Physical activity in daily life assessed by an accelerometer in kidney transplant recipients and hemodialysis patients.

BACKGROUND: Sedentary lifestyle is a problem among hemodialysis (HD) patients, potentially attenuated after kidney transplantation. However, the effect of kidney transplantation on physical activity has not been thoroughly investigated. OBJECTIVE: This study sought to evaluate the physical activity in daily life in kidney transplant recipients (KTRs) compared with HD patients and to explore its relationship with clinical variables. METHODS: A cross-sectional study enrolled KTRs who received transplants at least 6 months before the study (N = 23; 48.3 ± 10.3 years) and patients undergoing HD for at least 6 months (N = 20; 47.3 ± 12.6 years). Time spent in different activities (walking, standing, sitting, and lying down) and number of steps taken, measured by a multiaxial accelerometer used for 12 h/d on 2 consecutive days for KTRs and on 4 consecutive days for HD patients, were evaluated. RESULTS: KTRs engaged in more active time per day (sum of walking and standing time) than HD patients (311 ± 87 vs 196 ± 54 min/d; P = .001), with longer walking (106 ± 53 vs 70 ± 27 min/d; P = .008) and standing time (205 ± 55 vs 126 ± 42 min/d; P < .001). Sixty-five percent of KTRs were classified as active (>7500 steps/d) compared with only 20% of the HD group (P < .05). The multivariate analysis showed that time posttransplantation was significantly associated with walking time and active time. CONCLUSIONS: By using an accelerometer, a precise method, this study showed that KTRs are significantly more active in daily life than HD patients, and that daily physical activity increases with time since transplantation.

The role of histologic grading in the prognosis of patients with carcinoma of the breast: is this a neglected opportunity?

BACKGROUND: Quantified grading of breast carcinoma through histologic analysis has been practiced for many years, but generally has not been used as an aid in treatment decision-making. METHODS: A representative sample of the literature is reviewed and discussed. RESULTS: The literature overwhelmingly confirms that histologic features suitable for grading provide important prognostic information at all stages of the disease, but there is no uniformly agreed on methodology for the application of this information. Disagreement still exists as to its validity and it is often ignored. CONCLUSIONS: It appears reasonable that serious attempts be made to overcome the perceived problems with the grading of breast carcinoma and to develop a consensus regarding a methodology for quantifying this well established index of the virulence of the disease that is comparable to the consensus reached in the American Joint Committee on Cancer staging of the extent of disease. This information then could be used in the design of clinical trials. [See editorial counterpoint on pages 1703-5 and reply to counterpoint on pages 1706-7, this issue.]

[Ambulatory anesthesia in arthroscopy of the knee: proposal of an intravenous general anesthesia technique]. / L'anestesia ambulatoriale nelle artroscopie del ginocchio: proposta di una tecnica di anestesia generale e.v..

The Authors propose a technique completely i.v. for arthroscopy of the knee by means of proposal discontinuous infusion. The advantage underlined are tolerability, efficaciousness, features of awakening and a few collateral effects verified, and this leads to be conclusion that this anaesthesia system must be considered of choice in this type of surgery.