Introduction Cardiac pacemaker (PM) therapy is of paramount importance. PM use increases with age, with an estimated increased use of 70% to 80% in patients over 65 years. This study evaluated the perception of the health-related quality of life (HRQoL) of elderly patients with PM, comparing them with patients without PM, by applying two quality of life questionnaires: EuroQoL 5-dimensions (EQ-5D) and 36-Item Short Form Health Survey (SF-36). Methods This study included elderly patients divided into a group with PM and another without PM. Information on HRQoL was obtained using the EQ-5D and SF-36 questionnaires. Results The study involved 104 elderly patients with PM and 150 without PM. The distribution of responses to the EQ-5D was similar between groups. Statistical differences within the gender variable in the group of elderly people with PM were significant for the mobility, habitual activities, and anxiety/depression domains and for the average EQoL utility score and visual analogue scale (EQ-VAS). Elderly patients with PM presented significant differences between New York Heart Association classes 1 and 2 for the mobility domain and EQ-VAS, while those evaluated through SF-36 presented higher averages in vitality, general health status, and pain. However, a different analysis was observed in the physical aspect domain. Conclusion The SF-36 demonstrated that elderly patients with PM had an HRQoL similar to or greater than those without PM. However, the results of the EQ-5D did not show significant differences regarding the implantation of PM and HRQoL between the two groups of elderly individuals in the study.
Introdução: A cefaleia em salvas (CS) é caracterizada por uma dor de cabeça intensa em apenas um lado da cabeça, que surge em crises. Não há cura para a CS e o seu tratamento consiste em minimizar a dor e diminuir a frequência das crises. Nesse cenário, que surge a investigação de maneiras eficazes para promover esse tratamento, entre eles o anticorpo monoclonal. Objetivo: Mostrar o que estudos recentes sobre o emprego de anticorpo monoclonal para esse fim têm trazido sobre sua segurança e eficácia. Metodologia: Trata-se de uma revisão sistemática da literatura realizada nos bancos de dados PubMed e BVS, com: “(Cluster Headache OR Headache Disorders) AND Antibodies, Monoclonal”. Excluiu-se os artigos que não se enquadravam nos objetivos. Resultados e Discussão: Grande parte dos estudos mostrou uma melhora significativa na frequência das crises, enquanto o uso para diminuir foi inconclusivo em quase todos estudos, principalmente quando usado a longo prazo, mas apesar disso, foi considerada uma opção segura para uso. Conclusão: É um tema ainda novo e com poucos estudos, principalmente de longos prazos, que diverge sobre a eficácia na redução da dor durante as crises, mas tende a convergir sobre a eficiência para redução dos intervalos das crises.
Aortic valve substitution is a standard technique with tolerable risk; nevertheless, the high mortality may be contraindicated. To reduce morbidity and mortality minimally invasive transcatheter aortic valve implantation (TAVI) may be an alternative approach. Although considered secure, after the method complications can occur, presenting as new-onset persistent left bundle branch block and demanding pacemaker implant. To establish how frequent this probability is, a systematic review from PUBMED (philters used were "15 years" and "free full texts") was achieved applying the terms "TAVI", "pacing" and "complications". For supporting literature, the other sources (SCIELO, Google Scholar and MEDLINE) were used and consulted for supporting literature. Catheter aortic prosthesis implantation is an effective modality for patients with high surgical risk and severe aortic stenosis. The review results suggest that the need for a pacemaker after endovascular treatment is neither inevitable nor easily predicted by known risk factors. Even though TAVI is considered a safe technique of selection, the implant position is near to functionally significant septal cardiac structures. Conduction disorders are frequent and need prudent checking after the procedure. Forthcoming studies must be necessary to validate the proposed algorithm and define the role of EP studies, ambulatory continuous electrocardiogram (Holter 24 hours) monitoring and preventive pacemaker in the management of conduction disturbances in patients undergoing transcatheter aortic valve replacement
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