PERFORMANCE DISORDERS AND QUALITY OF LIFE OF ALBANIAN CHILDREN AND ADOLESCENTS WITH CHRONIC KIDNEY DISEASE

It has been noticed that the interest in the Quality of Life (QOL) of children and adolescent with chronic kidney disease (CKD) in Albania is increasing rapidly. Thus, the aim of this study is to investigate the prevalence of performance disorders and to evaluate the Health-Related QOL (HRQOL) in 130 patients with CKD. To appraise the prevalence of performance disorders and analyze HRQOL, we used the Strengths and Difficulties Questionnaire (SDQ) and Pediatric Inventory of Quality of Life (PedsQL) Core scales as the measuring instruments for both the children and their parents. The CKD group has lower results in nearly all areas of PedsQL. Only the lack of religion was related in a significant way with a lower global HRQOL result (OR= 5.8; P= 0.07). Furthermore, only two factors were related with a lower HRQOL result between the parents: children’s age >10 years (OR = 4.9, P=0.026) and the lack of religion (OR= 2.8, P= 0.025). The CKD group showed a higher ratio of performance and emotional disorders in all SDQ fields. Therefore, our results recommend the significance of assessing performance and social impacts of CKD in order to improve the life quality of this pediatric population

Relationship of Anthropometric Measures with Cardiovascular Risk Factors in Children and Adolescents

This national study was performed to establish the relationship of anthropometric measures with cardiovascular risk factors and metabolic syndrome (MetS) in Albanian normal-weight children and adolescents. We examined the data of 3,548 children and adolescents (48.2% boys), aged 11-18 years, with a normal BMI (5th-84th percentile) achieved from a survey of 'Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease'. The diagnostic criteria for MetS were classified by the International Diabetes Federation agreement. The prevalence of MetS for 10- to 13.5-year-old boys, 14- to 18-year-old boys, 10- to 13.7-year-old girls, and 14- to 18-year-old girls were 1.3, 2.4, 2.1, and 3.2%, correspondingly. After adjustment for age and sex, each item increase in BMI (within normal range) and waist circumference enhanced the odds of MetS from 5 to 68 % and from 1 to 18 %, respectively. The principal model of dyslipidemia between the participants was high triglycerides and low high-density lipoprotein cholesterol. This study sets off current research about the high frequency of metabolic risk factors among normal-weight individuals in the pediatric age group. DOI: 10.5901/ajis.2014.v3n4p14

Effects of Physical Therapy in Older Women with Urinary Incontinence

Introduction: One of the most frequent public health issues between older females is urinary incontinence (UI). Regardless of conventional cure as the initial alternative, the outcomes of physical therapy in older females with UI is imprecise. Objective This survey intended to analytically assess the confirmation about the consequences of physical therapy on urinary indicators in older females with UI. Method The literature exploration for surveys estimating traditional cure for incontinency in elderly females was performed on PubMed/Medline, Lilacs, Scielo, ISI Web of Knowledge. We picked medical tests published in English after the year 2003. The procedural quality of the surveys was appraised applying the Pedro degree. The effects were investigated using a significant assessment technique. Results: Eight surveys were entirely reviewed exposing that pelvic floor muscle exercise was the cure choice in most surveys. Seven of the eight chosen surveys were categorized as having elevated methodological excellence. There was considerable enhancement in urinary indicators after healing in seven of the eight selected surveys. Conclusions: It was finalized that physical therapy healing appears to be useful to reduce urinary incontinence signs in older females. Nevertheless, the tiny number of surveys and the use of concomitant interventions limit the ending on this matter. DOI: 10.5901/mjss.2015.v6n1s1p18

CHD1L: a new candidate gene for congenital anomalies of the kidneys and urinary tract (CAKUT)

Background. Recently, we identified a microduplication in chromosomal band 1q21.1 encompassing the CHD1L/ALC1 gene encoding a chromatin-remodelling enzyme in congenital anomalies of the kidneys and urinary tract (CAKUT) patient. Methods. To explore the role of CHD1L in CAKUT, we screened 85 CAKUT patients for mutations in the CHD1L gene and performed functional analyses of the three heterozygous missense variants detected. In addition, we quantitatively determined CHD1L expression in multiple human fetal and adult tissues and analysed expression of CHD1L protein in human embryonal, adult and hydronephrotic kidney sections. Results. Two of three novel heterozygous missense variants identified in three patients were not found in >400 control chromosomes. All variants lead to amino acid substitutions in or near the CHD1L macro domain, a poly-ADP-ribose (PAR)-binding module interacting with PAR polymerase 1 (PARP1), and showed decreased interaction with PARP1 by pull-down assay of transfected cell lysates. Quantitative messenger RNA analysis demonstrated high CHD1L expression in human fetal kidneys, and levels were four times higher than in adult kidneys. In the human embryo at 7-11 weeks gestation, CHD1L immunolocalized in the early ureteric bud and the S- and comma-shaped bodies, critical stages of kidney development. In normal postnatal sections, CHD1L was expressed in the cytoplasm of tubular cells in all tubule segments. CHD1L expression appeared higher in the hydronephrotic kidney of one patient with a hypofunctional CHD1L variant than in normal kidneys, recapitulating high fetal levels. Conclusion. Our data suggest that CHD1L plays a role in kidney development and may be a new candidate gene for CAKU

CHD1L: a new candidate gene for congenital anomalies of the kidneys and urinary tract (CAKUT)

Recently, we identified a microduplication in chromosomal band 1q21.1 encompassing the CHD1L/ALC1 gene encoding a chromatin-remodelling enzyme in congenital anomalies of the kidneys and urinary tract (CAKUT) patient

Disparities in treatment rates of paediatric end-stage renal disease across Europe: insights from the ESPN/ERA-EDTA registry.

BACKGROUND Considerable disparities exist in the provision of paediatric renal replacement therapy (RRT) across Europe. This study aims to determine whether these disparities arise from geographical differences in the occurrence of renal disease, or whether country-level access-to-care factors may be responsible. METHODS Incidence was defined as the number of new patients aged 0-14 years starting RRT per year, between 2007 and 2011, per million children (pmc), and was extracted from the ESPN/ERA-EDTA registry database for 35 European countries. Country-level indicators on macroeconomics, perinatal care and physical access to treatment were collected through an online survey and from the World Bank database. The estimated effect is presented per 1SD increase for each indicator. RESULTS The incidence of paediatric RRT in Europe was 5.4 cases pmc. Incidence decreased from Western to Eastern Europe (-1.91 pmc/1321 km, P < 0.0001), and increased from Southern to Northern Europe (0.93 pmc/838 km, P = 0.002). Regional differences in the occurrence of specific renal diseases were marginal. Higher RRT treatment rates were found in wealthier countries (2.47 pmc/€10 378 GDP per capita, P < 0.0001), among those that tend to spend more on healthcare (1.45 pmc/1.7% public health expenditure, P < 0.0001), and among countries where patients pay less out-of-pocket for healthcare (-1.29 pmc/11.7% out-of-pocket health expenditure, P < 0.0001). Country neonatal mortality was inversely related with incidence in the youngest patients (ages 0-4, -1.1 pmc/2.1 deaths per 1000 births, P = 0.10). Countries with a higher incidence had a lower average age at RRT start, which was fully explained by country GDP per capita. CONCLUSIONS Inequalities exist in the provision of paediatric RRT throughout Europe, most of which are explained by differences in country macroeconomics, which limit the provision of treatment particularly in the youngest patients. This poses a challenge for healthcare policy makers in their aim to ensure universal and equal access to high-quality healthcare services across Europe