Search

In this work 99mTc-MIBI cardiac scintigraphs are quantitively analyzed with the aim to determine the radiopharmaceutical uptake in the heart (organ of interest) and in the liver. The impact of the radioactivity distribution in the diagnostic quality of the images is discussed.

Healthcare-Associated Infections (HAIs) are an important public health problem that impacts negatively on hospital costs and patient prognosis. Given the importance of the hospital environment in the development of HAIs, the objective was to evaluate the bacterial profile on surfaces and equipment of the Orthopedic Clinic of the Hospital Universitário do Vale do São Francisco. Methods: This is a cross-sectional, descriptive, quantitative study. Samples were collected in 13 wards, each ward with four beds and one was chosen at random, where surfaces and equipment were sampled using swabs soaked in saline and a 1cm2 filter paper mold to standardize the samples. After passing the swab, they were stored in a tube containing 5mL of BHI (Brain Heart Infusion) liquid medium. Then, samples were transported to the Clinical Analysis Laboratory/Microbiology Sector where the microbiological analyzes were performed. Results: In total, 257 bacteria were observed, of which 5.11% were possible causes of hospital infection and 79% coagulase-negative Staphylococcus. Antibiograms of these were performed and different resistance profiles were found. The bathroom doorknob, a high-touch surface, presented the greatest variety of species among the evaluated surfaces. Conclusion: Surfaces and equipment of the evaluated clinic present possible bacteria that cause hospital infection with different profiles of antimicrobial resistance, contributing to possible cross infections

Introduction: Most of existing work on burden among family caregivers has methodological sample constraints. Moreover, there is contradictory information regarding sociodemographic variables, especially those related to care, clinical variables, and burden. Few studies have analysed the self-esteem and personality characteristics as correlates of burden. In this study, an analysis is performed on the prevalence of burden among family caregivers and the relationship with their sociodemographic, care-related, and clinical characteristics. Materials and methods: The study consisted of a randomly selected sample of 294 family caregivers (mean age 55.3 years, 89.8% women) from the Autonomous Region of Galicia, Spain. Trained psychologists assessed the presence of burden via the Zarit Caregiver Burden Interview (CBI). Information was also collected on sociodemographic, care-related variables, social support, personality characteristics, and self-esteem. Results: More than half (55.4%) of the surveyed caregivers exhibited burden (CBI > 24), with mean score of 27.3 (SD = 13.3). Not being employed outside the home and having higher scores in neuroticism were associated with a greater probability of presenting with burden, while being older and having higher social support were associated with a lower risk. Conclusions: A significant number of caregivers suffered from burden in the current study. Psychotherapeutic interventions need to be developed for those who are already suffering from burden, as well as prevention strategies for those who have not yet developed it.

Exposure to high concentration levels of radon gas constitutes a major health hazard, being nowadays the second-leading cause of lung cancer after smoking. Facing this situation, the last years have seen a clear trend towards the search for methodologies that allow an efficient prevention of the potential risks derived from the presence of harmful radon gas concentration levels in buildings. With that, it is intended to establish preventive and corrective actions that might help to reduce the impact of radon exposure on people, especially in places where workers and external users must stay for long periods of time, as it may be the case of healthcare buildings. In this paper, a new methodology is developed and applied to the prevention of the risks derived from the exposure to radon gas in indoor spaces. Such methodology is grounded in the concurrent use of expert systems and regression trees that allows producing a diagram with recommendations associated to the exposure risk. The presented methodology has been implemented by means of a software application that supports the definition of the expert systems and the regression algorithm. Finally, after proving its applicability with a case study and discussing its contributions, it may be claimed that the benefits of the new methodology might lead on to an innovation in this field of study. Universidade de Vigo Xunta de Galicia

Diabetes is a chronical illness, commonly considered as the disease of the 21st Century. Diabetic foot is one of the several conditions associated to this disease, which in the most severe cases might be the cause of amputations on the lower limbs. Such condition involves a high social impact for patients and families, and puts an important burden on the health and care systems. It is essential to aim at an early detection of the pathology and at its continuous monitoring in order to perform a convenient follow-up of those patients’ condition, from both the preventive and the therapeutic viewpoints. Following this line, different decision support methodologies are nowadays under development within the remote medicine framework, that in this specific case might help to improve the process for monitoring and treating patients that are likely to develop wounds associated with diabetic foot condition. This communication, framed in the previously introduced context, aims to carry out the conceptual adaptation of the decision support methodology presented by the authors in a previous work, which addressed the prevention and monitoring of patients likely to develop wounds associated to diabetic foot condition. The revised methodology, complemented by the use of expert systems, will allow to generate alerts associated to the evolution of foot wounds in at-risk diabetic patients, by means of the interpretation and combined use of: a set of data coming from a test, a picture, and the opinions and considerations provided by an expert in the topic. Said information is fed into two concurrent inference systems, which produce a number of risk indicators that, after being appropriately combined, determine a final alert associated to a measurement of diabetic foot condition risk. Even if this system is at the moment at an active development stage, it is expected that its usage will make possible to improve the process for an early detection of the potential issues associated with diabetic foot condition, as well as the monitoring of its associated pathologies.

Respiratory diseases are currently considered to be amongst the most frequent causes of death and disability worldwide, and even more so during the year 2020 because of the COVID-19 global pandemic. Aiming to reduce the impact of these diseases, in this work a methodology is developed that allows the early detection and prevention of potential hypoxemic clinical cases in patients vulnerable to respiratory diseases. Starting from the methodology proposed by the authors in a previous work and grounded in the definition of a set of expert systems, the methodology can generate alerts about the patient&rsquo, s hypoxemic status by means of the interpretation and combination of data coming both from physical measurements and from the considerations of health professionals. A concurrent set of Mamdani-type fuzzy-logic inference systems allows the collecting and processing of information, thus determining a final alert associated with the measurement of the global hypoxemic risk. This new methodology has been tested experimentally, producing positive results so far from the viewpoint of time reduction in the detection of a blood oxygen saturation deficit condition, thus implicitly improving the consequent treatment options and reducing the potential adverse effects on the patient&rsquo, s health.

O artigo fala sobre o câncer gestacional. Esse tipo de neoplasia ocorre apenas em grávidas, ou até um ano após o parto, onde inclui a fase da lactação. O índice ainda é relativamente “pequeno”, porém, como foi observado nos estudos, esses números estão crescendo cada vez mais. Pois, as mulheres atualmente, estão prorrogando a gestação, em busca da sua liberdade financeira. Trata-se de uma revisão bibliográfica, realizada através da busca em revistas eletrônicas, manuais, portarias e sites governamentais, apresentando dados sobre o câncer gestacional no Brasil. Conclui-se que, essa neoplasia é uma enfermidade grave. Assim, é importante que os profissionais de saúde, principalmente a enfermagem, tenham o conhecimento sobre esse assunto, para sua atualização constante. Esse artigo tem como objetivo explicitar a importância do conhecimento sobre o câncer gestacional e mostrar que com o passar dos dias, o câncer gestacional está cada vez mais comum entre as gestantes.

Species distribution models (SDMs) are broadly used to predict species distributions from available presence data. However, SDMs results have been criticized for several reasons mainly related to two basic characteristics of most SDMs: 1) general lack of reliable species absence information, 2) the frequent use of an arbitrary geographical extent (GE) or accessible area of the species. These impediments have motivated us to generate a procedure called niche of occurrence (NOO). NOO provides the probable distribution of species (realized niche) relying solely on partial information about presence of species. It operates within a natural geographical extent delimited by available observations and avoids using misleading thresholds to obtain binary presence–absence estimations when the species prevalence is unknown. In this study the main characteristics of NOO are presented, comparing its performance with other recognized and more complex SDMs by using virtual species to avoid the omnipresent error sources of real data sets., This study has been partially supported by the project BIOWEB (CGL2011-15622-E BOS) founded by Spanish Ministerio de Ciencia e Innovación, and by the projects BANDENCO (POII11-0277-5747) and IBERARTRO (SBPLY/17/180501/000492) founded by the Consejería de Educación, Ciencia y Cultura-Junta de Comunidades de Castilla-La Mancha.

Understanding the factors shaping species’ distributions is a key longstanding topic in ecology with unresolved issues. The aims were to test whether the relative contribution of abiotic factors that set the geographical range of freshwater fish species may vary spatially and/or may depend on the geographical extent that is being considered. The relative contribution of factors, to discriminate between the conditions prevailing in the area where the species is present and those existing in the considered extent, was estimated with the instability index included in the R package SPEDInstabR. We used 3 different extent sizes: 1) each river basin where the species is present (local); 2) all river basins where the species is present (regional); and 3) the whole Earth (global). We used a data set of 16,543 freshwater fish species with a total of 845,764 geographical records, together with bioclimatic and topographic variables. Factors associated with temperature and altitude show the highest relative contribution to explain the distribution of freshwater fishes at the smaller considered extent. Altitude and a mix of factors associated with temperature and precipitation were more important when using the regional extent. Factors associated with precipitation show the highest contribution when using the global extent. There was also spatial variability in the importance of factors, both between species and within species and from region to region. Factors associated with precipitation show a clear latitudinal trend of decreasing in importance toward the equator.

Perceived social support has been shown to be one of the most important protective factors for emerging adult students during their transition to university. However, the relationships between perceived social support and dimensions of gender and family background, which have been shown to affect adjustment to college life, remain unexplored. The current study analyzes the effect of gender, parents' education, and family income level on social support perceived by Spanish university students. The sample consisted of 575 women and 280 men, of average age 18.02 years (SD=0.52) enrolled in the first year of degree courses at the University of Santiago de Compostela (Spain). Three measures were used to assess various facets of perceived social support, namely perceived acceptance, social provisions, and support availability and satisfaction. Gender differences were identified for several perceived social support dimensions; women reported a wider social network, which should cover more diverse needs of social support. In addition, differences related to mother's education and family income level emerged for the availability of support and perceived acceptance. The results highlight the different role of gender and family background in several dimensions of perceived social support during the transition to emerging adulthood.

The ketogenic diet, a non-drug treatment with proven effectiveness, has been the most commonly used therapy in the past decade for the management of refractory epilepsy in the pediatric population. Compared to adding a new drug to a pre-existing treatment, the ketogenic diet is highly effective and reduces the number of seizures by 50-90% in approximately 45-60% of children after six months of treatment. For this reason, the Argentine Society of Pediatric Neurology established the Ketogenic Diet Working Group. It is integrated by pediatric dietitians, pediatricians, pediatric neurologists and B.S. in Nutrition, who developed recommendations for the optimal management of patients receiving the classical ketogenic diet based on expert consensus and scientific publications in this field.La dieta cetogénica constituye el tratamiento no farmacológico de eficacia probada más utilizado en la última década para el manejo de la epilepsia refractaria en la población pediátrica. En comparación con el agregado de un nuevo fármaco a un tratamiento preexistente, esta terapia es altamente efectiva, con una reducción de las crisis de entre un 50% y un 90% en aproximadamente 45%-60% de los niños tras 6 meses de tratamiento. Es por ello por lo que la Sociedad Argentina de Neurología Infantil creó el Grupo de Trabajo de Dieta Cetogénica. Este está conformado por médicos nutricionistas infantiles, pediatras, neurólogos infantiles y licenciados en Nutrición, quienes elaboraron estas recomendaciones para un manejo óptimo de los pacientes que reciben la dieta cetogénica clásica, basándose en el consenso de los expertos y la bibliografía publicada en el tema.

This paper analyses the impact of learning strategies, gender, academic field attended and students’ entrance classification to the university on academic achievement at the end of the first academic year. The study, developed with 445 first-year college students (68.5% female), ages between 17 and 57 years old (M = 18.3; SD = 2.17), from the University of Minho (Portugal), implicated answering a questionnaire on learning strategies, which concerned five dimensions (comprehensive approach, surface approach, personal competency perceptions, intrinsc motivation and organization of study activities). Regression analyses showed that academic achievement was more related to students’ entrance classifications to the university than to their learning strategies, independently of the academic field attended. Despite the significance of the other variables, these results seem to highlight the relationship between students’ academic preparation and their achievement at the end of the first-year., Cet article analyse le rôle de la préparation académique et des stratégies d’apprentissage dans la prediction des resultats académiques des étudiants collegiens portugais de premiere année, considerant le sexe des étudiants et le champ d’etudes poursuivies. Un échantillon de 445 etudiants collegiens de première annee (68,5% féminin) de l’Universite de Minho (25,8% inscrits en economie, 35,3% en sciences et technologies et 38,9% en sciences humaines) a participe à cette étude. Les étudiants ont répondu à un questionnaire sur les stratégies d’apprentissage, dans la classe à la fin du premier semestre, lequel consistait à 44 items organisés en cinq dimensions : approche comprehensive, approche de surface, perceptions des competences personnelles, motivation intrinse que et organisation des activites d’étude. Les resultats académiques (moyenne des notes à la fin de la premiere année) et la préparation acadeémique (score combinant les résultats academiques à l’école secondaire et les résultats aux examens d’entree à l’universite) furent obtenus en consultant les dossiers académiques conservés à l’université Les résultats ont montré que la préparation académique était le plus fort prédicteur des résultats académiques lors de la première année. Seulement une variance marginale additionnelle était expliquee par les stratégies d’apprentissage tel qu’évaluées par le questionnaire auto-rapporté. En dépit des différences relatives au sexe des étudiants et au champ d’études, ces variables ne semblent pas assez puissantes pour affecter les résultats. Malgré tout, les differents pourcentages de variance expliquée par chaque modèle et les differents poids associes à la preparation academique stimulent l’utilisation de ces variables ou d’autres variables personnelles et contextuelles lors de l’analyse du phenomene., E l presente trabajo analiza el papel de la preparación académica y las estrategias de aprendizaje en la predicción del rendimiento de los estudiantes del primer curso de la universidad, teniendo en cuenta el sexo de los estudiantes y el campo académico al que pertenecen. La muestra consistio´ en 445 estudiantes del primer curso (68,5% mujeres) de la Universidad de Minho (25,8% matriculados en economı´a, 35,3% en ciencia/tecnología, y 38,9% en humanidades). Los estudiantes contestaron a un cuestionario sobre las estrategias de aprendizaje al final del primer cuatrimestre, el cual consistió en 44 ítems organizados en cinco dimensiones: enfoque comprensivo, enfoque superficial, percepción de la competencia personal, motivación intrínseca y organización de las actividades de estudio. El rendimiento académico (la media de las notas al final del primer curso) y la preparación académica (la nota de acceso a los estudios superiores) fueron obtenidos de los registros de la universidad. Los resultados demostraron que la preparación académica fue el predictor más importante del rendimiento acadeémico en el primer curso y solo la varianza marginal adicional fue explicada por las estrategias de aprendizaje recogidas en el cuestionario de auto-informe. A pesar de las diferencias de género y campo académico, estas variables no parecen suficientemente fuertes como para afectar a los resultados. Aún así, los diferentes porcentajes de varianza capturados por cada modelo y los diferentes pesos asociados a las notas de acceso a los estudios estimulan el uso de estas y/u otras variables personales y contextuales al analizar este fenómeno.

Background End-stage renal disease is a troublesome health problem worldwide. The most usual renal replacement therapy is conventional haemodialysis (CHD), performed three times a week, 3.5-4 h per session. It has been proposed that this schedule is unphysiologic and that daily haemodialysis would be a more appropriate schedule. One of the variants of daily haemodialysis is the so-called short daily haemodialysis (SDHD), performed five to seven times per week, 1.5-3 h per session. The objective of this paper is to compare, through a systematic review, the clinical effectiveness and safety of SDHD versus CHD. Methods The following databases were searched: MEDLINE, EMBASE, NHS Centre for Reviews and Dissemination (HTA, DARE and NHS EED), Cochrane, ISI Web of Knowledge, IME and IBECS. Two independent reviewers decided which papers were to be included after applying inclusion and exclusion criteria. Any discrepancy was resolved by consensus. The quality of the included papers was measured using a quality scale developed for the purpose of this report. Results Seventeen original articles were included. There were no randomized controlled trials. SDHD seems to be more effective than conventional dialysis. Patients on daily haemodialysis seem to present less vascular access problems, better control of hypertension and in turn a reduction in the antihypertensive treatment, better quality of life, lower incidence of ventricular hypertrophy, lower consumption of rHuEPO due to the better control of anaemia and a reduction in the use of phosphate binders as a consequence of the better control of plasmatic phosphorous. Conclusions SDHD might result in a better clinical effectiveness, mainly through a better control of the arterial tension and, therefore, a lower consumption of antihypertensive drugs, and a better quality of life than CHD.

We herein present FactorsR, an RWizard application which provides tools for the identification of the most likely causal factors significantly correlated with species richness, and for depicting on a map the species richness predicted by a Support Vector Machine (SVM) model. As a demonstration of FactorsR, we used an assessment using a database incorporating all species of terrestrial carnivores, a total of 249 species, distributed across 12 families. The model performed with SVM explained 91.9% of the variance observed in the species richness of terrestrial carnivores. Species richness was higher in areas with both higher vegetation index and patch index, i.e., containing higher numbers of species whose range distribution is less fragmented. Lower species richness than expected was observed in Chile, Madagascar, Sumatra, Taiwan, and Sulawesi., We acknowledge support by the CSIC Open Access Publication Initiative through its Unit of Information Resources for Research (URICI), We thank Empresa Nacional de Electricidad (ENDESA) for technical and financial support.

BACKGROUND Atherosclerosis associated with hyperlipidaemia is a major cause of morbidity and mortality after renal transplantation. Atorvastatin is a new HMG-CoA reductase inhibitor that has shown a favourable profile of lipid reduction when compared with other statins. The aim of the study was to assess the efficacy and safety of atorvastatin in hypercholesterolaemic renal transplant patients who had previously been on statins with little or no effect. METHODS Atorvastatin, 10 mg/day, was administered to 10 renal transplant recipients with persistent hypercholesterolaemia (total cholesterol >240 mg/dl) for a period of 3 months. All of them had already been on statins for at least 3 months. RESULTS Atorvastatin exerted a satisfactory lipid-lowering effect in seven of 10 patients. On average, serum total cholesterol (311+/-36.2 vs 253+/-48.8 mg/dl; P

Whether microalbuminuria (MA) is the result of intrarenal hemodynamic changes induced by increased systemic blood pressure (BP) or a marker of capillary leakiness at the glomerular level that reflects more generalized atherosclerotic vascular damage is still debated. To address this question, 319 patients without diabetes, 154 men and 165 women aged 57 ± 8.6 years (range, 37 to 73 years), but with essential hypertension (EH) never treated with drugs were enrolled onto the study. Using a multiple linear regression analysis, we analyzed the prevalence of MA and its relationship with BP level as well as with other risk factors for the development of atherosclerosis. MA was present in 40% of the population studied. A univariable analysis of ambulatory BP monitoring measurements showed that only 24-hour systolic BP ( P = 0.04), daytime systolic BP ( P = 0.02), and 24-hour daytime and nighttime systolic BP load ( P P P P P

‘Magic mushrooms’ ingestion among the drug-using population has become a popular cheap way to get hallucinogenic effects which is not free of complications. One of these is acute renal failure related to Cortinarius genus intake. This one greatly resembles ‘magic mushrooms’ and confusion is possible for inexperienced collectors. We report the case of a young male ex-drug addict who developed acute tubulointerstitial nephritis after voluntary ingestion of Cortinarius orellanus. The clinical picture was preceded by a long latency period, had an insidious course without any data of hepatoxicity and evolved to a chronic state. Renal biopsy showed nonspecific histopathological findings. In summary, it is important to bear this possibility in mind when facing an acute tubulointerstitial nephritis of unknown origin in a drug-taking patient.

Background Transplantation is the treatment of choice for many patients with end-stage liver disease. We evaluated the results of liver transplantation in Galicia, an autonomous community in Northwest Spain. Methods We analyzed 452 patients and 490 grafts from 1996 to 2000 for causes of loss with respect to recipient and donor variables using the actuarial method, Kaplan-Meier curves, log-rank test, and Cox proportional risks model. Results The overall graft survival was 77% and 64% at 1 and 5 years, respectively; while that of the patients was 83% and 69%. The risk factors for graft loss were donation in heart failure (HR = 4.91, CI:2.51–9.61); donor age (HR = 1.70, CI:1.01–2.85 between 40 and 60 years; HR = 2.37, CI:1.37–4.10 in those over 60 years, as compared to patients under 40); urgent transplant (HR = 3.95, CI:2.07–7.54); and transplant due to acute liver failure (HR = 3.53, CI:1.72–7.25) as compared to alcoholic cirrhosis. For patient death the risk factors were age of recipient over 60 years, compared to those under 40 (HR = 2.42, CI:1.11–5.28); foreign place of origin (HR = 2.02, CI:1.14–3.59); transplant due to viral cirrhosis (HR = 1.76, CI:1.03–3.02) and transplant due to acute liver failure (HR = 4.62, CI:2.12–10.06), as compared to alcoholic cirrhosis; urgent transplant (HR = 2.65, CI:1.48–4.72), and age of donor over 60 years, as compared to those under 40 (HR = 2.65, CI:1.48–4.72). Infections were the principal cause of death (45%), mostly in the first month (72%); while after the first year, 74% were due to recurrence of the primary disease and de novo malignancy. Conclusions Graft and patient survivals were comparable to international registries. The donor characteristics had a greater influence on graft survival than on patient survival.

Involvement in extra-curricular campus activities has been un- derlined as an important factor in promoting the adjustment, success and development of students during their university course. The present study analyses the academic experience, achievement and adjustment of univer- sity students through the comparison of three groups: (i) students without any involvement in extra-curricular campus activities; (ii) students involved in University Governing Bodies; and (iii) students involved in Student Un- ion activities. At the beginning of the second semester, selected students of the University of Minho (N=223) responded to a questionnaire - Aca- demic Experiences Questionnaire (AEQ; Almeida and Ferreira, 1997) - and a short questionnaire about their diligence in classes and their involvement in extra-curricular campus activities. The results obtained in the three groups were statistically related to certain dimensions of their academic adjustment process, as well as to their academic achievement. Significant statistical contrasts are noticeable when students with no involvement in extra-curricular activities are compared with those involved in Student Un- ion administration, sports, cultural and social activities. The latter group presents lower class diligence and academic achievement.

We have studied the response of hemoglobin (Hb), hematocrit, reticulocytes, mean corpuscular volume, ferritin, serum iron, total iron-binding capacity (TIBC) and the transferrin saturation index in 9 patients on chronic hemodialysis (HD) with minimal aluminum overload who were treated with recombinant human erythropoietin (rHuEPO) when a single dose of deferoxamine (DFO; 40 mg/kg b.w.) was administered. Analytical determinations were performed basally and 48 h, 7 days and 14 days after a DFO test. Hb increased from a basal value of 10 +/- 0.28 to 10.7 +/- 0.33 (p0.05), 10.4 +/- 0.33 (p0.05) and 10.1 +/- 0.31 g/dl (NS), respectively, and similar increases were seen with the hematocrit. Serum iron increased from 52 +/- 7.62 to 89.2 +/- 14.48 (p0.01), 94 +/- 18.73 (p0.01) and 85 +/- 14.01 micrograms/dl (p0.01), respectively. TIBC and ferritin did not change but the transferrin saturation index increased significantly. DFO produces an immediate improvement of the anemia in HD patients treated with rHuEPO and who have minimal aluminium accumulation: it should be related to an increased iron availability to erythroid precursors either releasing stored iron or decreasing aluminum-bound transferrin.

The taxonomic identification of fishes is a time-consuming process for those who are not specialists and, therefore, are more liable to make mistakes. We measured morphometric characters in more than 8900 individuals belonging to 6 classes, 43 orders, 192 families, 510 genera and 847 marine and freshwater species. The aim was to determine if the taxonomic identification of juvenile and adult fishes is possible using these measurements. We developed the expert system IPez, which is based on machine learning techniques, and found that, when the number of individuals measured of a species and, hence, included in the database of IPez, is higher than approximately 15 individuals, IPez identifies correctly 100% of new individuals of this species that are not included into the database. Moreover, besides helping in the taxonomic identification of fish, this software allows the determining of the main morphometric characters that have promoted or are promoting divergence among closely related species. The software is free and available at the web page http://www.ipez.es/index%20ingles.html. We suggest increased international collaboration to introduce more species into IPez.

Background: End-stage renal disease is a major health problem worldwide nowadays. Although conventional hemodialysis is the most widely used modality, short daily hemodialysis has been proposed as a more physiologic treatment. The objective of this article is to compare the quality of life of patients on each hemodialysis modality. Methods: A multicentric cross-sectional study was performed in 9 Spanish hospitals. Patients treated for at least 3 months with conventional or short daily hemodialysis were included and quality of life measured using the Euroqol-5D quality of life questionnaire. Bayesian models were used for analyzing quality of life results. Results: Ninety-three patients were included, 27 were on daily hemodialysis and 66 on conventional hemodialysis. All models demonstrated a better quality of life for daily hemodialysis versus conventional hemodialysis. Only 14% of the patients on conventional hemodialysis were willing to change to a daily schedule. Conclusions: Short daily hemodialysis shows a better quality of life than conventional hemodialysis with all Bayesian approaches considered.

A Teoria da Atribuição de Causalidade representa um interessante corpo teórico para analisar como os alunos explicam as suas situações de sucesso e de insucesso escolar. Este artigo analisa se essas atribuições causais se diferenciam de acordo com o gênero e o ano escolar dos alunos. A amostra foi composta por 868 alunos do 5º ao 9º ano de escolaridade. A avaliação recorreu ao Questionário de Atribuições de Resultados Escolares, no qual os alunos ordenam seis causas possíveis (esforço, método de estudo, bases/conhecimentos, ajuda dos professores, sorte e capacidade) consoante a sua importância na explicação dos seus sucessos e dos seus insucessos escolares. Os resultados sugerem que os alunos, independentemente do sexo e do ano escolar, associam os seus resultados acadêmicos (sucesso e fracasso) ao esforço, surgindo ainda para explicar o insucesso a falta de métodos apropriados de estudo. À medida que se avança na escolaridade, as bases de conhecimentos surgem mais valorizadas na explicação do sucesso escolar. Por outro lado, os rapazes parecem recorrer mais à capacidade para explicar o seu sucesso, e as meninas mais ao esforço e às bases de conhecimentos. Na explicação do insucesso, a falta de esforço e de método de estudo surgem mais valorizados que a capacidade conforme se avança na escolaridade, o que parece proteger a auto-estima dos alunos. The causal attribution theory represents an interesting theoretical framework in which to analyze how students explain their academic success or failure. This paper analyzes if the causal attributions are different according to gender and school grade. The sample comprised 868 students from 5th to 9th grade. The evaluation of the attributions was conducted by means of a school results Attribution Questionnaire (known in Brazil as QARE), in which students rank six possible causes (effort, studying methods, academic background, teacher support, luck and ability) according to their importance in explaining personal academic successes and failures. The data suggest that students, regardless of gender and grade, related their academic achievement (success and failure) to effort, citing poor studying methods as a secondary reason to explain academic failure. Progressing through the school system, the academic knowledge base becomes more important when explaining success at school. On the other hand, male students resort more to ability to explain their academic success, while female students cite effort and existing academic knowledge. For the explanation of failure at school, effort and studying methods are more significant than lack of ability as their education progresses, which seems to reinforce the students' self-esteem.

Background At present, transplantation of organs represents a therapeutic alternative, but the candidates for this treatment suffer from the scarcity of donors. We analyzed the process of the donation of organs in Galicia, an autonomous region in the northwest of Spain. Methods We summed all the potential donors in Galicia between January 1996 and December 2000 to analyze the reasons for nonconversion, the characteristics of the actual donors, and the use of the generated organs. Results We found 779 potential donors of whom 443 (56%) became actual donors (annual rate 31.6 pmp), although an important interterritorial variability was observed. The main reason for not obtaining potential donors was family refusal (32%), with denial during life being given as the reason in 45% of these families. We observed a progressive aging of the donors (39% older than 60 years in 2000), who had a mean age of 46 ± 18 years. There also was an increased percentage of deaths due to vascular causes (mean 53%), while traumatic deaths (mean 40%) showed an inverse tendency. Donation because of asystole represented 5%. Among all the retrievals, 90% were multiorgan, generating 1437 organs including 1227 that were transplanted, yielding 3.3 possible organs from each donor including 2.8 organs that were transplanted. Among donors younger than 45 years, the numbers increased to 3.7 and 3.4, respectively, and for donors older than 60 years, the numbers were 2.7 and 1.9, respectively. Conclusions Despite the increase in donors and organs, family refusal did not decrease, as this was the main reason for potential donor loss. Therefore it is necessary to create a regional program to promote donation.

Background: transplantation is the best treatment for patients with chronic renal failure, including the elderly. However, the patient’s age was traditionally considered as a relative contraindication for it. Objective: to compare the results of renal transplantation in patients over and under 60 years of age. Methods: analysis of 621 transplant recipients in Galicia (Spain) between 1996 and 2000, divided into two groups, according to age over 60 years (484) or under 60 years (137). The actuarial method, Kaplan–Meier curves, log-rank test and Cox proportional hazard model were used to study survival. Results: graft survival for those aged under 60 years was 82% and 70% at 1 and 5 years, while it was 73% and 56% for those over 60 years. However, censuring the deceased patients with a functioning graft, it was 84% and 76% for those aged under 60 years and 83% and 77% for those over 60 years. A total of 47% of the graft losses in the group over 60 years were due to the patient’s death. Overall graft survival for all the patients was greater (P < 0.0001) when the donor was under 60 years of age. Conclusions: recipient age alone cannot be a criterion to exclude patients over 60 years from transplantation, since their lower survival is influenced by comorbidity and the donor’s age.

Objective The objective of this study is to assess a Simulect (basiliximab) regimen in routine clinical practice in the Spanish kidney transplantation units to evaluate efficacy and safety. Methods In this prospective, observational study, data on demographics, parameters of efficacy, and safety in patients who under with kidney transplantation treated with Simulect (basiliximab) were collected through an on-line collection system. Results One hundred sixty three patients at 18 kidney transplant units included 12 months follow-up. The patient mean age was 52 years (DS 13,67) including 96 (58.90%) men and 67 (41.10%) women. Cold ischemia time was 19 hours (DS 6,79). Only 2 patients presented with PRA >50%. For prophylactic immunosuppression, 67.13% of patients received triple therapy with CNI (cyclosporine 49.65% or tacrolimus 17.48%), MMF (66.43%) or AZA (10.49%), and steroids. Incidence of acute rejection (AR) at 12 months was 12.27% (1.84% steroid-resistant). In subgroup analysis, AR was 13.5% in nondiabetics and 4.5% in diabetics, including 3 steroid-resistant episodes (1.84%) in nondiabetics and none in diabetics. In relation to donor age, AR was incidence 10.3% in patients with kidneys from donors aged 50 years or younger and 10.6% when donors were older than 50 years, including 1 (1.73%) and 2 (1.93%) steroid-resistant episodes, respectively. The graft and patient survival rates at 12 months were 90% and 98%, respectively. Conclusions Simulect (basiliximab) used in routine clinical practice provided good prophylaxis against acute rejection in several kidney transplant patient populations, similar to that observed in randomized clinical studies with excellent tolerability and safety.

regimens, especially the introduction of cyclosporin A Background. Hypertension is common after renal (CsA) in the early 1980s [1]. However, despite these transplantation. Angiotensin II type 1 receptor antag- impressive results the rate of late renal allograft failure onists are a new class of agents that, without the side- has remained relatively unchanged. Chronic CsA eVects mediated by kinins, have shown their eYcacy nephrotoxicity and cardiovascular risk factors such as in the treatment of hypertension and heart failure. The hypertension have been suggested to play a role in this aim of the study was to assess the eYcacy and safety phenomenon [1,2]. of Losartan for the treatment of hypertension and to The benefits of angiotensin-converting-enzyme evaluate its long-term eVect on graft function in a (ACE) inhibitors in the treatment of hypertension and group of stable renal transplant patients. renal diseases have been widely reported. In contrast Methods. Eighteen non-diabetic renal transplant to other antihypertensive drugs, ACE inhibitors lower recipients evaluated at our unit for more than 1 year both systemic and intraglomerular pressure, which is after transplantation (13‐155 months) were enrolled. translated into a decrease in glomerular hypertension, Losartan was administered for a period of 14.2±6.86 a reduction in proteinuria and an increase in renal (6‐28) months at a dose of 25‐100 mg/day depending functional reserve [3]. In renal transplantation, intraon the antihypertensive response obtained. glomerular hypertension can contribute to the developResults. Losartan satisfactorily lowered systemic blood ment of renal failure. The increase of this pressure pressure. Overall graft function remained stable and may result from an increase in systemic blood pressure a significant reduction in proteinuria was observed in conjunction with a reduction in functioning renal throughout the period on Losartan (1.0±0.87 vs mass secondary to repeated renal rejection episodes, 0.4±0.83 g/l, P=0.003). No serious side-eVects were cyclosporin nephrotoxicity, small renal size and glomreported except for a significant reduction in the mean erulonephritis [4]. On the basis of these pathophysiohaemoglobin concentration (from 13.5±1.74 g/dl to logical considerations the use of ACE-inhibitors in 12.2±2.19 g/dl; P=0.001). hypertensive renal transplant patients has also been Conclusions. A satisfactory antihypertensive eVect was recommended. Moreover, recent data support an in observed with long-term therapy with Losartan. A vitro decrease in TGF b-induced fibrosis after angiosignificant reduction in proteinuria without adversely tensin blockade in a chronic CsA nephrotoxicity model aVecting graft function was the main beneficial eVect [5]. Clinical trials, except for those regarding postobserved. Losartan was generally well tolerated and a transplant erythrocytosis [6 ], are scant since ACEdecrease in haemoglobin was the major side-eVect. inhibitors can induce a decline in glomerular filtration rate when renal artery stenosis is present, as well as