ABSTRACT
Abstract BACKGROUND: Chronic urticaria is a debilitating disease that considerably affects health-related quality of life, and the Chronic Urticaria Quality of Life Questionnaire is the only questionnaire specifically designed for its evaluation. OBJECTIVE: To evaluate the quality of life of patients with chronic urticaria, using the Brazilian Portuguese version of the Chronic Urticaria Quality of Life Questionnaire. METHODS: The Chronic Urticaria Quality of Life Questionnaire was self-administered in 112 chronic urticaria patients and disease activity was assessed through the Urticaria Activity Score. Clinical and socio-demographic characteristics of patients were studied, such as: age, sex, etiologic diagnosis of chronic urticaria, duration of disease and Urticaria Activity Score. RESULTS: The population studied was composed 85.72% of women with a mean age of 46 years (18-90), while the median disease duration period was 10 years (3 months-60 years). Regarding the etiologic diagnosis, 48.22% had chronic spontaneous urticaria; 22.32% associated with inducible urticaria, 28.57% with chronic autoimmune urticaria, and 23.21% had physical urticaria alone. Disease activity evaluated using the Urticaria Activity Score was 1.04 ± 1.61 (0-6). The total score for the Chronic Urticaria Quality of Life Questionnaire was 36 (0-100) and dimension I (sleep/mental status/eating) had a greater impact on quality of life. The items with the highest mean scores were nervousness and shame over lesions, while the items with the lowest scores were lip swelling and limitations on sporting activities. CONCLUSIONS: Chronic urticaria compromises patients' quality of life, mainly those with more severe disease or who are diagnosed with chronic autoimmune urticaria.
Subject(s)
Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Quality of Life , Urticaria/physiopathology , Self Report , Socioeconomic Factors , Urticaria/pathology , Urticaria/psychology , Severity of Illness Index , Brazil , Chronic Disease , Cross-Sectional Studies , Reproducibility of Results , Sex Distribution , Age Distribution , Hospitals, University/statistics & numerical dataABSTRACT
Aims: To determine the frequency of viral pathogens causing upper respiratory tract infections in non-hospitalized, symptomatic adults in the city of Rio de Janeiro. Methods: Respiratory samples (nasal/throat swabs) were collected between August 2010 and November 2012 and real time PCR was used to detect different viral pathogens. Results: Viruses were detected in 32.1% (43/134) of samples from 101 patients. Specifically, 9% (12/134) were positive for HBoV, 8.2% (11/134) were positive for HAdV, 5.2% (7/134) were positive for HRV, and 1.5% (2/134) were positive for FLUBV or HMPV, as single infections. HRSV-A, HPIV-3, and HCoV-HKU1 were detected in one (0.75%) sample each. Co-infections were detected in 4.8% (6/134) of the samples. Peaks of viral infections were observed in March, April, May, August, and October. However, positive samples were detected all year round. Only 23.3% (10/43) of the positive samples were collected from patients with febrile illness. Conclusion: Results presented in this report suggest that respiratory viral infections are largely under diagnosed in immunocompetent adults. Although the majority of young adult infections are not life-threatening they may impose a significant burden, especially in developing countries since these individuals represent a large fraction of the working force. .
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Respiratory Tract Infections/virology , Age Distribution , Brazil/epidemiology , Real-Time Polymerase Chain Reaction , Respiratory Tract Infections/epidemiology , SeasonsABSTRACT
BACKGROUND: atopic dermatitis is directly related to psychological stress, reduced quality of life and psychosomatic symptoms. The Psychosomatic Scale for Atopic Dermatitis is the only questionnaire developed specifically for assessment of psychosomatization in atopic dermatitis. OBJECTIVES: the objective of this study was to cross-culturally adapt and validate a Brazilian-Portuguese version of the Psychosomatic Scale for Atopic Dermatitis. METHODS: adaptation consisted of independent translation and backtranslation by three bilingual translators, followed by a pre-test. The Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index were self-administered to 47 patients with atopic dermatitis. Disease severity was evaluated using the Eczema Area and Severity Index. Factor analysis was used to identify the dimensions of the Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis. Internal consistency and convergence validity were also analyzed. Reproducibility was assessed using the Kappa coefficient. RESULTS: factor analysis revealed a two-dimensional structure: stress/laziness/insecurity (I) and maladjustment/social relationships (II), explaining 54.4% of total variance. All dimensions revealed excellent internal consistency. External construct validity was confirmed by positive correlations between the Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index. Test-retest reliability was excellent, with k>0.7 for all questions. CONCLUSIONS: the Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis demonstrated acceptable psychometric properties and can be used for the evaluation of psychosomatic symptoms in patients with atopic dermatitis and as a tool in clinical and epidemiological research. .
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Dermatitis, Atopic/psychology , Psychophysiologic Disorders/diagnosis , Surveys and Questionnaires/standards , Translations , Brazil , Cross-Cultural Comparison , Psychometrics/methods , Quality of Life/psychology , Reference Values , Reproducibility of Results , Stress, Psychological/diagnosisABSTRACT
Asma induzida por aspirina (AIA) é doença comum e freqüentemente subdiagnosticada. Aproximadamente 20% da população asmática é sensível à aspirina e a outros antiinflamatórios não hormonais (AINEs) e apresentam a tríade de rinossinusite com pólipos nasais, asma e hipersensibilidade à aspirina. A patogênese da AIA está associada às vias do metabolismo do ácido araquidânico: a via da lipo-oxigenase (LO) e a via da ciclo-oxigenase (CCX). Ao inibir a via da ciclo-oxigenase (CCX), a aspirina desvia os metabóhtos do ácido araquidânico para a via da LO. Isso leva à queda nos níveis de prostaglandina E2, associado ao aumento da síntese de leucotrienos cisteínicos (Cys-LT5). Os anti-leucotrienos são eficazes em bloquear a broncoconstrição provocada pela aspirina e são utilizados no tratamento desta condição. A dessensibilização tem papel importante no manejo da AIA, principalmente em pacientes que necessitam de profilaxia para doenças tromboembólicas, infarto agudo do miocárdio, e AVE. Esta revisão tem por objetivo dissertar sobre alguns aspectos atuais desta doença.
Subject(s)
Humans , Anti-Inflammatory Agents, Non-Steroidal , Aspirin , Asthma , Lipoxygenase , Prostaglandin-Endoperoxide Synthases , Diagnosis , VirulenceABSTRACT
o angioedema hereditário (AEH) é uma patologia de curso crônico, que resulta da deficiência do inibidor de Cl (Cl-INH). Esta deficiência pode ser quantitativa (AEH tipo I) ou qualitativa (AEH tipo Ir). É caracterizado por edema recorrente, não pruriginoso, que pode acometer qualquer região do corpo: face,. laringe (levando a risco de morte por asfixia), extremidades, genitália, órgãos intra-abdominais (causando dor abdominal, vômitos, diarréia). O tratamento divide-se em profilático, a curto ou longo prazo, e sintomático, baseando-se sempre no impacto da doença na qualidade de vida e/ou risco de fatalidade para o paciente. As medicações utilizadas para uso crônico são os antifibrinolíticos e os androgênios atenuados. Estes últimos são geralmente mais eficazes. Esta revisão tem por objetivo abordar as principais opções terapêuticas para o tratamento do AEH, dando ênfase aos androgênios atenuados, que permanecem como drogas de primeira escolha pela sua eficácia e perfil de segurança. Para a realização deste artigo, foram consultadas publicações científicas nacionais e internacionais distribuídas em periódicos e livros-texto. As referências bibliográficas foram obtidas através da base de dados Pubmed, abrangendo o período de 1974 a 2007.
Hereditary Angioedema (AEH) is a long course pathology, which results from Cl-inhibitor (Cl-INH) deficiency. It can be a quantitative (AEH type I) or qualitative (AEH type Ir) deficiency. It is characterized by non-pruritic recurrent swellings in any part of the body: face, larynx (which could lead to death by asphyxia), extremities, genital area, abdominal organs (Ieading to abdominal pain, vomiting, diarrhea). Treatment is divided into prophylactic, short term or long term, and symptomatic, always based on the disease's impact on patient's quality of life and/or the risk of fatality. Medications used for long-term treatment are antifibrino/ytic agents and attenuated androgens. The latter usually are more effective. The aim of this review is to approach the main therapeutic options to be used in the treatment of AEH, emphasizing the attenuated androgens, which are still the first line option because of its efficacy and security.
Subject(s)
Humans , Male , Female , Child , Adult , Androgens , Angioedemas, Hereditary , Antifibrinolytic Agents , Protein C Inhibitor , Receptors, Androgen , Critical Pathways , Edema , MethodsABSTRACT
É feita uma revisao sobre a associaçao de asma brônquica e sinusite, com ênfase na sua prevalência, investigaçao e nos possíveis mecanismos patogênicos.
Subject(s)
Humans , Asthma/etiology , Sinusitis/etiologyABSTRACT
A urticária de pessåo tardia (UPT) é uma síndrome cujos mecanismos patogênicos ainda nåo foram totalmente esclarecidos. Nåo é rára sua associaçåo com outras formas de urticária crônica. Relatamos um caso de UPT acompanhada de demografísmo imediato e tardio, lesÆes espontâneas compatíveis com urticária crônica e de uma reaçåo cutânea nas regiÆes de contato com fígado bovino fresco
Subject(s)
Humans , Female , Urticaria/pathologyABSTRACT
As manifestaçöes clínicas da anafilaxia resultam das alteraçöes fisiopatológicas que ocorrem pela açäo de mediadores químicos primários ou secundários em diferentes órgäos, sendo o choque anafilático sua manifestaçäo mais grave. A identificaçäo precoce e o tratamento imediato säo fundamentais, sendo a adrenalina a principal droga. Os anti-histamínicos, corticosteróides e broncodilatadores também estäo indicados. Outros medicamentos podem ser necessários nos casos refratários às medidas iniciais. Os autores comentam essas drogas e ressaltam a importância das medidas preventivas
Subject(s)
Humans , Anaphylaxis/therapyABSTRACT
É apresentado um caso clínico da Síndrome de Melkersson-Rosenthal, que vem sendo acompanhado no Ambulatório do Serviço de Imunologia do HUCFF. Após breve revisäo da literatura, concentrando-se nas consideraçöes sobre a etiopatogenia da enfermidade, os autores postulam pela hipótese imunitária. Diante dessa possibilidade, preconizam pela conveniência da tipagem para antígenos dos sistema HLA
Subject(s)
Middle Aged , Humans , Male , Melkersson-Rosenthal Syndrome/pathology , Antibodies, Monoclonal , Melkersson-Rosenthal Syndrome/etiology , T-Lymphocytes/immunologyABSTRACT
Os autores tecem comentários sobre a importância clínica da asma brônquica, classificando as crises em leves, moderadas e graves. Fazem uma rápida revisäo sobre os mecanismos de açäo das drogas simpaticomiméticas, das metilxantinas e dos corticosteróides, apresentando as vantagens e inconvenientes da utilizaçäo de cada um desses grupos de fármacos; ao mesmo tempo, valorizam a hidrataçäo no tratamento das crises de asma. Alertam para a necessidade de um atendimento abrangente por parte das equipes de emergência, às quais compete estabelecer as primeiras medidas após a alta hospitalar e orientar sobre a necessidade de tratamento intercrise