Dnevni hospicij: Depresija i anksioznost nakon mastektomije zbog raka dojke

The aim of the study was to define the effects of daily hospice team’s activities on depression and anxiety in breast cancer patients having undergone mastectomy after three-month therapy. This prospective study included 35 patients that underwent mastectomy for breast cancer, followed by 3-month treatment at daily hospice, Tuzla University Clinical Center. Control group consisted of 35 mastectomized patients that did not visit daily hospice. Depression and anxiety were estimated by use of Zung’s scale. Patients were tested initially and retested at 12 weeks. On initial testing, the mean value of depression was 59.85±6.97 in the study group and 55.65±7.91 in the con¬trol group. On three-month retesting, the level of depression was lower in the study group, with a mean value of 48.57±7.06 (P<0.0001) (steam T-test and Wilcoxon’s test) and higher in the control group, with a mean value of 60.45±7.47 (P=0.0001) (steam T-test and Wilcoxon’s test). On initial testing, the mean value of anxiety was 54.97±6.35 and 52.20±6.03 in the study and control group, respectively. On three-month retesting, the level of anxiety was lower in the study group, with a mean value of 43.43±5.97 (P<0.0001), showing improvement from initial testing, but was higher in the control group, with a mean value of 55.68±7.47 (P=0.0002). In conclusion, daily hospice team’s treatment had favorable effects on lowering the levels of depression and anxiety in patients undergo¬ing mastectomy for breast cancer.Cilj studije bio je utvrditi učinak rada tima dnevnog hospicija na depresiju i anksioznost bolesnica s rakom dojke poslije mastektomije te nakon tromjesečne terapije. Ova prospektivna studija obuhvatila je 35 bolesnica podvrgnutih mastektomiji zbog raka dojke, koje su se liječile u dnevnom hospiciju Kliničkog bolničkog centra Tuzla kroz razdoblje od 12 tjedana. Kontrolna skupina sastojala se od 35 bolesnica koje nisu posjećivale dnevni hospicij. Depresija i anksioznost su se procjenjivale pomoću Zungove ljestvice. Bolesnice su testirane dva puta u 12-tjednom razdoblju. Srednja vrijednost depresije na prvom testu bila je 59,85±6,97 u ispitivanoj skupini i 55,65±7,91 u kontrolnoj skupini. Na drugom testu tri mjeseca kasnije depresija je bila niža u ispitivanoj skupini, sa srednjom vrijednošću od 48,57±7,06 (P<0,0001) (steam T-test i Wilcoxonov test), dok je u kontrolnoj skupini bila viša, sa srednjom vrijednošću od 60,45±7,47 (P<0,0001) (steam T-test i Wilcoxonov test). Srednja vrijednost za anksioznost na prvom testu bila je 54,97±6,35 u ispitivanoj skupini i 52,20±6,03 u kontrolnoj skupini. Drugo testiranje tri mjeseca kasnije pokazalo je bolji rezultat, odnosno nižu razinu anksioznosti u ispitivanoj skupini (srednja vrijednost 43,43±5,97; P<0,0001), dok je u kontrolnoj skupini zabilježena viša razina anksioznosti (srednja vrijednost 55,68± 7,47; P=0,0002). Zaključuje se kako rad tima u dnevnom hospiciju djeluje povoljno na snižavanje razine depresije i anksioznosti kod bolesnica podvrgnutih mastektomiji zbog raka dojke

Micophenolat Mofetil Versus Azathioprine: Effects on Renal Graft Function in Early Posttransplant Period

All conventional immunosuppressive tree drugs-protocols are based on Cyclosporine; consisting of low doses of Cyclosporine (CsA), Azathioprine (AZA) or Mycophenolate Mofetil (MMF) and Prednisolone, AZA has been used in clinical transplantation for more than 30 years and was the first immunosuppres-sive agent to achieve widespread use in organ transplantation. MMF was introduced in clinical practice in 1995 after several clinical trials proved that it was more efficient than AZA for prevention of acute rejection episodes. Our aim was to evaluate influence of AZA and MMF on renal graft function in early post-transplant stage. Study recruited 74 patients who underwent kidney transplantation in University Clinical Centre Tuzla. All patients received CsA and corticosteroid-based immunosuppression, as a part of triple immunosuppressive regiment, 40 patients received AZA and 34 MMF. In order to assess renal graft function, following parameters were evaluated: glomerular filtration rate GFR (ml/min) creatinine clearance (CrCl) (ml/min), 24 h urine output (ml/day), and from the serum potassium, sodium, urea and creatinine (mmol/dm3). Significantly higher average values of 24 hour urine output were recorded during first seven postoperative days in patients receiving MMF compared to those treated with AZA. Serum creatinine values showed statistically significant decrease, starting with the second postoperative day, in MMF vs. AZA group (168,7±70,5 vs. 119,9±42,6; p<0,0007). GFR was significantly higher in MMF compared to the AZA group of patients. On the first post-transplant day CrCl was higher in AZA group (24,3±10 vs. 17,5±7,3; p=0,01), next six days situation is reversed CrCl is significantly higher in the MMF group (43,7±15 vs. 53, 4±22, 8 p=0,006). MMF vs. AZA therapy was associated with protective effect against worsening of renal function in first seven post-transplant days

Micophenolat Mofetil Versus Azathioprine: Effects on Renal Graft Function in Early Posttransplant Period

All conventional immunosuppressive tree drugs-protocols are based on Cyclosporine; consisting of low doses of Cyclosporine (CsA), Azathioprine (AZA) or Mycophenolate Mofetil (MMF) and Prednisolone, AZA has been used in clinical transplantation for more than 30 years and was the first immunosuppres-sive agent to achieve widespread use in organ transplantation. MMF was introduced in clinical practice in 1995 after several clinical trials proved that it was more efficient than AZA for prevention of acute rejection episodes. Our aim was to evaluate influence of AZA and MMF on renal graft function in early post-transplant stage. Study recruited 74 patients who underwent kidney transplantation in University Clinical Centre Tuzla. All patients received CsA and corticosteroid-based immunosuppression, as a part of triple immunosuppressive regiment, 40 patients received AZA and 34 MMF. In order to assess renal graft function, following parameters were evaluated: glomerular filtration rate GFR (ml/min) creatinine clearance (CrCl) (ml/min), 24 h urine output (ml/day), and from the serum potassium, sodium, urea and creatinine (mmol/dm3). Significantly higher average values of 24 hour urine output were recorded during first seven postoperative days in patients receiving MMF compared to those treated with AZA. Serum creatinine values showed statistically significant decrease, starting with the second postoperative day, in MMF vs. AZA group (168,7±70,5 vs. 119,9±42,6; p<0,0007). GFR was significantly higher in MMF compared to the AZA group of patients. On the first post-transplant day CrCl was higher in AZA group (24,3±10 vs. 17,5±7,3; p=0,01), next six days situation is reversed CrCl is significantly higher in the MMF group (43,7±15 vs. 53, 4±22, 8 p=0,006). MMF vs. AZA therapy was associated with protective effect against worsening of renal function in first seven post-transplant days

Influence of Donor Age on Renal Graft Function in First Seven Post Transplant Days

Increasing gap between demand and availability of human kidneys for transplantation has forced a re-evaluation of the limits on donor age acceptability. The present study included 74 patients who underwent kidney transplantation in University Clinical Centre Tuzla. In an observational cohort study we assessed impact of donor age on post transplant renal function by analyzing following parameters: 24 hour urine output, creatinine clearance (Cr Cl) and glomerular filtration rate (GFR). Depending on donor age recipients were allocated in to two groups. Group I included patients who received renal graft from donors age up to 55 years, and Group II encountered recipients who received renal graft from donors older than 55 years. Our goal was to determine whether donor age over 55 years significantly diminishes renal graft function in first seven post transplant days. No statistically significant difference was found between Group I and II regarding 24 hour urine output. From second to fifth postoperative day creatinine clearance values were higher in the group of patients who received kidney from donors older than 55 years (47±19, 1 vs. 44, 4±20, 8). On the fifth, sixth and seventh post operative day GFR was significantly higher in patients who received renal graft from donors age up to 55 years (p 55 years is acceptable and may considerably expand the donor pool

Influence of Donor Age on Renal Graft Function in First Seven Post Transplant Days

Increasing gap between demand and availability of human kidneys for transplantation has forced a re-evaluation of the limits on donor age acceptability. The present study included 74 patients who underwent kidney transplantation in University Clinical Centre Tuzla. In an observational cohort study we assessed impact of donor age on post transplant renal function by analyzing following parameters: 24 hour urine output, creatinine clearance (Cr Cl) and glomerular filtration rate (GFR). Depending on donor age recipients were allocated in to two groups. Group I included patients who received renal graft from donors age up to 55 years, and Group II encountered recipients who received renal graft from donors older than 55 years. Our goal was to determine whether donor age over 55 years significantly diminishes renal graft function in first seven post transplant days. No statistically significant difference was found between Group I and II regarding 24 hour urine output. From second to fifth postoperative day creatinine clearance values were higher in the group of patients who received kidney from donors older than 55 years (47±19, 1 vs. 44, 4±20, 8). On the fifth, sixth and seventh post operative day GFR was significantly higher in patients who received renal graft from donors age up to 55 years (p 55 years is acceptable and may considerably expand the donor pool