scholarly journals P1087HOME HEMODIALYSIS THROUGH THE YEARS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Verica Todorov Sakic ◽  
Zivka Djuric ◽  
Petar Djuric ◽  
Ana Bulatovic ◽  
Jelena Tosic Dragovic ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Hormone Level ◽  
Polycystic Kidney ◽  
Ipth Level ◽  
Time Points ◽  
Results Of Treatment ◽  
Home Based ◽  
History Of ◽  
Frequent Reason

Abstract Background and Aims Outcome of dialysis patients differ considerably across the globe and many studies confirmed that home-based treatments offer some advantages, not only in regard of quality of life but also regarding of patients’ outcome. History of home hemodialysis (HOHD) in our country dates from 1971. and since that time many patients were treated with this dialysis modality. HOHD changed over the time together with general improving of dialysis techniques and we aimed to analyze the results of treatment of our population treated by HOHD during different time points. Method We analyzed patients characteristics, dialysis and uremia-related complications and survival of patients on HOHD during three different time points: 2001. (No=70), 2011. (No=29) and 2019. (No=22). Results The most frequent reason for ESRD in 2001, 2011 and 2019. was glomerulonephritis (48%, 45%, 36% respectively), followed by polycystic kidney disease 24% in 2011. and 36% in 2019. Diabetes mellitus (DM) was rarely cause of ESRD: in 2001. 2.1%; 4.5% in 2019. and none in 2011. In 2001. the patients were more frequently treated using high flux membranes (HF) as compared to HDF (87.1% vs.12.9%), and through years this changed in favor of HDF (48% vs. 52% in 2011, and 13.6% vs. 86.4% in 2019). Anti HCV prevalence was 27.4%, 38%, 27%, in 2001, 2011. and 2019. respectively. Anemia status was better controlled in recent years revealed by Hb level: 10.5±2.0 g/dl in 2001, 12.1±1.6 in 2011. and 11.9±2.3 in 2019. with almost similar percentage of patients treated with ESA (31%, 28% and 36% respectively). In 2001, parathyroid hormone level (iPTH) was 379±236 pmol/l and only 20% of patients underwent parathyroidectomy while in 2011. and in 2019. parathyroidectomy was performed in 69% and 59% of patients respectively. Therefore, in 2011. and in 2019. mean iPTH level was 33.8±48.5 and 40±46.2pmol/l respectively. Kaplan-Mayer analysis confirmed ten-year survival of 42% for period 1982-2001, and the most frequent reasons for death were infection and cardiovascular diseases. During the period 2011. to 2019., ten-year survival was 88% and cardiovascular diseases led to death in most of the cases. Conclusion our results have shown that HOHD treatment improved through the years considering patients’ survival, anemia status and secondary hyperparathyroidism treatment. Apart from HDF, the other factors have to be taken into consideration.

scholarly journals Adaptive servoventilation in clinical practice: beyond SERVE-HF?

2017 ◽  
Vol 3 (4) ◽  
pp. 00078-2017 ◽  
Author(s):  
Winfried Randerath ◽  
Katja Schumann ◽  
Marcel Treml ◽  
Simon Herkenrath ◽  
Alessandra Castrogiovanni ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Real Life ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Inclusion Criteria ◽  
Adaptive Servoventilation ◽  
Ventricular Ejection Fraction ◽  
History Of ◽  
Expected Mortality

Adaptive servoventilation (ASV) has proven effective at suppressing breathing disturbances during sleep, improving quality of life and cardiac surrogate parameters. Since the publication of the SERVE-HF-trial, ASV became restricted. The purpose of this study was to evaluate the clinical relevance of the SERVE-HF inclusion criteria in real life and estimate the portion of patients with these criteria with or without risk factors who are undergoing ASV treatment.We performed a retrospective study of all patients who were treated with ASV in a university-affiliated sleep laboratory. We reviewed the history of cardiovascular diseases, echocardiographic measurements of left ventricular ejection fraction (LVEF) and polysomnography.From 1998 to 2015, 293 patients received ASV, of which 255 (87.0%) had cardiovascular diseases and 118 (40.3%) had HF. Among those with HF, the LVEF was ≤45% in 47 patients (16.0%). Only 12 patients (4.1%) had LVEF <30%. The SERVE-HF inclusion criteria were present in 28 (9.6%) ASV recipients. Of these patients, 3 died within 30–58 months of therapy, all with systolic HF and a LVEF <30%.In this study, only a small minority of ASV patients fell in the risk group. The number of fatalities did not exceed the expected mortality in optimally treated systolic HF patients.

scholarly journals Cardiovascular Diseases and Drug Treatment in Patients with the History of Cerebral Stroke: Data of the Outpatient Registry REGION

2019 ◽  
Vol 14 (6) ◽  
pp. 879-886 ◽  
Author(s):  
M. M. Loukianov ◽  
S. S. Yakushin ◽  
S. Yu. Martsevich ◽  
O. M. Drapkina ◽  
A. N. Vorobyev ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Drug Therapy ◽  
Cardiovascular Diseases ◽  
Drug Treatment ◽  
Outpatient Clinics ◽  
Cerebral Stroke ◽  
History Of ◽  
Drug Provision

Aim. To evaluate the structure of combined cardiovascular diseases, drug treatment and observation of patients with a history of stroke in the framework of prospective outpatient registries. Material and methods. The study was conducted based on 3 outpatient clinics of Ryazan city. Patients with a history of acute cerebrovascular accident (ACVA) of any remoteness (AR) were included into ACVA-AR outpatient registry (n=511). Patients who had visited the outpatient clinics for the first time (FT) after cerebral stroke (n=475) were included into the ACVA-FT outpatient registry. The structure of the cardiovascular diseases (CVD), compliance with the clinical recommendations of the prescribed and received drug therapy were evaluated. The proportion of patients with dispensary observation for CVD, using preferential drug provision was determined. Results. A combination of 2 or more CVDs was found in 84.4% and 82.5% of cases, and severe cardiovascular multimorbidity (3-4 CVDs) – in 69% and 64% of cases, respectively, in ACVA-AR and ACVA-FT registers. Compliance with the clinical guidelines prescribed and received drug therapy was insufficient at the outpatient stage. Necessary prescription of drugs with a proven beneficial effect on the prognosis were observed significantly more frequent in the ACVA-FT registry, compared to the ACVA-AR registry at the enrolling stage of the study (p<0.05): statins for stroke – 50.1% vs 25.2%; statins for coronary heart disease (CHD) – 47.2% vs 27.9%; antiplatelet agents for CHD without atrial fibrillation – 65.6% vs 54.3%; anticoagulants for atrial fibrillation – 17.7% vs 9.3%; beta-blockers for heart failure 43.5% vs 33.1%, respectively. After 2-3 years of the follow-up frequency of prognostically significant prescriptions in patients of the compared registries were not significantly different, except prescriptions for statin therapy (47.6% vs 21.3%, respectively). The prognostically significant prescriptions during the enrolling stage in ACVA-AR and ACVA-FT registries occurred in 44.4% and 54% of the total number of proper prescriptions, and in the long-term follow-up period – in 55% and 57%, respectively; and the dispensary observation coverage was only 35.0% and 31.8%, respectively. According to patient contact only 21-24% of patients used the system of preferential drug provision at the stage of inclusion into the registers, and after 2-3 years of follow-up – 1.5-2 times less (12-14%). Conclusion The results of the study REGION found the presence of cardiovascular multimorbidity in 83% of patients with a history of stroke, insufficient quality of prescribed drug therapy in the out-patient clinic, especially in the ACVA-AR registry. The quality of medical treatment of patients improved within 2-3-year follow-up after the reference visit to out-patient clinic, but not sufficiently. Increase in dispensary observation coverage and optimization of the system of preferential drug provision are also important reserves for improving the quality of treatment of patients with a history of stroke, as well as prevention of cardiovascular complications. 

scholarly journals A Qualitative Study of the Impact of COVID-19 on Hospice and Home-Based Palliative Care in Taiwan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1029-1030
Author(s):  
YuHsuan (Olivia) Wang ◽  
Susan Enguidanos
Keyword(s):  
Palliative Care ◽  
Medical Team ◽  
Structured Interviews ◽  
Team Members ◽  
Time Points ◽  
Home Based ◽  
Alpha Variant ◽  
The Impact ◽  
Tremendous Impact

Abstract COVID-19 has had a tremendous impact on individuals and health care, particularly among those with serious illnesses. Although Taiwan initially reported low rates of COVID-19 (20.7 cases per million in 2020), by early 2021 the Alpha variant began spreading in Taiwan, which went into a soft lockdown from May to July. This study aimed to investigate the impact of COVID-19 on Hospice and Home-Based Palliative Care (HBPC) patients, family, and medical team member in Taiwan during different COVID-related time points. From November 2020 to May 2021, we conducted semi-structured interviews with 2 patient, 5 caregivers, and 8 medical team members in the hospice and HBPC setting to elicit their views about the impact of COVID-19 on care. Content analysis was used to guide the analysis of themes. Two researchers independently coded transcripts and met to reconcile codes. Results showed varying impact across the time points. In 2020, patients, caregivers, medical team members felt little impact of COVID-19. However, in 2021, HBPC caregivers reduced the frequency of HBPC visits to lower the household COVID-19 infection risk. Hospice and HBPC team members reported that more caregivers selected HBPC over hospice. They also observed an increase in complicated grief among family survivors following the soft lockdown. The impact of the pandemic on homecare provision increased as prevalence of COVID-19 increased, impacting care and quality of hospice and HBPC. Further research is needed to better understand the impact of the pandemic on the quality of hospice /HBPC and grief experiences.

scholarly journals Association of stress with cardiovascular diseases and risk factors in a population (ESSE-RF in Kemerovo region)

2019 ◽  
pp. 7-13
Author(s):  
E. B. Shapovalova ◽  
S. A. Maksimov ◽  
E. V. Indukaeva ◽  
G. V. Artamonova
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Arterial Hypertension ◽  
Cardiovascular Risk Factors ◽  
Demographic Characteristics ◽  
Inverse Association ◽  
History Of

Aim. To assess the prevalence of stress and its association with socio-demographic characteristics, cardiovascular risk factors and cardiovascular diseases (CVD) in the Siberian population.Material and methods. A cross-sectional study was performed in the framework of the Russian multicenter epidemiological study ESSE-RF in the Kemerovo Region in 2013. The presented study included 1628 individuals aged 25 to 64 years. Information was assessed on the presence of stress, some socio-demographic and economic characteristics, a history of CVD, as well as behavioral habits and quality of life. To eliminate the modifying effect of socio-demographic characteristics, a logistic regression analysis was used. The odds ratio (OR) and the 95% confidence interval (CI) were calculated.Results. The prevalence of stress was 22,6%; stress was statistically significantly more often recorded in women (28,1%) than in men (11,7%). After adjusting for sociodemographic characteristics, stress was statistically significantly more often recorded in people with secondary and primary education compared with those with higher education (24,9% and 19,1%, p=0,006), as well as in people with middle and high financial affluence compared with low affluence (24,5% and 11,3%, p<0,001). This association is observed only at the expense of women. For unemployed participants, the stress rate is higher only among males — 18,8% versus 11,4% among workers (p=0,015). Stress was also statistically significantly more often recorded in groups with arterial hypertension, lack of sleep, quality of life on the EQ-VAS scale and on the EuroQol scale. Smokers are more likely to have stress (23,8% vs 22,0%) and have a history of stroke (35,3% vs 22,2%). Among all CVDs and their risk factors, an inverse association of stress with obesity was revealed only in men.Conclusion. Study showed that people with stress are under large load of some cardiovascular risk factors. At the same time, ambiguous associations between stress and arterial hypertension and quality of life were obtained. This confirms the need for further study of the association of stress with other factors of cardiovascular risk, taking into account age and gender and socio-economic characteristics of the population.

Self-efficacy and quality of life among people with cardiovascular diseases: A meta-analysis.

2018 ◽  
Vol 63 (2) ◽  
pp. 295-312 ◽  
Author(s):  
Anna Banik ◽  
Ralf Schwarzer ◽  
Nina Knoll ◽  
Katarzyna Czekierda ◽  
Aleksandra Luszczynska
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Diseases ◽  
Self Efficacy ◽  
Meta Analysis

Probiotics in gastroenterology – from a different angle

2013 ◽  
Vol 154 (8) ◽  
pp. 294-304 ◽  
Author(s):  
György Miklós Buzás
Keyword(s):  
Side Effects ◽  
Beneficial Effect ◽  
Analytical Data ◽  
Well Being ◽  
Gastrointestinal Diseases ◽  
Convincing Evidence ◽  
Probiotic Treatment ◽  
History Of ◽  
Irritable Bowel

After a short overview of the history of probiotics, the author presents the development of human intestinal microflora based on the newest genetic data and the microbiological features of main probiotics. The indications of probiotic administration have been defined and extended in recent years. The author reviews significant results of probiotic treatment in some gastrointestinal diseases based on meta-analytical data. Probiotics are useful in preventing and treating diarrhoea caused by antibiotics and Clostridium difficile caused diarrhoea. In the treatment of Helicobacter pylori infection, preparations containing certain Lactobacillus,Bifidobacterium strains or Saccaromyces boulardii could enhance by 5–10% the rate of successful eradication and reduce the incidence and severity of the side effects. Some symptoms of irritable bowel syndrome and thus the quality of life can be improved by probiotics. Their beneficial effect in ulcerative colitis was proven, while in Crohn’s disease has not yet been defined. The use of probiotics is not included in guidelines, with the exception of the Maastricht IV/Florence consensus. For each disease it is advisable to use probiotics containing strains only with proven beneficial effect. The efficiency of preparations containing mixed strains has not yet been properly investigated. The author reviews the rare but potentially serious side effects of probiotics. In Hungary, there are many probiotic preparations available which can be purchased in pharmacies without prescription: their use is more empirical than evidence-based. The European Food Safety Authority has recently rejected claims for probiotics to be classed as medicines given the lack of convincing evidence on the effects of probiotics on human health and well-being. Clearly, further research is needed to collect evidence which could be incorporated into the international guidelines. Orv. Hetil., 2013, 154, 294–304.

EXPLORING HEALTHCARE ARCHITECTURE THROUGH THE MEDIUM OF FILM: Motives and Techniques

2014 ◽  
Vol 8 (1) ◽  
pp. 29
Author(s):  
Stephen Verderber
Keyword(s):  
Real World ◽  
The Real ◽  
Healthcare Settings ◽  
Interdisciplinary Field ◽  
Body Of Knowledge ◽  
Behavior Setting ◽  
Physical Environments ◽  
Scant Attention ◽  
History Of

The interdisciplinary field of person-environment relations has, from its origins, addressed the transactional relationship between human behavior and the built environment. This body of knowledge has been based upon qualitative and quantitative assessment of phenomena in the “real world.” This knowledge base has been instrumental in advancing the quality of real, physical environments globally at various scales of inquiry and with myriad user/client constituencies. By contrast, scant attention has been devoted to using simulation as a means to examine and represent person-environment transactions and how what is learned can be applied. The present discussion posits that press-competency theory, with related aspects drawn from functionalist-evolutionary theory, can together function to help us learn of how the medium of film can yield further insights to person-environment (P-E) transactions in the real world. Sampling, combined with extemporary behavior setting analysis, provide the basis for this analysis of healthcare settings as expressed throughout the history of cinema. This method can be of significant aid in examining P-E transactions across diverse historical periods, building types and places, healthcare and otherwise, otherwise logistically, geographically, or temporally unattainable in real time and space.

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

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