RESUMO
Previous reports of comorbid conditions in poliomyelitis survivors mainly focused on some disease categories, such as respiratory diseases, gastrointestinal diseases, psychiatric diseases, neurological diseases and cancer. Data regarding a wide spectrum of medical comorbidities in patients with poliomyelitis is still sparse. This study aimed to investigate and profile the wide range of comorbidities among the survivors of paralytic poliomyelitis in a Chinese population. In total, 2,032 paralytic poliomyelitis patients were selected as the study group and the comparison group consisted of 10,160 randomly selected enrollees. The comorbidities for analysis were based on a modified version of the Elixhauser Comorbidity Index. Conditional logistic regression analyses were computed to investigate the risk of comorbidities for these two groups. As compared to controls, patients with paralytic poliomyelitis had significantly higher prevalence of hypertension, ischemic heart disease, hyperlipidemia, congestive heart failure, cardiac arrhythmias, peripheral vascular disorder, stroke, paralysis, migraines, Parkinson's disease, rheumatoid arthritis, ankylosing spondylitis, pulmonary circulation disorders, chronic pulmonary disease, liver disease, peptic ulcers, hepatitis B or C, deficiency anemias, depression, and lymphoma. Most of the differences are of clinical interest, ORs often being between 2 and 3. No significant difference between poliomyelitis patients and controls was observed in the prevalence of SLE, tuberculosis, alcohol abuse and drug abuse. Our findings demonstrate that survivors of paralytic poliomyelitis in Taiwan are at higher risk of having multiple medical comorbidities although some potential confounding factors including educational level, marital status, obesity and physical activity are not available in our database. The pattern is generally consistent with previous observations from Western populations. Nevertheless, we found several novel associations which have rarely, if ever, been reported previously.
Assuntos
Poliomielite/epidemiologia , Poliomielite/mortalidade , Sobreviventes/estatística & dados numéricos , Povo Asiático , Doenças Cardiovasculares/epidemiologia , Planejamento em Saúde Comunitária , Comorbidade , Feminino , Humanos , Doenças Renais Císticas/epidemiologia , Modelos Logísticos , Masculino , Transtornos Mentais/epidemiologia , Programas Nacionais de Saúde/estatística & dados numéricos , Doenças do Sistema Nervoso/epidemiologia , Taiwan/epidemiologiaRESUMO
BACKGROUND: This study investigated prevalence and correlates of anemia and uncontrolled anemia in chronic hemodialysis patients. METHODS: A cross-sectional analysis was performed on registry data for 2,746 chronic (>6 months) hemodialysis patients aged 25-84. Data collection included years of dialysis, hours of dialysis/wk, disease causing hemodialysis, body mass index (BMI), erythropoietin (EPO) treatment, hemoglobin, markers of viral hepatitis, serum albumin, calcium, and phosphorus. RESULTS: Prevalence was 88.7% for anemia (hemoglobin <11 g/100 mL and EPO treatment at any Hb level), 39.4% for uncontrolled anemia (hemoglobin<11 g/100 mL). Gender, years of dialysis, hereditary cystic kidney disease (HCKD), and low BMI (<24 kg/m2) were independent correlates of anemia (P<0.001). Gender, HCKD, low BMI, serum albumin and calcium were independent correlates of uncontrolled anemia (P<0.05). An interaction was found between age (not correlated with anemia and uncontrolled anemia) and the association of gender with uncontrolled anemia (P<0.05). EPO doses were higher in patients with high prevalence of uncontrolled anemia than in patients with low prevalence (i.e., women vs men, other diseases vs HCKD, low vs not-low BMI, P<0.01). Gender, years of dialysis, HCKD, BMI, serum albumin, and calcium were independent correlates of the hemoglobin/EPO dose ratio in patients on EPO treatment (P<0.05). CONCLUSION: Anemia and uncontrolled anemia are more frequent in hemodialysis patients with shortterm dialysis, diseases other than HCKD, low BMI, and female gender. Gender effect was lower in elderly patients. Uncontrolled anemia was also associated with low serum albumin and calcium, suggesting that these parameters are indices of EPO resistance.
Assuntos
Anemia/epidemiologia , Diálise Renal/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Cálcio/sangue , Estudos Transversais , Eritropoetina/uso terapêutico , Feminino , Hematínicos/uso terapêutico , Hemoglobinas/análise , Hepatite B/sangue , Hepatite C/sangue , Humanos , Itália/epidemiologia , Doenças Renais Císticas/epidemiologia , Masculino , Pessoa de Meia-Idade , Fósforo/sangue , Prevalência , Sistema de Registros , Albumina Sérica/análise , Fatores Sexuais , Fatores de TempoRESUMO
An endoscopical method of treating solitary renal cysts (RC) > 5 cm in diameter has been used in the Research Institute of Urology since 1989. The method implies percutaneous puncture of the cyst controlled by x-ray television or ultrasound, dilatation of the cystostomy fistula, cystoscopy followed by resection or dissection of the cyst wall with a cold knife or electrosurgically. A total of 38 patients with large solitary cysts have been treated. A 6-12-month follow-up revealed no recurrences. Complications of the surgery were not reported. The method is easy to accomplish, effective and well tolerated.