Nívea Macedo Morales

Health-related quality of life of medical students

Medical Education 2010: 44 : 227–235

Long-term use of glatiramer acetate by 11 pregnant women with multiple sclerosis: a retrospective, multicentre case series.

AbstractBackground: Glatiramer acetate is a US FDA category B drug with regard to use by pregnant women with multiple sclerosis (MS). There are no data currently available for the continuous use of glatiramer acetate during pregnancy. Objective: To assess the risks and benefits of glatiramer acetate used throughout pregnancy among women with active MS. Design: Retrospective and multicentre case series. Settings: Outpatient services of academic and private institutions caring for patients with MS in Brazil. Patients: Eleven women with MS and their children were assessed. Intervention: Retrospective evaluation of women with MS who received glatiramer acetate continuously for at least 7 months during pregnancy. This evaluation was performed by the neurologist responsible for the patient. Children aged 1 year and over, born to mothers who received glatiramer acetate during pregnancy, were assessed using the Denver II developmental screening test. Main Outcome Measurements: Obstetric, neonatal and developmental outcomes. Results: No drug-related obstetric complications were observed. No specific drug-related malformations, neonatal complications or developmental abnormalities were observed in the children. Postnatal MS relapse rates remained significantly lower than antenatal rates in these patients. Conclusions: No deleterious effects from glatiramer acetate were observed in these pregnant women with MS or in their offspring. No increment in postnatal relapse rate was observed. However, the use of glatiramer acetate during pregnancy should be restricted to the most difficult cases, in which the benefits clearly outweigh the risks.

Evaluation of the health-related quality of life in elderly patients according to the type of hip fracture: femoral neck or trochanteric

OBJECTIVE To evaluate the effect the type of hip fracture (femoral neck or trochanteric) has on the Health-Related Quality of Life of elderly subjects. METHODS Forty-five patients with hip fractures (mean 74.30 +/- 7.12 years), 24 with a femoral neck fracture and 21 with a trochanteric fracture, completed the 36-item Short Form Health Survey (SF-36) at baseline and four months after fracture. The Health-Related Quality of Life scores were compared according to fracture type, undisplaced and displaced femoral neck fractures, and stable and unstable trochanteric fractures. RESULTS Compared to baseline, all patients scored lower in the physical functioning, role limitation-physical, bodily pain and vitality categories four months after the fracture had occurred. The SF-36 scores for all the scales did not differ significantly between patients with femoral neck versus trochanteric fractures, or between patients with displaced versus undisplaced femoral neck fractures and stable versus unstable trochanteric fractures. CONCLUSIONS The mental and physical quality of life of elderly patients with a hip fracture is severely impaired one month after fracture, with partial recovery by the end of the fourth month. The negative impact on the Health-Related Quality of Life did not differ significantly according to fracture type.

Parents' perception of health-related quality of life in children and adolescents with excess weight

Objective To evaluate the perception of parents or caregivers on the health-related quality of life (HRQOL) of children/adolescents with overweight/obesity and possible factors associated with this perception.

Quality of life of caregivers of overweight or obese children and adolescents

Este estudo avaliou a qualidade de vida relacionada a saude (QVRS) de cuidadores de criancas e adolescentes com sobrepeso e obesidade. Trezentos e sessenta cuidadores de criancas e adolescentes com idade entre 9 e 12 anos, com diagnostico de sobrepeso (n=96; idade media=11,1 anos), obesidade (n=62; idade media de 10,9 anos) e eutrofia (n=202; idade media de 10,7 anos), matriculadas em escolas publicas e particulares da cidade de Uberlândia (MG), foram convidados a responder o questionario The 36 item Short Form Questionnaire (SF-36). Os escores obtidos pelo questionario foram comparados segundo o indice de massa corporea (IMC) das criancas e adolescentes e nao foram encontradas diferencas significativas entre os cuidadores de criancas e adolescentes com sobrepeso, obesidade e eutrofia.Logo, os cuidadores de criancas e adolescentes com sobrepeso ou obesidade nao apresentam prejuizo na sua QVRS.This study evaluated the health-related quality of life (HRQL) of caregivers of overweight and obese children and adolescents. Three-hundred and sixty caregives of children and adolescents (ages ranging from 9 to 12 years) diagnosed with overweight (n=96; average age 11.1 years), obesity (n=62; average age 10.9 years) and eutrophy (n=202; average age 10.7 years), regular students of public and private schools in Uberlândia (Minas Gerais), were invited to answer The 36 item Short Form Questionnaire (SF-36). The scores obtained were compared according to the body mass index (BMI) of the children and adolescents, and no significant differences were found between caregivers of overweight, obese and etrophic children and adolescents. Hence, there is no harm to the HRQL of caregivers of overweight and obese children and adolescents.

Qualidade de vida de cuidadores de crianças e adolescentes com sobrepeso ou obesidade

Este estudo avaliou a qualidade de vida relacionada a saude (QVRS) de cuidadores de criancas e adolescentes com sobrepeso e obesidade. Trezentos e sessenta cuidadores de criancas e adolescentes com idade entre 9 e 12 anos, com diagnostico de sobrepeso (n=96; idade media=11,1 anos), obesidade (n=62; idade media de 10,9 anos) e eutrofia (n=202; idade media de 10,7 anos), matriculadas em escolas publicas e particulares da cidade de Uberlândia (MG), foram convidados a responder o questionario The 36 item Short Form Questionnaire (SF-36). Os escores obtidos pelo questionario foram comparados segundo o indice de massa corporea (IMC) das criancas e adolescentes e nao foram encontradas diferencas significativas entre os cuidadores de criancas e adolescentes com sobrepeso, obesidade e eutrofia.Logo, os cuidadores de criancas e adolescentes com sobrepeso ou obesidade nao apresentam prejuizo na sua QVRS.This study evaluated the health-related quality of life (HRQL) of caregivers of overweight and obese children and adolescents. Three-hundred and sixty caregives of children and adolescents (ages ranging from 9 to 12 years) diagnosed with overweight (n=96; average age 11.1 years), obesity (n=62; average age 10.9 years) and eutrophy (n=202; average age 10.7 years), regular students of public and private schools in Uberlândia (Minas Gerais), were invited to answer The 36 item Short Form Questionnaire (SF-36). The scores obtained were compared according to the body mass index (BMI) of the children and adolescents, and no significant differences were found between caregivers of overweight, obese and etrophic children and adolescents. Hence, there is no harm to the HRQL of caregivers of overweight and obese children and adolescents.

Functional Outcome of School Children With History of Global Developmental Delay

This study aimed to investigate the functional and developmental outcomes in school age children diagnosed with global developmental delay before 2 years old and to verify the association between their final diagnosis and environmental and biological factors. Forty-five Brazilian children (26 boys), mean age 95.84 (7.72) months, who attended regular school and were diagnosed with global developmental delay before they were 2 years old had their functions evaluated. Children with global developmental delay were diagnosed with several conditions at school age. Students with greater chances of receiving a diagnosis were those whose mothers were younger at the time their children were born (OR = 1.47, CI = 1.04-2.09, P = .03), who had impaired motor performance, specially balance (OR = 1.33, CI = 1.01-1.75, P = .04), and who needed help during cognitive and behavioral tasks at school (OR = 1.08, CI = 1.00-1.17, P = .048). Interdisciplinary evaluation contributed to defining the specific diagnosis and to identifying the necessity of specialized support.

EFEITO DO EXERCÍCIO FÍSICO SOBRE A SAÚDE E SOBRECARGA DE MÃES DE CRIANÇAS E ADOLESCENTES COM PARALISIA CEREBRAL

Introducao: A paralisia cerebral (PC) e considerada a incapacidade fisica mais comum na infância. Essa doenca afeta profundamente a saude e o bem-estar dos individuos acometidos e tambem pode influenciar multiplos aspectos da vida de seus cuidadores, especialmente as maes. Objetivo: Avaliar o efeito de um programa de exercicio resistido sobre a qualidade de vida relacionada a saude (QVRS) de maes de criancas e adolescentes com PC. Metodo: Vinte e duas maes sedentarias cuidadoras de criancas e adolescentes com PC, aptas a pratica de exercicio resistido, participaram de um programa de exercicio resistido de intensidade moderada, em 2 sessoes semanais durante 12 semanas. Todos os participantes responderam ao questionario de QVRS, Short Form Questionnaire (SF-36), a escala de sobrecarga Caregiver Burden Scale (CBS) e ao Inventario de Depressao de Beck (BDI) antes e apos o programa de intervencao. Os escores dos questionarios pre e pos-intervencao foram comparados pelo teste de Wilcoxon e a magnitude das diferencas foi medida pelo tamanho do efeito. Resultados: A mediana de idade das maes foi de 41 anos e variou de 18 a 58 anos. A mediana da idade das criancas/adolescentes foi de 14 anos, variando 3 a 21 anos. Apos a intervencao foram encontrados aumentos significativos nos escores do SF-36 (p < 0,05), exceto nos dominios aspectos fisicos e aspectos emocionais, que ja obtiveram pontuacao maxima pre-intervencao. Os escores do CBS e do BDI tiveram reducao significativa pos-intervencao (p < 0,05). Conclusao: A pratica regular de exercicios resistidos tem impacto positivo sobre a QVRS, a percepcao de sobrecarga e a intensidade de sintomas depressivos de maes cuidadoras de criancas e adolescentes com PC.

Calidad de vida de cuidadores de niños y adolescentes con sobrepeso o obesidad

Este estudo avaliou a qualidade de vida relacionada a saude (QVRS) de cuidadores de criancas e adolescentes com sobrepeso e obesidade. Trezentos e sessenta cuidadores de criancas e adolescentes com idade entre 9 e 12 anos, com diagnostico de sobrepeso (n=96; idade media=11,1 anos), obesidade (n=62; idade media de 10,9 anos) e eutrofia (n=202; idade media de 10,7 anos), matriculadas em escolas publicas e particulares da cidade de Uberlândia (MG), foram convidados a responder o questionario The 36 item Short Form Questionnaire (SF-36). Os escores obtidos pelo questionario foram comparados segundo o indice de massa corporea (IMC) das criancas e adolescentes e nao foram encontradas diferencas significativas entre os cuidadores de criancas e adolescentes com sobrepeso, obesidade e eutrofia.Logo, os cuidadores de criancas e adolescentes com sobrepeso ou obesidade nao apresentam prejuizo na sua QVRS.This study evaluated the health-related quality of life (HRQL) of caregivers of overweight and obese children and adolescents. Three-hundred and sixty caregives of children and adolescents (ages ranging from 9 to 12 years) diagnosed with overweight (n=96; average age 11.1 years), obesity (n=62; average age 10.9 years) and eutrophy (n=202; average age 10.7 years), regular students of public and private schools in Uberlândia (Minas Gerais), were invited to answer The 36 item Short Form Questionnaire (SF-36). The scores obtained were compared according to the body mass index (BMI) of the children and adolescents, and no significant differences were found between caregivers of overweight, obese and etrophic children and adolescents. Hence, there is no harm to the HRQL of caregivers of overweight and obese children and adolescents.