Subject(s)
Carnitine/blood , Coronary Artery Bypass , Aged , Female , Humans , Male , Middle Aged , Postoperative PeriodABSTRACT
OBJECTIVE: To validate the use of the 36-item short-form questionnaire (SF-36) for measuring health-related quality of life (HRQL) in patients with idiopathic pulmonary fibrosis (IPF). DESIGN: : Observational data at a single point in time. SETTING: : A specialized outpatient respiratory clinic. PARTICIPANTS: Thirty-four patients (mean +/- SE age, 58.29 +/- 1.87 years) with IPF and no significant comorbidity. A matched control group for HRQL measurements was composed of 34 normal subjects (mean age, 58.00 +/- 1.89 years). MEASUREMENTS AND RESULTS: Dyspnea was measured by the baseline dyspnea index (BDI). Respiratory function evaluation included FVC, FEV(1), and resting arterial blood gases. IPF patients showed a mean BDI score of 5.21 +/- 0.46. The mean FVC and FEV(1) values were 62.41 +/- 2.96% and 66.41 +/- 3.33%, respectively. The mean PaO(2) was 67 +/- 2.51 mm Hg, and the mean PaCO(2) was 37 +/- 1. 05 mm Hg. Patients scored significantly worse than control subjects with respect to the SF-36 domains of physical functioning, physical role, general health perceptions, vitality, social functioning, emotional role, and mental health index. BDI scores were significantly correlated with five SF-36 components, and FVC and FEV(1) were significantly correlated with two SF-36 components. Significant negative correlations were found between arterial pH and four SF-36 domains. CONCLUSIONS: Patients with IPF have a significant impairment of HRQL in both physical and psychological functioning. Dyspnea is the most important factor influencing the quality of life in these subjects. The SF-36 questionnaire is a valid instrument to evaluate HRQL in IPF patients.
Subject(s)
Pulmonary Fibrosis/psychology , Quality of Life , Sickness Impact Profile , Adaptation, Psychological , Depression/diagnosis , Depression/psychology , Female , Forced Expiratory Volume , Humans , Male , Middle Aged , Oxygen/blood , Pulmonary Fibrosis/diagnosis , Sick Role , Vital CapacityABSTRACT
Diffuse panbronchiolitis (DPB) is a unusual form of bronchiolar disease that has been reported almost exclusively in Asians. We describe DPB in a non-Asian Brazilian citizen who has never traveled outside the country. The clinical, radiographic, and histologic features of this case resemble those described in Japanese patients. The present case shows that DPB, although rare in Western countries, is not a disease restricted to Asia. It always should be considered in the differential diagnosis of nodular radiographic opacities associated with airflow limitation, especially in non-smokers with a history of chronic sinusitis.
Subject(s)
Bronchiolitis/diagnosis , Adult , Anti-Bacterial Agents/therapeutic use , Bronchiolitis/diagnostic imaging , Bronchiolitis/drug therapy , Bronchiolitis/pathology , Bronchiolitis/physiopathology , Erythromycin/therapeutic use , Humans , Male , Tomography, X-Ray ComputedSubject(s)
Amyloidosis/etiology , Amyloidosis/genetics , Prealbumin/genetics , Renal Dialysis/adverse effects , Spinal Diseases/etiology , beta 2-Microglobulin/physiology , Aged , Fatal Outcome , Female , Humans , Point Mutation/physiology , Spinal Diseases/diagnostic imaging , Spinal Diseases/pathology , Tomography, X-Ray ComputedABSTRACT
Renal amyloidosis has been considered rare and late in the evolution of the transthyretin (TTR) familial amyloid polyneuropathy (FAP) of the Portuguese type (type I). Renal biopsy has been performed systematically in 14 patients with FAP type I before liver transplantation. In all patients, TTR Met30 mutation was shown. Seven had proteinuria or abnormal microalbuminuria, whereas seven others had no urinary abnormalities. All had renal amyloid deposition predominantly in the medulla. Glomerular and vascular involvement was more prominent in patients with urinary abnormalities. Patients with the most extensive renal lesions represented a subgroup with a low score of polyneuropathy disability, a high prevalence of nephropathy in the proband generation, or a late onset for relatives with nephropathy. Immunohistochemistry studies showed that the amyloid substance corresponded to transthyretin. We have shown that renal TTR-derived amyloid deposition is common in patients with FAP type I, even in the absence of urinary abnormalities. The clinical presentation of nephropathy is not a late occurrence in the disease.
Subject(s)
Amyloid Neuropathies/metabolism , Amyloid/analysis , Kidney/chemistry , Adult , Amyloid Neuropathies/genetics , Amyloid Neuropathies/pathology , Female , Humans , Kidney/pathology , Male , Middle Aged , Pedigree , Prealbumin/analysisABSTRACT
The present study describes the antimicrobiological methods used for ooscopic instruments and also recommends a routine of material caring, methods and products to be employed. These orientations were also based on the author's experience with those methods of cleaning, disinfection and sterilization at a school hospital. It is expected to simplify the procedures describing its steps with scientific embasement.