Health Care for Older Adults with Kidney Failure
Bibliographic record
Abstract
Background Intake of urate-lowering drugs (ULD) leads to an improvement in the quality of life (QoL) in pts with gout. However, it is not clear to what extend the QoL is changed in pts who did not achieve the target level of serum uric acid (sUA). Objectives to evaluate the dynamics of the QoL in pts, taking ULD, who have achieved and have not achieved the target sUA level. Methods 98 pts with gout were included in the prospective study. The follow-up period was 24 months, allopurinol or febuxostat at doses sufficient to achieve the target sUA level (<360 µmol/l) were used. The maximum daily dose of allopurinol was 900 mg/day, febuxostat - 120 mg/day. Pts who did not achieve the target sUA level continued taking ULD at the maximum dosages. The values of the Qol in dynamics were calculated using the SF-36v2 questionnaire. The assessment of the QoL was carried out separately in pts who achieved and did not achieve the target level of sUA. The frequency of exacerbations of arthritis was also assessed. Statistica 12.0 package was used for statistical data processing. Results 69 of 98 (70%) pts achieved the target sUA level, wherein allopurinol was taken by 46 pts, febuxostat – 34 pts. Pts who achieved the target level of sUA after 6 mo. of ULD usage, demonstrated a significant improvement in the physical health (PH), including physical functioning (PF), role limitations due to physical functioning (RP), general health (GH), as well as vitality (VT) (p<0.05 for all). After 12 and 24 mo. improvement was achieved in RH, GH and PF (p<0.01), RP, bodily pain intensity (BP) and VT (p<0.05). General mental health (MH), role-emotional functioning (RE) and social functioning (SF) were unchanged throughout the study. Pts who did not achieve the target sUA level after 6 and 12 mo. significantly improved: PF, RP (p<0.05 for all). After 24 months, for all QoL parameters, the values did not differ from the initial ones. The frequency of arthritis exacerbation in pts who achieved the target sUA level decreased from 3.1±1.6 cases per year to 0.9±1.1 cases per year (p=0.0013); in those who did not achieve - from 3.1±1.9 cases per year to 2.4±1.6 cases per year (p=0.047). Conclusion : The QoL in gout pts who achieved target sUA level continues to improve during the first year of ULD intake. Even if the target sUA level is not achieved, the QoL of patients with gout treated with ULD remains stable for at least 2 years of therapy. This predetermines the need to use maximum daily doses of ULD, even if the target serum UA level is not achieved. Disclosure of Interests Maria Chikina: None declared, Olga Sheliabina Speakers bureau: Berlin Chemie Menarini Group, Maxim Eliseev Speakers bureau: Berlin Chemie Menarini Group, Sobi, EGIS, CSC, MosFarma, Alium Group
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.068 | 0.009 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".