10 research outputs found
Heme oxygenase-1 repeat polymorphism in septic acute kidney injury
Acute kidney injury (AKI) is a syndrome that frequently affects the critically ill. Recently, an increased number of dinucleotide repeats in the HMOX1 gene were reported to associate with development of AKI in cardiac surgery. We aimed to test the replicability of this finding in a Finnish cohort of critically ill septic patients. This multicenter study was part of the national FINNAKI study. We genotyped 300 patients with severe AKI (KDIGO 2 or 3) and 353 controls without AKI (KDIGO 0) for the guanine-thymine (GTn) repeat in the promoter region of the HMOX1 gene. The allele calling was based on the number of repeats, the cut off being 27 repeats in the S-L (short to long) classification, and 27 and 34 repeats for the S-M-L2 (short to medium to very long) classification. The plasma concentrations of heme oxygenase-1 (HO-1) enzyme were measured on admission. The allele distribution in our patients was similar to that published previously, with peaks at 23 and 30 repeats. The S-allele increases AKI risk. An adjusted OR was 1.30 for each S-allele in an additive genetic model (95% CI 1.01-1.66; p = 0.041). Alleles with a repeat number greater than 34 were significantly associated with lower HO-1 concentration (p<0.001). In septic patients, we report an association between a short repeat in HMOX1 and AKI risk
ToimintakyvystÀ toimijuuteen : Tavoitteena ympÀrivuorokautisessa hoivassa elÀvien ikÀÀntyneiden hyvÀ elÀmÀnlaatu
TiivistelmÀ
OpinnÀytetyö tarkastelee ympÀrivuorokautisessa hoivassa asuvien asiakkaiden elÀmÀnlaatua
ja heidÀn toimijuutensa toteutumista arjessa. Tavoitteena oli selvittÀÀ iÀkkÀÀn omaa
kokemusta arjen tekemisen riittÀvyydestÀ ja subjektiivista kokemusta hoitohenkilöstön ymmÀrrystÀ
heidÀn tarpeistaan.
Tuomme esiin nÀkökulmia, kuinka kuntoutuksen ohjauksella tuetaan toimijuutta, keskiössÀ
ovat iÀkkÀÀn omat voimavarat. Tutkimus on kvantitatiivinen ja se on tehty Care kays mittaristolla
tehdyllĂ€ post-doc âtutkimuksen aineistosta. KysymyksistĂ€ muodostuu neljĂ€ ulottuvuutta,
jotka mittaavat elÀmÀnlaadun fyysistÀ, psyykkistÀ, sosiaalista ja ympÀristöulottuvuutta.
Lomakkeen 51 kysymyksen tuloksena syntyy elÀmÀnlaadun profiili. LisÀksi jokaiselta
osa -alueelta voi laskea erilliset pisteet, jolloin muodostuu kuva henkilön kokemasta elÀmÀnlaadusta
kullakin ulottuvuudella. ElÀmÀn-laatupisteet saadaan laskemalla vastausten
antamat pisteet yhteen.
Tulosten perusteella haastateltujen vanhusten koettu elÀmÀnlaatu voidaan todeta kohtuulliseksi.
Toimintakyky ja sen kÀyttömahdollisuudet ovat yhteydessÀ vanhuksen kokemaan elÀmÀnlaatuun. ElÀmÀnlaatua tuotti riittÀvÀ tekeminen arjessa. Vanhan ihmisen toimijuus
tarvitsee tukea toimiakseen hyvin. Toimijuus ei pÀÀse toteutumaan, jos aika kÀytetÀÀn vain vÀlttÀmÀttömien hoitotoimenpiteiden suorittamiseen vaan tulee ottaa huomioon vanhuksen kyky ja halu pÀivittÀisiin toimiin.
OpinnÀytetyössÀ pohdimme myös uudenlaista kuntoutuksen ohjaajan roolia vanhusten ympÀrivuorokautisessa hoivassa. Toimijuuden tukemiseksi tarvitaan aktiivista panostusta
vanhuksen voimavarojen kartoitukseen sekÀ keskittymistÀ ja seurantaa aktuaalisen toimintakyvyn toteutumiseen. Tuommekin esille mahdollisuuksia asiakkaan toimijuuden tukemiseen
ympÀrivuorokautisen hoivan palveluissa.This thesis examined the quality of life of clients in round-the-clock assisted living and the
implementation of their human agency in everyday life. The aim was to study elderly individualsâ
personal experiences of the adequacy of their everyday activities as well as their
subjective perceptions of the care personnelâs understanding of their needs.
The thesis present perspectives on how rehabilitation guidance can support human agency
by focusing on the elderly peopleâs personal resources. The study was conducted with a
quantitative approach based on the research data a post-doctoral study in which the Care
Keys scorecard was used. The issues constitute four dimensions that measure the quality of
life: physical, psychological, social and environmental dimensions. The result of the formâs
51 questions is a quality-of-life profile. In addition, in each of these areas it is possible to
count separate scores so as to form a picture of the subjectsâ personal experiences of their
quality of life in each dimension. The quality of life score is calculated by adding together the
scores of the responses.
According to the results, the interviewed elderly personsâ perceived quality of life could be
considered reasonable. The respondentsâ functional capacity and the possibilities of its use
correlated with their perception of the quality of their life. The quality of life was a result of a
sufficient number of meaningful activities in everyday life. Aging individualsâ human agency
needs support in order to function well. Human agency cannot be implemented if the time is
used only for carrying out the necessary care procedures. Elderly personsâ ability and willingness
to participate in daily activities should also be taken into account.
In this thesis discusses a new kind of rehabilitation counselor role in the assisted living for
the elderly. The support of human agency needs an active investment in the charting of
elderly peopleâs resources as well as the monitoring of and concentration on the realization
of an actual functional capacity in elderly individuals. This thesis highlights the opportunities
for supporting elderly individualsâ human agency in assisted care services
Ennen leikkausta annettavilla ketoprofeenilla ja deksametasonilla ei ole vaikutusta laparoskooppisen sterilisaation jÀlkeiseen kipuun.
SyventÀvÀ työ ei kirjastoss
Ennen leikkausta annettavilla ketoprofeenilla ja deksametasonilla ei ole vaikutusta laparoskooppisen sterilisaation jÀlkeiseen kipuun.
SyventÀvÀ työ ei kirjastoss
Tiikerin tahtiin. : Liikunnallinen leiri 7-9-vuotiaille lapsille, joilla on motorista kehitysviivettÀ
OpinnĂ€ytetyö on toiminnallinen kehittĂ€mistyö, jonka tarkoituksena oli tuottaa malli liikunnallisesta leiristĂ€ 7â9-vuotiaille lapsille, joilla on motorista kehitysviivettĂ€. Leirin tavoitteena oli antaa lapsille innostavia kokemuksia liikunnasta sekĂ€ kehittÀÀ heidĂ€n motorisia ja sosiaalisia taitojaan. Tiikerin tahtiin -leiri jĂ€rjestettiin syyslomalla 2011 pĂ€ivĂ€leirinĂ€, jonka kesto oli kolme pĂ€ivÀÀ. Työn toimeksiantajana on Kuopion kaupunki, jolle leirimalli tuotettiin.
OpinnĂ€ytetyössĂ€ kuvataan 7â9-vuotiaiden lasten motorista kehitystĂ€, lapsen liikkumisen kehittymistĂ€, motorisia kehityshĂ€iriöitĂ€ ja lasten erityisryhmien ohjaamista. LisĂ€ksi opinnĂ€ytetyön teoriaosuus sisĂ€ltÀÀ leirin suunnittelun, toteuttamisen ja arvioinnin. OpinnĂ€ytetyön lĂ€hteinĂ€ on kĂ€ytetty useiden eri alojen ammattikirjallisuutta, pro gradu -tutkimuksia sekĂ€ kansainvĂ€lisiĂ€ tutkimuksia. LeiriltĂ€ saatuja kokemuksia tulkitaan ja arvioidaan tutkimus- ja muun teoriatiedon avulla.
Leiriohjelman malli on erityislasten ryhmille rakennettu kokonaisuus, jota voidaan kÀyttÀÀ joko sellaisenaan tai osina. Leiriohjelma sisÀltÀÀ pelejÀ ja leikkejÀ, jotka kehittÀvÀt lasten sosiaalisia ja motorisia taitoja. Motoriset taidot kÀsittÀvÀt keskilinjan ylittÀmisen, tasapainon, rytmiikan, kehonhahmotuksen, koordinaation sekÀ silmÀ-kÀsi ja silmÀ-jalkayhteistyön. Leirin onnistumista on arvioitu ohjaajien kokemusten sekÀ lasten ja heidÀn vanhempiensa palautteen pohjalta. Arvioinnissa on hyödynnetty leirillÀ kuvattua videomateriaalia, lasten suullista palautetta ja vanhempien sÀhköpostikyselyiden vastauksia.
Myös erityislapset kaipaavat virikkeellistÀ ympÀristöÀ perusliikkumis- ja lajitaitojen kehittymiseksi. RyhmÀmuotoinen toiminta kehittÀÀ lisÀksi heidÀn sosiaalisia taitojaan ja luo edellytyksiÀ kaveritaitojen syntymiselle. LeiristÀ saadun positiivisen palautteen ja kokemuksen perusteella leirin mallia voi suositella hyödynnettÀvÀksi myös laajemmin erityislasten ryhmillÀ.This thesis is a functional development, the purpose of which was to produce a model of a physical exercise camp for children aged 7 to 9 with motor development delay. The aim of the camp was to give children positive and exciting experiences of exercise, as well as to develop their motor and
social skills. Tiikerin tahtiin -camp was held in September 2011 on holiday and it was held as a course which lasted three days. The model of the camp was produced for the City of Kuopio, which is the orderer of this thesis.
This thesis describes the 7-9 year old childrenÂŽs motor development, childrenÂŽs movement development, motor developmental disorders and children's special needs guidance. In addition, the thesis contains a theory of contemplation, implementation and evaluation of the camp. The sources of this thesis have been gathered from various sectors of professional literature, master's studies, and international studies. In the thesis theory and the results of researches are compared to the practical experience we got from the camp.
The model of the camp is constructed for the groups of children with learning disabilities and the model may be used either as such or in part. The camp program includes games that develop children's social and motor skills. Motor skills include mid-line crossing, balance, rhythm, body awareness,
coordination, and eye-hand and eye-foot co-operation. The succeeding of the camp has been assessed as based of our own experience and feedback given by children and their parents.
In the assessment of the camp the video material of the camp, children's verbal feedback and answers to parents' e-mail queries have been benefitted.
Also, children with learning disabilities need stimulating environment for developing the basic movement and type of skills. In addition, the group-scale operating develops their social skills and creates the conditions for the emergence of mate skills. The model of the camp can be also used, by the base of received positive feedback and of our own experience, in the wider range of groups of children with learning disabilities
Long-term safety of pirfenidone: results of the prospective, observational PASSPORT study
Real-world studies include a broader patient population for a longer duration than randomised controlled trials (RCTs) and can provide relevant insights for clinical practice. PASSPORT was a multicentre, prospective, post-authorisation study of patients who were newly prescribed pirfenidone and followed for 2â
years after initiating treatment. Physicians collected data on adverse drug reactions (ADRs), serious ADRs (SADRs) and ADRs of special interest (ADRSI) at baseline and then every 3â
months. Post hoc stepwise logistic regression models were used to identify baseline characteristics associated with discontinuing treatment due to an ADR. Patients (n=1009, 99.7% with idiopathic pulmonary fibrosis) had a median pirfenidone exposure of 442.0â
days. Overall, 741 (73.4%) patients experienced ADRs, most commonly nausea (20.6%) and fatigue (18.5%). ADRs led to treatment discontinuation in 290 (28.7%) patients after a median of 99.5â
days. Overall, 55 (5.5%) patients experienced SADRs, with a fatal outcome in six patients. ADRSI were reported in 693 patients, most commonly gastrointestinal symptoms (38.3%) and photosensitivity reactions/skin rashes (29.0%). Older age and female sex were associated with early treatment discontinuation due to an ADR. Findings were consistent with the known safety profile of pirfenidone, based on RCT data and other post-marketing experience, with no new safety signals observed
Heme oxygenase-1 repeat polymorphism in septic acute kidney injury
Abstract
Acute kidney injury (AKI) is a syndrome that frequently affects the critically ill. Recently, an increased number of dinucleotide repeats in the HMOX1 gene were reported to associate with development of AKI in cardiac surgery. We aimed to test the replicability of this finding in a Finnish cohort of critically ill septic patients. This multicenter study was part of the national FINNAKI study. We genotyped 300 patients with severe AKI (KDIGO 2 or 3) and 353 controls without AKI (KDIGO 0) for the guanineâthymine (GTn) repeat in the promoter region of the HMOX1 gene. The allele calling was based on the number of repeats, the cut off being 27 repeats in the SâL (short to long) classification, and 27 and 34 repeats for the SâMâLâ (short to medium to very long) classification. The plasma concentrations of heme oxygenase-1 (HO-1) enzyme were measured on admission. The allele distribution in our patients was similar to that published previously, with peaks at 23 and 30 repeats. The S-allele increases AKI risk. An adjusted OR was 1.30 for each S-allele in an additive genetic model (95% CI 1.01â1.66; p = 0.041). Alleles with a repeat number greater than 34 were significantly associated with lower HO-1 concentration (p<0.001). In septic patients, we report an association between a short repeat in HMOX1 and AKI risk