Depression and anxiety among caregivers of children and adolescents with neurodevelopmental disorders in a government tertiary hospital during the Covid-19 pandemic

Objectives@#To determine the burden of COVID-19 related mental health problems such as anxiety and/or depression among caregivers of children and adolescents with neurodevelopmental disorders in a government tertiary hospital.@*Materials and Methods@#This is a cross-sectional study conducted at the Out-patient Department of PCMC. Caregiver data sheet and HADS-P forms were given to eligible caregivers.@*Results@#A total of 102 caregivers were included. The prevalence of significant risk for anxiety disorder among caregivers of children and adolescents with neurodevelopmental disorders is 34.31% (n=35), 1.96% (n=2) for depression and 3.92% (n=4) for both anxiety and depression. Using logistic regression, marital status of common law partner and female sex have significant association with depression and anxiety; the number of household members has a direct association to significant risk for both anxiety and depression.@*Conclusion@#Female sex and common law partnership as marital status are associated with 2-3 times of having significant risk for anxiety or depression. The number of household members is correlated with an increased significant risk of having both anxiety and depression. Screening caregivers using appropriate tests would identify caregivers at significant risk for anxiety and depression and further create intervention programs.

Comparación de fórmulas para la estimación del filtrado glomerular: correlación e implicancia clínica / Comparison of formulas for the estimation of glomerular filtration: correlation and clinical implication / Comparação de fórmulas para a estimativa da filtração glomerular: correlação e implicações clínicas

La Enfermedad Renal Crónica (ERC) es un importante problema de salud pública que trae aparejada una gran morbi-mortalidad. Una de las herramientas diagnósticas es la estimación del filtrado glomerular (eFG). Los objetivos de este estudio fueron comparar el eFG según dos ecuaciones: MDRD-4 y CKD-EPI, evaluar su comportamiento en valores clínicamente relevantes y evidenciar Enfermedad Renal Oculta (ERO) según cada una de las fórmulas evaluadas, clasificando a la población estudiada en estadíos de ERC. Se evaluaron 2.526 pacientes con factores de riesgo asociados a ERC. La media de los resultados obtenidos con ambas fórmulas fue: para MDRD-4 84,5 mL/min/1,73 m², y para CKD-EPI 90,9 mL/min/1,73 m². De la relación entre el eFG en sus diversos estadíos y los resultados de creatininemia resultó que 83 pacientes se clasificaron como ERO según MDRD-4, y 23 lo hicieron para CDK-EPI, con lo que se manifestó una subestimación de la eFG utilizando la ecuación MDRD-4. La importancia de este estudio radica en el hallazgo precoz y en la prevención de complicaciones que podrían limitar el bienestar de estos pacientes. La participación de Laboratorios nucleados en red brinda herramientas accesibles y de bajo costo para su asistencia temprana, en busca de seguridad, cuidado y educación del paciente.

Chronic Kidney disease (CKD) is an important public health problem which is associated to an increase in mortality. An important diagnostic tool is the estimated glomerular filtration rate (GFR). The aims of this study were to compare GFR according to two different formulas: MDRD-4 and CKD-EPI, in order to evaluate its performance in clinically relevant values and to display occult chronic kidney disease (OCKD) according to each of the equations reviewed to classify the studied population into different stages of CKD. A total of 2526 patients with CKD-associated risk factors were analyzed. Mean of the results with both formulas were: 84.5 mL/min/1.73 m² for MDRD-4 and 90.9 mL/min/1.73 m² for CKD-EPI. Considering the associations between GFR in each of the stages and the results of blood creatinine, 83 patients were classified as OCKD by MDRD-4 while 23 were classified by MDRD-EPI; showing an underestimation of the GFR when using MDRD-EPI. The importance of this study lies in the early detection of the disease and in preventing the complications that could restrict the patient’s well-being. The support of the networking laboratories brings the appropriate and low cost tools for an early assistance in search of security, care and education forthe patient.

A Doença Renal Crônica (DRC) é um importante problema de saúde pública que traz grande morbimortalidade. Uma das ferramentas de diagnóstico é a estimativa de filtração glomerular (eFG). Os objetivos deste estudo foram comparar eFG de acordo com duas equações: MDRD-4 e CKD-EPI, avaliar seu comportamento em valores clinicamente relevantes e evidenciar Doença Renal Oculta (DRO) de acordo com cada uma das fórmulas avaliadas, classificando a população estudada em estágios de DRC. Foram avaliados 2526 pacientes com fatores de risco associados à DRC. A média dos resultados obtidos com as duas formulações foi: MDRD-4 a 84,5 mL/min /1,73 m², e CKD-EPI 90,9 mL/min/1.73 m². A relação entre o eFG nas suas diversas fases e os resultados de creatininemia mostrou que 83 pacientes foram classificados como ERO segundo MDRD-4, e 23 fizeram para CDK-EPI, demonstrando uma subestimação da eFG usando a equação MDRD-EPI. A importância desse estudo está na detecção precoce e prevenção de complicações que poderiam limitar o bem-estar desses pacientes. A participação de Laboratórios reunidos em uma rede fornece ferramentas acessíveis e de baixo custo para sua assistência precoce, em busca de segurança, cuidado e educação do paciente.