Psychometric properties of the portuguese version of the chronic urticaria quality of life questionnaire (CU-Q2oL).

BACKGROUND: Chronic urticaria is defined as the appearance of urticarial lesions and/or angioedema during a period of more than six weeks. We aimed at developing the Portuguese version of the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) and at testing its reliability and the content, construct and criterion validity. METHODS: The forward-backward approach to a linguistic equivalence was followed, after which a clinical review and a cognitive debriefing with patients were performed. The intraclass correlation coefficient checked test-retest reliability with patients filling the same questionnaire with one week apart and the Cronbach's alpha indicator assessed the internal consistency. Construct validity was tested by an exploratory factor analysis and by hypothesis tests involving sociodemographic and clinical patient characteristics, including the urticaria control test (UCT). On the other hand, criterion validity was tested through correlations with the Short-Form Health Survey SF-36, EQ-5D-5 L, and the Dermatology Quality of Life Index (DLQI). RESULTS: A total of 162 patients from seven hospital units were included. The mean (standard deviation) age was 42.6 (13.3) and 81.6% were female. CU-Q2oL was entirely filled by all respondents. Internal consistency was 0.947 for the overall score, ranging from 0.661 (limits) to 0.899 (sleep problems) and the corresponding reproducibility indicator was 0.910, based on 23 patients and ranging from 0.711 (swelling) and 0.957 (looks). Exploratory factor analysis in general confirmed the original structure originally obtained by the authors. All CU-Q2oL dimensions were highly correlated with DLQI Index and differentiated well between males and females, and between different levels of wheals and pruritus. In addition, moderate negative correlations were found between Cu-Q2oL scores and the dimensions from SF-36 and EQ-5D-5 L. CONCLUSIONS: The satisfactory metric properties confirmed the cultural adaptation and validity of CU-Q2oL into Portuguese population, providing the clinicians with a valid tool to evaluate the impact of chronic urticaria on patient's QoL and therefore adjust their treatment. TRIAL REGISTRATION NUMBER: Not applicable.

Avaliação da concentração da enzima anidrase carbônica VI e sua relação com cárie dentária em crianças obesas / Evaluation of the concentration of the carbonic anydrase VI and its relation with dental caries in obese children

A obesidade e a cárie dentária são problemas de saúde pública, que atingem a população infantil. O objetivo deste estudo foi identificar a prevalência de cárie dentária e relacioná-la com a concentração da enzima anidrase carbônica VI, do íon cálcio, fluxo salivar e quantidade de biofilme dentário em crianças com sobrepeso/obesidade. Foram avaliadas 112 crianças de 4 a 6 anos de idade, de ambos os gêneros. A análise antropométrica foi realizada (percentil do IMC) e através dessa análise as crianças foram divididas em dois grupos: G1 sobrepesos/obesos (n=41) e G2 normais (n=71). Os exames bucais realizados para a cárie dentária foram os índices ceo-s e ICDAS II, quantidade de biofilme dentário pelo Índice de Placa de Turesky e volume de fluxo salivar estimulado. A concentração do íon Cálcio na saliva foi analisada pelo kit colorimétrico e da enzima Anidrase Carbônica VI pelo kit ELISA. Na sequência, as crianças de cada grupo foram divididas em 3 subgrupos: LC (livres de cárie), LI (com lesões iniciais) e C (com cárie). Os testes Wilcoxon, Mann-Whitney, teste t e correlação de Spearman foram aplicados (p<0,05). Não houve diferença significativa no ceo-s entre os grupos. Houve maior concentração média de cálcio salivar no G1 (G1=2847,96mM; G2=1230,90mM;p=0,001) e maior concentração da Anidrase Carbônica VI no G2 (G1=3455,18 pg/mL; G2=442428,9pg/mL;p=0,000). No G1 houve correlação negativa entre o ceo-s e íon Cálcio (r=-0,444;p=0,010). Já no G2, houve correlação negativa entre placa e a Anidrase Carbônica VI (r=-0,551;p=0,014). Pode-se concluir que o íon cálcio é fator protetor para cárie dentária em crianças. Já a anidrase carbônica VI parece não ser biomarcador para a cárie dentária.

Obesity and dental caries are public health problems that affect the child population. The aim of this study was to identify the prevalence of dental caries and relate it to the concentration of the enzyme carbonic anhydrase VI, calcium ion, salivary flow, and dental plaque in overweight/obesity children. The study was conducted on 112 children aged 4-6, of both genders. Anthropometric analysis was performed (BMI percentile) and by this analysis the children were divided into two groups: G1 - overweight/obese (n=41) and G2 - normal (n=71). The oral examinations performed for dental caries were the dmfs and ICDAS II indexes, measurement of the amount of dental plaque by the Turesky Board Index and volume of stimulated salivary flow. The concentration of calcium ion in saliva was measured by a colorimetric kit and the enzyme carbonic anhydrase VI by an ELISA kit. Then, children from each group were divided into three subgroups: CF (caries-free), IL (initial lesions) and D (decayed teeth). The Wilcoxon test, Mann-Whitney, t test and Spearman correlation (p<0.05) were applied. There was no significant difference in the dmfs between groups. There was higher concentration of salivary calcium in G1 (G1=2847.96mM; G2=1230.90mM; p=0.001), and higher concentration of carbonic anhydrase VI in G2 (G1 = 3455.18 pg/ml; G2 = 442428.9pg/ml; p = 0.000). In G1, there was negative correlation between dmfs and salivary calcium (r = -0.444; p = 0.010). In G2, there was negative correlation between dental plaque and carbonic anhydrase VI (r=-0.551; p=0.014). It can be concluded that the calcium ion is a protective factor for dental caries in children. The carbonic anhydrase VI does not seem to be a biomaker of dental caries.

Oncological patients and the nursing field: ration between the oral mucositis grade and the implemented therapeutic / Pacientes oncológicos e a enfermagem: relação entre grau de mucosite oral e a terapêutica implementada / Pacientes con cáncer y la enfermería: relación entre grado de estomatitis y terapéutica de implementación

Objetivo: Caracterizar a mucosite oral em pacientes em tratamento oncológico. Método: Estudo exploratório-descritivo com abordagem quantitativa, o qual foi realizado com 50 pacientes em um hospital filantrópico em Teresina/PI, de agosto a outubro de 2010. Resultados: Os achados apontaram a prevalência de mucosite oral no gênero masculino e nas faixas etárias inferiores a 17 e superiores a 60 anos. Os diagnósticos oncológicos mais freqüentes foram as leucemias e os cânceres das vias aerodigestivas superiores, cujos tratamentos se concentravam na quimiorradiação, determinando predominantemente graus 1 e 2 de mucosite oral. Os quimioterápicos mais associados à afecção foram: cisplatina, citarabina, metotrexate, sulfato de vincristina, etoposídeo, cloridrato de doxorrubicina. Conclusão: Conclui-se que há necessidade da inserção da enfermagem no fomento às ações preventivas e de controle da mucosite oral, com vistas à manutenção do bem-estar, otimização da resposta terapêutica e melhoria da qualidade de vida do paciente oncológico.

Objetivo: Caracterizar la estomatitis en pacientes en tratamiento contra el cáncer. Método: Estudio descriptivo, exploratorio, cuantitativo, con 50 pacientes en hospital de caridad de Teresina-PI, Brasil, de agosto a octubre de 2010. Resultados: Los hallazgos señalaron prevalencia de la estomatitis en hombres y en los grupos de edad inferiores a 17 y mayores de 60 años. Los diagnósticos de cáncer fueron las leucemias y los cánceres más frecuentes del tracto digestivo superior, cuyos tratamientos se centraron en la quimiorradioterapia, determinando principalmente grado 1 y 2 de la estomatitis. Los quimioterapéuticos más asociados con la enfermedad fueron: cisplatino, citarabina, metotrexato, sulfato de vincristina, etopósido y doxorubicina clorhidrato. Conclusión: hay necesidad de inclusión de la enfermería en la promoción de acciones para controlar y prevenir la estomatitis para el mantenimiento del bienestar, optimización de la respuesta terapéutica y mejora de la calidad de vida de pacientes con cáncer.

Objective: To characterize the oral mucositis in patients under oncological treatment. Method: This is a descriptive and exploratory study with a quantitative approach, which was performed with 50 patients in a philanthropic hospital in the city of Teresina/PI/Brazil, from August to October 2010. Results: The outcomes showed the prevalence of oral mucositis in males and in the age groups lesser than 17 and over 60 years. The most frequent oncological diagnoses were leukemias and aerodigestive route cancers, whose treatments were focused on chemoradiotherapy, by predominantly determining the grades 1 and 2 of oral mucositis. The most associated chemotherapic agents with the disease were: cisplatin, cytarabine, methotrexate, vincristine sulfate, etoposide, doxorubicin hydrochloride. Conclusion: It is concluded that there is a need of including the nursing in fostering the preventive and controlling actions towards the oral mucositis, in order to maintain the welfare, therapeutic response optimization and improvement of the life quality of the oncological patient.

"Minor" hemoglobinopathies: a risk factor for asthma.

BACKGROUND: Thalassemia, sickle cell disease and other hemoglobinopathies are not rare in Portugal and European Mediterranean area. Homozygotic patients present major hematological disease but heterozygotic minor assymptomatic forms are frequent, mainly thalassemia minor and sickle cell trait. In these cases mycrocytosis with decrease or red cell volume and mean corpuscular volume or abnormal rigid erythrocytes are found and can lead to hemorheologic disturbances. The purpose of this study is to evaluate the incidence of asthma in hemoglobinopatic patients allergic to house dust mites. METHOD: From 4.000 patients seen in the last 5 years in an out-patient allergy clinic, 63 cases of hemoglobinopathies have been confirmed by red cell count, hemoglobin electrophoresis, assays of hemoglobin A2, Fc, and S, and sickle cell test. All these patients had allergic disease characterized by clinical history, skin prick test to aeroallergens total and specific IgE (RAST-CAP-FEIA) and respiratory function evaluation. RESULTS: 66 Hemoglobinopathies: Betathalassemia 61 cases, Betadelta thalassemia 2, sickle cell trait 2, Hemoglobin C, 1.57 patients have respiratory allergy, rhinitis in 14 cases of thalassemia and 1 of hemoglobin C, asthma with or without rhinitis in 41 cases of thalassemia and 1 case of sickle cell trait, the other 6 cutaneous allergy. Therefore asthma was present in 75.0% of the respiratory allergic patients and rhinitis only in 25.0%. In contrast in a control group of 491 respiratory allergic patients wihout hemoglobinopathies, 57% has asthma and 43% only rhinitis. CONCLUSION: The prevalence of asthma is higher in thalassemia minor and sickle cell trait (p<0.05 Square chi test). Hemorheological changes probably a greater rigidity of red blood cells in capillary bed can contribute to changes in bronchial circulation and bronchial hypereactivity. Detection of hemoglobinopathies must be done in asthmatic patients with slight anemia or mycrocytosis.