Translation into Portuguese language (Brazil), transcultural adaptation and validation of the quality of life questionnaire in female pattern hair loss (WAA-QoL-BP)

Abstract: Background: Female pattern hair loss (FPHL) is a common complaint in adult women and inflicts major impact in quality of life, however, there is no specific questionnaire available in Portuguese for such evaluation. Objectives: Translation into Brazilian Portuguese, cultural adaptation and validation of the WAA-QoL (Women's Androgenetic Alopecia Quality of Life Questionnaire). Methods: Methodological study. After authorization by the author, cultural (linguistic) translation and adaptation to Portuguese of the WAA-QoL questionnaire were carried out. The translated version (WAA-QoL-BP) and DLQI (Dermatology Life Quality index) were submitted to patients with FPHL for concurrent validation. Twenty patients were reevaluated to assess temporal stability. Results: A total of 116 patients with APF were evaluated, the mean age (SD) was 47 (14) years, and 89 (76%) patients were classified as grades II and III (Sinclair). There was high internal consistency: Cronbach´s alpha was 0.97 for the WAA-QoL-BP and 0.87 for the DLQI. The correlation between WAA-QoL and DLQI resulted in (rho) 0.81 (p <0.01). The intraclass correlation coefficient for complete agreement of WAA-QoL-BP was 0.95 (p <0.01) in the test-retest comparison. Study Limitations: Sampling of patients only from the State of São Paulo. Conclusions: A Brazilian version for WAA-QoL was translated and adapted, which proved to be valid and consistent.

Translation into Portuguese language (Brazil), transcultural adaptation and validation of the quality of life questionnaire in female pattern hair loss (WAA-QoL-BP).

BACKGROUND: Female pattern hair loss (FPHL) is a common complaint in adult women and inflicts major impact in quality of life, however, there is no specific questionnaire available in Portuguese for such evaluation. OBJECTIVES: Translation into Brazilian Portuguese, cultural adaptation and validation of the WAA-QoL (Women's Androgenetic Alopecia Quality of Life Questionnaire). METHODS: Methodological study. After authorization by the author, cultural (linguistic) translation and adaptation to Portuguese of the WAA-QoL questionnaire were carried out. The translated version (WAA-QoL-BP) and DLQI (Dermatology Life Quality index) were submitted to patients with FPHL for concurrent validation. Twenty patients were reevaluated to assess temporal stability. RESULTS: A total of 116 patients with APF were evaluated, the mean age (SD) was 47 (14) years, and 89 (76%) patients were classified as grades II and III (Sinclair). There was high internal consistency: Cronbach´s alpha was 0.97 for the WAA-QoL-BP and 0.87 for the DLQI. The correlation between WAA-QoL and DLQI resulted in (rho) 0.81 (p <0.01). The intraclass correlation coefficient for complete agreement of WAA-QoL-BP was 0.95 (p <0.01) in the test-retest comparison. STUDY LIMITATIONS: Sampling of patients only from the State of São Paulo. CONCLUSIONS: A Brazilian version for WAA-QoL was translated and adapted, which proved to be valid and consistent.

Psoríase pustulosa palmoplantar como efeito paradoxal do uso de adalimumabe: relato de caso / Palmoplantar pustular psoriasis as a paradoxical effect of adalimumab use: case report

Contexto: A psoríase é uma doença crônica com taxa de prevalência variável no mundo, e com uma infinidade de opções terapêuticas para o seu tratamento. Para as formas mais graves ou associadas a outras comorbidades, vem se destacando o uso dos imunobiológicos. Dentre estes, os antagonistas do fator de necrose tumoral alfa apresentam grande espectro de uso em todo o território nacional. Descrição do caso: Homem de 36 anos de idade, tabagista, fez uso de infliximabe por dois anos devido a espondilite anquilosante, com insucesso terapêutico, mas sem efeitos adversos. Devido à má resposta clínica, a medicação foi substituída por adalimumabe e, após quatro anos de uso deste imunobiológico, o paciente evoluiu com lesões eritematosas-descamativas encimadas por pústulas estéreis na região palmoplantar. Não tinha história pessoal ou familiar de psoríase, sendo realizado o diagnóstico de efeito paradoxal ao uso da medicação imunobiológica, caso raro. Discussão: Os efeitos adversos dos imunobiológicos incluem infecções, reativação de infecções latentes, insuficiência cardíaca, efeito paradoxal. Este último consiste no aparecimento de psoríase em pacientes que usavam imunobiológicos devido a outras doenças de base; exacerbação de uma psoríase já em tratamento; ou surgimento de novas formas de psoríase. São reações raras, porém causam grande prejuízo na qualidade de vida do paciente, podendo até interferir no tratamento em andamento. Conclusões: Os efeitos paradoxais são divididos entre lesões de novo nos pacientes ou exacerbação de uma patologia previamente existente. Isso dificulta o diagnóstico do efeito adverso e, muitas vezes, retarda o tratamento do paciente. Buscamos, com este relato, alertar os médicos sobre a doença e seu tratamento.

Beyond Fifty Years of Millard's Rotation-Advancement Technique in Cleft Lip Closure: Are There Many "Millards"?

In 1955, Millard developed the concept of rotation-advancement flap to treat cleft lip. Almost 6 decades later, it remains the most popular technique worldwide. Since the technique evolved and Millard published many technical variations, we decided to ask 10 experienced cleft surgeons how they would mark Millard's 7 points in two unilateral cleft lip patient photos and compared the results. In both pictures, points 1 and 2 were marked identically among surgeons. Points 3 were located adjacent to each other, but not coincident, and the largest distances between points 3 were 4.95 mm and 4.03 mm on pictures 1 and 2, respectively. Similar patterns were obtained for points 4, eight of them were adjacent, and the greatest distance between the points was 4.39 mm. Points 5 had the most divergence between the points among evaluators, which were responsible for the different shapes of the C-flap. Points 6 also had dissimilar markings, and such difference accounts for varying resection areas among evaluators. The largest distances observed were 11.66 mm and 7 mm on pictures 1 and 2, respectively. In summary, much has changed since Millard's initial procedure, but his basic principles have survived the inexorable test of time, proving that his idea has found place among the greatest concepts of modern plastic surgery.