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Bond MMK, de Oliveira JLR, Farsky PS, Amato VL, Jara AA, Farias E, Jacomine AM, Sehn A, França JÍD, de Souza LCB, dos Santos MA. Use of Quality of Life in Cardiovascular Surgery in Coronary Artery Bypass Grafting: Validation, Reproducibility, and Quality of Life in One Year of Follow-Up. Ann Thorac Surg 2019; 108:764-769. [DOI: 10.1016/j.athoracsur.2019.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 01/29/2019] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
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Bond MMK, Oliveira JLRD, Souza LCBD, Farsky PS, Amato VL, Togna DJD, Ghorayeb SK, Santos MAD. Quality of Life in Cardiovascular Surgery: Elaboration and Initial Internal Validation of a Quality of Life Questionnaire. Braz J Cardiovasc Surg 2019; 33:476-482. [PMID: 30517256 PMCID: PMC6257538 DOI: 10.21470/1678-9741-2018-0108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/24/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Elaboration and internal validation of the Quality of Life in Cardiovascular Surgery (QLCS) questionnaire adapted to the reality of Brazilian cardiovascular surgery. METHODS Cross-sectional pilot study of a prospective cohort included in the Documentation and Surgical Registry Center (CEDREC) for internal validation of the QLCS questionnaire. Four hundred forty-five patients submitted to cardiovascular surgery and who answered a QLCS questionnaire 30 days after hospital discharge were included. It was applied via telephone. To verify the questions' internal consistency, Cronbach's alpha was used. The total QLCS score was calculated as the sum of 5 questions, ranging from 5 to 25 points. Mann-U-Whitney test was used to relate the symptoms with the quality of life (QoL). Level of significance was 5%. RESULTS After 30 days of surgery, about 95% of the patients had already returned to normal routine and 19% of them were already performing physical activity. In the evaluation of the QLCS's internal consistency, a Cronbach's alpha of 0.74 was found, suggesting that this was probably an adequate questionnaire to evaluate QoL in this population. In the comparison between the presence and absence of symptoms and the median of QoL, the presence of pain at the incision (P=0.002), chest pain (P<0.001), shortness of breath (P<0.001), and return to physical activity (P<0.001) were statistically significant. CONCLUSION The process of elaboration and validation of questionnaires includes a series of steps. The QLCS questionnaire is probably an adequate tool for the evaluation of QoL in the postoperative patient of cardiovascular surgery, in this first stage of internal validation.
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Brandão SMG, Rezende PC, Rocca HPBL, Ju YT, de Lima ACP, Takiuti ME, Hueb W, Bocchi EA. Comparative cost-effectiveness of surgery, angioplasty, or medical therapy in patients with multivessel coronary artery disease: MASS II trial. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2018; 16:55. [PMID: 30410425 PMCID: PMC6215652 DOI: 10.1186/s12962-018-0158-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 10/24/2018] [Indexed: 02/08/2023] Open
Abstract
Background The costs for treating coronary artery disease (CAD) are high worldwide. We performed a prespecified analyses of cost-effectiveness of three therapeutic strategies for multivessel CAD. Methods From May 1995 to May 2000, a total of 611 patients were randomly assigned to coronary artery bypass graft (CABG), n = 203; percutaneous coronary intervention (PCI), n = 205; or medical treatment (MT), n = 203. This cost analysis study was based on the perspective of the Public Health Care System. Initial procedural and follow-up costs for medications, cardiology examinations, and hospitalizations for complications were calculated after randomization. Life-years and quality-adjusted life years (QALYs) were used as effectiveness measures. Incremental cost-effectiveness ratios (ICER) were obtained by using nonparametric bootstrapping methods with 5000 resamples. Results Initial procedural costs were lower for MT. However, the subsequent 5-year cumulative costs were lower for CABG. Compared with baseline, the three treatment options produced significant improvements in QALYs. After 5 years, PCI and CABG had better QALYs results compared with MT. The ICER results favored CABG and PCI, and favored PCI over CABG in 61% of the drawings. On the other hand, sensitivity analysis showed MT as the preferred therapy compared with CABG and PCI, in the analysis considering higher costs. Conclusions At 5-year follow-up, the three treatment options yielded improvements in quality of life, with comparable and acceptable costs. However, despite higher initial costs, the comparison of cost-effectiveness after 5 years of follow-up among the three treatments showed both interventions (CABG and PCI) to be cost-effective strategies compared with MT.Trial registration ISRCTN, ISRCTN66068876, Registered 06/10/1994, http://www.controlled-trials.com/ISRCTN66068876.
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Affiliation(s)
- Sara Michelly Gonçalves Brandão
- 1Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Av Dr Eneas de Carvalho Aguiar 44 - Cerqueira Cesar, São Paulo, SP CEP 05403-000 Brazil
| | - Paulo Cury Rezende
- 1Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Av Dr Eneas de Carvalho Aguiar 44 - Cerqueira Cesar, São Paulo, SP CEP 05403-000 Brazil
| | - Hans-Peter Brunner-La Rocca
- 2Heart Failure Clinic, Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Yang Ting Ju
- 3Department of Statistics, Institute of Mathematics and Statistics, University of São Paulo, São Paulo, SP Brazil
| | | | - Myrthes Emy Takiuti
- 1Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Av Dr Eneas de Carvalho Aguiar 44 - Cerqueira Cesar, São Paulo, SP CEP 05403-000 Brazil
| | - Whady Hueb
- 1Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Av Dr Eneas de Carvalho Aguiar 44 - Cerqueira Cesar, São Paulo, SP CEP 05403-000 Brazil
| | - Edimar Alcides Bocchi
- 1Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Av Dr Eneas de Carvalho Aguiar 44 - Cerqueira Cesar, São Paulo, SP CEP 05403-000 Brazil
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Bahall M, Khan K. Quality of life of patients with first-time AMI: a descriptive study. Health Qual Life Outcomes 2018; 16:32. [PMID: 29433517 PMCID: PMC5810028 DOI: 10.1186/s12955-018-0860-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 02/07/2018] [Indexed: 03/01/2023] Open
Abstract
Background Outcomes following acute myocardial infarction (AMI) may result in death, increased morbidity, and change in quality of life (QOL). This study explores health-related QOL of first-time patients following AMI. Methods This cross-sectional study used a sample of patients with first-time AMI experienced between April 2011 and March 2015 at a tertiary health institution. Recruited patients belonged to different post-AMI periods: 2–10 weeks, 5–22 months, and > 22 months to 4 years post AMI. Inclusion criteria were not confused and communicating freely. Exclusion criteria were non-contactable, refusing to participate, and deceased. One-on-one interviews were conducted using the validated and pre-tested Quality of Life after Myocardial Infarction (QLMI) questionnaire. QOL of patients after AMI was evaluated at each period. Descriptive, Mann–Whitney U, Kruskal–Wallis, and regression analyses were conducted using SPSS version 24. Results A total of 534 participant interviews (overall response rate 65.4%) were conducted. Interviewees were predominantly male (67%), aged 51–65 years (45%), Indo-Trinidadian (81.2%), NSTEMI (64.4%), and hypertensive (72.4%). Overall QOL improved over time and in all domains: Emotional, Physical, and Social. Lower QOL was found among women, patients with NSTEMI, and diabetics in all domains; in patients with hypertension and renal disease in the Physical and Social domains only; and in patients with ischaemic heart disease (IHD) in the Physical domain only. Self-reported stress and lack of exercise were associated with lower QOL while drinking alcohol and eating out were related to better QOL. Hypercholesterolemia, smoking, and ethnicity showed no association with QOL. Declining QOL in the Physical domain with age was also found. The leading components of QOL were self-confidence and social exclusion (early post AMI), lack of self-confidence (intermediate post AMI), and tearfulness (late post AMI). Conclusions QOL in AMI survivors improves over time. Female gender, NSTEMI, diabetes, hypertension, renal disease, stress, and lack of exercise were associated with lower QOL while hypercholesterolemia, smoking, and ethnicity showed no association with QOL. Cardiac rehabilitation and psychological support may enhance earlier increased QOL among survivors, particularly among vulnerable groups.
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Affiliation(s)
- Mandreker Bahall
- Department of Clinical Medical Sciences, University of the West Indies, St. Augustine, Trinidad, Trinidad and Tobago.
| | - Katija Khan
- Department of Clinical Medical Sciences, University of the West Indies, St. Augustine, Trinidad, Trinidad and Tobago
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Nunes JKVRS, de Figueiredo Neto JA, de Sousa RML, Costa VLXDC, Silva FDMAM, da Hora AFLT, da Silva ELC, Reis LMCB. Depression after CABG: a prospective study. Braz J Cardiovasc Surg 2014; 28:491-7. [PMID: 24598954 PMCID: PMC4389428 DOI: 10.5935/1678-9741.20130080] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 09/10/2013] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Depression during or shortly after hospitalization elevated two to three times the risk of mortality or nonfatal cardiac events, significantly increasing the morbidity and mortality of these patients. OBJECTIVE To assess the impact of revascularization on symptoms of depression in patients with coronary artery disease. METHODS A prospective cohort study of 57 patients of both sexes undergoing coronary artery bypass grafting between June 2010 and June 2011. We used the SF-36 to assess quality of life, and the Beck Depression Inventory to detect depressive symptoms, applied preoperatively and six months. RESULTS The prevalence of patients aged 60-69 years was 22 patients (38.60%), 39 men (68.42%), 26 described themselves as mixed race (45.61%), 16 literate (28.07 %) and 30 married (52.63%). The beck depression inventory score demonstrated increased after revascularization: 15 patients mild (26.32%) at time zero to 17 (29.82%) after. And with moderate, seven patients (12.28%) before and 10 (17.54%) after. In the categories of individuals with decreased minimum degree of 32 (56.14%) to 28 (49.12%), and severe of three (5.26%) for two (3.51%) patients. Association was observed between beck depression inventory, gender, age, lifestyle, comorbidities and quality of life. CONCLUSION There was a high prevalence of elevated beck depression inventory scores, lowest scores of depressive symptoms among men and association between the improvement of quality of life scores and beck depression inventory.
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Affiliation(s)
- Joana Kátya Veras Rodrigues Sampaio Nunes
- Postgraduate Program in Health Sciences, Universidade Federal do
Maranhão (UFMA), São Luís, MA, Brazil
- Correspondence address: Joana Kátya Veras Rodrigues Sampaio,
Universidade Federal do Maranhão, Av. dos Portugueses, 1966 - Bacanga - São Luís, MA,
Brazil - Zip code: 65080-805. E-mail:
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Hernandez AJ. Artigos publicados em periódicos brasileiros de interesse para a medicina do exercício e do esporte: uma revisão. REV BRAS MED ESPORTE 2009. [DOI: 10.1590/s1517-86922009000700011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Esta nova série de artigos tem por objetivo levar aos leitores nacionais e internacionais algumas das mais importantes contribuições provenientes da literatura médica brasileira recente. Embora possa parecer que não tenham relação direta com a Medicina do Exercício e do Esporte, são trabalhos que podem oferecer suporte a muitas linhas de pesquisa nessa área. Os artigos originais mais relevantes são selecionados por experientes editores, a quem solicitamos que escolham palavras- chave para que sejam destacadas para chamar a atenção do leitor. Para facilitar a leitura, os artigos são organizados por área de interesse. Para aproveitar ao máximo o limitado espaço editorial, não são incluídos os nomes dos autores dos artigos. Entretanto, a referência completa é oferecida ao final do artigo. O resultado final traz o que há de melhor do artigo, seguido de uma sintética interpretação pessoal. Endereçado ao médico ocupado, esperamos que esta inciativa possa contribuir para o sucesso da translação do conhecimento da evidência científica para a prática clínica.
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Abstract
This article reviews 69 original research articles published in 6 Brazilian Medical Journals recently incorporated into the Institute for Scientific Information Journal of Citation Reports, with a view of making them comprehensively available to the readership of CLINICS within a subject category division. We expect this review to increase the visibility of a wide specter of original Brazilian research which may otherwise remain relatively unseen by the interested readership.
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Affiliation(s)
- Mauricio Rocha-e-Silva
- Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
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