BackgroundTo date, the majority of studies on hyponatremia focussed on hyponatremia at admission, and came from developed countries. This study aimed to identify the prevalence of hyponatremia during hospitalization in patients hospitalized for HF and its association with in-hospital mortality.MethodsThis was an observational study using retrospective data from patients’ records between 2010–2013. It focused on those patients carrying an ICD-10 code of 150.0(Congestive Heart Failure) as their primary diagnosis.Hyponatremia during hospitalization was defined as serum sodium level lower than 135 mEq/L obtained from a blood chemistry measurement on the next days after admission. Patients’ characteristics were examined and the association between hyponatremia during hospitalization and in-hospital mortality was analyzed.ResultsAmong 464 patients hospitalized for HF, hyponatremia during hospitalization was observed in 22 % of patients with 44 % of this group had normal serum sodium level on admission.Hyponatremia during hospitalization was associated with lower blood pressure on admission, both systolic and diastolic, peripheral oedema, ascites and fatigue. Patients having history of hospitalization for cardiac diseases and renal failure were higher in patients developing hyponatremia during hospitalization. In this group, amiodarone, heparin, insulin and antibiotics were administered more frequently. Factors potentially increase the risk of hyponatremia during hospitalization include history of fatigue (OR = 3.23, 95 % CI 1.79–5.82), presence of ascites (4.14, 1.84–9.31), and administration of heparin (3.85, 1.78–8.31) and antibiotics (3.08, 1.71–5.53). Length of hospital stay was significantly longer in patients with hyponatremia during hospitalization and in-hospital mortality was also higher compared to non-hyponatremic patients, 7.7 % and 29.1 %, respectively.ConclusionThis study found that the prevalence of hyponatremia during hospitalization in patients hospitalized for HF was almost the same as hyponatremia on admission and administration of heparin and antibiotics can potentially worsen hyponatremia during hospitalization. In this study population, hyponatremia during hospitalization was found to be associated with in-hospital mortality.
This article discusses several language theories and psychological theories that influence the educator's point of view in teaching languages both mother tongue and second language learners. Among the linguistic theories described are structuralism theories pioneered by Ferdinand de Saussure in Europe; the first figure to do a study of language with scientific principles and codified so that it can be analyzed using systematic and clear methods. Other figures in this genre are Leonardo Bloomfield, Edward Saphier, Charles Hokait and Charles Fries. Second, the transformational generative theory pioneered by Noam Chomsky, who was born in 1928 in Pennsylvania, United States. Psychological theories discussed are the theories of behaviorism, nativism, cognitivism, functional, constructivism, humanism and cybernetics. ABSTRAKArtikel ini membahas bebarapa teori kebahasaaan dan teori kejiwaan yang mempengaruhi sudut pandang pendidik dalam mengajarkan bahasa baik bahasa ibu maupun bahasa kedua peserta didik. Di anatar teori kebahasaan (linguistic theory) yang dijelaskan adalah teori strukturailisme yang dipelopori oleh Ferdinand de Saussure di Eropa; tokoh pertama yang melakukan kajian tentang bahasa dengan prinsip-prinsip ilmiah dan terkodifikasi sehingga dapat dianalisis dengan menggunakan metode yang sistematis dan Jelas. Tokoh lain aliran ini adalah Leonardo Bloomfield, Edward Saphier, Charles Hokait dan Charles Fries. Kedua, teori transformational generative yang dipelopori oleh Noam Chomsky yang lahir tahun 1928 di Pennsylvania, Amerika Serikat. Sedangkan teori kejiwaan yang dibahas adalah teori behaviorisme, nativisme, kognitivisme, fungsional, konstruktivisme, humanism dan sibernetik. PENDAHULUANPerkembangan pembelajaran bahasa baik bahasa pertama (B1) dan bahasa kedua (B2) tidak terlepas dari perkembangan model, strategi, pendekatan, metode, teknik, dan taktik baik yang khusus untuk pembelajaran bahasa maupun umum yang dapat diadaptasi.Metode pembelajaran yang khusus atau metode yang lahir dari proses pembelajaran bahasa adalah metode tata bahasa dan terjemah (grammar and translation method), metode langsung (direct method), metode membaca (reading method), metode dengar ucap (audiolingual method ), metode guru diam (the silent way), metode respon fisik total (total physical response), metode suggestopedia, metode pembelajaran bahasa berkelompok (language learning community), dan metode komunikatif (communicative language learning).Adapun model atau metode umum yang dapat diadaptasi dalam pembelajaran bahasa, misalnya model pembelajaran kooperatif, saintifik proses, contextual teaching and learning (CTL), active learning, PAIKEM, blended learning, web based learning, dan lain-lain.Keberadaan model maupun metode pembelajaran bahasa tersebut tidak terlepas dari pengaruh sudut pandang seseorang dan teori tentang bahasa dan pembelajaran bahasa. Misalnya, metode audilingual yang menekankan pembiasaan melalui teknik repeatation dan drill merupakan bukti dari adanya pengaruh teori pembeljaran yaitu behaviorisme. Maka, pe...
Background Hyponatremia has been known as an important predictor of clinical outcomes in patients with heart failure (HF). While information on hyponatremia in patients with HF has been available abundantly, information on factors associated with increased risk of developing hospital-acquired hyponatremia (HAH) is still limited. Objective To identify patients and medication-related factors associated with HAH in patients hospitalized from HF. Setting Fatmawati Hospital in Jakarta, Indonesia. Methods This is a nested case-control study with patients developing HAH served as case group and each patient in case group was matched by age and gender to three patients in control group. Patients included in this study are patients hospitalized from HF, and coded with I.50 according to ICD-10, during 2011-2013 at Fatmawati Hospital in Jakarta, Indonesia. Information retrieved from patients' medical records included demographic profiles, vital signs and symptoms at admission, past medical history, medication during hospitalization and clinical chemistry laboratory records. Multivariable logistic regression analysis was performed to find out patient and treatment-related factors associated with the development of HAH. Main outcome measures Patients and medication related factors having significant association with HAH. Results Four hundreds sixty-four patients were included in this study and 45 of them (9.7 %) met criteria of developing HAH so then, accordingly, 135 patients were selected as controls. 36 patient- and 22 treatment-related factors were analyzed in univariate logistic regression resulted in 20 factors having p value <0.2 and were included in multivariable logistic regression analysis. Final factors showing significant association with HAH are presence of ascites at admission (odds ratio = 4.7; 95 % confidence interval 1.9-11.5) and administration of amiodarone (3.2; 1.3-7.4) and heparin (3.1; 1.2-7.3) during hospital stay. Conclusion Presence of ascites at admission was found as patient-related factors associated with HAH in this study. In addition, administration of amiodarone and heparin during hospital stay were found as medication-related factors associated with HAH in patients hospitalized from HF.
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