Health-related quality of life is influenced by the severity and etiology of cirrhosis-patients with Child class C and those with alcoholic or viral cirrhosis have the poorest quality of life. There were no differences observed among the groups after the transplantation, as the patients with the lowest HRQoLs prior to surgery demonstrated greater gains in HRQoL associated with liver transplantation.

This study was designed to determine whether the surgical procedures for gastroduodenal ulcers influence sulfamethazine (SMZ) absorption and disposition. Prior to and on the average 79 days after surgery, eight patients received 10 mg kg-1 of sulfamethazine orally. Blood samples were obtained at regular intervals over 24 h and urine was collected for 48 h. Vagotomy with pyloroplasty or with gastrojejunostomy had no effect on SMZ kinetics. Vagotomy with partial gastrectomy decreased the SMZ plasma peak concentrations from 43.9 +/- 7.1 (mean +/- SEM) to 17.2 +/- 5.2 micrograms ml-1 (p less than 0.05) and increased the time required to reach this peak from 2.6 +/- 0.8 to 9.8 +/- 2.8 h (p less than 0.05). SMZ rate constant of absorption decreased only slightly (1.22 +/- 0.45 to 0.24 +/- 0.07 h-1) and SMZ bioavailability was not affected at all. In two (out of four) patients, SMZ volume of distribution and total body clearance increased, as reflected in the 41 per cent decrease in the mean area under the SMZ plasma concentration-time curve. No changes were detected in SMZ protein binding. Computer simulations indicated that in some subjects SMZ plasma concentrations at steady state could be 76 per cent lower following vagotomy with partial gastrectomy than before surgery. It was concluded that vagotomy and antrectomy with a gastroduodenostomy or Billroth I reconstruction decreased the rate of SMZ absorption and only in some subjects increased the SMZ volume of distribution and rate of elimination. The possible mechanisms involved in these reported kinetic changes are discussed.

RESUMENObjetivo: traducir y evaluar las propiedades psicométricas de un cuestionario de calidad de vida específico para pacientes sometidos a trasplante hepático.Material y métodos: el cuestionario fue administrado a 60 pacientes en lista de espera de trasplante hepático de la Unidad de Trasplante del Hospital de Cruces, y a los 6 meses tras la intervención. Se estudió la fiabilidad, la validez, la sensibilidad al cambio y el mínimo cambio detectable (MCD). Para evaluar la validez convergente se utilizaron dos cuestionarios, SF-36 (Health Survey Short Form 36) y el HAD (Hospital Anxiety and Depression Scale).Resultados: el cuestionario específico presenta un coeficiente alfa de Cronbach superior a 0,7. El análisis factorial demuestra una única dimensión. Las correlaciones con las áreas del SF-36 oscilaron entre -0,34 y -0,71 en el preoperatorio, y entre -0,21 y -0,67 a los 6 meses. Respecto al HAD-ansiedad, los coeficientes eran 0,44 en el preoperatorio y 0,51 a los 6 meses, y para HADdepresión de 0,64 y 0,39 respectivamente. Los estudios de validez discriminante confirman que el cuestionario muestra diferencias entre pacientes con cirrosis de diversas etiologías o gravedad. En el estudio de la sensibilidad al cambio se obtuvieron unos valores para los índices TEE (tamaño del efecto estandarizado) y MRE (media de respuesta estandarizada) de 0,92 y 0,99 respectivamente. Además, un 58,33% de los pacientes superaba el MCD.Conclusiones: el cuestionario específico posee adecuadas propiedades psicométricas, lo cual puede aconsejar su utilización en estos pacientes, como otra medida más para evaluar los resultados de esta intervención. ABSTRACTObjective: to translate and evaluate the psychometric properties of a quality of life questionnaire specific to liver transplant patients.Material and methods: the questionnaire was administered to 60 patients on the waiting list for liver transplant in the Cruces Hospital Transplant Unit, and again at 6 months after the transplant. The reliability, validity, sensitivity to change, and minimum detectable change (MDC) were studied. Two questionnaires, the SF-36 (Health Survey Short Form 36) and HADS (Hospital Anxiety and Depression Scale), were used to evaluate the convergent validity.Results: the specific questionnaire presented a Cronbach's alpha coefficient of over 0.7. The factor analysis demonstrates a single dimension. Correlations with the areas of SF-36 varied between -0.34 and -0.71 in the preoperative phase, and between -0.21 and -0.67 at 6 months. With respect to the HAD-anxiety scale, the coefficients were 0.44 in the preoperative phase and 0.51 at 6 months, and for the HAD-depression scale these were 0.64 and 0.39, respectively. Discriminant validation studies confirm that the questionnaire shows differences between patients with cirrhosis of various etiologies and severities. In the study of sensitivity to change, values were obtained for the SES (standardised effect size) and SRM (standardised response mean) indices of 0.92 and 0.99, respectively. Furthermore, 58.3...

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Ryan WH. Present role of thoramscopy in the diagnosis and treatment of diseases of the chest. Ann Thorac Surg 1992; 54: 403-9. 3 Miller DL. Alien MS. Trastek VF, Dcschamps C, Pairolero PC.