 of the 200 patients had a history of SARS-Cov-2 infection during the last 12 months. Forty-two (49.5%) patients with SARS-CoV-2 infection were hospitalized. Patients with SARS-CoV-2 had longer dialysis time, increased mortality, and significantly higher comorbidities such as coronary artery disease, congestive heart failure. Besides, heart failure and hypertension were the determining factors in the risk factor analysis for SARS-CoV-2 infection. In dialysis patients, the mortality rate in the last year, due to all causes, including SARS-CoV-2 infection, was 23% while the mortality rate due to "SARS-CoV-2 infection only" was 13%) ( p > 0.05). Our findings are important in guiding clinical decision-making and informing the public and health authorities about the risk of death associated with COVID-19 in this patient group.
This paper proposes new strength models to predict compressive, splitting tensile and flexural strengths of steel, synthetic and hybrid fiber reinforced concretes. The strength models depending on fiber reinforcing index, concrete compressive strength, and fiber volume fraction have been developed by multiple regression analyses of the experimental results obtained from a comprehensive experimental program. Twenty-five concrete batches, one control and 24 fiber reinforced concrete with target compressive strength of 40 MPa were produced. Steel and synthetic fibers, namely hooked-end steel (HF) and polyamide (PA) synthetic fibers of total volume of 0.25, 0.5, and 0.75% were added in single and hybrid forms to concrete mixes. Moreover, the predictions of the proposed strength models have been compared with the existing strength models in the literature. The test results clearly showed that the predictions of the proposed strength models are more accurate than the existing strength models for compressive, splitting tensile and flexural strengths of all the fiber types. Although the existing strength models may be applicable to the prediction of compressive strength of steel, synthetic, hybrid fiber reinforced concrete (FRC), they may not be safely used for splitting tensile and flexural strength of steel, synthetic and hybrid FRC. K E Y W O R D S compressive strength, fiber reinforced concrete, flexural strength, splitting tensile strength, strength model
ÖzetVitamin D, güneş ışığı ile temas sonucu deride üretilen, yağda çözünen, secosteroid yapıda bir prohormondur. Vücutta çeşitli metabolik değişikliklerle kalsitriol olarak bilinen, kalsiyum ve fosfor metabolizmasında önemli rol oynayan bir hormona dönüşür. Böbrek dokusu haricinde D vitaminine ait reseptörler; T lenfositler, beyin, prostat, pankreas, gonadlar, meme dokusu, kas ve kolon gibi birçok organ ve dokuda bulunmaktadır. D vitamininin etkinliği sadece kalsiyum homeostazisini düzenleyerek kemik sağlığını idame ettirmekle sınırlı olmayıp, aynı zamanda pro-apopitotik, antienflamatuar ve immün-modülatuar özelliklere sahip olduğu bildirilmektedir. Son yıllarda yapılan epidemiyolojik çalışmalarda, düşük D vitamini düzeyinin kanser insidansını ve kardiyovasiküler mortaliteyi arttırdığı, diyabet ve multipl skleroz gibi otoimmün hastalıklar ile birlikte olduğu bildirilmiştir. SummaryVitamin D is a liposoluble prohormon and and a secosteroid that is produced in the skin after exposure to sunlight. It is turned to calcitriol that has an important role in the calcium and phosphate metabolism by different metabolic pathways. Vitamin D receptors excluding kidney tissues are available in the following organs and tissues; T lenfosit, brain, prostate, pancreas, gonad, breast tissues, muscles and colon. It is known that function of Vitamin D is not only to maintain healthy bones through arranging calcium homeostasis but also has pro-apopitotic, anti-inflammatory and immune modulator characteristics. In recent epidemiologic studies, low level vitamin D increases cancer incidence and cardiovascular mortality and comes along with auto-immune low levels of vitamin D and diabetes mellitus.The development of chronic kidney disease (CKD) is accompained by a progressive reduce in ability to produce 1,25-dihydroxyvitamin D. Low 25-hydroxyvitamin D levels are common in patients with all the stages of CKD and this stuation has triggered the secondary hyperparathyroidism in CKD patients. Extrarenal conversion of 25-hydroxyvitamin D to 1,5-dihydroxyvitamin D may have significant biological role beyond those traditionally
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