Functional performance of upper limb and quality of life after sentinel lymph node biopsy of breast câncer.

A biópsia de linfonodo sentinela (BLS) é um procedimento cirúrgico minimamente invasivo para o tratamento do câncer de mama, o qual pode reduzir a morbidade de membros superiores (MMSS). Objetivos: Investigar as possíveis deficiências e o desempenho funcional de MMSS em atividades de vida diária (AVDs) e a qualidade de vida relacionada à saúde (QVRS) entre mulheres submetidas à BLS em hospital da região sudeste do Brasil e estudar a associação entre essas variáveis. Métodos: Trata-se de estudo descritivo, transversal e correlacional do qual participaram 45 mulheres (58,9±9,3 anos). A avaliação das disfunções foi realizada por meio da medida da perimetria e da amplitude de movimento (ADM) de ombros, do relato e da quantificação da intensidade da dor/desconforto, utilizando Escala Visual Analógica (EVA). O questionário Disabilites of Arm Shoulder and Hand (DASH) foi utilizado para medir o desempenho funcional de MMSS durante as AVDs. Para avaliar a QVRS, foram utilizados os questionários European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Cancer 30 (EORTC QLQ-C30) e a escala de Sintomas do Braço (SB) do European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Breast Cancer Module 23 (EORTC BR-23). Resultados: Houve alta prevalência (75%) de sintomas que acometem MMSS (dor ou desconforto no braço ou ombro) ou mama. Apesar disso, os sintomas foram de leve intensidade. Apenas 4,4% apresentaram linfedema. Não houve limitação da ADM de ombros, e houve pouca limitação no desempenho funcional de MMSS, o que esteve associado com a escala SB do EORTC BR-23. As disfunções e o desempenho funcional de MMSS não interferiram na percepção sobre a QVRS, que foi considerada boa. Conclusão: Nesta amostra, observou-se pouca disfunção e limitação do desempenho funcional de MMSS nas AVDs, sem influenciar a QVRS.Sentinel lymph node biopsy (SLNB) is commonly used for the treatment of breast cancer with minimal surgical intervention as well as with low morbidity rates of upper limbs. Objectives: The aim of the present study was to investigate possible impairments and functional performance of the upper limb on activities of daily living (ADL) and health related quality of life (HRQL) among women treated through SLNB in a Brazilian hospital and to study the association among these variables. Methods: Forty-five women (58.9±9.3 years) participated in this descriptive, cross-sectional and correlational study. The visual analogue scale (VAS) was used to quantify pain intensity/discomfort, arm circumference and shoulder range of motion (ROM) measurement were used to measure upper limb impairments. The Disabilites of Arm Shoulder and Hand questionnaire (DASH) was used to quantify functional performance of upper limb during ADL and European Organisation for Research and Treatment of Cancer - Quality of Life Questionnaire - Cancer 30 (EORTC-QLQ-C30) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Breast Cancer Module 23 (EORTC-BR23) were used to characterize HRQL. Results: Results revealed a 75% prevalence of symptoms affecting upper limb (pain or discomfort in arm, shoulder) or breast, although the severity of the symptoms was only mild. Only 4.4% exhibited lymphedema and no ROM restriction was observed. There was little limitation in functional performance of the upper limb, which was associated with Arm Symptoms scale (EORTC BR-23). Impairments and functional performance of upper limb did not interfere on HRQL perception, which was considered to be good. Conclusion: SLNB caused small impairments and limitation on the functional performance of the upper limb during ADL and did not influence HRQL in our sample

Disfun??es de assoalho p?lvico em atletas.

Disfun??es do assoalho p?lvico s?o condi??es que acometem mulheres em idades variadas, por?m aquelas que se encontram no per?odo do climat?rio, assim como as mult?paras, s?o as mais suscet?veis. Entretanto, h? relatos na literatura de jovens nul?paras que apresentam sintomas de disfun??es nesta regi?o, tais como a incontin?ncia urin?ria e a anal durante a pr?tica de esportes. Essas condi??es podem levar ao abandono da atividade f?sica e comprometer a qualidade de vida. Com o intuito de conhecer a ocorr?ncia das disfun??es do assoalho p?lvico e seus fatores etiol?gicos em atletas jovens e nul?paras, foi feita uma revis?o da literatura. Foram consultadas as bases de dados BVS e PubMed nos ?ltimos dez anos. Os resultados dos estudos revisados indicaram alta preval?ncia de disfun??es do assoalho p?lvico entre atletas, muitas delas nul?paras. A incontin?ncia urin?ria ? a disfun??o do assoalho p?lvico mais documentada e acomete principalmente atletas que praticam atividades consideradas de alto impacto, como trampolim e paraquedismo. As condi??es que desencadeiam as disfun??es do assoalho p?lvico em mulheres jovens e nul?paras ainda n?o est?o completamente elucidadas, altera??es extr?nsecas ou gen?ticas do tecido conjuntivo frouxo e atividades que envolvem longos saltos s?o as hip?teses mais frequentes. Apenas um estudo foi encontrado documentando a preval?ncia das disfun??es do assoalho p?lvico entre atletas envolvendo os sistemas intestinal e sexual, al?m do urin?rio.Pelvic floor dysfunctions are conditions that affect women in various ages, however those in the climacteric period, as well as the multiparous are more susceptible to it. However, there are studies in the scientific literature reporting the occurrence of urinary incontinence during sports among young and nuliparous women. Such conditions can lead to a withdrawn from physical activity compromising the quality of life. A literature review in PubMed and in VHL databases, within the last ten years, was done in order to understand the occurrence of symptoms suggestive of pelvic floor dysfunctions other than urinary incontinence, such as anorectal or sexual dysfunction, and their etiological factors in young and nulliparous athletes. Results indicated a high prevalence of urinary incontinence among athletes, who were engaged in high-impact activities such as trampoline, and skydiving. The conditions that contribute to the urinary incontinence etiology in young and nulliparous women are still not fully understood, extrinsic or genetic changes in loose connective tissue and activities involving long jumps are the most common hypotheses to this condition. Other than urinary tract symptoms, it was found only one study documenting pelvic floor disorders involving the intestinal and sexual systems in such population