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This study explored the perception of older adults with diabetes regarding the areas of service considered helpful to their daily activities and routines. A survey questionnaire was designed and given to 52 community-dwelling older adults with diabetes. Results showed that cholesterol control, managing blood sugar, foot care, fatigue management and pacing, and pain management/reduction were the areas of most concern that deserve services. The findings suggest that, in providing holistic client-centered interventions to individuals with diabetes, occupational therapists need to be able to prioritize clients' concerns and help them incorporate diabetes management into their routines and lifestyle. [ABSTRACT FROM AUTHOR]

Background: Acceptable post-transplant outcomes were reported in kidney transplant recipients from donors with coronavirus disease 2019 (COVID-19); however, there are no comparative studies with well-matched controls., Methods: This multicenter, prospective observational study, which included three transplant centers in the United States, enrolled 61 kidney recipients from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected deceased donors. Using optimal matching methods, we matched every recipient to three comparators receiving kidneys from SARS-CoV-2-negative deceased donors with otherwise highly similar characteristics in the same transplant centers to compare 6-month eGFR., Results: Among recipients of SARS-CoV-2-infected donor kidneys, one recipient died with a functional graft within 6 months. Mean 6-month eGFR was not significantly different between SARS-CoV-2-infected and noninfected donor groups (55±21 and 57±25 ml/min per 1.73 m 2 , respectively; P = 0.61). Six-month eGFR in recipients from SARS-CoV-2-infected donors who died of reasons other than COVID-19 was not significantly different from those from SARS-CoV-2-negative donors (58±22 and 56±25 ml/min per 1.73 m 2 , respectively; P = 0.51). However, recipients from donors who died of COVID-19 had significantly lower 6-month eGFR than those from SARS-CoV-2-negative donors (46±17 and 58±27 ml/min per 1.73 m 2 , respectively; P = 0.03). No donor-to-recipient SARS-CoV-2 transmission was observed., Conclusions: Six-month eGFR was not significantly different between recipients of kidneys from SARS-CoV-2-infected and noninfected donors. However, those receiving kidneys from donors who died of COVID-19 had significantly lower 6-month eGFR. Donor-to-recipient SARS-CoV-2 transmission was not observed., (Copyright © 2023 by the American Society of Nephrology.)

Introduction: Assessing vaccine serologic status presents opportunities to provide live vaccinations to kidney transplant candidates (KTC). This is especially important given the increased risk of infection while taking lifelong immunosuppression following transplant and the inability to routinely provide live vaccines to patients on immunosuppressive medications. In March 2019, the American Society of Transplantation Infectious Disease Community of Practice (AST-IDCOP) released updated guidelines for vaccination of KTC, which emphasize pretransplant viral serology screening and live vaccine administration prior to transplant., Primary Endpoint: The primary endpoint of this study was to determine adherence to AST-IDCOP guidelines for live measles, mumps, and rubella (MMR) and VZV vaccination prior to transplant in KTC non-immune by serology., Methods: This retrospective, descriptive study examined serologic status and rates of live vaccination in 672 patients listed for kidney transplant at our center between July 2014 and July 2019. Secondary endpoints included subgroup analysis of adherence to full AST-IDCOP vaccination recommendations and validation of CDC presumed immunity definitions for measles and VZV., Results: Seventeen patients (2.7%) were nonimmune by serology for VZV, while 182 (27.1%) were nonimmune by serology to MMR. In a subgroup analysis of the seronegative KTC, none received VZV vaccination, and 6% received MMR vaccination prior to transplant or last follow-up., Conclusions: Overall, a large portion of KTC had immunity gaps that were not resolved before transplantation. These findings are limited due to the retrospective, single-center nature of this study and should be confirmed with larger, prospective assessments of serologic status and vaccine administration., (© 2022 Wiley Periodicals LLC.)

Study Design: Case series., Introduction: Pain and injury at the radial and ulnar aspects of the wrist due to overuse or trauma are commonly treated in hand therapy clinics., Purpose of Study: Describe two orthoses that allow targeted rest and recovery of involved anatomical structure(s) while preserving function of surrounding uninvolved structures in patients who have sustained overuse or traumatic injury at the radial or ulnar aspect of the wrist., Methods: Outline the fabrication of the Ulnar-Wrist Articulating Control Orthosis (U-WACO) and Radial-Wrist Articulating Control Orthosis (R-WACO) as well as presents case examples for each orthosis., Results: The U-WACO and R-WACO designs may improve comfort, compliance, and functional ability to complete daily tasks while allowing targeted rest and recovery of involved anatomical structure(s) at the radial and ulnar aspects of the wrist due to overuse or trauma., Conclusion: Dynamic orthoses that allow for movement in one plane while restricting movement in another may overcome the shortcomings of some static orthotic designs., (Copyright © 2019 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.)

Background: The use of prophylactic antifungal therapy is suggested after kidney transplantation. However, efficacy of low-dose (50 mg) oral fluconazole and its effect on tacrolimus trough levels in patients maintained on tacrolimus and mycophenolic acid, with or without corticosteroids, is unknown., Methods: A retrospective analysis to evaluate efficacy was performed in 305 kidney transplant recipients. An additional analysis to evaluate the fluconazole-tacrolimus drug interaction was performed in 103 patients. Complete tacrolimus area under the curve measurements were also performed in seven patients to further evaluate this drug interaction., Results: The incidence of fungal infections was very low (0.6%, n = 2). The average tacrolimus trough level at the time of discontinuation and one wk after stopping fluconazole was unchanged (11.69 ± 3.18 and 11.15 ± 3.69 ng/mL, p = 0.145, n = 103). Tacrolimus trough levels on and off of fluconazole in a subgroup of patients continued on corticosteroids, was not significantly different (p = 0.952) but was significantly lower after fluconazole discontinuation if corticosteroids were withdrawn (p = 0.037). However, data from complete tacrolimus pharmacokinetics in the corticosteroid withdrawal group demonstrated no clinically significant differences., Conclusion: Low-dose, once daily oral fluconazole is effective antifungal prophylaxis after kidney transplantation without significant effects on tacrolimus trough levels or overall exposure., (© 2012 John Wiley & Sons A/S.)