Modifiable risk factors for cardiovascular diseases and quality of life among first-year nursing students.

OBJECTIVE: To describe the risk factors for cardiovascular diseases and the quality of life of first-year college students. METHODS: A cross-sectional study conducted with first-year undergraduate nursing students attending a public university located in São Paulo, Brazil. The students completed nine questionnaires and the students'cervical and abdominal circumferences were measured along with their weight and height, blood pressure, lipid profile, and capillary blood glucose. RESULTS: 67 undergraduate students were included. Half of the students were physically inactive (73.1%), 7.5% reported smoking, 40.3% alcohol consumption, 25.4% overweight, and 16,4% increased total cholesterol. Depressive symptoms, anxiety, and stress were also reported, as well as excessive daytime sleepiness, risk of sleep apnea, and risky and harmful consumption of alcohol. As for the quality of life, the domains with the lowest scores were vitality and emotional aspects. CONCLUSION: The most prevalent risk factors found in undergraduates were sedentary lifestyle, excessive daytime sleepiness and stress.

Relações entre depressão, estresse percebido e ansiedade e a qualidade de vida e características dos estudantes de enfermagem / Relaciones entre depresión, estrés percibido y ansiedad y calidad de vida y características de los estudiantes de enfermería / Relationships between depression, perceived stress and anxiety and quality of life and characteristics of nursing students

RESUMO Objetivo: avaliar a relação entre ansiedade, estresse percebido e sintomas de depressão com qualidade de vida e as características sociodemográficas, acadêmicas e clínicas dos estudantes de Enfermagem. Métodos: este é um estudo transversal correlacional realizado com 173 estudantes de Enfermagem matriculados em 2017 na Universidade Federal de São Paulo, Brasil. Ansiedade, sintomas de depressão, estresse e qualidade de vida foram avaliados, respectivamente, pelo Beck Anxiety Inventory, o Beck Depression Inventory, a Perceived Stress Scale e o Short-Form Health Survey. Resultados: 24,6% dos estudantes tinham ansiedade leve, 24,0% tinham ansiedade moderada e 11,1% tinham ansiedade severa. A maioria dos diagnosticados com depressão apresentava sintomas graves (47,4%) da doença. A maioria dos que não foram diagnosticados com depressão não apresentava sintomas (67,1%). O nível médio de estresse foi de 20,9 da pontuação máxima de 40. O domínio da qualidade de vida com a pontuação mais baixa foi a vitalidade, enquanto o domínio com a pontuação mais alta foi a capacidade funcional. Conclusão: depressão, ansiedade e estresse estavam relacionados a diferentes características sociodemográficas, acadêmicas e clínicas, assim como apresentaram relação com alguns domínios da qualidade de vida, os quais deveriam ser objeto das intervenções.

RESUMEN Objetivo: evaluar la relación entre los síntomas de ansiedad, estrés percibido y depresión con la calidad de vida y las características sociodemográficas, académicas y clínicas de los estudiantes de Enfermería. Métodos: se trata de un estudio correlacional transversal realizado con 173 estudiantes de Enfermería matriculados en 2017 en la Universidad Federal de São Paulo, Brasil. La ansiedad, los síntomas de depresión, el estrés y la calidad de vida se evaluaron, respectivamente, mediante el Inventario de Ansiedad de Beck, el Inventario de Depresión de Beck, la Escala de Estrés Percibido y la Encuesta de Salud de Forma Corta. Resultados: el 24,6 % de los estudiantes tenía ansiedad leve, el 24,0 % tenía ansiedad moderada y el 11,1 % tenía ansiedad grave. La mayoría de los diagnosticados de depresión tenía síntomas graves (47,4 %). La mayoría de los que no fueron diagnosticados de depresión no tenía síntomas (67,1 %). El nivel medio de estrés fue de 20.9 sobre la puntuación máxima de 40. El ámbito de la calidad de vida con la puntuación más baja fue la vitalidad, mientras que el ámbito con la puntuación más alta fue la capacidad funcional. Conclusión: la depresión, la ansiedad y el estrés se relacionaron con diferentes características sociodemográficas, académicas y clínicas, además de presentar una relación con algunos dominios de la calidad de vida, que deberían ser objeto de intervenciones.

ABSTRACT Objective: to evaluate the relationships of anxiety, perceived stress and depression symptoms with quality of life and with sociodemographic, academic and clinical characteristics of Nursing students. Methods: this is a correlational cross-sectional study conducted with 173 undergraduate Nursing students enrolled in 2017 at the Federal University of São Paulo, Brazil. Anxiety, depression symptoms, stress and quality of life were evaluated by means of the Beck Anxiety Inventory, the Beck Depression Inventory, the Perceived Stress Scale and the Short-Form Health Survey, respectively. Results: 24.6%, 24.0% and 11.1% of the students presented mild, moderate and severe anxiety, respectively. Most of those diagnosed with depression had severe symptoms (47.4%), while most of those not diagnosed with depression presented no symptoms (67.1%). The mean stress level was 14.1 out of the maximum score of 40. The quality of life domain with the lowest score was vitality, while the one with the highest score was physical functioning. Conclusion: depression, anxiety and stress were related to different sociodemographic, academic and clinical characteristics, as well as to some quality of life domains, which should be targets of interventions.

Modifiable risk factors for cardiovascular diseases and quality of life among first-year nursing students / Factores de riesgo modificables para enfermedades cardiovasculares y calidad de vida de los graduados de enfermeira / Fatores de risco modificáveis para doenças cardiovasculares e qualidade de vida de ingressantes da graduação de enfermagem

ABSTRACT Objective To describe the risk factors for cardiovascular diseases and the quality of life of first-year college students. Methods A cross-sectional study conducted with first-year undergraduate nursing students attending a public university located in São Paulo, Brazil. The students completed nine questionnaires and the students'cervical and abdominal circumferences were measured along with their weight and height, blood pressure, lipid profile, and capillary blood glucose. Results 67 undergraduate students were included. Half of the students were physically inactive (73.1%), 7.5% reported smoking, 40.3% alcohol consumption, 25.4% overweight, and 16,4% increased total cholesterol. Depressive symptoms, anxiety, and stress were also reported, as well as excessive daytime sleepiness, risk of sleep apnea, and risky and harmful consumption of alcohol. As for the quality of life, the domains with the lowest scores were vitality and emotional aspects. Conclusion The most prevalent risk factors found in undergraduates were sedentary lifestyle, excessive daytime sleepiness and stress.

RESUMEN Objetivo describir los factores de riesgo de enfermidades cardiovasculares y la calidad de vida de los estudiantes universitários de primer año. Métodos estúdio transversal realizado con estudiantes de primer año de enfermeira de uma universidad pública ubicada em São Paulo, Brasil. Los estudiantes completaron nueve cuestionarios y se midieron las circunferencias cervical y abdominal de los estudiantes junto con su peso y altura, presión arterial, perfil de lípidos y glucosa en sangue capilar. Resultados se incluyeron 67 estudiantes. La mitad de los estudiantes eran fisicamente inactivos (73,1%), el 7,5% informó que fumaba, el 40,3% consumía alcohol, el 25,4% tenía sobrepeso y el 16,4% aumentaba el colesterol total. También se informaron síntomas depresivos, ansiedad y estrés, así como somnolencia diurna excesiva, riesgo de apnea del sueño y consumo peligroso y nocivo de alcohol. Em cuanto a la calidad de vida, los dominios com puntuaciones más bajas fueron vitalidad y aspectos emocionales. Conclusión Los factores de riesgo más prevalentes encontrados em los universitários fueron el estilo de vida sedentário, la somnolencia diurna excessiva y el estrés.

RESUMO Objetivo Descrever os fatores de risco para doenças cardiovasculares e a qualidade de vida de alunos ingressantes no curso de enfermagem. Métodos Estudo transversal realizado com ingressantes no curso de enfermagem de uma Universidade Pública de São Paulo, Brasil. Os alunos responderam a nove questionários e as circunferências cervical e abdominal foram medidas, juntamente com peso e altura, pressão arterial, perfil lipídico e glicemia capilar. Resultados 67 alunos foram incluídos. Alguns estudantes apresentaram inatividade física (73,1%), 7,5% reportaram tabagismo, 40,3% consumiam álcool, 25,4% estavam acima do peso e 16,4% tinham aumento do colesterol total. Sintomas de depressão, ansiedade e estresse também foram reportados, assim como sonolência diurna excessiva, risco de apneia do sono e uso de risco ou nocivo de álcool. Quanto a qualidade de vida, os domínios com menor pontuação foram vitalidade e aspecto emocional. Conclusão Os fatores de risco mais prevalentes encontrados nos alunos foram sedentarismo, sonolência diurna excessiva e estresse.

Cardiopatias congênitas: alimentação com leite humano em um hospital cardiológico / Congenital heart defects: feeding with human milk in a cardiology hospital / Enfermedades congénitas del corazón: alimentación con leche materna en un hospital cardiológico

Objetivo: descrever o perfil de recém-nascidos e lactentes alimentados com leite humano de um posto de coleta de leite de um hospital cardiológico. Método: trata-se de um estudo quantitativo, descritivo, transversal que utilizou prontuários de recém-nascidos e lactentes que receberam exclusivamente leite humano até os seis meses e que continuaram a ser alimentados com ele até um ano. Compôs-se a amostra por 32 prontuários, com dados coletados por meio de roteiro construído pelas pesquisadoras, utilizando-se a análise estatística descritiva. Resultados: informase que os lactentes compuseram 22 (68,8%) da amostra; o sexo masculino foi prevalente em 18 (56,0%); a idade média foi de 96 dias; o peso médio ao nascer foi de 3.080g; 17 (50,0%) apresentaram renda acima de sete salários-mínimos; o tempo de permanência médio na UTI foi de 9,5 dias e de enfermaria foi de seis dias; das 18 complicações encontradas, a mais frequente foi a distensão abdominal 11(61,1%) e as doenças de maior incidência foram Tetralogia de Fallot e Coarctação de Aorta, com cinco (15,7%) cada. Conclusão: conclui-se que o perfil de crianças que receberam exclusivamente leite humano foi caracterizado e poucos estudos trouxeram o impacto da amamentação em crianças com cardiopatias. Podem-se aprimorar os protocolos clínicos.(AU)

Objective: to describe the profile of newborns and infants fed with human milk from a milk collection station of a cardiology hospital. Method: This is a quantitative, descriptive, crosssectional study that used medical records of newborns and infants who received exclusively human milk up to the age of six months and continued to be fed with it for up to a year. The sample was composed by 32 medical records, with data collected through a script built by the researchers, using the descriptive statistical analysis. Results: It is reported that infants composed 22 (68.8%) of the sample; the male gender was prevalent in 18 (56.0%); mean age was 96 days; mean birth weight was 3. 080g; 17 (50.0%) presented income above seven minimum wages; the average length of stay in the ICU was 9.5 days and the average length of infirmary was six days; of the 18 complications found, the most frequent was abdominal distention 11(61.1%) and the defects with higher incidence were Tetralogy of Fallot and Aortic Coarctation, with five (15.7%) each. Conclusion: It is concluded that the profile of children who received exclusively human milk was characterized and few studies have brought the impact of breastfeeding on children with heart defects. Clinical protocols can be improved.(AU)

Objetivo: describir el perfil de recién nacidos y lactantes alimentados con leche materna en una estación de recogida de leche en un hospital de cardiología. Método: se trata de un estudio cuantitativo, descriptivo, transversal que utilizó historias clínicas de recién nacidos y lactantes que recibieron exclusivamente leche materna hasta los seis meses y que continuaron siendo alimentados con ella hasta un año. La muestra estuvo compuesta por 32 historias clínicas, con datos recolectados a través de un guion construido por los investigadores, mediante análisis estadístico descriptivo. Resultados: se reporta que los lactantes constituyeron 22 (68,8%) de la muestra; el sexo masculino predominó en 18 (56,0%); la edad promedio fue de 96 días; el peso promedio al nacer fue de 3.080 g; 17 (50,0%) tenían ingresos superiores a siete salarios mínimos; la estancia promedia en la UCI fue de 9,5 días y en la sala de 6 días; de las 18 complicaciones encontradas, la más frecuente fue la distensión abdominal 11 (61,1%) y las enfermedades más prevalentes fueron la Tetralogía de Fallot y la Coartación Aórtica, con cinco (15,7%) cada una. Conclusión: se concluye que se caracterizó el perfil de los niños que recibieron exclusivamente leche materna y pocos estudios han demostrado el impacto de la lactancia materna en los niños con cardiopatía. Se pueden mejorar los protocolos clínicos.(AU)

Depressive symptoms in the family caregivers of patients with heart failure: an integrative review. / Sintomas depressivos em cuidadores familiares de pacientes com insuficiência cardíaca: revisão integrativa.

AIMS: Identify the occurrence of depressive symptoms in family caregivers of patients with heart failure and the correlation of other variables with depressive symptoms. DESIGN/METHOD: The literature review was conducted in the Web of Science, Medline, LILACS and PubMed databases in March 2017. Papers published between 2004 and 2016, written in English, Spanish or Portuguese were included. The descriptors used were health, heart failure, depression, caregivers, and family. RESULTS: 26 papers were selected. 6% to 64% reported depressive symptoms. Depressive symptoms were associated with patients' and caregivers' characteristics. In most cases, depressive symptoms were greater among family caregivers than in the general population and were mainly associated with care burden and quality of life. CONCLUSIONS: The studies report depressive symptoms in caregivers of patients with heart failure.

Sintomas depressivos em cuidadores familiares de pacientes com insuficiência cardíaca: revisão integrativa / Síntomas depresivos en cuidadores familiares de pacientes con insuficiencia cardíaca: una revisión integradora / Depressive symptoms in the family caregivers of patients with heart failure: an integrative review

Resumo OBJETIVOS Identificar a ocorrência de depressão em cuidadores familiares de pacientes com insuficiência cardíaca e a correlação de outras variáveis com a depressão. MÉTODO A busca bibliográfica foi realizada nas bases de dados Web of Science, Medline, LILACS e PubMed, em março de 2017. Artigos publicados entre 2004 e 2016, escritos em inglês, espanhol ou português, utilizando os descritores saúde, insuficiência cardíaca, depressão, cuidadores e familiares foram incluídos. RESULTADOS Foram selecionados 26 trabalhos. 6% a 64% reportaram sintomas depressivos. Os sintomas depressivos foram associados com as características dos pacientes e cuidadores. Em sua maioria, os sintomas depressivos foram maiores entre os cuidadores familiares que a população em geral e se relacionou principalmente com a sobrecarga do cuidado e a qualidade de vida. CONCLUSÃO Os estudos identificaram sintomas depressivos nos cuidadores de pacientes com insuficiência cardíaca.

Resumen OBJETIVOS Identificar la ocurrencia de síntomas depressivos en los cuidadores familiares de pacientes con insuficiencia cardíaca y la correlación de otras variables con los síntomas depressivos. MÉTODO La búsqueda bibliográfica se realizó en las bases de datos Web of Science, Medline, LILACS y PubMed en marzo de 2017. Se incluyeron artículos publicados entre 2004 y 2016, escritos en inglés, español o portugués, utilizando los descriptores de salud, insuficiencia cardíaca, depresión, cuidadores y familia. RESULTADOS Se seleccionaron 26 trabajos. De 6% a 64% reportaron síntomas depresivos. Los síntomas depressivos se asociaron a características de pacientes y cuidadores. En la mayoría de los casos, los síntomas depresivos fueron mayores entre los cuidadores familiares que en la población general y se relacionaron principalmente con la carga asistencial y la calidad de vida. CONCLUSIONES Los estudios identificaron síntomas depresivos en los cuidadores de pacientes con insuficiencia cardiaca.

Abstract AIMS Identify the occurrence of depressive symptoms in family caregivers of patients with heart failure and the correlation of other variables with depressive symptoms. DESIGN/METHOD The literature review was conducted in the Web of Science, Medline, LILACS and PubMed databases in March 2017. Papers published between 2004 and 2016, written in English, Spanish or Portuguese were included. The descriptors used were health, heart failure, depression, caregivers, and family. RESULTS 26 papers were selected. 6% to 64% reported depressive symptoms. Depressive symptoms were associated with patients' and caregivers' characteristics. In most cases, depressive symptoms were greater among family caregivers than in the general population and were mainly associated with care burden and quality of life. CONCLUSIONS The studies report depressive symptoms in caregivers of patients with heart failure.

Correlations between stress, anxiety and depression and sociodemographic and clinical characteristics among outpatients with heart failure.

Aim To describe and investigate correlations among anxiety, stress and depression and identify their relationship with sociodemographic and clinical characteristics of patients with heart failure. METHODS: This is an analytical cross-sectional study. Sociodemographic and clinical characteristics were collected, along with levels of anxiety, stress and depression from 309 outpatients. RESULTS: The mean levels of stress, anxiety and depression were correlated but low. Time since diagnosis, the disease's functional class, family income, and smoking influenced stress. Functional class and Chagas disease influenced anxiety and depression. Being unemployed and smoking influenced anxiety, while being a homeowner influenced depression. CONCLUSION: These findings should be considered when planning nursing interventions.

Anxiety, stress and depression in family members of patients with heart failure.

OBJECTIVE: Identifying the level of anxiety, stress and depression symptoms in family members of patients with heart failure; identifying the relationship between these feelings with sociodemographic and clinical variables. METHOD: A cross-sectional study carried out with 100 family members. Depression, anxiety, and stress were evaluated by the Beck Depression and Anxiety Inventories and the Perceived Stress Scale - 10. The relationship between feelings and variables was performed through the t-test, Mann-Whitney or Kruskal-Wallis. RESULTS: Mean depression was 8.24, anxiety was 77.95, and stress was 17.43. The correlation coefficient between depression and anxiety and depression and stress was 0.53, and it was 0.66 between anxiety and stress. Females (p=0.002, p=0.031), smoking (p=0.05, p=0.011) and sedentary lifestyle (p=0.023, p=0.001) were related to anxiety and stress, respectively. Family income lower than five minimum wages (p=0.012) was related to depression, and regular/poor self-perceived health status related to the three feelings. CONCLUSION: Family members did not present high levels of these feelings. The scales were directly correlated with each one another and some variables were related to stress, anxiety and depression. OBJETIVO: Identificar o nível de ansiedade, estresse e sintomas de depressão de familiares de pacientes com insuficiência cardíaca; identificar a relação entre esses sentimentos com as variáveis sociodemográficas e clínicas. MÉTODO: Estudo transversal composto por 100 familiares. A depressão, a ansiedade e o estresse foram avaliados pelos Inventários de Depressão e Ansiedade de Beck e pela Escala de Estresse Percebido ‒ 10. A relação dos sentimentos com as variáveis foi realizada pelo teste t, Mann-Whitney ou Kruskal-Wallis. RESULTADOS: A média de depressão foi de 8,24, ansiedade, 7,95 e estresse, 17,43. O coeficiente de correlação entre depressão e ansiedade e depressão e estresse foi de 0,53 e de 0,66 entre ansiedade e estresse. Sexo feminino (p=0,002; p=0,031), tabagismo (p=0,05; p=0,011) e sedentarismo (p=0,023; p=0,001) se relacionaram com a ansiedade e estresse respectivamente. Renda familiar menor que cinco salários mínimos (p=0,012) se relacionou com a depressão, e autoavaliação de saúde regular/ruim se relacionou com os três sentimentos. CONCLUSÃO: Os familiares não apresentaram níveis elevados desses sentimentos. As escalas foram diretamente correlacionadas entre si e algumas variáveis se relacionaram com estresse, ansiedade e depressão.

Anxiety, stress and depression in family members of patients with heart failure / Ansiedad, estrés y depresión de familiares de pacientes con insuficiencia cardiaca / Ansiedade, estresse e depressão de familiares de pacientes com insuficiência cardíaca

Abstract OBJECTIVE Identifying the level of anxiety, stress and depression symptoms in family members of patients with heart failure; identifying the relationship between these feelings with sociodemographic and clinical variables. METHOD A cross-sectional study carried out with 100 family members. Depression, anxiety, and stress were evaluated by the Beck Depression and Anxiety Inventories and the Perceived Stress Scale - 10. The relationship between feelings and variables was performed through the t-test, Mann-Whitney or Kruskal-Wallis. RESULTS Mean depression was 8.24, anxiety was 77.95, and stress was 17.43. The correlation coefficient between depression and anxiety and depression and stress was 0.53, and it was 0.66 between anxiety and stress. Females (p=0.002, p=0.031), smoking (p=0.05, p=0.011) and sedentary lifestyle (p=0.023, p=0.001) were related to anxiety and stress, respectively. Family income lower than five minimum wages (p=0.012) was related to depression, and regular/poor self-perceived health status related to the three feelings. CONCLUSION Family members did not present high levels of these feelings. The scales were directly correlated with each one another and some variables were related to stress, anxiety and depression.

Resumen OBJETIVO Identificar el nivel de ansiedad, estrés y síntomas de depresión de familiares de pacientes con insuficiencia cardiaca; identificar la relación entre dichos sentimientos con las variables sociodemográficas y clínicas. MÉTODO Estudio transversal compuesto de 100 familiares. La depresión, la ansiedad y el estrés fueron evaluados por los Inventarios de Depresión y Ansiedad de Beck y la Escala de Estrés Percibido ‒ 10. La relación de los sentimientos con las variables fue realizada por la prueba t, Mann-Whitney o Kruskal-Wallis. RESULTADOS El promedio de depresión fue de 8,24, ansiedad, 7,95 y estrés, 17,43. El coeficiente de correlación entre depresión y ansiedad y depresión y estrés fue de 0,53 y de 0,66 entre ansiedad y estrés. Sexo femenino (p=0,002; p=0,031), tabaquismo (p=0,05; p=0,011) y sedentarismo (p=0,023; p=0,001) se relacionaron con ansiedad y estrés respectivamente. Renta familiar menor que cinco salarios mínimos (p=0,012) se relacionó con depresión, y autoevaluación de salud regular/mal se relacionó con los tres sentimientos. CONCLUSIÓN Los familiares no presentaron niveles elevados de esos sentimientos. Las escalas estuvieron directamente correlacionadas entre sí y algunas variables se relacionaron con estrés, ansiedad y depresión.

Resumo OBJETIVO Identificar o nível de ansiedade, estresse e sintomas de depressão de familiares de pacientes com insuficiência cardíaca; identificar a relação entre esses sentimentos com as variáveis sociodemográficas e clínicas. MÉTODO Estudo transversal composto por 100 familiares. A depressão, a ansiedade e o estresse foram avaliados pelos Inventários de Depressão e Ansiedade de Beck e pela Escala de Estresse Percebido ‒ 10. A relação dos sentimentos com as variáveis foi realizada pelo teste t, Mann-Whitney ou Kruskal-Wallis. RESULTADOS A média de depressão foi de 8,24, ansiedade, 7,95 e estresse, 17,43. O coeficiente de correlação entre depressão e ansiedade e depressão e estresse foi de 0,53 e de 0,66 entre ansiedade e estresse. Sexo feminino (p=0,002; p=0,031), tabagismo (p=0,05; p=0,011) e sedentarismo (p=0,023; p=0,001) se relacionaram com a ansiedade e estresse respectivamente. Renda familiar menor que cinco salários mínimos (p=0,012) se relacionou com a depressão, e autoavaliação de saúde regular/ruim se relacionou com os três sentimentos. CONCLUSÃO Os familiares não apresentaram níveis elevados desses sentimentos. As escalas foram diretamente correlacionadas entre si e algumas variáveis se relacionaram com estresse, ansiedade e depressão.

Quality of life and functional capacity after long-term right ventricular pacing in pediatrics and young adults with congenital atrioventricular block.

BACKGROUND: Although several studies have demonstrated deleterious consequences of chronic right ventricular (RV) pacing on ventricular function and synchronicity, its effects on health-related quality of life (HRQoL) and functional exercise capacity remain uncertain. We aimed to evaluate the effect of RV pacing on HRQoL and functional capacity of children and young adults with congenital complete atrioventricular block (CCAVB). METHODS: We included 66 consecutive subjects with RV cardiac pacemaker due to CCAVB and under clinical follow-up for more than 1 year. Multidimensional HRQoL scores were evaluated by Short Form-36 Health Survey (SF-36) and Child Health Questionnaire-Parent Form 50 (CHQ-PF50). Functional capacity was tested by a 6-minute walk distance test (6MWDT). Association analysis was performed to examine if any demographic and clinical characteristics were associated with lower HRQoL scores and shorter distances at the 6MWDT. RESULTS: Domains presenting lower HRQoL scores were vitality (64.0 ± 17.3), mental health (67.3 ± 8.0), role emotional (69.7 ± 35.8) in the SF-36 questionnaire; general health perceptions (61.3 ± 8.3), general behavior (61.9 ± 15.6), parental impact-emotional (67.7 ± 28.7) in the CHQ-PF50. Female gender (P = 0.009), left ventricular ejection fraction lower than 55% (P = 0.013), cardiovascular drugs (P = 0.003) were significantly associated with lower HRQoL scores. Average distance traveled during the 6MWDT was 539.8 ± 82.9 m. The 6MWDT showed significant association with age (P = 0.006) and cardiovascular drugs (P = 0.024). CONCLUSIONS: Chronic RV pacing did not affect the HRQoL and physical capacity of pediatrics and young subjects. Female gender, ventricular function, and cardiovascular drugs were associated with lower HRQoL scores. Older subjects walked shorter distances in the 6MWDT, as well as subjects who were taking cardiovascular drugs.

Glocal clinical registries: pacemaker registry design and implementation for global and local integration--methodology and case study.

BACKGROUND: The ability to apply standard and interoperable solutions for implementing and managing medical registries as well as aggregate, reproduce, and access data sets from legacy formats and platforms to advanced standard formats and operating systems are crucial for both clinical healthcare and biomedical research settings. PURPOSE: Our study describes a reproducible, highly scalable, standard framework for a device registry implementation addressing both local data quality components and global linking problems. METHODS AND RESULTS: We developed a device registry framework involving the following steps: (1) Data standards definition and representation of the research workflow, (2) Development of electronic case report forms using REDCap (Research Electronic Data Capture), (3) Data collection according to the clinical research workflow and, (4) Data augmentation by enriching the registry database with local electronic health records, governmental database and linked open data collections, (5) Data quality control and (6) Data dissemination through the registry Web site. Our registry adopted all applicable standardized data elements proposed by American College Cardiology / American Heart Association Clinical Data Standards, as well as variables derived from cardiac devices randomized trials and Clinical Data Interchange Standards Consortium. Local interoperability was performed between REDCap and data derived from Electronic Health Record system. The original data set was also augmented by incorporating the reimbursed values paid by the Brazilian government during a hospitalization for pacemaker implantation. By linking our registry to the open data collection repository Linked Clinical Trials (LinkedCT) we found 130 clinical trials which are potentially correlated with our pacemaker registry. CONCLUSION: This study demonstrates how standard and reproducible solutions can be applied in the implementation of medical registries to constitute a re-usable framework. Such approach has the potential to facilitate data integration between healthcare and research settings, also being a useful framework to be used in other biomedical registries.