RESUMO
BACKGROUND: Anemia frequently occurs after kidney transplantation, its origin is multifactorial. The objective of this study was to evaluate the frequency of anemia among kidney transplantation patients at 3 months after transplantation and its relationship to inflammatory, oxidative, and nutritional states. Furthermore, we determined serum prohepcidin, a precursor of hepcidin, the main hormone implicated in iron metabolism. MATERIALS AND METHODS: We performed a transverse retrospective study in 130 patients who underwent kidney transplantation, including 89 men and 41 women. Patients were randomized according to the presence or absence of anemia at 3 months. The patients' inflammatory, oxidative, and nutritional states were evaluated as well as renal function and serum prohepcidin at 3 months. RESULTS: Twenty-four percent of the patients developed anemia at 3 months after transplantation. These patients presented with a greater inflammatory state, a poor nutritional status, and poor renal function. Serum prohepcidin was significantly lower compared with the transplantation patients who did not show anemia. CONCLUSIONS: Serum prohepcidin was significantly higher among kidney transplantation patients who did not develop anemia. The inflammatory state may be a determinant of the response to treatment with erythropoiesis-stimulating agents in anemic kidney transplant recipients.
Assuntos
Anemia/etiologia , Peptídeos Catiônicos Antimicrobianos/sangue , Mediadores da Inflamação/sangue , Inflamação/etiologia , Transplante de Rim/efeitos adversos , Estresse Oxidativo , Precursores de Proteínas/sangue , Adulto , Idoso , Anemia/sangue , Anemia/tratamento farmacológico , Anemia/imunologia , Biomarcadores/sangue , Feminino , Hematínicos/uso terapêutico , Hepcidinas , Humanos , Inflamação/sangue , Inflamação/imunologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Estudos Retrospectivos , Espanha , Fatores de TempoRESUMO
BACKGROUND: Depression and anxiety have been associated with interferon treatment and low treatment adherence. AIM: To study the incidence and associated risk factors of depressive and anxiety disorders during pegylated interferon plus ribavirin and treatment adherence in a prospective cohort of 176 patients with chronic hepatitis C patients. METHODS: Patients were interviewed at baseline using the Structured Clinical Interview for DSM-IV Mental Disorders and the Patient Health Questionnaire and the Hospital Anxiety and Depression Scale were completed. Both questionnaires were completed also after 4, 12 and 24 weeks of treatment. RESULTS: De novo depressive and/or anxiety disorders were diagnosed in 53 (36%) patients, in whom antidepressants and/or anxiolytics were administered. Higher baseline depression-subscale score (OR = 27.8, 95% CI = 2.82-333), primary education level (OR = 3.1, 95% CI = 1.40-7.03) and being an immigrant (OR = 3.2, 95% CI = 1.12-9.47) were predictors of psychiatric disorders during anti-viral therapy. The percentage of patients with good adherence was lower in those with depression and/or anxiety (79% vs. 90%, P < 0.04). Only one patient (1%) discontinued treatment because of a major depressive episode. Depression and/or anxiety disorders had no effect on attainment of sustained virological response. CONCLUSION: Early detection and treatment of depressive and anxiety disorders favours good adherence to anti-viral treatment in hepatitis C.
Assuntos
Hepacivirus , Hepatite C Crônica/psicologia , Interferon-alfa/efeitos adversos , Polietilenoglicóis/efeitos adversos , Ribavirina/efeitos adversos , Adulto , Antivirais/efeitos adversos , Antivirais/uso terapêutico , Transtornos de Ansiedade/induzido quimicamente , Transtornos de Ansiedade/virologia , Distribuição de Qui-Quadrado , Depressão/induzido quimicamente , Depressão/virologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Quimioterapia Combinada , Escolaridade , Emigrantes e Imigrantes , Emprego , Feminino , Hepatite C Crônica/tratamento farmacológico , Humanos , Interferon alfa-2 , Interferon-alfa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Polietilenoglicóis/uso terapêutico , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Proteínas Recombinantes , Ribavirina/uso terapêutico , Resultado do TratamentoRESUMO
Bioko is the only island known in the world with endemic onchocerciasis. The island's rural communities consist of villages and cocoa plantations inhabited by Bubi and Fang ethnic groups. The aim of this study was to evaluate the impact of 8 years of vertical ivermectin distribution on the prevalence and intensity of Onchocerca volvulus infection in the rural population by means of pre- (1989) and post-long term treatment (1998) epidemiological surveys. In both surveys, the entire population of 12 randomly selected communities (1723 and 1082 individuals) was examined. The mean ivermectin therapeutic coverage for the 8 years was 53.2%. Iliac crest skin snips were used for differential diagnosis between O. volvulus and Mansonella streptocerca. The crude O. volvulus infection prevalence before ivermectin intervention was 74.5% (1284/1723); after the intervention it was 38.4% (415/1082). The Community Microfilarial Load (CMFL) before and after ivermectin intervention was 28.29 microfilariae/snip vs. 2.32 microfilariae/snip. The reduction in prevalence and CMFL after eight annual rounds of ivermectin treatment corroborates the drug microfilaricidal activity and good tolerability. In the pre-treatment survey, the prevalence was higher in the Bubi group (77.1%, 1126/1461); post-treatment it was higher among the Fang (51.1%, 92/180). The reduction in prevalence and intensity of O. volvulus infection differed between ethnic groups and communities.
Assuntos
Anti-Helmínticos/uso terapêutico , Ivermectina/uso terapêutico , Onchocerca volvulus/isolamento & purificação , Oncocercose/tratamento farmacológico , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Guiné Equatorial/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Assistência de Longa Duração , Masculino , Microfilárias/isolamento & purificação , Pessoa de Meia-Idade , Oncocercose/epidemiologia , Oncocercose/etnologia , Vigilância da População , Prevalência , Saúde da População Rural , Distribuição por Sexo , Pele/parasitologiaRESUMO
After observing the existence of a case of articular blockade and normal aperture, we must ask ourselves if we can diagnose all such articular blockade following this example as a guide to predict articular blockades.
Assuntos
Transtornos da Articulação Temporomandibular/fisiopatologia , Adulto , Bruxismo , Feminino , Humanos , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia , Radiografia , Amplitude de Movimento Articular , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Trismo/fisiopatologiaRESUMO
Patients, who present severe facial defects, become the most disturbing challenge of prosthodontia. In this cases, with extensive loose of substance, some times other therapies, are contraindicated. In this paper, we review the procedures to make facial prostheses.
Assuntos
Carcinoma de Células Escamosas/reabilitação , Prótese Maxilofacial , Neoplasias Nasais/reabilitação , Idoso , Cor , Estética , Humanos , Masculino , SiliconesRESUMO
We have registered mandibular movements produced during the reading of a text in spanish with a Sirognathograph in a random sample of 71 subjects, aged between 24 and 35, on the three planes of space. The obtained curves have allowed to measure 7 variables in order to define the characteristics of mandibular movements during speech. The results demonstrate that determinant planes for this purpose are sagittal and frontal.
Assuntos
Registro da Relação Maxilomandibular , Fonação , Articulação Temporomandibular/fisiologia , Adulto , Humanos , Mandíbula/fisiologia , MovimentoRESUMO
The prevalence of anti-retroviral therapy (ART) use over time and the incidence of AIDS in a cohort of HIV-seroconverting injecting drug users (IDUs) were assessed by means of a hospital-based study of IDUs with a well documented date of HIV infection. Use of ART and clinical endpoints were assessed by hospital records. Three calendar periods (before 1992, 1992-6 and 1997-2000) were defined as corresponding to modalities of ART available. Prevalence of ART usage in each calendar period, changes in medication and, hazard of AIDS in patients reaching the same duration of HIV infection at different calendar periods were analysed. In total, 132 IDUs with a median age of 23 years at seroconversion were followed up for 6.8 years (median) (range 0.2-15.7). At the end of the study, 58 patients (44%) had developed AIDS. Before the introduction of highly active anti-retroviral therapy (HAART) 12% of patients were on ART. Starting in 1997, an increasing proportion were receiving HAART with a prevalence of 39.5% by January 2000. Taking 1992-6 as the reference category the relative hazard of AIDS during 1997-2000 was 0.42 (95% CI, 0.1-1.1) (P = 0.09). A 40% penetration of HAART in a cohort of IDUs with known dates of seroconversion resulted in a 58 % reduction of the hazard of AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Terapia Antirretroviral de Alta Atividade/estatística & dados numéricos , Soropositividade para HIV/epidemiologia , Avaliação de Resultados em Cuidados de Saúde , Cooperação do Paciente/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/complicações , Síndrome da Imunodeficiência Adquirida/sangue , Síndrome da Imunodeficiência Adquirida/etiologia , Adulto , Contagem de Linfócito CD4 , Estudos de Coortes , Feminino , Soropositividade para HIV/sangue , Soropositividade para HIV/mortalidade , Hospitais com mais de 500 Leitos , Humanos , Estudos Longitudinais , Masculino , Prontuários Médicos , Prevalência , Estudos Retrospectivos , Espanha/epidemiologia , Inquéritos e Questionários , Análise de Sobrevida , Fatores de TempoRESUMO
In this article we describe a modification of the gauge of the surveyor in such a way that we can measure the height of the retention arms' slide area over the abutment teeth, in order to obtain the same height in the reciprocal arm slide area to avoid the jiggle movements of the abutment teeth during the removal and insertion.