Modulation of Myostatin/Hepatocyte Growth Factor Balance by Different Hemodialysis Modalities

Background. In this study we investigated the relevance of myostatin and Hepatocyte Growth Factor (HGF) in patients undergoing hemodialysis HD and the influence of different HD modalities on their levels. Methods. We performed a prospective crossover study in which HD patients were randomized to undergo 3-month treatment periods with bicarbonate hemodialysis (BHD) followed by online hemodiafiltration (HDF). Clinical data, laboratory parameters, and myostatin and HGF serum levels were collected and compared. Results. Ten patients and six controls (C) were evaluated. In any experimental condition myostatin and HGF levels were higher in HD than in C. At enrollment and after BHD there were not significant correlations, whereas at the end of the HDF treatment period myostatin and HGF were inversely correlated (r -0.65, p<0.05), myostatin serum levels inversely correlated with transferrin (r -0.73, p<0.05), and HGF levels that resulted positively correlated with BMI (r 0.67, p<0.05). Moving from BHD to HDF, clinical and laboratory parameters were unchanged, as well as serum HGF, whereas myostatin levels significantly decreased (6.3 \ub1 4.1 versus 4.3 \ub1 3.1 ng/ml, p<0.05). Conclusions. Modulation of myostatin levels and myostatin/HGF balance by the use of different HD modalities might represent a novel approach to the prevention and treatment of HD-related muscle wasting syndrome

Multidimensional evaluation of performance with experimental application of balanced scorecard: a two year experience

<p>Abstract</p> <p>Background</p> <p>In today's dynamic health-care system, organizations such as hospitals are required to improve their performance for multiple stakeholders and deliver an integrated care that means to work effectively, be innovative and organize efficiently. Achieved goals and levels of quality can be successfully measured by a multidimensional approach like Balanced Scorecard (BSC). The aim of the study was to verify the opportunity to introduce BSC framework to measure performance in St. Anna University Hospital of Ferrara, applying it to the Clinical Laboratory Operative Unit in order to compare over time performance results and achievements of assigned targets.</p> <p>Methods</p> <p>In the first experience with BSC we distinguished four perspectives, according to Kaplan and Norton, identified Key Performance Areas and Key Performance Indicators, set standards and weights for each objective, collected data for all indicators, recognized cause-and-effect relationships in a strategic map. One year later we proceeded with the next data collection and analysed the preservation of framework aptitude to measure Operative Unit performance. In addition, we verified the ability to underline links between strategic actions belonging to different perspectives in producing outcomes changes.</p> <p>Results</p> <p>The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the specific perspective contribution to overall performance enhancement. After time results comparison was possible depending on the selection of feasible and appropriate key performance indicators, which was occasionally limited by data collection problems.</p> <p>Conclusions</p> <p>The first use of BSC to compare performance at Operative Unit level, in course of time, suggested this framework can be successfully adopted for results measuring and revealing effective health factors, allowing health-care quality improvements.</p

A Round Table Conference on Indian Adolescent Wellness in a Holistic Context- A Consensus Statement Final Report

This report summarizes the results of a meeting of experts in the area of Indian adolescent health and wellness. The group produced a consensus statement described in this final report. The Adolescent Health Roundtable participants refocused the mission of the roundtable from Adolescent Health to Adolescent Wellness. There was agreement among the participants that the term health is too often defined with statistics of morbidity and mortality indicating the absence of health. The group took the position that Indian adolescent wellness is much more than the disease and death statistics; the wellness of Indian adolescents is very much influenced by other aspects of family and community life.Understanding the historical, spiritual, and psychosocial factors affecting Indian adolescent wellness was the foundation for this Roundtable\\u27s consensus statements

FATORES ASSOCIADOS À AUTOPERCEPÇÃO NEGATIVA DE SAÚDE EM IDOSOS ASSISTIDOS PELA ATENÇÃO BÁSICA

O objetivo o presente estudo foi verificar a prevalência e os fatores associados à autopercepção negativa de saúde em idosos assistidos pela atenção básica. Foi realizado um estudo observacional transversal, do tipo analítico, com 241 idosos de uma comunidade em Vitória, Espírito Santo. A autopercepção de saúde foi a variável desfecho, e as características sociodemográficas, hábitos de vida e características de saúde foram as variáveis de exposição. Os dados foram analisados a partir do teste Qui-Quadrado de Pearson e foi calculado a Razão de Prevalência para as variáveis associadas significativamente com o desfecho (p < 0,05). A prevalência da autopercepção negativa de saúde encontrada foi de 46,5%, e os fatores associados a este desfecho foram: raça branca, polifarmácia, incapacidade para atividades cotidianas, sintomas depressivos, risco de quedas e percepção negativa da qualidade de vida. Os achados deste estudo podem auxiliar no gerenciamento do cuidado prestado aos idosos, visando a manutenção e recuperação da independência, autonomia e saúde da pessoa idosa, e assim contribuir para uma melhor qualidade de vida desta população