Bu çalışmada Paul Helm’in ilahi inayet doktrini üzerinden geliştirdiği teolojik determinist görüşünü ele alacağız. Helm’e göre, bütün âlemde her şey Tanrı’nın inayeti kaynaklı takdirine uygun olarak ...meydana gelir. Bu yaklaşımda, Tanrı’nın önbilgisini insanın özgürlüğü ile mezcetme konusunda birtakım zorluklar ve böyle bir âlemde kötülüklerin neden var olduğuyla ilgili bazı problemler ortaya çıkmaktadır. İnsanın özgürlüğünü “bağdaşırcı özgür irade” üzerinden açıklayan Helm’e göre, her şeyin Tanrı’nın takdirine uygun olarak meydana geldiği dünyamızda insan yaptığı eylemlerden sorumludur. Muhaliflere göre, onun bu yaklaşımı Tanrı’yı kötü eylemlerin faili yapmaktadır. Helm’e göre ise insanın özgürlüğü determinizmin her türüyle bağdaştığı gibi ilahi determinizm ile de bağdaşabilir, bu nedenle insan yaptığı eylemlerden sorumludur. Dünyamızda neden kötülüklerin var olduğuyla ilgili “daha büyük iyi savunmasını” yapan Helm’e göre, Tanrı’nın bazı kötülüklere izin verdiğiyle ilgili gerekçelerini bilmek her zaman mümkün değildir. Onun bu açıklaması genel manada sağduyulu ve makul görünse de özellikle bazı korkunç kötülüklerin açıklanması konusunda tatmin edici olmayabilir.
Multisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory ...features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9–12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells × μL,
p
= 0.028; platelet count 166 vs. 216 cells × 10
3
/μL,
p
< 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 µg/L,
p
= 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%,
p
= 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%,
p
= 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% (
p
< 0.001, 95% CI 0.217–0.550), lethargy increased the risk of overlap with KD by 2.6-fold (
p
= 0.011, 95% CI 1.244–5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (
p
< 0.001, 95% CI 0.298–0.559).
Conclusion
: Almost half of the patients with MISC had clinical features that overlapped with KD; in particular, incomplete KD was present. The median age was lower in patients with KD-like features. Lymphocyte and platelet counts were lower, and ferritin and procalcitonin levels were significantly higher in patients with overlap with KD.
What is Known:
• In some cases of MIS-C, the clinical symptoms overlap with Kawasaki disease.
• Compared to Kawasaki disease, lymphopenia was an independent predictor of MIS-C.
What is New:
• Half of the patients had clinical features that overlapped with Kawasaki disease.
• In patients whose clinical features overlapped with KD, procalcitonin levels were almost 15 times higher than normal.
• Lethargy increased the risk of overlap with KD by 2.6-fold in MIS-C patients.
• Transient bradycardia was noted in approximately 10% of our patients after initiation of treatment.
In this study, two new Cu(II) complexes of p-tert-butylcalix4arene amide derivatives (8, 9) have been synthesised and investigated their DNA cleavage and antimicrobial activities. On the basis of ...spectral studies, a smaller distortion of square planar geometry has been proposed for both of the copper(II) complexes. The DNA cleavage studies show that the ligands are not efficacious, whereas the complexes have high activity. Futhermore, in order to determine the site of DNA cleavage, the DNA interactions of these compounds were investigated with some restriction enzymes. In addition, all synthesised compounds were screened for antimicrobial activities against some bacteria and for antifungal activities against yeast strains. The results showed that ethyl ester and furfuryl amide derivatives of the calixarenes are more efficient than other compounds against tested bacteria. However, complexes have not been effective. In case of DNA interaction studies, compounds were very effective against plasmid DNA.
Purpose
Due to its link with the 2019 coronavirus, the multisystem inflammatory syndrome in children (MISC) has garnered considerable international interest. The aim of this study, in which MISC ...patients were evaluated multicenter, and the data of the third period of the Turk-MISC study group, to compare the clinical and laboratory characteristics and outcomes of MISC patients who did and did not require admission to an intensive care unit (ICU).
Methods
This retrospective multicenter observational study was carried out between June 11, 2021, and January 01, 2022. The demographics, complaints, laboratory results, system involvements, and outcomes of the patients were documented.
Results
A total of 601 patients were enrolled; 157 patients (26.1%) required hospitalization in the intensive care unit (ICU). Median age was 8 years (interquartile range (IQR) 4.5–11.3 years. The proportion of Kawasaki disease-like features in the ICU group was significantly higher than in the non-ICU group (56.1% vs. 43.2%
p
= 0.006). The ICU group had considerably lower counts of both lymphocytes and platelets (lymphocyte count 900 vs. 1280 cells × μL, platelet count 153 vs. 212 cells × 10
3
/ μL, all for
p
< 0.001). C-reactive protein, procalcitonin, and ferritin levels were significantly higher in the ICU group (CRP 164 vs. 129 mg/L, procalcitonin 9.2 vs. 2.2 μg/L, ferritin 644 vs. 334 μg/L, all for
p
< 0.001). Being between ages 5–12 and older than 12 increased the likelihood of hospitalization in the ICU by four 95% confidence intervals (CI)1.971–8.627 and six times (95% CI 2.575–14.654), respectively, compared to being between the ages 0–5. A one-unit increase in log
d
-dimer (µg/L) and log troponin (ng/L) was also demonstrated to increase the need for intensive care by 1.8 (95% CI 1.079–3.233) and 1.4 times (95% CI 1.133–1.789), respectively.
Conclusion
: By comparing this study to our other studies, we found that the median age of MISC patients has been rising. Patients requiring an ICU stay had considerably higher levels of procalcitonin, CRP, and ferritin but significantly lower levels of lymphocyte and thrombocyte. In particular, high levels of procalcitonin in the serum might serve as a valuable laboratory marker for anticipating the need for intensive care.
What is Known:
• Lymphopenia and thrombocytopenia were an independent predictor factors in patients with MISC who needed to stay in intensive care unit
.
• The possibility of the need to stay in the intensive care unit in patients with MISC who had Kawasaki disease-like findings was controversial compared with those who did not
.
What is New:
• A one-unit increase log D dimer and log troponin was demonstrated to require for intensive care unit by 1.8 and 1.4 times, respectively
.
• Serum procalcitonin levels had the best performance to predict stay in the intensive care unit stay
.
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