160 research outputs found

    Quality Of Life And Menopausal Symptoms In Women With Liver Transplants [qualidade De Vida E Sintomas Da Menopausa Em Mulheres Transplantadas Hepáticas]

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    PURPOSE: To assess quality of life and climacteric symptoms in women with and without liver transplants. METHODS: This was a cross-sectional study of 52 women undergoing follow-up at a university hospital in southeastern Brazil from February 4th, 2009 to January 5th, 2011. Twenty-four of these women were 35 years old or older and had undergone liver transplantation at least one year before study entry. The remaining 28 women had no liver disease and were matched by age and menstrual patterns to the patients with transplants. The abbreviated version of the World Health Organization (WHOQOL-BREF) questionnaire was used to assess quality of life. Menopausal symptoms were assessed using the Menopause Rating Scale (MRS). Statistical analysis was carried out by Student's I{stroke} -test, Mann-Whitney test and analysis of variance. Correlations between MRS and the WHOQOL-BREF were established by correlation coefficients. RESULTS: The mean age of the women included in the study was 52.2 (±10.4) years and the mean time since transplantation was 6.1 (±3.3) years. Women with liver transplants had better quality of life scores in the environment domain (p=0.01). No difference was noted between the two groups in any domain of the MRS. For women in the comparison group, there was a strongly negative correlation between somatic symptoms in the MRS and the physical domain of the WHOQOL-BREF (p<0.01; r=-0.8). In contrast, there was only a moderate association for women with liver transplants (p<0.01; r=-0.5). CONCLUSIONS: Women with liver transplants had better quality of life scores in the domain related to environment and did not exhibit more intense climacteric symptoms than did those with no liver disease. Climacteric symptoms negatively influenced quality of life in liver transplant recipients, although less intensely than in women without a history of liver disease.353103110Saab, S., Ng, V., Landaverde, C., Lee, S.J., Comulada, W.S., Arevalo, J., Development of a disease-specific questionnaire to measure health-related quality of life in liver transplant recipients (2011) Liver Transpl, 17 (5), pp. 567-579Lim, K.B., Schiano, T.D., Long-term outcome after liver transplantation (2012) Mt Sinai J Med, 79 (2), pp. 169-189van Ginneken, B.T., van den Berg-Emons, R.J., van der Windt, A., Tilanus, H.W., Metselaar, H.J., Stam, H.J., Persistent fatigue in liver transplant recipients: A two-year follow-up study (2010) Clin Transplant, 24 (1), pp. E10-E16Bryan, S., Ratcliffe, J., Neuberger, J.M., Burroughs, A.K., Gunson, B.K., Buxton, M.J., Health-related quality of life following liver transplantation (1998) Qual Life Res, 7 (2), pp. 115-120Nickel, R., Wunsch, A., Egle, U.T., Lohse, A.W., Otto, G., The relevance of anxiety, depression, and coping in patients after liver transplantation (2002) Liver Transpl, 8 (1), pp. 63-71Masala, D., Mannocci, A., Unim, B., Del Cimmuto, A., Turchetta, F., Gatto, G., Quality of life and physical activity in liver transplantation patients: Results of a case-control study in Italy (2012) Transplant Proc, 44 (5), pp. 1346-1350Sirivatanauksorn, Y., Dumronggittigule, W., Limsrichamrern, S., Iramaneerat, C., Kolladarungkri, T., Kositamongkol, P., Quality of life among liver transplantation patients (2012) Transplant Proc, 44 (2), pp. 532-538Wang, G.S., Yang, Y., Li, H., Jiang, N., Fu, B.S., Jin, H., Health-related quality of life after liver transplantation: The experience from a single Chinese center (2012) Hepatobiliary Pancreat Dis Int, 11 (3), pp. 262-266de Bona, M., Ponton, P., Ermani, M., Iemmolo, R.M., Feltrin, A., Boccagni, P., The impact of liver disease and medical complications on quality of life and psychological distress before and after liver transplantation (2000) J Hepatol, 33 (4), pp. 609-615Jabiry-Zienjewicz, Z., Kaminski, P., Bobrowska, K., Pietrzak, B., Wielgos, M., Zieniewicz, K., Menstrual cycle and sex hormone profile in perimenopausal women after liver transplantation (2006) Transplant Proc, 38 (9), pp. 2909-2912Boin, I.F., Ataide, E.C., Leonardi, M.I., Stucchi, R., Sevá-Pereira, T., Pereira, I.W., Elderly donors for HCV(+) versus non-HCV recipients: Patient survival following liver transplantation (2008) Transplant Proc, 40 (3), pp. 792-796Guyton, A.C., Hall, J.E., (1996) Textbook of Medical Physiology, , Philadelphia, SaundersParolin, M.B., Rabinovitch, I., Urbanetz, A.A., Scheidemantel, C., Cat, M.L., Coelho, J.C., Impact of successful liver transplantation on reproductive function and sexuality in women with advanced liver disease (2004) Transplant Proc, 36 (4), pp. 943-944Mass, K., Quint, E.H., Punch, M.R., Merion, R.M., Gynecological and reproductive function after liver transplantation (1996) Transplantation, 62 (4), pp. 476-479Cundy, T.F., O'Grady, J.G., Williams, R., Recovery of menstruation and pregnancy after liver transplantation (1990) Gut, 31 (3), pp. 337-338Hickey, M., Davis, S.R., Sturdee, D.W., Treatment of menopausal symptoms: What shall we do now? (2005) Lancet, 366 (9483), pp. 409-421Hess, R., Thurston, R.C., Hays, R.D., Chang, C.C., Dillon, S.N., Ness, R.B., The impact of menopause on health-related quality of life: Results from the STRIDE longitudinal study (2012) Qual Life Res, 21 (3), pp. 535-544Ozkan, S., Alatas, E.S., Zencir, M., Women ́s quality of life in the premenopausal and postmenopausal periods (2005) Qual Life Res, 14 (8), pp. 1795-1801Dennerstein, L., Lehert, P., Guthrie, J., The effects of the menopausal transition and biopsychosocial factors on well-being (2002) Arch Womens Ment Health, 5 (1), pp. 15-22Mishra, G.D., Brown, W.J., Dobson, A.J., Physical and mental health: Changes during menopause transition (2003) Qual Life Res, 12 (4), pp. 405-412Kumari, M., Stafford, M., Marmot, M., The menopausal transition was associated in a prospective study with decreased health functioning in women who report menopausal symptoms (2005) J Clin Epidemiol, 58 (7), pp. 719-727Cheng, M.H., Lee, S.J., Wang, S.J., Wang, P.H., Fuh, J.L., Does menopausal transition affect the quality of life? A longitudinal study of middle-aged women in Kinmen (2007) Menopause, 14 (5), pp. 885-890Avis, N.E., Colvin, A., Bromberger, J.T., Hess, R., Matthews, K.A., Ory, M., Change in health-related quality of life over the menopausal transition in a multiethnic cohort of middle-aged women: Study of Women ́s Health Across the Nation (2009) Menopause, 16 (5), pp. 860-869Birkhauser, M.H., Barlow, D.H., Notelovitz, M., Rees, M.C., (2005) Management Handbook: Health Plan For the Adult Woman, , London, Taylor & FrancisHeinemann, L.A., Potthoff, P., Schneider, H.P., International versions of the Menopause Rating Scale (MRS) (2003) Health Qual Life Outcomes, 1, p. 28Fleck, M.P., Louzada, S., Xavier, M., Chachamovich, E., Vieira, G., Santos, L., Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida WHOQOL-bref (2000) Rev Saúde Pública, 34 (2), pp. 178-183Santos, C., (2007) Estatística Descritiva - Manual De Auto-aprendizagem, , Lisboa, Edições SílaboTelles-Correia, D., Barbosa, A., Mega, I., Mateus, E., Monteiro, E., When does quality of life improve after liver transplantation? A longitudinal prospective study (2009) Transplant Proc, 41 (3), pp. 904-905Aadahl, M., Hansen, B.A., Kirkegaard, P., Groenvold, M., Fatigue and physical function after orthotopic liver transplantation (2002) Liver Transpl, 8 (3), pp. 251-259Goetzmann, L., Klaghofer, R., Wagner-Huber, R., Halter, J., Boehler, A., Muellhaupt, B., Quality of life and psychosocial situation before and after a lung, liver or an allogeneic bone marrow transplant (2006) Swiss Med Wkly, 136 (17-18), pp. 281-290Schwartz, C.E., Rapkin, B.D., Reconsidering the psychometrics of quality of life assessment in light of response shift and appraisal (2004) Health Qual Life Outcomes, 2, p. 16Dennerstein, L., Dudley, E., Guthrie, J., Barrett-Connor, E., Life satisfaction, symptoms, and the menopausal transition (2000) Medscape Womens Health, 5 (4), pp. E4Brzyski, R.G., Medrano, M.A., Hyatt-Santos, J.M., Ross, J.S., Quality of life in low-income menopausal women attending primary care clinics (2001) Fertil Steril, 76 (1), pp. 44-50Ekström, H., Hovelius, B., Quality of life and hormone therapy in women before and after menopause (2000) Scand J Prim Health Care, 18 (2), pp. 115-12

    Patient Centric Pharmaceutical Drug Product Design—The Impact on Medication Adherence

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    Medication adherence is a growing concern for public health and poor adherence to therapy has been associated with poor health outcomes and higher costs for patients. Interventions for improving adherence need to consider the characteristics of the individual therapeutic regimens according to the needs of the patients. In particular, geriatric and paediatric populations as well as dermatological patients have special needs/preferences that should be considered when designing drug products. Patient Centric Drug Product Pharmaceutical Design (PCDPD) offers the opportunity to meet the needs and preferences of patients. Packaging, orodispersible formulations, fixed dose combinations products, multiparticulate formulations, topical formulations and 3D printing are of particular relevance in a PCDPD process. These will be addressed in this review as well as their impact on medication adherence

    Cardiovascular abnormalities in patients with oral cleft: a clinical-electrocardiographic-echocardiographic study

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    OBJECTIVES: The present study aims to describe the clinical, electrocardiographic, and echocardiographic cardiological findings in a group of patients with oral clefts. METHODS: This is a prospective cross-sectional study on 70 children (age range from 13 days to 19 years) with oral clefts who attended the multidisciplinary program of a university hospital from March 2013 to September 2014. The patients were evaluated by a pediatric cardiologist and underwent detailed anamnesis, physical examination, electrocardiogram, and echocardiogram. RESULTS: Sixty percent of the patients were male; 55.7% presented with cleft lip and palate, and 40.0% presented with health complaints. Comorbidities were found in 44.3%. Relevant pregnancy, neonatal, family and personal antecedents were present in 55.7%, 27.1%, 67.2%, and 24.3% of the patients, respectively. Regarding the antecedents, 15.2% of the patients presented with a cardiac murmur, 49.0% with a familial risk of developing plurimetabolic syndrome, and 6% with family antecedents of rheumatic fever. Electrocardiographic evaluation showed one case of atrioventricular block. Echocardiograms were abnormal in 35.7% of the exams, including 5 cases of mitral valve prolapse — one of which was diagnosed with rheumatic heart disease. CONCLUSION: The finding of a family risk of developing plurimetabolic syndrome and a diagnosis of rheumatic heart disease indicates that patients with oral clefts may be more prone to developing acquired heart disease. Thus, our findings highlight the importance of anamnesis and methodological triangulation (clinical-electrocardiographic-echocardiographic) in the investigation of patients with oral clefts and emphasize that cardiological follow-up to evaluate acquired and/or rhythm heart diseases is necessary. This strategy permits comorbidity prevention and individualized planned treatment

    Estudos sobre a nutrição mineral do arroz: XI. Marcha de absorção de micronutrientes pela variedade IAC-47

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    Dry matter yield and uptake of B, Cu, Fe, Mn and Zn by the rice variety IAC-47 were studied under controlled conditions, namely, by growing plants in nutrient solution and by falcing samples for analyses in set physiological periods. It was observed that only the curves describing dry matter production and accumulation of B and Fe was verified.A produção de matéria seca e a absorção de micronutrientes (B, Cu, Fe, Mn e Zn) pelo arroz var. IAC-47 foram estudadas usando-se plantas cultivadas em solução nutritiva. Verificou-se que: enquanto as curvas que descrevem o crescimento e a acumulação de B e Fe mostram tendência sigmóide, as demais não o fazem, evidência de redistribuição foi observada somente nos casos do B (diminuição no conteúdo foliar) e no do Fe (diminuição no conteúdo da raiz)
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