Morbidity pattern of underfives with moderate acute malnutrition in southern Nigeria

Background:Moderate acute malnutrition (MAM) is a leading cause of childhood morbidity and mortality globally. The morbidity pattern of underfives with this condition is yet to be described. Objective: To describe the morbidity pattern of underfives with MAM.Method: Across sectional study was conducted in two Primary Health Centres in Uruan Local Government Area of Akwa Ibom State. Caregivers'brought children aged 6- 59 months to the health facilities following community mobilization. Eligible children were recruited into the study after obtaining parental consent. Avalidated proforma was used to obtain the biodata and symptoms of common illnesses in the children. Ageneral physical examination, anthropometric measurements and systemic examination were performed. Results: Atotal of 162 children were recruited into the study. Their mean (±SD) age was 20.4 ± 13.0 months. Over 70% of them were 6 - 23 months of age. Their mean (±SD) length/height was 77.3 ± 29.6 cm, mean (±SD) weight was 8.3 ± 3.4 kg and mean (±SD) mid upper arm circumference was 12.4 ± 4.5 cm. The main symptoms noted in the children were; fever 99 (61.1%), cough 84 (51.9%), weight loss 81 (50.0%), diarrhoea 40 (24.7%) and vomiting 40 (24.7%) while pallor 77 (47.5%), lymphadenopathy 56 (34.6%), hair changes 49 (30.2%), skin changes 27 (16.6%) were the main signs in them.Conclusion: The main symptomatology of underfives with MAM were fever, cough and weight loss

Visual outcomes of toxic optic neuropathy secondary to Ethambutol: A retrospective observational study from India, an endemic country

Purpose: Ethambutol (EMB) is one of the first?line drugs used for treating tuberculosis. Vision loss due to optic nerve toxicity is a well?known potential side effect of the drug. Our aim was to evaluate the clinical features and visual outcomes of patients with EMB optic neuropathy (EON). Methods: A retrospective, observational, single?center study of all patients who were diagnosed to have EON during January 2017–December 2019 was done. All these patients were screened in the Department of Neuro?ophthalmology at a referral tertiary eye care institution in India. Clinical features, visual outcomes, and neuroimaging findings of these patients were analyzed. Results: Two hundred and fifty?six eyes of 128 patients were included. Of these, 73 were male and 55 were female. Mean age was 50.55 ± 15 years. Mean visual acuity at presentation was 1.12 ± 0.45 logarithm of the minimum angle of resolution (logMAR). One hundred and forty three eyes had normal optic disk on presentation, 111 had disk pallor, and two eyes had disk edema. The most common field defect was central/paracentral scotoma (26.2%) followed by temporal defects (24.6%). Magnetic resonance imaging (MRI) brain and orbit showed optic nerve signals in 19.6% and chiasmal signals in 5.2%. At the final follow?up, a ?2?line vision improvement was noted in 161 eyes (62.9%), which was statistically significant. Conclusion: Multiple prognostic factors were analyzed to predict the visual recovery of EON. We observed that patients presenting with visual acuity worse than 6/60 had poor visual outcome and long duration of follow?up showed better visual recovery, proving the possibility of a gradual recovery pattern of EON. Interestingly, we found in our study that the chances of favorable visual outcome were directly proportionate to early diagnosis and cessation of EMB.

Megaloblastic anemia in children from Eastern Odisha, India: A clinical and hematological profile analysis

Background: Anemia can have severe implications on the health of children including motor development, behavioral and cognitive development. Furthermore, morbidity from infectious disease is higher in anemic children. Nutritional anemia is a major concern in rural India. Aim and Objective: We aimed to observe the percentage of megaloblastic anemia among the anemic children and their clinical and hematological parameters. Materials and Methods: After obtaining permission from the Institutional Ethics Committee, this cross-sectional study was conducted from September 2018 to August 2021. The setting was a tertiary care hospital in the eastern part of Odisha, India. Children of 1� years of age presenting with anemia were included in the study. Details clinical examination and blood tests namely mean corpuscular volume, red blood cell count, total leucocyte count, and platelet count were carried out from venous blood. Descriptive statistical analyses were conducted in STATA software version 15.1. Results: Among the total 150 anemic patients, the majority (126 [84%]) were in the 11� years of age group followed by 24 (16%) in 6� years of age (P < 0.0001). Girls were more (94 [62.7%]) than boys (56 [37.3%]), P < 0.0001. Anorexia was the most frequently encountered clinical symptom (99.3%) followed by pallor (94%), weakness (86%), fatigue (62%), and hyperpigmentation (37.4%). According to hemoglobin level, 40% were suffering from severe anemia, 38.7% was having moderate, and 21.3% was having mild anemia. The majority (74%) were having both Vitamin B12 and folic acid deficiency followed by 16.7% Vitamin B12, and 9.3% folic acid deficiency. Conclusion: Girls were presenting with megaloblastic anemia more than boys. Majority of them were suffering from both Vitamin B12 and folic acid deficiency. Children suffering from megaloblastic anemia present with anorexia, pallor, weakness, and fatigue. A proper health promotion program may be designed to aware the parents about the prevention of nutritional anemia.

Proficiency of Pallor in Predicting Anemia.

Introduction: Anemia is one of the most commonlyencountered hematologic disease of infancy and childhood.More than 75% of Indian children under 36 months of age arefound to be anemic. Iron-deficiency anemia (IDA) has beenfound to be correlated with decreased cognitive performancein many studies, hence prompt diagnosis and treatment arenecessary. Pallor is a clinical sign in the diagnosis of anemia.Current research aimed to study about the predictive value ofpallor in various sites and its relation to anemia.Material and methods: 500 children attending the outpatientdepartment of pediatrics were evaluated for clinical pallor andHemoglobin was estomated by cyanmethemoglobin method.Results: When the various parameters were comparedbetween conjunctival, palmar, mucosal and nail bed pallor;it has been observed that sensitivity was highest for nail bedpallor in the evaluation of anemia. Specificity was highest forconjunctival pallor. The positive predictive value and negativepredictive value were both highest for conjunctival pallorand least for palmar pallor. However, when all the evaluatedparameters were compared in patients with severe anemia,highest sensitivity and specificity was observed for palmarpallor. The positive predictive value was highest for palmarpallor and least for nail bed pallor. The negative predictivevalue was highest for conjunctival pallor and least for nail bedpallor.Conclusion: Clinical pallor of the nailbeds had highestsensitivity for detection of moderate anemia while palmarpallor had the highest sensitivity for the detection of severeanemia. These are simple clinical signs which can be read evenby non doctors and can thus be taught to various personnellike health workers and school teachers for early detection andprompt management of anemia in children below 5 years.

Oral manifestation in pre-renal transplant patients in Tertiary Care Hospital in Punjab

The incidence of renal failure is known to be increasing globally. Kidney transplant are considered the most efficient renal replacement therapy for a significant number of patients with end- stage renal disease. Renal failure can give rise to a large spectrum of oral manifestations, affecting overall health of patients with renal disease. End-stage renal disease (ESRD) patients have a plethora of oral findings. The aim of this study was to study oral symptoms and lesions in pre-renal transplant patients. This prospective study was conducted over a 6-month period. A total of 80 individuals (40 pre renal transplant patients and 40 controls) were recruited. Each patient was interviewed individually using questionnaire about oral symptoms. Each patient was examined for oral lesions and documented. For Caries DMFT and for Gingivitis CPITN index was used. In both study and control group majority were males and majority were in age group 21-30 years. In study group knowledge of importance of oral hygiene was more. The most common symptoms were dry mouth (20%), altered taste (52.5%) and bleeding gums (42.5%). Study group showed significantly more oral changes than those in the control group. DMFT index was positive in 60% of study and 80% control group. CPITN index was equally positive (92.5%) in both study and control group. Mucosal pallor, suburral tongue, leukoplakia and hyperplastic gingivitis was seen in 27.5%, 10%, 10% and 2.5% respectively in the study group. Prevalence of oral lesions is significantly higher in renal patients. The potential source of active infective lesions in medically compromised patients with ESRD must be treated before transplant.

Clinical study of anemia in rural school children of Mangalore, Karnataka, India

Background: The study was conducted to know the prevalence of anemia in rural school children located within 15km radius of Yenepoya Medical college hospital, Mangalore and to study the risk factors associated with anemia also to correlate the detection of anemia by clinical examination and by lab estimation of hemoglobin.Methods: A total of 550 children in the age group of 6-15 years were included in this study. Parental informed consent was obtained. A preplanner questionnaire was used to collect the health and socio demographic details. Blood was collected by venepuncture method and haemoglobin was determined by automated sysmex machine. Diagnosis of anemia was made according to WHO cut off value of Hb.Results: Out of 550 children 114(20.6%) were anemic. There was no significant difference between age and sex. Anemia was found to be more prevalent in children with h/o passing worms, undernourished, pica and low socio-economic status. Out of 550 children 174 children had conjunctival pallor on clinical examination. Among that 58 (33.3%) children had anemia on hemoglobin estimation. Majority of the children 116 (66.7%) who had pallor on clinical examination was found as non-anemic on hemoglobin estimation. On kappa co efficient, statistics showed that two examinations to detect anemia was 18.47 %, which indicates poor agreement.Conclusions: The overall prevalence of anemia among rural population is variable depending upon the region. Major factors which influence the prevalence of anemia were nutrition, socioeconomic status, pica and worm infestation. Clinical diagnosis by examination of pallor is poorly correlated by estimation of haemoglobin, hence anemia cannot be diagnosed by detection of pallor alone and it requires lab haemoglobin estimation to prevent wrong diagnosis of anemia.

Clinical Profile Of Anemia In A Tertiary Care Center

India is a second most populous country in the world which has been severely affected by global anemic epidemic. Aim-To study clinical profile of anemia and to assess the clinical presentation and severity of anemia. Design- Observational Study. Result-According to our study, majority of anemic cases were seen in 30-39 years of age group(22%). Most patients were females(67%) and high prevalence of anemia was found in patients of Hindu religion (62%). Conclusion- Improvement in literacy, health education, prevention of early marriages and teenage pregnancies may help to reduce the prevalence of anemia.

Diagnostic dilemma in catching anaemia early

Anaemia is major health problem in our country and the foremost cause of disability. The non-specific clinical signs together with lack of knowledge among people are a hindrance for people seeking early care for this disease. Palmar pallor in children for diagnosing anaemia is anaemia has shown to have low sensitivity. Laboratory estimation of haemoglobin levels still are the diagnostic modality of choice in most primary care settings. There are numerous methods based on different principles to estimate haemoglobin. Each method has its own merit and demerit and has to be used appropriately based on that. Some methods like Hemoglobin colour scale have shown have good result to replace Sahli's method but more validation is required. HemoCue also can be used for secondary and tertiary care health institution. A strong political commitment and dedication is required for overcoming operational issues in early diagnosis of anaemia.

Chronic papilledema in a child with classical tuberous sclerosis

Tuberous sclerosis complex (TSC) is a neurocutaneous syndrome manifesting as hamartomas in various organs. Vision loss in patients with TSC may occur due to astrocytic hamartoma affecting macula or Optic nerve. Rarely papilledema due to supbependymal nodule may result in bilateral pale disc and subsequent vision loss. We report a patient with vision loss due to papilledema secondary to subependymal nodule.

Avaliação ectoscópica simples da anemia: um novo sinal / Simple ectoscopic examination of anemia: A new sign

Foram examinados 130 pacientes e realizadas 241 observações, com a finalidade de investigar a acurácia da palidez no diagnóstico da anemia no adulto. As regiões anatômicas observadas foram as comumente utilizadas pelos médicos, a conjuntiva, lábio, palma da mão, linha palmar e uma região ainda não relatada, a extremidade digital, examinando-se a antiga técnica da gradação da palidez. Os autores concluem pela recomendação dos velhos exames e pela adoção do novo sinal, descrito neste trabalho. Este estudo foi aprovado pela Comissão de Ética da Instituição e todos os pacientes assinaram um consentimento informado.

Role of vaginal pallor reaction in predicting late vaginal stenosis after high-dose-rate brachytherapy in treatment-naive patients with cervical cancer / 부인종양

OBJECTIVE: To assess actual rates of late vaginal stenosis and identify predisposing factors for complications among patients with previously untreated cervical cancer following high-dose-rate brachytherapy. METHODS: We performed longitudinal analyses of 57 patients using the modified Dische score at 6, 12, 18, 24, 36, and 60 months after treatment, which consisted of 15 interstitial brachytherapys and 42 conventional intracavitary brachytherapys, with a median follow-up time of 36 months (range, 6 to 144 months). RESULTS: More than half of the patients developed grade 1 (mild) vaginal stenosis within the first year of follow-up, and grade 2 (97.5%, moderate) to grade 3 (severe) stenosis gradually increased with time. Actual stenosis rates for grade 1, 2, and 3 were 97.5% (95% confidence interval [CI], 92.7 to 97.5), 60.7% (95% CI, 42.2 to 79.3), and 7.4% (95% CI, 0 to 18.4) at 3 years after treatment. Pallor reaction grade 2-3 at 6 months was only a statistically significant predisposing factor for grade 2-3 late vaginal stenosis 3 years or later with a hazard ratio of 3.48 (95% CI, 1.32 to 9.19; p=0.018) by a multivariate Cox proportional hazard model. Patients with grade 0-1 pallor reaction at 6 months showed a grade > or =2 vaginal stenosis rate of 53%, whereas the grade 2-3 pallor reaction group achieved a grade > or =2 vaginal stenosis rate at 3 years at 100% (p=0.001). CONCLUSION: High-dose-rate brachytherapy was associated with high incidence of late vaginal stenosis. Pallor reaction grade 2-3 at 6 months was predictive of late grade 2-3 vaginal stenosis at 3 years after treatment. These findings should prove helpful for patient counseling and preventive intervention.

A study of mode of transmission, clinical presentations, WHO and immunological staging among HIV infected children.

Background: The clinical manifestations of HIV infection vary widely among infants, children, and adolescent. So there is a need to study the mode of transmission, clinical presentations, WHO and immunological staging among HIV infected children. Methods: Observational analytic cross sectional study. The children who were HIV positive (confirmed by ELISA for HIV-1 and HIV-2), and attending the OPD of ART Centre and SN Children Hospital, Allahabad during period of one year. The study population consisted of 47 patients, belonging to both sexes and age of 18 months to 19 years. Detailed history was taken and full clinical examination done in all cases. CD4 count was estimated at the time of presentation. Results: Predominant mode of transmission in our study was vertical and it was present in 95% cases. Fever was the most common presenting complaint and was present in 28 (59.57%) cases. The most common clinical sign was pallor in our study, present in 37 cases (78.72%) followed by lymphadenopathy 34 (72.34%). On the basis of WHO clinical staging, most of the patients in our study were found in stage 2 .On the basis of immunological staging, 51% had no evidence of immunosuppression (stage1), 18 (38.3%) had mild to advanced immunosuppression (stage 2 and 3) and 5 (10.63%) patients were severely immunosuppressed (stage 4). Conclusion: In HIV infected children predominant mode of transmission is vertical. Fever and pallor are common clinical manifestations. Most of the patients are found in WHO clinical stage 2 and immunological stage 1.

Cupped disc with normal intraocular pressure: The long road to avoid misdiagnosis.

We present a series of six patients who had been receiving treatment for normal tension glaucoma (NTG; five patients) or primary open angle glaucoma (one patient). All of them were found to have optic neuropathy secondary to compression of the anterior visual pathway. Even though uncommon, compression of the anterior visual pathway is an important differential diagnosis of NTG. Diagnosis of NTG should be by exclusion. Here the possible causes of misdiagnosis are discussed. We present an approach to distinguish glaucomatous from nonglaucomatous optic neuropathy. The article also emphasizes how important it is for the clinicians to consider the total clinical picture, and not merely the optic disc morphology, to avoid the mismanagement of glaucoma, especially the NTG.

Prevalência da anemia em crianças avaliada pela palidez palmar e exame laboratorial: implicações para enfermagem / Prevalence of anemia in children assessed by clinical method known as "palmar pallor"

Buscou-se analisar a prevalência de anemia ferropriva em crianças e comparar os dados obtidos pelo método clínico "palidez palmar" e exame laboratorial em uma Estratégia de Saúde da Família no município de Panambi/RS. Pesquisa exploratória/descritiva, quantitativa, realizada de março a junho de 2009. Foram sujeitos 41 crianças de 2 meses a 5 anos. Os dados foram analisados pela estatística descritiva. Das crianças, 51,2% eram do sexo masculino; 41,46% estavam na faixa etária de 0 a 12 meses; 53,6% das famílias situavam-se no nível social D e 43,9% dos chefes de família tinham o Ensino Fundamental completo ou o Ensino Médio incompleto. Pela palidez palmar, a prevalência de anemia foi de 51,2% e pelo exame laboratorial, de 58,53%. O estudo mostra que a palidez palmar e o exame laboratorial, quando usados juntos, fornecem um diagnóstico mais preciso da anemia ferropriva, podendo ser inseridos na prática assistencial da enfermagem na ESF.

We sought to examine the prevalence of iron deficiency anemia in children and compare the data obtained by the clinical method known as "palmar pallor" and the laboratory exam on the Family Health Strategy services in the municipality of Panambi-RS. The exploratory, descriptive and quantitative research was carried out from March to June 2009. The subjects were 41 children from the age of 2 months up to 5 years old. The data were analyzed by descriptive statistics. Out of the total number of children, 51,2% of them were male; 41,46% of them fit in the age frame from 0 to 12 months old; 53,6% belonged to families of D social level while 43,9% of the family chiefs have complete Elementary Education or incomplete Junior High School. Considering the palmar pallor, the prevalence of anemia was 51,2% and as per the lab exam, by 58,53%. The study shows that the palmar pallor and the laboratory exam when used together provide a more accurate diagnosis of iron deficiency anemia, can be inserted in the professional nursing practice in the ESF.

Se intenta analizar la prevalencia de anemia por deficiencia de fierro en niños y comparar el método clínico "palidez palmar" y el examen de laboratorio en una Estrategia de Salud de la Familia en la municipalidad de Panambi-RS. La pesquisa exploratoria, descriptiva y cuantitativa fue realizada de marzo hasta junio de 2009. Los sujetos fueron 41 niños de 2 meses a 5 años de edad. Los datos fueron analizados por la estadística descriptiva. Del total de niños, 51,2% eran del sexo masculino; 41,46% estaban en la franja etaria de 0 a 12 meses; 53,6% de las familias se sitúan en el nivel social D y 43,9% de los jefes de familia tienen la Enseñanza Fundamental Completa o la Enseñanza Media Incompleta. Por la palidez palmar, la prevalencia de anemia fue de 51,2% y por el examen de laboratorio, de 58,53%. El estudio muestra que la palidez palmar y el examen de laboratorio, cuando usados juntos, proveen un diagnóstico más preciso de la anemia por deficiencia de fierro, pudiendo ser inserido en la práctica asistencial de enfermería en la ESF.

Pallor in the clinical evaluation of anemia / Palidez como dado semiológico de avaliação de anemias

A palidez como dado semiológico de importância para avaliação de anemia é confrontado em um grupo de médicos e de estudantes, e os resultados da pequisa mostram a necessidade de maior treinamento dos estudantes.

Pallor, an important clinical sign of anemia, is assessed by physicians and medical students. There is a necessity to better train medicine students.

Clinical evaluation of the paleness: agreement between observers and comparison with hemoglobin levels

INTRODUÇÃO: A palidez é caracterizada pelo descoramento da pele e mucosas, decorrente da pouca quantidade de hemoglobina circulante. OBJETIVO: O objetivo é comparar o grau de palidez, estratificada em cruzes, com os níveis séricos de hemoglobina, e avaliar o grau de concordância entre observadores. MÉTODOS: Foram avaliados, no período de fevereiro a abril de 2009, por meio de estudo transversal observacional, os indivíduos com idade superior a 18 anos internados em um hospital no sul do estado de Santa Catarina, para os quais haviam sido solicitadas dosagens de hemoglobina. Os pacientes foram avaliados por dois observadores (médicos e estudantes de medicina) quanto à presença e grau de palidez (de ausente a ++++/4) na conjuntiva ocular. O índice de concordância Kappa foi utilizado para avaliar a concordância entre observadores. Foram avaliados 96 pacientes, caucasianos, com idade média de 57,7 anos, sendo 45,8 por cento do gênero masculino e 54,2 por cento do gênero feminino. RESULTADOS: A comparação entre os níveis médios de hemoglobina com a palidez graduada em cruzes não apresentou diferença estatisticamente significativa para os profissionais medicos, sendo a diferença significativa para os estudantes de medicina. O índice de concordância Kappa entre os observadores foi baixo. CONCLUSÃO: Esta pesquisa demonstrou que não houve boa concordância entre os observadores na avaliação de palidez estratificada em cruzes, sendo a avaliação mais fidedigna com relação aos níveis séricos de hemoglobina entre os profissionais médicos.

INTRODUCTION: Pallor is characterized by discoloring of the skin and mucous membranes due to a reduction in the amount of circulating hemoglobin. The objective of this study was to compare the degree of pallor, stratified using crosses, with hemoglobin levels and to evaluate the correlation between observers. METHOD: From February to April 2009, an observational cross-sectional study was carried out of over 18-year-old individuals admitted to a hospital in the south of the state of Santa Catarina, for whom the measurement of hemoglobin levels had been requested. The degree of Pallor (from absent to ++++/4) of the ocular mucosa of 96 patients was evaluated by two types of examiners (physicians and medical students). The Kappa agreement index was used to assess the agreement between observers. RESULTS: All patients (45.8 percent male and 54.2 percent female) were Caucasian with a mean age of 57.7 years. There were statistically significant differences on comparing the mean hemoglobin levels with pallor for the medical students but no significant differences were seen for the physicians. The Kappa agreement index between the observers was low. This research demonstrates that the agreement between the observers was not good for the evaluation of pallor. The most reliable evaluation regarding the hemoglobin levels was by the physicians.

Retinal nerve fiber layer thickness analysis in suspected malingerers with optic disc temporal pallor.

Purpose: To investigate the value of temporal retinal nerve fiber layer (RNFLtemporal) thickness in the prediction of malingering. Materials and Methods: This prospective, cross-sectional study was conducted on 33 military conscripts with optic disc temporal pallor (ODTP) and 33 age-and sex-matched healthy controls. Initial visual acuity (VAi) and visual acuity after simulation examination techniques (VAaset) were assessed. The subjects whose VAaset were two or more lines higher than VAi were determined as malingerers. Thickness of the peripapillary RNFL was determined with OCT (Stratus OCT™, Carl Zeiss Meditec, Inc.). RNFLtemporal thickness of the subjects were categorized into one of the 1+ to 4+ groups according to 50% confidence interval (CI), 25% CI and 5% CI values which were assessed in the control group. The VAs were converted to LogMAR-VAs for statistical comparisons. Results: A significant difference was found only in the temporal quadrant of RNFL thickness in subjects with ODTP (P=0.002). Mean LogMAR-VA increased significantly after SETs (P<0.001). Sensitivity, specificity, positive and negative predictive values of categorized RNFLtemporal thickness in diagnosing malingering were 84.6%, 75.0%, 68.8%, 88.2%, respectively. ROC curve showed that RNFLtemporal thickness of 67.5 μm is a significant cut-off point in determining malingering (P=0.001, area under the curve:0.862). The correlations between LogMAR-VAs and RNFLtemporal thicknesses were significant; the correlation coefficient for LogMAR-VAi was lower than the correlation for LogMAR-VAaset (r=−0.447, P=0.009 for LogMAR-VAi; r=−0.676, P<0.001 for LogMAR-VAaset). Conclusions: RNFLtemporal thickness assessment may be a valuable tool in determining malingering in subjects with ODTP objectively.

Avaliação clínica de palidez estratificada em cruzes: concordância entre observadores e comparação com níveis séricos de hemoglobina / Clinical evaluation of cross-stratified pallor: agreement between observers and comparison with the hemoglobin levels

O transplante hepático é um recurso caro e sofisticado e, quando o procedimento é bem sucedido, tende a proporcionar uma melhora física significativa, apesar da necessidade de acompanhamento médico e do uso de medicações imunossupressoras durante toda a vida. Uma das preocupações atuais das equipes transplantadoras é a qualidade de vida dos pacientes após o transplante, e a presença de sintomas depressivos de pacientes portadores de doença hepática crônica, transplantados e em lista de espera, para transplante de fígado. A amostra constou de 15 pacientes transplantados e 15 aguardando transplante. Foram utilizados: ficha sociodemográfica, Short-Form Health Survey (SF-36), Inventário Beck de Depresão (IBD) e a classificação de gravidade de doença Child-Turcotte-Pugh (CTP). A qualidade de vida dos transplantados apresentou melhor resultado quanto aos domínios do componente físico e pior nos domínios do componente mental do SF-36. Os resultados do IBD revelaram uma tendência dos transplantados a apresentar escores para depressão maior que aqueles em lista de espera. Os pacientes transplantados, embora com escores para depressão mais elevados, apresentaram melhora da capacidade física e da qualidade de vida em relação ao componente físico, porém mostraram piora em relação à condição psicossocial.

The liver transplant is an expensive and sophisticated resource and, when successful, provides a significant physical improvement, despite the need for medical surveillance and the use of immunosuppressive medications throughout life. One of the transplanting team's current concerns is the patients' quality of life after the transplant and the presence of depressive symptoms in transplanted patients with chronic liver disease and those in the waiting list for liver transplant. The sample consisted of 15 transplanted patients and 15 waiting transplant. The following were used to assess the patients: sociodemographic form, Short-Form Health Survey (SF-36), Beck Depression Inventory (BDI), and the Child-Turcotte-Pugh (CTP) rating of illness severity. The quality of life of those with a liver transplant produced better results concerning the SF-36 physical component areas and worst in the mental components. The BDI results revealed a tendency for those with a transplant to present greater depression scores than those in the waiting list. Even though the transplanted patients presented higher scores for depression, they showed an improvement in the physical capacity and quality of life in relation to the physical component, but showed worsening in relation to psychosocial condition.