scholarly journals Renal Health: Providing Information and Technological Tools to Empower Patients to Live Better with Kidney Disease

2021 ◽  
Author(s):  
Geraldo Bezerra da Silva Junior ◽  
Juliana Gomes Ramalho de Oliveira ◽  
Erica Maria Rodrigues de Araújo ◽  
Ana Carolina Rattacaso Marino de Mattos Albuquerque ◽  
Fabio Augusto Xerex Mota ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Weight Control ◽  
Patient Empowerment ◽  
Vital Signs ◽  
Public Health Problem ◽  
Treatment Modalities ◽  
Water Ingestion ◽  
Technological Tools ◽  
Virtual Stores ◽  
The University

Chronic kidney disease (CKD) is a growing Public Health problem. Recent evidence points that low education and poor socio-economic conditions are associated with higher risk of developing CKD and progressing to dialysis or transplantation need. Hence patient empowerment through health education and qualification with technological tools that allows better treatment adherence may play an important role in the achievement of optimal clinical outcomes. The Renal Health is a multidisciplinary project created at the University of Fortaleza, northeast Brazil, in 2015, aiming to create novel educational material and technological tools for people with CKD, in different treatment modalities, including dialysis and transplant. The products developed so far in the project include an application for smartphones aiming to help patients in dialysis and transplant in their treatments, including schedule for medications, with alarms, water ingestion control, laboratory tests results, and medical appointments’ agenda, besides all information regarding CKD. The other tools include a medication box, an insole for weight control (both are in the prototype phase), connection with smartbands (for vital signs monitoring) and multimedia educational tools, including a profile in the Instagram and a channel in YouTube. Since the first release of the application in the virtual stores, there were more than 1,000 downloads, predominantly in Brazil, although the app is also available in English and Spanish. All these tools represent innovative ways of patient empowerment and may be increasingly present in daily life. Further studies are required to assess the impact of these tools in patients’ outcomes, including CKD progression and mortality.

scholarly journals Chronic Kidney Disease: Implications for Progression Using Telehealth Monitoring

2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Abeera Mansur
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medical Condition ◽  
Vital Signs ◽  
Public Health Problem ◽  
Management Approach ◽  
Study Group ◽  
Multiple Parameters ◽  
Ckd Stage ◽  
Common Medical Condition

Background: Chronic Kidney Disease (CKD) is a complex and common medical condition requiring a multidisciplinary management approach, including control of multiple parameters to delay progression of the disease. Telehealth has been used for monitoring chronic conditions and can be used for managing chronic kidney disease. Materials and Methods: Patients (N = 34) with CKD Stage II-V were studied for four months. Vital signs, weight, intake and output, blood glucose level, oxygen saturation, and edema were checked twice weekly by trained nurses, transmitted via WhatsApp, and incorporated into the electronic medical records of the patients. Monthly serum creatinine, hemoglobin, and electrolytes were obtained and reviewed by a nephrologist. Necessary intervention was conveyed to the patients. Results: Patient satisfaction rate with telehealth management was high. Measured parameters were maintained in the recommended range in a higher percentage of the study group compared to the controls. Glomerular filtration rate was maintained in a significantly more patient in the study group (p<0.001). Conclusions: Telehealth monitoring of patients with CKD (tele-nephrology) is a viable and effective option for management of this increasingly prevalent disease. Chronic kidney disease (CKD) is a worldwide public health problem with increasing severity in renal dysfunction extending to dialysis.

scholarly journals Assessment of Ambivalent Sexism in University Students in Colombia and Spain: A Comparative Analysis

2021 ◽  
Vol 18 (3) ◽  
pp. 1009
Author(s):  
Aura Yolima Rodríguez-Burbano ◽  
Isabel Cepeda ◽  
Ana Magdalena Vargas-Martínez ◽  
Rocío De-Diego-Cordero
Keyword(s):  
University Students ◽  
Essential Element ◽  
Public Health Problem ◽  
Sociodemographic Factors ◽  
Ambivalent Sexism ◽  
Gender Violence ◽  
Legal Responsibility ◽  
Social Boundaries ◽  
Gender Based Violence ◽  
The University

(1) Background: Gender-based violence has no geographical, personal, or social boundaries. It constitutes a serious public health problem that affects the entire society. This research aims to identify and compare the level of ambivalent sexism in Spanish and Colombian university students and its relationship with sociodemographic factors. Ambivalent sexism, developed by Glick and Fiske (1996), is considered a new type of sexism since, for the first time, it combines negative and positive feelings that give rise to hostile and benevolent sexism, maintaining the subordination of women through punishment and rewards. (2) Methods: The methodology consisted of the application of the validated Spanish version of the Ambivalent Sexism Inventory (ASI) to a sample of 374 students in their final academic year of the Law program, of which 21.7% were students at the University of Santander (Bucaramanga, Colombia), 45.5% at the University Rey Juan Carlos (Madrid, Spain), and the remaining 32.9% at the University of Seville (Seville, Spain). (3) Results: A high level of ambivalent sexism is reported in Colombian students nowadays. In the two countries. there are similarities (e.g., the great weight of religion and the variation in attitudes towards sexism in people who identify themselves as women, compared to male or students consulted that prefer not to answer) and differences (e.g., absence in Colombia of gender-specific legislation, low number of students who have received gender education in Spain). (4) Conclusions: These findings may contribute to the construction of laws that take into account the particular problems of women and the development of educational programs on gender that are offered in a transversal and permanent way and that take into account cultural factors and equity between men and women as an essential element in the training of future judges who have the legal responsibility to protect those who report gender violence.

scholarly journals Human Chorionic Gonadotrophin (hCG) Trigger-Mediated Ovulation Induction in Infertility Management in South Indian Women Undergoing IVF/ICSI Regimens: A Pilot Sexual Medicine Study with Public Health Perspective

2021 ◽  
Vol 3 (1) ◽  
pp. 57-64
Author(s):  
Saumya Pandey
Keyword(s):  
Public Health ◽  
Tamil Nadu ◽  
Endometrial Thickness ◽  
Cardiac Activity ◽  
Public Health Problem ◽  
Predictive Biomarkers ◽  
Clinical Pregnancy ◽  
Treatment Modalities ◽  
Infertile Women ◽  
South Indian

Introduction: Infertility is a global public health problem; cost-effective patient-friendly treatment modalities along with psychosexual intervention strategies are essential for infertility control/prevention/management among ethnically disparate populations. Objectives: This study aimed to assess differential in vitro fertilization (IVF) success trends among infertile women of South Indian ethnicity. Materials and Methods: Prospective, observational study designed in a hospital-based setting with active enrollment of infertile women undergoing IVF/intracytoplasmic sperm injection (ICSI) at Indira IVF Center, Chennai, Tamil Nadu, India (April-September 2019); inclusion criteria: age >35 years, South Indian ethnicity, married >1 year, absence of full-term clinical pregnancy, endometrial thickness <6 mm/thin endometrium; exclusion criteria: prior ≥2 IVF failures, fibroids/adenomyosis/cervical cancer/endometriosis. IVF success was determined by evaluating total frozen embryos transferred/month, average oocyte yield/donor, oocyte quality, M-II oocytes, biochemical/clinical pregnancy (beta-human chorionic gonadotropin positivity/fetal cardiac activity). Mycobacterium tuberculosis positivity was assessed by GeneXpert polymerase chain reaction-based technology, and psychosexual intervention-incorporated marital relationship counseling sessions/therapy, referrals for psychiatric assessments (cognitive impairment/schizophrenia/depression). Written informed consent of participants was taken and study was approved by Institutional Review Board. Results: Mean age and endometrial thickness of study participants were 33.3 years (SD ±1.9) and 8.7 mm (SD ±0.5), respectively; average Body Mass Index (BMI) and anti-müllerian hormone (AMH) levels were 28.4 kg/m2 and 4.7 ng/mL, respectively. Embryos transferred/month: 7 in April/13 in May/24 in June/36 in July/24 in August/30 in September, and pregnancies: 4/8/17/26/20/22 for the months of April, May, June, July, August, and September 2019, respectively. Subgroup stratification demonstrated M-II vs total oocytes retrieved were 76%, 73%, 60%, 71%, 77%, and 77%. Overall IVF success rates were 57% in April/62% in May/71% in June/72% in July/83% in August/73% in September; frozen embryo transfer success was 0 in April-May/67% in June/73% in July/89% in August/100% in September 2019. English/Tamil-speaking infertile women self-reported treatment-related satisfaction rates of 80% to 100%. Conclusion: M-II oocytes’ yield, sociodemographics of infertile women, and increasing age/aberrant AMH/BMI profiles/endometrial receptivity/diminished ovarian reserve are promising predictors of IVF/ICSI success in genetically distinct patient population subset(s). Future multicentric gene epidemiology studies with larger sample size and precision-based psychiatric assessments/interventions are warranted for development of predictive biomarkers in infertility management.

scholarly journals A Systematic Review and Meta-Analysis of Pharmacogenetic Studies in Patients with Chronic Kidney Disease

2021 ◽  
Vol 22 (9) ◽  
pp. 4480
Author(s):  
Maria Tziastoudi ◽  
Georgios Pissas ◽  
Georgios Raptis ◽  
Christos Cholevas ◽  
Theodoros Eleftheriadis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Response To Treatment ◽  
Genotype Distribution ◽  
Global Public Health ◽  
High Prevalence ◽  
Additive Inheritance

Chronic kidney disease (CKD) is an important global public health problem due to its high prevalence and morbidity. Although the treatment of nephrology patients has changed considerably, ineffectiveness and side effects of medications represent a major issue. In an effort to elucidate the contribution of genetic variants located in several genes in the response to treatment of patients with CKD, we performed a systematic review and meta-analysis of all available pharmacogenetics studies. The association between genotype distribution and response to medication was examined using the dominant, recessive, and additive inheritance models. Subgroup analysis based on ethnicity was also performed. In total, 29 studies were included in the meta-analysis, which examined the association of 11 genes (16 polymorphisms) with the response to treatment regarding CKD. Among the 29 studies, 18 studies included patients with renal transplantation, 8 involved patients with nephrotic syndrome, and 3 studies included patients with lupus nephritis. The present meta-analysis provides strong evidence for the contribution of variants harbored in the ABCB1, IL-10, ITPA, MIF, and TNF genes that creates some genetic predisposition that reduces effectiveness or is associated with adverse events of medications used in CKD.

Tubular cell-enriched subpopulation of primary renal cells improves survival and augments kidney function in rodent model of chronic kidney disease

2010 ◽  
Vol 299 (5) ◽  
pp. F1026-F1039 ◽  
Author(s):  
Rusty Kelley ◽  
Eric S. Werdin ◽  
Andrew T. Bruce ◽  
Sumana Choudhury ◽  
Shay M. Wallace ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Transforming Growth Factor ◽  
Kidney Tissue ◽  
Tubular Cell ◽  
Acute Injury ◽  
Treatment Modalities ◽  
Histological Evaluation ◽  
Renal Cells

Established chronic kidney disease (CKD) may be identified by severely impaired renal filtration that ultimately leads to the need for dialysis or kidney transplant. Dialysis addresses only some of the sequelae of CKD, and a significant gap persists between patients needing transplant and available organs, providing impetus for development of new CKD treatment modalities. Some postulate that CKD develops from a progressive imbalance between tissue damage and the kidney's intrinsic repair and regeneration processes. In this study we evaluated the effect of kidney cells, delivered orthotopically by intraparenchymal injection to rodents 4–7 wk after CKD was established by two-step 5/6 renal mass reduction (NX), on the regeneration of kidney function and architecture as assessed by physiological, tissue, and molecular markers. A proof of concept for the model, cell delivery, and systemic effect was demonstrated with a heterogeneous population of renal cells (UNFX) that contained cells from all major compartments of the kidney. Tubular cells are known contributors to kidney regeneration in situ following acute injury. Initially tested as a control, a tubular cell-enriched subpopulation of UNFX (B2) surprisingly outperformed UNFX. Two independent studies (3 and 6 mo in duration) with B2 confirmed that B2 significantly extended survival and improved renal filtration (serum creatinine and blood urea nitrogen). The specificity of B2 effects was verified by direct comparison to cell-free vehicle controls and an equivalent dose of non-B2 cells. Quantitative histological evaluation of kidneys at 6 mo after treatment confirmed that B2 treatment reduced severity of kidney tissue pathology. Treatment-associated reduction of transforming growth factor (TGF)-β1, plasminogen activator inhibitor (PAI)-1, and fibronectin (FN) provided evidence that B2 cells attenuated canonical pathways of profibrotic extracellular matrix production.

scholarly journals FC 054FUNCTIONAL SODIUM MAGNETIC RESONANCE IMAGING OF THE HUMAN KIDNEY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Sandrine Lemoine ◽  
Alireza Akbari ◽  
Taylor Marcus ◽  
Christopher McIntyre
Keyword(s):  
Kidney Disease ◽  
Human Kidney ◽  
Surface Coil ◽  
Urine Concentration ◽  
Tubular Dysfunction ◽  
Healthy Controls ◽  
Water Load ◽  
Spot Urine ◽  
Water Ingestion ◽  
Spot Urine Sample

Abstract Background and Aims Maintenance of a cortico-medullary concentration gradient (CMG) required for urine concentration, is one of most important tubular function. However, we are lacking of functional tubular parameters to explore this function. The only tool available to assess it currently, is urinary osmolarity that is an indirect and nonspecific maker of CMG. In this study, we explore the ability of 23NaMRI in measuring 1) the dynamics of CMG for the first time compared to urinary osmolarity after a water load 2) the CMG in kidney disease. Method We conducted an exploratory pilot study for 10 healthy controls with water load then 5 cardiorenal patients with kidney disease. 1) Healthy controls were asked to be fasting since midnight. Urines sample were collected to measure fasting osmolarity and a first MRIscan were performed to acquire baseline anatomical and sodium images. Once the baseline was completed, healthy participants were asked to ingest water (15 mL/kg) within 15 minutes. Four subsequent sodium pictures were acquired an hour after water ingestion. Urine samples were obtained after each sodium acquisition every 15 min during one hours. 2) Cardiorenal patients underwent an MRI scan, provided a spot urine sample and have blood work collected. All MR experiments were carried out on a GE MR750 3T (GE Healthcare, WI). A custom-built two-loop (18cm in diameter) butterfly radiofrequency surface coil tuned for 23Na frequency (33.786 MHz) was used to acquire renal 23Na images. Results Mean age of the 10 healthy controls was 41.8 ± 15.3 years, mean body mass index (BMI) was 24.3 ± 3.8 kg/m2. Mean water intake was 1092 ± 233 mL, total water excreted was 1250 ± 301 mL . Mean age of the 5 cardiorenal patients was 76.6 ± 12.2 years, mean BMI was 28.1 ± 6.9 kg/m2. eGFR was 54 ± 37 mL/min/1.73m2. Urinary osmolarity was 498 ± 145 mosm/L and medulla/cortex ratio was 1.35 ± 0.11. Sodium imaging was successfully acquired in all volunteers. In the morning fasting, medulla/cortex ratio was 1.55 ± 0.11 regarding to a urinary osmolarity to 814 ± 121 mosm/L. Mean ± SD fasting urinary osmolarity dropped significantly to 73 ± 14 mosm/L for maximal dilution, p=0.001. Mean medulla/cortex ratio dropped significantly to 1.31 ± 0.09 mosm/L for maximal dilution, p=0.002. Figure 1 displays changes of 23NaMRI pictures before (A) then 1h (B), 1H15 (C), 1h30 (D) and 1h45 (E) after a water load. Urinary osmolarity and medulla/cortex ratio are significantly correlated, r=0.54, p=0.0001. We measured corticomedullary gradient in cardiorenal patient with different level of eGFR to show the ability and feasibility to measure this gradient in pathological settings. We were able to measure medulla/cortex ratio in patients with CKD with a mean SNR of 20.45 ± 9.45. Conclusion We explored CMG dynamically every 15 min and we were able to discriminate significant changes after a water load. We were also able to provide efficient 23NaMRI pictures in cardiorenal patients with kidney disease. CMG exploration would provide a relevant assessment of tubular dysfunction independently of glomerular alteration and thus could be of prognostic value.

scholarly journals Outcomes of Patients Who Have Undergone AV Shunt Procedure at Dr. Zainoel Abidin General Hospital in Banda Aceh

2020 ◽  
Vol 3 (1) ◽  
pp. 721-725
Author(s):  
Khalikul Razi ◽  
Yopie Afriandi Habibie ◽  
Zulfan Zulfan ◽  
Rovy Pratama
Keyword(s):  
Kidney Disease ◽  
General Hospital ◽  
Vascular System ◽  
Average Duration ◽  
Public Health Problem ◽  
Survey Study ◽  
Global Public Health ◽  
Shunt Procedure ◽  
Av Shunt ◽  
Banda Aceh

In recent decades, kidney disease has been documented as a global public health problem. The current challenge is about improving the treatment of chronic kidney disease (CKD) patients in order to provide a longer life expectancy for them. In hemodialysis, there has been a considerable development in finding access to the vascular system, one of which developments was the creation of arteriovenous access by Cimino and Brescia (called an AV shunt). Research on the AV shunt is still limited, so the researchers are interested in conducting this descriptive epidemiological survey study on the profile of patients undergoing AV shunt procedures at Dr. Zainoel Abidin General Hospital in Banda Aceh in 2017. Data were obtained retrospectively from the medical records of the Central Surgery Installation Department of Dr.Zainoel Abidin General Hospital in Banda Aceh, and there were 105 patients have undergone AV shunt, 72 men (68.6%) and 33 women (31.4%). The frequency based on the age was the risking age about 45-54 years as many as 30 people (28.6%). Based on the outcomes obtained 95 people (90.48%) who have used the AV shunt for hemodialysis access, consisting of 66 men (62.86%) and 29 women (27.62). Based on the duration of use, AV Shunt is mostly used for 1 year with the number of 48 patients (50.52%) in the proportion of men and women were 38.95% and 11.57%. With an average duration of use of AV Shunt 2,6 years. From the results of this study, we conclude that the result was obtained that the highest cases in patients who have undergone AV Shunt is man as much as 68.6%. Furthermore, Pertaining to this study, it was obtained that the majority of age who undergo Av shunt is 45-54 years. In addition, the result of this study showed that the success rate of surgery AV shunt in Dr. Zainoel Abidin General Hospital in Banda Aceh was high. It is about 90, 48% with an average duration use of Av shunt is 2.6 years.

scholarly journals SQoF-WEAR Project. The Use of Wearable Devices to Identify the Impact of Stress on Workers’ Quality of Life

2021 ◽  
Vol 7 (1) ◽  
pp. 25
Author(s):  
Patricia Concheiro-Moscoso ◽  
Betania Groba ◽  
Sílvia Monteiro-Fonseca ◽  
Nereida Canosa ◽  
Cristina Queirós
Keyword(s):  
Quality Of Life ◽  
Public Health Problem ◽  
Wearable Devices ◽  
Assessment Tools ◽  
Self Report ◽  
Major Public Health Problem ◽  
The University ◽  
And Control ◽  
The Impact

(1) Background: Stress is a major public health problem due to its relevant health, social and economic repercussions. Moreover, stress can be associated with work; when stress increases over time, burnout can occur, an occupational phenomenon recognized by the WHO in 2019. There is interest in the use of wearable devices to monitor and control stressors and their influence on the condition of workers. This study aims to identify the level of job stress and its influence on the quality of life of workers. (2) Methods:This longitudinal study was carried out between the end of May and mid-July 2021. Three assessment tools along with a daily and a weekly questionnaire were computerized through the RedCap platform. The participants had to fill out the diary and weekly questionnaires and wear a Xiaomi Mi Band 5 during the project. (3) Results and discussion: Thirty-six workers from the University of Coruña and from the University of Porto participated in the project. This study promotes the awareness of workers regarding their work stress and the influence of this factor on their quality of life using physiological (e.g., activity, sleep, and heart rate) and psychological indicators (self-report questionnaires in different moments).

scholarly journals Describing the Programme on Methadone Maintenance Therapy in Selangor, Malaysia

2020 ◽  
Vol 12 (9) ◽  
pp. 151
Author(s):  
Vengketeswara Rao ◽  
Nor Asiah Muhamad ◽  
Salmah Nordin ◽  
Ruziaton Hasim ◽  
Siti Nurhani Rafan ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Drug Use ◽  
Maintenance Therapy ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Methadone Maintenance ◽  
Public Health Problem ◽  
Methadone Maintenance Therapy ◽  
Treatment Modalities ◽  
Drug Use Disorders

INTRODUCTION: Drug addiction and drug abuse is a serious public health problem worldwide. Millions of people worldwide suffered from drug use disorders, directly and indirectly, attributable to drug use and included deaths related to HIV and hepatitis C acquired through unsafe injecting practices. Many parts of the world have a shortfall in prevention and treatment for drug use disorders, with only less than 10% of people with drug use disorders receiving treatment yearly. Medication-assisted treatment of opioid dependence like Methadone is used in maintenance therapy or detoxification helps people with drug use disorders. MATERIAL AND METHODS: Secondary data from an existing electronic dataset in Ministry of Health (MOH) from 2015 until 2019, which includes registered patients who had undergone Methadone Maintenance Therapy (MMT) either government or private facilities were included. The dataset divided into few domains namely socio-demographic, treatment modalities, clinic location and history of infection. RESULTS: A total of 37 various government and private facilities deliver MMT programme in the state of Selangor offered to a total of 5337 patients. The youngest patients were in the early twenties and oldest were in late seventies. The median age of patients was 45 years and the majority were males. Most of them were having secondary education (SPM holder) and below. Most of MMT programme takers were opioid drug users then followed by Amphetamine Type Stimulant (ATS) as the second most used. Among MMT programme takers, about 34.1% were reactive for Hepatitis C, 6.6% reactive for HIV, 4.2% reactive for Hepatitis B and 1.7% acquired tuberculosis infection. Almost 5% of MMT takers had passed away, which the three main causes of death were AIDS, alleged motor vehicle accident and septic shock. None of MMT takers was died due to methadone. CONCLUSION: It is a great concern of the nation in combating drug-related problems due to the growing number of substance abusers. This review concluded that the MMT programme that widely available had shown a positive outcome by keeping lower mortality among MMT patients.

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