Tradução, adaptação cultural e validação do questionário Sinonasal Outcome Test (SNOT): 22 para a Língua Portuguesa (BR)

Quality of life questionnaires have been increasingly used in clinical trials to help establish the impact of medical intervention or to assess the outcome of health care services. Among disease-specific outcome measures, SNOT-22 was considered the most suitable tool for assessing chronic rhinosinusitis and patients with nasal polyps. AIMS: To perform translation, cross-cultural adaptation and validation of the SNOT-22 to Brazilian Portuguese. METHODS: Prospective study involving eighty-nine patients with chronic rhinosinusitis or nasal polyps submitted to functional endoscopic sinus surgery, who answered the questionnaire before and after surgery. Furthermore, 113 volunteers without sinonasal disease also answered the questionnaire. Internal consistency, test-retest reliability, measure validity, responsiveness and clinical interpretability were assessed. RESULTS: Mean preoperative, postoperative and no sinonasal disease scores were 62.39, 23.09 and 11.42, respectively (p<0.0001); showing validity and responsiveness. Internal consistency was high (Cronbach's alpha = 0.9276). Reliability was sufficiently good, considering inter-interviewers (r=0.81) and intra-interviewers within a 10 to 14 day-interval (r=0.72). Surgery effect size was 1.55. Minimally important difference was 14 points; and scores up to 10 points were considered normal. CONCLUSION: The Brazilian Portuguese SNOT-22 version is a valid instrument to assess patients with chronic rhinosinusitis and nasal polyps.Os questionários de qualidade de vida têm sido utilizados para determinar o impacto promovido por uma intervenção ou avaliar os resultados dos serviços de saúde. Dentre os questionários específicos, o SNOT-22 foi considerado o mais adequado para avaliar pacientes com rinossinusite crônica (RSC) e polipose nasossinusal (PNS). OBJETIVO: Realizar a tradução, adaptação cultural e validação do SNOT-22 para o Português Brasileiro (BR). MATERIAL E MÉTODO: Estudo prospectivo com 89 pacientes no pré e pós-operatório de cirurgia endoscópica nasossinusal por RSC ou PNS e 113 voluntários sem doença nasossinusal. RESULTADOS: O escore médio no pré-operatório foi de 62,39 pontos; no pós-operatório, de 23,09 e dos sem doença nasossinusal, de 11,42 (p<0,0001), mostrando a validade e responsividade. A consistência interna foi alta (alfa de Cronbach de 0,9276). A reprodutibilidade foi suficiente na aplicação interentrevistadores (r=0,81) e intraentrevistadores com 10 a 14 dias de intervalo (r=0,72). O tamanho de efeito da cirurgia foi de 1,55. A diferença minimamente importante foi de 14 pontos e escores até 10 pontos foram considerados como normais. CONCLUSÃO: A versão para Português Brasileiro do questionário SNOT-22 é um instrumento válido para avaliar pacientes com RSC e PNS.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) ENT Residency ProgramPUC-SorocabaUNIFESP-EPM ENT ResidentUNIFESP-EPMUNIFESP-EPM ENTUNIFESP-EPM Rhino-LaryngologyUNIFESP-EPM Department of Otorhinolaryngology and Head and Neck SurgeryUNIFESP, EPM, ENT Residency ProgramUNIFESP, EPM ENT ResidentUNIFESP-EPMUNIFESP, EPM ENTUNIFESP, EPM Rhino-LaryngologyUNIFESP, EPM Department of Otorhinolaryngology and Head and Neck SurgerySciEL

Long-term outcomes of endoscopic sinus surgery for chronic rhinosinusitis with and without nasal polyps

Chronic rhinosinusitis (CRS) significantly affects patient quality of life. Medical and surgical treatments aim to clinically manage the condition. OBJECTIVE: To assess the long-term quality of life and clinical management of CRS in patients submitted to endoscopic sinus surgery. METHOD: This prospective cross-sectional cohort study enrolled 38 patients and looked into the follow-up data of subjects diagnosed with CRS before surgery, three months after surgery, and at least two years after surgery. The Sinonasal Outcome Test 22 (SNOT-22) was used to assess response to treatment and long-term clinical management of the disease. RESULTS: Significant improvements in the SNOT-22 scores were seen between the preoperative (61.3) and postoperative assessments with three (16.9) and 24 (32.3) months. No statistically significant differences were seen when patients with polyps were compared to polyp-free subjects. Few patients were controlled in both groups, and 7.89% of the subjects had revision surgery during the study. CONCLUSION: Endoscopic sinus surgery significantly improved the quality of life of patients with chronic rhinosinusitis. Clinical control of the condition was acceptable, with few patients requiring re-operation within two years of the first surgery.Rinossinusite crônica (RSC) afeta significativamente a qualidade de vida e o tratamento clínico e cirúrgico visa apenas seu controle clínico. OBJETIVO: Avaliar a qualidade de vida e o controle clínico da RSC em longo prazo em pacientes submetidos à cirurgia endoscópica nasossinusal. MÉTODO: Estudo observacional longitudinal prospectivo que seguiu pacientes com diagnóstico clínico de RSC no pré-operatório, pós-operatório de 3 meses e depois por no mínimo 2 anos após cirurgia nasossinusal endoscópica com a utilização do questionário Sinonasal Outcome Test 22 (SNOT-22) como principal medida de resposta ao tratamento, além da avaliação do controle clínico a longo prazo. RESULTADOS: Trinta e oito pacientes foram avaliados em todos os intervalos. Houve uma grande melhora dos valores do SNOT-22 entre o pré-operatório (61,3) e o pós-operatório de 3 (16,9) e 24 meses (32,3). Não houve diferença estatisticamente significante entre os pacientes com e sem pólipos nasais. Nota-se pouca proporção de pacientes controlados em ambos os grupos, e 7,89% foram submetidos à cirurgia revisional no período estudado. CONCLUSÃO: A cirurgia endoscópica nasossinusal promoveu importante melhora da qualidade de vida nos pacientes com rinossinusite crônica, atingindo controle clínico aceitável com baixa necessidade de reintervenção cirúrgica, mesmo após dois anos de seguimento pós-operatório.UNIFESP-EPMUNIFESP, EPMSciEL

Dosagem sérica dos marcadores inflamatórios em crianças submetidas à adenotonsilectomia

The palatine and pharyngeal tonsils in humans are the largest component of Waldeyer ring. They are immunologically reactive lymphoid organs, which play functions of humoral and cellular immunity. The palatine tonsil is the primary site of cytokine produced by macrophages and neutrophils. Objective: To quantitate serum levels of key inflammatory markers (IL-1?, IL-4, IL-6, IL-8, IL-10, IL-15, TNF-?, CReactive Protein and ?-1GP), the preoperative and postoperative, in patients undergoing adenotonsillectomy. Method: We prospectively studied 19 children who complained of snoring, difficulty breathing during sleep and / or recurrent tonsillitis were evaluated. Patients underwent clinical exam, nasofibrolaryngoscopy and collecting blood sample for measurement of inflammatory markers. All the children underwent adenotonsillectomy. After a postoperative period of at least 1 month, a new collection of blood samples were performed. Results: Statistically significant values for the difference in values of serum inflammatory mediators pre and post procedure weren't found. Conclusion: We conclude that surgery does not result in a statistically significant (p <0.05) of these mediators.As tonsilas palatinas e faríngeas são o maior componente do Anel de Waldeyer. São órgãos linfóides imunologicamente reativos que desempenham funções de imunidade humoral e celular. A tonsila palatina é o sítio primário de citocinas produzidas pelos macrófagos e neutrófilos. Objetivo: dosar os níveis séricos dos marcadores inflamatórios (IL-1?, IL-4, IL-6, IL-8, IL-10, IL-15, TNF-?, PCR e ?1-GP), no pré e pós operatório, em pacientes submetidos a adenotonsilectomia. Método: Foram avaliadas prospectivamente 19 crianças que apresentavam queixa de ronco, dificuldade respiratória durante o sono e/ou tonsilites de repetição. Os pacientes foram submetidos a exame otorrinolaringológico completo, nasofibrolaringoscopia e coleta de amostra de sangue para dosagem das citocinas. Todas crianças foram submetidas a cirurgia de adenotonsilectomia. Após um período pós operatório de pelo menos 1 mês, foram realizadas coletas de novas amostras de sangue para a dosagem das citocinas. Resultados: Não foram encontrados valores estatisticamente significantes para a diferença dos valores dos mediadores inflamatórios séricos pré e pós procedimento. Conclusão: Conclui-se que a cirurgia não resulta em em alterações estatisticamente significantes (p<0,05) destes mediadores.Dados abertos - Sucupira - Teses e dissertações (2013 a 2016

Resultados em longo prazo da cirurgia endoscópica nasossinusal no tratamento da rinossinusite crônica com e sem pólipos nasais Long-term outcomes of endoscopic sinus surgery for chronic rhinosinusitis with and without nasal polyps

Rinossinusite crônica (RSC) afeta significativamente a qualidade de vida e o tratamento clínico e cirúrgico visa apenas seu controle clínico. OBJETIVO: Avaliar a qualidade de vida e o controle clínico da RSC em longo prazo em pacientes submetidos à cirurgia endoscópica nasossinusal. MÉTODO: Estudo observacional longitudinal prospectivo que seguiu pacientes com diagnóstico clínico de RSC no pré-operatório, pós-operatório de 3 meses e depois por no mínimo 2 anos após cirurgia nasossinusal endoscópica com a utilização do questionário Sinonasal Outcome Test 22 (SNOT-22) como principal medida de resposta ao tratamento, além da avaliação do controle clínico a longo prazo. RESULTADOS: Trinta e oito pacientes foram avaliados em todos os intervalos. Houve uma grande melhora dos valores do SNOT-22 entre o pré-operatório (61,3) e o pós-operatório de 3 (16,9) e 24 meses (32,3). Não houve diferença estatisticamente significante entre os pacientes com e sem pólipos nasais. Nota-se pouca proporção de pacientes controlados em ambos os grupos, e 7,89% foram submetidos à cirurgia revisional no período estudado. CONCLUSÃO: A cirurgia endoscópica nasossinusal promoveu importante melhora da qualidade de vida nos pacientes com rinossinusite crônica, atingindo controle clínico aceitável com baixa necessidade de reintervenção cirúrgica, mesmo após dois anos de seguimento pós-operatório.<br>Chronic rhinosinusitis (CRS) significantly affects patient quality of life. Medical and surgical treatments aim to clinically manage the condition. OBJECTIVE: To assess the long-term quality of life and clinical management of CRS in patients submitted to endoscopic sinus surgery. METHOD: This prospective cross-sectional cohort study enrolled 38 patients and looked into the follow-up data of subjects diagnosed with CRS before surgery, three months after surgery, and at least two years after surgery. The Sinonasal Outcome Test 22 (SNOT-22) was used to assess response to treatment and long-term clinical management of the disease. RESULTS: Significant improvements in the SNOT-22 scores were seen between the preoperative (61.3) and postoperative assessments with three (16.9) and 24 (32.3) months. No statistically significant differences were seen when patients with polyps were compared to polyp-free subjects. Few patients were controlled in both groups, and 7.89% of the subjects had revision surgery during the study. CONCLUSION: Endoscopic sinus surgery significantly improved the quality of life of patients with chronic rhinosinusitis. Clinical control of the condition was acceptable, with few patients requiring re-operation within two years of the first surgery

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved