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      Quality of Life of Patients with Nephrolithiasis and Recurrent Painful Renal Colic

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          Abstract

          Background: Quality of life (QoL) has not been a priority goal for patients with recurrent painful colic of renal lithiasis. Aim: To evaluate QoL in patients with recurrent painful symptoms due to renal colic. Methods: In this case-control study, 194 subjects (97 cases/97 controls) were matched according to age and gender. Cases were patients at an outpatient clinic with a confirmed diagnosis of nephrolithiasis with recurrent painful renal colic. The control group consisted of patients seen at an ophthalmology outpatient clinic for refraction symptoms. Main outcome measures: QoL was measured using the SF-36. Results: Average SF-36 dimension scores for cases and controls, respectively, were: physical function 70/95, role-emotional function 33.3/100, role limitations due to physical problems 25/100, bodily pain 41/84, general health status 52/82, vitality 45/80, social function 62.5/100 and mental health 52/84. All values were statistically different (p < 0.001). Using multiple linear regression, there was a statistically significant QoL drop in subjects with lithiasis. Low social and economic levels were associated with the following SF-36 domains: physical function, general health status, vitality and mental health. The influence of the diagnosis on role-physical and role-emotional domains. Analysis of the physical and mental components of the SF-36 Scale showed significantly lower averages between cases and controls: PCS (p < 0.001) and MCS (p < 0.001). Conclusion: The QoL of patients with painful recurrent symptoms due to renal colic was substantially impaired.

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          Most cited references 20

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          Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries.

          1624 patients who were attending primary health facilities in 4 developing countries were examined to determine how many were suffering from mental disorder. Using stringent criteria to establish the presence of psychiatric morbidity, 225 cases were found, indicating an overall frequency of 13.9%. The great majority of cases were suffering from neurotic illnesses and for most the presenting complaint was of a physical symptom, such as headache, abdominal pain, cough or weakness. The health workers following their normal procedure correctly detected one third of the psychiatric cases.
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            The impact of chronic pain in the community.

            Chronic pain is known to be very common in the community. Less is known about the epidemiology of more significant or severe chronic pain. The impact of chronic pain in the community, in terms of general health, employment and interference with daily activity, has not been quantified. The aim of this study was to describe the prevalence and distribution in the community of chronic pain defined as 'significant' and 'severe', and to explore the impact of chronic pain on health and activity. A questionnaire survey was carried out of a sample drawn from the general population in the Grampian region of SCOTLAND: Questionnaires were sent to a random sample of 4611 individuals aged 25 years and over, stratified for age and gender, selected from the practice lists of 29 general practices (total practice population 136,383). The study instrument included a case definition questionnaire, from which were identified individuals with 'any chronic pain' (pain of at least 3 months duration). The instrument also included a level of expressed need questionnaire and the chronic pain grade questionnaire, from which were derived definitions for 'significant chronic pain' (based on the reported need for treatment and professional advice) and 'severe chronic pain' (based on reported intensity and pain-related disability). The SF-36 general health questionnaire and demographic questions were also included. Of the sample, 14.1% reported 'significant chronic pain', and this was more prevalent among women and older age groups. A total of 6.3% reported 'severe chronic pain', and this was more common in older age groups. On multiple logistic regression modelling, female gender, housing tenure, employment category and educational attainment were found to be independently associated with both 'significant' and 'severe' chronic pain. The presence of 'any', 'significant' and 'severe' chronic pain had progressively more marked adverse associations with employment, interference with daily activities and all measured dimensions of general health. Comparison of the epidemiology of 'significant chronic pain' and 'severe chronic pain' with 'any chronic pain' allows an understanding of the more clinically important end of the chronic pain spectrum. These results support the suggestion that chronic pain is multidimensional, both in its aetiology and in its effects, particularly at this end of the spectrum. This must be addressed in management and in further research.
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              Quality of life in end-stage renal disease patients.

              Health-related quality of life (QOL) refers to the measure of a patient's functioning, well-being, and general health perception in each of three domains: physical, psychological, and social. Along with survival and other types of clinical outcomes, patient QOL is an important indicator of the effectiveness of the medical care they receive. QOL of patients with end-stage renal disease is influenced by the disease itself and by the type of replacement therapy. Numerous studies have identified the effect of such factors as anemia, age, comorbidity, and depression on QOL. Most of these factors appear during the predialysis period, and the adequate management of some of them could influence patient outcomes. Among replacement therapies, transplantation appears to give the best QOL for large groups of patients. No conclusive data exist to prove differences in QOL between hemodialysis patients and peritoneal dialysis patients. In the case of elderly patients or those with a high degree of comorbidity, the best treatment option should be assessed in each individual case, taking all possible factors into account. Finally, it has been proven that physical and mental function are inversely correlated with the risk for hospitalization and mortality.
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                Author and article information

                Journal
                NEC
                Nephron Clin Pract
                10.1159/issn.1660-2110
                Nephron Clinical Practice
                S. Karger AG
                1660-2110
                2007
                July 2007
                21 May 2007
                : 106
                : 3
                : c91-c97
                Affiliations
                aNephrology Division and bPsychiatry Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
                Article
                102995 Nephron Clin Pract 2007;106:c91–c97
                10.1159/000102995
                17522476
                © 2007 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 2, Tables: 3, References: 51, Pages: 1
                Categories
                Original Paper

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