Quality of life after coronary artery bypass surgery

This study assessed the quality of life (QoL) of 124 people with coronary artery disease who had coronary artery bypass surgery in a hospital in Brazil, by using the Modified Flanagan`s QoL instrument as the outcome measure. In addition, we studied the association between QoL and demographic, clinical, and perceived health status (using SF-36 Health Survey) measures. The mean for the Modified Flanagan`s QoL was high (M = 84.8, SD = 13.6) when compared to similar studies in the United States. In a linear regression analysis, the SF-36 subscales of vitality, and general and mental health were statistically significant (p < .01 for all), after adjusting for other demographic and clinical variables. Increasing values of those SF-36 subscales corresponded to increasing Modified Flanagan`s QoL. Despite the limitations of the study, this result suggests that future clinical interventions aimed to improve QoL in this population could focus on the patient`s psychological conditions after the surgery.

The Outcomes of Visualization and Acupuncture on the Quality of Life of Adult Cancer Patients Receiving Chemotherapy

Background: The use of complementary and alternative medicine (CAM) to treat cancer patients has increased around the world, and its benefits have been described. These therapies represent an important theme in oncology and have been used in parallel with conventional therapies. Objective: This study aimed to assess the outcomes of using relaxation with visualization and acupuncture on the quality of life of cancer patients undergoing chemotherapy treatment and to compare these outcomes with patients who did not choose to receive the intervention. Methods: Participants chose to be in either the intervention group (IG) or control group (CG). They completed the Quality of Life Questionnaire-Core 30 at the start and end of chemotherapy. The IG was chosen by 38 patients with different types of cancer who completed weekly relaxation with visualization and acupuncture sessions, whereas the CG was composed of 37 patients who did not receive the intervention. Results: Statistically significant results evidenced an increase in global health and emotional and social functions and a decrease in fatigue and loss of appetite for the IG, and an increase in global health for the CG (P <= .05). A highly significant difference was found when comparing the post-chemotherapy scores of the Quality of Life Questionnaire-Core 30 in the global health domain between the CG and the IG (P <= .001), indicating positive outcomes of the CAM intervention. Conclusion: Adults with cancer are able to choose between involvement or not with this kind of CAM intervention. Global health could be improved by participating in this type of intervention. Implications for Practice: Choosing whether to be involved may be assisted by knowing the positive outcomes for some patients.

Cultural meaning of quality of life: perspectives of Brazilian burn patients

Purpose. This study was designed to explore the cultural meaning and dimensions of quality of life from the perspective of Brazilian burn patients. Method. A qualitative research approach was used. Nineteen burn patients and their close relatives participated in this ethnographic study. Data were collected by means of direct observation and semi-structured interviews, conducted in a hospital outpatient clinic and during visits to patients` homes. The following inter-related phases guided the analysis process: reading of the material and data reduction, data display, conclusion outlining and verification. Results. Participants reported that the quality of life is related to autonomy and the ability to work. The dimensions of quality of life included: resuming work and functional ability, body image, having leisure and interpersonal relationships. Their descriptions revealed their feelings and attitudes about resuming their previous activities and social lives, particularly concerning the work. Conclusion. For burn patients, quality of life is associated with the concept of normality, the satisfactory performance of social roles in the context of family life and the social world. The results showed the importance of the sociocultural dimension in the concept of quality of life for persons undergoing burn rehabilitation.

Body composition and quality of life (QoL) of the elderly offered by the ""University Third Age`` (UTA) in Brazil

The investigation of the factors that interfere in the well-being of the elderly and their QoL can provide theoretical and methodological subsidies in structuring actions and policies in the health area, in order to fulfill the needs of that population. In this descriptive transversal study, body composition and QoL of elderly women at the UTA program in Piracicaba (Sao Paulo, Brazil) were verified. The participants were 81 women from UTA, and the general levels of physical activity were evaluated, as well as body weight (BW), height, and bodymass index (BMI). The waist circumference (WC) was measured at the level of the umbilical scar and the body composition by impedance (BIA 310e). QoL was verified by means of WHOQOL-Bref and statistical analysis developed with the SAS program. The decrease of weight, height, BMI, and fat-free mass (FFM) was observed among the several age groups, although with no significant difference. The average levels of the general QoL scores and physical, psychological and environmental domains decreased in higher age groups, but social domains showed the opposite result. This fact can be a particular characteristic of the UTA group, and factors the influence such behavior are yet to be studied. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Mitochondrial function in the yeast form of the pathogenic fungus Paracoccidioides brasiliensis

Differences between the respiratory chain of the fungus Paracoccidioides brasiliensis and its mammalian host are reported. Respiration, membrane potential, and oxidative phosphorylation in mitochondria from P. brasiliensis spheroplasts were evaluated in situ, and the presence of a complete (Complex I-V) functional respiratory chain was demonstrated. In succinate-energized mitochondria, ADP induced a transition from resting to phosphorylating respiration. The presence of an alternative NADH-ubiquinone oxidoreductase was indicated by: (i) the ability to oxidize exogenous NADH and (ii) the lack of sensitivity to rotenone and presence of sensitivity to flavone. Malate/NAD(+)-supported respiration suggested the presence of either a mitochondrial pyridine transporter or a glyoxylate pathway contributing to NADH and/or succinate production. Partial sensitivity of NADH/succinate-supported respiration to antimycin A and cyanide, as well as sensitivity to benzohydroxamic acids, suggested the presence of an alternative oxidase in the yeast form of the fungus. An increase in activity and gene expression of the alternative NADH dehydrogenase throughout the yeast`s exponential growth phase was observed. This increase was coupled with a decrease in Complex I activity and gene expression of its subunit 6. These results support the existence of alternative respiratory chain pathways in addition to Complex I, as well as the utilization of NADH-linked substrates by P. brasiliensis. These specific components of the respiratory chain could be useful for further research and development of pharmacological agents against the fungus.

Health-related quality of life in Australian children with asthma: lessons for the cross-cultural use of quality of life instruments

The development of Australian forms of the Childhood Asthma Questionnaires (CAQs) is reported. Focus group methods and psychometric analyses were used to establish the conceptual, semantic and technical equivalence of these forms with the UK versions. Both versions also provide for data collection from non-asthmatic youngsters. The internal consistency was found to be acceptable (Cronbach's alpha 0.52-0.90) and the health-related quality of life (HRQoL) scores were found to vary with asthma severity (p < 0.05). Comparison with the UK data revealed that the non-asthmatic scores were higher for Australian than British children (p < 0.001) but that the scores for children with asthma did not differ between the two countries. It was only In the Australian sample that the group with asthma reported impaired HRQoL when compared to their healthy peers. These findings were interpreted in the context of cultural expectations of life quality and conclusions are presented regarding the importance of the gap between experience and expectations. The difficulties raised by the developmental and cultural issues inherent in paediatric HRQoL research were discussed. Qual. Life Res. 7:409-419 (C) 1998 Kluwer Academic Publishers

Dysregulated hematopoiesis and a progressive neurological disorder induced by expression of an activated form of the human common beta chain in transgenic mice

Previously we described activating mutations of h beta(c), the common signaling subunit of the receptors for the hematopoietic and inflammatory cytokines, GM-CSF, IL-3, and IL-5. The activated mutant, h beta(c)FI Delta, is able to confer growth factor-independent proliferation on the murine myeloid cell line FDC-P1, and on primary committed myeloid progenitors. We have used this activating mutation to study the effects of chronic cytokine receptor stimulation. Transgenic mice were produced carrying the h beta(c)FI Delta cDNA linked to the constitutive promoter derived from the phosphoglycerate kinase gene, PGK-1. Transgene expression was demonstrated in several tissues and functional activity of the mutant receptor was confirmed in hematopoietic tissues by the presence of granulocyte macrophage and macrophage colony-forming cells (CFU-GM and CFU-M) in the absence of added cytokines. All transgenic mice display a myeloproliferative disorder characterized by splenomegaly, erythrocytosis, and granulocytic and megakaryocytic hyperplasia. This disorder resembles the human disease polycythemia vera, suggesting that activating mutations in h beta(c) may play a role in the pathogenesis of this myeloproliferative disorder. In addition, these transgenic mice develop a sporadic, progressive neurological disease and display bilateral, symmetrical foci of necrosis in the white matter of brain stem associated with an accumulation of macrophages. Thus, chronic h beta(c) activation has the potential to contribute to pathological events in the central nervous system.

The cost of life expectancy and the implicit social valuation of life

A new method of estimating the economic value of life is proposed. Using cross-country data, an equation is estimated to explain life expectancy as a function of real consumption of goods and services. The associated cost function for life expectancy in terms of the prices of specific goods and services is used to estimate the cost of a reduction in age-specific mortality rates sufficient to save the life of one person. The cost of saving a life in OECD countries is as much as 1000 times that in the poorest countries. Ethical implications are discussed.