The overall study findings indicated a significant correlation between the levels of anxiety and depression in patients on hemodialysis. Patients with high levels of anxiety had higher levels of depression and those with high depression scores had higher anxiety scores.
Depression in dialysis populations is affected by co-morbid diseases, such as cardiovascular disease, diabetes, and immune dysfunction, and it also includes high suicide risk and frequent hospitalizations. Depressive disorders have a close association with malnutrition and chronic inflammation, as well as with cognitive impairment. Impaired cognitive function may be manifested as low adherence to dialysis treatment, leading to malnutrition. Additionally, chronic pain and low quality of sleep lead to high rates of depressive symptoms in haemodialysis patients, while an untreated depression can cause sleep disturbances and increased mortality risk. Depression can also lead to sexual dysfunction and non-adherence, while unemployment can cause depressive disorders, due to patients' feelings of being a financial burden on their family. The present review provides a holistic approach to the factors affecting depression in haemodialysis, offering significant knowledge to renal professionals.
AbstractWe describe a new simple reconstruction for neglected chronic ruptures of patellar tendon using ipsilateral hamstrings tendon autograft. This has been validated in thirteen patients with mean follow up six years resulting in favorable outcome. Thirteen patients with mean age 58.2 years (range 30–64 years) presented with chronic patellar tendon rupture. They all underwent patellar tendon reconstruction using ipsilateral hamstrings tendon autograft. The average time from injury was 10 months (range 3–20 months). The cause of rupture was fall from height or after TKA and the preoperative Lysholm score was 65 (range 50–80). Postoperatively with a mean follow up of six years (range 5–7 years), all patients had a stable knee with mean flexion of 123°, extension lag 0°, and Insall-Salvati index 1.2. Quadriceps power was regained in 8 cases to 5/5 and in 5 cases to 4/5. No complications were inspected. The postoperative Lysholm score was 93 (range 89–95). Patellar tendon reconstruction using ipsilateral hamstrings as free autograft, consists an effective treatment option for chronic neglected patellar tendon ruptures. Our technique has favorable clinical outcome, complications are not expected, and consist a simple and anatomic reconstruction with a powerful graft, without the requirement for allograft or implants.
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