Top PDF The role of sociodemographic factors in health - related quality of life of patients with end stage renal disease

The role of sociodemographic factors in health - related quality of life of patients with end stage renal disease

The role of sociodemographic factors in health - related quality of life of patients with end stage renal disease

A sample of 144 patients was recruited from three General Hospitals in the broader area of Athens, consisting of 84 patients (58.3%) undergoing in-centre haemodialysis (HD) and 60 patients (41.7%) in continuous ambulatory peritoneal dialysis (CAPD). The rate of response was very high, reaching 99%.Thus, the total sample includes almost all patients of these three units, consisting of 86 males (59.7%) and 58 females (40.3%), with a mean age of 60.6 years ± 14.9. Participants were Greek adults having signed a consent form for participation. All subjects had been informed of their rights to refuse or discontinue participation in the study according to the ethical standards of the Helsinki Declaration in 1983. Ethical permission for the study was obtained from the scientific committees of the hospitals. Full descriptive data of the sample are presented in table 1. Measurements were conducted with the following instruments: 1) WHOQOL-BREF is a self-report 26-item QoL inventory developed by the World Health Organization (WHOQOL Group, 2004). The items comprise a 4-domain model: a) physical health, b) psychological health, c) social relationships and d) environment. Also, a facet of two items is included referring to overall QoL/health. The Greek version is a 30-item form with 4 new national items referring to: 1) nutrition, 2) satisfaction with work, 3) home life and 4) social life (Ginieri- Coccossis et al., 2003; Ginieri-Coccossis et al., 2006). Higher scores indicate a better QoL.
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Rev. Soc. Bras. Med. Trop.  vol.48 número2

Rev. Soc. Bras. Med. Trop. vol.48 número2

Chagas disease (ChD), a neglected tropical disease caused by infection with the parasite Trypanosoma cruzi (T. cruzi), remains a serious p ublic health issue in Latin America and is an emerging disease in several non-endemic countries, where knowledge of the condition and experience with its clinical management are limited. Regionally, the disease is the major cause of disability secondary to tropical diseases in young adults. Health-related quality of life (HRQoL) impairment is common in patients with ChD, especially in those with Chagas dilated cardiomyopathy, the most severe manifestation of the disease, which frequently leads to heart failure. The aim of this review was to conduct a literature search for studies that have evaluated the determining factors of HRQoL in ChD patients. We included cross-sectional, case-control, cohort, and experimental studies, as well as clinical trials that evaluated the HRQoL in ChD patients aged 18 to 60 years and are presenting an explicit description of statistical analysis. Using a combination of keywords based on Descriptors in Health Sciences (DeCS) and Medical Subject Headings (MeSH) for searches in PubMed and the Scientifi c Electronic Library Online (SciELO), 148 studies were found. After exclusions, 12 studies were selected for analysis. Three main fi ndings were extracted from these studies: 1) cardiac involvement is associated with a worse HRQoL in ChD patients; 2) HRQoL is associated with the patients’ functional capacity; and 3) simple and inexpensive therapeutic measures are effective for improving HRQoL in ChD patients. Hence, ChD patients’ functional capacity, the effectiveness of non-surgical conservative treatment, and cardiac involvement are important determining factors for the HRQoL in ChD patients.
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Cultural adaptation and validation of the Kidney Disease and Quality of Life - Short Form (KDQOL-SF 1.3) in Brazil

Cultural adaptation and validation of the Kidney Disease and Quality of Life - Short Form (KDQOL-SF 1.3) in Brazil

The objective of the present study was to translate the Kidney Disease Quality of Life - Short Form (KDQOL-SF™ 1.3) questionnaire into Portuguese to adapt it culturally and validate it for the Brazilian population. The KDQOL-SF was translated into Portuguese and back- translated twice into English. Patient difficulties in understanding the questionnaire were evaluated by a panel of experts and solved. Meas- urement properties such as reliability and validity were determined by applying the questionnaire to 94 end-stage renal disease patients on chronic dialysis. The Nottingham Health Profile Questionnaire, the Karnofsky Performance Scale and the Kidney Disease Questionnaire were administered to test validity. Some activities included in the original instrument were considered to be incompatible with the activities usually performed by the Brazilian population and were replaced. The mean scores for the 19 components of the KDQOL-SF questionnaire in Portuguese ranged from 22 to 91. The components “Social support” and “Dialysis staff encouragement” had the highest scores (86.7 and 90.8, respectively). The test-retest reliability and the inter-observer reliability of the instrument were evaluated by the intraclass correlation coefficient. The coefficients for both reliability tests were statistically significant for all scales of the KDQOL-SF (P < 0.001), ranging from 0.492 to 0.936 for test-retest reliability and from 0.337 to 0.994 for inter-observer reliability. The Cronbach’s α coeffi- cient was higher than 0.80 for most of components. The Portuguese version of the KDQOL-SF questionnaire proved to be valid and reliable for the evaluation of quality of life of Brazilian patients with end-stage renal disease on chronic dialysis.
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Evaluation of the Frequency and Related Factors of Depression and Anxiety in Patients with End Stage Renal Disease Receiving Renal Replacement Therapies

Evaluation of the Frequency and Related Factors of Depression and Anxiety in Patients with End Stage Renal Disease Receiving Renal Replacement Therapies

The ABO blood group system was irst discovered by Karl Landsteiner, who found three different blood types (A, b, and o) in 1900 (3). blood group antigens are chemical components on membrane of the red blood cells but they are also expressed on a variety of epithelial cells including the urothelium, gastrointestinal system, mucosa and lung as well as saliva and body luids (4,5). The ABO blood group genes are mapped at chromosome 9q and consist of 7 exons, in which a genetic alteration is common in many cancers (6). blood group antigens have an important role in identifying matched blood products for transfusion. It has been reported that some of these molecules have varied and important functions in cell physiology and human pathology (7). The relationships between Abo blood groups and benign or malignant diseases have been observed for a long time. Deiciency of these membrane components is related to certain erythrocyte disorders (7). Aird et al. reported such a relationship with gastric cancer. They found that blood group A was signiicantly more frequent, while blood group O was less frequent in patients with gastric cancer when compared with the normal population in England (8). Some recent studies have reported a signiicant association between the ABO blood groups and pancreas cancer (9,10). There are a few studies in which the relationship between Abo blood groups and diabetes mellitus has been investigated. In 1957, Zeytinoglu reported predominance of group A in the Kimmelstiel-Wilson syndrome (11). Pontiroli et al. did not ind an association between ABO and Rh blood groups and the development of diabetic late complications in both patients with type 1 diabetes mellitus and those with type 2 diabetes mellitus (12,13).
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Mechanisms of endothelial dysfunction in resistance arteries from patients with end-stage renal disease.

Mechanisms of endothelial dysfunction in resistance arteries from patients with end-stage renal disease.

MEGJs to EDHF type responses appeared to be unaltered in uremic arteries, the upstream machinery of both endothelial pathways (i.e. NO and EDHF) were impaired. Since relaxation in response to NO donor or hyperpolarizing agent pinacidil (after NOS/COX inhibition) were similar between the groups, we confirm that the endothelium is the main target of uremic environment, whereas functional capacity of the vascular smooth muscle appeared to be rather tolerant. In accordance with our previous study [11] we corroborate a central role of the uremic milieu in the genesis of endothelial dysfunction. The present study also shows that among measured plasma markers of endothelial dysfunction only ADMA was strongly associated with the magnitude of endothelial dysfunction in uremic resistance arteries. Thus, our findings provide novel insights into the mechanisms of endothelial dysfunction in resistance circulation of ESRD patients. The pattern of impairment of EDHF type responses after BK but not ACh stimulation in uremic arteries emphasizes the agonist- specific mechanisms of endothelial dysfunction in this toxic milieu. We speculate that conventional and/or disease-specific risk factors may differently affect kinin and muscarinic receptors and/or their
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The Impact of Liver Cell Injury on Health-Related Quality of Life in Patients with Chronic Liver Disease.

The Impact of Liver Cell Injury on Health-Related Quality of Life in Patients with Chronic Liver Disease.

In non-NAFLD liver diseases, only 18 patients were obese. This subgroup was too small to be further analyzed for an association of obesity and CK18 and will have to be studied in future trials. Interestingly, women had significant lower CK18 values compared to men. While there were no gender specific differences in metabolic factors, we found differences regarding the dis- ease stage. Women presented with lower grades or no fibrosis more often and CTP was signifi- cantly different, as 76% of women had no cirrhosis in comparison to 66% of men. Additionally, CTP stage C was not observed in women. This was likely related to the underlying liver disease. In the study population women suffered more often from cholestatic liver diseases–a total of 74% were female—and autoimmune hepatitis, with 90% being female. On the contrary, men presented more frequently with alcoholic liver diseasein this group, 73% were male. On uni- variate variance analysis the underlying disease, but not gender influenced CK18.
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Rev. Bras. Psiquiatr.  vol.38 número4

Rev. Bras. Psiquiatr. vol.38 número4

Objective: To prospectively evaluate depressive symptoms, nutritional status, and quality of life (QoL) and search for possible associations in patients with end-stage renal disease undergoing hemodialysis. Methods: A cohort study of 104 adult patients with end-stage renal disease undergoing hemodialysis was conducted. Anthropometric, clinical, and biochemical variables were evaluated after a midweek hemodialysis session. The participants’ body composition was assessed by direct segmental multi- frequency bioimpedance analysis. The WHOQOL-Bref questionnaire was used to evaluate QoL. Participants were separated into two groups - depressive symptoms and no depressive symptoms - at inclusion and evaluated annually for 2 years thereafter using the Beck Depression Inventory. Survival analysis used the Kaplan-Meier method and Cox regression analysis for the goodness of fit of associated factors. All-cause mortality was the outcome of interest.
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Effect of Aging in the Perception of Health-Related Quality of Life in End-Stage Renal Disease Patients under Online-Hemodiafiltration

Effect of Aging in the Perception of Health-Related Quality of Life in End-Stage Renal Disease Patients under Online-Hemodiafiltration

ABSTRACT: This work aimed to evaluate how aging could influence patients’ perception of health quality of life (HRQOL), as well as, the effect of aging on dialysis adequacy and in hematological, iron status, inflammatory and nutritional markers. In this transversal study were enrolled 305 ESRD patients under online-hemodiafiltration (OL-HDF) (59.67% males; 64.9 ± 14.3 years old). Data about comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected from patient’s records. Moreover, HRQOL score, by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF), was assessed. Analyzing the results according to quartiles of age, significant differences were found for some parameters evaluated by the KDQOL-SF instrument, namely for work status, physical functioning and role-physical, which decreased with increasing age. We also found a higher proportion of diabetic patients, a decrease in creatinine, iron, albumin serum levels, transferrin saturation and nPCR, with increasing age. Moreover, significant negative correlations were found between age and mean cell hemoglobin concentration, iron, transferrin saturation, albumin, nPCR, work status, physical functioning and role-physical. In conclusion, our results showed that aging is associated with a decreased work status, physical functioning and role-physical, with a decreased dialysis adequacy, iron availability and nutritional status, and with an increased proportion of diabetic patients and of patients using central venous catheter, as the vascular access. The knowledge of these changes associated with aging, which have impact in the quality of life of the patients, could be useful in their management.
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Investigating The Use Of Mobile Computing In Zimbabwe Polytechnics Case Of A Polytechnic In Zimbabwe

Investigating The Use Of Mobile Computing In Zimbabwe Polytechnics Case Of A Polytechnic In Zimbabwe

ABSTRACT: Mobile computing has become an invaluable and inevitable part of teaching and learning in educational institutions globally. Zimbabwean polytechnics are not spared and those institutions that have chosen to integrate mobile computing with existing teaching and learning applications stand to benefit more than their slow and stagnant counterparts. This paper is investigated whether mobile computing is being used in Zimbabwe Polytechnics. It is based mainly on primary research since no particular research has targeted Polytechnics in Zimbabwe and specifically the Polytechnic understudy in this area, thus a survey was conducted and the survey results were used as the main data source. However, secondary research was incorporated to see what other researchers have found in similar topics the world over. This paper identifies the mobile computing hardware technology, software and communication technologies used at the Polytechnic. It then outlines the achievements made in this area and the associated benefits of such achievements. Finally highlights the challenges currently being faced by the polytechnic in implementing mobile computing and the opportunities the institution can exploit by fully utilizing the technology. The main findings of this research were that Zimbabwe polytechnics in general and the polytechnic in particular have adopted usage of mobile computing to enhance their teaching and learning and administrative activities. There are visible and tangible achievements and benefits that have been realized. Opportunities have been identified which the polytechnic can exploit if it fully embraces mobile computing. However there are some challenges hindering the progress in this regard.
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Estudo de perfusão e viabilidade miocárdicas por ressonância magnética em pacientes...

Estudo de perfusão e viabilidade miocárdicas por ressonância magnética em pacientes...

O IMS foi descrito há muitos anos 21 e estudos mostram que a sua prevalência varia entre 5 a 40%, dependendo do sexo, idade e presença de DAC, sendo maior em pessoas idosas, mulheres, pacientes diabéticos e hipertensos 22, 23, 24 25, 26, 27, 28 . Como o prognóstico de pacientes com IMS é similar ao de pacientes com infarto miocárdico documentado 24, 26 , ele é considerado importante problema de saúde pública 29 . Considerando a alta prevalência de DAC, hipertensão arterial, diabete melito e, sobretudo, a elevação dos níveis séricos de troponina nos pacientes com doença renal crônica 30 , pode-se suspeitar que a presença de IMS neste grupo de pacientes não seja desprezível, fato este até o momento não avaliado.
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J. Coloproctol. (Rio J.)  vol.33 número3

J. Coloproctol. (Rio J.) vol.33 número3

Results: thirty-one patients submitted to IPAA by the same group of professionals were evaluated. QoL was classii ed as regular in all domains evaluated (intestinal and system- ic symptoms and emotional and social aspects). There were no differences in relation to gender, type of pouch or postoperative time. However, elderly patients showed a tendency toward lower scores. Having a professional activity was associated with higher scores in systemic symptoms and social aspects (p < 0.05). Patients with ileostomy showed lower values in the domains of systemic symptoms, emotional and social aspects (p <0.05). Conclusion: in all domains assessed, patients with IPAA for UC had QoL classii ed as regular. Ileostomy and lack of professional activity negatively inl uenced QoL.
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Analysis of quality and cost of FeSiMg treatment master alloy vs. cored wire in production of ductile cast iron

Analysis of quality and cost of FeSiMg treatment master alloy vs. cored wire in production of ductile cast iron

At the Foundrys of Drawski M łyn and “WSK–Rzeszów” Metallurgical Plant in Rzeszów, a special technique of the nodularising (or vermicularising ) treatment was implemented. It was based on the use of cored wires, one cored with magnesium, and another with inoculant.

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Qualidade de vida relacionada à saúde avaliada pelo Inventário Pediátrico de Qualidade de Vida 4.0 em pacientes pediátricos com hanseníase e manifestações musculoesqueléticas.

Qualidade de vida relacionada à saúde avaliada pelo Inventário Pediátrico de Qualidade de Vida 4.0 em pacientes pediátricos com hanseníase e manifestações musculoesqueléticas.

Results: The median of current age was similar in leprosy patients and controls [12(6-18) vs. 15(5-18)years, p = 0.384], likewise the frequencies of female gender (p = 0.835) and mid- dle/lower Brazilian socio-economic classes (p = 1.0). The domain school activities according the child-self report was significantly lower in leprosy patients compared to controls in the age group of 13-18 years [75(45-100) vs. 90(45-100), p = 0.021]. The other domains were alike in both groups (p > 0.05). At least one musculoskeletal manifestation (arthralgia, arthritis and/or myalgia) was observed in 15% of leprosy patients and none in controls (p = 0.012). Further comparison between all leprosy patients showed that the median of the physical capacity domain [81.25(50-100) vs. 98.44(50-100), p = 0.036] and school activities domain by child-self report [60(50-85) vs. 80(45-100), p = 0.042] were significantly lower in patients with musculoskeletal manifestations compared to patients without these manifestations. No differences were evidenced between the other HRQL parameters in both groups, reported by patients and parents (p > 0.05).
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Evaluation of susceptibility of the ZRE1 alloy to hot cracking in conditions of forced strain

Evaluation of susceptibility of the ZRE1 alloy to hot cracking in conditions of forced strain

Nowadays, magnesium alloys are used for casting into sand moulds of huge dimensional castings, high-pressure castings and precise casings. In castings of magnesium alloys defects or inconsistencies often appear (like casting misrun, porosities and cracks) particularly in the huge dimensional castings. Such defects are mended with the use of padding and welding. The welding techniques can be applied by using weld material consisting of magnesium alloy, as well as for regeneration of alloys after excessive wear. Nevertheless, the number of the repaired castings, which were permitted for use, is not satisfactory for a profitable production. The main reasons for wear are the cracks appearing during welding in brittleness high-temperature range.
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Effect of heat treatment parameters on the properties of low-alloy cast steel with microadditions of vanadium

Effect of heat treatment parameters on the properties of low-alloy cast steel with microadditions of vanadium

This article examines the effect of prolonged time of holding at the temperature of 620 0 C on the processes of secondary phase precipitation and mechanical properties of low-alloy cast steel with an addition of vanadium subjected to two variants of heat treatment, i.e. U:1150 0 C+H:950 0 C+O:620 0 C and H:950 0 C+O:620 0 C. To determine an impact of the applied heat treatment operations, testing of mechanical properties and microstructural examinations of the cast steel with 0,21 and 0,27%C were carried out.
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J. Bras. Nefrol.  vol.39 número3

J. Bras. Nefrol. vol.39 número3

A doença renal cística adquirida (ACKD) é considerada uma condição tardia relacio- nada à doença renal crônica terminal e man- ifesta-se de modo mais evidente no contexto de hemodiálise de longo prazo. ACKD é amplamente reconhecida como lesão pré- maligna. Sua ocorrência em enxertos renais cronicamente rejeitados é rara, de modo que a frequência e o comportamento da entidade nesse cenário não estão bem documentados. Relatamos a ocorrência de ACKD em um al- oenxerto renal não funcionante sem maligni- dade após 215 meses de transplante e breve- mente revisamos a literatura relacionada.
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Clinics  vol.67 número6

Clinics vol.67 número6

In the analysis of the distance walked during the 6MWT with 100-meter increments, our findings show that the shorter the distance walked, the greater the probability of death in terminal renal insufficiency patients. A similar result was found by Rostagno et al. (39) when evaluating a series of HF patients. Thus, performing physical activities would improve the functional capacity and, consequently, the distance walked, constituting a protection factor for these types of patients (32). Due to the great prevalence of comorbidities, any physical activity prescribed must follow the principle of specificity and account for the functional capacity of the patients to avoid adversely affecting their health status (13). Based on our study, the distance obtained in the 6MWT may be considered as a reliable alternative to elaborate community rehabilitation programs for ESRD patients and a method of evaluating the physical capacities of these patients. The latter recommendation has already been adopted for the management of patients with HF (40). This study is potentially limited by the sample size, which was reduced due to the difficulty of adherence of the subjects to the proposed evaluations and the loss of patients during the follow-up period. Another limitation is the Figure 1 - Flowchart of the patients allocated in the study.
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CONTINUOUS CREATION IN THE PROBABILISTIC WORLD OF THE THEOLOGY OF CHANCE

CONTINUOUS CREATION IN THE PROBABILISTIC WORLD OF THE THEOLOGY OF CHANCE

I think we can answer this question in the positive: Yes, He can, because He is the most perfect being and His omnipotence is absolutely unlimited. A very important premise underlying the answer to the last question is that the risk is not so great, or even that it is very small. It is so because the nature and mechanism of the created world ensure with a very high proba- bility that all purposes intended by God will be attained without his causal action in the processes occurring in the world. The emergence of life in the universe is almost inevitable, because the universe is large and old enough, and biochemical mechanisms are very effective. The emergence of sentient beings was also almost inevitable because of longstanding and countless mutations and adaptations of living organisms to their environment. All this was very probable and hence in a sense necessary (inevitable). The great advantage of the non-deterministic world is its own creativity, which is possible because of the chance events happening in a way restricted only by the laws of nature. Thus, if one evolutionary path fails another one is opened. Perhaps a mutation suitable for the growth and development of a given species happened by chance and enabled it to survive in hard con- ditions and further develop. Elasticity and redundancy are very typical for the world of chance, but because of these properties, this world has a large number of possibilities and abilities to develop and regenerate after various natural catastrophes (Łukasiewicz 2006).
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Qualidade de vida relacionada à saúde dos indivíduos com diabetes mellitus atendidos...

Qualidade de vida relacionada à saúde dos indivíduos com diabetes mellitus atendidos...

Fayers e Machin (2000) citam diversos instrumentos genéricos e específicos. Dentre os genéricos: o WHOQOL (FLECK, 1999a; WHOQOL, 1998) que foi desenvolvido utilizando um enfoque transcultural original e para isso foram selecionados centros, de forma a incluir países com diferenças no nível de industrialização, disponibilidade de serviços de saúde, importância da família e religião dominante, entre outros, o Sickness Impact Profile (SIP) (GILSON, 1979), o Nottingham Health Profile (NHP) (HUNT et al., 1980; TEIXEIRA-SALMELA et al., 2004), o Medical Outcomes Study 36-Item Short Form (SF-36) (CICONELLI et al.,1999; WARE et al., 1986), e o EuroQol (EQ-5D) (BADIA; ROSSET; HERDMAN, 1999); já dentre os específicos: o European Organization for Reserch and Tratament of Cancer (EORTC) QLQ-C30 (GROENVOLD; KLEN; SPRANGRS, 1997), o EORTC Disease or Treatment-Specific Modules (SPRANGERS; BJORDA, et al., 1993) e o Quality of Life Epilepsy (QOLIE-89) (FAYERS; MACHIN, 2000; FLECK et al., 2000; STAVEM; BJORNAES; LOSSIUS, 1999).
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Determination Of Longevity Of Teeth In Buckets Of Loading Equipment In Coal Mines - A Case Study

Determination Of Longevity Of Teeth In Buckets Of Loading Equipment In Coal Mines - A Case Study

device was studied. The study took into account the effects of machine scale, wear surface structure of the rolls, grinding pressures and rolls speed, gap settings, feed size distribution and moisture content for a range of ores. The authors proposed a prevailing wear mechanism and a methodology for minimising wear of the grinding rolls, specific to the high pressure grinding device only. An example of a direct method, Bond (1964) and Buchi (1995) developed testing apparatus that determine rock abrasiveness in a low abrasion/medium impact mode of wear where rock abrasiveness is measured as the amount of material lost by a standard steel paddle which rotates on a shaft in a sample of loose rock particles of a certain specified size range. As can be seen from the above examples, the indirect methods of rock abrasivity assessment have the advantage of using data which is either readily available or relatively straightforward to obtain. However, they do not take into account process variables for specific modes of wear. Hence, they are normally not used in isolation, but rather in combination with direct methods, or holistic approaches, to supplement or confirm other more relevant direct measures. However, there is no universally accepted one standard test to determine the rock abrasivity although a large number of different tests are in use. All the studies about rock abrasiveness are concentrated on the amount of quartz, grain size and cementation degree of quartz, the geometry of the abrasive mineral and mechanical strength of rock.
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