Evaluation of objective and subjective indicators of death in a period of one year in a sample of prevalent patients under regular hemodialysis

<p>Abstract</p> <p>Background</p> <p>To identify objective and subjective indicators of death in prevalent hemodialysis (HD) patients in a follow-up study of 12 months.</p> <p>Methods</p> <p>The study included end-stage renal disease patients undergoing HD and analyzed demographic and laboratory data from the dialysis unit's records. Baseline data concerning socioeconomic status, comorbidity, quality of life level, coping style and depression were also assessed. For variables that differed in the comparison between survivors and non-survivors, Cox proportional hazards for death were calculated.</p> <p>Results</p> <p>The mortality rate was 13.0%. Non-survivors differed in age, comorbidity, inclusion on the transplant waiting list and physical functioning score. The hazard ratios of death were 8.958 (2.843-28.223; <it>p </it>< 0.001) for comorbidity, 3.992 (1.462-10.902; <it>p </it>= 0.007) for not being on the transplant waiting list, 1.038 (1.012-1.066; <it>p </it>= 0.005) for age, and 0.980 (0.964-0.996; <it>p </it>= 0.014) for physical functioning.</p> <p>Conclusions</p> <p>Comorbidity, not being on the transplant waiting list, age and physical functioning, which reflects physical status, must be seen as risk indicators of death among patients undergoing HD.</p

The Role Of Biological Agents For Rheumatoid Arthritis: Best Evidence And Guidelines For Clinical Decision [uso De Agentes Biológicos Para O Tratamento Da Artrite Reumatóide: Melhores Evidências E Recomendações Para A Prática Clínica]

Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune disease of unknown etiology, which predominantly involves small joints and is more common in women. It has a high degree of morbidity and is an important health problem. The treatment of RA includes DMARDs (disease-modifying anti-rheumatic drugs) and more recently the so-called biological agents. Carry out a structured literature review to determine the best existing evidences in medical literature regarding the diagnosis and treatment of rheumatoid arthritis. Six questions on RA were prepared: 1) What are the diagnostic criteria for initial rheumatoid arthritis diagnosis?; 2) For patients with diagnosis of rheumatoid arthritis what are the prognosis markers and what are their clinical implications?; 3) For patients with rheumatoid arthritis, when should DMARDs (MTX, sulfasalazine, among others) be introduced? What is the initial choice drug?; 4) For patients with rheumatoid arthritis, when should biological agents be introduced? Should they be administered after the initial administration of methotrexate or at the time of diagnosis?; 5) What are the indications of the biological agents in early onset RA?; 6) Are biological agents effective and safe in the treatment of rheumatoid arthritis: Is there evidence of the relative superiority of any of the biological agents in terms of efficacy and safety? A structured literature review was carried out using different databases. In this review, the objective was to identify clinical studies which are methodologically more adequate that might respond to each of the questions. A committee of specialists evaluated literature data and prepared responses to each one of the questions. The respective evidence levels and degrees of recommendations were then established for each response and an evidence-based recommendation was made.624156165Harris Jr., E.D., Rheumatoid arthritis: Pathophysiology and implications for therapy (1990) N Engl J Med, 322, pp. 1277-1289Hochberg, M.C., Adult and juvenile rheumatoid arthritis: Current epidemiologic concepts (1981) Epidemiol, pp. 27-44. , Rev 3Marques Neto, J.F., Gonçalves, H.T., Langen, L.F.O.B., Estudo multicêntrico da prevalência da AR do adulto em amostras da população brasileira (1993) Rev Bras Reum, 33, pp. 169-173Senna, E.R., De Barros, A.L.P., Silva, E.O., Prevalence of Rheumatic diseases in Brazil: A study using the COPCORD approach (2004) J Rheumatol, 31, pp. 594-597Guyatt, G., Rennie, D., (2002) User's Guide to the Medical Literature - A Manual for Evidence-Based Clinical Practice 1 Ed., , Chicago-IL: AMA press;(2004), http://minerva.minervation.com/cebm/docs/levels.html, Centre for Evidence Based Medicine. 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(2001) Best Pract Res Clin Rheumatol, 15 (1), pp. 49-66Aletaha, D., Eberl, G., Nell, V.P., Machold, K.P., Smolen, J.S., Attitudes to early rheumatoid arthritis: Changing patterns. Results of a survey (2004) Ann Rheum Dis, 63 (10), pp. 1269-1275Berthelot, J.M., Saraux, A., Maugars, Y., Prost, A., Le Goff, P., The nosology-taxonomy of recent-onset arthritis: The experience of early-arthritis clinics (2001) Semin Arthritis Rheum, 30 (5), pp. 354-365Arnett, F.C., Edworthy, S.M., Bloch, D.A., McShane, D.J., Fries, J.F., Cooper, N.S., The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis (1988) Arthritis Rheum, 31 (3), pp. 315-324Visser, H., Le Cessie, S., Vos, K., Breedveld, F.C., Hazes, J.M., How to diagnose rheumatoid arthritis early: A prediction model for persistent (erosive) arthritis (2002) Arthritis Rheum, 46 (2), pp. 357-365Scott, D.L., The diagnosis and prognosis of early arthritis: Rationale for new prognostic criteria (2002) Arthritis Rheum, 46 (2), pp. 286-290(1993) Arthritis and Allied Conditions. 12a Edition, , Ed. Pensilvania: Lea & FebigerJansen, L.M., Van Der Horst-Bruinsma, I.E., Van Schaardenburg, D., Bezemer, P.D., Dijkmans, B.A., Predictors of radiographic joint damage in patients with early rheumatoid arthritis (2001) Ann Rheum Dis, 60 (10), pp. 924-927Guillemin, F., Gerard, N., Van Leeuwen, M., Smedstad, L.M., Kvien, T.K., Van Den Heuvel, W., Prognostic factors for joint destruction in rheumatoid arthritis: A prospective longitudinal study of 318 patients (2003) J Rheumatol, 30 (12), pp. 2585-2589Combe, B., Dougados, M., Goupille, P., Cantagrel, A., Eliaou, J.F., Sibilia, J., Prognostic factors for radiographic damage in early rheumatoid arthritis: A multiparameter prospective study (2001) Arthritis Rheum, 44 (8), pp. 1736-1743Jantti, J.K., Kaarela, K., Luukkainen, R.K., Kautiainen, H.J., Prediction of 20-year outcome at onset of seropositive rheumatoid arthritis (2000) Clin Exp Rheumatol, 18 (3), pp. 387-390Berglin, E., Lorentzon, R., Nordmark, L., Nilsson-Sojka, B., Rantapaa Dahlqvist, S., Predictors of radiological progression and changes in hand bone density in early rheumatoid arthritis (2003) Rheumatology (Oxford), 42 (2), pp. 268-275Paimela, L., Palosuo, T., Leirisalo-Repo, M., Helve, T., Aho, K., Prognostic value of quantitative measurement of rheumatoid factor in early rheumatoid arthritis (1995) Br J Rheumatol, 34 (12), pp. 1146-1150Belghomari, H., Saraux, A., Allain, J., Guedes, C., Youinou, P., Le Goff, P., Risk factors for radiographic articular destruction of hands and wrists in rheumatoid arthritis (1999) J Rheumatol, 26 (12), pp. 2534-2538Combe, B., Eliaou, J.F., Daures, J.P., Meyer, O., Clot, J., Sany, J., Prognostic factors in rheumatoid arthritis. Comparative study of two subsets of patients according to severity of articular damage (1995) Br J Rheumatol, 34 (6), pp. 529-534Scott, D.L., Prognostic factors in early rheumatoid arthritis (2000) Rheumatology (Oxford), 39 (SUPPL.), pp. 24-29Valenzuela-Castano, A., Garcia-Lopez, A., Perez-Vilches, D., Rodriguez-Perez, R., Gonzalez-Escribano, M.F., Nunez-Roldan, A., The predictive value of the HLA shared epitope for severity of radiological joint damage in patients with rheumatoid arthritis. A 10 year observational prospective study (2000) J Rheumatol, 27 (3), pp. 571-574Wassmuth, R., Wagner, U., Prognostic use of human leukocyte antigen genotyping for rheumatoid arthritis susceptibility, disease course, and clinical stratification (2002) Rheum Dis Clin North Am, 28 (1), pp. 17-37Meyer, O., Labarre, C., Dougados, M., Goupille, P., Cantagrel, A., Dubois, A., Anticitrullinated protein/peptide antibody assays in early rheumatoid arthritis for predicting five year radiographic damage (2003) Ann Rheum Dis, 62 (2), pp. 120-126Kroot, E.J., De Jong, B.A., Van Leeuwen, M.A., Swinkels, H., Van Den Hoogen, F.H., Van't Hof, M., The prognostic value of anti-cyclic citrullinated peptide antibody in patients with recent-onset rheumatoid arthritis (2000) Arthritis Rheum, 43 (8), pp. 1831-1835Jansen, L.M., Van Schaardenburg, D., Van Der Horst-Bruinsma, I., Van Der Stadt, R.J., De Koning, M.H., Dijkmans, B.A., The predictive value of anti-cyclic citrullinated peptide antibodies in early arthritis (2003) J Rheumatol, 30 (8), pp. 1691-1695Bas, S., Genevay, S., Meyer, O., Gabay, C., Anti-cyclic citrullinated peptide antibodies, IgM and IgA rheumatoid factors in the diagnosis and prognosis of rheumatoid arthritis (2003) Rheumatology (Oxford), 42 (5), pp. 677-680Vencovsky, J., Machacek, S., Sedova, L., Kafkova, J., Gatterova, J., Pesakova, V., Autoantibodies can be prognostic markers of an erosive disease in early rheumatoid arthritis (2003) Ann Rheum Dis, 62 (5), pp. 427-430Huizinga, T.W., Machold, K.P., Breedveld, F.C., Lipsky, P.E., Smolen, J.S., Criteria for early rheumatoid arthritis: From Bayes' law revisited to new thoughts on pathogenesis (2002) Arthritis Rheum, 46 (5), pp. 1155-1159Quinn, M.A., Conaghan, P.G., Emery, P., The therapeutic approach of early intervention for rheumatoid arthritis: What is the evidence? (2001) Rheumatology (Oxford), 40 (11), pp. 1211-1220Nell, V.P., Machold, K.P., Eberl, G., Stamm, T.A., Uffmann, M., Smolen, J.S., Benefit of very early referral and very early therapy with disease-modifying anti-rheumatic drugs in patients with early rheumatoid arthritis (2004) Rheumatology (Oxford), 43 (7), pp. 906-914Smolen, J.S., Aletaha, D., Patients with rheumatoid arthritis in clinical care (2004) Ann Rheum Dis, 63 (3), pp. 221-225Boers, M., Verhoeven, A.C., Markusse, H.M., Van De Laar, M.A., Westhovens, R., Van Denderen, J.C., Randomised comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone in early rheumatoid arthritis (1997) Lancet, 350 (9074), pp. 309-318Emery, P., Breedveld, F.C., Dougados, M., Kalden, J.R., Schiff, M.H., Smolen, J.S., Early referral recommendation for newly diagnosed rheumatoid arthritis: Evidence based development of a clinical guide (2002) Ann Rheum Dis, 61 (4), pp. 290-297Jones, G., Halbert, J., Crotty, M., Shanahan, E.M., Batterham, M., Ahern, M., The effect of treatment on radiological progression in rheumatoid arthritis: A systematic review of randomized placebo-controlled trials (2003) Rheumatology (Oxford), 42 (1), pp. 6-13Rau, R., Herborn, G., Menninger, H., Sangha, O., Radiographic outcome after three years of patients with early erosive rheumatoid arthritis treated with intramuscular methotrexate or parenteral gold. Extension of a one-year double-blind study in 174 patients (2002) Rheumatology (Oxford), 41 (2), pp. 196-204Van Aken, J., Lard, L.R., Le Cessie, S., Hazes, J.M., Breedveld, F.C., Huizinga, T.W., Radiological outcome after four years of early versus delayed treatment strategy in patients with recent onset rheumatoid arthritis (2004) Ann Rheum Dis, 63 (3), pp. 274-279Guidelines for the management of rheumatoid arthritis: 2002 Update (2002) Arthritis Rheum, 46 (2), pp. 328-346Gordon, P., West, J., Jones, H., Gibson, T., A 10 year prospective followup of patients with rheumatoid arthritis 1986-96 (2001) J Rheumatol, 28 (11), pp. 2409-2415Suarez-Almazor, M.E., Belseck, E., Shea, B., Homik, J., Wells, G., Tugwell, P., Antimalarials for treating rheumatoid arthritis (2000) Cochrane Database Syst Rev, (4). , CD000959Suarez-Almazor, M.E., Belseck, E., Shea, B., Wells, G., Tugwell, P., Sulfasalazine for rheumatoid arthritis (2000) Cochrane Database Syst Rev, (2). , CD000958Suarez-Almazor, M.E., Belseck, E., Shea, B., Wells, G., Tugwell, P., Methotrexate for rheumatoid arthritis (2000) Cochrane Database Syst Rev, (2). , CD000957Osiri, M., Shea, B., Robinson, V., Suarez-Almazor, M., Strand, V., Tugwell, P., Leflunomide for treating rheumatoid arthritis (2003) Cochrane Database Syst Rev, (1). , CD002047Suarez-Almazor, M.E., Spooner, C., Belseck, E., Azathioprine for treating rheumatoid arthritis (2000) Cochrane Database Syst Rev, (4). , CD001461Suarez-Almazor, M.E., Spooner, C., Belseck, E., Penicillamine for treating rheumatoid arthritis (2000) Cochrane Database Syst Rev, (4). , CD001460Clark, P., Tugwell, P., Bennet, K., Bombardier, C., Shea, B., Wells, G., Injectable gold for rheumatoid arthritis (2000) Cochrane Database Syst Rev, (2). , CD000520O'Dell, J.R., Paulsen, G., Haire, C.E., Blakely, K., Palmer, W., Wees, S., Treatment of early seropositive rheumatoid arthritis with minocycline: Four-year followup of a double-blind, placebo-controlled trial (1999) Arthritis Rheum, 42 (8), pp. 1691-1695Wells, G., Haguenauer, D., Shea, B., Suarez-Almazor, M.E., Welch, V.A., Tugwell, P., Cyclosporine for rheumatoid arthritis (2000) Cochrane Database Syst Rev, (2). , CD001083Quinn, M.A., Emery, P., Window of opportunity in early rheumatoid arthritis: Possibility of altering the disease process with early intervention (2003) Clin Exp Rheumatol, 21 (5 SUPPL. 31), pp. S154-S157Lard, L.R., Visser, H., Speyer, I., Vander Horst-Bruinsma, I.E., Zwinderman, A.H., Breedveld, F.C., Early versus delayed treatment in patients with recent-onset rheumatoid arthritis: Comparison of two cohorts who received different treatment strategies (2001) Am J Med, 111 (6), pp. 446-451Emery, P., Breedveld, F.C., Dougados, M., Kalden, J.R., Schiff, M.H., Smolen, J.S., Early referral recommendation for newly diagnosed rheumatoid arthritis: Evidence based development of a clinical guide (2002) Ann Rheum Dis, 61 (4), pp. 290-297Breedveld, F.C., Kalden, J.R., Appropriate and effective management of rheumatoid arthritis (2004) Ann Rheum Dis, 63 (6), pp. 627-633St. Clair, E.W., Disease-modifying anti-rheumatic drugs (2001) Primer on the Rheumatic Diseases. 12th Edition, pp. 599-602. , ed. Atlanta: The Arthritis FoundationSmolen, J.S., Sokka, T., Pincus, T., Breedveld, F.C., A proposed treatment algorithm for rheumatoid arthritis: Aggressive therapy, methotrexate, and quantitative measures (2003) Clin Exp Rheumatol, 21 (5 SUPPL. 31), pp. S209-S210Galindo-Rodriguez, G., Avina-Zubieta, J.A., Russell, A.S., Suarez-Almazor, M.E., Disappointing longterm results with disease modifying antirheumatic drugs. A practice based study (1999) J Rheumatol, 26 (11), pp. 2337-2343Aletaha, D., Smolen, J.S., Effectiveness profiles and dose dependent retention of traditional disease modifying antirheumatic drugs for rheumatoid arthritis. An observational study (2002) J Rheumatol, 29 (8), pp. 1631-1638Bathon, J.M., A comparison of etarnecept e methotrexate in patients with early rheumatoid arthritis (2000) N Engl J Med, 343, pp. 1586-1593Smolen, J.S., Treatment of early rheumatoid arthritis with infliximabe plus methotrexate or methotrexate alone: Preliminary results of ASPIRE Trial (2003) Ann Rheum Dis, 62 (SUPPL. 1), p. 64Bredveld, F., BeST study: How should we use TNF antagonists best in RA? (2004) EULARMaini, R.N., Therapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor alpha monoclonal antibody combined with low-dose weekly methotrexate in rheumatoid arthritis (1998) Arthritis Rheum, 41 (9), pp. 1552-1563Maini, R., Infliximabe (chimeric anti-tumour necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: A randomised phase III trial (1999) Lancet, 354 (9194), pp. 1932-1939. , ATTRACT Study GroupLipsky, P.E., Infliximabe and methotrexate in the treatment of rheumatoid arthritis (2000) N Engl J Med, 343 (22), pp. 1594-1602. , Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study GroupMoreland, L.W., Etanercepte therapy in rheumatoid arthritis. A randomized, controlled trial (1999) Ann Intern Med, 130 (6), pp. 478-486Weinblatt, M.E., A trial of etanercepte, a recombinant tumor necrosis factor receptor: Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate (1999) N Engl J Med, 340 (4), pp. 253-259Bathon, J.M., A comparison of etanercepte and methotrexate in patients with early rheumatoid arthritis (2000) N Engl J Med, 343 (22), pp. 1586-1593Genovese, M.C., Etanercepte versus methotrexate in patients with early rheumatoid arthritis: Two-year radiographic and clinical outcomes (2002) Arthritis Rheum, 46 (6), pp. 1443-1450Klareskog, L., Therapeutic effect of the combination of etanercepte and methotrexate compared with each treatment alone in patients with rheumatoid arthritis: Double-blind randomised controlled trial (2004) Lancet, 363 (9410), pp. 675-681Keystone, E.C., Once-weekly administration of 50 mg etanercepte in patients with active rheumatoid arthritis: Results of a multicenter, randomized, double-blind, placebo-controlled trial (2004) Arthritis Rheum, 50 (2), pp. 353-363Weinblatt, M.E., Adalimumabe, a fully human anti-tumor necrosis factor alpha monoclonal antibody, for the treatment of rheumatoid arthritis in patients taking concomitant methotrexate: The ARMADA trial (2003) Arthritis Rheum, 48 (1), pp. 35-45Van De Putte, L.B., Efficacy and safety of adalimumabe as monotherapy in patients with rheumatoid arthritis for whom previous disease modifying antirheumatic drug treatment has failed (2004) Ann Rheum Dis, 63 (5), pp. 508-516Furst, D.E., Adalimumabe, a fully human anti tumor necrosis factor-alpha monoclonal antibody, and concomitant standard antirheumatic therapy for the treatment of rheumatoid arthritis: Results of STAR (Safety Trial of Adalimumabe in Rheumatoid Arthritis) (2003) J Rheumatol, 30 (12), pp. 2563-2571Keystone, E.C., Radiographic, clinical, and functional outcomes of treatment with adalimumabe (a human anti-tumor necrosis factor monoclonal antibody) in patients with active rheumatoid arthritis receiving concomitant methotrexate therapy: A randomized, placebo-controlled, 52-week trial (2004) Arthritis Rheum, 50 (5), pp. 1400-1411Jiang, Y., A multicenter, double-blind, dose-ranging, randomized, placebo-controlled study of recombinant human interleukin-1 receptor antagonist in patients with rheumatoid arthritis: Radiologic progression and correlation of Genant and Larsen scores (2000) Arthritis Rheum, 43 (5), pp. 1001-1009Cohen, S., Treatment of rheumatoid arthritis with anakinra, a recombinant human interleukin-1 receptor antagonist, in combination with methotrexate: Results of a twenty-four-week, multicenter, randomized, double-blind, placebo-controlled trial (2002) Arthritis Rheum, 46 (3), pp. 614-624Khanna, D., McMahon, M., Furst, D.E., Safety of tumour necrosis factor-alpha antagonists (2004) Drug Saf, 27 (5), pp. 307-324Keane, J., Tuberculosis associated with infliximabe, a tumor necrosis factor alpha-neutralizing agent (2001) N Engl J Med, 345 (15), pp. 1098-1104Gomez-Reino, J.J., Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: A multicenter active-surveillance report (2003) Arthritis Rheum, 48 (8), pp. 2122-2127(2004) Arthritis Res Ther, 6 (SUPPL. 2), pp. S19-S23Hochberg, M.C., Comparison of the efficacy of the tumour necrosis factor alpha blocking agents adalimumabe, etanercepte, and infliximabe when added to methotrexate in patients with active rheumatoid arthritis (2003) Ann Rheum Dis, 62 (SUPPL. 2), pp. ii13-ii1

Effect of PR interval and pacing mode on persistent atrial fibrillation incidence in dual chamber pacemaker patients: A sub-study of the international randomized MINERVA trial

Aims Per standard of care, dual-chamber pacemakers are programmed in DDDR mode with fixed atrioventricular (AV) delay or with long AV delay to minimize ventricular pacing. We aimed to evaluate whether the PR interval may be a specific criterion of choice between standard DDDR, to preserve AV synchrony in long PR patients, and managed ventricular pacing (MVP), to avoid ventricular desynchronization imposed by right ventricle apical pacing, in short PR patients. Methods and results In the MINERVA trial, 1166 patients were randomized to Control DDDR, MVP, or atrial anti-tachycardia pacing plus MVP (DDDRP + MVP). We evaluated the interaction of PR interval with pacing mode by comparing the risk of atrial fibrillation (AF) longer than 7 consecutive days as a function of PR interval. Out of 906 patients with available data, the median PR interval was 180 ms. The PR interval was found to significantly (P = 0.012) interact with pacing mode for AF incidence: The risk of AF &gt; 7 days was lower [hazard ratio (HR) 0.58, 95% confidence interval (95% CI) 0.34-0.99; P = 0.047] in patients with short PR (shorter than median PR) if programmed in MVP mode compared with DDDR mode and it was lower (HR 0.65, 95% CI 0.43-0.99; P = 0.049) in patients with long PR (equal to or longer than median PR) if programmed in DDDR mode compared with MVP. Conclusion Our data show that PR interval may be used as a selection criterion to identify the optimal physiological pacing mode. Persistent AF incidence was lower in short PR patients treated by right ventricular pacing minimization and in long PR patients treated by standard dual-chamber pacing

A experiência brasileira com o core set da classificação internacional de funcionalidade, incapacidade e saúde para lombalgia La experiencia brasileña con el core set de la clasificación internacional de funcionalidad, incapacidad y salud para dorsalgia The Brazilian experience with the international classification of functioning, disability and health core set for low back pain

OBJETIVO: Validar empiricamente o core set da CIF para lombalgia e descrever a funcionalidade de uma amostra de pacientes com lombalgia mecânica crônica inespecífica. MÉTODOS: Vinte e nove pacientes de um centro de reabilitação foram avaliados por meio do core set da CIF para lombalgia e pelo questionário de Roland Morris (QRM) e SF-36. RESULTADOS: Todas as categorias de estruturas do corpo do core set se mostraram comprometidas em ao menos 80% dos pacientes, sendo consideradas validadas. Entre as 19 categorias de Funções do corpo, apenas quatro estavam comprometidas em menos que 80% dos pacientes, sendo consideradas não-validadas, o mesmo foi observado para cinco das 29 de Atividades e participações e cinco das 25 categorias de Fatores ambientais. CONCLUSÕES: As categorias selecionadas para o core set da CIF para lombalgia foram consideradas empiricamente validadas e em conjunto permitiram descrever a multiplicidade de repercussões dessa condição de saúde sobre a funcionalidade das pessoas. O core set da CIF serve para guiar a intervenção terapêutica interdisciplinar.<br>OBJETIVO: Validar empíricamente el core set de la CIF para dorsalgia y describir la funcionalidad de una muestra de pacientes con dorsalgia mecánica crónica inespecífica. MÉTODOS: Veintinueve pacientes de un centro de rehabilitación fueron evaluados por medio del core set de la CIF para dorsalgia, y mediante el cuestionario Roland Moris (QRM) y SF-36. RESULTADOS: Todas las categorías de Estructuras del cuerpo del core set se mostraron comprometidas en por lo menos 80% de los pacientes, siendo consideradas validadas. Entre las 19 categorías de Funciones del cuerpo, sólo cuatro estaban comprometidas en menos de 80% de los pacientes, siendo consideradas como no validadas; lo mismo fue observado para 5 de las 29 categorías de Actividades y participaciones, y 5 de las 25 categorías de Factores ambientales. CONCLUSIONES: Las categorías seleccionadas para el core set de la CIF cuanto a dorsalgia fueron consideradas como empíricamente validadas y, en conjunto, permitieron describir la multiplicidad de repercusiones de esa condición de salud sobre la funcionalidad de las personas. Este core set de la CIF sirve para guiar la intervención terapéutica interdisciplinaria.<br>OBJECTIVE: To empirically validate the ICF Core Set for low back pain, describing functioning, in a sample of chronic unspecific mechanical low back pain patients. METHODS: Twenty-nine patients from a rehabilitation center were assessed with the ICF Core Set for low back pain, Roland Morris Questionnaire (RMQ) and SF-36. RESULTS: All Body structures categories of this ICF Core Set were impaired in at least 80% of the patients, thus they were considered validated. Among the 19 Body functions categories, only four were impaired in less than 80%, thus not-validated, the same was observed in five out of the 29 Activities and participation categories and five of the 25 Environmental factors categories. CONCLUSIONS: The selected categories of the ICF Core Set for low back pain were empirically validated, and together, they allowed the description of functioning of those patients. This ICF Core Set can be used to guide interdisciplinary therapeutic interventions

Tradução, equivalência semântica e adaptação cultural do Marijuana Expectancy Questionnaire (MEQ) Translation, semantic equivalence and cultural adaptation of Marijuana Expectancy Questionnaire (MEQ)

O objetivo desse estudo foi traduzir, adaptar culturalmente e verificar a equivalência semântica do Marijuana Expectancy Questionnaire (MEQ), o qual avalia as crenças em relação ao uso de maconha, podendo ser importante no tratamento e prognóstico dos dependentes químicos desta substância. O MEQ foi traduzido do inglês para o português, aplicado em 10 sujeitos e submetido ao brainstorming num grupo de 4 sujeitos para reprodução individual e verbal, item a item. Realizou-se o back-translation, uma versão para o idioma de origem, a partir da primeira tradução e do brainstorming. Logo após, traduziu-se novamente para o português. Todo o processo foi analisado por um comitê de juízes especialistas, os quais emitiram pareceres com as observações pertinentes. Realizou-se a análise descritiva interjuízes, verificando-se freqüências e porcentagens. Considerando-se os pareceres dos especialistas, construiu-se então a versão final do MEQ - adaptação brasileira.<br>The objective of this study was to translate, to adapt culturally and verify the semantic equivalence of the Marijuana Expectancy Questionnaire (MEQ), which evaluates the beliefs to the marijuana&#8217;s use, which may be important in the treatment and prognostic of the chemical dependents of this substance. The MEQ was firstly translated from English to Portuguese, administered to 10 persons, and then submitted to brainstorming in a group of 4 persons for individual and verbal reproduction, item by item. Back-translation was executed based on first translation and from brainstorming to the origin language. Soon after, it was translated again into Portuguese. All the process was analyzed by a committee of specialists, which emitted a decision and the pertinent comments. The descriptive judges&#8217; analysis was done verifying frequencies and percentages. Considering the decision of the specialists, the final version of the MEQ (Brazilian Adaptation) was constructed