Validation of AQoL-8D: a health-related quality of life questionnaire for adult patients referred for otolaryngology.

PURPOSE: The purpose of the study was to validate the AQoL-8D questionnaire in the adult population of patients referred to an otolaryngology clinic. METHODS: AQoL-8D was translated into Polish. 463 patients (age18-80 years) with otolaryngological conditions were assessed with the AQoL-8D, SF-6D, and SWLS questionnaires. We investigated the item content-relevance, factor structure by means of Confirmatory Factor Analysis, corrected item-total correlations, Cronbach's alpha, Pearson correlation of the AQoL-8D scores with results from SF-6D and from the SWLS questionnaires. Finally, ANOVA was used to test the AQoL-8D ability to group the HRQoL of patients in terms of their otolaryngological management type. RESULTS: The median score of item content-relevance was 5.0 for all AQoL-8D items. Confirmatory Factor Analysis revealed the following fit indices: Comparative Fit Index = 0.81; Tucker-Lewis Index = 0.80; and Root Mean Square Error of Approximation = 0.07. Cronbach's alpha for AQoL-8D dimensions ranged from 0.48 to 0.79. Mean item-total correlations over all dimensions, super dimensions, and the instrument overall were higher than 0.3. There was a significant Pearson correlation between the results obtained with AQoL-8D and SF-6D (r = 0.68), and with AQoL-8D and SWLS (r = 0.43). A one-way ANOVA showed a significant effect of management type on HRQoL as measured by AQoL-8D [F(4,458) = 6.12, p < 0.001] CONCLUSION: AQoL-8D provides valid and reliable measures of HRQoL in patients undergoing otolaryngological treatment. Because it is a generic questionnaire, it is possible to make general comparisons of otolaryngology outcomes with those from other subspecialties.

Factores influyentes en la supervivencia de los segundos trasplantes renales / Influential factors in the survival of the second kidney transplants

Introducción: La realización de un segundo trasplante renal es la mejor opción de tratamiento de reemplazo de la función de este órgano para aquellos enfermos que han perdido un primer injerto, no obstante, parece una terapéutica poco empleada y existe la opinión de que sus resultados son inferiores a un primer trasplante. Objetivos: Determinar el porcentaje de utilización de los segundos trasplantes renales, su supervivencia e identificar los factores que influyen en estos. Métodos: Estudio analítico, retrospectivo de corte longitudinal, que abarcó todos los trasplantes renales realizados desde 1984 al 2015, excluyendo los trasplantes en receptores menores de 15 años, dobles, combinados o cuando no se pudo obtener toda la información. Se compararon los resultados de la supervivencia en general, y los de cada variable de los segundos trasplantes con los de los primarios a través de las curvas de Kaplan y Meier y de forma multivariada con una regresión de Cox. Resultados: La utilización de los segundos trasplantes renales fue de 5,6 por ciento, con una supervivencia global similar a los primarios. En el análisis comparativo de las curvas de acuerdo a las variables utilizadas no se encontraron diferencias estadísticamente significativas entre los dos grupos de estudio, de forma multivariada sí emergieron como factores de riesgo independientes para la pérdida del injerto, la edad del receptor ≥ 55 años, la edad del donante ≥ 50 años, la presencia de necrosis tubular aguda y el rechazo en los trasplantes primarios, mientras que en los secundarios esto solo ocurrió cuando la edad del donante fue ≥ a 50 años y presentaron necrosis tubular aguda. Conclusiones: El porcentaje de utilización de un segundo trasplante fue bajo, con una supervivencia similar al primero, influenciada por variables propias del receptor y del acto del trasplante(AU)

Introduction: Performing a second kidney transplant is the best treatment option to replace the function of this organ for those patients who have lost a first graft. However, it seems a little used therapeutics and there is the opinion that its results are inferior to a first transplant. However, it seems a little used therapy and there is the opinion that its results are inferior to a first transplant. Objective: To determine the percentage of use of the second kidney transplants, their survival and identify the influential factors. Methods: An analytical, retrospective longitudinal study was done in all renal transplants performed from 1984 to 2015, excluding transplants in recipients under 15 years old, doubles, combined or when all the information could not be obtained. The results of survival in general were compared, and those of each variable of the second transplants were compared with those of the primary ones through Kaplan and Meier curves and multivariate with a Cox regression. Results: The use of a second renal transplants was 5.6 percent, with global survival similar to the primary ones. The comparative analysis of the curves according to the variables used were found no statistically significant different between the two study groups, although multivariate did emerge as independent risk factors for graft loss, the age of the recipient 55 years, the age of the donor 50 years, the presence of acute tubular necrosis and rejection in primary transplants, while in secondary cases this only occurred when the age of the donor was 50 years and they presented acute tubular necrosis. Conclusions: The percentage of a second transplant was low, with similar survival to the primary one, influenced by specific variables of the recipient and the act of transplantation(AU)