Evaluation of quality of life before and after videothoracoscopic simpathectomy for primary hyperhidrosis

Objective: To assess quality of life before and after thoracoscopic sympathectomy for treatment of primary hyperhidrosis.Methods: we conducted an observational, analytical, cross-sectional and quantitative study. We evaluated patients undergoing thoracoscopic sympathectomy for primary axillary hyperhidrosis, primary palmar hyperhidrosis, and axillary hyperhidrosis associated with palmar one. We applied a questionnaire on quality of life related to hyperhidrosis before and after the operation.Results: The questionnaire was administered to 51 patients with a mean age of 32.4 years, 45 women and six men. The average quality of life related to hyperhidrosis in a score of 0-100 before sympathectomy was 34.6 and after the operation it was 77.1. Compensatory hyperhidrosis occurred in 84.3% of patients.Conclusion: thoracoscopic sympathectomy improves the quality of life of patients with primary hyperhidrosis, with results supported over time. Compensatory hyperhidrosis occurred in most patients, but did not significantly influence the improved quality of life.

Quality of life and menopausal symptoms in women with liver transplants

PURPOSE: To assess quality of life and climacteric symptoms in women with and without liver transplants. METHODS: This was a cross-sectional study of 52 women undergoing follow-up at a university hospital in southeastern Brazil from February 4th, 2009 to January 5th, 2011. Twenty-four of these women were 35 years old or older and had undergone liver transplantation at least one year before study entry. The remaining 28 women had no liver disease and were matched by age and menstrual patterns to the patients with transplants. The abbreviated version of the World Health Organization (WHOQOL-BREF) questionnaire was used to assess quality of life. Menopausal symptoms were assessed using the Menopause Rating Scale (MRS). Statistical analysis was carried out by Student's t-test, Mann-Whitney test and analysis of variance. Correlations between MRS and the WHOQOL-BREF were established by correlation coefficients. RESULTS: The mean age of the women included in the study was 52.2 (±10.4) years and the mean time since transplantation was 6.1 (±3.3) years. Women with liver transplants had better quality of life scores in the environment domain (p=0.01). No difference was noted between the two groups in any domain of the MRS. For women in the comparison group, there was a strongly negative correlation between somatic symptoms in the MRS and the physical domain of the WHOQOL-BREF (p<0.01; r=-0.8). In contrast, there was only a moderate association for women with liver transplants (p<0.01; r=-0.5). CONCLUSIONS: Women with liver transplants had better quality of life scores in the domain related to environment and did not exhibit more intense climacteric symptoms than did those with no liver disease. Climacteric symptoms negatively influenced quality of life in liver transplant recipients, although less intensely than in women without a history of liver disease.

Fatigue and quality of life in breast cancer survivors: a comparative study

PURPOSE: To assess fatigue and quality of life in disease-free breast cancer survivors in relation to a sample of age-matched women with no cancer history and to explore the relationship between fatigue and quality of life.METHODS: A cross-sectional study was conducted in a sample of 202 consecutive disease-free Brazilian breast cancer survivors, all of whom had completed treatment, treated at 2 large hospitals. The patients were compared to age-matched women with no cancer history attending a primary health care center. The Piper Fatigue Scale-Revised and the World Health Organization Quality of Life Instrument (WHOQOL-BREF) were used to measure the fatigue and quality of life, respectively. Socio-demographic and clinical variables were also obtained. The χ2 test, generalized linear model, and Spearman correlation coefficient were used for statistical purposes. The adopted level of significance was 5%.RESULTS: Breast cancer survivors experienced significantly greater total and subscale fatigue scores than comparison group (all p-values<0.05). In addition, survivors reported a poorer quality of life in physical (p=0.002), psychological (p=0.03), and social relationships (p=0.03) domains than comparison group. No difference was found for the environmental domain (p=0.08) for both groups. For survivors of breast cancer and for comparison group, the total and subscale fatigue scores were related to lower quality of life (all p-values<0.01).CONCLUSION: The findings of this study highlight the importance of assessing fatigue and quality of life in breast cancer survivors.

Tradução, adaptação e validação da versão brasileira do questionário Utian Quality of Life para avaliação da qualidade de vida no climatério

OBJETIVOTraduzir, realizar a equivalência e validar o questionário Utian Quality of Life(UQOL) para a população brasileira.MÉTODOSParticiparam do estudo mulheres selecionadas aleatoriamente, na fase do climatério, residentes na cidade de Natal, Rio Grande do Norte, localizada na região do nordeste brasileiro. Foram utilizados os questionários UQOL e SF-36, sendo a fase da tradução realizada da língua inglesa para o português por três professores, enquanto que a fase de adaptação da versão traduzida foi feita através da aplicação do questionário a 35 mulheres, que poderiam marcar a opção de resposta "não compreendi a questão"; e para a validação foram usadas as medidas de reprodutibilidade (teste-reteste) e validade de construto, seguindo as normas metodológicas padronizadas internacionalmenteRESULTADOSA versão brasileira foi reconhecida plenamente pela população-alvo, que foi composta por 151 mulheres, devido a nenhuma questão apresentar percentual de "não compreensão" igual ou superior a 20%. Os resultados obtidos para a reprodutibilidade intra e interobservador demonstraram concordância significativa em todos os itens do questionário. Essa versão apresentou consistência acima do critério requerido (>70), demonstrando sua precisão, enquanto que a validade de construto foi obtida através de correlações estatisticamente significativas entre os domínios ocupação, saúde e emocional do UQOL com os domínios do SF-36. O coeficiente alfa de Cronbach para o instrumento como um todo foi de 0,82, representando boa precisão. Análise da correlação item-total demonstrou a homogeneidade da escala.CONCLUSÃOA partir das etapas realizadas, o questionário UQOL foi traduzido e adaptado para aplicação no Brasil, apresentando alta reprodutibilidade e validade. Dessa forma, pode ser incluído e utilizado em estudos brasileiros que visem avaliar a qualidade de vida durante a peri e pós-menopausa.

Cultural adaptation and validation of the "Kidney Disease and Quality of Life - Short Form (KDQOL-SF™ 1.3)" in Brazil

The objective of the present study was to translate the Kidney Disease Quality of Life - Short Form (KDQOL-SF™1.3) questionnaire into Portuguese to adapt it culturally and validate it for the Brazilian population. The KDQOL-SF was translated into Portuguese and back-translated twice into English. Patient difficulties in understanding the questionnaire were evaluated by a panel of experts and solved. Measurement properties such as reliability and validity were determined by applying the questionnaire to 94 end-stage renal disease patients on chronic dialysis. The Nottingham Health Profile Questionnaire, the Karnofsky Performance Scale and the Kidney Disease Questionnaire were administered to test validity. Some activities included in the original instrument were considered to be incompatible with the activities usually performed by the Brazilian population and were replaced. The mean scores for the 19 components of the KDQOL-SF questionnaire in Portuguese ranged from 22 to 91. The components "Social support" and "Dialysis staff encouragement" had the highest scores (86.7 and 90.8, respectively). The test-retest reliability and the inter-observer reliability of the instrument were evaluated by the intraclass correlation coefficient. The coefficients for both reliability tests were statistically significant for all scales of the KDQOL-SF (P < 0.001), ranging from 0.492 to 0.936 for test-retest reliability and from 0.337 to 0.994 for inter-observer reliability. The Cronbach's alpha coefficient was higher than 0.80 for most of components. The Portuguese version of the KDQOL-SF questionnaire proved to be valid and reliable for the evaluation of quality of life of Brazilian patients with end-stage renal disease on chronic dialysis.

Group cognitive behavior therapy for bipolar disorder can improve the quality of life

Bipolar disorder (BD) can have an impact on psychosocial functioning and quality of life (QoL). Several studies have shown that structured psychotherapy in conjunction with pharmacotherapy may modify the course of some disorders; however, few studies have investigated the results of group cognitive behavior therapy (G-CBT) for BD. Our objective was to evaluate the effectiveness of 14 sessions of G-CBT for BD patients, comparing this intervention plus pharmacotherapy to treatment as usual (TAU; only pharmacotherapy). Forty-one patients with BD I and II participated in this study and were randomly allocated to each group (G-CBT: N = 27; TAU: N = 14). Thirty-seven participants completed the treatment (women: N = 66.67%; mean age = 41.5 years). QoL and mood symptoms were assessed in all participants. Scores changed significantly by the end of treatment in favor of the G-CBT group. The G-CBT group presented significantly better QoL in seven of the eight sub-items assessed with the Medical Outcomes Survey SF-36 scale. At the end of treatment, the G-CBT group exhibited lower scores for mania (not statistically significant) and depression (statistically significant) as well as a reduction in the frequency and duration of mood episodes (P < 0.01). The group variable was significant for the reduction of depression scores over time. This clinical change may explain the improvement in six of the eight subscales of QoL (P < 0.05). The G-CBT group showed better QoL in absolute values in all aspects and significant improvements in nearly all subscales. These results were not observed in the TAU control group.

The impact of short daily hemodialysis on anemia and the quality of life in Chinese patients

Anemia is a frequent complication in hemodialysis patients. Compared to conventional hemodialysis (CHD), short daily hemodialysis (sDHD) has been reported to be effective in many countries except China. The aim of the present study was to determine whether sDHD could improve anemia and quality of life (QOL) for Chinese outpatients with end-stage renal disease. Twenty-seven patients (16 males/11 females) were converted from CHD to sDHD. All laboratory values were measured before conversion (baseline), at 3 months after conversion (sDHD1), and at 6 months after conversion (sDHD2). The patient's QOL was evaluated at baseline and 6 months after conversion using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). Hemoglobin concentration increased significantly from 107.4±7.9 g/L at baseline to 114.4±6.8 g/L (P<0.05) at sDHD1, and 118.3±8.4 g/L (P<0.001) at sDHD2 (Student paired t-test). However, the dose requirement for erythropoietin decreased from 6847.8±1057.3 U/week at baseline to 5869.6±1094.6 U/week (P<0.05) at sDHD2. Weekly stdKt/V increased significantly from 2.05±0.13 at baseline to 2.73±0.20 (P<0.001) at sDHD1, and 2.84±0.26 (P<0.001) at sDHD2. C-reactive protein decreased from baseline to sDHD1 and sDHD2, but without statistically significant differences. Physical and mental health survey scores increased in the 6 months following conversion to sDHD. sDHD may increase hemoglobin levels, decrease exogenous erythropoietin dose requirements, and improve QOL in Chinese hemodialysis patients compared to CHD. A possible mechanism for improvement of clinical outcomes may be optimized management of uremia associated with the higher efficiency of sDHD.

Short-term follow-up of exercise training program and beta-blocker treatment on quality of life in dogs with naturally acquired chronic mitral valve disease

This study aimed to evaluate the effects of carvedilol treatment and a regimen of supervised aerobic exercise training on quality of life and other clinical, echocardiographic, and biochemical variables in a group of client-owned dogs with chronic mitral valve disease (CMVD). Ten healthy dogs (control) and 36 CMVD dogs were studied, with the latter group divided into 3 subgroups. In addition to conventional treatment (benazepril, 0.3-0.5 mg/kg once a day, and digoxin, 0.0055 mg/kg twice daily), 13 dogs received exercise training (subgroup I; 10.3±2.1 years), 10 dogs received carvedilol (0.3 mg/kg twice daily) and exercise training (subgroup II; 10.8±1.7 years), and 13 dogs received only carvedilol (subgroup III; 10.9±2.1 years). All drugs were administered orally. Clinical, laboratory, and Doppler echocardiographic variables were evaluated at baseline and after 3 and 6 months. Exercise training was conducted from months 3-6. The mean speed rate during training increased for both subgroups I and II (ANOVA, P>0.001), indicating improvement in physical conditioning at the end of the exercise period. Quality of life and functional class was improved for all subgroups at the end of the study. The N-terminal pro-brain natriuretic peptide (NT-proBNP) level increased in subgroup I from baseline to 3 months, but remained stable after training introduction (from 3 to 6 months). For subgroups II and III, NT-proBNP levels remained stable during the entire study. No difference was observed for the other variables between the three evaluation periods. The combination of carvedilol or exercise training with conventional treatment in CMVD dogs led to improvements in quality of life and functional class. Therefore, light walking in CMVD dogs must be encouraged.

Negative emotions affect postoperative scores for evaluating functional knee recovery and quality of life after total knee replacement

This study aimed to determine whether psychological factors affect health-related quality of life (HRQL) and recovery of knee function in total knee replacement (TKR) patients. A total of 119 TKR patients (male: 38; female: 81) completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), Eysenck Personality Questionnaire-revised (EPQR-S), Knee Society Score (KSS), and HRQL (SF-36). At 1 and 6 months after surgery, anxiety, depression, and KSS scores in TKR patients were significantly better compared with those preoperatively (P<0.05). SF-36 scores at the sixth month after surgery were significantly improved compared with preoperative scores (P<0.001). Preoperative Physical Component Summary Scale (PCS) and Mental Component Summary Scale (MCS) scores were negatively associated with extraversion (E score) (B=-0.986 and -0.967, respectively, both P<0.05). Postoperative PCS and State Anxiety Inventory (SAI) scores were negatively associated with neuroticism (N score; B=-0.137 and -0.991, respectively, both P<0.05). Postoperative MCS, SAI, Trait Anxiety Inventory (TAI), and BAI scores were also negatively associated with the N score (B=-0.367, -0.107, -0.281, and -0.851, respectively, all P<0.05). The KSS function score at the sixth month after surgery was negatively associated with TAI and N scores (B=-0.315 and -0.532, respectively, both P<0.05), but positively associated with the E score (B=0.215, P<0.05). The postoperative KSS joint score was positively associated with postoperative PCS (B=0.356, P<0.05). In conclusion, for TKR patients, the scores used for evaluating recovery of knee function and HRQL after 6 months are inversely associated with the presence of negative emotions.

Effect of thinning on flower and fruit and of edible coatings on postharvest quality of jaboticaba fruit stored at low temperature

Jaboticaba is a Brazilian fruit, native to the Atlantic forest, which belongs to the Myrtaceae family. In this work we describe the effect of the thinning of "flower", "fruit" and "flower & fruit" compared to non-thinned fruit (control) and of edible coatings with respect on nutritional composition, overall acceptability and shelf-life of jaboticaba ‘Sabara’, grown in an irrigated commercial orchard. "Flower and fruit" thinning allows fruit with higher quality as diameter, volume and mass. Non-thinned fruit shows higher yield, however fruit have lower quality. As a result of the improving quality at harvest, the shelf life was twice (~8 days) for thinned fruit. The lack of change in concentration of soluble sugar and absence of formation of volatile compounds during storage indicate that there was no natural fermentation of the jaboticaba pulp after harvest. Treatments with wax and calcium did not improve the jaboticaba shelf life.

Quality of deep frying oils and fats used in street-fairs in Goiânia, Brazil

Fried foods are widely consumed in Brazil and their quality depends on the oil or fat they are fried. Qualitative (physical chemistry indices) and quantitative measurements (fry-life oil or fat until disposal, oil turnover, type of oil or fat and amount and type of fried foods) and associations were performed. We applied a structured form and collected 60 mL of frying oil or fat in each of the 70 fried food stands of 15 street-fairs in Goiânia, Brazil. All samples were suitable in the quantity of free fat acids (<0.9% oleic acid), one was inadequate to peroxide value (>10 mEq/kg) and 1/3 was unsuitable to polar compounds (<25%). The majority (62%) use temperature up to the allowed (180 ºC). Approximately 250 units of products are fried in at least one day in 42% of the fried food stands. Soybean oil is used in the majority (94%) of fried food stands and the fry-life is of 6 hours (60%) or a day of work/sale. The nonconformity of the content of total polar compounds in fried foods had significant association with frying time and the conformity of acidity had significant relationship with frying time by a chi-square test. All other associations were not significant. A fry-life of oil or fat up to 6 hours can avoid the excess of polar compounds in the frying medium and protect the quality of fred foods.

Effect of chitosan-carvacrol edible coatings on the quality and shelf life of tilapia (Oreochromis niloticus) fillets stored in ice

Abstract Fish consumption has increased in recent years. However, fish meat is highly perishable, which demonstrates the need for technologies to preserve its quality. Edible coatings (EC) might provide an alternative to extend the shelf life of fish. The goal of this study was to evaluate the effect of EC of chitosan (C) in combination with carvacrol (CAR) on the physical and microbiological changes of tilapia fillets. Fillets were submerged for two minutes in different treatments (T1: control; T2: C 2%; T3: C 2% + 0.125% CAR; T 4: C 2% + 0.25% CAR). At the end of storage, T1 and T2 showed the lowest values of total volatile bases (TVB). The color parameters L*, a* and b* varied from each treatment. The texture decreased and the different treatments reduced the microbial population in relation to the control; T3 and T4 were the most effective. These results show that the use of C with CAR might be an alternative method to preserve the quality and safety of tilapia fillets.

Effect of different proportions of brea gum in the functional characteristics of wheat flour starch: impact on the physical quality of bread

The aim of this work was to study the changes induced by BG in the behaviour of wheat starch, and observe the influence of these variations on the quality of a basic white bread. The effect of four BG addition levels in the wheat flour functional characteristics (WAI, WSI, and pasting properties) and bread quality (physical parameters, crumb grain structure, moisture and hardness) was investigated. The highest levels of BG (1% and 2%) decreased the peak viscosity, and increased the stability and setback of the flour. This was due to a lower gelatinization of the starch granules, caused by a competition for water between the hydrocolloid and starch. These changes influenced the bread quality. The loaves added with 1% and 2% of BG presented smaller alveoli: this resulted in more compact, hard and less airy crumbs. Nevertheless, the moisture of the samples at 1% and 2% of added gum was higher than the control bread. However, the incorporation of BG at 0.5% did not affect the pasting parameters and bread quality, but increased moisture of crumb, so this concentration would be most recommended for baking, since higher humidity could favour the shelf- life of the product.

Dyadic Relationship and Quality of Life Patients with Chronic Kidney Disease

AbstractIintroduction:Chronic Renal insufficiency (CRI) and dialysis treatment lead to a succession of situations for kidney chronic patient, which compromises his aspect, not only physically, and psychologically, with personal, family and social repercussions.Objective:(1) to verify the existence of differences of dyadic adjustment (DA) according to renal replacement treatment (RRT) and (2) verify the existence of differences quality of life (QOL) in accordance with the RRT.Methods:This is a cross-sectional study of a descriptive nature through surveys, exploratory and correlational. The sample consisted of 125 participants. Of these, 31 were to be made RRT by automated peritoneal dialysis (APD) and 94 hemodialysis (HD). Participants were selected from three renal centers: (1) Centro Renal da Prelada (Porto, Portugal), (2) Centrodial (S. João da Madeira, Portugal) and Centro Renal da Misericórdia de Paredes (Paredes, Portugal). The study was carried out for 6 months. The following instruments were applied: Socio-demographic and clinical questionnaire (SDCQ), Dyadic Adjustment Scale (DAS), World Health Organization Quality of Life (WHOQOL-Bref).Results:The results demonstrate the existence of statistically significant differences between the type of RRT and most areas of QOL, as well as the existence of statistically significant differences between the subscales of the DAS evaluated and the type of RRT.Conclusion:The present study demonstrates a greater commitment in terms of QOL of individuals undergoing treatment for HD when compared with those subjected to APD. It turns out, also, that DA is most strongly perceived by patients in APD than with HD.