RESUMO
The aim of this study was to evaluate the factors that prevent dry weight achievement in patients with end-stage renal disease (ESRD) in renal replacement therapy through the change in their body weight after kidney transplant (KT) compared with 1 week before KT. The study included 188 ESRD patients of diverse etiology who received living kidney transplantation with normal immediate graft function, 62.2% were male, age 29 ± 11 years old. All patients were on renal replacement therapy for at least 1 month before KT with either hemodiafiltration (N = 106), hemodialysis (N = 25), or peritoneal dialysis (N = 57). Based on body weight difference (after transplant-before transplant), patients with body weight difference ≤2 kg were considered as being close to their dry weight (Group 1, N = 112), whereas patients with body weight difference >2 kg were considered as being overhydrated (Group 2, N = 76). Clinical and biochemical characteristics were obtained from the medical records at three periods of time: time of ESRD initiation (baseline), 1 week before undergoing KT, and 1 week after KT. The mean time (± standard deviation) from renal replacement therapy initiation to the week before KT was 9.2 ± 5 months. Group 2 had a higher proportion of men, antihypertensive use, peritoneal dialysis, and higher urine output during all periods. Before KT, Group 2 had higher systolic and diastolic blood pressures than Group 1. After KT, both systolic and diastolic blood pressures decreased in Group 2, whereas no change occurred in Group 1. Before KT, Group 2 had higher levels of blood urea nitrogen, creatinine, uric acid, and phosphorous compared with Group 1. Compared with baseline, Group 1 had more optimal blood urea nitrogen, creatinine, and uric acid parameters before KT than Group 2. After KT, all parameters improved with respect to baseline in both groups. Hemoglobin, albumin, and sodium were similar between groups, except for higher hemoglobin in Group 2 than Group 1 after KT. Multivariate regression analysis showed that male sex, peritoneal dialysis, and systolic blood pressure before KT were independent risk factors for overhydration. In conclusion, high systolic blood pressure and peritoneal dialysis were two independent modifiable variables associated with overhydration before KT. Assessment of the body weight change after KT is a useful tool to evaluate dry weight, in addition to identifying variables associated with poor volume control. This could allow adjustment of clinical and dialysis parameters in future patients.
Assuntos
Falência Renal Crônica/terapia , Transplante de Rim , Rim/cirurgia , Terapia de Substituição Renal , Adolescente , Adulto , Feminino , Humanos , Rim/fisiopatologia , Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/cirurgia , Masculino , Resultado do Tratamento , Adulto JovemRESUMO
Background: The measurement of psychosocial risk among workers is becoming increasingly important. Aim: To adapt, validate and standardize a questionnaire to measure psychosocial risks in the workplace. Material and Methods: The Spanish version of the Copenhagen Psychosocial Questionnaire was adapted and evaluated. Its contents were first validated with a panel of experts. Afterwards a semantic adaptation of the questionnaires was carried out applying it to a pilot sample. Finally, it was applied to 1,557workers (65% men). Results: A preliminary questionnaire containing 97 questions was constructed. A good item-test correlation was found, the factorial structure was similar to the original questionnaire and it had a good internal consistency, convergent validity with the Goldberg Health Questionnaire and test-retest correlation. Ranges for the different dimensions and sub-dimensions of psychosocial risk were calculated by tertiles. Conclusions: The resulting questionnaire is useful for measuring psychosocial risk factors at work, with good psychometric properties.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Saúde Ocupacional , Inquéritos e Questionários , Local de Trabalho/psicologia , Chile , Psicometria , Medição de Risco , TraduçãoRESUMO
BACKGROUND: The measurement of psychosocial risk among workers is becoming increasingly important. AIM: To adapt, validate and standardize a questionnaire to measure psychosocial risks in the workplace. MATERIAL AND METHODS: The Spanish version of the Copenhagen Psychosocial Questionnaire was adapted and evaluated. Its contents were first validated with a panel of experts. Afterwards a semantic adaptation of the questionnaires was carried out applying it to a pilot sample. Finally, it was applied to 1,557 workers (65% men). RESULTS: A preliminary questionnaire containing 97 questions was constructed. A good item-test correlation was found, the factorial structure was similar to the original questionnaire and it had a good internal consistency, convergent validity with the Goldberg Health Questionnaire and test-retest correlation. Ranges for the different dimensions and sub-dimensions of psychosocial risk were calculated by tertiles. CONCLUSIONS: The resulting questionnaire is useful for measuring psychosocial risk factors at work, with good psychometric properties.
Assuntos
Saúde Ocupacional , Inquéritos e Questionários , Local de Trabalho/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Chile , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Medição de Risco , Tradução , Adulto JovemRESUMO
Los profundos cambios ocurridos en los últimos años en el Sistema de Salud en Chile han traído consecuencias en la formación de médicos especialistas. El propósito de este trabajo fue estudiar las características socioeconómicas y la percepción que los médicos especialistas tienen de su formación en Psiquiatría. Entrevistamos casi todo el universo de becados en los Hospitales bajo tuición de la Universidad de Chile. Observamos una paulatina disminución del número de psiquiatras en formación. Hay un constante aumento del número de mujeres que entran a Programas de Formación en esta especialidad. La mayoría de los médicos hacen su especialización apenas terminada su formación médica. Sólo un 25%de los residentes tenían una beca y beneficios sociales durante su formación