Psychosocial indicators of primary congenital glaucoma and filtering surgeries impacts on children and family's quality of life.

PURPOSE: To identify psychosocial indicators and evaluate the filtering surgeries impacts on quality of life (QOL) of children with primary congenital glaucoma (PCG) and their family. METHODS: Parents of children with bilateral PCG who underwent filtering surgery were included. Data were collected through: (a) psychological inquiry to determine psychosocial indicators; (b) Children's Visual Function Questionnaire (CVFQ). The associations between the CVFQ scores and visual acuity, intraocular pressure, optic disk cupping, horizontal corneal diameter, axial length, number of surgeries, and hypotensive eye drops were investigated. The statistical significance level was considered as p ⩽ 0.05. RESULTS: The mean age of the nine mothers interviewed and their children (six boys and three girls) was 29 ± 5 years and 35 ± 18 months, respectively. The psychosocial indicators determined were: emotional impact of the diagnosis, disease knowledge, mother and family's feelings on facing the surgical treatment, surgical result comprehension, treatment adherence, child's emotional and behavioral reactions, social support, and future expectations. In CVFQ analysis, QOL score was strongly associated with visual acuity (r = -0.79; p = 0.01). Besides the treatment score was correlated to intraocular pressure (r = -0.68; p < 0.05), optic disk cupping (r = -0.85; p = 0.03), and corneal diameter (r = -0.69; p = 0.02). Correlations were not found for number of surgeries and eye drops. CONCLUSIONS: This study confirmed the PCG surgical treatment impact on QOL and determined psychosocial indicators which may favor the suitable actions in psychological treatment and follow-up of the children and families.

Adaptações crônicas sobre a função pulmonar em indivíduos infectados pela leishmaniose visceral / Chronic adaptations on lung function in individuals infected with Visceral Leishmaniasis

INTRODUÇÃO: Apesar de escassas, as principais alterações cardiopulmonares verificadas durante a infecção com Leishmaniose Visceral (LV) se referem a alterações histológicas e imunológicas e poucos relatos de repercussões funcionais. OBJETIVO: Verificar e analisar a existência de adaptações crônicas na função pulmonar de indivíduos assintomáticos previamente infectados pela LV. MATERIAIS E MÉTODOS: Trata-se de um estudo do tipo transversal descritivo, para o qual foram selecionados todos os indivíduos que contraíram LV em Parnaíba (Piauí, Brasil) entre 2007 e 2010 de acordo com informações do Setor de Epidemiologia do município. De um total de 20 indivíduos com confirmação parasitológica de LV, foram avaliados nove com idades entre 18 e 62 anos entre setembro e outubro de 2011. Excluíram-se indivíduos que não apresentaram diagnóstico parasitológico de LV, doenças ou sintomas cardiorrespiratórios recentes, usuários crônicos de drogas ilícitas e gestantes. Foram realizadas medidas antropométricas e testes de espirometria e de manovacuometria conforme especificações da American Thoracic Society / European Respiratory Society (ATS/ERS). Para comparação das médias dos valores medidos e preditos foi realizado Teste t Student para dados dependentes. O nível de significância adotado foi p < 0,05. RESULTADOS: A Capacidade Vital Forçada (CVF) (3,8 ± 0,9 vs. 4,2 ± 0,8 L) e o Volume Expiratório Forçado no primeiro segundo (VEF1) (3,3 ± 0,7 vs. 3,5 ± 0,7 L) foram estatisticamente menores do que os valores medidos (p < 0,01). A relação VEF1/CVF (87,6 vs. 84,4%) foi maior nos valores medidos (p = 0,08). CONCLUSÃO: Apesar de o número de indivíduos avaliados ser pequeno, os dados indicam que a infecção por LV parece desenvolver adaptações crônicas sobre o sistema respiratório, resultando em volumes pulmonares significativamente diminuídos e uma tendência a padrões respiratórios restritivos.

INTRODUCTION: Although scarce, the main changes observed during cardiopulmonary infection with Visceral Leishmaniasis (VL) refer to histological and immunological and few reports of functional repercussions. OBJECTIVE: To verify and analyze the existence of chronic adaptations in pulmonary function in individuals who have been infected by VL. MATERIALS AND METHODS: It is a descriptive cross-sectional study, which evaluated nine people aged between 18 and 62 years. Anthropometric measurements and spirometry and manometer tests were performed according to the specifications of the American Thoracic Society / European Respiratory Society (ATS/ERS). For comparison of the measured and predicted values was performed Student t test for dependent data. The level of significance was p < 0.05. RESULTS: The Forced Vital Capacity (FVC) (3,8 ± 0,9 ± 0,8 vs. 4,2 l) and Forced expiratory volume in first second (FEV1) (3,3 ± 0,7 ± 0,7 vs. 3,5 l) were statistically smaller in measured values (p < 0.05). The FEV1/FVC ratio (87.6 vs. 84.4%) was higher in the measured values (p = 0.08). CONCLUSION: The data indicate that infection with VL seems to develop chronic adaptations on the respiratory system, resulting in decreased lung volumes and a tendency to restrictive breathing patterns.