Three-year health-related quality-of-life outcomes for sirolimus-treated kidney transplant patients after elimination of cyclosporine

The definitive version can be found at www.blackwell-synergy.comThis study compared 3-year health-related quality-of-life (HRQL) outcomes of sirolimus (SRL)-treated kidney transplant patients after elimination of cyclosporine (CsA) with patients continuing on a combined CsA and SRL regimen. A randomized, multi-country, open-label, clinical trial was performed. 430 kidney transplant patients were randomly assigned to SRL+corticosteroids (ST) (n = 215) or SRL+CsA+ST (n = 215) therapy after an initial 3-month period of combined SRL+CsA+ST treatment. HRQL was measured using the Kidney Transplant Questionnaire (KTQ) and the SF-36 Health Survey at month 3 (time of randomization) and months 12, 24, and 36 post-transplantation. Mixed-model ancova was used to evaluate treatment differences in HRQL outcomes. HRQL scores were available for 361 (86.4%) eligible study patients. Significant treatment-by-assessment time interactions, favoring SRL+ST, were found on KTQ fatigue (P = 0.0005), emotions (P = 0.028), and appearance scores (P = 0.006). Statistically significant treatment-by-assessment time interactions were observed for SF-36 vitality (P = 0.0001), general health (P = 0.011), social function (P = 0.020), and role-physical scores (P = 0.049). Vitality scores improved in the SRL+ST group (mean 3.5-point change) over 36 months, compared with decreases in the SRL+CsA+ST group (mean –3.2-point change). SRL-based therapy with early CsA-elimination results in fewer appearance-related problems, less fatigue, greater vitality, and improved general health status and social functioning compared with continuous SRL+CsA+ST treatment.Graeme Russ, Neville Jamieson, Rainer Oberbauer, Manuel Arias, Maria G. Murgia, Gilles Blancho, Reiko Sato, Maria Stoeckl, Dennis A. Revick

Gender differences in fundamental motor skill development in disadvantaged preschoolers from two geographical regions

This study examined the influence of gender and region on object control (OC) and locomotor skill development. Participants were 275 midwestern African American and 194 southwestern Hispanic preschool children who were disadvantaged. All were evaluated on the Test of Gross MotorDevelopment-2 (Ulrich, 2000). Two, 2 Gender (girls, boys) x 2 Region (midwest, southwest) analyses of variance were conducted on OC and locomotor percentile rank. Both midwestern and southwestern preschoolers were developmentally delayed in locomotor and OC skills (< 30th percentile). There was a significant difference for gender (p < .0001) and Gender x Region interaction (p = .02) for OC skills. Boys outperformed girls in the midwestern and southwestern regions. For locomotor skills, there was a significant difference for region (p < .001), with midwestern preschoolers having better locomotor skills