Outcomes of immunosuppression minimization and withdrawal early after liver transplantation

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149209/1/ajt15205.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149209/2/ajt15205_am.pd

Análise crítica do uso do índice de massa corporal para idosos Critical analysis of the use of the body mass index for the elderly

Esta comunicação discute a utilização do índice de massa corporal, suas limitações e aplicações na avaliação do estado nutricional de idosos. Há um consenso entre os pesquisadores de que um aumento no peso corporal em indivíduos de idade mais avançada seja aconselhável, mudando os pontos de corte até então utilizados. Atualmente, recomendam-se pontos de corte para definição de baixo peso (índice de massa corporal <22kg/m²), eutrofia (índice de massa corporal entre 22 a 27kg/m²) e sobrepeso (índice de massa corporal >27kg/m²) que diferem dos valores recomendados para adultos e freqüentemente utilizados para idosos. Esta proposta leva em consideração as mudanças na composição corporal que ocorrem com o envelhecimento. Apesar de não representar a composição corporal dos indivíduos, a facilidade de obtenção de dados de peso e estatura bem como sua boa correlação com morbidade e mortalidade justificam a utilização do índice de massa corporal em estudos epidemiológicos e na prática clínica desde que se usem pontos de corte específicos para a idade, especialmente se associados a outras medidas antropométricas que expressem a composição e a distribuição da gordura corporal.<br>This communication discusses the use of the body mass index, its limitations and applications in the assessment of the nutritional status of the elderly. There is consensus between researchers that an increase in body weight in individuals of more advanced age is advisable, changing the cut-off points previously used. Currently, the cut-off points recommended for the definition of underweight (body mass index <22kg/m²), normal range (body mass index between 22 and 27kg/m²) and overweight (body mass index >27kg/m²), differ from the values recommended for adults and frequently used for the elderly. This proposal takes into consideration the changes in body composition that occur with aging. Although not representing the individual's body composition, the ease of obtaining weight and height data, as well as their good correlation with morbidity and mortality, justify the use of the body mass index in epidemiological studies and in clinical practice if age-specific cut-off values are used, especially if associated with other anthropometric measurements that express the composition and distribution of body fat

Tiempos para pensar : investigación social y humanística hoy en Venezuela. Tomo II

En nuestros tiempos, hacer investigación en Ciencias Sociales y Humanidades e intentar aportar pensamiento crítico es un hacer personal y también una tarea colectiva que se gesta en el intercambio y en el encuentro, en el debate y en la puesta en común de visiones, análisis, puntos de partida y espacios que se recorren. Hay desafíos del nuevo tiempo que son desafíos de las sociedades, e interpelan a la producción de conocimiento social y humano, le proponen preguntas y encomiendas, exigen que responda a sus demandas éticas y epistémicas desde el Sur, piden que se construyan saberes alternativos, decoloniales, que expliquen, acompañen y prefiguren la emancipación. Este libro, que cuenta con dos tomos, encara este desafío con rigurosidad y espíritu crítico

Improved Health-Related Quality of Life in a Phase 3 Islet Transplantation Trial in Type 1 Diabetes Complicated by Severe Hypoglycemia

OBJECTIVE Attaining glycemic targets without severe hypoglycemic events (SHEs) is a challenging treatment goal for patients with type 1 diabetes complicated by impaired awareness of hypoglycemia (IAH). The CIT Consortium Protocol 07 (CIT-07) trial showed islet transplantation to be an effective treatment for subjects with IAH and intractable SHEs. We evaluated health-related quality of life (HRQOL), functional health status, and health utility before and after pancreatic islet transplantation in CIT-07 trial participants. RESEARCH DESIGN AND METHODS Four surveys, the Diabetes Distress Scale (DDS), the Hypoglycemic Fear Survey (HFS), the Short Form 36 Health Survey (SF-36), and the EuroQoL 5 Dimensions (EQ-5D), were administered repeatedly before and after islet transplantation. Summary statistics and longitudinal modeling were used to describe changes in survey scores from baseline and to characterize change in relation to a minimally important difference (MID) threshold of half an SD. RESULTS Improvements in condition-specific HRQOL met the MID threshold. Reductions from baseline in the DDS total score and its four DDS subscales (all P ≤ 0.0013) and in the HFS total score and its two subscales (all P &amp;lt; 0.0001) were observed across all time points. Improvements were observed after both 1 and 2 years for the EQ-5D visual analog scale (both P &amp;lt; 0.0001). CONCLUSIONS In CIT-07, 87.5% of the subjects achieved the primary end point of freedom from SHE along with glycemic control (HbA1c &amp;lt;7% [&amp;lt;53 mmol/mol]) at 1 year post–initial islet transplantation. The same subjects reported consistent, statistically significant, and clinically meaningful improvements in condition-specific HRQOL as well as self-assessments of overall health. </jats:sec