BACKGROUNDChronic leg ulcer may have an impact on patients' quality of life. OBJECTIVESThis study aimed to identify the impact of leg ulcers on patient's quality of life using the Dermatology Life Quality Index and to define the main factors correlated with this perception. METHODCross-sectional, non-probabilistic sampling study. We included patients with chronic leg ulcers being treated for at least 3 months. A sociodemographic and clinical survey was conducted to assess the profile of the ulcers. We administered a screening for depressive symptoms and the Dermatology Life Quality Index. We performed a descriptive statistical analysis, chi-square test and Mann-Whitney test for categorical data, Pearson for numeric variables, and multiple regression for categorical data. RESULTSForty-one patients were assessed. Their mean age was 61.78 years. Venous ulcers (48.8%) were the most prevalent. Seventy-three percent of the sample perceived no impact/low impact on quality of life in the past week, and 26.8% perceived moderate/high impact. A multiple regression analysis identified the causes of lesion, pain related to the ulcers, time of onset, and severity of the depressive symptoms as the variables that had an influence on quality of life. CONCLUSIONSThe majority of the sample perceived low or no impact of the condition on the quality of the life. The variables etiology of the lesion (p<0.001), pain related to the ulcers (p=0.001), time of onset (p=0.006), and severity of the depressive symptoms (p<0.001) had an influence on the quality of life, suggesting the need for further studies with more robust designs to confirm the causal relationship between these characteristics and quality of life.

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To support the development of internationally comparable common data elements (CDEs) that can be used to measure essential aspects of long-term care (LTC) across low-, middle-, and high-income countries, a group of researchers in medicine, nursing, behavioral, and social sciences from 21 different countries have joined forces and launched the Worldwide Elements to Harmonize Research in LTC Living Environments (WE-THRIVE) initiative. This initiative aims to develop a common data infrastructure for international use across the domains of organizational context, workforce and staffing, person-centered care, and care outcomes, as these are critical to LTC quality, experiences, and outcomes. This article reports measurement recommendations for the care outcomes domain, focusing on previously prioritized care outcomes concepts of well-being, quality of life (QoL), and personhood for residents in LTC. Through literature review and expert ranking, we recommend nine measures of well-being, QoL, and personhood, as a basis for developing CDEs for long-term care outcomes across countries. Data in LTC have often included deficit-oriented measures; while important, reductions do not necessarily mean that residents are concurrently experiencing well-being. Enhancing measurement efforts with the inclusion of these positive LTC outcomes across countries would facilitate international LTC research and align with global shifts toward healthy aging and person-centered LTC models.

Chromoblastomycosis is one of the most frequent deep mycoses found in rural populations. This cross-sectional, retrospective and descriptive study was conducted with cases of chromoblastomycosis diagnosed throughout 20 years. A higher prevalence was observed among White male rural workers, with an average age of 59.69 years. Median time between onset of symptoms and diagnosis was 156 months. Lesions were predominantly located on the lower limbs; 34% of cases reported previous trauma. The most common associated symptoms were itching, pain and burning sensation. Mycological examination was positive in 91% of cases and Fonsecaea pedrosoi was the most prevalent etiologic agent.

The infection by Mycobacterium marinum in humans is relatively uncommon. When it occurs, it mainly affects the skin, usually with a chronic, indolent and benign evolution. The diagnosis requires a high index of suspicion, and a significant delay may be observed between the first symptoms to the final diagnosis. This present case reports a M. marinum infection in an immunocompetent patient that had a chronic undiagnosed injury on the dominant hand for at least five years. The patient had several medical consultations, without proper suspicion, hampering adequate diagnostic investigation. Histopathology detected tuberculoid granulomas, but showed no acid-fast bacilli. The culture in appropriate medium and the polymerase chain reaction-restriction enzyme analysis (PRA)-hsp65 confirmed the diagnosis. Treatment with clarithromycin (1 g/day) for three months was effective. Although uncommon, this infection is a contact zoonosis. Therefore, it is important for clinicians to be aware of this diagnosis and properly guide preventable measures to professionals that are in risk group.

We conducted a transversal retrospective study with secondary data collection from 25 cases of sporotrichosis, treated at a teaching unit in inner São Paulo (Brazil), between the years 2003-2013. We found that the prevalence was higher in men (72%), rural workers (44%) and those living in rural areas (60%), with an average age of 42.48 years. The median between the onset of lesions and diagnosis was six weeks. Lesions predominated in the upper limbs (92%), and were classified as lymphocutaneous (80%) and fixed cutaneous (20%) forms. Clinical cure was observed in 62.5% of the cases treated with potassium iodide and 100% of cases treated with itraconazole.

Aim To compare subjective and objective measures of adherence to prophylaxis in haemophilia. Methods In this cross‐sectional study, we compared participants’ self‐perceived adherence and their estimate of the number of clotting factor concentrates (CFCs) that had been missed over the last period of CFC dispensation with an objective measure of adherence based on counts of CFC vials returned by participants. Results We included 29 out of 31 eligible patients in the study. There was no significant correlation between self‐perceived degree of adherence and the objective classification of adherence (Rho: 0.10, 95% CI: −028 to 0.46, P: 0.61) and between the classification of adherence based on the proportion of missed CFC doses assessed by participants’ self‐report and objectively (Rho: 0.32, 95% CI: −0.01 to 0.59, P: 0.11). Conversely, we found evidence of moderate correlation between the proportion of missed CFC doses as assessed by participants’ self‐report and objectively (Rho: 0.56, 95% CI: 0.24 to 0.77, P: 0.003). Participants’ self‐perceived adherence was 3 times more likely to be rated as very good or good than it was for the objective assessment to be classified as adherent or suboptimally adherent. Conclusion Our results showed significant discrepancies between subjective and objective measures of adherence, which likely reflect the influence of social desirability bias in self‐reported measures and different concepts of adherence between patients/caregivers and haemophilia experts. Additionally, our results allow us to hypothesize that studies on adherence to prophylaxis in haemophilia relying exclusively on information from self‐reports and questionnaires may substantially overestimate adherence levels.

OBJETIVOS: Analisar as correlações entre o grau de dependência funcional de idosos residentes na comunidade, o nível de sobrecarga relacionada ao cuidado e a percepção de qualidade de vida dos cuidadores familiares desses idosos. MÉTODOS: Estudo observacional, descritivo e analítico, com amostragem não probabilística selecionada por conveniência entre dezembro de 2008 e maio de 2009 na área urbana de Curitiba e Colombo, estado do Paraná. As entrevistas foram aplicadas aos cuidadores, empregando-se: inquérito sociodemográfico; avaliação funcional do idoso; avaliação da sobrecarga (Zarit-Burden-Interview) e qualidade de vida (WHOQOL-Bref). Utilizaram-se os coeficientes de Spearman, de Mann-Whitney e Kruskal Wallis para avaliar as correlações entre as escalas e destas com variáveis sociodemográficas. Análise bivariada identificou quais variáveis se correlacionariam à sobrecarga, incluídas as significativas em modelo de regressão linear múltipla. RESULTADOS: Foram entrevistados 45 cuidadores, predominando mulheres (91,11%) com elevada escolaridade, assistindo idosos funcionalmente dependentes (66,77%). Percebeu-se sobrecarga moderada/severa em 75,55% da amostra. Observou-se correlação entre dependência funcional e maior sobrecarga no cuidador (r=-0,281, p=0,013) e pior percepção de qualidade de vida. A regressão linear múltipla identificou forte associação entre sobrecarga relacionada ao cuidado e o domínio psicológico do WHOQOL-bref e o tempo como cuidador (R²=0,58, p<0,001). CONCLUSÃO: Em amostra de cuidadores familiares, foram identificadas correlações significativas entre menor nível de sobrecarga relacionada ao cuidado e melhores percepções de qualidade de vida, bem como associação entre maior grau de dependência do idoso assistido e maior sobrecarga e qualidade de vida menos satisfatórias.