WHOQOL-BREF survey of quality of life among dialyzed end-stage renal disease patients

Introduction: Hemodialysis (HD) improves health and prolongs the life of end-stage renal disease patients, but simultaneously leads to emotional disturbances and impairs the quality of life (QOL). The study was conducted to evaluate the QOL of HD patients. The study was approved by the Regional Bioethical Committee (K.B.Cz.-0014/2017). Material and methods: The World Health Organization Questionnaire of QOL (WHOQOL-BREF) was used in this study with the formal agreement of the WHO. The associations between each patient-related and dialysis-related factor and WHOQOL-BREF domains and questions were computed. The variables were compared by the Student t-test. Results: Data were collected in August 2017 in a single access center. Sixty-nine patients, including 23 (33.3%) women, were evaluated. The factors lowering the scores for particular questions and domains of WHOQOL-BREF were senility, marriage, wrist and arm AVF, not-tunneled CVCs (vs. tunneled), and unwillingness to have a kidney graft. The factors that increased scores for particular questions and domains of WHOQOL-BREF were short dialysis, tunneled CVCs (vs. not-tunneled), and higher URR. The relations between domains and questions of WHOQOL-BREF and sex, education, months on dialysis, kidney graft in the past, fulfillment of medical recommendations, Kt/V and UF were not significant. Conclusions: Although a kidney graft is the best kidney replacement therapy, there is a large group of patients who do not want to receive this treatment. This group should be given special attention. The medical professionals in HD units should remember that patients may not feel comfortable with their disease and satisfied with their body image affected by therapy

Comparison of the results of laparoscopic appendectomies with application of different techniques for closure of the appendicular stump

BACKGROUND: Nowadays laparoscopy is used frequently not only in elective surgery but also in abdominal emergencies, including acute appendicitis. There are several techniques used to close the appendicular stump during laparoscopic appendectomy. The aim of the study was to present and compare the results of minimally invasive appendectomies performed with the use of endoscopic staplers (group A), titanium endoclips (group B) and invaginating sutures (group C). METHODS: Three hundred seven patients (mean age = 35.6; SD = 15.9; 178 males,129 females) operated on laparoscopically for acute appendicitis from January 2010 to December 2014 at our department were included in the study. We reviewed retrospectively patients’ data including: age, sex, duration of the surgical procedure and hospital stay, mortality, intraoperative and postoperative complication rates in all analyzed groups. RESULTS: There were 102 patients in group A (mean age = 35.8;SD = 15.4; 57 males, 45 females). The average hospital stay in this group was 4.3 days (SD = 1.7), average operation time was 62.0 min (SD = 15), postoperative complication rate was 5.9 %. There were 160 patients in group B (mean age = 35.0; SD = 16.3; 96 males, 64 females). The average hospital stay in this group was 3.6 days (SD = 1.4), average operation time was 62.9 min (SD = 13.5), postoperative complication rate was 5.6 %. There were 45 patients in group C (mean age =37.3; SD = 15.8; 25 males, 20 females). The average hospital stay in this group was 4.6 days (SD = 2.0), average operation time was 73.9 min (SD = 20.8), postoperative complication rate was 6.7 %. There were no intraoperative complications and no mortality in all compared groups of patients operated on laparoscopically for acute appendicitis. CONCLUSIONS: Laparoscopic appendectomies with application of different techniques for closure of the appendicular stump are useful and safe. In our study the shortest hospital stay and lowest complication rate were observed in patients operated with the use of titanium endoclips. The longest hospital stay and operation time and the highest complication rate was associated with the use of invaginating sutures

Accuracy of preoperative tumor localization in large bowel using 3D magnetic endoscopic imaging : randomized clinical trial

Abstract Background Laparoscopic surgery has become the standard treatment for colorectal cancer. A tumor that does not involve serosa is invisible intraoperatively, and manual palpation of the tumor during laparoscopy is not possible. Therefore, accurate localization of the neoplastic infiltrate remains one of the most important tasks prior to elective laparoscopic surgery. The aim of this study was to evaluate the utility of a magnetic endoscopic imaging (MEI) for precise preoperative endoscopic localization of neoplastic infiltrate within the large bowel. Materials and methods The study enrolled 246 patients who underwent elective surgery for colorectal cancer in 2012–2015 with accurate preoperative colonoscopic localization of the tumor. The analysis concerned patients with neoplastic infiltrate localized more than 30 cm from the anal verge. For evaluative purposes and accuracy of localization, the intestine was divided anatomically into 13 parts. Colonoscopic examinations were conducted with two types of endoscopes: group I—with MEI and group II—without MEI. Patients were assigned to the groups by random allocation. Ultimate confirmation of the tumor localization was accomplished by intraoperative evaluation. Results Group I involved 127 patients and group II 129. The two groups were compared in terms of age, sex, BMI and frequency of previous abdominal procedures. Proper localization of the lesion was confirmed in 95.23 % of group I patients and in 83.19 % of group II patients (p &lt; 0.05). The greatest discrepancy in localization occurred in 8.9 % of patients from group I and 20 % of patients from group II in which the lesion was assessed primarily in the distal sigmoid. Conclusions A magnetic endoscopic imaging allows more accurate localization of neoplastic infiltrate within the large intestine compared to standard colonoscopy alone, especially within the sigmoid colon. This method can be particularly useful in planning and performing laparoscopic procedures to diminish the likelihood of improper bowel segment resection. ClinicalTrials.gov number NCT01688557 </jats:sec

Role of the molybdenum addition on the mechanical properties and structure of the NiCoMnIn alloys

In this paper, the influence of Mo addition on the structure and mechanical properties of the NiCoMnIn alloys have been studied. Series of polycrystalline NiCoMnIn alloys containing from 0 to 5 mas.% of Mo were produced by the arc melting technique. For the alloys containing Mo, two-phase microstructure was observed. Mo-rich precipitates were distributed randomly in the matrix. The relative volume fraction of the precipitates depends on the Mo content. The numbers of the Mo rich precipitates increases with the Mo contents. The structures of the phases were determined by the TEM. The mechanical properties of the alloys are strongly affected by Mo addition contents. Brittleness of the alloys increases with the Mo contents