Versão brasileira da Escala de Estado Funcional em UTI: tradução e adaptação transcultural / Brazilian version of the Functional Status Score for the ICU: translation and cross-cultural adaptation

RESUMO Objetivo: Traduzir e adaptar culturalmente a Escala de Estado Funcional em UTI (FSS-ICU - Functional Status Score for the ICU) para o português do Brasil. Métodos: O presente estudo consistiu das seguintes fases: tradução (realizada por dois tradutores independentes), síntese da tradução inicial, tradução de volta ao inglês (realizada por dois tradutores independentes não familiarizados com a FSS-ICU original) e fase de teste, para avaliar a compreensão por parte da audiência alvo. Um comitê de especialistas supervisionou todas as fases e foi responsável pelos ajustes ao longo do processo e pela versão final da tradução. Resultados: A fase de testes incluiu dois fisioterapeutas experientes que avaliaram um total de 30 pacientes críticos (escore da FSS-ICU médio de 25 ± 6). Como os fisioterapeutas não relataram problemas com incertezas ou problemas de interpretação que afetassem seu desempenho, não foram feitos outros ajustes à versão em português brasileiro após a fase de teste. Obteve-se uma boa confiabilidade entre observadores para cada uma das cinco tarefas da FSS-ICU e entre os escores dos dois avaliadores (o coeficiente de correlação intraclasse variou de 0,88 a 0,91). Conclusão: A versão adaptada da FSS-ICU para o português brasileiro comprovou ser de fácil compreensão e aplicação clínica no ambiente da unidade de terapia intensiva.

ABSTRACT Objective: The aim of the present study was to translate and cross-culturally adapt the Functional Status Score for the intensive care unit (FSS-ICU) into Brazilian Portuguese. Methods: This study consisted of the following steps: translation (performed by two independent translators), synthesis of the initial translation, back-translation (by two independent translators who were unaware of the original FSS-ICU), and testing to evaluate the target audience's understanding. An Expert Committee supervised all steps and was responsible for the modifications made throughout the process and the final translated version. Results: The testing phase included two experienced physiotherapists who assessed a total of 30 critical care patients (mean FSS-ICU score = 25 ± 6). As the physiotherapists did not report any uncertainties or problems with interpretation affecting their performance, no additional adjustments were made to the Brazilian Portuguese version after the testing phase. Good interobserver reliability between the two assessors was obtained for each of the 5 FSS-ICU tasks and for the total FSS-ICU score (intraclass correlation coefficients ranged from 0.88 to 0.91). Conclusion: The adapted version of the FSS-ICU in Brazilian Portuguese was easy to understand and apply in an intensive care unit environment.

The effect of erythromycin on toxoplasma gondii in vitro

The comparative in vitro effect of Erythromycin Lactobionate (E) on two different strains of T. gondii was assayed. Monolayers of mammalian cells in 4 ml of MEM + 2% calf serum were inoculated with Toxoplasma (1.5 to 2.5 x 10 5 parasites per flask) and thereafter incubated with different concentrations of E at 37o C for 24 h. Monolayers were then fixed and stained by Giemsa and Mean Number of Infective Units (MNIU) assessed. Human lung fibroblast cultures showed total inhibition and/or death of T. gondii with 100-200 mcg/ml of E and 81% decrease of MNIU at 20 mcg/ml of E (P< 0,05 as compared to controls) for both strains. Later experiments on monkey kidney cells showed a difference in sensitivity to E, between both T. gondii strains: while strains A showed 1 61% decrease in MNIU at 5 mcg/ml E (P< 0.005) strain B was sensitive only to a concentration of 50 mcg/ml E (66% reduction of MNIU, P< 0.005). A distint effect of E against intracellular T. gondii was shown. Results indicate that E, at concentrations similar to those reached in the human serum standard IV dose, may prove effective against infections due to sensitive Toxoplasma strains. Initial experiments suggest that the combination of E (1,25 mcg/ml) plus sulfisoxazole (0,25-25 mcg/ml), significantly increase the anti-toxoplasma effect of the individual agents