CRIS

Permanent URI for this communityhttps://scripta.up.edu.mx/handle/20.500.12552/1

Browse

Search Results

Now showing 1 - 10 of 53

Some of the metrics are blocked by your
consent settings
Pain reduction with VR in indigenous vs urban patients in ambulatory surgery
(2019)
;
;
Moss Lara, Dejanira
;
Mosso Lara, José Luis
;
Wiederhold, Brenda K.
The current report presents comparisons of pain reduction and heart rate response using supplemental virtual reality (VR) pain distraction between 22 indigenous and 22 urban patients during ambulatory surgery. Material and methods. Forty-four (44) patients participated under full informed consent. Half (n = 22) were indigenous peoples and half (n = 22) were urban patients (those residing in Mexico City). For the urban group, a surgeon performed ambulatory surgeries with local anesthesia to remove lesions in soft tissues, such as lipomas, cysts located in the head, neck, back, shoulders, arms, limbs, and abdomen. For the indigenous group, operating rooms, intravenous line, analgesics, and sedatives were not used. Materials included laptop-linked virtual reality, PlayStation, Smartphones and Google Cardboard googles alongside virtual environments such as Enchanted Forest, The Sea, Lake Valley, Jurassic Dinosaur and Coast Space VR. Results. Pain scale indicated 2.92 before, 1.67 during and 0.67 after for indigenous participants, and 5.8 before, 3.32 during and 1.48 after for urban participants. Heart rate responses in indigenous were 80.42(before), 78.5 (during) and 72.42 (after) and urban responses were 74.07 (before), 68.53 (during) and 73.1(after). Discussion. Indigenous patients presented more pain reduction during ambulatory surgery without intravenous lines, analgesics or sedatives and required recovery time or hospitalization. Supplemental VR during medical and surgical procedures is discussed in light of cultural, economic and psychological variables associated with medical care in Mexico. ©2019, Interactive Media Institute. All rights reserved.
19 2
Some of the metrics are blocked by your
consent settings
Prevalencia, factores de riesgo y consecuencias de la referencia tardía al nefrólogo
(2011-01)
Laris González, Almudena
;
Madero, Magdalena
;
Pérez-Grovas, Héctor
;
Franco-Guevara, Martha
;
Late referral of patients with chronic kidney disease (CKD) to specialized care by the nephrologist is associated with worse patient outcomes while on dialysis. To determine the prevalence, risk factors, and consequences of late nephrology referral at a Mexican tertiary care hospital. Retrospective chart review of all adult patients who began chronic hemodialysis between 2002 and 2006 at the National Institute of Cardiology "Ignacio Chavez" (NICICh), Mexico City. Timing of referral to Nephrology Department was classified as early, late or very late if the time elapsed between referral and initiation of dialysis was < 1 month, between 1-6 months or > or = 6 months, respectively. Socio-demographic, clinical, laboratory and echocardiographic characteristics were compared according to timing of referral. Eighty four out of 150 patients were included in the analysis. Of these, 56% were referred < 1 month, and an additional 15% between 1-6 months prior to the initiation of chronic hemodialysis. In univariate analysis, being referred by a relative or friend was associated with a higher risk (p = 0.04), and being employed with a lower risk of late referral (p = 0.05). Late referred patients were more likely to require emergency dialysis and hospitalization, and of not having a permanent vascular access for their first dialysis. They also had a higher prevalence of severe anemia (hematocrit < 28%) and of residual kidney function (estimated glomerular filtration rate < 5 mL/min/1.73 m2), as well as increased left ventricular mass. Late nephrology referral is highly prevalent in our population and is associated with markers of suboptimal predialysis care at the onset of chronic dialysis.
Scopus© Citations 11 20 1
Some of the metrics are blocked by your
consent settings
Anemia of chronic kidney disease and end-stage renal disease: Are there unique issues in disadvantaged populations?
(2009-03)
Several sources of data indicate that there are racial and ethnic disparities in the management of anemia of chronic kidney disease and end-stage renal disease. In this article, I present evidence documenting these disparities and discuss possible factors that may explain the suboptimal anemia management. I also provide recommendations to improve anemia management in disadvantaged populations.
Scopus© Citations 2 16 1
Some of the metrics are blocked by your
consent settings
Systemic complications of chronic kidney disease
(2015)
;
Pereira, Brian J. G.
The kidney plays a critical role in the maintenance of homeostasis. As kidney function diminishes, excretory, regulatory, and endocrine function is lost, and complications develop in essentially every organ system. Kidney failure is the last stage in the continuum of progressive CKD. Management of the complications associated with CKD mainly includes dietary counseling, adequate control of volume and blood pressure, and use of phosphate binders, calcitriol (Calcijex, Rocaltrol), and erythropoietin. Many of these complications can be prevented or attenuated with optimal CKD care, which involves early detection of progressive kidney disease, interventions to retard its progression, prevention of uremic complications, attenuation of comorbid conditions, adequate preparation for kidney replacement therapy, and timely initiation of dialysis (figure 2). Closer attention to CKD care is likely to be the key to improved outcomes among patients with kidney failure.
Scopus© Citations 16 7 1
Some of the metrics are blocked by your
consent settings
Anaemia of chronic kidney disease: an under-recognized and under-treated problem
(2002)
;
Pereira, Brian J. G.
Patients with chronic kidney disease (CKD) almost invariably develop anaemia, which is associated with increased morbidity and mortality, and reduced quality of life. Anaemia begins early in the course of CKD, and although treatment with erythropoietin is effective, the condition is often under‐treated. Because of the growing body of scientific literature on the significant morbidity and mortality associated with anaemia of CKD, a Renal Anaemia Management Period (RAMP) was proposed. This is defined as the time after onset of CKD when anaemia develops and requires early diagnosis and treatment. The RAMP was developed to call attention to the need to improve outcomes for patients with CKD and possibly lower the economic burden by correcting anaemia earlier. It is an important opportunity for preventive care and has the potential to limit costs associated with comorbidities of CKD.
Scopus© Citations 32 12 1
Some of the metrics are blocked by your
consent settings
Chronic Kidney Disease in the United States: An Underrecognized Problem
(2002)
;
Pereira, Brian J.G.
;
Kausz, Annamaria T.
The continued growth of the population with end-stage renal disease (ESRD) is partially related to the underrecognition of earlier stages of chronic kidney disease (CKD) and risk factors for the development of CKD. There are several published estimates of the prevalence of CKD in the United States. From Third National Health and Nutrition Examination Survey data it has been estimated that there are 6.2 million individuals with serum creatinine levels at or above 1.5 mg/dL, or 8.3 million individuals with decreased glomerular filtration rate (<60 mL/min/1.73 m (2)). Estimates of prevalence from a health maintenance organization study suggest that there are 4.2 million Americans with persistently elevated serum creatinine levels. In addition to the high prevalence, several studies have shown that CKD is associated with increased risk for cardiovascular disease, hospitalizations, and mortality. To promote earlier detection of CKD, The National Kidney Foundation Guidelines for CKD: Evaluation, Classification and Stratification, recommended screening individuals at increased risk for CKD, such as patients with diabetes, high blood pressure, and family history of kidney disease. Therapeutic interventions to delay progression and reduce comorbidity, such as cardiovascular disease, are more likely to be effective if they are implemented early in the course of CKD. Copyright 2002, Elsevier Science (USA). All rights reserved.
Scopus© Citations 68 13 1
Some of the metrics are blocked by your
consent settings
Prevalence of Malnutrition in Low-Income Mexican CAPD Patients
(2003)
García-García, Guillermo
;
Nuñez-Martinez, Maria Guadalupe
;
Malnutrition is a common finding in continuous ambulatory peritoneal dialysis (CAPD) patients (1-6) and has been shown to be associated with increased morbidity and mortality (5). Identified risk factors are diabetes mellitus and female gender, nutritional status at the start of therapy, length of time on dialysis, age, and residual renal function (1,4,7,8). The reported prevalence in developed countries varies from 18% to 55% (1-3,5,6). In Mexico, it has been reported that 82% of CAPD patients show some degree of malnutrition (4). Socioeconomic factors and diabetes mellitus might contribute to the problem, since reduced income limits the availability of food. Our program provides CAPD to patients from the lowest social strata in Mexico. The average annual income in our state is US$1,775 and the prevalence of malnutrition is 25% (9). Our patients’ annual income per capita ranges between US$30 and US$430. (10). Diabetes mellitus is the main cause of end-stage renal disease (ESRD) in our state, representing 40% of our prevalent CAPD population (11). In this study, we report the prevalence of malnutrition among low-income Mexican CAPD patients and compare results with other series. Copyright © by International Society for Peritoneal Dialysis
Scopus© Citations 7 26 2
Some of the metrics are blocked by your
consent settings
Level of renal function at the initiation of dialysis in the U.S. end- stage renal disease population
(1999)
;
Pradeep, Arora
;
Kausz, Annamaria T.
;
Ruthazer, Robin
;
Pereira, Brian J.G.
Background: More than 285,000 individuals in the United States suffer from end-stage renal disease (ESRD) and are treated predominantly by dialysis. Despite the high cost and poor outcomes of dialysis treatment for ESRD, there are few data about the level of renal function at the onset of ESRD and no established medical criteria for the initiation of dialysis. Methods: We report the level of serum creatinine and glomerular filtration rate (GFR) in 90,897 patients who began dialysis in the U. S. between April 1995 through September 1997. Data were obtained from the U.S. Renal Data System. GFR was predicted by an equation developed from the Modification of Diet in Renal Disease Study. ©1999 by the International Society of Nephrology
Scopus© Citations 119 9 2
Some of the metrics are blocked by your
consent settings
Late initiation of dialysis among women and ethnic minorities in the United States
(2000-12)
Kausz, Annamaria T.
;
;
Arora, Pradeep
;
Ruthazer, Robin
;
Levey, Andrew S.
The ideal timing of initiation of renal replacement (RRT) therapy has been debated. It is currently recommended that RRT be instituted once the GFR falls below 10.5 ml/min per 1.73 m(2), unless edema-free body weight is stable or increased, the normalized protein nitrogen appearance rate is 0.8 g/kg per d or greater, and there are no clinical signs or symptoms of uremia. However, the mean estimated GFR at initiation of dialysis in the United States is 7.1 ml/min per 1.73 m(2). Factors that are associated with timing of initiation of dialysis in the United States are not clear. A cross-sectional study was performed to determine the factors that are associated with late initiation of dialysis as defined by GFR at initiation of less than 5 ml/min per 1.73 m(2) among patients who began dialysis in the United States between 1995 and 1997. Data were obtained from the U.S. Renal Data System, and GFR was estimated using the formula derived from the Modification of Diet in Renal Disease Study. Twenty-three percent of patients started dialysis late. In the multivariate analysis, women (odds ratio [OR] = 1.70), Hispanics and Asians (OR = 1.47 and 1.66, respectively, compared with Caucasians), uninsured patients (OR = 1.55 compared with private insurance), and employed patients (OR = 1.20) were more likely to start dialysis late. Patients with diabetes, cardiac disease, peripheral vascular disease, and poor functional status were less likely to start dialysis late compared with patients without these comorbid conditions. Certain nonclinical patient characteristics, notably female gender, race, and lack of insurance, are related to an increased likelihood of late initiation of dialysis. These factors may reflect reduced access to care. Additional studies are indicated to determine the potential impact of reduced access to care and whether late initiation of dialysis results in adverse clinical and economic outcomes among patients with end-stage renal disease in the United States. © Journal of the American Society of Nephrology
Scopus© Citations 153 9 2
Some of the metrics are blocked by your
consent settings
Anemia management in patients with chronic renal insufficiency
(2000)
Kausz, Annamaria T.
;
;
Gutiérrez, Sebastián
The introduction of recombinant human erythropoietin (rHuEPO) more than a decade ago provided the first effective treatment for the anemia of chronic renal insufficiency (CRI). The use of rHuEPO in the treatment of anemia has been associated with partial regression of left ventricular hypertrophy among both dialysis and nondialysis patients, and has been shown to reduce the frequency of cardiac complications such as congestive heart failure and number of days of hospitalization among dialysis patients. Despite this evidence, the anemia of CRI remains highly prevalent, underrecognized, and undertreated. A number of considerations arise regarding the management of anemia among patients with CRI. In this article, we review the rationale for treatment of anemia, current management practices, proposed treatment strategies, and the economic implications of improved anemia treatment. ©American Journal of Kidney Diseases
Scopus© Citations 43 8 1

CRIS

Browse

Filters

Settings

Sort By

Results per page

Search Results