Relación entre variables sociodemográficas y clínicas y calidad de vida relacionada con la salud en pacientes con enfermedad inflamatoria intestinal / Relationship between socio-demographic and clinical variables, and health-related quality of life in patients with inflammatory bowel disease

Objetivo: el objetivo principal del presente trabajo consiste en evaluar la influencia de las variables sociodemográficas y clínicas en la calidad de vida relacionada con la salud de los pacientes con enfermedad inflamatoria intestinal. Pacientes y método: se trata de un estudio transversal. La calidad de vida relacionada con la salud se investigó utilizando el “Inflammatory Bowel Disease Questionnaire” (IBDQ). Un total de 120 pacientes, 60 con colitis ulcerosa y 60 con enfermedad deCrohn participaron en el estudio. Resultados: no se apreciaron diferencias significativas en la calidad de vida relacionada con la salud en las dimensiones delIBDQ en función de la enfermedad, sin embargo, tras el análisis multivariante, el sexo, el tipo de tratamiento, las manifestaciones extradigestivas, el número de recaídas anual, la satisfacción con la cirugía y la necesidad de apoyo psicológico aparecieron relacionadascon la calidad de vida relacionada con la salud.Conclusiones: la identificación de las variables de calidad de vida relacionada con la salud en pacientes con enfermedad inflamatoria intestinal parece vinculada básicamente a elementos externos al tipo de enfermedad. El conocimiento de tales elementos puede resultar muy útil para orientar y modificar factores específicosen futuras actuaciones

Objective: the principal aim of the present study is to evaluate the influence of socio-demographic and clinical variables on health-related quality of life (HRQL) in patients with inflammatory bowel disease. Patients and method: this was a cross-sectional study. health-related quality of life was measured with the Inflammatory ;;Bowel Disease Questionnaire (IBDQ). A total of 120 patients, 60 with ulcerative colitis and 60 with Crohn’s disease, participated in the study. Results: no significant differences were observed between ulcerative ;;colitis and Crohn’s disease patients in IBDQ dimensions. ;;However, a multivariate analysis revealed that sex, type of treatment, extraintestinal symptoms, number of relapses in previous year, satisfaction with surgery, and need for psychological support were related to HRQL. ;;Conclusions: the identification of these variables associated with HRQL in patients with inflammatory bowel disease shows them to be basically non-disease factors. Knowledge of such elements can turn out to be very useful in order to guide future research and modify specific factors in further interventions

Association between vitamin D receptor FokI. Polymorphism and serum parathyroid hormone level in patients with chronic renal failure.

We investigated the relationship between vitamin D receptor (VDR) start codon polymorphism and serum levels of PTH, calcidiol, and calcium in 64 Spanish patients with chronic renal failure (CRF). An exon 2 fragment of the VDR gene was amplified by PCR, and cleaved with the restriction enzyme FokI. The alleles were identified according to the digestion pattern obtained as F (absence of restriction site) and f (presence of restriction site). Genotype frequencies in the patient population were 54.7% FF, 28.1% Ff and 17.2% ff, vs 46.7% FF, 43.3% Ff and 10% ff in a healthy control population. The difference between the two populations was statistically significant (p<0.01). Within the patient population, mean serum PTH level in the FF group was significantly higher (159.77+/-25.69 pg/ml) than in both the Ff and ff groups (106.67+/-19.07 and 77.55+/-15.85 pg/ml, respectively; p<0.05). However there were no significant differences in serum levels of calcidiol or calcium among genotypes. These results suggest that FokI polymorphisms of the VDR gene may determine parathyroid response in CRF patients.

Relationship between socio-demographic and clinical variables, and health-related quality of life in patients with inflammatory bowel disease.

OBJECTIVE: The principal aim of the present study is to evaluate the influence of socio-demographic and clinical variables on health-related quality of life (HRQL) in patients with inflammatory bowel disease. PATIENTS AND METHOD: This was a cross-sectional study. health-related quality of life was measured with the Inflammatory Bowel Disease Questionnaire (IBDQ). A total of 120 patients, 60 with ulcerative colitis and 60 with Crohn s disease, participated in the study. RESULTS: No significant differences were observed between ulcerative colitis and Crohn s disease patients in IBDQ dimensions. However, a multivariate analysis revealed that sex, type of treatment, extraintestinal symptoms, number of relapses in previous year, satisfaction with surgery, and need for psychological support were related to HRQL. CONCLUSIONS: The identification of these variables associated with HRQL in patients with inflammatory bowel disease shows them to be basically non-disease factors. Knowledge of such elements can turn out to be very useful in order to guide future research and modify specific factors in further interventions.

Traumatic anal incontinence. Role of unilateral gluteus maximus transposition supplementing and supporting direct anal sphincteroplasty.

PURPOSE: This study was designed to describe the surgical technique and discuss the possible beneficial role of unilateral gluteus maximus transposition supplementing and supporting a tensile-direct anal sphincteroplasty. METHODS: Based on our experience with bilateral gluteus transposition, direct apposition of the remaining muscular ends combined with unilateral gluteus transposition (to avoid the tendency of the sphincter ends to separate) was undertaken in two patients with severe destruction of more than half of the anal muscular ring. RESULTS: Both postoperative courses were uneventful. Three months after colostomy closure, both patients were classified as Pescatori's B1. CONCLUSION: As with any other combined surgical technique, the benefit derived may be attributed entirely to one of the procedures, but it is our impression that the gluteus transposition was worthwhile in achieving satisfactory repair.

[Hemorrhoidectomy: conventional or by Nd:Yag contact laser? A prospective and randomized study]. / Hemorroidectomía: convencional o con láser Nd:YAG de contacto? Estudio prospectivo y randomizado.

OBJECTIVE: To assess whether hemorrhoidectomy done with the Nd:YAG laser was associated with less pain or fewer complications and sequels than with conventional surgery. DESIGN: A prospective comparative, randomized study. PATIENTS: Over a period of six months, a total of 35 consecutive patients, 13 females and 22 males, with symptomatic hemorrhoidal disease requiring surgery, were alternatively randomized to either laser hemorrhoidectomy (17 patients) or surgery (18 patients). The type of disease and the number of affected and treated hemorrhoids were prospectively recorded in each patient. Patients were monitored prospectively for postoperative complications, pain (assessed daily for five days using a standard 10 mm. linear analogue scale), wound healing, time until full recovery and sequelae 6 moths later. RESULTS: These two groups were well matched. No differences were seen between laser and non-laser groups for postoperative complications. Linear analogue pain scores were not significantly different between the two groups at any stage after operation. Healing time was longer in laser group. Two few patients returned at 6 months for rectoscopy for any meaningful conclusion to be drawn. CONCLUSIONS: This study has failed to confirm any reduction in postoperative pain, complications, or healing time laser when performing a hemorrhoidectomy.

[Colorectal carcinoma. Multifactorial analysis of prognostic factors following curative resection]. / Carcinoma colorrectal. Análisis multifactorial de factores pronósticos tras resección curativa.

Cox regression analysis was used in the study of 151 cases of surgically treated colorrectal carcinoma. A "curative" resection was performed in all of them. Clinical data from medical records, histology, biochemical determinations, and intraoperative findings were assessed. Four of the studied variables were significantly related to tumor recurrence: Dukes stage, tumor spread, histological variety and preoperative CEA level. Age, sex, tumor location, surgical technique, lymphocytes in the peripheral blood, preoperative levels of acute phase reactants and hepatic enzymes did not provide information about the final outcome of these patients. An index of prognosis was statistically obtained in order to identify a high risk of recurrence group of patients, who may benefit from adjuvant therapy.

[Neuroendocrine changes induced by craniospinal radiation in children with acute lymphoblastic leukemia and medulloblastoma]. / Análisis de las alternaciones neuroendocrinas inducidas por radiación craneoespinal en niños con leucemia linfoblástica aguda y meduloblastoma.

In order to investigate effects produced by external cranial irradiation on neuroendocrine systems. GH secretion (elicited by oral clonidine and by GRF-29 as iv bolus) and TSH and PRL responses to an iv bolus of TRH were evaluated in children previously irradiated for LLA (n-7) or medulloblastoma (n-3). Growth velocity was also periodically evaluated. Three years after radiotherapy, while a normal GH response to clonidine challenge was observed in 60% of cases, growth velocity was impaired in 83.3% of them. GH release induced by GRF-29 was normal in another 60% of patients. Either basal TSH values or its' response to TRH were significantly increased in the three medulloblastomas, in spite of clinical and biochemical euthyroid status of these patients. Our data indicate that cranial radiotherapy produces functional neuroendocrine alterations; specificity and degree of these are dependent on the dose received. Therefore, to allow a suitable replacement hormonal therapy as soon as possible, this type of patients need a periodic evaluation of their endocrine status.