Traducción y adaptación al castellano del cuestionario de calidad de vida relacionado con el síndrome de apnea-hipopnea del sueño Quebec Sleep Questionnaire / Translation and adaptation to Spanish language of the quality of life questionnaire for sleep apnea-hipopnea syndrome Quebec Sleep Questionnaire

Fundamento y objetivo: El objetivo del estudio es realizar la traducción y adaptación al castellano del cuestionario Quebec Sleep Questionnaire (QSQ). Método: Para la adaptación transcultural del QSQ se ha utilizado la técnica de retrotraducción. Un psicólogo y un neumólogo hicieron una primera traducción del cuestionario. Se puntuó de forma independiente la naturalidad/corrección de los ítems y la equivalencia conceptual y se pasó el cuestionario a un grupo de pacientes. Se remitió al autor una retrotraducción al inglés. Resultados: La mayoría de los ítems tuvieron una dificultad mínima en la traducción. Tan solo en 4 de ellos (ítems 2, 7, 8, 30) la dificultad fue moderada. La naturalidad/corrección fue máxima en casi todos los ítems excepto en 4 que, sin embargo, era excelente (de 8 a 9 puntos). La equivalencia conceptual fue completa en todos menos en el ítem 2, en el que fue parcialmente equivalente. Conclusiones: Se ha realizado la primera traducción y adaptación al castellano del cuestionario de calidad de vida QSQ. La traducción tiene una dificultad mínima y su equivalencia conceptual es prácticamente completa (AU)

Background and objective: The objective of this study was to translate and adapt to Spanish the Québec Sleep Questionnaire (QSQ).Methods: For QSQ tran-cultural adaptation, the back-translation technique was used. A psychologist and a pneumonologist made a first translation of the questionnaire. Naturalness-correctness of items and conceptual equivalence were evaluated by external researchers and a group of patients. A back-translation was finally remitted to author. Results: Most of the items had minimal difficulty in translation. The difficulty was moderate in only 4 of them (items 2, 7, 8, 30). Naturalness-correctness was maximal in most items and excellent in 4 (8 to 9 points). The conceptual equivalence was complete in all the items, except item 2 that showed a partial equivalence. Conclusions: The first translation and adaptation to Spanish language of the quality of life questionnaire QSQ has been done. The translation has minimal difficulty and the conceptual equivalence is almost complete (AU)

[Translation and adaptation to Spanish language of the quality of life questionnaire for sleep apnea-hipopnea syndrome Quebec Sleep Questionnaire]. / Traducción y adaptación al castellano del cuestionario de calidad de vida relacionado con el síndrome de apnea-hipopnea del sueño Quebec Sleep Questionnaire.

BACKGROUND AND OBJECTIVE: The objective of this study was to translate and adapt to Spanish the Québec Sleep Questionnaire (QSQ). METHODS: For QSQ tran-cultural adaptation, the back-translation technique was used. A psychologist and a pneumonologist made a first translation of the questionnaire. Naturalness-correctness of items and conceptual equivalence were evaluated by external researchers and a group of patients. A back-translation was finally remitted to author. RESULTS: Most of the items had minimal difficulty in translation. The difficulty was moderate in only 4 of them (items 2, 7, 8, 30). Naturalness-correctness was maximal in most items and excellent in 4 (8 to 9 points). The conceptual equivalence was complete in all the items, except item 2 that showed a partial equivalence. CONCLUSIONS: The first translation and adaptation to Spanish language of the quality of life questionnaire QSQ has been done. The translation has minimal difficulty and the conceptual equivalence is almost complete.

[Low doses of megestrol acetate increase weight and improve nutrition status in patients with severe chronic obstructive pulmonary disease and weight loss]. / Dosis bajas de acetato de megestrol aumentan el peso y mejoran la nutrición de los pacientes con enfermedad pulmonar obstructiva crónica grave y pérdida de peso.

BACKGROUND AND OBJECTIVE: Weight loss in patients with severe chronic obstructive pulmonary disease (COPD) is a prognostic bad factor. The objective of this study is to analyze the effectively of megestrol acetate (MA) to increase appetite of these patients. PATIENTS AND METHODS: Randomized double blind placebo controlled trial to study the effect of 160 mg/bid of MA, for 8 weeks, on nutritional, functional, analytical and quality of life parameters, in 38 patients with severe COPD and body mass index (BMI) < 21 kg/m(2), or between 21-25 with involuntary weight loss of 5% in the last 3 months. RESULTS: At 8 weeks, in the MA group the body weight increased (2.3 kg) with respect to the control group (0.1 kg) (p<0.04). MA improved significantly the triceps skin-fold thickness (p < 0.04), prealbumin (p<0.004), lymphocytes (p<0.0006), C3 (p<0.04), PCO(2) (p<0.007) and bicarbonate levels (p<0.008). MA did not increase the MRC and SGRQ scales, the distance of 6 MWT nor BODE index. The IL-6 and TNF alpha levels were not modified in the MA group, but leptin did increase (p<0.043). MA improved the sense of wellbeing (p<0.02) and the appetite (p<0.008), compared to the control group. Adverse effects were similar in both groups. CONCLUSIONS: MA safely increases the body weight and the appetite in severe COPD patients with weight loss. MA improves blood gases and nutritional parameters and the sense of wellbeing, but it does not improve the respiratory muscular function or exercise tolerance.

Dosis bajas de acetato de megestrol aumentan el peso y mejoran la nutrición de los pacientes con enfermedad pulmonar obstructiva crónica grave y pérdida de peso / Low doses of megestrol acetate increase weight and improve nutrition status in patients with severe chronic obstructive pulmonary disease and weight loss

Fundamento y objetivo:La pérdida de peso en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) grave indica mal pronóstico. El objetivo de este estudio es analizar la efectividad del acetato de megestrol (AM) como estimulante del apetito en estos pacientes. Pacientes y método: Ensayo clínico aleatorizado, doble ciego y controlado con placebo para estudiar el efecto de 320mg/d de AM durante 8 semanas sobre parámetros nutricionales, funcionales, analíticos y de calidad de vida en 38 pacientes con EPOC grave e índice de masa corporal (IMC) < 21kg/m2, o entre 21-25kg/m2 con pérdida involuntaria del 5% del peso en los últimos 3 meses. Resultados: A las 8 semanas, el peso aumentó en el grupo AM (2,3kg) respecto al control (0,1kg) (p < 0,04). Mejoraron con AM de forma significativa el grosor del pliegue tricipital (p < 0,04), los valores de prealbúmina (p<0,004), linfocitos (p<0,0006), fracción 3 del complemento (C3) (p<0,04), presión parcial de dióxido de carbono (PCO2) (p<0,007) y bicarbonato (p<0,008). No mejoraron las escalas MCR y SGRQ, la distancia recorrida en 6 minutos (6MWT) ni el índice BODE. La interleucina 6 (IL-6) y el factor de necrosis tumoral alfa (TNF-alfa) tampoco se modificaron en el grupo AM, pero aumentó la leptina (p<0,043). El AM mejoró la sensación de bienestar (p<0,02) y el apetito (p<0,008) frente al control. El índice de acontecimientos adversos fue similar en ambos grupos. Conclusiones: El AM incrementa de forma segura el peso y el apetito en pacientes con EPOC grave y pérdida de peso. Mejora los parámetros gasométricos, nutricionales y la sensación de bienestar, pero no la función muscular respiratoria o la tolerancia al ejercicio (AU)

Background and objective: Weight loss in patients with severe chronic obstructive pulmonary disease (COPD) is a prognostic bad factor. The objective of this study is to analyze the effectively of megestrol acetate (MA) to increase appetite of these patients. Patients and methods: Randomized double blind placebo controlled trial to study the effect of 160mg/bid of MA, for 8weeks, on nutritional, functional, analytical and quality of life parameters, in 38 patients with severe COPD and body mass index (BMI) < 21kg/m2, or between 21-25 with involuntary weight loss of 5% in the last 3 months. Results: At 8weeks, in the MA group the body weight increased (2.3kg) with respect to the control group (0.1kg) (p<0.04). MA improved significantly the triceps skin-fold thickness (p < 0.04), prealbumin (p<0.004), lymphocytes (p<0.0006), C3 (p<0.04), PCO2 (p<0.007) and bicarbonate levels (p<0.008). MA did not increase the MRC and SGRQ scales, the distance of 6MWT nor BODE index. The IL-6 and TNF alpha levels were not modified in the MA group, but leptin did increase (p<0.043). MA improved the sense of wellbeing (p<0.02) and the appetite (p<0.008), compared to the control group. Adverse effects were similar in both groups. Conclusions: MA safely increases the body weight and the appetite in severe COPD patients with weight loss. MA improves blood gases and nutritional parameters and the sense of wellbeing, but it does not improve the respiratory muscular function or exercise tolerance (AU)

Determinants of health-related quality of life in patients with pulmonary emphysema.

QUESTION OF THE STUDY: The aim of our study was to examine the relationship between health-related quality of life (HRQL), lung function parameters and intensity of dyspnea in order to determinate what variables influence the HRQL in patients with pulmonary emphysema. PATIENTS AND METHODS: Forty (mean aged 66+/-9) consecutive male patients with pulmonary emphysema were evaluated. All patients underwent spirometry, measurement of lung volumes, inspiratory and expiratory respiratory pressure (MIP and MEP), measurement of corrected carbon monoxide diffusing capacity (KCO), and 6-min walking test (6MWT). The scale of dyspnea by the baseline dyspnea index (BDI) and British Medical Council Research (MCR), and the quality of life by Chronic Respiratory Question Disease (CRQD) were also assessed. RESULTS: FEV1, FVC, 6MWT, KCO, MEP, MIP, BDI and MCR were correlated with dimensions of CRQD. Factor analysis reduced these variables to four factors, which accounted for 86.2% of the total variance: (1) airway obstruction, (2) dyspnea, (3) capacity of effort, (4) maximum static respiratory pressure. In the multiple regression model BDI and MEP explained the 64% of the total variance of CRQD. CONCLUSIONS: Quality of life measured by CRQD in patients with emphysema is predominantly determined by dyspnea, and in minor degree by expiratory muscle strength. Our results underscore the usefulness of dyspnea scales and MEP in the evaluation of HRQL in patients with emphysema.