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Background: Complications related to peritoneal dialysis (PD) in patients with autosomal-dominant polycystic kidney disease (ADPKD), including intraperitoneal rupture of renal cyst, hernia, membrane failure and peritonitis, have been reported. However, long-term clinical outcomes of ADPKD patients on PD remain unclear. We performed this meta-analysis to assess the risks of death, technique failure and peritonitis in ADPKD patients on PD. Methods: A systematic review was conducted using MEDLINE, EMBASE and Cochrane databases from inception to October 2017 to identify studies that evaluated the outcomes of ADPKD patients on PD, including the risks of death, technique failure and peritonitis. Non-ADPKD patients on PD were used as controls. Effect estimates from the individual study were extracted and combined using the random-effect, generic inverse variance method of DerSimonian and Laird. Results: Twelve cohort studies with a total of 14 673 patients on PD (931 ADPKD and 13 742 non-ADPKD patients) were enrolled. Compared with non-ADPKD status, ADPKD was associated with significantly decreased mortality risk with pooled odds ratio (OR) of 0.68 (95% confidence interval (CI), 0.53–0.86; I 2 = 0). There were no associations of ADPKD with the risks of technique failure of PD and peritonitis with pooled OR of 0.93 (95% CI, 0.79–1.10; I 2 = 0) and 0.88 (95% CI, 0.75–1.05; I 2 = 0), respectively. We found no publication bias as assessed by Egger's regression asymmetry test, with P = 0.90, 0.28 and 0.60 for the risks of mortality, technique failure and peritonitis in ADPKD patients on PD, respectively. Conclusion: Compared with non-ADPKD patients on PD, our study demonstrates that ADPKD patients on PD have 0.68-fold decreased mortality risk. There are no associations of ADPKD status with the risks of technique failure or peritonitis.

OBJECTIVE: After comparing the top 10 menstrual tracking applications, there are no applications that address symptoms specific to Polycystic Ovary Syndrome (PCOS). This thesis demonstrates the need for a comprehensive menstrual tracking application that caters toward all populations, including patients with PCOS. METHODS: Mobile application usage was evaluated through data from the Ovulation and Menstruation (OM) Health Study to view relationships between PCOS/demographic groups and preference for tracking methods. The top 10 most popular mobile menstrual tracking applications were compiled through a search on the iOS operating system. Mobile menstrual tracking applications were then evaluated through an adapted APPLICATIONS system, which includes categories to score for PCOS-specific symptoms. RESULTS: PCOS groups showed clear preference for tracking methods overall, and are more likely to view their own health as fair/poor. P values for tests between other demographic variables in the OM Health study were insignificant, but there are observable trends in education, income, and age and usage of tracking methods. Evaluation of the top 10 mobile menstrual applications resulted in Clue scoring the highest, but no applications scored a complete PCOS-specific score. CONCLUSIONS: With continual variance in menstrual cycles, there needs to be development of a mobile menstrual application that is effective for all populations. Mobile menstrual applications have proven their popularity through PCOS groups and the rising usage within younger age groups. However, through the adapted APPLICATIONS system, major features are still missing, and are necessary to cater towards unique groups such as people with menstrual irregularities and PCOS.

Polycystic ovary syndrome (PCOS) is a chronic condition that affects 6-18 % of all fertile women, PCOS manifests itself through various clinical symptoms, such as hirsutism and obesity. It is also a contributing factor to irregular menstrual cycles, which has an impact on life and future pregnancies. The aim of the literature study was to describe the experiences of women living with PCOS. A systematic literature review was conducted, which resulted in the selection of ten scientific articles. The result of the study is based on three categories: The women’s self-image, the women’s physical and mental well-being and the women’s experience of support. The results of the literature study describe the way the women perceived themselves based on clinical symptoms such as hirsutism and obesity. The experience of the symptoms, the reduced fertility and the constant comparisons made with other women were based on society’s norms. This later on had an emotional impact on women´s physical and mental well-being. In conclusion the women found support through support groups, family members and information online. However, the women perceived a lack of support from healthcare professionals. If healthcare professionals can gain a greater understanding of how women with PCOS experience their symptoms, they can in this way contribute to more person-centred care. / Polycystiskt ovarialsyndrom (PCOS) är ett kroniskt syndrom som drabbar 6-18 % av alla fertila kvinnor. PCOS visar sig genom olika kliniska symtom, såsom hirsutism, övervikt och är en bidragande faktor till oregelbundna menstruationer, vilket kan påverka livet samt bidra till svårigheterna att bli gravid. Litteraturstudiens syfte var att beskriva kvinnors upplevelser och erfarenheter av att leva med PCOS. En systematisk litteratursökning genomfördes vilket resulterade i tio utvalda vetenskapliga artiklar. I resultatet framkom tre kategorier: Kvinnornas självbild, Kvinnornas fysiska och psykiska mående och Kvinnornas upplevelse av stöd. Kategorierna beskriver hur kvinnorna såg på sig själva utifrån hirsutism, övervikt och andra kliniska symtom. Kvinnorna beskrev upplevelsen kring symtomen, infertiliteten samt de ständiga jämförelserna kvinnorna gjorde med andra kvinnor utifrån samhällets normer. Den emotionella upplevelsen bidrog till en fysiskt och psykisk påfrestning på kvinnornas mående. Sammanfattningsvis fann kvinnorna stöd genom bland annat stödgrupper, familj och information på internet, däremot upplevde de brist på stöd från hälso- och sjukvårdspersonal. Genom denna litteraturstudie kan hälso- och sjukvårdspersonal få en ökad förståelse över vad kvinnor med PCOS upplever gällande sina symtom och på detta sätt bidra till en mer personcentrerad omvårdnad.

Polycystic kidney disease is an inherited degenerative disease in which the uriniferous tubules are replaced by expanding fluid-filled cysts that ultimately destroy organ function. Autosomal dominant polycystic kidney disease (ADPKD) is the most common form, afflicting approximately 1 in 1,000 people. It primarily is caused by mutations in the transmembrane proteins Polycystin-1 (PKD1) and Polycystin-2 (PKD2). The most proximal effects of polycystin mutations leading to cyst formation are not known, but pro-proliferative signaling must be involved for the tubule epithelial cells to increase in number over time. The stress-activated mitogen-activated protein kinase (MAPK) pathway c-Jun N-terminal kinase (JNK) promotes proliferation in specific contexts and is activated in acute and chronic kidney disease. Previous work found evidence of JNK activation in cystic tissues (Le et al., 2005) and others showed that JNK signaling is activated by aberrant expression of PKD1 and PKD2 in cell culture (Arnould et al., 1998; Arnould et al., 1999; Parnell et al., 2002; Yu et al., 2010) but the contribution of JNK signaling to cystic disease in vivo has not been investigated. This body of work describes the use of conditional and germline deletion of Pkd2, Jnk1 and Jnk2 to model ADPKD and JNK signaling inhibition in juvenile and adult mice. Immunoblots and histological staining were used to measure JNK activation and evaluate the effect of JNK deletion on cystic disease. Results show that Pkd2 deletion activated JNK signaling in juvenile and adult mice. Reduction of JNK activity significantly reduced cystic burden in kidneys of juvenile Pkd2 mutant mice. This correlated with reduced tubule cell proliferation and reduced kidney fibrosis. The improvement in cystic phenotype was driven primarily by Jnk1 deletion rather than Jnk2. JNK signaling inhibition in adult Pkd2 mutants significantly reduced liver cysts when mice were aged six months. JNK inhibition reduces the severity of cystic disease caused by the loss of Pkd2 suggesting that the JNK pathway should be explored as a potential therapeutic target for ADPKD.

Polycystic kidney disease is a severe genetic disease occurring in both adult and pediatric patients. The basic characteristic of this disease is the development and progressive enlargement of renal cysts gradually replacing functional kidney tissue. This leads to renal failure in many patients. However, renal cysts may also occur in a number of other diseases, including multisystem syndromes. This complicates differential diagnosis in some patients. In our study, we first focused on the diagnosis and characterization of genotypic-phenotypic relationships in patients with polycystic disease arising in childhood, later we extended our study to adult patients and patients with unclear clinical diagnosis. At the same time, we expanded the portfolio of analyzed disorders to a number of diseases in which the phenotype of polycystic kidneys may occur, and noncystic diseases as well. During our project, massive parallel sequencing was used to analyze 149 patients - 128 with cystic and 21 with noncystic clinically diagnosed nephropathies. At the same time, the findings were verified by Sanger sequencing in 176 relatives of our probands. Mutation detection reached 59% in cystic patients, and 43% in non-cystic patients, respectively. In many patients, molecular genetic analysis revealed a different etiology...

Objective: To evaluate the influence of obesity, fertility status, and androgenism scores on health-related quality of life in women with polycystic ovary syndrome (PCOS). Design: Cross-sectional, correlational. Setting: Private reproductive endocrinology practice in two southeast U.S. cities. Participants: Convenience sample of 128 women with PCOS, half of whom were attempting to conceive in addition to being treated for PCOS. Most were White (97%), married (78%), with a mean age of 30.4 years (SD ± 5.5). Main Outcome Measures: The Health-Related Quality of Life Questionnaire (PCOSQ) for women with polycystic ovary syndrome. A laboratory panel and clinical measures, including body mass index, waist-to-hip ratio, and degree of hirsutism. Results: The most common health-related quality of life concern reported by women with PCOS was weight, followed in descending order by menstrual problems, infertility, emotions, and body hair. Conclusions: The psychological implications of PCOS are easily underestimated and have been largely ignored. Nursing has a pivotal role in recognizing these concerns and implementing therapy to improve quality of life in women with PCOS.

Bakgrund: Polycystiskt ovarialsyndrom (PCOS) är den vanligaste orsaken till endokrin obalans hos kvinnor. Den drabbar 5–10% av fertila kvinnor och påverkar äggstockarna och den hormonella balansen. Det visar sig genom oregelbunden eller utebliven menstruation, ökad kroppsbehåring, viktuppgång samt risk för infertilitet. Sjuksköterskor ska kunna tillgodose patienter med relevant information och motivera till livsstilsförändringar. Vårdrelationen har en viktig betydelse för att patienter ska känna ett stöd och bli delaktiga i sin vård. Syfte: Syftet var att skildra kvinnors upplevelser av att leva med polycystiskt ovarialsyndrom. Metod: En litteraturöversikt skapad av elva vetenskapliga artiklar hämtade från databaserna Cinahl Complete och PubMed. Resultat: Resultatet mynnade ut i tre huvudteman; Upplevelser i mötet med hälsosjukvård, Upplevelser av symtom och Upplevelser av kvinnlig identitet. Det framkom fyra tillhörande underteman. Sammanfattning: I resultatet framkom det att kvinnorna upplevt att vårdpersonalen har haft dålig kunskap om PCOS vilket påverkade vårdpersonalens bemötande. Kvinnorna upplevde svårigheter med att hantera sina symtom från PCOS och hade ett behov av stöd från närstående eller andra kvinnor med samma diagnos. Kvinnorna upplevde sig okvinnliga på grund av deras symtom och ovissheten över förmågan att bli gravid. / Backround: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. The prevalence of PCOS is 5–10% of fertile women and the disorder affects the ovaries and hormonal balance. The symptoms are irregular or absent menstruation, increased body hair, weight gain and the risk of infertility. Nurses should be able to provide patients with relevant information and motivate lifestyle changes. The caring relationship has an important meaning for patients to feel supported and to become more involved in their own care.  Aim: The aim of this study was to depict women’s experiences of living with polycystic ovary syndrome. Method: A literature review based on eleven scientific articles retrieved from the databases Cinahl Complete and Pubmed.  Results: The analysis resulted in three main themes; Experiences in the encounter with health care, Experience of symptoms and Experience of femine identity. Four belonging subthemes emerged. Summary: The result showed that women experienced a lack of knowledge from the health care which resulted in poor treatment. The women experienced difficulties with handling their symptoms from PCOS and had a need for support from relatives or other women with the same diagnosis. The women felt unfeminine because of their symptoms and the uncertainty about their fertility.

Polycystic ovary syndrome is the single most common endocrine abnormality of women of reproductive age and is a leading cause of female infertility. Common clinical features include hirsutism, various ovarian abnormalities, obesity, and insulin resistance. Expert consensus recommendations on diagnostic criteria vary, but the most recent focus on the presence of clinical features of hyperandrogenism, hyperandrogenemia, polycystic ovaries, and ovulatory and menstrual dysfunction to the exclusion of alternative diagnoses. In adolescence, diagnosis is more difficult because of the frequent presence of individual clinical findings in otherwise "normal" individuals. Laboratory tests and pelvic ultrasound are necessary to confirm polycystic ovary syndrome and exclude other disorders that may mimic this syndrome. Treatment is centered on the clinical manifestations and should be initiated early to prevent/limit long-term complications, including the metabolic syndrome, diabetes, endometrial carcinoma, and infertility.