scholarly journals Avaliação da adesão à terapia imunossupressora por autorrelato de pacientes submetidos ao transplante renal

2017 ◽  
Vol 27 (4) ◽  
pp. 28181
Author(s):  
Dagoberto França Rocha ◽  
Ana Elizabeth Figueiredo ◽  
Simone Travi Canabarro ◽  
Aline Winter Sudbrack

***Evaluation of adherence to immunosuppressive therapy by self-report of patients submitted to renal transplantation***AIMS: To evaluate the characteristics and risk factors related to the adherence to immunosuppressive treatment of renal transplant patients using the self-report method by means of the Basel Assessment of Adherence Scale for Immunosuppressives (BAASIS).METHODS: A prospective cohort study with a quantitative approach was performed at the Nephrology and Transplantation Service of São Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul, with patients older than 18 years, transplanted from kidneys from deceased or living donors, with a minimum transplant time of three months and a maximum of 12 months. The BAASIS instrument was applied to evaluate adhesion. For statistical analysis, Fisher exact test (Monte Carlo simulation) was used to verify the association between the categorical variables, Student t test for independent sample means and Mann Whitney test in the variables without normality. A p<0.05 was adopted for the results to be considered significant.RESULTS: The sample consisted of 59 patients, 57.6% of whom were male, 79.7% were white, the mean age was 45.8 years, 57.6% had elementary school and 72.9% were catholic. Hemodialysis was the most used method, in 86.4% of patients before transplantation, and the mean time in the waiting list was 19.5 months. After transplantation, the mean time of hospitalization was 17.2 days. The assessment of adherence by BAASIS characterized 83% of patients as non-adherent. The main fact considered as non-adherence was to take the immunosuppressive drugs with more than two hours difference from the prescribed time, at least once a week, in the last four weeks. There was no significant difference when the statistical analysis was performed to compare the adhesion rate among the various categories of the demographic and clinical variables of the patients.CONCLUSIONS: A high rate of patients not adherent to the immunosuppressive treatment was identified, and the change in the schedule of immunosuppressants was the main fact that characterized this behavior. A shorter waiting time in the transplant queue was associated with non-adherence. The other variables, demographic and clinical, were not associated to the classification of adherent or non-adherent.

Trauma ◽  
2021 ◽  
pp. 146040862094972
Author(s):  
Ahmed Fadulelmola ◽  
Rob Gregory ◽  
Gavin Gordon ◽  
Fiona Smith ◽  
Andrew Jennings

Introduction: A novel virus, SARS-CoV-2, has caused a fatal global pandemic which particularly affects the elderly and those with comorbidities. Hip fractures affect elderly populations, necessitate hospital admissions and place this group at particular risk from COVID-19 infection. This study investigates the effect of COVID-19 infection on 30-day hip fracture mortality. Method: Data related to 75 adult hip fractures admitted to two units during March and April 2020 were reviewed. The mean age was 83.5 years (range 65–98 years), and most (53, 70.7%) were women. The primary outcome measure was 30-day mortality associated with COVID-19 infection. Results: The COVID-19 infection rate was 26.7% (20 patients), with a significant difference in the 30-day mortality rate in the COVID-19-positive group (10/20, 50%) compared to the COVID-19-negative group (4/55, 7.3%), with mean time to death of 19.8 days (95% confidence interval: 17.0–22.5). The mean time from admission to surgery was 43.1 h and 38.3 h, in COVID-19-positive and COVID-19-negative groups, respectively. All COVID-19-positive patients had shown symptoms of fever and cough, and all 10 cases who died were hypoxic. Seven (35%) cases had radiological lung findings consistent of viral pneumonitis which resulted in mortality (70% of mortality). 30% ( n = 6) contracted the COVID-19 infection in the community, and 70% ( n = 14) developed symptoms after hospital admission. Conclusion: Hip fractures associated with COVID-19 infection have a high 30-day mortality. COVID-19 testing and chest X-ray for patients presenting with hip fractures help in early planning of high-risk surgeries and allow counselling of the patients and family using realistic prognosis.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hussein Soffar ◽  
Mohamed F. Alsawy

Abstract Background Neuronavigation is a very beneficial tool in modern neurosurgical practice. However, the neuronavigation is not available in most of the hospitals in our country raising the question about its importance in localizing the calvarial extra-axial lesions and to what extent it is safe to operate without it. Methods We studied twenty patients with calvarial extra-axial lesions who underwent surgical interventions. All lesions were preoperatively located with both neuronavigation and the usual linear measurements. Both methods were compared regarding the time consumed to localize the tumor and the accuracy of each method to anticipate the actual center of the tumor. Results The mean error of distance between the planned center of the tumor and the actual was 6.50 ± 1.762 mm in conventional method, whereas the error was 3.85 ± 1.309 mm in IGS method. Much more time was consumed during the neuronavigation method including booting, registration, and positioning. A statistically significant difference was found between the mean time passed in the conventional method and IGS method (2.05 ± 0.826, 24.90 ± 1.334, respectively), P-value < 0.001. Conclusion In the setting of limited resources, the linear measurement localization method seems to have an accepted accuracy in the localization of calvarial extra-axial lesions and it saves more time than neuronavigation method.


1954 ◽  
Vol 45 (1) ◽  
pp. 19-27 ◽  
Author(s):  
R. Braude ◽  
P. M. Clarke ◽  
K. G. Mitchell

1. A survey and. statistical analysis of the records of litters born in the N.I.R.D. herd of Large White pigs over a period of 16 years are presented.2. The mean length of gestation was 114 days for both gilts and sows.3. The mean numbers of pigs born alive and born dead per litter from gilts, 10·0 and 0·2 respectively, were both significantly smaller than the corresponding figures for sows, 11·8 and O·8. No seasonal differences were found.4. The mean total losses of pigs from birth to weaning at 8 weeks were 29·5% of pigs born alive. The losses in litters from gilts, 23·0%, were significantly smaller than in litters from sows, 31·0%. The losses during the winter months both for gilts, 32·5%, and for sows, 35·9%, were significantly higher than during the summer months, 19·4% and 26·7% for gilts and sows respectively.5. Over 50% of the total losses were due to crushing by the dam, 74·1% of the losses from this cause occurring during the first 48 hr. after birth.6. The mean number of pigs weaned per litter was 8·0. The difference between the number weaned per litter from gilts, 7·7, and per litter from number of pigs was weaned per litter from sows during the summer months, 8·7, than during the winter months, 7·4.7. There was no significant difference between the number of male and of female pigs weaned.8. The mean weight at weaning was 29·9 lb., male pigs, 30·3 lb., being significantly heavier than females, 29·51b. Pigs in litters from gilts, 27·81b., were significantly lighter at weaning than those from sows, 30·0 lb., and for both gilts and sows, pigs reared during the summer months, 29·7 and 31·8 lb. respectively, were significantly heavier than those reared during the winter months, 25·9 and 28·2 lb. respectively.


Author(s):  
Maria E. Currie ◽  
Ana Luisa Trejos ◽  
Reiza Rayman ◽  
Michael W.A. Chu ◽  
Rajni Patel ◽  
...  

Objective The purpose of this study was to determine the effect of three-dimensional (3D) binocular, stereoscopic, and two-dimensional (2D) monocular visualization on robotics-assisted mitral valve annuloplasty versus conventional techniques in an ex vivo animal model. In addition, we sought to determine whether these effects were consistent between novices and experts in robotics-assisted cardiac surgery. Methods A cardiac surgery test-bed was constructed to measure forces applied during mitral valve annuloplasty. Sutures were passed through the porcine mitral valve annulus by the participants with different levels of experience in robotics-assisted surgery and tied in place using both robotics-assisted and conventional surgery techniques. Results The mean time for both the experts and the novices using 3D visualization was significantly less than that required using 2D vision (P < 0.001). However, there was no significant difference in the maximum force applied by the novices to the mitral valve during suturing (P = 0.7) and suture tying (P = 0.6) using either 2D or 3D visualization. The mean time required and forces applied by both the experts and the novices were significantly less using the conventional surgical technique than when using the robotic system with either 2D or 3D vision (P < 0.001). Conclusions Despite high-quality binocular images, both the experts and the novices applied significantly more force to the cardiac tissue during 3D robotics-assisted mitral valve annuloplasty than during conventional open mitral valve annuloplasty. This finding suggests that 3D visualization does not fully compensate for the absence of haptic feedback in robotics-assisted cardiac surgery.


2021 ◽  
pp. 1

Background and objective: Ileal conduit for urinary diversion can be completed using either end-to-end handsewn or stapled anastomosis. This study aimed to compare stepled and handsewn anastomosis methods in terms of complications, hospitalization and cost. Materials and methods: Forty-three patients were included in the hand-sewn and 44 patients in the stapler group. After creating an ileal conduit, continuity of the loop was achieved either with handsewn or stapler method. Patients' demographic data, time to onset of bowel movement, time to transit to oral intake, time to removal of the drain, perioperative and postoperative complications, mortality and total costs were retrospectively recorded and compared between the two groups. Results: There was no statistically significant difference between the groups in terms of the mean to the onset of bowel movements (p = 0.51) and the mean time to transit to oral intake (p = 0.23). The mean time to removal of the drain was significantly lower in the stapler group (p = 0.023). Perioperative complications were seen in eight patients in the handsewn group, while none of the patients in the stapler group developed perioperative complication (p = 0.003). Postoperative complications were similar between both groups (p = 0.75). The duration of hospitalization was statistically significantly lower in the stapler group (p = 0.004) and the mean total cost was statistically significantly more advantageous (p < 0.001). Conclusion: No significant difference was found between stapler and handsewn anastomosis techniques in terms of postoperative complications. On the other hand, hospitalization and total cost were in favour of stapler technique, showing that this technique can be used safely.


2020 ◽  
Vol 9 (2) ◽  
pp. 52-58
Author(s):  
Atefeh Pakray ◽  
Atefeh Ahmadi ◽  
Younes Jahani ◽  
Masoumeh Ghazanfarpour

Background: Insufficient information about sex during pregnancy as well as negative attitude towards it may lead to serious problems in the couple’s communication and sexual relationship. Therefore, this study was conducted to determine the effect of educational counselling on sexual knowledge and attitude of pregnant women during 2014-2015. Materials and Methods: This study was performed on 200 pregnant women referred to 5 health care centers in Kerman. The random allocation method was used to assign mothers to intervention (n=100) and control (n=100) groups. Data were collected by demographic information, sexual knowledge, and attitude questionnaires. Data were analyzed by paired and independent t test, Fisher exact test, chi-square test, Mann-Whitney, Wilcoxon, ANOVA, Kruskal-Wallis, and Pearson’s and Spearman’s correlation tests in SPSS software version 22.0. Results: The mean scores of sexual knowledge and attitude before educational counselling in intervention group were 33.7±15.44 and 50.09±10.88, respectively. Before the intervention, no significant differences were observed between the two groups in knowledge and attitude. One month after the counselling, the mean scores of knowledge and attitude in the intervention and control groups were respectively 79.03±8.71 and 67.88±8.62, indicating a significant difference (P<0.0001). Conclusion: The results of this study confirmed the positive role of counseling and education in increasing knowledge and creating positive attitude towards sexual relationships in pregnant women.


2019 ◽  
Vol 75 (01) ◽  
pp. 6178-2019
Author(s):  
RAFAŁ SAPIERZYŃSKI ◽  
MICHAŁ CZOPOWICZ ◽  
DIANA STOPKA

Perivascular wall tumors (PWTs or haemangiopericytomas) are common in dogs, and they are clinically important in veterinary oncology, but there is no data on the occurrence of these tumors in dogs in Poland. The aim of the present study was an epidemiological analysis of canine perivascular wall tumors. The study included 136 dogs with recognized PWTs (whose frequency of occurrence was the same in females and males). The mean age of the dogs was 9.8±3.0 years, with no statistically significant difference between sexes. Among the dogs, 40.7% were mongrels, and 59.3% were purebred. Among the purebred dogs, 21 (26.3%) were German Shepherds, 17 (21.3%) were Boxers, 5 (6.3%) were Doberman pinchers and Rottweilers. Statistical analysis revealed that four breeds were predisposed to perivascular wall tumors in comparison to the general dog population: German Shepherds, Boxers, Doberman pinchers and Rottweilers. Moreover, large-breed (but not giant-breed) dogs were shown to be predisposed to PWTs. Tumors were located in the skin or subcutis of the entire body, mostly on the legs, more seldom on the trunk or the head. The most typical location for PWTs was the elbow area (11% of all cases).


1970 ◽  
Vol 2 (1) ◽  
pp. 35-38 ◽  
Author(s):  
E Shrestha

Introduction: Seasonal hyper-acute panuveitis (SHAPU) is a sight-threatening disease and its management is challenging. Objective: To study the profile and evaluate the visual outcome of the patients of clinicallydiagnosed cases of SHAPU after treatment. Subjects and methods: A retrospective interventional hospital-based study was carried out involving 21 subjects with clinically-diagnosed SHAPU. The data were retrieved from the record section of the hospital and analyzed. The variables studied were demographic pattern, clinical condition, duration of presentation and visual acuity before and after the treatment. Statistics: The data were analyzed using Epi Info version 2000. Percentage prevalence, mean values with standard deviation, relative risk, 95% CI and p value were calculated. P value of < 0.05 was considered to be significant. Results: Among the 21 cases, the numbers of male and female were 11 (52.4 %) and 10 (46.7 %) respectively. A comparative analysis of gender in children and adults did not show any significant difference (RR=0.47, 95% CI = 0.22 - 1.01, Fisher exact test: p = 0.14). The mean for all ages was 7 ± 12.68 years, while the mean age in pediatric cases was 4.5 ± 3.91 years. Thirteen (61.9%) cases occurred in children below fifteen years. Fifteen (71.4 %) cases reported during September and October. Presenting visual acuity of all cases was less than 3/60. All of them received medical treatment. By the end of the 4th week, seven (33.3 %) patients regained vision to 6/18. Conclusion: SHAPU is more prevalent in pediatric age group. It is equally prevalent among males and females. The visual acuity can improve with early medical treatment. Keywords: SHAPU; panuveitis; steroid; phthisis bulbi DOI: 10.3126/nepjoph.v2i1.3702 Nep J Oph 2010;2(1) 35-38


Author(s):  
Nadia Nastassia Ifran ◽  
Ying Ren Mok ◽  
Lingaraj Krishna

AbstractThe aim of the study is to compare the tear rates of ipsilateral anterior cruciate ligament (ACL) grafts and the contralateral native ACL as well as to investigate the correlation of gender, age at time of surgery, and body mass index (BMI) with the occurrence of these injuries. The medical records of 751 patients who underwent ACL reconstruction surgery with follow-up periods of 2 to 7 years were retrospectively analyzed. Survival analyses of ipsilateral ACL grafts and contralateral native ACL were performed. Univariate and multivariate logistic regression analyses were performed to identify risk factors that were associated with these injuries. The tear rates of the ipsilateral ACL graft and contralateral ACL were 5.86 and 6.66%, respectively with no significant difference between groups (p = 0.998). The mean time of tears of the ipsilateral ACL and contralateral ACL was also similar (p = 0.977) at 2.64 and 2.78 years, respectively after surgery. Both the odds of sustaining an ipsilateral ACL graft and contralateral ACL tear were also significantly decreased by 0.10 (p = 0.003) and 0.14 (p = 0.000), respectively, for every 1-year increase in age at which the reconstruction was performed. However, graft type, gender, and BMI were not associated with an increased risk of these injuries. There was no difference between tear rates of ipsilateral ACL graft and contralateral ACL following ACL reconstruction. Patients who undergo ACL reconstruction at a young age are at an increased risk of both ipsilateral graft and contralateral ACL rupture after an ACL reconstruction. Patients who are young and more likely to return to competitive sports should be counselled of the risks and advised to not neglect the rehabilitation of the contralateral knee during the immediate and back to sports period of recovery. This is a Level III, retrospective cohort study.


1996 ◽  
Vol 33 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Thomas Watterson ◽  
Julie Hinton ◽  
Stephen Mcfarlane

The use of novel stimuli for obtaining nasalance measures in young children was the focus of this study. The subjects were 20 children without a history of communication disorders and 20 children at risk for velopharyngeal insufficiency (VPI). Each subject recited three passages; the standard Zoo Passage, and two novel stimuli that were named the Turtle Passage and the Mouse Passage. Like the Zoo Passage, the Turtle Passage contained no normally nasal consonants. The Mouse Passage was about 11% nasal consonants, which is similar to the Rainbow Passage. Statistical analysis showed no significant difference between the mean nasalance for the Zoo Passage and the Turtle Passage for either the subjects without risk of VPI (15.4% vs 15.7%) or for those at risk (30.4% vs 28.8%). Nasalance measures for the Mouse Passage were significantly higher than for either the Zoo Passage or the Turtle Passage. Listeners rated the stimuli on a 5-point equal-appearing intervals scale. The correlation coefficient between listener judgments of hypernasality and nasalance was significant for the Zoo Passage (r = 0.70) and for the Turtle Passage (r = 0.51) but not significant for the Mouse Passage (r = 0.32). Using cut-off scores of 22% for nasalance and 2.25 for hypernasality, the sensitivity for the Zoo Passage was 0.72, and for the Turtle Passage, 0.83.


Sign in / Sign up

Export Citation Format

Share Document