Role of voiding and storage symptoms for the quality of life before and after treatment in men with voiding dysfunction

Previous studies on associations between voiding dysfunction and quality of life (QoL) have largely been limited to baseline data. Therefore, we have explored associations between Q (max) and voiding and storage sub-scores of the International Prostate Symptom Score (IPSS) before and after treatment with QoL. Analysis of a single-center database of 2,316 men with voiding dysfunction attributed to benign prostatic hyperplasia undergoing various medical and surgical treatment forms. Q (max) exhibited little correlation with QoL before or after treatment. IPSS inversely correlated with QoL at baseline and after treatment, and IPSS improvements correlated with those of QoL. The associations applied to both the voiding and storage sub-score of the IPSS, with the latter consistently exhibiting somewhat tighter associations. Our post-treatment data support the idea of a cause-effect relationship between voiding symptoms and QoL irrespective of treatment form. While both voiding and storage symptoms contribute to this relationship, storage symptoms play a somewhat greater rol

Representação do enfermeiro sobre infecções em pacientes submetidos a transplante de células-tronco hematopoiéticas

O estudo teve por objetivo identificar as representações de 36 enfermeiros sobre a ocorrência de infecções em pacientes submetidos a transplante de células-tronco hematopoiéticas de um hospital universitário em 2010. Os dados foram coletados mediante entrevista semiestruturada embasada nas representações sociais e analisados por meio da Análise de Conteúdo Temático, a qual resultou na categoria infecção e culpabilidade. Os enfermeiros referiram utilizar medidas para a prevenção de infecções durante a prática assistencial e reconhecem a condição imunológica desfavorável dos pacientes; contudo, consideram-se vetores das infecções e sentem-se culpados diante da ocorrência do agravo. Os resultados apontam para a necessidade de serviço de apoio aos profissionais, visando contextualizar o cuidado a paciente imunodeprimido e minimizar o sentimento de culpa.El estudio tuvo por objeto identificar las representaciones de 36 enfermeros sobre el acometimiento de infecciones en pacientes sometidos a trasplante de células-tronco hematopoyéticas de un hospital universitario en 2010. Los datos fueron obtenidos mediante entrevista seme-estructurada basada en las representaciones sociales y analizadas por medio del Análisis de Contenido Temático, el cual resultó en la categoría infección y culpabilidad. Los enfermeros prefirieron utilizar medidas para la prevención de infecciones durante la práctica asistencial y reconocen la condición inmunológica desfavorable de los pacientes, sin embargo, se consideran vectores de las infecciones y se sienten culpados ante el agravamiento. Los resultados apuntan hacia la necesidad de servicio de apoyo a los profesionales, con el objeto de contextualizar el cuidado al paciente inmunodeprimido y minimizar el sentimiento de culpa.The study aimed to identify the representations from 36 nurses concerning to the infections occurred in patients submitted to transplantation of hematopoietic stem-cell in from a university hospital in 2010. The data were collected through semi-structured interview based on social representations and analyzed by thematic content analysis, which resulted in the infection and guilt category. The nurses have chosen to use measures in order to prevent infections during care practice and recognize the unfavorable immune status of the patients, however, they considered vectors of infections and feel guilty when the injury occurs. The result points to the need of a support service to the professional in this area, focusing in contextualize the care to immunosuppressed patient care and minimize their guilt

Stroke Correlates in Chagasic and Non-Chagasic Cardiomyopathies

BACKGROUND: Aging and migration have brought changes to the epidemiology and stroke has been shown to be independently associated with Chagas disease. We studied stroke correlates in cardiomyopathy patients with focus on the chagasic etiology. METHODOLOGY/PRINCIPAL FINDINGS: We performed a cross-sectional review of medical records of 790 patients with a cardiomyopathy. Patients with chagasic (329) and non-chagasic (461) cardiomyopathies were compared. There were 108 stroke cases, significantly more frequent in the Chagas group (17.3% versus 11.1%; p<0.01). Chagasic etiology (odds ratio [OR], 1.79), pacemaker (OR, 2.49), atrial fibrillation (OR, 3.03) and coronary artery disease (OR, 1.92) were stroke predictors in a multivariable analysis of the entire cohort. In a second step, the population was split into those with or without a Chagas-related cardiomyopathy. Univariable post-stratification stroke predictors in the Chagas cohort were pacemaker (OR, 2.73), and coronary artery disease (CAD) (OR, 2.58); while atrial fibrillation (OR, 2.98), age over 55 (OR, 2.92), hypertension (OR, 2.62) and coronary artery disease (OR, 1.94) did so in the non-Chagas cohort. Chagasic stroke patients presented a very high frequency of individuals without any vascular risk factors (40.4%; OR, 4.8). In a post-stratification logistic regression model, stroke remained associated with pacemaker (OR, 2.72) and coronary artery disease (OR, 2.60) in 322 chagasic patients, and with age over 55 (OR, 2.38), atrial fibrillation (OR 3.25) and hypertension (OR 2.12; p = 0.052) in 444 non-chagasic patients. CONCLUSIONS/SIGNIFICANCE: Chagas cardiomyopathy presented both a higher frequency of stroke and an independent association with it. There was a high frequency of strokes without any vascular risk factors in the Chagas as opposed to the non-Chagas cohort. Pacemaker rhythm and CAD were independently associated with stroke in the Chagas group while age over 55 years, hypertension and atrial fibrillation did so in the non-Chagas cardiomyopathies

Performance of Polymerase Chain Reaction Techniques Detecting Perforin in the Diagnosis of Acute Renal Rejection: A Meta-Analysis

BACKGROUND: Studies in the past have shown that perforin expression is up-regulated during acute renal rejection, which provided hopes for a non-invasive and reliable diagnostic method to identify acute rejection. However, a systematic assessment of the value of perforin as a diagnostic marker of acute renal rejection has not been performed. We conducted this meta-analysis to document the diagnostic performance of perforin mRNA detection and to identify potential variables that may affect the performance. METHODOLOGY/PRINCIPAL FINDINGS: Relevant materials that reported the diagnostic performance of perforin mRNA detection in acute renal rejection patients were extracted from electronic databases. After careful evaluation of the studies included in this analysis, the numbers of true positive, true negative, false positive and false negative cases of acute renal rejection identified by perforin mRNA detection were gathered from each data set. The publication year, sample origin, mRNA quantification method and housekeeping gene were also extracted as potential confounding variables. Fourteen studies with a total of 501 renal transplant subjects were included in this meta-analysis. The overall performance of perforin mRNA detection was: pooled sensitivity, 0.83 (95% confidence interval: 0.78 to 0.88); pooled specificity, 0.86 (95% confidence interval: 0.82 to 0.90); diagnostic odds ratio, 28.79 (95% confidence interval: 16.26 to 50.97); and area under the summary receiver operating characteristic curves value, 0.9107±0.0174. The univariate analysis of potential variables showed some changes in the diagnostic performance, but none of the differences reached statistical significance. CONCLUSIONS/SIGNIFICANCE: Despite inter-study variability, the test performance of perforin mRNA detected by polymerase chain reaction was consistent under circumstances of methodological changes and demonstrated both sensitivity and specificity in detecting acute renal rejection. These results suggest a great diagnostic potential for perforin mRNA detection as a reliable marker of acute rejection in renal allograft recipients