RESUMO
The aim of this study was to determine the validity and reliability of the KFORCE Sens® electrogoniometer in the evaluation of wrist proprioception. Wrist position sense was assessed on a Baseline® 360° universal goniometer and a KFORCE Sens® device. The validity and reliability of the KFORCE Sens® device for wrist position sense evaluation were investigated by comparing the two data sets. Fifty-three healthy volunteers (39 female, 14 male) with a mean age of 22.83 ± 1.28 years (range, 21-27 years) were included. Joint position sense test-retest reliability (intra-class correlation coefficient) on KFORCE Sens® was "very good" for all wrist movements. There was a very strong correlation between flexion-extension movements on the dominant side (r = 0.955), and a strong correlation between ulnar-radial deviation movements (r = 0.745). There was also a very strong (r = 0.863) correlation between flexion-extension movements on the non-dominant side and a strong correlation (r = 0.690) between ulnar-radial deviation movements (p < 0.05). Our results showed that the KFORCE Sens® device was a valid and reliable evaluation means of assessing wrist position sense.
Assuntos
Articulação do Punho , Punho , Adulto , Feminino , Humanos , Masculino , Propriocepção , Amplitude de Movimento Articular , Reprodutibilidade dos Testes , Adulto JovemRESUMO
PURPOSE: To assess the quality of life (QoL) and difficulties of patients encountered after (at least day 100+) autologous stem cell transplantation (ASCT). METHODS: Patients from 4 bone marrow transplantation (BMT) centers in Ankara formed the study group. Data were collected via a socio-demographic form, the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30), the Long-term BMT recovery questionnaire and a specific questionnaire adapted from Bush BMT Symptom Inventory for measuring symptom severity and symptom distress related to ASCT. Out of 114 eligible patients 67 (58.8%) responded the questionnaires and were included in the study. RESULTS: The mean time elapsed since transplantation was 16.1 months (range 4-43). Sixteen (23.9%) patients returned to work after transplantation; the mean time from transplantation to active work was 8 months. The symptoms experienced most, interfering with the patients' daily activities related to ASCT were fatigue, dental problems, hair loss, tingling sensation /numbness in hands and feet, mouth/throat problems, taste alterations, cough and skin problems. The majority of them reported fear of infection and disease relapse. Sexual dysfunctions, difficulty of concentration and difficulties of maintaining religious activities were also reported. 76% of patients reported their current QoL was the same or better than before transplantation and rated their current health-related QoL as good to excellent (mean 64.5). Financial difficulties, fatigue, sleeping problems, and pain were the factors most rated affecting QoL. CONCLUSION: Fear of disease relapse, economical problems and difficulties with physical activities were reported as the most difficult factors to deal with after transplantation, showing the importance of creating multidisciplinary teamwork for these groups of patients.
Assuntos
Transplante de Medula Óssea , Neoplasias/psicologia , Neoplasias/terapia , Qualidade de Vida , Adaptação Psicológica , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Inquéritos e Questionários , Taxa de Sobrevida , Transplante Autólogo , Adulto JovemRESUMO
UNLABELLED: Liver allografts from donors previously exposed to hepatitis B virus (HBV) carry the risk of transmission of HBV infection to immunosuppressed recipients. However, exclusion of donor candidates with the serologic evidence of resolved hepatitis B-HBV surface antigen (HbsAg) negative and HBV core antibody (anti-HBc) positive-is not feasible in countries endemic for HBV. AIM: Our aim was to assess the safety of living donor liver transplantation from anti-HBc positive donors. MATERIALS AND METHODS: In our institution, 152 transplants were performed between June 1999 and April 2004. Fifty-six (37%) of the living donors were anti-HBc positive. Twenty of these liver grafts were transplanted to HbsAg-negative recipients. We excluded four HBsAg negative recipients who died because of early complications after transplantation. Lamivudine (100 mg/day) was given for prophylaxis of de novo HBV infection. RESULTS: The mean follow-up time for 16 HBsAg-negative recipients was 21.7 (7-48) months. None of them experienced de novo HBV infection. CONCLUSION: The use of liver allografts from anti-HBc-positive living donors is reasonably safe in HBsAg-negative recipients under lamivudine prophylaxis.
Assuntos
Antígenos do Núcleo do Vírus da Hepatite B/sangue , Imunoglobulinas/uso terapêutico , Doadores Vivos , Hepatite B/epidemiologia , Humanos , Imunização Passiva , Lamivudina/uso terapêutico , Transplante de Fígado , Seleção de Pacientes , Prevalência , Estudos Retrospectivos , Inibidores da Transcriptase Reversa/uso terapêutico , Turquia/epidemiologiaRESUMO
Perianal tuberculosis, without the presence of any previous or active pulmonary infection, is extremely rare. A case of isolated perianal tuberculosis without gastrointestinal or pulmonary spread will be discussed here with an evaluation of the clinical features.
Assuntos
Canal Anal/microbiologia , Doenças do Ânus/diagnóstico , Tuberculose Gastrointestinal/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Canal Anal/patologia , Antituberculosos/uso terapêutico , Doenças do Ânus/tratamento farmacológico , Doenças do Ânus/microbiologia , Biópsia , DNA Bacteriano/genética , Diagnóstico Diferencial , Seguimentos , Humanos , Masculino , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/isolamento & purificação , Reação em Cadeia da Polimerase , Tuberculose Gastrointestinal/tratamento farmacológico , Tuberculose Gastrointestinal/microbiologiaAssuntos
Cistos/cirurgia , Duodenopatias/cirurgia , Duodenoscopia/métodos , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Doença Aguda , Adolescente , Colangiopancreatografia Retrógrada Endoscópica/métodos , Cistos/diagnóstico por imagem , Duodenopatias/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Pancreatite/diagnóstico , Pancreatite/etiologia , Recidiva , Medição de Risco , Resultado do TratamentoRESUMO
Von Recklinghausen's disease, now classified as neurofibromatosis type 1 (NF-1), is a relatively frequent autosomal dominant disorder and has clinical manifestations, such as cafe-au-lait spots, freckling, generalised cutaneus neurofibroma, Lisch nodules, short stature, optic glioma and central nervous system tumours. In adults, anaemia in the course of NF-1 is usually due to gastrointestinal tumour bleeding. Association of NF-1 and autoimmune haemolytic anaemia is unusual. Here, we report a 48-year-old woman with NF-1 presenting as autoimmune haemolytic anaemia. We also reviewed the literature about the association of NF-1 and autoimmune diseases.
Assuntos
Anemia Hemolítica Autoimune/diagnóstico , Neurofibromatose 1/fisiopatologia , Anemia Hemolítica Autoimune/tratamento farmacológico , Anemia Hemolítica Autoimune/etiologia , Manchas Café com Leite/etiologia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Síndromes Neurocutâneas/etiologia , Neurofibromatose 1/diagnóstico , Prednisolona/uso terapêutico , Dermatopatias/etiologiaAssuntos
Cateterismo/métodos , Colangiopancreatografia Retrógrada Endoscópica/métodos , Colestase Extra-Hepática/terapia , Doenças do Ducto Colédoco/terapia , Transplante de Fígado , Doadores Vivos , Complicações Pós-Operatórias/terapia , Stents , Anastomose Cirúrgica , Colestase Extra-Hepática/diagnóstico , Doenças do Ducto Colédoco/diagnóstico , Humanos , Complicações Pós-Operatórias/diagnósticoAssuntos
Adenocarcinoma/complicações , Migração de Corpo Estranho/diagnóstico por imagem , Obstrução da Saída Gástrica/terapia , Doenças do Íleo/etiologia , Íleo , Obstrução Intestinal/etiologia , Cuidados Paliativos , Stents , Neoplasias Gástricas/complicações , Adenocarcinoma/cirurgia , Adenocarcinoma/terapia , Anastomose Cirúrgica , Diagnóstico Diferencial , Obstrução da Saída Gástrica/diagnóstico por imagem , Humanos , Doenças do Íleo/diagnóstico por imagem , Doenças do Íleo/cirurgia , Íleo/diagnóstico por imagem , Íleo/cirurgia , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Antro Pilórico , Radiografia , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/terapiaAssuntos
Colangiopancreatografia Retrógrada Endoscópica/métodos , Vesícula Biliar/cirurgia , Ducto Hepático Comum/cirurgia , Imãs , Ferimentos não Penetrantes/cirurgia , Adolescente , Anastomose Cirúrgica/métodos , Colangiopancreatografia por Ressonância Magnética , Colecistectomia , Vesícula Biliar/lesões , Ducto Hepático Comum/lesões , Humanos , MasculinoRESUMO
BACKGROUND: Pretransplantation clearance of hepatitis C virus (HCV)-RNA reduces the risk of HCV recurrence after transplantation. Furthermore, a sustained virological response could reduce disease progression and slow clinical deterioration in nontransplanted patients. AIM: To evaluate the safety, tolerability and efficacy of pegylated-interferon (PEG-IFN) alfa-2a plus ribavirin therapy in HCV-related decompensated cirrhotics. METHODS: Twenty HCV-related decompensated cirrhotics (44-67 years, 12 males, six Child-Pugh score A, 14 Child-Pugh score B, all with genotype 1b) were enrolled into the study. Treatment with PEG-IFN alfa-2a (135 microg, once a week) plus ribavirin (1000-1200 mg/day) was commenced. A 48-week treatment was planned in patients who had early virological response. RESULTS: Treatment was stopped in 8 (40%) patients. The remaining 12 (60%) patients completed 48 weeks of therapy; nine (45%) of them obtained end-of-therapy virological response and six (30%) of them obtained sustained virological response. Living donor liver transplantation was performed in three (15%) patients. Eight (40%) and six (30%) patients needed to reduce PEG-IFN alfa-2a and ribavirin dosages, respectively. No patient died during the follow-up period. CONCLUSION: PEG-IFN alfa-2a plus ribavirin therapy is safe, tolerable and efficacious in selected HCV-related decompensated cirrhotics.
Assuntos
Antivirais/efeitos adversos , Hepatite C/tratamento farmacológico , Interferon-alfa/efeitos adversos , Interferon-alfa/uso terapêutico , Cirrose Hepática/tratamento farmacológico , Transplante de Fígado , Polietilenoglicóis/efeitos adversos , Polietilenoglicóis/uso terapêutico , Ribavirina/efeitos adversos , Ribavirina/uso terapêutico , Adulto , Idoso , Quimioterapia Combinada , Feminino , Humanos , Interferon alfa-2 , Cirrose Hepática/cirurgia , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Proteínas Recombinantes , Estatística como Assunto , Resultado do TratamentoRESUMO
The purpose of this research was to identify the needs of lay caregivers of bone marrow transplant (BMT) patients throughout the BMT trajectory. The sample consisted of 58 lay caregivers of BMT patients (5 of which were inpatients) from the 4 BMT units in Ankara, Turkey. Data were collected through a demographic data form and the Psychological and Social Needs Scale. Data analysis was performed using SPSS 10.0 for Windows. Among the descriptive statistics, frequencies and percentages were used to define the characteristics of lay caregivers and responses related to information. Mean values, standard deviations, and the Pearson correlation coefficients were also calculated for the results of the subscales. Most of the lay caregivers were spouses. The rest were other family members: brother/sister, mother, son/daughter, or father. Only one lay caregiver was a friend. The most common type of BMT was autologous. Most of the surveys were completed by the lay caregivers whose patients had been out of the hospital for 100+ days after BMT. The lay caregivers were educated on the BMT process by various sources, and 67.24% of them expressed satisfaction with the information that they were given. A majority of them preferred face-to-face communication with a healthcare professional. The categories of the information provided were diagnosis and treatment, homecare after discharge, follow-ups and laboratory tests, and nutrition. They indicated a need for more information, particularly regarding homecare after discharge and diagnosis. Fear was the highest scoring psychological needs/problems of lay caregivers, whereas leisure activity deficit was highest among the social needs/problems. The information gathered from this study led us to reevaluate our healthcare services for both patients and lay caregivers to improve physical, psychological, and social aspects of the nursing care as a whole.