Purpose The use of patient-orientated questionnaires is of utmost importance in assessing the outcome of spine surgery. Standardisation, using a common set of outcome measures, is essential to aid comparisons across studies/in registries. The Core Outcome Measures Index (COMI) is a short, multidimensional outcome instrument validated for patients with spinal disorders. This study aimed to produce a Brazilian-Portuguese version of the COMI. Methods A cross-cultural adaptation of the COMI into Brazilian-Portuguese was carried out using established guidelines. 104 outpatients with chronic LBP ([3 months) were recruited from a Public Health Spine Medical Care Centre. They completed a questionnaire booklet containing the newly translated COMI, and other validated symptomspecific questionnaires: Oswestry Disability Index (ODI) and Roland Morris disability scale (RM), and a pain visual analogue scale. All patients completed a second questionnaire within 7-10 days to assess reproducibility. ResultsThe COMI summary score displayed minimal floor and ceiling effects. On re-test, the responses for each individual domain of the COMI were within 1 category in 98% patients for the domain 'function', 96% for 'symptom-specific well-being', 97% for 'general quality of life', 99% for 'social disability' and 100% for 'work disability'. The intraclass correlation coefficients (ICC 2,1 ) for COMI pain and COMI summary scores were 0.91-0.96, which compared favourably with the corresponding values for the RM (ICC, 0.99) and ODI (ICC, 0.98). The standard error of measurement for the COMI was 0.6, giving a ''minimum detectable change'' (MDC95%) of approximately 1.7 points i.e., the minimum change to be considered ''real change'' beyond measurement error. The COMI scores correlated as hypothesised (Rho, 0.4-0.8) with the other symptom-specific questionnaires. Conclusions The reproducibility of the Brazilian-Portuguese version of the COMI was comparable to that of other language versions. The COMI scores correlated in the expected manner with existing but longer symptom-specific questionnaires suggesting good convergent validity for the COMI. The Brazilian-Portuguese COMI represents a valuable tool for Brazilian study-centres in future multicentre clinical studies and surgical registries.

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Aim:In hemodialysis patients, depression appears as the most common psychopathological condition. States of advanced chronic kidney disease and dialysis are associated with a state of chronic inflammation. Depression has been linked to activation of the immune system characterized by high levels of pro-inflammatory cytokines. In this study, we investigated the possible correlations between depression, and interleukin-6 (IL-6) in hemodialysis patients.Methods: Seventy-five hemodialysis patients were enrolled in a cross-sectional study from September to November 2011 in Pelotas, Rio Grande do Sul. Demographic data were obtained from a questionnaire and the Beck Depression Inventory (BDI) was used to determine the presence or absence of depression symptoms. Biochemical parameters, dialysisdosage delivery, and IL-6 serum levels were measured.Results: Prevalence of depression among hemodialysis patients was 48% (BDI ≥ 14). In biochemical assessments, depressed patients showed a decrease in urea (P = 0.01) and increase of IL-6 (P = 0.04) levels. The correlation analysis between BDI scores and the biochemical variables showed that BDI was negatively correlated with urea (P = 0.03) and potassium (P = 0.04), but not with IL-6 levels.Conclusion: Hemodialysis patients with depression showed higher levels of IL-6 but the severity of depressive symptoms was not correlated with levels of this cytokine.

RESUMO Objetivo: Analisar o efeito da entrevista motivacional no autocuidado de pessoas com insuficiência cardíaca crônica. Método: Ensaio clínico randomizado, multicêntrico, dividindo as pessoas em grupo intervenção (n=59) e grupo controle (n=59), acompanhadas por 60 dias nos centros do Brasil e Uruguai. O grupo intervenção recebeu três consultas por entrevista motivacional, com intervalo de 30 dias, e o grupo controle manteve o acompanhamento convencional nas clínicas especializadas. Os dados foram avaliados através do Self-Care of Heart Failure Index 6.2, antes e após a intervenção, em cada um dos centros e analisados através de média, mediana, teste-t, análise de correlação pelo coeficiente de Spearman e efeito da intervenção pelo d de Cohen. Resultados: 118 pessoas concluíram o estudo. Diante da avaliação do efeito da entrevista motivacional no autocuidado, comparando-se ao acompanhamento convencional, foi identificado efeito médio na manutenção e manejo (Cohen-d=0,6723; 0,5086) e alto na confiança do autocuidado (Cohen-d=0,9877). Conclusão: A entrevista motivacional foi efetiva na melhora do autocuidado dos pacientes com insuficiência cardíaca, sendo uma estratégia factível a ser implementada em clínicas especializadas. Registro Brasileiro de Ensaios Clínicos: RBR-6fp5qt.

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Introduction: Heart failure is a pathology with high prevalence. In advanced stages its survival is less than 50% at 4 years. Few data are available about morbidity and mortality in Uruguay. The multidisciplinary unit of heart failure at Hospital de Clínicas (UMIC) develops a management program through a specialized out-patient service. The objective of this study is to know causes of death of the UMIC cohort and analyze possible associated factors. Material and methods: Descriptive, observational, retrospective cohort study. The vital status of the patients admitted and registered from October 2003 to September 2016 was verified through passive and active data collection. The degree of certification was established through the death certificate. Characteristics of death subjects were analyzed. Causes of death were differentiated in cardiac and non-cardiac and predictors associated to the different causes of death were analyzed. Results: From 1041 patients, 182 deaths were recorded in the period studied. The average age was 69 ± 5 years with males 'predominance (3/1). Median survival was 2.6 years since recruitment. In 99 patients (61%), cardiac death was documented, 35% of them as sudden death, 56% CI and