Estudio longitudinal del Índice de masa corporal (IMC) en pacientes en diálisis

Chronic renal failure is commonly related to hyponutrition, affecting approximately on third of patients with advanced renal failure. We carried out a longitudinal study to assess nutritional evolution of 73 patients on a regular hemodialysis program, assessing changes in the anthropometrical parameter body mass index (BMI) and its correspondence to biochemical nutritional parameters such as total protein (TP) levels and serum albumin (Alb). Every three months plasma TP and albumin levels were collected and BMI was calculated by the standard formula: post-dialysis weight in kg/height in m2. For classifying by BMI categories, overweight and low weight were defined according to the WHO Expert Committee. Studied patients had a mean age of 53 years, 43 were male and 30 were female patients. BMI in women was lower than that in men (p < 0.001), as well as TP (p < 0.001) and Alb (p < 0.001) levels. Mean BMI was 29.3 kg/m2. Three point two percent of the determinations showed low weight, 12.16% overweight, and 83.97% normal BMI. TP were normal in 90.76% and decreased in 9.24%. Alb was normal in 82.2% and low in 17.78%. After the follow-up time (21.6 months, minimum 18 months, maximum 53 months), the Kruskal-Wallis test did not show a statistically significant change for BMI but it did show a change for the biochemical parameters albumin and total proteins (p < 0.05): nutritional impairment in CRF patients is manifested on biochemical parameters (TP and Alb) with no reflection on anthropometrical data.

Cambios emocionales y alteraciones en la Inmunoglobulina A (IgA) tras el tratamiento psicológico en mujeres víctimas de violencia doméstica

The aim of this study was to determine the benefits of a psy-chological treatment in women victims of mistreatments in psychological health and in the immune system. The participants in this study were 60 women users of the Equality Area of the City Council of Malaga. We set two groups of women up in relation of whether the women attended or not to the given therapy. Psychological variables (self-esteem, depression and anxiety) and levels of Inmunoglobulin A were evaluated before and after the treatment. The results showed differences between all the vari-ables before and after the treatment, with better valuation after the treat-ment. These differences were not shown in women that did not assist to the therapeutic sessions, and even, the values of depression and immu-noglobulin A levels were worse. We found also differences in the values of these variables when the two groups were compared. Women that re-ceived the treatment showed fewer indicators of psychological alterations and higher levels of immunoglobulin A than the women that did not assist to the sessions; in the pre-treatment these differences were not shown. This study enhances the significance of the psychological treatment for psychological and physic health in women victims of

Ensenyament i facilitació de l'aprenentatge d'estratègies de relaxació, a través d'internet, en nens i adolescents amb dolor abdominal

L'objectiu d'aquest treball és el disseny d'un tractament de relaxació progressiva online, basat en l'evidència de la seva efectivitat en teràpies presencials, per poder abordar la simptomatologia en els primers estadis del dolor crònic abdominal en nens i adolescents.

Accumulation of scandium in plasma in patients with chronic renal failure.

Scandium (Sc) is an element with many industrial applications, but relatively little is known about its physiological and/or toxicological effects, and very little data are available concerning the role of Sc in chronic renal failure (CRF). This paper examines the changes in plasma levels of Sc in predialysis patients with CRF and the relationship with blood parameters. The participants in this trial were 48 patients with CRF in predialysis and 53 healthy controls. Erythrocyte, haemoglobin, and haematocrit counts in blood were determined, and levels of creatinine, urea, uric acid, albumin, total protein and Sc were measured in plasma. The glomerular filtration rate (GFR) was calculated using the Cockcroft-Gault index. The CRF patients were found to have higher plasma levels of creatinine, urea, uric acid, albumin, total protein, and Sc and a lower GFR than that the controls. Scandium in plasma was positively correlated with creatinine and plasma urea and negatively correlated with GFR, haemoglobin, and haematocrit and was associated with the risk of lower levels of erythrocytes, haemoglobin, and haematocrit. CRF was associated with increases in the circulating levels of scandium.

Suicidal ideation and the risk of suicide in patients with fibromyalgia: a comparison with non-pain controls and patients suffering from low-back pain.

Fibromyalgia is associated with an increased rate of mortality from suicide. In fact, this disease is associated with several characteristics that are linked to an increased risk of suicidal behaviors, such as being female and experiencing chronic pain, psychological distress, and sleep disturbances. However, the literature concerning suicidal behaviors and their risk factors in fibromyalgia is sparse. The objectives of the present study were to evaluate the prevalence of suicidal ideation and the risk of suicide in a sample of patients with fibromyalgia compared with a sample of healthy subjects and a sample of patients with chronic low-back pain. We also aimed to evaluate the relevance of pain intensity, depression, and sleep quality as variables related to suicidal ideation and risks. Logistic regression was applied to estimate the likelihood of suicidal ideation and the risk of suicide adjusted by age and sex. We also used two logistic regression models using age, sex, pain severity score, depression severity, sleep quality, and disease state as independent variables and using the control group as a reference. Forty-four patients with fibromyalgia, 32 patients with low-back pain, and 50 controls were included. Suicidal ideation, measured with item 9 of the Beck Depression Inventory, was almost absent among the controls and was low among patients with low-back pain; however, suicidal ideation was prominent among patients with fibromyalgia (P<0.0001). The risk of suicide, measured with the Plutchik Suicide Risk Scale, was also higher among patients with fibromyalgia than in patients with low-back pain or in controls (P<0.0001). The likelihood for suicidal ideation and the risk of suicide were higher among patients with fibromyalgia (odds ratios of 26.9 and 48.0, respectively) than in patients with low-back pain (odds ratios 4.6 and 4.7, respectively). Depression was the only factor associated with suicidal ideation or the risk of suicide.

Factors associated with chronic pain in patients with bipolar depression: a cross-sectional study.

BACKGROUND While pain is frequently associated with unipolar depression, few studies have investigated the link between pain and bipolar depression. In the present study we estimated the prevalence and characteristics of pain among patients with bipolar depression treated by psychiatrists in their regular clinical practice. The study was designed to identify factors associated with the manifestation of pain in these patients. METHODS Patients diagnosed with bipolar disorder (n=121) were selected to participate in a cross-sectional study in which DSM-IV-TR criteria were employed to identify depressive episodes. The patients were asked to describe any pain experienced during the study, and in the 6 weeks beforehand, by means of a Visual Analogical Scale (VAS). RESULTS Over half of the bipolar depressed patients (51.2%, 95% CI: 41.9%-60.6%), and 2/3 of the female experienced concomitant pain. The pain was of moderate to severe intensity and prolonged duration, and it occurred at multiple sites, significantly limiting the patient's everyday activities. The most important factors associated with the presence of pain were older age, sleep disorders and delayed diagnosis of bipolar disorder. CONCLUSIONS Chronic pain is common in bipolar depressed patients, and it is related to sleep disorders and delayed diagnosis of their disorder. More attention should be paid to study the presence of pain in bipolar depressed patients, in order to achieve more accurate diagnoses and to provide better treatment options.

Sistema de Información de la Coordinación Autonómica de Trasplantes de Andalucía (SICATA) : Subsistema de Insuficiencia Renal Crónica : Informe 2013

Coordinación Autonómica de Trasplantes

Intervenció per millorar la comunicació dels nens i adolescents amb DAR i els seus pares : Aplicació pel programa d'intervenció online DARWeb

Chronic pain is a relevant problem in our society. Concerning the young population, recurring abdominal pain (RAP in English, DAR in Spanish and Catalan) is very common among children and adolescents. DARWeb is an online treatment program addressed to children and teenagers with DAR and their parents. This work is aimed to develop an intervention to improve the communication skills of the children/adolescents with DAR and their parents. It is also proposed how this could be implemented to DARWeb.

Educação em saúde para portadores de doença mental: relato de experiência

A experiência descrita no presente texto refere-se a um projeto efetivo de educação em saúde num ambulatório de Saúde Mental em São Paulo, realizado por discentes de Enfermagem. A crença na conquista da cidadania pelo doente mental e a compreensão de que a educação pode tornar-se um dos instrumentos de emancipação dos sujeitos, foram os pressupostos do projeto. Houve uma fase curta e outra prolongada, ocorrendo no formato de grupo semanal aberto a usuários e familiares, com caráter participativo onde todos tinham liberdade, pois o espaço era aberto a discussões com trocas de opinião e experiências. As temáticas abordadas foram referentes às doenças crônicas, destacando dentre estas os transtornos mentais, transmissíveis e crônico-degenerativas.

Dialética do modo de vida de portadores de hipertensão arterial: o objetivo e subjetivo

Procurou-se compreender o modo de vida de portadores de hipertensão arterial assistidos por uma unidade do Programa de Saúde da Família, sob o referencial teórico-metodológico do materialismo histórico e dialético. As onze entrevistas realizadas com indivíduos hipertensos foram submetidas ao procedimento de análise de discurso, revelando temas da realidade social da vida cotidiana. As categorias empíricas identificadas crenças, sentimentos, além do individual, controle e descontrole pressórico e causas da hipertensão arterial, foram analisadas diante de categorias dialéticas o subjetivo e o objetivo e processo saúde-doença-cuidado. A vida cotidiana revelou contradições quanto ao tratamento necessário e a doença que não é assumida como doença; necessidade de modificações em hábitos e valores humanos que se contrapõem a essas modificações; impossibilidade concreta de controle dos níveis pressóricos decorrentes de situações do modo de vida como o nervosismo e problemas familiares. A Enfermagem precisa rever o modo de cuidado da pessoa com adoecimento crônico.

Análise de indicadores de risco para hipertensão arterial em crianças e adolescentes

O objetivo da pesquisa foi avaliar os indicadores de risco para a hipertensão arterial em crianças e adolescentes. Estudo transversal desenvolvido com 342 indivíduos de seis a 18 anos de uma escola da cidade de Fortaleza (CE). A maioria eram homens (51,5%). A média de idade foi 11,73 anos ( 3,19). Foram freqüentes os escolares com sobrepeso / obesidade (16,8%) e com pressão arterial acima do percentil 90 (44,7%). Sedentarismo, tabagismo e etilismo estiveram presentes em 51,5%, 38% e 15,5% dos avaliados. A pressão arterial sistólica esteve correlacionada com as variáveis: idade, peso, estatura, perímetros da cintura e do quadril, prega subescapular e Índice de Massa Corporal. Houve correlação da pressão arterial diastólica com idade, peso, estatura, perímetros da cintura e do quadril. Confirma-se a influência de fatores de risco sobre os valores da pressão arterial em jovens. A pressão arterial sistólica foi especialmente influenciada por indicadores antropométricos.

A problemática do cuidador familiar do portador de acidente vascular cerebral

Objetivou-se identificar a problemática da família de pessoas acometidas de acidente vascular cerebral hospitalizadas e discutir as dificuldades do cuidador familiar para o cuidado no âmbito domiciliar. A amostra constou de 154 famílias de pacientes internados em um hospital da rede pública de saúde, Fortaleza-CE. Conforme os resultados denotam, a maioria dos cuidadores são mulheres, 104 (67,5%); 122 casos (79,2%) apresentam comprometimento familiar e alterações na vida diária em 115 dos acompanhantes (74,7%); 150 (97,4%) não receberam orientações acerca dos cuidados, mas 143 (92,9%) sentem-se seguros para acompanhá-los. O sentimento predominante foi a tristeza, 125 (81,2%), e as dúvidas principais foram: alimentação, 64 (41,6%), administração de medicamentos, 49 (29,9%), e possíveis complicações clínicas após a alta, 49 (29,9%). Estes resultados alertam para o papel do enfermeiro como educador, não somente na prevenção das doenças crônico-degenerativas, mas, também, na orientação aos cuidadores familiares sobre os cuidados dispensados após a alta hospitalar.