Quality of life and performance status after cardiopulmonary resuscitation: A study in Cova da Beira University Hospital Center's intensive care unit.

INTRODUCTION AND OBJECTIVES: Cardiac arrest (CA) is associated with high morbidity and mortality. Many studies focus on survival, but few explore the outcomes. The aim of this study is to analyze the survival curve, independence, quality of life, and performance status after CA. METHODS: This retrospective study included adults admitted to the intensive care unit of Cova da Beira University Hospital Center after CA between 2015 and 2019. We analyzed patient records and applied a questionnaire including EuroQoL's EQ-5D-3L and ECOG performance status. RESULTS: Ninety-seven patients were included (mean age 75.74 years). Thirty-one patients (32.0%) survived to hospital discharge. There was a significant loss of independence for activities of daily living, with 50.0% of those previously independent becoming dependent and 47.5% of those previously at home being institutionalized. Diabetes, female gender, and length of hospital stay were especially impactful on these findings. One year after CA, only 20.6% were alive and only 13.4% (65% of the one-year survivors) were independent. Nine patients answered our questionnaire. Mean EQ-5D quality of life index (0.528±0.297) and the most affected domains ('Pain/discomfort' and 'Anxiety/depression') were similar to the Portuguese population aged >30 years. However, 66.6% reported a decline in their quality of life. Lastly, seven respondents had a good performance status (ECOG 0-1). CONCLUSIONS: There was a significant loss of independence after CA. Moreover, despite the acceptable performance status and the quality of life results being similar to the general population, there was a perceived deterioration post-CA. Ultimately, we emphasize the need to improve care for these patients.

Portuguese Heart Failure Prevalence Observational Study (PORTHOS) rationale and design - A population-based study.

INTRODUCTION AND OBJECTIVES: Current epidemiological data on heart failure (HF) in Portugal derives from studies conducted two decades ago. The main aim of this study is to determine HF prevalence in the Portuguese population. Using current standards, this manuscript aims to describe the methodology and research protocol applied. METHODS: The Portuguese Heart Failure Prevalence Observational Study (PORTHOS) is a large, three-stage, population-based, nationwide, cross-sectional study. Community-dwelling citizens aged 50 years and older will be randomly selected via stratified multistage sampling. Eligible participants will be invited to attend a screening visit at a mobile clinic for HF symptom assessment, anthropomorphic assessment, N-terminal pro-B-type natriuretic peptide (NT-proBNP) testing, one-lead electrocardiogram (ECG) and a sociodemographic and health-related quality of life questionnaire (EQ-5D). All subjects with NT-proBNP ≥125 pg/mL or with a prior history of HF will undergo a diagnostic confirmatory assessment at the mobile clinic composed of a 12-lead ECG, comprehensive echocardiography, HF questionnaire (KCCQ) and blood sampling. To validate the screening procedure, a control group will undergo the same diagnostic assessment. Echocardiography results will be centrally validated, and HF diagnosis will be established according to the European Society of Cardiology HF guidelines. A random subsample of patients with an equivocal HF with preserved ejection fraction diagnosis based on the application of the Heart Failure Association preserved ejection fraction diagnostic algorithm will be invited to undergo an exercise echocardiography. CONCLUSIONS: Through the application of current standards, appropriate methodologies, and a strong research protocol, the PORTHOS study will determine the prevalence of HF in mainland Portugal and enable a comprehensive characterization of HF patients, leading to a better understanding of their clinical profile and health-related quality of life.

Coronary sinus Reducer device for the treatment of refractory angina: A multicenter initial experience.

INTRODUCTION: The coronary sinus Reducer (CSR) device has emerged as a complementary therapy in patients with severe angina refractory to optimal medical therapy and not amenable to revascularization. Our aim was to assess the safety and efficacy of the CSR in a real-world setting. METHODS: Twenty-six patients with refractory angina (RA) and evidence of myocardial ischemia attributable to the left coronary artery considered unsuitable for revascularization were treated with the CSR at two centers between May 2017 and July 2019. Safety endpoints were procedural success and complications. Efficacy endpoints, assessed at six-month follow-up, were reduction in CCS class, improvement in quality of life (QoL) assessed using the short version of the Seattle Angina Questionnaire (SAQ-7), and reduction in antianginal therapy. RESULTS: Twenty-three patients had end-stage coronary artery disease without revascularization targets and three had microvascular disease without epicardial stenosis. Procedural success was achieved in 23 patients, with two device/procedure-related complications and one anatomically-related failure to deliver the device. A total of 24 patients had the device implanted and entered the efficacy analysis. Eighteen patients (75.0%) had a reduction of at least one CCS class, 41.7% had a reduction of at least two classes, and 16.7% became asymptomatic, with a mean reduction in CCS class of 1.3±0.2 (p=0.001) at six-month follow-up. All SAQ-7 domains improved, notably physical limitation (p=0.001), angina frequency (p=0.005) and QoL (p=0.006). There was a mean reduction in anti-ischemic drugs from 3.4±1.1 to 2.9±1.2 (p=0.010). CONCLUSION: In this real-world, multicenter experience, implantation of the CSR was associated with improvement in angina and QoL in patients with RA.

Levosimendan in outpatients with advanced heart failure: Single-center experience of 200 intermittent perfusions.

INTRODUCTION: Patients with advanced heart failure (HF) have high morbidity and mortality, with only a small proportion being eligible for advanced therapies. Intermittent outpatient levosimendan infusion has been shown to provide symptomatic relief and reduce the rate of HF events. Our aim was to assess the safety and efficacy of outpatient levosimendan administration in an advanced HF population. METHODS: This is a report of a single-center experience of consecutive advanced HF patients referred for intermittent intravenous outpatient administration of levosimendan, between January 2018 and March 2021. Baseline and follow-up evaluation included clinical assessment, laboratory tests, transthoracic echocardiography and cardiopulmonary exercise testing. Baseline and clinical follow-up data were compared using the Wilcoxon signed-rank test. RESULTS: A total of 24 patients (60.8 years, 83% male, mean left ventricular ejection fraction [LVEF] 24%), with a median of 1.5 HF hospitalizations in the previous six months, were referred for outpatient levosimendan pulses, the majority as a bridge to transplantation or due to clinical deterioration. At six-month follow-up there was a significant reduction in HF hospitalizations to 0.4±0.7 (p<0.001). NYHA class IV (52.2% to 12.5%, p=0.025) and NT-proBNP (8812.5 to 3807.4 pg/ml, p=0.038) were also significantly reduced. Exercise capacity was significantly improved, including peak oxygen uptake (p=0.043) and VE/VCO2 slope (p=0.040). LVEF improved from 24.0% to 29.7% (p=0.008). No serious adverse events were reported. CONCLUSION: Repeated levosimendan administration in advanced HF patients is a safe procedure and was associated with a reduction in HF hospitalizations, functional and LVEF improvement, and reduction in NT-proBNP levels during follow-up.

[Sexual dysfunction among oncological patients: The importance of a specialized approach]. / Disfunção sexual nos doentes oncológicos: a importância de uma abordagem especializada.

OBJECTIVES: Determination of the emotional and sexual impact after oncologic disease and patient's satisfaction regarding information provided by healthcare professionals. We also aim to evaluate the importance of sexology care during cancer treatment and follow-up. METHODS: This is a cross-sectional study including patients admitted for radiation therapy. A questionnaire and an assessment of clinical data were assessed. RESULTS: The study sample was composed by 104 patients. 60.6% had a negative impact on their sexual life after treatment and 62.5% were satisfied about the information given by healthcare professionals. About two thirds of the patients would accept sexology care during cancer treatment and/or follow-up. After a sub-group analysis, there were no statistically significant differences between groups regarding the prevalence of sexual dysfunction or needs for sexual care. DISCUSSION: There is a well-known impact of cancer on sexuality since its diagnosis. Our patients feel themselves well informed about this by health professionals. Most of them would accept being referred to an oncosexology appointment. CONCLUSIONS: Sexuality must be discussed with cancer patients since their diagnosis. Oncosexuality care is necessary and desired by most patients as a mean for reduction of the cancer impact in their life quality.

Quality of life among adults with repaired tetralogy of fallot: A literature review.

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect. Survival into adulthood is currently expected following surgical repair, leading to a growing population of adults with repaired TOF. In this literature review, we aim to summarize the current state of knowledge on the quality of life of adults with repaired TOF. A search was conducted on PubMed and results were reviewed for articles published between January of 2010 and June of 2020. Search terms included "Tetralogy of Fallot", "repaired", "adults" and "quality of life". For the subjective health status evaluation, most published studies used Short-Form-36. Most studies agree that physical complex status is poorer for adult patients with repaired TOF than for controls. Mental complex status was also lower. Patients reported similar satisfaction with their lives and levels of social participation. Most patients had a college or university degree. Higher education, male gender and having a partner were positively associated with being employed. Studies found no difference in the proportion of patients that are married or living with a partner, compared to control groups. Patients operated for TOF have a lower reproduction rate compared with the background population. A consistent finding of these studies is abnormal physical parameters compared to psychosocial issues. The diverse needs of adults with repaired TOF require a multidisciplinary care, that takes into consideration all aspects that affect their quality of life. Despite abnormal physical functional status, it is reassuring that most adult patients with TOF lead independent and productive lives.

Heart and brain interactions in heart failure: Cognition, depression, anxiety, and related outcomes.

BACKGROUND: Cognitive impairment, anxiety and depression are common in heart failure (HF) patients and its evolution is not fully understood. OBJECTIVES: To assess the cognitive status of HF patients over time, its relation to anxiety and depression, and its prognostic impact. METHODS: Prospective, longitudinal, single center study including patients enrolled in a structured program for follow-up after hospital admission for HF decompensation. Cognitive function, anxiety/depression state, HF-related quality of life (QoL) were assessed before discharge and during follow-up (between 6th and 12th month) using Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS) and Kansas City Cardiomyopathy Questionnaire, respectively. HF related outcomes were all cause readmissions, HF readmissions and the composite endpoint of all-cause readmissions or death. RESULTS: 43 patients included (67±11.3 years, 69% male); followed-up for 8.2±2.1 months. 25.6% had an abnormal MoCA score that remained stable during follow-up (22.6±4.2 vs. 22.2±5.5; p=NS). MoCA score <22 at discharge conferred a sixfold greater risk of HF readmission [HR=6.42 (1.26-32.61); p=0.025], also predicting all-cause readmissions [HR=4.00 (1.15-13.95); p=0.03] and death or all-cause readmissions [HR=4.63 (1.37-15.67); p=0.014]. Patients with higher MoCA score showed a greater ability to deal with their disease (p=0.038). At discharge, 14% and 18.6% had an abnormal HADS score for depression and anxiety, respectively, which remained stable during follow-up and was not related to MoCA. CONCLUSIONS: Cognitive function, anxiety and depressive status remain stable in HF patients despite optimized HF therapy. Cognitive status shall be routinely screened to adopt attitudes that improve management as it has an impact on HF-related QoL and prognosis.

Cardiac rehabilitation in older patients: Indication or limitation?

OBJECTIVE: To assess the clinical impact of a cardiac rehabilitation program in an older population. METHODS: This is a retrospective analysis of 731 coronary patients who attended phase 2 of a cardiac rehabilitation program between January 2009 and December 2016. We compared the response to the program of older (≥65 years) and younger (<65 years) patients, analyzing changes in metabolic profile (including body mass index, waist circumference and lipid profile), exercise capacity, cardiac autonomic regulation parameters (such as chronotropic index and resting heart rate), and health-related quality of life scores. RESULTS: Older patients represented 15.9% of our cohort. They showed significant reductions in waist circumference (male patients: 98.0±7.9 cm vs. 95.9±7.9 cm, p<0.001; female patients: 90.5±11.4 cm vs. 87.2±11.7 cm, p<0.001), LDL cholesterol (102.5 [86.3-128.0] mg/dl vs. 65.0 [55.0-86.0] mg/dl, p<0.001) and triglycerides (115.0 [87.8-148.5] mg/dl vs. 97.0 [81.8-130.0] mg/dl, p<0.001). Post-training data also showed a noticeable improvement in older patients' exercise capacity (7.6±1.8 METs vs. 9.3±1.8 METs, p<0.001), along with a higher chronotropic index and lower resting heart rate. Additionally, health-related quality of life indices improved in older subjects. However, our overall analysis found no significant differences between the groups in changes of the studied parameters. CONCLUSION: Older coronary patients benefit from cardiac rehabilitation interventions, similarly to their younger counterparts. Greater involvement of elderly patients in cardiac rehabilitation is needed to fully realize the therapeutic and secondary preventive potential of such programs.

Quality of life in adults living in the community with previous self-reported myocardial infarction.

AIM: Quality of life (QoL) is one of the most important patient-reported outcomes in chronic diseases. Using a population-based cohort, our objective was to assess health-related QoL in individuals with a previous myocardial infarction (MI). METHODS: This study was conducted on a large database representative of the adult Portuguese population aged 18 years or over, living in the community. Participants were assessed through telephone interview. A standardized questionnaire was applied to every individual about self-reported chronic diseases, including previous MI. QoL was assessed with the EQ-5D-3L version of EuroQol. The prevalence of previous MI was calculated and linear regression analysis was performed. RESULTS: The estimated prevalence of previous MI in the adult Portuguese population was 1.1%. These patients were older and more often male, had lower income and lower education levels, and were more often from urban areas. Respondents with self-reported MI assigned a lower self-perception to their health status in all domains, particularly in mobility and anxiety/depression. The mean EQ-5D-3L score in patients with MI was 0.73±0.34, significantly lower than in patients without MI (0.78±0.29). Also, the number of chronic diseases was significantly higher in patients with MI (5.0±2.2 vs. 1.7±1.8). Previous MI was not independently associated with QoL, which was related to age, gender and number of comorbidities. CONCLUSIONS: Adults with previous MI have a worse self-perceived health status and QoL. Previous MI was not an independent predictor of health-related QoL after controlling for age, gender and associated chronic diseases.

Factors influencing the quality of life of children with cochlear implants.

INTRODUCTION: The multidimensional impact of hearing loss on the various demands of life in children using cochlear implants is represented by variables that can influence the hearing, language and quality of life outcomes of this population. OBJECTIVE: To evaluate the factors influencing the quality of life of children with cochlear implantation, considering age, hearing age, age at evaluation, hearing skills, spoken language, family degree of receptiveness, schooling and socioeconomic status of the parents. METHODS: Participated 30 children using cochlear implants, aged 6 to 12 years and their respective parents. The children were evaluated by the categories auditory performance, by language category, and by the children with cochlear implants: perspectives parents questionnaire. Parents were assessed by the family involvement scale. RESULTS: The cochlear implant impacted the quality of life of the children, with more significant results on the increase of the social relations domain and the decrease of the family support domain. Overall, the increase of the age in the evaluation, better hearing and language skills, the mother's level of schooling and the family receptiveness correlated with the quality of life of children with cochlear implants. CONCLUSION: The influencing factors that correlated with the quality of life of the implanted children were the child's older age at the evaluation, the better hearing and language skills, the mother's level of schooling and the family receptiveness.

Prevalence and impact of asthma in schoolchildren in the city of Caxias do Sul-RS.

OBJECTIVE: To analyze the prevalence and impact of asthma in schoolchildren from the city of Caxias do Sul, RS, Brazil. METHODS: Cross-sectional observational and case-control study with children and adolescents between 7 and 15 years old, from public schools in Caxias do Sul, RS. The study is composed of two phases: Phase I analyzed the prevalence of asthma in the delimited population, investigating 1915 schoolchildren; Phase II quality of life questionnaires, asthma control and classification (for the asthmatic group), physical activity, school performance, pulmonary function tests and anthropometric measures were applied to 266 asthmatics and 288 controls. RESULTS: The estimated prevalence of asthma was 16.1%. In the comparison between asthmatics and nonasthmatics premature birth (p<0.001) and diagnosis of another chronic disease at birth (p<0.001) were found. Regarding pulmonary function, significant differences were found in the values between groups in FEV1, FEV1/FVC and forced expiratory flow in the 25 and 75% (FEF25-75%), being that asthmatics presented lower values. Among asthmatics, 133 (50.8%) did not have the disease controlled. In the anthropometric variables, significant differences were observed, with higher values in controls, in the the waist-to-height ratio (p=0.009) and in the perception of health (p<0.001). Quality of life is lower in asthmatics in the physical well-being domain (p=0.001) and in the total score (p=0.016). The total school performance score did not present a statistically significant difference between the groups. CONCLUSION: The prevalence of asthma is similar to that of other industrialized urban centers and may negatively affect some areas of the development of schoolchildren.

Impact of intervention on nutritional status, consumption of processed foods, and quality of life of adolescents with excess weight.

OBJECTIVE: To evaluate the impact of a nutritional intervention on nutritional status, ultra-processed food consumption, and quality of life of adolescents with excess weight. METHODS: Experimental study with adolescent students with excess weight, divided into two groups, an intervention group and a control group. The nutritional intervention lasted six months, with an educational and motivational approach. Nutritional status (waist circumference and body mass index), quality of life, and ultra-processed food consumption were evaluated before and after the period. RESULTS: Sixty-two adolescents with overweight or obesity participated in the study, 37 in the intervention group and 25 in the control group, aged 13.2±1.5 years in intervention group, and 13.0±1.8 years in control group, both of which had a higher female participation. There were changes in the body mass index (intervention group Δ: -0.81±2.28, control group Δ: -0.64±1.28) and in the waist circumference for intervention group (Δ:-3.31±5.47). For the pre- and post-ultra-processed food consumption, there was a significant reduction in the consumption of soft drinks in the intervention group (Δ: -0.07 [-0.27 to 0.00]), instant noodles (Δ: -0.03 [-0.07 to 0.00]), and sandwich cookies (Δ: -0.06 [-0.26 to 0.00]). The quality of life increased in the intervention group and decreased in the control group, with no intra- (p=0.162) or intergroup statistical relevance in the pre- (p=0.426) and post- (0.249) intervention period, with a reduction in the emotional domain score, with a significant variation in the intervention group (pre and post; Δ: -19.0±40.6). CONCLUSION: There was a decrease in body mass index and waist circumference (central obesity being more often related to insulin resistance), reduction of ultra-processed food consumption (soft drinks, sandwich cookies, and instant noodles), and a tendency toward quality of life improvement (however, there was a decrease in the domains of emotional and school quality of life).

Evaluation of the measurement properties of the Brazilian version of two quality-of-life questionnaires in food allergy - for children and their parents.

OBJECTIVE: To evaluate the psychometric properties of the Brazilian version of health-related quality-of-life questionnaires of children with food allergy and their parents. METHODS: The translation and cultural adaptation processes were previously performed, according to the method proposed by the World Health Organization. After this stage, the questionnaires were applied to 201 parents of children under 6 years of age with food allergy. The assessment of the psychometric properties included: evaluation of the internal consistency by Cronbach's alpha coefficient; of the reproducibility by the intraclass correlation coefficient between test and retest; and of the construct, using Spearman's correlation coefficient, comparing the obtained scores with those of generic questionnaires that evaluate health-related quality of life. RESULTS: The means of the obtained scores were 2.44 and 3.35, for the children and their parents, respectively. Cronbach's alpha coefficients were 0.85 and 0.91, respectively, which showed good internal consistency of the tools. The intraclass correlation coefficients between test and retest were 0.87 and 0.84 for children and their parents, respectively, showing good reproducibility for both questionnaires. The correlation between the specific and the generic questionnaires was significant (-0.27 for the children, -0.64 for their parents, p<0.05). CONCLUSIONS: The specific questionnaires to evaluate the health-related quality of life of children with food allergy and of their parents were satisfactorily validated to be used in Brazil.

Use of the long-term quality of life assessment in the decision to indicate surgery in patients with chronic rhinosinusitis.

INTRODUCTION: Quality-of-life questionnaires have been used to support decision-making in patients with chronic rhinosinusitis in the past decade. The choice of treatment in practice, however, also considers the patient's decision. OBJECTIVE: To assess the long-term quality of life of patients with chronic rhinosinusitis who decided to avoid surgery. METHODS: This is a prospective longitudinal study with a group of patients with chronic rhinosinusitis, with and without indication for surgery, with application of the questionnaire SNOT-22 in two periods: between 2011 and 2012 and between June and August 2016, via email. RESULTS: Data were collected from 42 patients, of which 13 presented indications for surgery and 29 were not indicated for surgery. The average quality of life score was 42.1 (±16.4) in the group with an indication for surgery and 40.6 (±23.4) in the group without this indication, p=0.84. All the patients were assessed by a single doctor with blinding in relation to the initial score. No differences were detected between the groups. The impact of the chronic rhinosinusitis was reduced even among the patients with the indication for surgery. Both groups scored over 40. CONCLUSION: This study can help predict the impact of the chronic rhinosinusitis over time and better adjust expectations with non-surgical treatment.

Cross-cultural adaptation and validation of the Quality of Life in School (QoLS) Questionnaire into Brazilian Portuguese / Adaptação cultural e validação para o Brasil do Quality of Life School Questionnaire (QoLS) para análise da qualidade de vida na escola

Abstract The school is fundamental for the development of societies and caring for the student is part of the educational process. Reflections on collective health allowed the expansion of the vision of the concept of quality of life considering different social spaces and indicators. Thus, the aim of this study was to assess of some psychometric Properties of the Quality of Life in School instrument into Brazilian Portuguese (QoLS-BR) among elementary school students. The processes of translation, content evaluation, focus group and Confirmatory Factor Analysis (CFA) were carried out. Reproducibility analysis was performed by administering QoLS-BR to 30 students. The sample used for Internal Consistency and CFA comprised 434 students with a mean age of 12.31 years. High indices of language clarity, practical relevance, theoretical relevance, internal consistency, and reproducibility were obtained. In the AFC, adjustments were not necessary in the QoLS-BR model with four factors (RMSEA=0.065; TLI=0.959; CFI=0.962; SRMR=0.080) indicating that the indices were adequate when investigating all four domains. QoLS-BR has adequate psychometric indicators for investigating the quality of life in school.

Resumo A escola é fundamental para o desenvolvimento das sociedades e o cuidado com o estudante faz parte do processo educativo. As discussões em saúde coletiva permitiram a ampliação da visão do conceito de qualidade de vida considerando diferentes espaços sociais e indicadores. Assim, o objetivo deste estudo foi a avaliação de algumas propriedades psicométricas do questionário de qualidade de vida na escola para o português brasileiro (QoLS-BR) em alunos do ensino fundamental. Foram realizados os processos de tradução, avaliação do conteúdo, grupo focal e Análise Fatorial Confirmatória (AFC). A análise de reprodutibilidade foi realizada por meio da aplicação do QoLS-BR em amostra de 30 estudantes. Para a análise de Consistência Interna e AFC, a amostra foi de 434 estudantes, com média de idade de 12,31 anos. Os resultados revelaram altos índices de clareza de linguagem, pertinência prática, relevância teórica, altos índices de consistência interna e de reprodutibilidade. Na AFC não foram necessários ajustes no modelo do QoLS com quatro fatores (RMSEA=0,065; TLI=0,959; CFI=0,962; SRMR=0,080) indicando que os índices estavam adequados. Assim, o QoLS-BR possui indicadores psicométricos adequados para investigação do construto qualidade de vida na escola.

A new classification for septal perforation and effects of treatment methods on quality of life.

INTRODUCTION: Septal perforation is a condition characterized by loss of cartilage and/or bony structures along with the mucoperichondrium and mucoperiosteum lining them. The etiology includes a history of nasal surgery or trauma, nose picking, bilateral septal cauterization, overuse of nasal sprays, cocaine abuse, vasculitis, and malignancies. OBJECTIVE: Comparison of quality of life in patients with septal perforation after conservative or surgical treatment, and a new approach for the determination of the diameter of the perforation from a different point of view. METHODS: The diameter of septal perforation, total vertical diameter of septum, and horizontal diameter of the perforation were measured in a total of 34 patients. Nineteen of the patients underwent surgical septal perforation repair, and 15 of them received septal button application. The patients were asked to complete the Glasgow Benefit Inventory quality of life questionnaire. RESULTS: The septal perforation successfully healed in 18 of 19 patients who underwent surgical treatment. The quality of life scores were statistically significantly higher in the surgical treatment group when compared to the button group (p<0.05). CONCLUSION: The septal perforation classification we propose would be beneficial for providing realistic dimensions, treatment methods, and surgical techniques.

Health-related quality of life in adolescents with excess weight.

OBJECTIVE: To identify health-related quality of life in adolescents with excess weight and associated factors, such as gender, age, and weight categories. METHOD: A cross-sectional study with collected and secondary data from 276 adolescents aged between 10 and 19 years with overweight and obesity, and whose parents or guardians authorized their participation. Anthropometric data, pubertal development, and the PedsQL 4.0 questionnaire were collected for the health-related quality of life assessment. Categorical data were described as numbers and percentages. For the description of health-related quality of life subscales, medians and the 25th and 75th percentiles were used, as well as the Mann-Whitney test for comparisons between age group, gender, and weight categories. RESULTS: The median health-related quality of life total score was 78.3 (68.5-87.4). The lowest scale was the "emotional score", 65 (50-80). Higher health-related quality of life was found in boys in most of the scores (p<0.05), except for the "school score" (p=0.09). Regarding the age group, the median of the "physical scores" (p=0.03) and "social score" (p=0.02) were significantly lower in the group younger than 14 years. When separated according to weight categories, it was verified that obese adolescents differed significantly in relation to the "physical score" (p=0.00), "school score" (p=0.04), and "total score" (p=0.02) of the health-related quality of life. However, there was no significant difference between the emotional, social, and psychosocial scores. CONCLUSIONS: Adolescents with overweight and obesity show losses in the health-related quality of life and also between the different domains, when separated by age, gender, and weight categories.

Quality of life after necrotizing enterocolitis: an integrative review / Qualidade de vida após enterocolite necrosante: uma revisão integrativa

ABSTRACT Objective: To describe the long-term health outcomes of neonates affected by necrotizing enterocolitis (NEC) and its implications for quality of life. Data source: This is an integrative review, conducted by searching the literature in the following databases: Virtual Health Library (BVS), Latin American and Caribbean Health Sciences Literature (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), and PubMed, using Health Sciences Descriptors (DeCS): "necrotizing enterocolitis," "quality of life," and "prognosis" combined with the Boolean operators AND and OR: "quality of life" OR "prognosis." Inclusion criteria were: publication period between 2012 and 2022. Data synthesis: A total of 1,010 studies were located, of which ten were selected to comprise the bibliographic sample of this review. Children with NEC are prone to exhibit cognitive neurological impairment, especially those who undergo surgical procedures due to more severe conditions. Motor development was considered below average when compared to healthy children, with more noticeable delays in fine and gross motor function development. The search for the relationship between NEC and quality of life revealed that this condition has a negative impact on the well-being of affected individuals. Conclusions: NEC has proven to be a serious condition contributing to high rates of morbidity and mortality in newborns, potentially leading to a reduction in the quality of life of affected patients.

RESUMO Objetivo: Descrever os desfechos em longo prazo na saúde de neonatos acometidos com enterocolite necrosante (ECN) e suas repercussões na qualidade de vida. Fontes de dados: Trata-se de uma revisão integrativa, realizada com base no levantamento da bibliografia nas bases de dados: Biblioteca Virtual em Saúde (BVS), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Medical Literature Analysis and Retrieval System Online (Medline) e PubMed por meio dos Descritores em Ciências da Saúde (DeCS): "necrotizing enterocolitis", "quality of life" e "prognosis" combinados com os operadores booleanos AND e OR: "quality of life" OR "prognosis". Os critérios de inclusão foram: período de publicação entre 2012 e 2022; Síntese dos dados: Foram localizados 1.010 estudos, dos quais dez foram selecionados para compor a amostra bibliográfica desta revisão. As crianças com ECN são propensas a apresentar comprometimento neurológico cognitivo, principalmente aquelas submetidas a procedimentos cirúrgicos em razão de quadros mais graves. O desenvolvimento motor foi considerado abaixo da média se comparado ao de crianças saudáveis, com atraso mais perceptível no desenvolvimento de funções motoras finas e grossas. A busca pela relação entre enterocolite necrosante e qualidade vida trouxe como resultado que essa condição tem impacto negativo sobre o bem-estar dos indivíduos acometidos. Conclusões: A enterocolite necrosante mostrou-se como uma condição grave que contribui para altas taxas de morbimortalidade em recém-nascidos, sendo uma potencial causa para a redução da qualidade de vida dos pacientes acometidos.

Efficacy of selective laser trabeculoplasty versus latanoprost as initial management in glaucoma / Eficácia da trabeculoplastia seletiva a laser versus latanoprosta como tratamento inicial no glaucoma

ABSTRACT Objective: To compare the hypotensive effect of SLT vs the use of latanoprost in the initial management of patients with suspected glaucoma and diagnosis of glaucoma. To evaluate the patients' quality of life using the Glaucoma Quality of Life questionnaire. Methods: Randomized controlled clinical trial conducted in the city of Cartagena, Colombia, between October 2021 to June 2023. Assignment to the SLT or latanoprost group with follow-up at days 7, 30, 90, 180, and 365 in patients diagnosed with suspected glaucoma, mild and moderate glaucoma. Results: 31 patients (60 eyes), of which 17 were men. Group SLT were 31 eyes and the latanoprost group included 29 eyes. The mean baseline IOP of the SLT group was 18.9mmHg and in the latanoprost group, it was 19.6mmHg. The mean IOP at the end of the follow-up group SLT was 13.9mmHg and for latanoprost 14.5mmHg. The IOP reduction percentage at one year of follow-up in the SLT group was 23.4% and that of the latanoprost group was 23.6% Conclusions: Selective laser trabeculoplasty with Nd-YAG laser is as effective as the use of prostaglandin analogues as initial treatment in the early stages of glaucoma. Regarding the quality of life scale, although there were no statistically significant differences in both groups, the SLT showed an increase in the difficulty perceived by the patient for activities that involve peripheral vision, which is the most affected in patients with glaucoma.

RESUMO Objetivo: Comparar o efeito hipotensor da trabeculoplastia seletiva a laser versus o uso de latanoprosta no tratamento inicial de pacientes com suspeita de glaucoma e diagnóstico de glaucoma; avaliar a qualidade de vida dos pacientes por meio do Glaucoma Quality of Life Survey. Métodos: Ensaio clínico randomizado controlado realizado na cidade de Cartagena, Colômbia, entre outubro de 2021 e junho de 2023. Atribuição ao grupo trabeculoplastia seletiva a laser ou latanoprosta com acompanhamento nos dias 7, 30, 90, 180 e 365 em pacientes diagnosticados com suspeita de glaucoma, glaucoma leve e moderado. Resultados: Foram incluídos 31 pacientes (60 olhos), sendo 17 homens. No Grupo Trabeculoplastia Seletiva a Laser, foram 31 olhos, e, no Grupo Latanoprosta, 29 olhos. A pressão intraocular basal média do Grupo Trabeculoplastia Seletiva a Laser foi de 18,9mmHg e, no Grupo Latanoprosta, foi de 19,6mmHg. A pressão intraocular média no fim do grupo de acompanhamento trabeculoplastia seletiva a laser foi de 13,9mmHg e para latanoprosta de 14,5mmHg. A percentagem de redução da pressão intraocular em 1 ano de acompanhamento no Grupo Trabeculoplastia Seletiva a Laser foi de 23,4% e a do Grupo Latanoprosta foi de 23,6%. Conclusões: A trabeculoplastia seletiva a laser com Nd-YAG é tão eficaz quanto o uso de análogos de prostaglandinas como tratamento nas fases iniciais do glaucoma. Em relação à escala de qualidade de vida, embora não tenha havido diferenças estatisticamente significativas em ambos os grupos, a A trabeculoplastia seletiva a laser mostrou aumento na dificuldade percebida pelo paciente para atividades que envolvem a visão periférica, que é a mais afetada em pacientes com glaucoma.

Sex differences in the impact of musculoskeletal disorders on health-related quality of life: a population-based study, Campinas, SP - ISACamp 2014/15 / Diferenças entre os sexos no impacto das doenças musculoesqueléticas na qualidade de vida relacionada à saúde: estudo de base populacional, Campinas, SP - ISACamp 2014/15

Abstract This article aims to estimate the prevalence of musculoskeletal disorders (MD) on the adult population of Campinas, São Paulo, Brazil, verifying associated demographic and socioeconomic factors, and to analyze their impact on Health-Related Quality of Life (HRQoL) according to sex. A population-based study was conducted with 2,166 individuals using data from the ISACamp 2014/15. The Medical Outcomes Study SF-36-Item Short Form Health Survey (SF-36) was used to measure HRQoL according to MD. Prevalence ratios (PR) were estimated by Poisson regression. Musculoskeletal disorders had a prevalence of 8.5% (6.7% tendonitis and 2.7% work-related musculoskeletal disorders - WMSD). Results showed a higher prevalence of musculoskeletal disorders in women, active or on leave due to illness, and in individuals with higher education levels. Moreover, reduced HRQoL scores were observed in 6 of the 8 domains, due to MD. The mental component and physical component showed greater impairment respectively among women and men after self-reported WMSD. These findings point to substantial damage from musculoskeletal disorders on the population's HRQoL. WMSD affect the HRQoL of men and women distinctly.

Resumo O objetivo deste artigo é estimar a prevalência de doenças musculoesqueléticas (DM) na população adulta de Campinas/SP, Brasil, verificar fatores demográficos e socioeconômicos associados e analisar o seu impacto na qualidade de vida relacionada à saúde (QVRS) segundo sexo. Este é um estudo de base populacional utilizando dados do ISACamp 2014/15, com 2.166 indivíduos. Para a medida de QVRS, foram calculados os escores médios do Short Form Health Survey 36 (SF-36) segundo as DM e utilizada a regressão de Poisson para estimar as razões de prevalência (RP). A prevalência de DM foi de 8,5% (6,7% de tendinite e 2,7% de doenças osteomusculares relacionadas ao trabalho - DORT). Os resultados deste estudo mostraram maior prevalência de DM em mulheres, na população adulta ativa ou afastada por doença e em indivíduos com maior escolaridade. Além disso, observou-se redução nos escores de QVRS, devido às DM, em quase todos os domínios do instrumento. O maior comprometimento foi observado no componente mental entre as mulheres, e no componente físico, entre os homens, após autorrelato de DORT. Os achados mostram o impacto substancial das DM na QVRS da população. As DORT afetam distintamente a QVRS de homens e mulheres.