Fatores de personalidade e evolu??o cl?nica em pacientes transplantados de rim

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS ([email protected]) on 2015-10-28T22:00:26Z No. of bitstreams: 1 475925 - Texto Completo.pdf: 4376108 bytes, checksum: 6bf0771ea7aea9aa52f43e4e367e7bab (MD5)Made available in DSpace on 2015-10-28T22:00:26Z (GMT). No. of bitstreams: 1 475925 - Texto Completo.pdf: 4376108 bytes, checksum: 6bf0771ea7aea9aa52f43e4e367e7bab (MD5) Previous issue date: 2015-08-31Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPESConselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPqThe relationship between personality and health is frequently studied in scientific research. This study aimed to investigate the clinical/biochemical course of kidney transplant patients and its relationship with personality traits in the 3rd, 6th and 9th month after transplantation. Participants were 114 kidney transplant patients, 68 men and 46 women, with an average age of 47.72 years (SD=11.4). Personality was assessed using the Brazilian Factorial Personality Inventory (BFP). Patient charts were used to record clinical/biochemical variables over nine months following transplantation (hypertension, acute rejection, graft loss, death, creatinine and estimated glomerular filtration rate/eGFR). In addition to sociodemographic variables, information was also collected on transfusions prior to transplantation and panel reactive antibodies (HLA I and II).Two groups with personality types were differentiated by psychological characteristics (hierarchical cluster analysis): Cluster 1- average Neuroticism, high Surgency, Agreeableness and Conscientiousness, and low Openness; Cluster 2- high Neuroticism, average Surgency and Agreeableness, average Conscientiousness and low Openness. There was no statistically significant difference between the two clusters in terms of hypertension, acute infection, graft loss, death and HLA I and II panel reactive antibodies. Creatinine levels, eGFR and transfusions were associated with personality types. Cluster 1 contained significantly higher creatinine levels than Cluster 2 and these remained high on all three assessment occasions, with transfusion prior to transplantation less frequent in this group. Cluster 1 exhibited a slight decrease in average eGFR over time, with an increase observed in cluster 2. In individual analyses, Neuroticism was higher in patients with lower schooling levels (p=0.002) and exhibited a significant positive correlation with average eGFR (r=0.250; p=0.008). Agreeableness was significantly higher in men patients (p<0.001) and those without infection (p=0.050). Agreeableness also showed a significant positive correlation with average creatinine levels (r= 0.250; p= 0.007) and a negative association with eGFR (r=-0.208; p=0.027). Higher levels of Conscientiousness were observed in participants with children (p=0.026) not taking medication for depression (p=0.033), as well as a positive correlation with HLA I panel reactive antibodies (r=0.223; p=0.018). In relation to Openness, the only statistically significant difference identified was in relation to schooling, with higher average values found among participants who had completed higher education (p=0.037). The results suggest that personality traits may be associated with transplant results. Monitoring these patients over a longer period may provide a better understanding of the relationship between personality traits and clinical course during the posttransplant period.A rela??o entre personalidade e sa?de tem sido objeto de estudo frequente em pesquisas cient?ficas. Este estudo teve como objetivo principal investigar a evolu??o cl?nica/laboratorial de pacientes transplantados de rim e sua rela??o com tra?os de personalidade no 30, 60 e 90 m?s ap?s o transplante. Participaram do estudo 114 pacientes transplantados renais, 68 homens e 46 mulheres, com idade m?dia de 47,72 anos (DP=11,4). Para a avalia??o da personalidade foi utilizada a Bateria Fatorial de Personalidade (BFP). A partir dos prontu?rios, foram registradas as vari?veis cl?nicas/laboratoriais ao longo de nove meses ap?s o transplante (hipertens?o arterial (HA), rejei??o aguda, infec??o, perda do enxerto, ?bito, creatinina e taxa de filtra??o glomerular estimada/ TFGe). Al?m das vari?veis sociodemogr?ficas, coletaram-se ainda informa??es sobre as transfus?es pr?vias ao transplante e Painel de ant?genos HLA (classe I e II). Dois grupos com perfis de personalidade foram diferenciados pelas caracter?sticas psicol?gicas (an?lise de cluster hierarquizado): Cluster 1- Neuroticismo m?dio, Extrovers?o, Socializa??o e Realiza??o altos e Abertura baixo; Cluster 2- Neuroticismo alto, Extrovers?o, Socializa??o, Realiza??o m?dio e Abertura baixo. Para HA, rejei??o aguda, infec??o, perda do enxerto, ?bito e Painel de ant?genos HLA, classe I e II n?o houve diferen?a estatisticamente significativa entre os dois Clusters. Os n?veis de creatinina, TFGe e transfus?es tiveram associa??o com os perfis de personalidade. Verificou-se que o Cluster 1 concentrou n?veis de creatinina significativamente mais altos que o Cluster 2 e que se mantiveram mais elevados nos tr?s momentos de avalia??o, sendo a transfus?o pr?via ao transplante menos frequente neste grupo. No Cluster 1 ocorreu leve redu??o da m?dia de TFGe ao longo do tempo, enquanto que no Cluster 2 houve aumento. Nas an?lises individuais, Neuroticismo apresentou m?dias mais elevadas nos pacientes com menor escolaridade (p=0,002) e correla??o significativa e positiva com a m?dia de TFGe (r=0,250; p=0,008). O fator Socializa??o apresentou m?dias significativamente mais elevadas nos pacientes homens (p<0,001) e em pacientes sem infe??o (p=0,050). Al?m disto, o fator Socializa??o indicou correla??o significativa positiva com a m?dia de creatinina (r= 0,250; p= 0,007) e negativa com TFGe (r=-0,208; p=0,027). O fator Realiza??o apontou n?veis mais altos nos participantes com filhos (p=0,026) e sem uso de medica??es para depress?o (p=0,033), al?m de correla??o positiva com Reatividade contra painel de ant?genos HLA I (r=0,223; p=0,018). No fator Abertura a ?nica diferen?a estat?stica significativa identificada foi em rela??o ? escolaridade que apontou maiores m?dias nos investigados com Ensino Superior (p=0,037). Os resultados sugerem que as caracter?sticas de personalidade podem estar associadas aos resultados do transplante O acompanhamento destes pacientes durante um per?odo maior poder? levar a um melhor entendimento da rela??o entre fatores de personalidade e evolu??o cl?nica no per?odo p?s-transplante

Underlying Event measurements in pp collisions at s=0.9 \sqrt {s} = 0.9 and 7 TeV with the ALICE experiment at the LHC

We present measurements of Underlying Event observables in pp collisions at s√=0.9 and 7TeV. The analysis is performed as a function of the highest charged-particle transverse momentum p T,LT in the event. Different regions are defined with respect to the azimuthal direction of the leading (highest transverse momentum) track: Toward, Transverse and Away. The Toward and Away regions collect the fragmentation products of the hardest partonic interaction. The Transverse region is expected to be most sensitive to the Underlying Event activity. The study is performed with charged particles above three different p T thresholds: 0.15, 0.5 and 1.0 GeV/c. In the Transverse region we observe an increase in the multiplicity of a factor 2–3 between the lower and higher collision energies, depending on the track p T threshold considered. Data are compared to Pythia 6.4, Pythia 8.1 and Phojet. On average, all models considered underestimate the multiplicity and summed p T in the Transverse region by about 10–30%

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially