Factors Affecting The Satisfaction Of Hemodialysis Patients From The Nursing Care Received

Introduction: In the field of hemodialysis care, the issue of patient satisfaction is of particular importance. These patients are users of health care, usually for a long time. Most of them are particularly sensitive to the attitude of the health care system towards them. This requires special attention, especially when it comes to their opinion about the quality of the service they receive.Objective: To study and analyze the factors influencing the satisfaction with the received nursing care in patients on hemodialysis treatment.Material and methods: Documentary, sociological and statistical methods were used in the study. An anonymous survey surveyed the opinion of 575 patients on hemodialysis treatment in dialysis structures located in 8 cities (Varna, Ruse, Dobrich, Burgas, Shumen, Razgrad, Targovishte and Silistra). The data was processed using SPSS Statistics.Results: Examining patient satisfaction as users of hemodialysis nurses, we found that almost all were satisfied (90%). 8.52% of the respondents cannot assess their degree of satisfaction, and 1.74% of the respondents are completely dissatisfied. It is noteworthy that those who expressed dissatisfaction with nursing care are only males. As the age of the patients increases, so does the satisfaction with the care provided by the dialysis nurse. As the time spent on hemodialysis treatment increases, so does the satisfaction of patients with the nursing care provided. Patients with lower levels of satisfaction are more adamant that the nurse can contribute to the quality of dialysis care.Conclusions: Patients on hemocial treatment were satisfied with the care they received during treatment (p<0.001). Among the factors influencing their satisfaction are: gender (p <0.05), age (p<0.001), duration of hemodialysis treatment (p<0.05). Our study found that patients who felt that the nurse could influence the quality of care provided had a lower level of satisfaction

Vector Lyapunov functions for practical stability of nonlinear impulsive functional differential equations

AbstractThis paper studies the practical stability of the solutions of nonlinear impulsive functional differential equations. The obtained results are based on the method of vector Lyapunov functions and on differential inequalities for piecewise continuous functions. Examples are given to illustrate our results

Stability criteria for impulsive Kolmogorov-type systems of nonautonomous differential equations

In this paper we consider a class of impulsive Kolmogorov- type systems. The problems of uniform stability and uniform asymptotic stability of the solutions are studied. We establish stability criteria by employing piecewise continuous Lyapunov functions. Examples are given to demonstrate the effectiveness of the obtained results. We show, also, that the role of impulses in changing the behavior of impulsive models is very important

Percutaneous Endoscopic Gastrostomy: Indications, Technique, and Care

Percutaneous endoscopic gastrostomy (PEG) is a valuable tool and preferred diet in patients with functional disorders of the gastrointestinal tract who need long-term enteral nutrition. Although it was originally described in children in 1980, it is now used with great success in many adult patients who need long-term enteral nutrition. Given that today the placement of PEG is one of the most common endoscopic procedures performed worldwide, knowledge of its indications and contraindications is of paramount importance in modern medicine. This review highlights the current indications, contraindications, and complications of percutaneous endoscopic gastrostomy and the necessary knowledge and skills to care for patients with gastrostomy

Atypical miRNA expression in temporal cortex associated with dysregulation of immune, cell cycle, and other pathways in autism spectrum disorders.

BackgroundAutism spectrum disorders (ASDs) likely involve dysregulation of multiple genes related to brain function and development. Abnormalities in individual regulatory small non-coding RNA (sncRNA), including microRNA (miRNA), could have profound effects upon multiple functional pathways. We assessed whether a brain region associated with core social impairments in ASD, the superior temporal sulcus (STS), would evidence greater transcriptional dysregulation of sncRNA than adjacent, yet functionally distinct, primary auditory cortex (PAC).MethodsWe measured sncRNA expression levels in 34 samples of postmortem brain from STS and PAC to find differentially expressed sncRNA in ASD compared with control cases. For differentially expressed miRNA, we further analyzed their predicted mRNA targets and carried out functional over-representation analysis of KEGG pathways to examine their functional significance and to compare our findings to reported alterations in ASD gene expression.ResultsTwo mature miRNAs (miR-4753-5p and miR-1) were differentially expressed in ASD relative to control in STS and four (miR-664-3p, miR-4709-3p, miR-4742-3p, and miR-297) in PAC. In both regions, miRNA were functionally related to various nervous system, cell cycle, and canonical signaling pathways, including PI3K-Akt signaling, previously implicated in ASD. Immune pathways were only disrupted in STS. snoRNA and pre-miRNA were also differentially expressed in ASD brain.ConclusionsAlterations in sncRNA may underlie dysregulation of molecular pathways implicated in autism. sncRNA transcriptional abnormalities in ASD were apparent in STS and in PAC, a brain region not directly associated with core behavioral impairments. Disruption of miRNA in immune pathways, frequently implicated in ASD, was unique to STS

Gram-negative bacterial molecules associate with Alzheimer disease pathology.

ObjectiveWe determined whether Gram-negative bacterial molecules are associated with Alzheimer disease (AD) neuropathology given that previous studies demonstrate Gram-negative Escherichia coli bacteria can form extracellular amyloid and Gram-negative bacteria have been reported as the predominant bacteria found in normal human brains.MethodsBrain samples from gray and white matter were studied from patients with AD (n = 24) and age-matched controls (n = 18). Lipopolysaccharide (LPS) and E coli K99 pili protein were evaluated by Western blots and immunocytochemistry. Human brain samples were assessed for E coli DNA followed by DNA sequencing.ResultsLPS and E coli K99 were detected immunocytochemically in brain parenchyma and vessels in all AD and control brains. K99 levels measured using Western blots were greater in AD compared to control brains (p &lt; 0.01) and K99 was localized to neuron-like cells in AD but not control brains. LPS levels were also greater in AD compared to control brain. LPS colocalized with Aβ1-40/42 in amyloid plaques and with Aβ1-40/42 around vessels in AD brains. DNA sequencing confirmed E coli DNA in human control and AD brains.ConclusionsE coli K99 and LPS levels were greater in AD compared to control brains. LPS colocalized with Aβ1-40/42 in amyloid plaques and around vessels in AD brain. The data show that Gram-negative bacterial molecules are associated with AD neuropathology. They are consistent with our LPS-ischemia-hypoxia rat model that produces myelin aggregates that colocalize with Aβ and resemble amyloid-like plaques

microRNA expression in peripheral blood cells following acute ischemic stroke and their predicted gene targets.

BackgroundmicroRNA (miRNA) are important regulators of gene expression. In patients with ischemic stroke we have previously shown that differences in immune cell gene expression are present. In this study we sought to determine the miRNA that are differentially expressed in peripheral blood cells of patients with acute ischemic stroke and thus may regulate immune cell gene expression.MethodsmiRNA from peripheral blood cells of forty-eight patients with ischemic stroke and vascular risk factor controls were compared. Differentially expressed miRNA in patients with ischemic stroke were determined by microarray with qRT-PCR confirmation. The gene targets and pathways associated with ischemic stroke that may be regulated by the identified miRNA were characterized.ResultsIn patients with acute ischemic stroke, miR-122, miR-148a, let-7i, miR-19a, miR-320d, miR-4429 were decreased and miR-363, miR-487b were increased compared to vascular risk factor controls. These miRNA are predicted to regulate several genes in pathways previously identified by gene expression analyses, including toll-like receptor signaling, NF-κβ signaling, leukocyte extravasation signaling, and the prothrombin activation pathway.ConclusionsSeveral miRNA are differentially expressed in blood cells of patients with acute ischemic stroke. These miRNA may regulate leukocyte gene expression in ischemic stroke including pathways involved in immune activation, leukocyte extravasation and thrombosis

Lipschitz quasistability of impulsive differential-difference equations with variable impulsive perturbations

AbstractIn the present paper, by means of a suitable comparison lemma sufficient conditions for uniform Lipschitz stability of an arbitrary solution of an impulsive system of differential-difference equations with variable impulsive perturbations are obtained