Calidad de vida y evolución clínica después de miotomía de Heller con fundoplicatura de Dor / Quality of Life and Clinical Evolution after Heller Myotomy plus Dor fundoplication

RESUMEN Introducción: La miotomía de Heller laparoscópica es considerada en la actualidad el tratamiento de elección para el alivio de la disfagia. Se ha demostrado que gracias a ella se logra una baja incidencia de reflujo gastroesofágico y una mejoría evidente de la calidad de vida Objetivo: Evaluar la calidad de vida y evolución clínica de los pacientes después de la miotomía de Heller con fundoplicatura de Dor. Método: Estudio observacional descriptivo longitudinal prospectivo mediante la aplicación del cuestionario de índice de calidad de vida gastrointestinal a pacientes operados de acalasia esofágica desde enero del 2010 hasta diciembre del 2017 en el Centro Nacional de Cirugía de Mínimo Acceso. Se aplicó un cuestionario en el preoperatorio y al año de operados. Análisis estadístico: Porcentajes para variables cualitativas, media ± desviación estándar o mediana y rango según corresponda para las cuantitativas, para la comparación de los resultados del cuestionario se emplearon pruebas de hipótesis de comparación de medias, con nivel de significación estadística α= 0,05. Resultados: Fueron incluidos en el estudio 101 pacientes. Las edades oscilaban entre 18 y 78 años con una media de 47 años. El tiempo medio de evolución de los síntomas fue de 62 meses, con una media de 3,3 en la escala de disfagia y una presión de reposo del esfínter esofágico inferior (mmHg) 38,7 ± 16,8, se obtuvo un GIQLI inicial de 85,3 ± 20,4 que aumentó al año a 131,6 ± 10,5 Conclusiones: La miotomía de Heller con fundoplicatura de Dor, mejora la calidad de vida de los pacientes con acalasia esofágica con una evolución clínica excelente(AU)

ABSTRACT Introduction: Laparoscopic Heller myotomy is now considered the treatment of choice for the relief of dysphagia. It has been shown that thanks to it a low incidence of gastroesophageal reflux and evident improvement in the quality of life is achieved. Objective: To evaluate the quality of life and clinical evolution of patients after Heller myotomy plus Dor fundoplication. Method: Prospective, longitudinal, descriptive, observational study carried out by applying the Gastrointestinal Quality of Life Index (GIQLI) questionnaire to patients operated on for esophageal achalasia, from January 2010 to December 2017, at the National Center for Minimum Access Surgery. The questionnaire was applied preoperatively and one year after surgery. Statistical analysis: Percentages for qualitative variables, mean and standard deviation, or median and range, as appropriate for quantitative variables. For the comparison of the results of the questionnaire, we used tests of hypothesis of comparison of means, with statistical significance level of 0.05. Results: The ages ranged between 18 and 78 years, with an average of 47 years. The mean time of evolution of symptoms was 62 months, with an average of 3.3 on the dysphagia scale and a resting pressure of the lower esophageal sphincter (mmHg) 38.7±16.8. An initial gastrointestinal quality of life index of 85.3±20.4 was obtained, which increased to 131.6±10.5 per year. Conclusions: Heller myotomy plus Dor fundoplication improves the quality of life of patients with esophageal achalasia and guarantees an excellent clinical evolution(AU)

Retrospective series of side-to-side ileosigmoidostomy shunting surgery for the treatment of slow transit constipation in elderly patients / 国际外科学杂志

Objective To evaluate the clinical and functional outcomes of Side-to-Side Ileosigmoidostomy Shunting Surgerys for the treatment of elder STC patients.Methods The clinical data of 67 patients all more than 63 years old with severe idiopathic STC treated with this novel approach between June 2010 and July 2017 were retrospectively analyzed.The perioperative complications and defection conditions were followed up by telephone and outpatient.The Wexner constipation score and gastrointestinal tract were compared before and after the operation.SPSS 19.0 software was used for statistical analysis.Independent sample t test was used for measurement data,t and x2 test were used for comparison of count data.Results All the patients received their operations successfully without deaths or serious complication.The center follow-up period (from outpatients or phone) was 12 months (6-29 months).only 16 patients developed complications including 2 and 14 total colonic exclusion.12 of the 14 got better obviously after enema and taken dynamic drugs,Only 2 patients with repeated abdominal pain and distention received jejunostomy.Six months after the operation,only 5 patients needed to take some drugs for defectation.Wexner constipation scores and Gastrointestinal Quality of Life Index (GIQLI) has improved obviously after 6 months and 12 months.Conclusions The novel surgical procedure,side-to-side ileosigmoidostomy Shunting Surgery that practised in our department,is an easy,safe and effective for the treatment of selected elderly patients with STC.Large-sample,randomized,controlled analyses are worth to investigate its clinical effects.

Factors related to gastrointestinal function and quality of life in postoperative patients with cholecystolithiasis / 现代临床护理

Objective To investigate the quality of life of post-operative patients with cholecystolithiasis and analyze the influencing factors. Methods About 206 patients with cholecystolithiasis were enrolled in the investigation by gastrointestinal quality of life index (GIQLI). Multivariate linear regression analysis was used to explore the influencing factors of their quality of life. Results The GIQLI score of 206 patients was (115.81 ±9.22) and the index value was 80.42%. Three independent variables such as breakfast habit, exercise, three hyperlipidemia, were the factors that affected the quality of life (P<0.05). Conclusions The quality of life of patients after cholelithiasis is lower than that of normal people. Patients should develop good eating habits and exercise habits, strengthen the interventions with high blood lipids, high blood pressure and hyperglycemia to improve the quality of life of post-operative patients with cholecystolithiasis.

Development of the Korean Version of the Sleep Apnea Quality of Life Index

OBJECTIVES: Obstructive sleep apnea (OSA) is a disorder characterized by repetitive partial or complete occlusion of the upper airway during sleep that affects quality of life. The aim of this study was to develop the Korean version of the sleep apnea quality of life index (K-SAQLI) and apply it in Korean patients with OSA. METHODS: Ninety-three patients with OSA completed the K-SAQLI. Its construct validity and responsiveness were tested by comparing the baseline and change scores obtained in each domain (i.e., daily functioning, social interactions, emotional functioning, and symptoms) using the medical outcome survey-short form 36 (SF-36). RESULTS: The Cronbach alpha coefficients of internal reliability exceeded 0.60 in all the domains (daily functioning, 0.89; social interactions, 0.88; emotional functioning, 0.92; symptoms, 0.67; and total, 0.94). The K-SAQLI had a high test-retest correlation coefficient of 0.73 in the 20 randomized selected patients. The construct validity was confirmed by significant correlations with SF-36 subscale scores. CONCLUSION: The results of this study demonstrate that the K-SAQLI may be applicable for clinical purposes.

Qualidade de vida em urticária crônica: inquérito em ambulatório público universitário, Botucatu (Brasil) / Quality of life in chronic urticaria: a survey at a public university outpatient clinic, Botucatu (Brazil)

OBJETIVO: Avaliar o impacto da urticária crônica na qualidade de vida dos pacientes de ambulatório universitário a partir do questionário DLQI (Dermatology Life Quality Index). MÉTODOS: Inquérito sobre o impacto na qualidade de vida infligido pela urticária crônica a partir do questionário DLQI validado para a língua portuguesa. Pacientes foram entrevistados durante suas consultas em ambulatório especializado, entre maio de 2009 e maio de 2010, em serviço público brasileiro (Botucatu-SP). Os escores do DLQI foram analisados segundo subgrupos: idade, gênero, escolaridade, tempo de doença e presença de angioedema. RESULTADOS: Foram entrevistados 100 pacientes com urticária crônica. Predominou o gênero feminino (86 por cento), a idade média foi de 41,8 anos, duração média da doença foi de seis anos e angioedema ocorreu em 82 por cento dos pacientes. O escore médio do DLQI foi de 13,5, caracterizando grave impacto à qualidade de vida, superior a hanseníase, psoríase, eczema atópico e carcinoma basocelular. Presença de angioedema se associou a maiores escores: 14,5 x 9,9 (p < 0,01). Pacientes do gênero feminino referiram maior impacto quanto ao vestuário, já o gênero masculino referiu quanto ao tratamento, trabalho e estudo (p < 0,05). CONCLUSÃO: Urticária crônica inflige grave comprometimento da qualidade de vida nos pacientes avaliados em serviço universitário brasileiro, especialmente nos portadores de angioedema.

OBJECTIVE: To evaluate the impact of chronic urticaria on quality of life of outpatients through the university questionnaire Dermatology Life Quality Index (DLQI). METHODS: Survey of the impact on quality of life caused by chronic urticaria, using the DLQI questionnaire validated for the Portuguese language. Patients were interviewed during visits to a specialized outpatient clinic between May 2009 and May 2010 at a Brazilian public service (Botucatu-SP). DLQI scores were analyzed according to the following subgroups: age, gender, education, disease duration, and presence of angioedema. RESULTS: We interviewed 100 patients with chronic urticaria. There was a female predominance (86 percent), mean age 41.8 years, mean disease duration of 6 years, and angioedema occurrence in 82 percent of patients. The mean DLQI score was 13.5, characterized by serious impact on quality of life, higher than Hansen's disease, psoriasis, atopic eczema, and basal cell carcinoma. The presence of angioedema was associated with higher scores: 14.5 x 9.9 (p < 0.01). Female patients reported greater impact on clothing, while male patients reported treatment interference with work and study (p < 0.05). CONCLUSION: Chronic urticaria seriously compromises the quality of life of patients evaluated at a university service in Brazil, particularly of patients with angioedema.

Validação do Índice de Qualidade de Vida de Ferrans e Powers para a população geral do município de Londrina / Validation of the Ferrans and Powers Quality of Life Index for the general population of Londrina city Brazil

Trata-se de um estudo que teve por objetivo a validação do Índice de Qualidade de Vida (IQV) de Ferrans e Powers para uma população geral do município de Londrina. O IQV é um instrumento genérico de avaliação de qualidade de vida, composto por duas partes distintas, com 34 ítens cada uma, correspondentes a quatro domínios: 1. Saúde/Funcionamento (14 ítens), 2. Socioeconômico (9 ítens), 3. Psicológico/Espiritual (7 ítens) e 4. Família (4 ítens). A primeira parte avalia o grau de satisfação quanto aos ítens do instrumento, e a segunda, mede o grau de importância atribuída a eles. O instrumento foi administrado por meio de auto-aplicação (93%), aplicação assistida (4,7%) e por entrevista (2,3%), a uma amostra de 300 pessoas da população geral de Londrina. O tempo médio para administração do instrumento foi de 16,5 minutos (DP=8,5). A avaliação de sua confiabilidade foi realizada pela análise da consistência interna dos ítens, através do coeficiente Alfa de Cronbach, aplicado a cada dimensão do IQV e à escala completa (IQV Total). A análise obteve um Alfa com índices de consistência interna satisfatórios, com os seguintes valores de Alfa: 0,82 = IQV Total; 0,76 = Saúde/Funcionamento; 0,67 =Socioeconômico; 0,82 = Psicológico/Espiritual; 0,54 = Família. Na análise discriminativa, observou-se a diferença estatisticamente significante dos ítens e domínios do instrumento em relação a indivíduos com melhor e pior qualidade de vida. Em relação à validade de critério, obteve-se uma correlação positiva e estatisticamente significante (r=0,69; p,0,0001) entre o escore total do IQV e o ítem 32 - "Satisfação com sua vida em geral". Os resultados desta pesquisa evidenciaram coeficientes de confiabilidade satisfatórios bem como validade discriminante de critério do instrumento analisado, permitindo sua utilização para avaliar a qualidade de vida da população geral do município de Londrina

The present study aimed to validate the Ferrans and Powers Quality of Life Index for the general population of Londrina city - Brazil. The Quality of Life Index (QLI) is a generic instrument to evaluate quality of life, divided into two distinct parts, with 34 items each, corresponding to four domains: 1. Health/Functioning (14 items), 2. Socioeconomical (9 items), 3. Psychological/Spiritual (7 items) and 4. Family (4 items). The first part evaluates the level of satisfaction related to the items of the instrument and the second measures the level of importance of each item to the subject. The instrument was administered to a sample of 300 people of the general population of Londrina, using the following strategies: self answering (93%), assisted answering (4,7%) and interviewing (2,3%). Mean time for managing the instrument was 16,5 minutes (SD=8,5). Internal consistency reliability was estimated through Cronbach's alpha applied to each of the dimensions of the QLI and to the total scale (Total QLI). The analysis demonstrated a satisfactory level of internal consistency, with the following Alpha coeficients: 0,82 = Total QLI; 0,76 = Health/Functioning; 0,67 = Socioeconomical; 0,82 =Psychological/Spiritual; 0,54 = Family. Discriminant analysis showed a statistically significant difference between items and domains of the instrument in relation to individuals with higher and lower quality of life. The correlation between scores from QLI and overall satisfaction with life question - item 32 - was 0,69 (p<0,0001), thus supporting the criterion-related validity. The results of this study indicate that Quality of Life Index shows a satisfactory level of internal consistency as well as discriminant and criterion-related validity, thus allowing its utilization to evaluate quality of life of the general population of Londrina city