Qualidade de vida em adultos com diabetes tipo 1 e validade do DQOL-Brasil / Quality of life in adults with type 1 diabetes and validity of DQOL-Brazil

O objetivo deste estudo foi estabelecer validade de critério e construto, e também, avaliar qualitativamente a versão brasileira do Questionário de Medida da Qualidade de Vida em Diabetes (DQOL-Brasil), quando utilizado em pacientes adultos com diabete melito (DM) tipo 1. O DQOL-Brasil foi autoadministrado a 150 indivíduos (63,3% mulheres) com tempo diagnóstico médio de DM tipo 1 de 14,17 anos e na faixa etária de 18 a 56 anos. O escore médio obtido foi de 2,46 (IC 95% 2,35 - 2,56). Entre os itens, os melhores e piores escores foram obtidos nos domínios de impacto da doença e preocupações com o DM, respectivamente. O instrumento como um todo apresentou elevada consistência interna, alfa de Cronbach = 0,94. Constatou-se validade convergente ao se co-administrar o questionário genérico de avaliação da qualidade de vida: Perfil de Saúde de Nottingham. O DQOL-Brasil foi readministrado a 52 pacientes em um intervalo médio de 98,25 dias, e constatou-se reprodutibilidade aceitável, através de coeficientes de correlação intraclasse superiores a 0,7. Entretanto, a análise fatorial comprovou deficiências. Deste modo, o DQOL-Brasil é válido para medida da qualidade de vida em pacientes adultos com DM tipo 1 e útil para aplicação em pesquisas e comparações com dados internacionais. Porém, para a prática clínica, recomenda-se seleção criteriosa dos itens do instrumento que sejam mais relacionados às características específicas da enfermidade em brasileiros; uma seleção ponderada de itens provavelmente seria útil às versões do DQOL traduzidas e validadas em outras nações...

The aim of this study was both to determine the criterion and construct validity and to make a qualitative assessment of the Brazilian version of the Diabetes Quality of Life questionnaire (DQoL-Brazil), when applied to adult patients with type 1 diabetes mellitus (DM1). The DQoL-Brazil was self-administered to 150 subjects (63.3% women) with DM1 diagnosed for an average of 14.17 years and aged 18 to 56 years. The mean score obtained was 2.46 (95% CI 2.35 to 2.56). Among the items in the questionnaire, the best and worst scores were obtained in the responses on disease impact and concerns about diabetes, respectively. The instrument as a whole had high internal consistency, with a Cronbach's alpha of 0.94. Convergent validity was observed when the Nottingham Health Profile, a general questionnaire used to measure patients' quality of life, was administered along side DQoL. DQoL-Brazil was readministered to 52 patients after a mean interval of 98.25 days and acceptable reproducibility was verified by intraclass correlation coefficients exceeding 0.7. Nevertheless, the factor analysis demonstrated shortcomings. We concluded that DQoL-Brazil is valid for measuring the quality of life of adult patients with type 1 DM and useful for application in research and comparisons with international data. However, for clinical practice, a careful selection of the items that are more related to the specific characteristics of the illnessin Brazilians is recommended. A weighted selection of items would probably be useful for versions of DQOL translated and validated in other societies...

Efficacy and safety of topical antifungals in the treatment of dermatomycosis: a systematic review.

The analysis of comparative efficacy and safety of topical antifungals in the literature is restricted to the treatment of tinea pedis and onychomycosis. Therefore our objective was to evaluate and compare the efficacy and safety of topical antifungals used in the treatment of dermatomycosis, we performed a comprehensive search for randomized controlled trials (RCTs) in the following databases: Medline, Cochrane Central Register of Controlled Trials, EMBASE, Lilacs and International Pharmaceutical Abstracts, we identified studies that compared the use of topical antifungals with other antifungals or with placebo published up to July 2010 in English, Spanish or Portuguese. The quality of reporting was assessed according to the Jadad scale; only studies with a score of 3 or more were included. The outcomes evaluated were mycological cure at the end of treatment, sustained cure, occurrence of adverse events and tolerability, including withdrawals due to adverse events. A total of 104 RCTs satisfied the inclusion criteria, containing a total of 135 comparisons, with 55 out of 120 possible comparisons among the 16 drugs evaluated. Pooled data on efficacy showed that all the antifungals were better than placebo. There were no significant differences among antifungal classes. No differences were found in safety or tolerability in any direct comparison. Sensitivity analysis indicated the robustness of the findings. Our results indicate the clear superiority of topical antifungals over placebo but that there is no consistent difference among classes. Mixed treatment comparisons are necessary to rank antifungals, as direct comparisons among many of them are lacking.

Desarrollo y validación de un método espectrofotométrico para cuantificación de ácido kójico / Development and validation of a spectrophotometric method for the quantification of kojic acid

Objetivo. Se desarrolló y validó un método para la cuantificación del ácido kójico en materias primas y en formulaciones por espectrofotometría ultravioleta. Material y métodos. Se utilizaron soluciones patrón de ácido kójico y se evaluaron parámetros de sensibilidad, robustez, exactitud, precisión y especificidad delo método. Resultados y Conclusiones. Los resultados mostraron que este método presenta linealidad entre 5 e 25 µg/ml, buena sensibilidad, robustez en cuanto a las variaciones en el tiempo de lectura y en la temperatura (pero no con variaciones de pH>7), exactitud y precisión. Sin embargo, la presencia de otra sustancia, que absorba en la misma longitud de onda que el ácido kójico (por ejemplo: el metilparaben), compromete la especificidad del método, pudiendo generar resultados erróneos (AU)