Sociodemographic characteristics and clinical features of patients with adult polycystic kidney disease undergoing hemodialysis

Aims:To analyze the socio-demographic and clinical characteristics of patients with adult polycystic kidney disease admitted to hemodialysis services in Northwestern Paraná state,Brazil. Methods: This was an observational, descriptive and retrospective longitudinal study. Medical records of patients with polycystic kidneys who initiated hemodialysis between 1995 and 2012, in four centers that treat patients of the coverage area of the 15th Regional Health Region of Paraná state where analyzed. Results:We found that 10.3% of hemodialysis patients had polycystic kidney disease as a leading cause of stage 5 of chronic kidney disease. The mean age of patients was 54.9±9.4 years (ranging between 27 and 74 years), with equal gender distribution and Caucasian predominance (72.9%). The average age of dialysis initiation was 50±10.2 years. The most common comorbidity was systemic hypertension (66.7%). Liver cyst was the main extra-renal manifestation (10.4%). Twenty-five percent of the patients required renal transplantation, and (22.9%) undergone nephrectomy. The most widely used classes of antihypertensive drugs were β-blockers (41.7%) and drugs that act on the renin-angiotensin system (31.3%), while 56.3% of patients were treated with recombinant human erythropoietin. Conclusions:This is a pioneering epidemiological study in Northwestern Paraná state. We found in this population a sociodemographic and clinical profile of adult polycystic kidney disease similar to that of North America and Europe, probably because the ethnic constitution of the sample was predominantly of Euro-descendants.

Autosomal dominant polycystic kidney disease in hemodialysis patients in southern Brazil

Introduction: Autosomal dominant polycystic kidney disease is the most common hereditary renal disease in humans. Objective: To examine the prevalence, clinical and laboratory characteristics of patients with polycystic kidneys and relate disease manifestations by gender. Methods: This was an observational and retrospective study. All the medical records of patients with polycystic kidneys who initiated hemodialysis between 1995 and 2012, in four centers that treat patients of the coverage area of the 15th regional health Paraná (Brazil), were analyzed. Results: The study included 48 patients with polycystic kidneys, the primary cause of stage 5 CKD. Disease prevalence was one in 10,912 people. The average age of dialysis initiation was 50.7 years and the follow-up time on dialysis until transplantation (36.5 months) was lower among men. Hypertension was the most frequent diagnosis in 73% of patients, predominantly in women (51.4%). The liver cyst was the most frequent extrarenal manifestations in men (60.0%). The death occurred in 10.4% of patients using hemodialysis, and 60% of men. The class of antihypertensive drug used was that acts on the renin-angiotensin system with higher frequency of use among women (53.3%). The post-dialysis urea was significantly higher in men. Conclusion: The prevalence of the disease is low among hemodialysis patients in southern Brazil. The differences observed between genders, with the exception of the post-dialysis urea, were not significant. The findings are different from those reported in North America and Europe.

The undergraduate level (1st study cycle) as a fundamental platform/standard for the development of Urban and Regional Planning in higher education programs

LUDA is a research project of Key Action 4 "City of Tomorrow & Cultural Heritage" of the programme "Energy, Environment and Sustainable Development" within the Fifth Framework Programme of the European Commission

The undergraduate level (1st study cycle) as a fundamental platform/ standard for the development of Urban and Regional Planning in higher education programs

The ongoing reforms, which were introduced under the Bologna Process and have already been extended outside of Europe , are a unique opportunity for reinforcing and structuring a common platform of understanding among members, based on the full time undergraduate courses in ( Urbanismo) Urban and Regional Planning. The training programs at this 1st cycle level, will obviously continue with the 2nd and 3rd cycles (Bachelor's Degree, Master's Degree and PhD Degree or 3+2+3 years). The training programs at this full time 1st cycle level, can also becomes the framework of understanding for the development of research in the urban fields at national and international levels.

A actuação do enfermeiro como gestor na unidade de terapia intensiva do Hospital Regional do Baixo Amazonas-Santarém-Pará-Brasil : um estudo de caso

Estudo descritivo que teve como objetivo avaliar a atuação do enfermeiro como gestor da Unidade de Terapia Intensiva do Hospital Regional do Baixo Amazonas Dr. Waldemar Pena – HRBA, o qual obteve o selo de Acreditado em Nível 1 em 2012. Para a obtenção dos dados utilizou-se um questionário elaborado com 10 perguntas subjetivas e aplicado aos enfermeiros gerentes que atuam nas Unidades de Terapia Intensiva e CTI do HRBA. Verificou-se nesse estudo que são indivíduos na faixa etária de 25 a 45 anos, com predominância do gênero feminino, com especialização em áreas diversas da enfermagem. Na atuação no setor de gerência, os enfermeiros estabelecem prioridades, direcionando sua equipe para os atendimentos assistenciais complexos aos pacientes, ficando o trabalho burocrático para ser realizado por último. Os entraves relatados são a insatisfação e o desgaste no exercício da função de gerente da unidade devido ao excesso de funcionários sem experiência em UTI, falta de autonomia, dupla jornada de trabalho, excesso de burocracia entre outras situações que se tornam motivos de estresse. Concluiu-se que a atuação do enfermeiro como gerente se respalda na função assistencial ao paciente através de cuidados diretos e indiretos e na organização dos trabalhos burocráticos na Unidade de Terapia Intensiva.