Lic.-avh. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 2 uppsatser.

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, 2003. / Kaynakça var.

Thesis ( M.Sc.). / Written for the Dept. of Epidemiology and Biostatistics. Title from title page of PDF (viewed 2008/05/29). Includes bibliographical references.

Thematic Paper (M.C.T.M. (Clinical Tropical Medicine))--Mahidol University, 2008. / LICL has E-Thesis 0038 ; please contact computer services. LIRV has E-Thesis 0038 ; please contact circulation services.

Thesis (M.N.)--Memorial University of Newfoundland, 2003. / Typescript. Bibliography: leaves 176-183. Also available online.

Thesis (M.N.)--Memorial University of Newfoundland, 2004. / Bibliography: leaves 188-195.

Thesis (M.S.)--University of Toledo, 2006. / "In partial fulfillment of the requirements for the degree of Master of Science in Nursing." Major advisor: Jane C. Evans. Includes abstract. Document formatted into pages: v, 53 p. Title from title page of PDF document. Bibliography: pages 42-43.

Η μακροπρόθεσμη έκθεση της περιτοναϊκής μεμβράνης σε μη βιοσυμβατά περιτοναϊκά διαλύματα οδηγεί σε δομικές αλλαγές και στην απώλεια της υπερδιήθησης. Σκοπός της παρούσας μελέτης είναι να περιγράψουμε τις ιστολογικές αλλαγές της περιτοναϊκής μεμβράνης που παρατηρούνται: α) σε ουραιμικούς ασθενείς που ξεκινούν θεραπεία υποκατάστασης της νεφρικής λειτουργίας με περιτοναϊκή κάθαρση και β) σε ασθενείς που ήδη υποβάλλονται στη μέθοδο για ικανό χρονικό διάστημα. Επίσης να καθορίσουμε κατά πόσο οι μορφολογικές αυτές αλλαγές επηρεάζουν τα λειτουργικά χαρακτηριστικά του περιτοναίου. Μέθοδος: Στη μελέτη περιλήφθηκαν 19 ασθενείς (ομάδα Α) οι οποίοι υποβλήθηκαν σε βιοψία περιτοναίου κατά την τοποθέτηση του περιτοναϊκού καθετήρα και πριν την έναρξη της περιτοναϊκής κάθαρσης (CAPD) και 18 ασθενείς οι οποίοι υποβλήθηκαν σε βιοψία περιτοναίου μετά από 4 χρόνια σε CAPD (ομάδα Β). Οι ιστολογικές παράμετροι που ελέχθησαν ήταν η μεσοθηλιακή επιφάνεια, η υπομεσοθηλιακή ζώνη, η κατάσταση του συνδετικού ιστού και η κατάσταση των αγγείων. Για την εκτίμηση των λειτουργικών χαρακτηριστικών του περιτοναίου και της επάρκειας της μεθόδου εφαρμόσθηκαν η δοκιμασία εξισορρόπησης της περιτοναϊκής μεμβράνης (PET), η συνολική εβδομαδιαία κάθαρση κρεατινίνης (wClcr) και το συνολικό εβδομαδιαίο KT/V της ουρίας (wKT/V). Αποτελέσματα: Οι κύριες ιστολογικές αλλαγές και στις δύο ομάδες ασθενών ήταν η απώλεια των μεσοθηλιακών κυττάρων, η πάχυνση της υπομεσοθηλιακής ζώνης και η υαλίνωση των αγγείων. Το πάχος της υπομεσοθηλιακής ζώνης και στις δύο ομάδες ασθενών ήταν σημαντικά υψηλότερο έναντι φυσιολογικών μαρτύρων (630μm και 1140μm vs. 50μm αντίστοιχα, p <0.05). Αν και δε βρέθηκε σημαντική διαφορά μεταξύ των μορφολογικών αλλαγών του περιτοναίου στους ασθενείς της ομάδας Α και στους ασθενείς της ομάδας Β, υπήρξε μια τάση για σοβαρότερου βαθμού βλάβες στους τελευταίους. Το PET, η wClcr και το wKT/V δεν παρουσίασαν στατιστικά σημαντικές διαφορές στις δύο ομάδες ασθενών, ούτε στους ασθενείς της ομάδας Β κατά την έναρξη και μετά από 4 χρόνια εφαρμογής της μεθόδου. Κανένας σημαντικός συσχετισμός δεν παρατηρήθηκε μεταξύ των ιστολογικών αλλαγών και των λειτουργικών δοκιμασιών και στις δύο ομάδες ασθενών. Συμπεράσματα: Σημαντικές δομικές αλλαγές του περιτοναίου παρατηρούνται στους ουραιμικούς ασθενείς και αυτές οι αλλαγές επιδεινώνονται με την εφαρμογή της CAPD. Οι δομικές αυτές αλλαγές δεν ακολουθούνται από λειτουργικές αλλαγές κατά τη διάρκεια των πρώτων τεσσάρων ετών σε CAPD. / The long-term exposure of peritoneal membrane to bioincompatible dialysis solutions leads to structural changes and loss of ultrafiltration capability. Objective: The aim of the present study is to describe the histological changes of peritoneum that are observed: a) in uremic patients and b) in patients that are in peritoneal dialysis for a period of time. Also to determine the possible relation of histological changes with the transport characteristics of peritoneal membrane and with adequacy of dialysis. Method: Thirty nine patients (M/F=18/19) that underwent a peritoneal biopsy in the initiation of treatment (group A, N=19) or after 4 years in continous ambulatory peritoneal dialysis (CAPD) (group B, N=18) were included in the study. The morphological changes of mesothelial cells and vascular compartment as well as the thickness of submesothelial collagenous zone were estimated. The relations of these changes to peritoneal equilibration test (PET) and to adequacy of dialysis (total weekly creatinine clearance (wClcr) and urea KT/V) were also investigated. Results: The main histological changes in both groups of patients were loss of mesothelial cells and decrease of normal mesothelial surface, thickening of submesothelial collagenous zone and presence of vascular hyalinosis. The thickness of submesothelial collagenous zone in both groups of patients was significantly higher compared to that of controls (630μm and 1140μm vs.50 μm respectively, p <0.05). Although no significant difference was found between morphologic changes of peritoneal membrane in uremic patients starting on CAPD and those on peritoneal dialysis for a mean period of 4 years, there was a trend towards more severe lesions in the latter. The PET, Clcr and urea KT/V were not significantly different in the two groups of patients. These parameters also showed no significant changes when examined in the initiation of CAPD and after four years in peritoneal dialysis in the same patients (group B). No significant correlations were observed between histological changes and PET, Clcr and KT/V in both groups of patients. Conclusions: Significant structural changes of peritoneal membrane are observed in uremic patients and these changes are deteriorated with CAPD treatment. Structural changes are not followed by functional changes during the first four years on CAPD.

Bakgrund: Njurarna har en central funktion i kroppen och sviktar dessa innebär det en stor påverkan på det dagliga livet samt en kontinuerlig kontakt med sjukvården. Sjukdomen och dess behandling påverkar inte bara kroppen fysiskt utan även psykiskt och socialt. Njurtransplantation är en kostnadseffektiv och väletablerad behandlingsform vilken ger god prognos för patienten. Dock är efterfrågan på organ större än tillgången vilket i många fall innebär en väntan på obestämd tid för patienten. Syfte: Syftet med studien var att beskriva patienters upplevelser av att leva med kronisk njursvikt i väntan på transplantation. Metod: Litteraturbaserad studie baserad på tio vetenskapliga artiklar med kvalitativ ansats. Resultat: Ur analysen framkom tre kategorier; Livet begränsas, en oviss väntan samt stöd från omgivningen med nio underkategorier. Diskussion: Livet i väntan på transplantation medför många begränsningar som i sin tur innebär lidande. Detta skapar ett behov av stöd från omgivningen, däribland sjuksköterskan. För att sjuksköterskan ska kunna ge stöd åt patienten är det viktigt att förstå hur patienter upplever livet i väntan på transplantation.

Orientador: Antonio Carlos Paes / Resumo: Introdução: Os números relacionados à letalidade na lesão renal aguda (LRA) em cães e gatos de acordo com a etiologia são pouco conhecidas. Este é o primeiro estudo que avaliou as evidências disponíveis sobre a LRA para ajudar na tomada de decisões na prática clínica. Objetivos: Avaliar a letalidade da LRA em cães e gatos de acordo com a etiologia, infecciosa ou não infecciosa, e também em cães e gatos que estavam recebendo tratamento dialítico ou conservador. Métodos: Pesquisas em Medline, EMBASE e LILACS até julho de 2016 e revisão de listas de referências dos trabalhos incluídos. Os critérios de inclusão foram estudos em série de casos que avaliaram o tratamento de dialítico ou conservativo em cães e gatos com LRA independentemente da etiologia e letalidade por todas as causas relatada. A proporção agrupada e o intervalo de confiança (IC) são apresentados para cada resultado. A significância estatística foi definida com a não sobreposição dos intervalos de confiança de 95%, obtidos para cada intervenção. Resultados: Dezenove séries de casos envolvendo 1.233 animais foram elegíveis. As proporções agrupadas para a letalidade global, independentemente do tratamento e da etiologia, foram: gatos 52,6% e cães 45,0%. Os valores de letalidade de acordo com o tratamento foram numericamente maiores nos cães e gatos que receberam diálise quando comparado com o tratamento conservador. As diferenças significativas foram observadas devido à não-sobreposição das IC 95%, mostrando maiores... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Background: Evidence related to lethality in acute kidney injury (AKI) in cats and dogs accordingly to the etiology are little known. This is the first study that evaluated the available evidence on AKI to allow decision-making in clinical practice. Objectives: To evaluate the lethality rate in cats and dogs with AKI accordingly to the etiology (i.e. infectious versus non-infectious), and the incidence of lethality in cats and dogs that were receiving either dialytic or conservative treatment. Methods: Searches of Medline, EMBASE, and LILACS to July 2016 and review of reference lists of previous review. Inclusion criteria were case series studies evaluating dialytic or conservative treatment in cats and dogs with AKI, regardless the etiology and all-cause lethality reported. The pooled proportion and the confidence interval (CI) are shown for each outcome. Statistical significance was defined if the 95% confidence intervals obtained for each intervention did not overlap. Results: 19 case series involving 1,233 animals proved eligible. The pooled proportions for overall lethality regardless the treatment and etiology were: cats 52.6% and dogs 45.0%.The rates of lethality accordingly the treatment were higher in the cats and dogs that receiving dialysis, regardless the etiology when comparing with conservative treatment, however there was no significant difference. Effect differences were seen due to the non-overlap of the 95% CIs showing higher proportions of mortality in AKI ... (Complete abstract click electronic access below) / Doutor