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1.
Infectio ; 23(supl.1): 73-91, dic. 2019. tab, graf
Artigo em Espanhol | LILACS-Express | ID: biblio-984511

RESUMO

Resumen: Los pacientes con infección por VIH tienen una mayor incidencia de eventos cardiovasculares en comparación con la población general; los factores que contribuyen al incremento del riesgo de eventos cardiovasculares son la prevalencia de factores de riesgo cardiovascular tradicionales (FRCV), la infección por VIH que condiciona tanto un proceso de inflamación crónica como alteración de la función endotelial y la exposición a los antirretrovirales. Los factores que deben ser objeto de intervención son los FRCV tradicionales, en especial la alta tasa de fumadores entre este grupo de pacientes, la tamización y tratamiento de HTA, el síndrome metabólico y el acceso temprano a la terapia antirretroviral con medicamentos con mayor perfil de seguridad . Esta guía pretende proveer información y recomendaciones en el ámbito nacional acerca de la relación entre la infección por VIH/SIDA (Síndrome de Inmunodeficiencia Adquirida), uso de antirretrovirales y riesgo cardiovascular.


Abstract: Patients with VIH infection have greater risk for cardiovascular diseases compared to general population. Risk factors that increase the frequency of cardiovascular events are: presence of cardiovascular traditional risk factors, chronic inflammation by HIV that impairs endothelial function and the exposure to antiretrovirals. The factors that should be the target for intervention are the traditional know cardiovascular factors such, especially high rate of smokers, screening and treatment for hypertension, metabolic syndrome and early access to HAART. The present guidelines provides information about the use of antiretrovirals in patients with HIV and its relation with cardiovascular risk.

2.
J Chem Theory Comput ; 15(9): 5024-5030, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31369257

RESUMO

The electronic properties of realistic (TiO2)n nanoparticles (NPs) with cuboctahedral and bipyramidal morphologies are investigated within the many-body perturbation theory (MBPT) G0W0 approximation using PBE and hybrid PBEx (12.5% Fock contribution) functionals as starting points. The use of a Gaussian and plane waves (GPW) scheme reduces the usual O4 computational time required in this type of calculation close to O3 and thus allows considering explicitly NPs with n up to 165. The analysis of the Kohn-Sham energy orbitals and quasiparticle (QP) energies shows that the optical energy gap (Ogap), the electronic energy gap (Egap), and the exciton binding energy (ΔEex) values decrease with increasing TiO2 NP size, in agreement with previous work. However, while bipyramidal NPs appear to reach the scalable regime already for n = 84, cuboctahedral NPs reach this regime only above n = 151. Relevant correlations are found and reported that will allow one to predict these electronic properties at the G0W0 level in even much larger NPs where these calculations are unaffordable. The present work provides a feasible and practical way to approach the electronic properties of rather large TiO2 NPs and thus constitutes a further step in the study of realistic nanoparticles of semiconducting oxides.

3.
Int J Nurs Knowl ; 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31379131

RESUMO

PURPOSE: To establish technical values for nursing diagnoses in primary healthcare with which to weight the delivery of care based on criteria of complexity and relevance. METHODS: A three-phase cross-sectional descriptive study: (1) establishing and weighting of the assessment criteria of technical values, (2) scoring of the assessment criteria per diagnosis, and (3) assigning technical values. FINDINGS: Diagnoses were ordered on the scoring scale obtained and a technical value of 1 to 4 was assigned according to their quartile. CONCLUSIONS: Having a technical value for each nursing diagnosis helps to measure the diversity and complexity of care. IMPLICATIONS FOR NURSING PRACTICE: Technical values may contribute to improving nursing management indicators, as they incorporate a quantitative view into the assessment process.

4.
Nutr Hosp ; 36(4): 898-904, 2019 Aug 26.
Artigo em Espanhol | MEDLINE | ID: mdl-31291738

RESUMO

Introduction: Introduction: the strict dietary recommendations we impose on patients with advanced chronic kidney disease (ACKD) have negative impact on quality of life. Objective: determine whether such restrictions are justified and if an educational program can improve health-related quality of life (HRQL) parameters. Methods: we carried out an educational intervention, single center, randomized, controlled clinical trial on ACKD outpatients in Albacete. Seventy-five patients were included, 35 in the control group and 40 in the intervention group. Nutritional assessment was based on the Subjetive Global Assessment (SGA) and body mass index (BMI). We used the SF-36 health questionnaire to measure HRQL. In the intervention group we carried out individual, collective and telephone nutritional interventions, adapting diet advice and restrictions in a personalized way. Results: malnutrition measured by Subjective Global Assessment (SGA) in the control group was 20%; meanwhile, in the intervention group it was 29.3% and it improved at the end of the study, but not significantly. BMI showed overweight with a mean of 28.83 kg/m² (DE: 5.4) and 26.96 kg/m² (DE: 4.09), respectively, and did not change throughout the study. The nutritional intervention improved the score in all the subscales except for body pain score. Besides, mental and physical components also improved their scores in the intervention group and worsened them in the control group (p < 0.001). Conclusions: quality of life can be improved in ACKD patients applying an educational nutrition program.

5.
Salud Publica Mex ; 61(4): 524-531, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31322845

RESUMO

OBJECTIVE: To analyze the possible effect of certification models and healthcare organizations' (HOs) participation incentives in the General Health Council certification process in the 1999-2017 period. MATERIALS AND METHODS: Official printed and online documents about HOs' certification were collected. Information from instances related to the process was requested through transparency mechanisms. Health organizations' participation in political-administrative periods between 1997-2017 was analyzed. RESULTS: The annual average participation in the certification process during the 1999-2000 period was 259.5 HOs; during the 2013-2016 period, the average was 72.5. Public units' participation in this process has been decreasing. In 2017, certified HO were <1%. CONCLUSIONS: No positive effects of adjustments to the certification model or the incentives applied were identified. Conversely, there is decreasing participation in the different political-administrative periods. The National HO Certification System and its possible effect on clinical quality must be thoroughly evaluated.

6.
Biotechnol Bioeng ; 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31317526

RESUMO

Concentration gradients that occur in large industrial-scale bioreactors due to mass transfer limitations have significant effects on process efficiency. Hence, it is desirable to investigate the response of strains to such heterogeneities to reduce the risk of failure during process scale-up. Although there are various scale-down techniques to study these effects, scale-down strategies are rarely applied in the early developmental phases of a bioprocess, as they have not yet been implemented on small-scale parallel cultivation devices. In this study, we combine mechanistic growth models with a parallel mini-bioreactor system to create a high-throughput platform for studying the response of Escherichia coli strains to concentration gradients. As a scaled-down approach, a model-based glucose pulse feeding scheme is applied and compared with a continuous feed profile to study the influence of glucose and dissolved oxygen gradients on both cell physiology and incorporation of noncanonical amino acids into recombinant proinsulin. The results show a significant increase in the incorporation of the noncanonical amino acid norvaline in the soluble intracellular extract and in the recombinant product in cultures with glucose/oxygen oscillations. Interestingly, the amount of norvaline depends on the pulse frequency and is negligible with continuous feeding, confirming observations from large-scale cultivations. Most importantly, the results also show that a larger number of the model parameters are significantly affected by the scale-down scheme, compared with the reference cultivations. In this example, it was possible to describe the effects of oscillations in a single parallel experiment. The platform offers the opportunity to combine strain screening with scale-down studies to select the most robust strains for bioprocess scale-up.

7.
Arch Physiol Biochem ; : 1-7, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291139

RESUMO

Aim: The purpose of this work was to identify and measure catecholamines, their metabolites, and the gene expression of catecholamine receptors in osteosarcoma tissue. Materials and methods: The levels of 3,4-dihydroxyphenylacetic acid, norepinephrine, serotonin, and 5-hydroxyindoleacetic acid in cancer tissue and in adjacent and non-oncological bone tissue were analysed by high-performance liquid chromatography, and the gene expression of catecholamine receptors and of dopamine ß-hydroxylase, monoaminoxidase, ki67, and Runx2 in the osteosarcoma tissue, tissue adjacent to the tumour, non-oncological bone, and human brain tissue was analysed by RT-PCR. Results: We found significantly higher levels of 3,4-dihydroxyphenylacetic acid and norepinephrine in the cancer sample than in adjacent and non-oncological bone. We found that ß-adrenergic receptors and dopaminergic receptors, dopamine ß-hydroxylase, ki67, Runx2, and serotonergic receptor gene expression were significantly higher in tumour tissue than in adjacent and non-oncological bone. Conclusion: Catecholamines and their receptors could be potential molecular markers for osteosarcoma progression.

8.
J Chem Phys ; 150(21): 214305, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31176334

RESUMO

Computational modeling has proven to be extremely useful for understanding how the morphology, size, and structure of TiO2 nanoparticles (NPs) affect their electronic properties and their usage in targeted applications (e.g., photocatalysis). Density functional theory (DFT) based calculations of NPs (on the order of hundreds to thousands of atoms) are, however, computationally highly demanding. Herein, we show that interatomic potentials (IPs) can provide a highly computationally efficient means to prepare NP structures which are sufficiently accurate to significantly reduce the computational cost of subsequent DFT calculations. We first compare the direct DFT optimization of faceted NPs directly cut from the anatase bulk crystal with the same calculation where the NP is preoptimized using four different IPs. We then establish the subsequent computational time saving for the respective complete DFT optimizations. We show that IP-based preoptimizing can greatly speed up DFT convergence, with speed-ups of 3×-10× for single point DFT energy evaluations. Moreover, as IP preoptimized NP structures can be closer to those of DFT energy minima, further speed-ups of 2× for DFT structure optimizations can be achieved. Finally, taking NPs derived from anatase spherical cuts, we show that IP-based molecular dynamics annealing gives rise to significant structural reconstruction with an associated high energetic stabilization, as confirmed by DFT calculations. Although similar results can be achieved using DFT tight binding methods, IP-based methods are 3-4 orders of magnitude faster and thus provide a particularly highly computationally efficient route to the preparation and design of large and diverse NP sets.

9.
Planta ; 2019 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-31190117

RESUMO

MAIN CONCLUSION: A MAPK module, of which MPK6 kinase is an important component, is involved in the coordination of the responses to Pi and Fe in the primary root meristem of Arabidopsis thaliana. Phosphate (Pi) deficiency induces determinate primary root growth in Arabidopsis through cessation of cell division in the meristem, which is linked to an increased iron (Fe) accumulation. Here, we show that Mitogen-Activated Protein Kinase6 (MPK6) has a role in Arabidopsis primary root growth under low Pi stress. MPK6 activity is induced in roots in response to low Pi, and such induction is enhanced by Fe supplementation, suggesting an MPK6 role in coordinating Pi/Fe balance in mediating root growth. The differentiation of the root meristem induced by low Pi levels correlates with altered expression of auxin-inducible genes and auxin transporter levels via MPK6. Our results indicate a critical role of the MPK6 kinase in coordinating meristem cell activity to Pi and Fe availability for proper primary root growth.

10.
J Reconstr Microsurg ; 35(7): 541-548, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31067581

RESUMO

BACKGROUND: In microsurgical reconstruction, vascular obstruction occurs in approximately 20% of patients. Close monitoring is central to their care. Clinical/Doppler detection of vascular obstruction could be enhanced by thermography. METHODS: A diagnostic test design included consecutive cases of hospitalized patients, ≥18 years old, who underwent surgery with free flaps. Two researchers separately evaluated patients with clinical/Doppler methods and thermographic camera hourly for 24 hours, every 2 hours for the next 24 hours, and then every 3 hours until discharge. The gold standard was visualization of thrombus or vascular obstruction during surgical reintervention. Sensitivity, specificity, positive/negative predictive value (PPV/NPV), and a delta temperature receiver operating characteristic (ROC) curve were calculated. RESULTS: A total of 2,364 tests were performed with a thermographic camera in 40 patients (31 females, 9 males) aged 50.12 ± 9.7 years. There were 28 deep inferior epigastric perforator, 5 anterolateral thigh, 3 radial, 2 scapular, 1 fibular, and 1 anteromedial thigh flaps included. Six (15%) had postoperative vascular obstruction (5 venous and 1 arterial). One flap developed partial necrosis and one total necrosis (overall survival 97.5%). ROC curve (area 0.97) showed the best results at ≥ 1.8°C of difference to the surrounding skin. Considering two consecutive positive evaluations, the sensitivity was 93%, specificity 96%, PPV 57%, and NPV 99%. The thermal imaging camera allows to identify the obstruction between 2 and 12 hours before the clinical method. CONCLUSION: Utilizing a thermographic camera can reduce detection time of vascular obstruction by several hours in microvascular free flaps that include the cutaneous island. This method proves useful for early diagnosis of postoperative vascular obstruction.

12.
Hum Pathol ; 89: 90-98, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31054899

RESUMO

Discrimination between low- and high-grade endometrial carcinomas (ECs) is clinically relevant but can be challenging for pathologists, with moderate interobserver agreement. Insulin-like growth factor-II mRNA-binding protein 3 (IMP3) is an oncofoetal protein that is associated with nonendometrioid endometrial carcinomas but has been limited studied in endometrioid carcinomas. The aim of this study is to investigate the diagnostic and prognostic value of IMP3 in the discrimination between low- and high-grade ECs and its added value to L1CAM. IMP3 and L1CAM expression was assessed in tumors from 378 patients treated for EC at 1 of 9 participating European Network for Individualised Treatment of Endometrial Cancer centers. IMP3 was expressed in 24.6% of the tumors. In general, IMP3 was more homogeneously expressed than L1CAM. IMP3 expression was significantly associated with advanced stage, nonendometrioid histology, grade 3 tumors, deep myometrial invasion, lymphovascular space invasion, distant recurrences, overall mortality, and disease-related mortality. Simultaneous absence of IMP3 and L1CAM expression showed the highest accuracy for identifying low-grade carcinomas (area under the curve 0.766), whereas simultaneous expression of IMP3 and L1CAM was strongly associated with high-grade carcinomas (odds ratio 19.7; 95% confidence interval 9.2-42.2). Even within endometrioid carcinomas, this combination remained superior to IMP3 and L1CAM alone (odds ratio 8.6; 95% confidence interval 3.4-21.9). In conclusion, IMP3 has good diagnostic value and together with L1CAM represents the optimal combination of diagnostic markers for discrimination between low- and high-grade ECs compared to IMP3 and L1CAM alone. Because of the homogenous expression of IMP3, this marker might be valuable in preoperative biopsies when compared to the more patchy L1CAM expression.

13.
Dermatol Ther ; 32(3): e12892, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30958613

RESUMO

Hailey-Hailey disease (HHD) or chronic benign familial pemphigus is an autosomal dominant genodermatosis with complete penetrance characterized by painful vesicles, erosions, and macerated intertriginous skin. We present a 66-year-old woman with a personal 35-year history of pruritic recurrent vesicles and erosions in both axillae and inguinal folds. HHD was confirmed by cutaneous biopsy. Past treatments had failed, including topical corticosteroids, antibiotics and oral doxycycline, minocycline, dapsone, and acitretin. Phototherapy and intralesional injection of toxin botulinum A was performed in the axillae. The patient was started on naltrexone 6.25 mg nightly. Six weeks later, complete clearing was observed. At typical doses, naltrexone blocks µ and δ opiod receptors, thereby blocking the union of ß-endorphins at those sites. Paradoxically, at low doses, the partial binding to those receptors leads to a homeostatic increase of opioid receptors and an upregulation of endogenous opioids. Low-dose naltrexone (LDN) may also exert an anti-inflammatory action through its antagonist effect on toll-like receptor 4 found on macrophages. We consider that LDN is an effective and safe alternative for the HHD, representing an important progress in the management of this disease with limited therapeutic options.

14.
Int J Nurs Knowl ; 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30941864

RESUMO

PURPOSE: To construct a questionnaire for measuring knowledge of a diabetic diet and validate its contents. METHODS: This study was carried out in three stages: (a) generation of items, (b) apparent and content validation, (c) cognitive pilot test. FINDINGS: An 88-item questionnaire was obtained with a content validity index and a representativeness index of 0.87. The experts modified the items that did not reach the preset values. The cognitive test was shown to be feasible, with good exploratory values of reliability and concurrent validity. CONCLUSIONS: The CoNOCidiet-Diabetes questionnaire was obtained from the NOC outcome "Knowledge: Prescribed Diet" and its contents were validated. IMPLICATIONS FOR NURSING PRACTICE: This research shows the usefulness of the NOC for generating tools to measure health outcomes sensitive to nursing interventions.

15.
Nanoscale ; 11(18): 9032-9041, 2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31021336

RESUMO

Anatase TiO2 nanoparticles (NPs) have the potential to photocatalyse water splitting using UV light, to thus provide hydrogen fuel in a clean and sustainable manner. Such NPs have optical gaps covering a small range of relatively high energy solar photons, giving rise to low photo-efficiencies. Although anatase NPs with 10-20 nm diameters thermodynamically prefer crystalline faceted morphologies, application of physico-chemical procedures can produce more rounded NPs with amorphous shells. Such engineered metastable core-shell NPs (so-called black TiO2 NPs) have reduced band gaps due to shell-induced band edge broadening, resulting in higher photoactivities. For <5 nm diameters, TiO2 NPs typically exhibit spherical-like NP morphologies, which also display enhanced photoactivity. For smaller NPs it is difficult to experimentally determine their thermodynamic stability and internal atomic structure, to help rationalise their higher photoactivities. Employing accurate electronic structure calculations, we establish the relative stability of spherical and faceted stoichiometric TiO2 NPs with 1-3.4 nm diameters. Mirroring experimental preparation, simulated thermal annealing is found to significantly stabilise relaxed spherical cut anatase NPs. We find that the smallest spherical NPs become amorphized by annealing, but, for diameters >2 nm, annealing yields NPs with anatase-cores and amorphous-shells. Like larger black TiO2 core-shell NPs, we confirm that our core-shell NPs are metastable relative to faceted anatase NPs and have significantly smaller optical gaps than faceted NPs. Our calculated gaps are in excellent agreement with experimental data, strongly supporting the validity of our NP models. Energy gap narrowing in these core-shell NPs is found to be due to broadening of valence band states induced by the amorphous shell, analogous to the mechanism proposed for black TiO2 NPs. Our stoichiometric NPs also show that this band narrowing effect does not require the disordered shells to be non-stoichiometric or for incorporation of other atom types. Instead, we find that this effect mainly arises from 4-coordinated Ti atoms in the amorphous shell. Our careful and systematic computational investigation, using NP models of unprecedented realism, thus provides direct confirmation that the enhanced photoactivity in small spherical TiO2 NP observed in experiment is due to the formation of metastable core-shell NPs with 4-coordinated Ti centres.

18.
Arch. esp. urol. (Ed. impr.) ; 72(1): 25-35, ene.-feb. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-181057

RESUMO

Objetivo: Estudiar la esfera psicosocial de los pacientes que se someten a algún tratamiento permite tener más información sobre la repercusión del mismo y puede ayudar a la elección de un tratamiento adecuado y personalizado. Debido a la ausencia de instrumentos específicos actualmente, el objetivo es diseñar y validar un cuestionario de salud en pacientes tratados con LEOC. Material y métodos: Se realizó en 6 fases utilizando una muestra de 50 pacientes tratados con LEOC en 2015 en nuestro centro, a los que entrevistamos por vía telefónica. En la fase 1 se propusieron ítems a partir de revisión bibliográfica. En la fase 2 se eliminaron los que puntuaban por debajo de 7 según la valoración de 0-10 sobre los ítems efectuada por especialistas en la materia. En la fase 3 se asignaron valores de 1 a 5 a cada ítem y se eliminaron aquellos cuya correlación corregida fuera mayor de 0,2 y cuya potencia discriminante con U-Mann Whitney no fuera significativa (p>0,05). En la fase 4 se comprobó la fiabilidad del cuestionario con dos índices (alfa de Cronbach y dos mitades de Guttman). En la fase 5 se realizó el análisis factorial con rotación Varimax para el cálculo de la validez de constructo. Finalmente, en la fase 6 se tipificaron de las puntuaciones para establecer valores de referencia. Resultados: 50 pacientes (32 hombres, 18 mujeres). Mediana edad 59 años (27-79). Fase 1: 35 ítems propuestos. Fase 2: 9 ítems eliminados. Distribución de cuestionario con 26 ítems. Fase 3: 18 ítems eliminados. Cuestionario final constituido por 8 ítems. Fase 4: valores de fiabilidad del cuestionario (alfa de Cronbach 0,44 e índice por técnica de dos mitades de Guttman 0,323). Fase 5: análisis factorial hallando 4 factores con 2 ítems cada uno (antecedentes, repercusión del cuadro agudo, post-tratamiento, calidad de vida) capaces de explicar el 71,19% de la varianza. Fase 6: mediana puntuación 50:17(mínimo-máximo 9-25), P25:14 y P75:20. Conclusiones: El trabajo realizado ha proporcionado un nuevo instrumento de evaluación de salud tras tratamiento con LEOC con valores de fiabilidad y validez adecuados. Serán necesarios futuros estudios para contrastar su verdadera utilidad clínica


Objectives: Studying the psychosocial sphere of patients who undergo any treatment allows to have more information about its repercussion and can help the choice of an appropriate and personalized treatment. Due to the absence of specific instruments at present, the objective is to design and validate a health questionnaire regarding the treatment received with ESWL. Methods: It was carried out in 6 phases using a sample of 50 patients treated with ESWL in 2015 in our center, whom we interviewed by telephone. In phase 1 the items were proposed based on bibliographic review, in phase 2 those that scored below 7 were eliminated according to the evaluation from 0 to 10 on the items made by specialists. In phase 3, values of 1 to 5 were assigned to each item and those with corrected correlation more than 0.2 and not significant (p>0.05) discriminant power with U-Mann Whitney were eliminated. In phase 4 the reliability of the questionnaire was checked with two indexes (Cronbach’s alpha and two Guttman's halves). In phase 5, the factor analysis with Varimax rotation was performed to calculate the construct validity and in stage 6, the scores were analyzed to establish reference values. Results: 50 patients (32 men, 18 women). Median age 59 years (27-79). In phase 1, 35 items were proposed, 9 of which were eliminated in phase 2. The initial questionnaire with 26 items was distributed, with 18 being eliminated in phase 3. The final questionnaire was formed with 8 items. In phase 4 the results of Cronbach’s alpha and Guttman’s two halves index were 0.44 and 0.323 respectively. In phase 5 after factor analysis, we found 4 factors with 2 items each (background, impact of the acute picture, post-treatment, quality of life) able to explain 71.19% of the variance. The median scores of the scale, extreme values and quartiles studied in phase 6 were respectively: P50: 17 (minimum-maximum 9-25), P25: 14 and P75: 20. Conclusions: The study carried out has provided a new instrument for assessing satisfaction after treatment with ESWL with adequate reliability and validity values. Future studies will be necessary to contrast its true clinical usefulness


Assuntos
Humanos , Masculino , Feminino , Litotripsia/métodos , Urolitíase/terapia , Satisfação Pessoal , Qualidade de Vida , Reprodutibilidade dos Testes , Inquéritos e Questionários
19.
Arch Esp Urol ; 72(1): 25-35, 2019 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-30741650

RESUMO

OBJECTIVES: Studying the psychosocial sphere of patients who undergo any treatment allows to have more information about its repercussion and can help the choice of an appropriate and personalized treatment. Due to the absence of specific instruments at present, the objective is to design and validate a health questionnaire regarding the treatment received with ESWL. METHODS: It was carried out in 6 phases using a sampleof 50 patients treated with ESWL in 2015 in ourcenter, whom we interviewed by telephone. In phase1 the items were proposed based on bibliographic review,in phase 2 those that scored below 7 were eliminatedaccording to the evaluation from 0 to 10 on theitems made by specialists. In phase 3, values of 1 to 5were assigned to each item and those with correctedcorrelation more than 0.2 and not significant (p>0.05)discriminant power with U-Mann Whitney were eliminated.In phase 4 the reliability of the questionnaire waschecked with two indexes (Cronbach's alpha and twoGuttman's halves). In phase 5, the factor analysis withVarimax rotation was performed to calculate the constructvalidity and in stage 6, the scores were analyzedto establish reference values. RESULTS: 50 patients (32 men, 18 women). Medianage 59 years (27-79). In phase 1, 35 items were proposed,9 of which were eliminated in phase 2. The initialquestionnaire with 26 items was distributed, with 18being eliminated in phase 3. The final questionnaire wasformed with 8 items. In phase 4 the results of Cronbach'salpha and Guttman's two halves index were 0.44 and0.323 respectively. In phase 5 after factor analysis, wefound 4 factors with 2 items each (background, impactof the acute picture, post-treatment, quality of life) able toexplain 71.19% of the variance. The median scores ofthe scale, extreme values and quartiles studied in phase6 were respectively: P50: 17 (minimum-maximum 9-25),P25: 14 and P75: 20. CONCLUSIONS: The study carried out has provided anew instrument for assessing satisfaction after treatmentwith ESWL with adequate reliability and validity values.Future studies will be necessary to contrast its true clinicalusefulness.


Assuntos
Litotripsia , Urolitíase , Feminino , Humanos , Masculino , Satisfação Pessoal , Qualidade de Vida , Reprodutibilidade dos Testes , Inquéritos e Questionários , Urolitíase/terapia
20.
Artigo em Inglês | MEDLINE | ID: mdl-30764535

RESUMO

Quality of life (QoL) indicators are now being adopted as clinical outcomes in clinical trials on cancer treatments. Technology-free daily monitoring of patients is complicated, time-consuming and expensive due to the need for vast amounts of resources and personnel. The alternative method of using the patients' own phones could reduce the burden of continuous monitoring of cancer patients in clinical trials. This paper proposes monitoring the patients' QoL by gathering data from their own phones. We considered that the continuous multiparametric acquisition of movement, location, phone calls, conversations and data use could be employed to simultaneously monitor their physical, psychological, social and environmental aspects. An open access phone app was developed (Human Dynamics Reporting Service (HDRS)) to implement this approach. We here propose a novel mapping between the standardized QoL items for these patients, the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and define HDRS monitoring indicators. A pilot study with university volunteers verified the plausibility of detecting human activity indicators directly related to QoL.


Assuntos
Aplicativos Móveis , Neoplasias , Qualidade de Vida , Smartphone , Acelerometria , Adulto , Estudos de Viabilidade , Feminino , Indicadores Básicos de Saúde , Voluntários Saudáveis , Humanos , Masculino , Projetos Piloto
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