Translation, cultural adaptation to Brazil and validation of the venous leg ulcer quality of life questionnaire (VLU-QoL-Br)

Objetivo:traduzir o instrumento Venous legulcer quality of life questionnaire (VLU-QoL), adaptá-lo culturalmente para o português do Brasil e validá-lo com pacientes do Hospital das Clínicas da Faculdade de Medicina de Botucatu (FMB) da Universidade Estadual Paulista (Unesp). Métodos:o questionário foi traduzido por um tradutor profissional e por dois dermatologistas especialistas na área de úlceras venosas (UV), sendo reformulado em reunião com os três tradutores. O constructo (VLU-QoL-Br) foi submetido a pré-entrevista com 10 portadores de UV para a adaptação da linguagem. Posteriormente, foi aplicado em pacientes do HC-Unesp, e como teste-reteste para verificação de sua reprodutibilidade. Resultados:foram avaliados 82 pacientes, sendo 56 (68%) do sexo feminino. A idade média foi de 67,3 anos. O questionário foi traduzido, adaptado e aplicado aos pacientes. O constructo apresentou alta consistência interna (alfa= 0,94) e adequada correlação item-total. Quando avaliados os 32 retestes, observou-se correlação intraclasse para concordância de 0,78 (p < 0,01), indicando boa reprodutibilidade do constructo. A análise fatorial confirmatória corroborou as dimensões do questionário original: atividades, psicológico e sintomas. Escores do VLU-QoL-Br se associaram, independentemente, à área total das úlceras e a menor escolaridade dos sujeitos (p < 0,01). Conclusão:a tradução, a adaptação e a validação do questionário VLU-Qol-Br demonstrou boa performance psicométrica, permitindo seu uso clínico no Brasil. É importante avaliar seu desempenho em outras regiões e em diferentes amostras de indivíduos.

Quality of life profile and correlated factors in chronic leg ulcer patients in the mid-west of São Paulo State, Brazil

BACKGROUND: Chronic leg ulcer may have an impact on patients' quality of life.OBJECTIVES:This study aimed to identify the impact of leg ulcers on patient's quality of life using the Dermatology Life Quality Index and to define the main factors correlated with this perception.METHOD:Cross-sectional, non-probabilistic sampling study. We included patients with chronic leg ulcers being treated for at least 3 months. A sociodemographic and clinical survey was conducted to assess the profile of the ulcers. We administered a screening for depressive symptoms and the Dermatology Life Quality Index. We performed a descriptive statistical analysis, chi-square test and Mann-Whitney test for categorical data, Pearson for numeric variables, and multiple regression for categorical data.RESULTS:Forty-one patients were assessed. Their mean age was 61.78 years. Venous ulcers (48.8%) were the most prevalent. Seventy-three percent of the sample perceived no impact/low impact on quality of life in the past week, and 26.8% perceived moderate/high impact. A multiple regression analysis identified the causes of lesion, pain related to the ulcers, time of onset, and severity of the depressive symptoms as the variables that had an influence on quality of life.CONCLUSIONS:The majority of the sample perceived low or no impact of the condition on the quality of the life. The variables etiology of the lesion (p<0.001), pain related to the ulcers (p=0.001), time of onset (p=0.006), and severity of the depressive symptoms (p<0.001) had an influence on the quality of life, suggesting the need for further studies with more robust designs to confirm the causal relationship between these characteristics and quality of life.

Factors that influence healing of chronic venous leg ulcers: a retrospective cohort

BACKGROUND: Venous ulcers have a significant impact on patient quality of life, and constitute a worldwide public health problem. Treatment is complex, with high failure rates.OBJECTIVES: To identify clinical and therapeutic factors that influence healing of venous ulcers.METHODS: Retrospective cohort study of patients with venous ulcers. Ulcer area was measured at the first visit (T0) and after 6 months (T6) and 1 year (T12). A reduction in ulcer area of 50% or more at T6 and T12 was the outcome of interest, weighted by clinical, demographic and treatment aspects.RESULTS: Ninety-four patients were included (137 ulcers). A reduction in ulcer area of 50% or more was seen in 40.1% of patients (95% CI 31.9 to 48.4%) at T6 and 49.6% (95% CI 41.2 to 58.1%) at T12. Complete healing occurred in 16.8% (95% CI 10.5 to 23.1%) at T6 and 27% (95% CI 19.5 to 39.5%) at T12. The lowest ulcer area reductions at T6 were associated with longstanding ulcer (RR=0.95; 95% CI 0.91 to 0.98), poor adherence to compression therapy (RR=4.04; 95% CI 1.31 to 12.41), and infection episodes (RR=0.42; 95% CI 0.23 to 0.76). At T12, lower reductions were associated with longstanding ulcer (RR=0.95; 95% CI 0.92 to 0.98), longer topical antibiotic use (RR=0.93; 95% CI 0.87 to 0.99), and systemic antibiotic use (RR=0.63; 95% CI 0.40 to 0.99).CONCLUSIONS: Longstanding ulcer, infection, poor adherence to compression therapy, and longer topical and systemic antibiotic use were independently correlated with worse healing rates.

Interactions of age and leg muscle fatigue on unobstructed walking and obstacle crossing

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Clinical and Microbiologic Evaluation of Chronic Leg Ulcers: A Cross-sectional Study

OBJECTIVE: This study aimed at evaluating the flora and bacterial load of chronic leg ulcers (CLUs) according to the clinical judgment of colonization or infection.DESIGN: This was an analytical and cross-sectional study.SETTING: This study was conducted in an outpatient wound care unit in the Dermatology Department of the Botucatu School of Medicine-UNESP, Brazil.PARTICIPANTS: The participants were patients with CLUs who did not use systemic antibiotics.METHODS: The ulcers were clinically divided into 3 groups: ulcers with good granulation tissue (GGT), critical colonization (CC), and infection. Secretion was collected from a 1-cm(2) area using a swab and seeded by the semiquantitative method.OUTCOME MEASURES: The main outcome measures were genus and species of the bacteria found in the cultures and result of the semiquantitative culture correlating with the clinical diagnosis of GGT, CC, and infection.MAIN RESULTS: Seventy-seven ulcers were evaluated: 27 with GGT, 29 with CC, and 21 with infection. Gram-negative bacteria were most often found in all groups (81%): Pseudomonas aeruginosa, in granulation and colonized ulcers, and Proteus mirabilis, in infected ulcers. Ulcers from the infected group showed higher bacterial load.CONCLUSIONS: The flora of CLUs was predominantly constituted by gram-negative bacteria, and P aeruginosa was the most prevalent. The bacterial load of infected ulcers was higher as compared with the others, although some ulcers with GGT also presented a high load. The interpretation of microbiologic tests based on the swab techniques and even on semiquantitative analysis requires close clinical correlation.

Leg Amputation for an Extensive, Severe and Intractable Sickle Cell Anemia Ulcer in a Brazilian Patient

A 35-year-old African Brazilian patient had sickle cell anemia complicated with recurrent vasoocclusive (VOC) crises and refractory painful leg ulcers for 16 years. The ulcers started over both medial malleoli and expanded gradually. The ulcer on the left leg spread from the foot to the knee circumferentially and was refractory to all forms of therapy within the frame work of multi-disciplinary care. The patient agreed to a below the knee amputation of the left leg. He felt much better after the amputation but developed severe neuropathic phantom pain that was well controlled medically. He could differentiate the sickle cell anemia and ulcer pain from the neuropathic pain. About 6 months after the amputation he had dengue fever with fatal outcome. This is the first report of treatment of refractory sickle cell anemia leg ulcer with amputation and probably the first report of a Brazilian patient with sickle cell anemia and dengue fever.

Glória e tragédia: a dualidade da prestação de contas do Sport Club Corinthians Paulista em seus relatórios de sustentabilidade

Pós-graduação em Comunicação - FAAC

Rock Hill Music Club Records - Accession 535

The Rock Hill Music Club Records consist of correspondence, an annual report, numerous awards, news clippings, yearbooks, conventions programs, musical programs, scrapbook pages, presidents’ reports, and magazines relating to the Rock Hill, SC Music Club.

Rock Hill Music Club Records - Accession 932

The Rock Hill Music Club Records consists of correspondence, yearbooks, and programs of the meetings, convention programs, numerous awards, newspaper articles, sheet music, presidents’ reports, handbooks, constitutions, photographs, and scrapbooks pertaining to the Rock Hill, SC club.

Rock Hill Civitan Club Records - Accession 244 - M107 (137)

The Rock Hill Civitan Club Records consist of manuals, brochures, newsletters and some correspondence relating to club projects, membership and the club organization related to the Civitan Club based in Rock Hill, SC.

Keystone Club Of Rock Hill Records - Accession 286 - M122 (155)

The Keystone Club of Rock Hill Records consist of constitutions, minutes, yearbooks and study program booklets from Winthrop’s Extension Dept. in the early 1920s. The Keystone Club of Rock Hill, SC was organized in 1914 as a women’s study group. The club was a charter member of Rock Hill City Federation of Women's Clubs and was a member of the State Federation of Women's Clubs and of the General Federation of Women's Clubs.

Women's Club of Rock Hill Records - Accession 219

The Women's Club of Rock Hill's mission is to further the cultural, educational, and social interest of its members and to promote interest in Rock Hill’s civic development and welfare. The Women's Club of Rock Hill Records consist of constitutions and bylaws, histories, minutes, reports, correspondence, memoranda, program notes, brochures, newsletters, membership lists, yearbooks, questions, certificates, awards, scrapbooks, newspaper clippings, and photographs. The records also relate to the thirteen affiliated clubs comprising the Woman’s Club of Rock Hill: Amateur Arts, Arts Appreciation, Book Discussion, Book Lovers, Crafts, Hearthstone, Hermitage, Home Study, Lantern, Literary, Outlook, Palmetto, and Politeia, and to other records for the South Carolina Federation of Women’s Club and the General Federation of Women’s Clubs. Records of various organizations not directly related to the Woman’s Club of Rock Hill are also included, such as the Tri-County Parents Without Partners, the Rock Hill Community Council, the Rock Hill Model Cities Commission, the Rock Hill Senior Center, and the South Carolina Conference on the Status of Women.

Woman's Club Yearbooks - Accession 39 - M14 (24)

The Woman's Club Yearbooks Collection consists of a Woman’s Club of Rock Hill Yearbook (1950-1951) and Woman's Club of Gaffney Yearbook (1935-1936).

Pilot Club International South Carolina District Records - Accession 205

The Pilot Club International was a service oriented club for women, however men are now allowed to join. The South Carolina District was founded in the 1930s for “the promotion of social welfare through the performance of civil and beneficial service of the character generally accomplished by civic organizations, rendering aid and assistance to local Pilot Clubs and implementing at the district level the programs and policies of Pilot Club International.” The Pilot Club International South Carolina District Records consist of a certificate of incorporation, minutes, annual reports, correspondence, resolutions and lists of standing rules.

Outlook Club of Rock Hill Records - Accession 210

Organized in 1904 as the Monday Afternoon Club and later the Monday Club, it became the Outlook Club in 1916. The original purpose of the book club (later the interests of the club were literary, social, and philanthropic) was to affect a better relationship between the wives of the Winthrop College faculty, and the women of Rock Hill, SC. The club was federated by the South Carolina Federation of Women’s Clubs in 1907 and the General Federation of Women’s Clubs in 1933. Minutes, reports, correspondence, financial records, program notes, newspaper clippings, membership records, publications, constitutions and bylaws, historical data, yearbooks, bulletins, convention records, magazines, catalogs, memorabilia, and a scrapbook. The records provide information, not only on the club but also on other subjects, including the General Federation of Women’s Clubs, the South Carolina Federation of Women’s Clubs, the role of women’s clubs during World War II, and the relationship between the wives of Winthrop College faculty and the women in the Rock Hill community.