Depression rather than liver impairment reduces quality of life in patients with hepatitis C

Objective: Patients with chronic hepatitis C (CHC) have a poorer quality of life than those with other chronic liver diseases. However, some of the factors that determine health-related quality of life (HRQOL) in these patients, such as the degree of liver fibrosis, are still controversial. Therefore, the aim of the present study was to investigate the impact of CHC on HRQOL by conducting clinical, psychiatric, and sociodemographic evaluations. Methods: One hundred and twenty-four consecutive patients attending a referral center for hepatitis were evaluated using the Mini-International Neuropsychiatry Interview, the Hamilton Depression Rating Scale, the Hospital Anxiety and Depression Scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey. Multiple linear regression analyses were used to quantify independent associations between HRQOL and the clinical, psychiatric, and sociodemographic variables of interest. Results: Reduced HRQOL was independently associated with major depressive disorder (MDD) and with elevated levels of alanine aminotransferase, but was not associated with hepatic cirrhosis. Conclusions: MDD rather than the grade of liver fibrosis was strongly associated with HRQOL impairment in patients with CHC. These findings highlight that, in patients with CHC, the psychological effects of the disease deserve more attention and the implementation of integrated medical, psychiatric, and psychological care may be helpful. .

Estudo de doenças de má absorçäo intestinal como causa de baixa estatura monossintomática / Study of intestinal malabsorption diseases as cause of monosymptomatic short stature

Objetivo: Este estudo foi realizado com o objetivo de avaliar causas de baixa estatura monossintomática na infância, enfatizando causas de má-absorçäo intestinal, especialmente doença celíaca. Métodos: Foram avaliadas, em um desenho transversal, crianças com estatura abaixodo terceiro percentil ou taxa de crescimento inferior a 5cm/ano. A seguinte propedêutica foi realizada: avaliaçäo hematológica, bioquímica, endocrinológica, idade óssea, pesquisa sorológica de anticorpos antigliadina, gordura fecal, dosagem de cloretos no suor e biópsia jejunal. Resultados: Um total de 51 crianças foi estutado, sendo que a maioria foi incluída no grupo dos variantes da normalidade. Näo foram encontradas portadoras de doença celíaca, mas identificaram-se 4 crianças com provável fibrose cística, assintomáticas em relaçäo ao trato respiratório e gastrintestinal. Conclusäo: Além da doença celíaca, a fibrose cística deve ser incluída no diagnóstico diferencial de baixa estatura na infância...