ABSTRACT
Abstract Background: To verify the validity of the 2016-revised Fibromyalgia Survey Questionnaire (FSQ) by telephone interview compared to self-administration and to produce a valid version of FSQ in Brazilian Portuguese language. Methods: The Brazilian version of FSQ was produced following the recommendations for cross-cultural adaptation. Validity of Brazilian FSQ self-administration was assessed by checking agreement of its results with fibromyalgia diagnosis according the 1990 American College of Rheumatology (ACR) criteria. Reproducibility and validity of FSQ by telephone were assessed by comparing its results with the previous FSQ self-administration. Results: A Brazilian Portuguese version (FSQ-Brazil) was produced. FSQ-Brazil had good internal consistency (Cronbach's alpha between 0.73 and 0.94). Agreement between the results obtained by self-administration of FSQ-Brazil and by telephone interview was substantial or almost perfect for almost all questions about pain sites and all questions about other somatic symptoms (Cohen's kappa higher than 0.6). There were small but significant bias toward higher scores of widespread pain index and fibromyalgia severity scale in the telephone interview compared to self-administration. Fibromyalgia definition by self-administration and telephone interview with FSQ-Brazil both revealed substantial agreement with the diagnosis based on ACR 1990 criteria (Cohen's kappa 0.62 and 0.65; respectively). Conclusions: FSQ-Brazil demonstrated good internal consistency, reproducibility and validity both by self-administration and by telephone interview. However, caution must be taken with the interpretation of quantitative scores of widespread pain index and symptoms severity scale, which slightly differed according the method (self-administration or interview) in our study.(AU)
Subject(s)
Humans , Pain Measurement/instrumentation , Fibromyalgia/physiopathology , Surveys and Questionnaires , Health Research EvaluationABSTRACT
Abstract Objective: To evaluate the parameters associated with quality of life in patients with Paget's disease of bone. Methods: Patients with Paget's disease of bone were evaluated with SF-36 and WHOQOL-bref questionnaires. Patients with other diseases that could cause significant impairment of their quality of life were excluded. We searched for correlations between the results and: age, time from diagnosis, type of involvement, pain related to Paget's disease of bone, limitation to daily activities, deformities, bone specific alkaline phosphatase, the extent of involvement and treatment. Results: Fifty patients were included. Results of the SF-36 total score and its domains, physical and mental health, were significantly correlated with bone pain and deformities. Marital status was significantly correlated with the SF-36 total score and Mental Health Domain. BAP levels and disease extension were significantly correlated to SF-36 Physical Health Domain. After multivariate analysis, the only parameters that remained significantly associated with the SF-36 total score and to its Mental Health and Physical Health Domains were pain and marital status.The WHOQOL-bref total score was significantly associated with pain, physical impairment and deformities. WHOQOL-bref Domain 1 (physical) score was significantly associated with marital status, pain and deformities, while Domain 2 (psychological) score was associated with marital status, physical impairment and kind of involvement. After multivariate analysis, the presence of pain, deformities, and marital status were significantly associated with results of the WHOQOL-bref total score and its Domain 1. WHOQOL-bref domain 2 results were significantly predicted by pain and marital status. Conclusion: The main disease-related factor associated with SF-36 results in Paget's disease of bone patients was bone pain, while bone pain and deformities were associated with WHOQOL-bref.
Resumo Objetivo: Avaliar os parâmetros associados à qualidade de vida em pacientes com doença de Paget óssea (DPO). Métodos: Avaliaram-se pacientes com DPO com os questionários SF-36 e WHOQOL-bref. Excluíram-se pacientes com outras doenças que pudessem causar comprometimento significativo da qualidade de vida. Buscou-se por correlações entre os resultados e idade, tempo de diagnóstico, tipo de envolvimento, dor relacionada com a DPO, limitação às atividades diárias, deformidades, fosfatase alcalina específica do osso, extensão do envolvimento e tratamento. Resultados: Incluíram-se 50 pacientes. Os resultados da pontuação total do SF-36 e seus domínios, saúde física e saúde mental, se correlacionaram significativamente com a dor óssea e deformidades. O estado civil se correlacionou significativamente com a pontuação total do SF-36 e com seu domínio saúde mental. Os níveis de BAP e a extensão da doença se correlacionaram significativamente com o domínio saúde física do SF-36. Depois da análise multivariada, os únicos parâmetros que permaneceram significativamente associados à pontuação total do SF-36 e aos seus domínios saúde mental e saúde física foram a dor e o estado civil. A pontuação total do WHOQOL-bref esteve significativamente associada à dor, ao comprometimento físico e a deformidades. O escore do Domínio 1 (físico) do WHOQOL-bref esteve significativamente associado ao estado civil, dor e deformidades, enquanto o Domínio 2 (psicológico) esteve associado ao estado civil, comprometimento físico e tipo de envolvimento. Depois da análise multivariada, a presença de dor, deformidades e estado civil esteve significativamente associada à pontuação total do WHOQOL-bref e à pontuação do seu Domínio 1. Os resultados do WHOQOL-bref 2 foram significativamente preditos pela dor e pelo estado civil. Conclusão: O principal fator associado aos escores do SF-36 foi a dor óssea, enquanto a dor óssea e as deformidades estiveram associadas ao WHOQOL-bref.
Subject(s)
Humans , Male , Female , Aged , Osteitis Deformans/psychology , Quality of Life , Osteitis Deformans/complications , Osteitis Deformans/physiopathology , Osteoarthritis/complications , Pain/complications , Health Status , Surveys and Questionnaires , Middle AgedABSTRACT
Objetivo: Avaliar por HR-pQCT a densidade mineral óssea volumétrica (vDMO), a microarquitetura e as características biomecânicas do rádio distal e tíbia, assim como os marcadores laboratoriais do metabolismo ósseo em pacientes com lúpus eritematoso sistêmico de início juvenil (LESJ) comparados com controles saudáveis e determinar se este método permite identificar parâmetros que diferenciem pacientes com e sem fraturas vertebrais (FV). Métodos: Foram avaliadas 56 pacientes e comparadas a 56 controles saudáveis pareados por sexo, idade e estágio de Tanner. A HRpQCT foi realizada no rádio distal e na tíbia. Marcadores bioquímicos do metabolismo ósseo foram avaliados: pró-peptídeo amino-terminal do colágeno tipo I (P1NP), telo-peptídeo carboxi-terminal do colágeno tipo I (CTX), paratormônio intacto (iPTH), esclerostina (SOST) e 25hidroxivitamina D (25OHD). Fratura vertebral foi avaliada por VFA-DXA (método semiquantitativo de Genant). Resultados: Redução na densidade volumétrica e na resistência óssea, assim como comprometimento da microarquitetura óssea tanto cortical como trabecular foram encontrados em pacientes com LESJ comparados com controles saudáveis, principalmente no rádio distal (p < 0.05). Além disso, pacientes com FV apresentavam valores significantemente menores nos parâmetros trabeculares, somente no rádio distal, comparados com pacientes sem FV (Total.DMO: 229,45 ± 42,09 vs 275,93 ± 56,87 mg/cm3; p = 0,034; Trabecular.DMO [Tb.DMO]: 136,96 ± 30,84 vs 163,17 ± 30,45 mg/cm3; p = 0,034; BV/TV: 0,114 ± 0,026 vs 0,136 ± 0,029; p = 0,034) e também menores valores em relação a propriedades biomecânicas (Módulo Aparente: 1236 ± 334 vs 1523 ± 367 N/mm2; p = 0,039). Pacientes com fratura vertebral apresentaram maiores índices de SLICC/ACR-DI (0,67 ± 0,78 vs 0,11 ± 0,32; p = 0,002). Parâmetros laboratoriais do metabolismo ósseo foram semelhantes entre os grupos avaliados. Análise de regressão logística incluindo parâmetros que foram...
Objective: The aim of this study was to investigate using HR-pQCT the volumetric bone mineral density (vBMD), microarchitecture and biomechanical features at distal radius and tibia, and laboratory bone markers in JoSLE patients compared to controls and determine whether this method can discriminate JoSLE patients with or without VF. Methods: We compared 56 female JoSLE patients with age- and Tanner- matched healthy controls. HR-pQCT was performed at distal radius and at tibia. Serum levels of amino-terminal pro-peptide of type I collagen (P1NP), C-terminal telopeptide of type I collagen (CTX), intact parathormone (iPTH), sclerostin (SOST) and 25 hydroxivitamin D (25OHD) were evaluated. Vertebral fractures (VF) were analyzed by VFA-DXA (Genant's method). Results: Reduced parameters of density and strength as well as microarchitecture alteration of cortical and trabecular bone were observed in JoSLE patients compared to controls, mainly at distal radius (p < 0.05). In addition, patients with VF had a significant decrease in trabecular bone parameters solely at distal radius (Total.BMD: 229.45 ± 42.09 vs. 275.93 ± 56.87 mg/cm3; p = 0.034; Trabecular.BMD[Tb.BMD]: 136.96 ± 30.84 vs. 163.17 ± 30.45 mg/cm3; p = 0.034; BV/TV: 0.114 ± 0.026 vs. 0.136 ± 0.29; p=0.034; Apparent modulus: 1,236 ± 334 vs. 1,523 ± 367 N/mm2; p = 0.039) and higher score disease damage (SLICC/ACR-DI: 0.67 ± 0.78 vs. 0.11 ± 0.32; p = 0.002). Bone metabolism markers were alike in all groups evaluated. Logistic regression analysis including parameters that were significant at univariate analysis reveal that Tb.BMD (OR:0.98, 95%CI 0.95-0.99, p = 0.039) and SLICC/ACR-DI (OR:7.37, 95%CI 1.75-30.97, p=0.006) were independent risk factors for vertebral fractures. Conclusion: In conclusion, this is the first demonstration of bone microstructure and strength deficit in JoSLE patients, particularly at distal radius. Furthermore, our results show that VF are associated with trabecular...