Evaluation of T-wave alternans in pediatric patients with chronic renal failure.

INTRODUCTION: Microvolt T-wave alternans (TWA) is known to be useful in prediction of ischemia and sudden death in high-risk populations and there are no studies in children with chronic renal failure (CRF). Cardiac problems seem to be responsible for an important part of death in children and young adults with CRF. The aim of this study is to evaluate Holter microvolts TWA measurements in children with CRF comparing to the control group. METHODS: This prospective study included 40 patients with CRF and 48 healthy controls. The history, echocardiography and microvolt TWA values based on 24-hour ECG recordings of the patients were evaluated. Analysis of microvolt TWA was considered on the basis of three leads (V5, V1 and AVF). RESULTS: Compared with the controls, the mean systolic and diastolic blood pressure values and average heart rates were significantly higher in the children with CRF (p = 0.001 and p = 0.026, respectively). Also, the values of left ventricular internal dimensions at end diastole and end-diastolic volume were significantly higher in CRF group (p = 0.01 and p = 0.049, respectively) and couplet ventricular extrasystole was detected in 2 patients with CRF. Consequently, all TWA values in three leads were increased in CRF group than the control group but the only increase in V5 lead was statistically significant (p = 0.028). CONCLUSIONS: This study has demonstrated that microvolt TWA values increased in pediatric patients with CRF. TWA might be used for early risk assessment in pediatric patients with CRF in the future.

Variables affecting medical faculty students' achievement: a mersin university sample.

BACKGROUND: TRAINING PROVIDED IN MEDICAL FACULTIES IS MAINLY COMPOSED OF TWO PHASES: preclinical and clinical. Preclinical period, or the first three years, consists of theoretical classes and practical implementations to develop vocational skills. In the clinical period, students are given applied courses. OBJECTIVES: This study aimed to determine the role of demographic characteristics and medical students' life habits on their academic achievement. PATIENTS AND METHODS: For this purpose, a 20-item survey form with two sections developed by the researchers was used. Students were also asked to identify the averages of committee exams as the academic achievement indicator. Participating students (n = 287) were from Mersin University Medical Faculty during 2012-2013 session. RESULTS: Totally, 60.3% of the students were males with an average age of 21.16 ± 1.39, and their general grade point average was 63.39 ± 9.08. Students in their second year (P = 0.000), who were females (P = 0.000), graduated from Anatolian Teachers High Schools (P = 0.002), financially well off (P = 0.026), stayed in state hostels (P = 0.032), did not smoke (P = 0.042) and regularly did sports (P = 0.016) were significantly more successful compared to others. CONCLUSIONS: Students' socioeconomic resources and habits play roles on academic achievement. Solutions that incorporate economic support which can eliminate negative situations leading to inequality of opportunity among students would increase students' achievement.