116 research outputs found
Longitudinal Changes in Health-Related Quality of Life in Primary Glomerular Disease: Results From the CureGN Study
Ā© 2020 Introduction: Prior cross-sectional studies suggest that health-related quality of life (HRQOL) worsens with more severe glomerular disease. This longitudinal analysis was conducted to assess changes in HRQOL with changing disease status. Methods: Cure Glomerulonephropathy (CureGN) is a cohort of patients with minimal change disease, focal seNorthwell Healthntal glomerulosclerosis, membranous nephropathy, IgA vasculitis, or IgA nephropathy. HRQOL was assessed at enrollment and follow-up visits 1 to 3 times annually for up to 5 years with the Patient-Reported Outcomes Measurement Information System (PROMIS). Global health, anxiety, and fatigue domains were measured in all; mobility was measured in children; and sleep-related impairment was measured in adults. Linear mixed effects models were used to evaluate HRQOL responsiveness to changes in disease status. Results: A total of 469 children and 1146 adults with PROMIS scores were included in the analysis. HRQOL improved over time in nearly all domains, though group-level changes were modest. Edema was most consistently associated with worse HRQOL across domains among children and adults. A greater number of symptoms also predicted worse HRQOL in all domains. Sex, age, obesity, and serum albumin were associated with some HRQOL domains. The estimated glomerular filtration rate (eGFR) was only associated with fatigue and adult physical health; proteinuria was not associated with any HRQOL domain in adjusted models. Conclusion: HRQOL measures were responsive to changes in disease activity, as indicated by edema. HRQOL over time was not predicted by laboratory-based markers of disease. Patient-reported edema and number of symptoms were the strongest predictors of HRQOL, highlighting the importance of the patient experience in glomerular disease. HRQOL outcomes inform understanding of the patient experience for children and adults with glomerular diseases
Memorials to the victims of Nazism: the impact on tourists in Berlin
This qualitative study explores tourist responses to memorials to the victims of Nazism in Berlin and the impact they have on the tourist experience. The findings are located in the field of study known as dark tourism, of which visiting memorials is a part. The analysis shows that tourists increased their knowledge of the crimes committed by the Nazis, thus fulfilling the educational function of memorials. Tourists were also overwhelmed by their experience; they attested to feelings of sadness, shock, anger, despair and incomprehension. These feelings made it hard for them to resume the role of tourist after their exposure to a memorial. There was acknowledgement of the extent of commemoration practised in Germany
Outcome of left heart mechanical valve replacement in West African children - A 15-year retrospective study
Adorno on Hope
I argue that Theodor W. Adornoās philosophy articulates a radical conception of hope. According to Lear, radical hope is ādirected toward a future goodness that transcends the current ability to understand what it isā (2006:103). Given Adornoās claim that the current world is radically evil, and that we cannot know or even imagine what the good is, it is plausible that his conception of hope must be radical in this sense. I develop this argument through an analysis of (i) Adornoās engagement with Kantās conception of hope, (ii) Adornoās references to hope, and (iii) his critical diagnosis of a metaphysical need for hope. Having demonstrated that Adorno must reject both ordinary and Kantian hope, I examine why Adorno thinks that we still may have reasons for hope. I also show that Adornoās conception of hope differs from Learās in one important respect
Seroepidemiology of coxsackievirus A6, coxsackievirus A16, and Enterovirus 71 infections among children and adolescents in Singapore, 2008-2010
10.1371/journal.pone.0127999PLoS ONE105e012799
Optical imaging in vivo with a focus on paediatric disease: technical progress, current preclinical and clinical applications and future perspectives
To obtain information on the occurrence and location of molecular events as well as to track target-specific probes such as antibodies or peptides, drugs or even cells non-invasively over time, optical imaging (OI) technologies are increasingly applied. Although OI strongly contributes to the advances made in preclinical research, it is so far, with the exception of optical coherence tomography (OCT), only very sparingly applied in clinical settings. Nevertheless, as OI technologies evolve and improve continuously and represent relatively inexpensive and harmful methods, their implementation as clinical tools for the assessment of children disease is increasing. This review focuses on the current preclinical and clinical applications as well as on the future potential of OI in the clinical routine. Herein, we summarize the development of different fluorescence and bioluminescence imaging techniques for microscopic and macroscopic visualization of microstructures and biological processes. In addition, we discuss advantages and limitations of optical probes with distinct mechanisms of target-detection as well as of different bioluminescent reporter systems. Particular attention has been given to the use of near-infrared (NIR) fluorescent probes enabling observation of molecular events in deeper tissue
Repaired tetralogy of Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support
Surgical management of tetralogy of Fallot (TOF) results in anatomic and functional abnormalities in the majority of patients. Although right ventricular volume load due to severe pulmonary regurgitation can be tolerated for many years, there is now evidence that the compensatory mechanisms of the right ventricular myocardium ultimately fail and that if the volume load is not eliminated or reduced by pulmonary valve replacement the dysfunction might be irreversible. Cardiovascular magnetic resonance (CMR) has evolved during the last 2 decades as the reference standard imaging modality to assess the anatomic and functional sequelae in patients with repaired TOF. This article reviews the pathophysiology of chronic right ventricular volume load after TOF repair and the risks and benefits of pulmonary valve replacement. The CMR techniques used to comprehensively evaluate the patient with repaired TOF are reviewed and the role of CMR in supporting clinical decisions regarding pulmonary valve replacement is discussed
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