ABSTRACT
OBJECTIVE: To identify factors related to a poor health-related and global quality of life (QoL) in a cohort of non-demented Parkinson's disease (PD) patients and compare to a control group. METHODS: The data correspond to the baseline evaluation of the COPPADIS-2015 Study, an observational, 5-year follow-up, multicenter, evaluation study. Three instruments were used to assess QoL: (1) the 39-item Parkinson's disease Questionnaire (PDQ-39), (2) a subjective rating of global QoL (PQ-10), and (3) the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Multiple linear regression methods were used to evaluate the direct impact of different variables on these QoL measures. RESULTS: QoL was worse in PD patients (nâ¯=â¯692; 62.6⯱â¯8.9 years old, 60.3% males) than controls (nâ¯=â¯206; 61⯱â¯8.3 years old, 49.5% males): PDQ-39, 17.1⯱â¯13.5 vs 4.4⯱â¯6.3 (pâ¯<â¯0.0001); PQ-10, 7.3⯱â¯1.6 vs 8.1⯱â¯1.2 (pâ¯<â¯0.0001); EUROHIS-QOL8, 3.8⯱â¯0.6 vs 4.2⯱â¯0.5 (pâ¯<â¯0.0001). A high correlation was observed between PDQ-39 and Non-Motor Symptoms Scale (NMSS) (râ¯=â¯0.72; pâ¯<â¯0.0001), and PDQ-39 and Beck Depression Inventory-II (BDI-II) (râ¯=â¯0.65; pâ¯<â¯0.0001). For health-related QoL (PDQ-39), non-motor symptoms burden (NMSS), mood (BDI-II), and gait problems (Freezing Of Gait Questionnaire [FOGQ]) provided the highest contribution to the model (ßâ¯=â¯0.32, 0.28, and 0.27, respectively; pâ¯<â¯0.0001); whereas mood and gait problems contributed the most to global QoL (PQ-10, ßâ¯=â¯-0.46 and -0.21, respectively; EUROHIS-QOL8, ßâ¯=â¯-0.44 and -0.23, respectively). CONCLUSIONS: QoL is worse in PD patients than in controls. Mood, non-motor symptoms burden, and gait problems seem to be the most relevant factors affecting health-related and global perceived QoL in non-demented PD patients.
Subject(s)
Affective Symptoms/physiopathology , Gait Disorders, Neurologic/physiopathology , Parkinson Disease/physiopathology , Quality of Life , Affective Symptoms/etiology , Aged , Female , Follow-Up Studies , Gait Disorders, Neurologic/etiology , Humans , Male , Middle Aged , Parkinson Disease/complications , Severity of Illness IndexABSTRACT
OBJECTIVE: To determine the prevalence of chronic renal failure (CRF) without replacement treatment (RT), and to describe the primary renal diseases and associated risk factors that might favour its evolution to terminal renal failure. Design. Cross-sectional, descriptive study. SETTING: Population attended at a primary care centre (PCC). PARTICIPANTS: Over-14s with a clinical history opened at the Bon Pastor PCC. RESULTS: Between the 1st of January 1997 and the 1st of December 1997, 12241 clinical histories were reviewed. 64 patients were identified who satisfied criteria of CRF without RT, a prevalence of 5228 patients per million inhabitants (95% CI, 3,950-6,510). 71.9% were men, and mean age was 72 (SD, 13.5). The most recent plasma creatinine averaged 2 mg/dl (SD, 0.66). Frequency according to kind of nephropathy was: 3 (4.7%) glomerular, 5 (7.8%) diabetic, 3 (4.7%) interstitial, 41 (64.1%) vascular (hypertension), 2 (3.1%) indeterminate and 10 (15.6%) unclassifiable. Associated risk factors in these patients were: 47 (73.4%) with hypertension, 16 (25%) diabetic, 26 (40.6%) with hypercholesterolaemia, 20 (31.3%) chronic consumers of analgesics, and 10 (15.6%) smokers. 51.6% of the patients suffered other cardiovascular illnesses. CONCLUSIONS: The estimated prevalence in the population of CRF without RT is 5,228 per million inhabitants. Hypertension is the risk factor most closely associated with this pathology.
Subject(s)
Kidney Failure, Chronic/epidemiology , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Prevalence , Primary Health CareABSTRACT
Objetivo. Determinar la prevalencia de insuficiencia renal crónica (IRC) sin tratamiento sustitutivo (TSR), describir el tipo de enfermedades renales primarias y los factores de riesgo asociados que pueden favorecer su evolución hacia la insuficiencia renal terminal. Diseño. Estudio descriptivo, transversal. Emplazamiento. Población atendida por un centro de atención primaria. Participantes. Mayores de 14 años con historia clínica abierta en el CAP Bon Pastor. Resultados. Durante el período 1-I-1997 hasta 1-XII-1997 se revisaron 12.241 historias clínicas. Se identificaron 64 pacientes que cumplían criterios de IRC sin TSR; prevalencia, 5.228 pacientes por millón de habitantes (pmp) (IC del 95 por ciento, 3.950-6.510 pmp). Un 71,9 por ciento era varón, la edad media era de 72 años (DE, 13,5). La media de la última creatinina plasmática fue de 2 mg/dl (DE, 0,66). La frecuencia según tipo de nefropatía fue: glomerular, 3 (4,7 por ciento); diabética, 5 (7,8 por ciento); intersticial, 3 (4,7 por ciento); vascular (HTA), 41 (64,1 por ciento); indeterminada, 2 (3,1 por ciento), e inclasificable, 10 (15,6 por ciento). Los factores de riesgo asociados en estos pacientes fueron: hipertensos, 47 (73,4 por ciento); diabéticos, 16 (25 por ciento); hipercolesterémicos, 26 (40,6 por ciento); consumidores crónicos de analgésicos, 20 (31,3 por ciento), y 10 (15,6 por ciento), fumadores. Un 51,6 por ciento de los pacientes presentaba otras enfermedades cardiovasculares. Conclusiones. La prevalencia estimada de IRC sin TRS en la población es de 5.228 pmp, y la hipertensión es el factor de riesgo más frecuente asociado a esta patología (AU)
Subject(s)
Middle Aged , Adult , Aged, 80 and over , Aged , Male , Female , Humans , Prevalence , Primary Health Care , Cross-Sectional Studies , Renal Insufficiency, ChronicSubject(s)
General Surgery , Nephrology , History, 19th Century , History, 20th Century , Humans , Research , Spain , Warfare , Wounds and Injuries/therapyABSTRACT
1. To assess the risk of end-stage renal disease (ESRD) associated with the regular use of three classes of non-narcotic analgesics, we performed a case-control study of 340 patients with ESRD on a haemodialysis maintenance program and 673 hospital controls. 2. The overall odds ratio estimate for non-narcotic analgesics taken at least every other day for 30 days or longer before the first symptom of renal disease was 2.89 (95% CI, 1.78 to 4.68). 3. The risk increased in relation to the use duration. 4. The previous regular consumption of combinations containing phenacetin was strongly associated with ESRD (odds ratio, 19.05; 95% CI, 2.31 to 157.4). The odds ratio for previous regular consumption of salicylates was 2.54 (95% CI, 1.24 to 5.20) and for pyrazolones 2.16 (95% CI, 0.87 to 5.32). 5. An analysis for possible confounding by a history of repeated headaches, arthritis, kidney stones, hypertension, and diabetes did not alter the results. 6. The odds ratio estimates for different pathological subgroups of ESRD patients in relation to previous use of any non-narcotic analgesic were glomerulonephritis. 10.57 (95% CI, 1.25 to 89.0), interstitial nephritis, 3.33 (95% CI, 1.21 to 9.17), cystic kidney disease, 0.71 (95% CI, 0.25 to 1.97), and unknown, 5.15 (95% CI, 2.29-11.57). 7. The results of this study suggest that the regular consumption of analgesics should be routinely considered as a risk factor for any non-congenital cause of chronic renal failure. They also suggest that the risk of ESRD associated with the regular consumption of phenacetin is much higher than the risk associated with other non-narcotic analgesics.
Subject(s)
Analgesics/adverse effects , Kidney Failure, Chronic/chemically induced , Adolescent , Adult , Case-Control Studies , Female , Humans , Male , Middle Aged , Odds Ratio , Phenacetin/adverse effects , Salicylates/adverse effects , Time FactorsSubject(s)
Granulomatosis with Polyangiitis/pathology , Kidney/pathology , Female , Humans , Male , Middle AgedSubject(s)
Granuloma/complications , Lung Diseases/complications , Lymphomatoid Granulomatosis/complications , Vasculitis/etiology , Adolescent , Adult , Child , Diagnosis, Differential , Female , Granuloma/diagnosis , Granulomatosis with Polyangiitis/diagnosis , Humans , Lung Diseases/diagnosis , Lymphomatoid Granulomatosis/diagnosis , Male , Middle AgedSubject(s)
Kidney Failure, Chronic/complications , Tuberculosis, Spinal/complications , Humans , Male , Middle AgedSubject(s)
Anemia, Hypochromic/drug therapy , Ferrous Compounds/administration & dosage , Iron-Dextran Complex/administration & dosage , Iron/administration & dosage , Renal Dialysis/adverse effects , Adult , Aged , Anemia, Hypochromic/blood , Ferritins/blood , Hemoglobins/analysis , Humans , Middle AgedABSTRACT
5 patients with acute renal failure (3 with thrombopenia and hemolysis) induced by the reintroduction of rifampicin are described. No correlation was found between the severity of clinical manifestations and the total dose taken by the patients. In all but 1 patient, antirifampicin antibodies were detected. Antibodies suggested to be of the IgM class were detected in all 3 patients with hematological disorders. The pattern of non-specific acute tubular necrosis found in the 2 biopsied patients, indistinguishable from that of ischemic origin, raised the possibility of a vascular-mediated damage. In 3 patients, the possibility of a triggering immunoallergic mechanism is discussed.
