Background and PurposeTo assess the psychometric properties of the PAM13 Brazilian-Portuguese (PAM13-B) among outpatients with chronic diseases.Methods513 adults participated, diagnosed with a chronic disease for more than 6 months, under outpatient monitoring. Reliability was tested using internal consistency and test-retest reliability. Construct validity was verified through different techniques (correlation between activation and self-esteem measures, anxiety, depression and health status), known-groups validity and dimensionality by means of confirmatory factor analysis. Significance was set at 0.05.ResultsThe PAM13-B presented appropriate results for internal consistency (α = 0.83) and test–retest reliability (intraclass correlation coefficient [ICC] = 0.81). A moderate correlation was found between activation and self-esteem only (r = 0.43, p < 0.001). The one-dimensional structure was not confirmed in the sample analyzed.ConclusionsIn the study sample, the version PAM13-B demonstrated its reliability and validity, but with a two-factor structure.
Objective: To compare the distributions of measurements of the Dutch Fatigue Scale (DUFS), Dutch Exertion Fatigue Scale (DEFS), and Fatigue Pictogram tools, according to the New York Heart Association (NYHA) Functional Classification and left ventricular ejection fraction (LVEF). Method: Methodological, cross-sectional study with 118 patients with heart failure. Variance analysis, Pearson's correlation, and Fisher's exact tests were carried out, with a significance level of 0.05. Results: There was an increase in the DUFS and DEFS means with worsening of the NYHA-FC (p<0.001, for both tools). Correlations among the LVEF resulted in positive and weak magnitude for the DEFS (r=0.18; p=0.05) and for the DUFS (r=0.16; p=0.08). Just the item A on the Fatigue Pictogram had an association with the NYHA-FC (p<0.001) and the LVEF (p=0.03). Conclusion: Three tools detected worsening in fatigue levels according to the illness severity assessed by the NYHA-FC.
Results have shown that the adapted version is reliable and valid, although the theoretical model cannot be explained in a single dimension.
Objective:To identify and describe the instruments used to assess patients' expectations toward spine surgery. Method: An integrative review was carried out in the databases PubMed, CINAHL, LILACS and PsycINFO. Results: A total of 4,402 publications were identified, of which 25 met the selection criteria. Of the studies selected, only three used tools that had confirmed validity and reliability to be applied; in five studies, clinical scores were used, and were modified for the assessment of patients' expectations, and in 17 studies the researchers developed scales without an adequate description of the method used for their development and validation. Conclusion: The assessment of patients' expectations has been methodologically conducted in different ways. Until the completion of this integrative review, only two valid and reliable instruments had been used in three of the selected studies. DESCRIPTORSPatients; Spinal Fusion; Spine; General Surgery; Review.Instruments used in the assessment of expectation toward a spine surgery: an integrative review Instrumentos utilizados na avaliação da expectativa diante do tratamento cirúrgico da coluna vertebral: revisão integrativa Instrumentos utilizados en la evaluación de la expectación ante el tratamiento quirúrgico de la columna vertebral: revisión integrativa
Objective: To evaluate the expectations of patients awaiting surgical treatment of lumbar canal stenosis and the association of Health-Related Quality of Life (HRQoL) with symptoms of anxiety and depression. Methods: The sample included 49 patients from a university hospital. HRQoL was assessed by the Oswestry Disability Index (ODI) and 36-item Medical Outcomes Survey Short Form (SF-36) and symptoms of anxiety and depression by the Hospital Anxiety and Depression Scale (HADS). Expectations were investigated by means of questions used in international studies. Data were analyzed descriptively and by Student's t test. Results: The mean time of disease progression was 34.5 months, the mean age was 58.8 years and 55.1% of the patients were women. Most patients had the expectation of improving with surgical treatment and 46.9% expected to be "much better" with regard to leg pain, walking ability, independence in activities and mental well being. The scores of anxiety and depression were respectively, 34.7% and 12.2%. We observed statistically significant differences between the groups with and without anxiety in the domains: General Health, Mental Health, and Vitality. Between the groups with and without depression there were statistically significant differences in the General Health and Mental Health domains. Conclusion: Patients showed great expectation to surgical treatment and the symptoms of anxiety and depression were related to some domains of HRQoL. Thus, the study contributes to broaden our knowledge and we can therefore guide the patients as to their expectations with respect to the real possibilities arising from surgery.
e16153 Background: Surgical castration is the gold standard for hormonal deprivation in metastatic prostate cancer, nevertheless this simple procedure may involve on psychological consequences. According to many studies, it's possible to achieve ischemic lesion in liver tissue beyond sclerosants agents (like alcohol or glycerol), however there are very few reports about the effects of such agents in testicles. These study objectives evaluating histological and morphological characteristics of rat testicles submitted to percutaneous administration of sclerosants agents and also, to compare serum testosterone levels between rats submitted to a surgical orchiectomy or percutaneous injection. Methods: Twenty four rats have been shared in four groups with eight animals each. In group O, rats were submitted to bilateral orchiectomy. In the other groups, rats were submitted to percutaneous administration of a sclerosant agent and orquiectomy after thirty days as follows: Group A, Alcohol injection; Group G - Glycerol; Group S - Saline solution (control group). Serum testosterone level was measured after 15 and 30 days in each animal. Results: There is no complication or death in this series. Rats of groups A and G comparing to control group (group S) had smaller testicular weight (0,8±0,1g; 1±0,2g versus 3,15±0,1g p<0,0000001) and smaller testicular volume (0,16±0,05mL; 0,23±0,11mL versus 2,38±0,05mL p<0,0000001). Testosterone serum levels were as similar in groups A and G (sclerosis) as in group O (orchiectomy). After 15 days testosterone levels were A=2,9±0,74 ng\dL; G=2,8±0,39 ng\dL versus O=2,91±1,46ng\dL p=0,99; and after 30 days were A=2,58±0,4ng\mL, G=2,78±0,3ng\mL versus O=2,7±0,95ng\mL p=0,895). Histological findings show extensive necrosis beyond macrophagic infiltration and no Leydig cells visualized.There is no significantly statistical difference between Alcohol and Glycerol groups. Conclusions: Percutaneous administration of alcohol or glycerol in rats testicles causes atrophy and reduces testosterone serum levels like it occurs after surgical castration. More studies are necessary to evaluate if this minimally invasive procedure may be an alternative to surgical orchiectomy in advanced prostate cancer. No significant financial relationships to disclose.
Ao meu pai, Paulo, por ser um exemplo de pessoa integra e esforçada. Obrigado, querido pai, por estar ao meu lado e por tudo isso que estou construindo a cada dia.À minha mãe, Neuza, pelo amor incondicional, conselhos e motivações. Agradeço por ter uma mãe tão digna que não mede esforços para me ver feliz.Ao meu noivo, João Vitor, pelo amor, compreensão, incentivo, entendimento e paciência. Obrigado por fazer parte da minha vida e deste momento tão importante.À minha irmã e ao meu cunhado, Estela e Mauri, e as minhas sobrinhas, Aymée e Alicia, pelas orações. Agradeço pelo amor e carinho que vocês têm por mim.À minha Orientadora, Rosana Aparecida Spadoti Dantas, por me dar a oportunidade de crescer profissionalmente ao seu lado. Agradeço por todos os ensinamentos. Obrigado, também, pela confiança, carinho e respeito doados neste processo de aprendizagem.À amiga e professora, Carina Aparecida Marosti Dessote, pelo tempo despendido nesta pesquisa. Agradeço o apoio, conselhos e conversas que compartilhamos durante esta jornada. Obrigado por ter sido uma amiga.Ao Professor Dr. Carlos Fernando Pereira da Silva Herrero, pelas considerações e apoio durante a realização desta pesquisa.À minha querida e companheira amiga, Eliana de Cássia Arantes, por ter me acolhido neste grupo de pesquisa como uma irmã e pelo carinho que criamos neste tempo.À amiga, Rejane Kiyomi Furuya, pelas considerações, conselhos e, principalmente, pelo exemplo de pessoa integra e pesquisadora exemplar.À amiga, Lilian Maria Pacola, obrigado por me receber e me ensinar os primeiros passos, por ter me aceitado nesta pesquisa e ter torcido por mim em cada momento.Às minhas colegas do Grupo de investigação em reabilitação e qualidade de vida (GIRQ), pelo companheirismo. Obrigado por me ensinar o significado da palavra coletivo, e transpor do profissional ao pessoal.Ao Departamento de Biomecânica, Medicina e Reabilitação do Aparelho Locomotor do Hospital das Clínicas de Ribeirão Preto, em especial Professor Dr. Helton Defino, que não mediu esforços para realização desta pesquisa.Aos pacientes desta pesquisa, agradeço por terem participado e pela colaboração durante a coleta de dados. Obrigado por terem me mostrado a importância do ouvir. with lumbar and cervical stenosis, respectively); a 10-item question regarding one's expectations towards improving the symptoms and a Visual Numeric Analogue Scale (expectation of the overall health condition after the surgical treatment). Data were submitted to descriptive analysis and to the Student's t and Chi-Square tests. The adopted significance level was 0.05. Results. Fifty-four patients were evaluated (32 with lumbar and 22 with cervical stenosis), 68.2% of which were men in the cervical stenosis group and 50% in the lumbar stenosis group. The mean ages were 56. (62,5 vs. 49,5; p=0,02) y Capacidad Funcional (20,1 vs. 32,0; p=0,01). No existieron diferencias entre los grupos en relación a las medidas de síntomas de ansiedad y depresión. La media de limitación funcional para el grupo con estenosis lumbar fue d...
e16156 Background: Radical Retropubic Prostatectomy (RRP) is one of the most frequent surgery performed by urologists and it has been accompanied by an improvement in surgical results such as duration of hospitalization. In this study we prospectively analyzed the viability of an early discharge from hospital after an open RRP. Methods: There were 37 consecutive RRP performed by the same surgeon from March 1st to August 30th of 2007. All of the patients were informed about the possibility of discharge from hospital in less than 30 hours after the surgery. The procedures were performed using a modified Walsh technique under combined anesthesia (general anesthesia and epidural anesthesia p analgesia with morphine) through midline incision initiated approximately 5,0 centimeters below of umbilicus. Obturatory lymphadenectomy was performed in only three patients and Exclusion criteria included patients with an Body Mass Index above 30, patients who refused to participate in the study and those with prior indication to go to the intensive care unit postoperatively. Respiratory and motor physiotherapy were initiated soon after return from the surgical block. Criteria to discharge from hospital included: good acceptance of oral diet, no need for parenteral analgesics; urinary volume > 75 ml/hour; no Foley catheter obstruction; absence of gross hematuria; urine drainage < 150 ml/24 hours. Results: 32 patients (86%) had discharged from hospital in less than 30 hours after the surgery: there were 25 patients (68%) discharged in the first 24 hours after surgery and 07 patients discharged between 24 and 30 hours after surgery. There wasn't any readmission in a period of 15 days after discharge from hospital. There were only three complications (8%)on days 07, 10 and 13 and 01 patient need to wash an obstructed Foley catheter with blood clot at postoperative day four. Conclusions: By means of simple criteria it is possible to early discharge patients after an open RRP in selected patients and it may represent a significant reduction in costs. No significant financial relationships to disclose.
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