ABSTRACT
OBJECTIVE: Translating the Venous leg ulcer quality of life questionnaire (VLU-QoL), and culturally adapting it to Brazilian Portuguese and validate it with patients at the Hospital das Clínicas of the Botucatu Medical School - Unesp. METHODS: The questionnaire was translated by a professional translator and two dermatologists specialized in the area of venous ulcers (VU), reformulated in a meeting of the three translators. The construct (VLU-QoL-Br) was submitted to pre-interviews with ten VU patients for adaptation of the language. Subsequently, it was applied to patients at the HC-Unesp, and for test-retest reliability for verification of its reproducibility. RESULTS: 82 patients were evaluated, with 56 (68%) women. The age average was 67.3 years. The questionnaire was translated, adapted and applied to the patients. The construct presented high internal consistency (alpha = 0.94) and adequate item-total correlation. When the 32 retests were evaluated, an intra-class correlation was noted for concordance of 0.78 (p<0.01), indicating good reproducibility of the construct. The confirmatory factor analysis corroborated the dimensions of the original questionnaire: activities, psychologies, and symptoms. VLU-QoL-Br scores were associated, independently, to the total area of the ulcers and a lower education level of the subjects (p<0.01). CONCLUSION: The translation, adaptation and validation of the VLU-QoL-Br questionnaire were concluded, demonstrating good psychometric performance, and enabling its clinical use in Brazil. It is important to evaluate its performance in other regions and different samples of individuals.
Subject(s)
Health Status Indicators , Leg Ulcer , Quality of Life , Surveys and Questionnaires , Translations , Venous Insufficiency , Adult , Aged , Aged, 80 and over , Brazil/ethnology , Cultural Characteristics , Factor Analysis, Statistical , Female , Humans , Language , Male , Middle Aged , Psychometrics , Reproducibility of Results , Surveys and Questionnaires/standardsABSTRACT
Objective: translating the Venous leg ulcer quality of life questionnaire (VLU-QoL), and culturally adapting it to Brazilian Portuguese and validate it with patients at the Hospital das Clínicas of the Botucatu Medical School - Unesp. Methods: the questionnaire was translated by a professional translator and two dermatologists specialized in the area of venous ulcers (VU), reformulated in a meeting of the three translators. The construct (VLU-QoL-Br) was submitted to pre-interviews with ten VU patients for adaptation of the language. Subsequently, it was applied to patients at the HC-Unesp, and for test-retest reliability for verification of its reproducibility. Results: 82 patients were evaluated, with 56 (68%) women. The age average was 67.3 years. The questionnaire was translated, adapted and applied to the patients. The construct presented high internal consistency (alpha = 0.94) and adequate item-total correlation. When the 32 retests were evaluated, an intra-class correlation was noted for concordance of 0.78 (p<0.01), indicating good reproducibility of the construct. The confirmatory factor analysis corroborated the dimensions of the original questionnaire: activities, psychologies, and symptoms. VLU-QoL-Br scores were associated, independently, to the total area of the ulcers and a lower education level of the subjects (p<0.01). Conclusion: the translation, adaptation and validation of the VLU-QoL-Br questionnaire were concluded, demonstrating good psychometric performance, and enabling its clinical use in Brazil. It is important to evaluate its performance in other regions and different samples of individuals. .
Objetivo: traduzir o instrumento Venous legulcer quality of life questionnaire (VLU-QoL), adaptá-lo culturalmente para o português do Brasil e validá-lo com pacientes do Hospital das Clínicas da Faculdade de Medicina de Botucatu (FMB) da Universidade Estadual Paulista (Unesp). Métodos: o questionário foi traduzido por um tradutor profissional e por dois dermatologistas especialistas na área de úlceras venosas (UV), sendo reformulado em reunião com os três tradutores. O constructo (VLU-QoL-Br) foi submetido a pré-entrevista com 10 portadores de UV para a adaptação da linguagem. Posteriormente, foi aplicado em pacientes do HC-Unesp, e como teste-reteste para verificação de sua reprodutibilidade. Resultados: foram avaliados 82 pacientes, sendo 56 (68%) do sexo feminino. A idade média foi de 67,3 anos. O questionário foi traduzido, adaptado e aplicado aos pacientes. O constructo apresentou alta consistência interna (alfa= 0,94) e adequada correlação item-total. Quando avaliados os 32 retestes, observou-se correlação intraclasse para concordância de 0,78 (p < 0,01), indicando boa reprodutibilidade do constructo. A análise fatorial confirmatória corroborou as dimensões do questionário original: atividades, psicológico e sintomas. Escores do VLU-QoL-Br se associaram, independentemente, à área total das úlceras e a menor escolaridade dos sujeitos (p < 0,01). Conclusão: a tradução, a adaptação e a validação do questionário VLU-Qol-Br demonstrou boa performance psicométrica, permitindo seu uso clínico no Brasil. É importante avaliar seu desempenho em outras regiões e em diferentes amostras de indivíduos. .
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Health Status Indicators , Leg Ulcer , Quality of Life , Surveys and Questionnaires , Translations , Venous Insufficiency , Brazil/ethnology , Cultural Characteristics , Factor Analysis, Statistical , Language , Psychometrics , Surveys and Questionnaires/standards , Reproducibility of ResultsABSTRACT
Toll-like receptors (TLRs) play an important role in mycobacterial infection, although little is known about the roles of these receptors, cytokines and nitric oxide during anti-tuberculosis treatment. Our objective was to evaluate the mRNA and cell surface expression of TLR2 and TLR4; inducible nitric oxide synthase (iNOS) expression; and cytokine Th1, Th2 and Th17 profiles in pulmonary tuberculosis patients at different time points of anti-tuberculosis treatment. Peripheral blood mononuclear cells (PBMCs) were obtained from PPD(+) healthy controls and from patients receiving anti-tuberculosis treatment. Gene expression quantification was performed by qPCR, cell surface expression was assessed using flow cytometry, and cytokine quantification was conducted using the CBA technique. The treated patients presented higher gene expression and higher numbers of receptors on the cell surface of lymphocytes and monocytes than did control individuals. IL-12 and IFN-γ levels increased after the start of treatment, whereas TNF-α levels were reduced. TGF-ß presented the highest levels during treatment. IL-10 and IL-17 expression and production tended to increase during treatment. iNOS gene expression was reduced throughout treatment in patients. Our results suggest that anti-tuberculosis treatment modulates the immune response, inducing an increase in the expression of TLRs and pro- and anti-inflammatory cytokines to combat bacteria and reduce the inflammatory process.
Subject(s)
Cytokines/metabolism , Nitric Oxide Synthase Type II/metabolism , Toll-Like Receptor 2/metabolism , Toll-Like Receptor 4/metabolism , Transforming Growth Factor beta1/metabolism , Tuberculosis, Pulmonary/drug therapy , Adult , Antitubercular Agents/therapeutic use , Cell Membrane/metabolism , Female , Gene Expression Profiling , Gene Expression Regulation , Humans , Inflammation , Interferon-gamma/blood , Interleukin-10/blood , Interleukin-12/blood , Interleukin-17/blood , Leukocytes, Mononuclear/drug effects , Male , Middle Aged , Sputum , Tuberculin Test , Tuberculosis, Pulmonary/blood , Tumor Necrosis Factor-alpha/bloodABSTRACT
BACKGROUND: Psoriasis is a chronic inflammatory disease of the skin that affects patients of all ages and both genders. The impact of the disease on quality of life is greater among patients with moderate to severe psoriasis. OBJECTIVE: to establish a correlation between the psoriasis area and severity index (PASI) and the Dermatology Life Quality Index (DLQI) based on a quality of life questionnaire adapted to the Brazilian context for patients with plaque psoriasis before and after systemic treatment. METHODS: This was a cross-sectional, descriptive study of psoriasis patients who did not undergo treatment or who manifested clinical activity of the disease. Patients were evaluated according to the PASI and the quality of life questionnaire adapted to the Brazilian context before and 60 days after systemic treatment. RESULTS: Thirty-five patients participated in the study. Twenty-six were men, with a mean age of 46 years. There was no correlation between the PASI and the quality of life questionnaire adapted to the Brazilian context, but there was a correlation between the PASI and some items of the quality of life questionnaire adapted to the Brazilian context, such as jobs involving public contact. CONCLUSION: The non-correlation between the PASI and the quality of life questionnaire adapted to the Brazilian context in this work may be associated with a history of chronic disease, which implies greater acceptance of the illness, or may be related to the low income and social status of the patients studied. The correlation observed among patients with careers involving public contact suggests that some professions are more impacted by the disease. It may be necessary to adapt the quality of life questionnaire to patients with a low income and cultural and social limitations. The small sample size (n=35 patients) and the short follow-up period of 60 days were some of the limitations of this work.
Subject(s)
Psoriasis/therapy , Quality of Life , Severity of Illness Index , Activities of Daily Living , Adult , Aged , Aged, 80 and over , Brazil , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Psoriasis/psychology , Socioeconomic Factors , Statistics, Nonparametric , Surveys and Questionnaires , Time Factors , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Psoriasis is a chronic inflammatory disease of the skin that affects patients of all ages andboth genders. The impact of the disease on quality of life is greater among patients with moderate to severe psoriasis. OBJECTIVE: to establish a correlation between the psoriasis area and severity index (PASI) and theDermatology Life Quality Index (DLQI) based on a quality of life questionnaire adapted to the Brazilian contextfor patients with plaque psoriasis before and after systemic treatment. METHODS: This was a cross-sectional, descriptive study of psoriasis patients who did not undergo treatment or who manifested clinical activity of the disease. Patients were evaluated according to the PASI and the quality of life questionnaire adapted to theBrazilian context before and 60 days after systemic treatment. RESULTS: Thirty-five patients participated in thestudy. Twenty-six were men, with a mean age of 46 years. There was no correlation between the PASI and thequality of life questionnaire adapted to the Brazilian context, but there was a correlation between the PASI andsome items of the quality of life questionnaire adapted to the Brazilian context, such as jobs involving public contact. CONCLUSION: The non-correlation between the PASI and the quality of life questionnaire adapted to the Brazilian context in this work may be associated with a history of chronic disease, which implies greater acceptance of the illness, or may be related to the low income and social status of the patients studied. The correlationobserved among patients with careers involving public contact suggests that some professions are more impacted by the disease. It may be necessary to adapt the quality of life questionnaire to patients with a low income andcultural and social limitations. The small sample size (n=35 patients) and the short follow-up period of 60 dayswere some of the limitations of this work. .
FUNDAMENTOS: Psoríase é doença inflamatória crônica da pele que afeta pacientes de todas as idades eambos os gêneros. O impacto negativo na qualidade de vida é mais importante naqueles pacientes com psoríasemoderada a grave. OBJETIVO: Correlacionar o índice de gravidade e extensão da psoríase e o índice de qualidadede vida, segundo questionário de qualidade de vida adaptado ao Brasil, em pacientes de psoríase em placas antes e depois de tratamento sistêmico. MÉTODO: Estudo transversal, descritivo, de pacientes de psoríase, virgens detratamento ou em atividade clinica, submetidos a avaliação do índice de gravidade e extensão da psoríase e aoquestionário de qualidade de vida adaptado ao Brasil antes e após 60 dias de tratamento com medicação sistêmica. RESULTADOS: Trinta e cinco pacientes foram estudados, 26 homens, com idade média de 46 anos. Não houvecorrelação entre índice de gravidade e extensão da psoríase e questionário de qualidade de vida adaptado aoBrasil. Mas, houve correlação entre índice de gravidade e extensão da psoríase e itens do questionário de qualidade de vida adaptado ao Brasil, tal como "atividade profissional com público". CONCLUSÃO: A não correlação entre índice de gravidade e extensão da psoríase e questionário de qualidade de vida adaptado ao Brasil nessainvestigação pode estar relacionada com história crônica de psoríase, o que implicaria em melhor aceitação dadoença ao longo do tempo ou às condições sociais e de baixa renda dos pacientes estudados. A correlação observada entre aqueles com atividade pública sugere que algumas profissões podem sofrer maior impacto da enfermidade. ...
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Psoriasis/therapy , Quality of Life , Severity of Illness Index , Activities of Daily Living , Brazil , Cross-Sectional Studies , Psoriasis/psychology , Socioeconomic Factors , Statistics, Nonparametric , Surveys and Questionnaires , Time Factors , Treatment OutcomeABSTRACT
Cytokines play an essential role during active tuberculosis disease and cytokine genes have been described in association with altered cytokine levels. Therefore, the aim of this study was to verify if IFNG, IL12B, TNF, IL17A, IL10, and TGFB1 gene polymorphisms influence the immune response of Brazilian patients with pulmonary tuberculosis (PTB) at different time points of antituberculosis treatment (T1, T2, and T3). Our results showed the following associations: IFNG +874 T allele and IFNG +2109 A allele with higher IFN- γ levels; IL12B +1188 C allele with higher IL-12 levels; TNF -308 A allele with higher TNF- α plasma levels in controls and mRNA levels in PTB patients at T1; IL17A A allele at rs7747909 with higher IL-17 levels; IL10 -819 T allele with higher IL-10 levels; and TGFB1 +29 CC genotype higher TGF- ß plasma levels in PTB patients at T2. The present study suggests that IFNG +874T/A, IFNG +2109A/G, IL12B +1188A/C, IL10 -819C/T, and TGFB1 +21C/T are associated with differential cytokine levels in pulmonary tuberculosis patients and may play a role in the initiation and maintenance of acquired cellular immunity to tuberculosis and in the outcome of the active disease while on antituberculosis treatment.
ABSTRACT
Cytokines play an essential role during active tuberculosis disease and cytokine genes have been described in association with altered cytokine levels. Therefore, the aim of this study was to verify if IFNG, IL12B, TNF, IL17A, IL10, and TGFB1 gene polymorphisms influence the immune response of Brazilian patients with pulmonary tuberculosis (PTB) at different time points of antituberculosis treatment (T1, T2, and T3). Our results showed the following associations: IFNG +874 T allele and IFNG +2109 A allele with higher IFN- γ levels; IL12B +1188 C allele with higher IL-12 levels; TNF -308 A allele with higher TNF- α plasma levels in controls and mRNA levels in PTB patients at T1; IL17A A allele at rs7747909 with higher IL-17 levels; IL10 -819 T allele with higher IL-10 levels; and TGFB1 +29 CC genotype higher TGF- ß plasma levels in PTB patients at T2. The present study suggests that IFNG +874T/A, IFNG +2109A/G, IL12B +1188A/C, IL10 -819C/T, and TGFB1 +21C/T are associated with differential cytokine levels in pulmonary tuberculosis patients and may play a role in the initiation and maintenance of acquired cellular immunity to tuberculosis and in the outcome of the active disease while on antituberculosis treatment.
Subject(s)
Polymorphism, Genetic , Tuberculosis, Pulmonary/immunology , Cytokines/genetics , Tuberculosis, Pulmonary/therapy , Immunity, CellularABSTRACT
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%), mean age 41.8 years, mean disease duration of 6 years, and angioedema occurrence in 82% 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.
Subject(s)
Quality of Life , Urticaria/psychology , Adult , Chronic Disease , Educational Status , Female , Hospitals, University , Humans , Male , Sex Distribution , Sex Factors , Socioeconomic Factors , Surveys and Questionnaires , Urticaria/epidemiologyABSTRACT
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.
Subject(s)
Adult , Female , Humans , Male , Quality of Life , Urticaria/psychology , Chronic Disease , Educational Status , Hospitals, University , Sex Distribution , Sex Factors , Socioeconomic Factors , Surveys and Questionnaires , Urticaria/epidemiologyABSTRACT
Paracoccidioidomycosis is the most prevalent systemic mycosis in Latin America, among immunecompetent patients. It's caused by the dimorphic fungus Paracoccidioiddes brasiliensis. Investigations regarding its immunopathogenesis are very important in the understanding of aspects related to natural history, as the protective immunity, and the relationship between host and parasite; also favoring the knowledge about clinical patterns and the elaboration of therapeutic strategies. The disease clinical polymorphism depends, at least, of the immune response profile according to the tissue and blood released citokynes, resulting in tissue damage.
Subject(s)
Cytokines/immunology , Paracoccidioides/physiology , Paracoccidioidomycosis/immunology , Acute Disease , Chronic Disease , Host-Pathogen Interactions/physiology , Humans , Paracoccidioides/immunology , Paracoccidioidomycosis/pathology , Severity of Illness IndexABSTRACT
Paracoccidioidomicose é a mais prevalente micose sistêmica na América Latina, em pacientes imunocompetentes, sendo causada pelo fungo dimórfico Paracoccidioiddes brasiliensis. O estudo da sua imunopatogênese é importante na compreensão de aspectos relacionados à história natural, como a imunidade protetora, e à relação entre hospedeiro e parasita, favorecendo o entendimento clínico e a elaboração de estratégias terapêuticas. O polimorfismo clínico da doença depende, em última análise, do perfil de resposta imune que prevalece expresso pelo padrão de citocinas teciduais e circulantes, além da qualidade da resposta imune desencadeada, que levam ao dano tecidual.
Paracoccidioidomycosis is the most prevalent systemic mycosis in Latin America, among immunecompetent patients. It's caused by the dimorphic fungus Paracoccidioiddes brasiliensis. Investigations regarding its immunopathogenesis are very important in the understanding of aspects related to natural history, as the protective immunity, and the relationship between host and parasite; also favoring the knowledge about clinical patterns and the elaboration of therapeutic strategies. The disease clinical polymorphism depends, at least, of the immune response profile according to the tissue and blood released citokynes, resulting in tissue damage.
Subject(s)
Humans , Cytokines/immunology , Paracoccidioides/physiology , Paracoccidioidomycosis/immunology , Acute Disease , Chronic Disease , Host-Pathogen Interactions/physiology , Paracoccidioides/immunology , Paracoccidioidomycosis/pathology , Severity of Illness IndexABSTRACT
Com o objetivo de avaliar a atividade de celulas natural killer na paracoccidioidomicose experimental do hamster, 80 hamsters foram infectados por via intratesticular com Paracoccidioides brasiliensis e sacrificados apos 24h, 48h, 96h, 1, 2, 4, 8 e 11 semanas de infeccao. Como controle foram avaliados 40 hamsters normais, nao infectados. Os animais foram submetidos ao estudo da atividade citotoxica de celulas NK pela tecnica de "single-cell assay" e da resposta imune humoral pelas tecnicas de imunodifusao dupla e Elisa...
