Samantha Mucci

Qualidade de vida e adesão ao tratamento anti-retroviral de pacientes portadores de HIV

Foi realizada uma revisao da literatura cientifica sobre adesao terapeutica a highly active antiretroviral therapy e sobre a qualidade de vida dos pacientes portadores do HIV, indexada no MEDLINE no periodo entre 1998 e 2008. Foram incluidos estudos em pacientes maiores de 18 anos, publicados em portugues, espanhol ou ingles. Foram excluidos estudos de revisao, relatos de caso e cartas. Dos 21 estudos encontrados, 12 foram incluidos (tres ensaios clinicos, tres coortes prospectivos, seis transversais). A relacao entre qualidade de vida e adesao terapeutica permanece controversa, embora estudos descritivos apontem a possibilidade de uma relacao positiva. Os resultados podem ter sido influenciados por caracteristicas especificas dos ensaios clinicos descritos e mostram nao haver consenso sobre o impacto da adesao terapeutica sobre a qualidade de vida dos pacientes.

Revisão sistemática sobre as evidências de associação entre zumbido e depressão

UNLABELLED Tinnitus has been associated with several psychiatric disorders, however there are still several questions regarding such association. OBJECTIVE To assess the scientific evidence on the associations between symptoms of depression, depression, and tinnitus. METHOD A systematic review was performed using PubMed, Lilacs, and SciELO scientific databases. This review included studies published in Portuguese, Spanish, or English correlating tinnitus with depression; letters to the editor and case reports were excluded. RESULTS A total of 64 studies were identified, of which only 20 met the inclusion criteria and only 2 were case-control clinical trials. The majority of the studies (n = 18) found that depression is associated with tinnitus, either as a predisposition - resulting in poor adaptation to tinnitus or as a consequence of severe disease. CONCLUSION An overall assessment of all of the selected studies suggests at least 3 possible associations between depression and tinnitus: depression affecting tinnitus, tinnitus predisposing individuals to depression, and tinnitus appearing as a comorbidity in patients with depression. There is a high prevalence of depressive symptoms in individuals with tinnitus, but the mechanisms by which depression and tinnitus mutually interact, are not fully understood.

Quality of life and adherence to HAART in HIV-infected patients

Foi realizada uma revisao da literatura cientifica sobre adesao terapeutica a highly active antiretroviral therapy e sobre a qualidade de vida dos pacientes portadores do HIV, indexada no MEDLINE no periodo entre 1998 e 2008. Foram incluidos estudos em pacientes maiores de 18 anos, publicados em portugues, espanhol ou ingles. Foram excluidos estudos de revisao, relatos de caso e cartas. Dos 21 estudos encontrados, 12 foram incluidos (tres ensaios clinicos, tres coortes prospectivos, seis transversais). A relacao entre qualidade de vida e adesao terapeutica permanece controversa, embora estudos descritivos apontem a possibilidade de uma relacao positiva. Os resultados podem ter sido influenciados por caracteristicas especificas dos ensaios clinicos descritos e mostram nao haver consenso sobre o impacto da adesao terapeutica sobre a qualidade de vida dos pacientes.

Adaptação cultural do Chronic Liver Disease Questionnaire (CLDQ) para população brasileira

The aims of this study were the English-to-Portuguese translation and cross-cultural adaptation of the Chronic Liver Disease Questionnaire (CLDQ) for use in Brazil. The instrument was translated from the original language, English, to Portuguese by the authors, and was subsequently reviewed and evaluated as to the degree of difficulty of the translation and equivalence, by bilingual translators. The questionnaire was then applied to 20 randomly selected patients with chronic liver disease. Patients had no difficulty understanding the questionnaire and considered all the questions applicable. The cultural equivalence of the CLDQ was demonstrated, without requiring changes in the original translation. The translation into Portuguese and cross-cultural adaptation of the CLDQ successfully completed this important stage for its validation and use in Brazil.

Validation of the Brazilian version of Chronic Liver Disease Questionnaire.

PurposeThe aim of this study was to validate the Chronic Liver Disease Questionnaire (CLDQ) for use in Brazilian population.MethodA total of 200 patients with chronic liver disease and varying disease severity answered a socio-demographic questionnaire, t CLDQ, and the Medical Outcome Study Short Form 36 (SF-36). Patients returned in 1–15 days to answer CLDQ again. The Cronbach’s alpha of the total CLDQ score was 0.95 and fluctuated between 0.69 and 0.83 in its six domains.ResultsThe intra-class correlation between total CLDQ scores in two evaluations was 0.97 and in all domains was >0.93. CLDQ was moderately correlated with the SF-36, 0.63 (total CLDQ vs. vitality, SF-36), 0.62 (CLDQ and mental health, SF-36), 0.62 (preoccupation, CLDQ, vs. General Health, SF-36), 0.59 (fatigue, CLDQ, vs. vitality, SF-36), 0.59 (activity, CLDQ, vs. vitality, SF-36), and 0.59 (fatigue, CLDQ, vs. mental health, SF-36). The highest scores were found in non-cirrhotic group. Child A patients had higher average scores than Child B and C groups in all domains, while patients with MELD <15 scored higher than patients with MELD ≥15.ConclusionCLDQ-BR was validated in Brazilian population and was appropriate for use in patients with liver disease of different etiologies and degrees of severity.

Systematic review of evidence on the association between personality and tinnitus

INTRODUCTION The scientific literature demonstrates that personality traits are associated with the individuals adaptation to chronic diseases, and can be an important factor in the etiology and prognosis of physical illness. Some studies indicate that personality characteristics may influence the perception of tinnitus. OBJECTIVE To assess the scientific evidence of the association between tinnitus and personality. METHODS A systematic review of the following databases: PubMed, SciELO, LILACS, and Web of Knowledge. Only studies of patients older than 18 years published in English, Portuguese, or Spanish that established an association between tinnitus and personality were selected. RESULTS Seventeen of the 77 articles found were selected: 13 cross-sectional studies, two longitudinal studies, one validation study, and one birth cohort study. The samples ranged from 27 to 970 patients. CONCLUSION Some personality traits, especially neuroticism, psychasthenia, and schizoid aspects, may be associated with tinnitus perception and with the annoyance due to this symptom.

Saúde mental nas práticas em saúde - a experiência do PROLIG

This paper presents the experience of the Psychosocial Service of Integrated Attention in Health (SAPIS) in a consultation-liaison psychiatry program (called PROLIG). The SAPIS was implemented in June 2002 at the Sao Paulo Hospital (HSP) to promote a broad attention to general and specific hospital psychosocial needs and also to reorganize the inclusion of mental health professionals in ambulatories and wards. This paper aims at describing the role of psychologists as mental health liaison professionals attending specific demands at these units of HSP. Their task involves providing psychological assistance to the patient and his family, as well as being a mental health specialist to the multi-professional team. Nevertheless, some difficulties have been found to implement and maintain these proposals. Concluding, psychologists as mental health liaison professionals promote changes in the health care offered by this institution; however, a deeper reflection and engagement of this institution as well as an implementation of health care policies are demanded to enable structural changes for the construction of an integral and integrated effective practice.

Development of Routine Dental Care for Liver Transplant Outpatients

BACKGROUND Liver transplantation has become commonplace for patients with end-stage liver disease. The liver is a bodily organ of great importance, and its dysfunction can cause significant complications throughout the body. Patients with hepatic disease should be able to acquire knowledge of the physiology of the liver via the dental profession, and it is also necessary to modify some aspects of dental treatment even in healthy patients. Problems such as excessive bleeding and hepatotoxicity caused by some of the drugs used in dental treatment can lead to a decrease in systemic health. Otherwise, patients with liver disease will have poorer oral health than the general population. Thus, it is important to have well-established routine dental care in this patient group and offer management of oral health in view of the effects of liver disease. METHODS The objective of this work was to undertake a bibliographic review of the dental approaches to patients with liver disease and liver transplant recipients and to propose a dental care routine for such patients in an outpatient setting. RESULTS A search was carried out on the main scientific databases (PubMed, Medline, and SciELO) for publications related to this subject and, particularly those published after 2010. The articles selected describe poor oral hygiene among patients, independent of the etiology of their liver disease. These patients also had a high index of xerostomia, caries, periodontal disease, apical lesions, and fungical infections. To control bleeding during and after surgery, hemostatic measures must be understood and adopted. CONCLUSION There are no data about routine dental care among liver disease/transplantation patients. Thus, our findings will hopefully encourage other services to structure their approaches and consider enhancing their dental care protocols for patients with liver-related complications.

Calidad de vida y adhesión al tratamiento antiretroviral de pacientes portadores de VIH

Foi realizada uma revisao da literatura cientifica sobre adesao terapeutica a highly active antiretroviral therapy e sobre a qualidade de vida dos pacientes portadores do HIV, indexada no MEDLINE no periodo entre 1998 e 2008. Foram incluidos estudos em pacientes maiores de 18 anos, publicados em portugues, espanhol ou ingles. Foram excluidos estudos de revisao, relatos de caso e cartas. Dos 21 estudos encontrados, 12 foram incluidos (tres ensaios clinicos, tres coortes prospectivos, seis transversais). A relacao entre qualidade de vida e adesao terapeutica permanece controversa, embora estudos descritivos apontem a possibilidade de uma relacao positiva. Os resultados podem ter sido influenciados por caracteristicas especificas dos ensaios clinicos descritos e mostram nao haver consenso sobre o impacto da adesao terapeutica sobre a qualidade de vida dos pacientes.

Salud mental en las prácticas en salud: la experiencia del PROLIG

This paper presents the experience of the Psychosocial Service of Integrated Attention in Health (SAPIS) in a consultation-liaison psychiatry program (called PROLIG). The SAPIS was implemented in June 2002 at the Sao Paulo Hospital (HSP) to promote a broad attention to general and specific hospital psychosocial needs and also to reorganize the inclusion of mental health professionals in ambulatories and wards. This paper aims at describing the role of psychologists as mental health liaison professionals attending specific demands at these units of HSP. Their task involves providing psychological assistance to the patient and his family, as well as being a mental health specialist to the multi-professional team. Nevertheless, some difficulties have been found to implement and maintain these proposals. Concluding, psychologists as mental health liaison professionals promote changes in the health care offered by this institution; however, a deeper reflection and engagement of this institution as well as an implementation of health care policies are demanded to enable structural changes for the construction of an integral and integrated effective practice.