Reference Outpatient Clinic Research Articles

A-250 Evaluation of Liver Fibrosis in Schistosomiasis Mansoni Using the ELF (Enhanced Liver Fibrosis) Score

Abstract Background Measuring the presence and pattern of periportal fibrosis (PPF) in schistosomiasis mansoni (SM) is essential for diagnosing its clinical forms and detection of portal hypertension. For these evaluations, the gold-standard has been ultrasound scan (US) using Niamey classification, however it requires sophisticated equipment and well-trained operator. ELF (Enhanced Liver Fibrosis) is an index capable of quantifying liver fibrosis in chronic liver diseases, although there have been few studies evaluating PPF in SM. Aim To assess serum ELF levels according to the PPF patterns established by ultrasound using the Niamey classification in patients with schistosomiasis. Methods A cross-sectional, bidirectional analytical study was carried out with patients from an endemic area (patterns A, B, C and D) and from an SM reference outpatient clinic (patterns D, E and F). Clinical data and 10 mL of blood were collected, centrifuged and frozen to measure and calculate the score by the ELF™ Test (Atellica® IM), according to the equation: [ELF = 2.278 + 0.851 ln(HA) + 0.751 ln(PIIINP) + 0.394 ln(TIMP-1)] and expressed as a numerical value without unit. US using GE Healthcare Logic E (endemic area) or Siemens Acuson S2000 (outpatient clinic) equipment were performed by a single examiner. Results Of the 196 patients evaluated, 114 (58.2%) were women with a mean age of 45 ± 15.42 years. They had the following PPF patterns: 18 pattern A+B; 64 pattern C; 56 pattern D; 49 pattern E and 9 pattern F. The median ELF values were higher according to PPF progression in these 5 groups (p = 0.0021), respectively: (A+B = 8.36); (C = 8.40); (D = 8.64); (E = 8.99) and (F = 9.75). The ELF was able to differentiate patients without PPF, with mild, moderate and advanced PPF: A+B vs C vs D vs E+F (p = 0.0024), as well as patients with advanced PPF from those without fibrosis or with moderate fibrosis: A+B vs E+F (p = 0.0464) and C+D vs E+F (p = 0.0007). The index was also able to differentiate patients with absent or mild PPF from those with moderate or advanced PPF: A+B+C vs D+E+F (p = 0.0015). Conclusions The ELF showed great potential as a tool for assessing PPF in patients with schistosomiasis mansoni, being able to differentiate those with little fibrosis from those with moderate or advanced fibrosis.

Perception of patients with skin lesions about nursing care in the light of Peplau

Objective: To understand the perceptions of patients with skin lesions about nursing care in the light of Peplau's theory. Method: Qualitative descriptive research carried out from November 2021 to February 2022, with patients treated in a reference outpatient clinic. The data were collected using an interview script, transcribed into a textual corpus, analyzed using Iramuteq software and interpreted using Hildegard Peplau's theory of interpersonal relationships in nursing. Results: The textual corpus consisted of 42 interviews, forming two subcorpora. The first is the origin of skin lesions with the classes: difficult to heal lesion, perceived need and traumatic lesion. The second is the patient's perception of the quality of care provided by the nurse: interpersonal process, exploration, therapeutic process and nursing. Conclusion: The perceptions of patients with skin lesions have shown that the care provided by nursing professionals plays a fundamental role in the therapeutic path to recovery from this health problem, as well as highlighting the considerable contribution that nursing theories can make to the interpretation of the data found.

Meanings attributed to health-related quality of life by caregivers of adolescents with diabetes.

to interpret the meanings attributed to the health-related quality of life by caregivers of adolescents with type 1 diabetes mellitus. qualitative, descriptive-exploratory study of 14 caregivers of adolescents with diabetes developed at the reference outpatient clinic for endocrine diseases in a city in the state of Paraíba. Interviews were performed between May and September 2021. Inductive thematic analysis of the empirical material, and its interpretation in light of the concepts of health-related quality of life and family functioning were performed. the meanings attributed by caregivers to the health-related quality of life of adolescents converged on the feeling of being healthy, healthy eating, satisfactory family income, family involvement in care and effective access to the care network. knowledge of these meanings enables health professionals to develop strategies that meet the unique demands of caregivers experiencing this diagnosis.

Effects of three physical exercise modalities on respiratory function of older adults with Parkinson's disease: A randomized clinical trial

IntroductionDeficits in respiratory function of patients with Parkinson's disease contribute to aspiration pneumonia, one of the main causes of mortality in this population. The aim of this study was to evaluate the effects of functional training, bicycle exercise, and exergaming on respiratory function of elderly with Parkinson's disease. MethodsA randomized clinical trial with single blinding was conducted in a public reference outpatient clinic for the elderly. The participants were randomly assigned to three groups. Group 1 was submitted to functional training (n = 18); group 2 performed bicycle exercise (n = 20), and group 3 trained with Kinect Adventures exergames (n = 20). The sessions performed lasted 8 weeks with a frequency of three 50-min sessions per week. The primary outcome was the forced expiratory volume in the first second; and the secondary outcomes were forced vital capacity, peak expiratory flow, and maximum inspiratory and expiratory pressures. ResultsThe interventions performed did not improve the forced expiratory volume in the first second, forced vital capacity, and peak expiratory flow. However, group 2 improved (p = 0.03) maximum expiratory pressure (from 65.5cmH2O to 73.1cmH2O) (effect size 0.47), and group 3 increased (p = 0.03) maximum inspiratory pressure (from −61.3cmH2O to −71.6cmH2O) (effect size 0.53). ConclusionsNo effect was found on lung volume, forced respiratory flow and capacity of the participants with Parkinson's disease submitted to three different modalities of motor training. However, bicycle exercise and exergaming have improved expiratory and inspiratory muscle strength, respectively. NCT02622737.

Experience of elderly women about the interpersonal violence suffered

This study aimed to understand the experiences of elderly women seen in a reference outpatient clinic, regarding to the interpersonal violence suffered in their daily lives. A cross-sectional, qualitative, and exploratory cohort study was chosen, with elderly women seen in a outpatient clinic of a hospital of reference in Recife, from February to March 2022. Data were obtained through semi-structured interviews, audio-recorded, and later transcribed in a literal way. Data analysis was carried out using Minayo's thematic content analysis technique. The sample included 13 elderly women, with a mean age of 68.8 years. The categories revealed, from the perspective of the elderly, an increase in the occurrence of violence and its relationship with substance use and financial dependence. Furthermore, it was observed that healthcare professionals and support services are ill-prepared to identify violence and provide protection and care measures. It is understood that there is a long way to go in terms of legislation and professional practice guidelines in elder protection commissions.

Sociodemographic and Clinical Factors Associated with Treatment Outcomes for Drug-resistant Tuberculosis.

Drug-resistant tuberculosis (DR-TB) continues to be a serious public health problem. The objective of this study was to evaluate the sociodemographic, radiological, clinical, and outcome characteristics and assess the determinants of unfavorable outcomes in DR-TB. The descriptive-analytical study was carried out in a reference outpatient clinic in Rio de Janeiro, Brazil, among DR-TB cases that received treatment between February 2016 and October 2020, using descriptive statistics, χ2 test, and logistic regression multivariate. Of the 148 cases, 12.2% were resistant to rifampicin, 12.2% were resistant to isoniazid, 18.2% were polyresistant, 56.1% multidrug resistant, and 1.3% were extensively drug resistant. Most of the patients were men, aged up to 44 years, with brown or black skin, having up to 8 years of schooling, unemployed or working in the informal economy, and of low income. Presenting with acquired resistance or positive sputum smear microscopy in the diagnosis, taking more than four drugs, and being unemployed were associated with unfavorable outcomes. Having no income or acquired resistance doubled the chances of unfavorable outcomes. There was a high proportion of unfavorable outcomes, thereby highlighting the need to concentrate efforts on planning and executing public policies that include the severity of DR-TB and its risk factors.

Vitamin D deficiency in children and adolescents with food allergy

Our objective was to describe the serum vitamin D concentrations of children and adolescents with food allergy (FA) and to verify the association between the number of food allergens involved, length of sun exposure, and nutritional status. Through a cross-sectional study, 79 patients with FA, from ages 2 to 15 years, were assessed and followed up in a reference outpatient clinic, in Sao Paulo, Brazil. Clinical and biochemical data were collected for analysis of 25(OH)D, calcium, phosphorus, phosphatase, parathyroid hormone (PTH), and high-sensitivity C-reactive protein (hs-CRP). The cut-off point used for vitamin D deficiency was 25(OH)D ≤ 20 ng/mL. Vitamin D deficiency was detected in 45.6% of patients with a median age of 6.9 years (Interquartile range [IQR] 4.7; 10.2). The median serum 25(OH)D concentration was 21.1 ng/mL (IQR 17.8; 26.0). Multivariate linear regression was performed considering serum vitamin D level as a dependent variable. Allergy to multiple foods (inverse) and length of sun exposure (direct), but not nutritional status, were independently associated with serum 25(OH)D levels (P = 0.034 and P = 0.014, respectively). Patients with cow's milk allergy also showed lower vitamin D concentrations in comparison with other FA (19.1 ng/mL [IQR 16.6; 24.4] vs 22.2 ng/mL [IQR 18.1; 27.1] [P = 0.056]). Vitamin D deficiency affected about half of individuals with FA. Multiple food allergy was associated with lower vitamin D concentrations, reinforcing the importance of monitoring vitamin D status in patients with FA.

ANALYSIS OF PATIENT’S SATISFACTION WITH CLEAN INTERMITTENT URETHRAL CATHETERIZATION

Objectives: To compare and evaluate the aspects of the use of two bladder catheters for the person undergoing treatment with post-void residual, in clean intermittent bladder catheterization (CIL). Method: Quantitative, observational, and descriptive analysis developed in a reference outpatient clinic, for 48 municipalities, from September to November 2020. Fifty patients with post-void residual, who underwent CVIL, took part in the study. Their average age was 44,8 years old, and 72% of them were male. Two lubricated catheters were compared, from different technologies, both with attached bags, for seven days, six catheterizations a day, using a validated instrument of perception of customer satisfaction. Data were analyzed by the software Statistical Package for the Social Sciences (SPSS) Statistics 23.0, and for the comparison of the two catheters it was used the Wilcoxon’s non-parametric test. Results: The polyvinyl chloride (PVC) catheter pre-lubricated with glycerol reached greaterparticipant satisfaction in the evaluated attributes (90 versus 86%) in relation to the hydrophilic polyurethane (PVP) pre-lubricated catheter, although there was no statistical significance on the partial or total scores of the instrument used. Conclusion: The study allowed the comparison of two catheters, and the evaluation of the general score for both was positive. Some negative evaluation for certain attributes is possible to be improved. This kind of study is able to discriminate the catheters, and it can be reproduced.

Parents' satisfaction with information received on psychotropic drugs used by adolescents in a Mental Health Unit.

Objective:To analyze the satisfaction of those responsible for adolescents with information received for the use of psychotropic drugs.Methods:Cross-sectional study carried out in a reference outpatient clinic in Brasília between 2017 and 2019. It involved 173 legal representatives of adolescents diagnosed with Mental and Behavioral Disorders using psychotropic drugs. In order to identify the level of satisfaction about the information received on psychotropic drugs, the Satisfaction with Information about Medicines Scale (SIMS) was used.Results:Most guardians were dissatisfied with the information received on psychotropic drugs (n=112; 64.7%). The dissatisfaction with information about potential problems of medication was the one that stood out the most (n=127; 73.4%) when compared to information about action and usage (n=89; 51.5%). Participants considered information on the impact of medication on the adolescent’s sexual life unsatisfactory or nonexistent.Conclusions:The parents’ satisfaction with the information received about psychotropic drugs was low. Participants showed dissatisfaction with the information about potential problems, especially related to the impact on the sexual life of their tutored.

Teleconsulta de enfermagem ao paciente submetido à cirurgia geral: inovação tecnológica

The aim was to describe the elaboration of the protocol for nursing teleconsultation for patients undergoing elective general surgery. Description of an innovative technological protocol developed in a reference outpatient clinic for general surgery, in Rio de Janeiro - RJ, Brazil. The steps involved in the construction of the protocol consisted of structuring the theoretical content and defining the form of operation. The theoretical framework of the protocol was developed based on the Safe Surgery Protocol, adapted to the needs of the chosen site. The principle of innovation is guided by the nursing teleconsultation for patients undergoing general surgery, which consists of telephone calls, with the aim of guiding and monitoring patients with surgical procedures according to their pathological condition, whether curative, diagnostic or palliative. A step-by-step infographic was made available to the patient, informing steps for scheduling their nursing teleconsultation with guidelines related to their perioperative period. The use of a protocol focused on educational actions represents an important initiative for the field of nursing teleconsultation in Brazil, offering important subsidies that will assist nurses in carrying out teleconsultation, proving to be an important guiding tool for the care of surgical patients.

Clinical and functional characteristics of women after stroke, fallers and non-fallers: a longitudinal study

BACKGROUND: Occurrence of falls is among the most frequent complications presented by the elderly and individuals with neurological diseases. It is known that in the elderly, there is a greater frequency of falls in women. However, in individuals after stroke, this relationship is not established. The purpose of this study was to differentiate the clinical and functional characteristics of fallers and non-fallers women after stroke and to verify the association between functional mobility and functional capacity in these women. DESIGN AND SETTING: This is a longitudinal prospective study conducted in Salvador, Bahia, Brazil. METHODS: Women with independent gait assisted in a reference outpatient clinic were included. Sociodemographic and clinical data were collected, and the National Institutes of Health Stroke Scale, Modified Barthel Index, Timed Up and Go (TUG), and European quality of life were applied. The level of significance was set at 5%. RESULTS: A total of 68 women with a mean age of 56 (± 13.7) years were selected; 51% of the women fell in the follow-up, the latter was younger than 55 years (± 13.4), with greater severity of the stroke. Impairment in the posterior vascular territory was more evident among falling women (P = 0.009), but all falling and non-falling women presented impaired functional mobility (TUG = 15seconds). However, the total sample was classified as totally independent or with slight dependence on the activities of daily living (ADLs) (MBI = 49). The correlation between TUG time and MBI was negative and significant (R = -0.702, P ? 0.001). CONCLUSIONS: The involvement of posterior circulation is an important predictor of falls, an important indicator in the monitoring of women after stroke. It also emphasizes that the lower functional mobility impacted women's functional capacity.

Poor glycemic control and associated factors in diabetic people attending a reference outpatient clinic in Mato Grosso, Brazil.

Objective:To identify the proportion of poor of glycemic control and associated factors among people with type 2 diabetes attending a regional reference outpatient clinic in Mato Grosso (Brazil).Methods:This is a cross-sectional quantitative study based on data from medical records of 338 people with type 2 diabetes who attend a state reference outpatient clinic in Mato Grosso (Brazil). Information on glycemic control, sociodemographic factors, lifestyle and clinical conditions was collected.Results:The prevalence of elevated glycated hemoglobin was 47.34%. In the Poisson multiple regression model analysis with robust variance, poor glycemic control was significantly associated (p<0.05) with the following factors: insulin use (Prevalence Ratio -PR = 2.03), fasting glucose ≤70 and ≥100 mg/dL (PR = 2.0), postprandial glucose ≥180 mg/dL (PR = 1.76), no physical activity (PR = 1.62), the interaction between age group ≤59 years and the time of disease diagnosis >10 years (PR = 1.58), and presence of arterial hypertension (PR = 0.79).Conclusion:Most users of the reference outpatient clinic with type 2 diabetes had poor glycemic control associated with risk factors that alter glycated hemoglobin and negatively affect the achievement of established glycemic levels.

P-22 ANALYSIS OF FEATURES ASSOCIATED WITH DIFFICULTY IN SCREENING AND EARLY DIAGNOSING HEPATOCELLULAR CARCINOMA IN RISK PATIENTS

Several barriers to access hepatocellular carcinoma (HCC) screening in Brazil and the large number of patients diagnosed at advanced disease stages, without prospect of curative treatment, are indicatives that access to early HCC diagnosis and treatment is not equitably guaranteed for entire population. The aim of the current study is to investigate the determining factors hindering the access to HCC screening and early diagnosis, based on abdominal ultrasound (US) application to risk patients. Descriptive and longitudinal study carried out in reference outpatient clinic, based on questionnaire application to patients at risk for HCC. Fifty patients (mean age of 59 years), whose main disease etiology lied on alcohol, and hepatitis B and C viruses, were evaluated; 76% of them underwent US monitoring on a regular basis and 58% understood the importance of undergoing such an examination. The main barriers to access examination comprised scheduling (25%) and financial issues (12.5%). Eight patients were diagnosed with HCC (16% of sample), 50% of them were diagnosed at the first consultation and 37.50% did not know about the importance of such diagnosis (Table); curative treatment was no longer applicable to 62.50% of these patients. It is worth emphasizing the essential role played by half-yearly screening in the early diagnosis and curative treatment of HCC. It is necessary developing policies focused on identifying and placing HCC patients at risk in health surveillance programs, as well as on providing greater access to, and education about the important role played by these exams.

Estilo de vida e nível de atividade física de indivíduos portadores de miocardiopatia chagásica

INTRODUÇÃO: A doença de Chagas (DC) constitui uma infecção parasitária causada pelo protozoário flagelado Tripanosoma cruzi. Estimativas apontam a existência de, aproximadamente, cinco milhões de indivíduos infectados, principalmente, na América Latina, com o Brasil datando entre 1,9 a 4,6 milhões de indivíduos sob o mesmo aspecto infeccioso. O desfecho cardíaco configura um dos aspectos mais importantes, com manifestações condizentes à disfunção ventricular sistólica ou diastólica, disfunção autonômica cardíaca e morte súbita. OBJETIVO: correlacionar o estilo de vida e o nível de atividade física de indivíduos portadores de miocardiopatia chagásica (MC). MATERIAL E MÉTODOS: Realizou-se um estudo analítico, de corte transversal, em ambulatório de referência para Miocardiopatias, com abrangência estadual. Utilizou-se formulário próprio construído pelas autoras, o qual contemplava além das variáveis clínicas e demográficas, variáveis relativas à análise do estilo de vida e atividade física dos participantes, sendo esse aplicado em sala de espera, enquanto os sujeitos aguardavam atendimento médico. RESULTADOS: Foram selecionados 74 indivíduos portadores de MC. A média de idade da amostra foi de 61,2 ± 8,5 anos, sendo que 50 (68,0%) indivíduos eram do sexo feminino. Em relação ao nível de atividade física, houve predomínio da categoria “não ativo”, correspondendo a 60 indivíduos (71,0%). O estilo de vida foi classificado como “muito bom” para 41 (55,0%) participantes e “bom” para 22 (30,0%) participantes, não havendo indivíduos alocados na categoria “necessita melhorar” do questionário. CONCLUSÃO: Os resultados obtidos permitem concluir que, de modo geral, o estilo de vida e o nível de atividade física de indivíduos portadores de MC caracterizaram-se como “bom” / “muito bom” e não ativos, respectivamente.

Serum 25-hydroxyvitamin D concentration among users of a referral outpatient unit for vascular diseases and associated factors.

Assess serum 25-hydroxyvitamin D (25OHD) concentration and associated factors among users of a referral outpatient unit for vascular diseases in Southern Brazil. Cross-sectional study conducted for almost one year, from March 2016 to January 2017. The serum vitamin D level was determined biochemically and classified as: sufficient (>50nmol/L), insufficient (30-50nmol/L) and deficient (<30nmol/L). Associations were tested through multiple linear regression. At a reference outpatient clinic specialized in vascular diseases located in a southern Brazilian medium-sized city (latitude 29°S). Consecutive sample of 133 individuals of both sexes, aged at least 40 years. The mean serum 25OHD concentration was 54.9±25.9nmol/L (57.7±27.9nmol/L for men; 52.2±24.2nmol/L for women, p=0.267). A total of 12.8% of the participants had vitamin D deficiency and 32.3% had insufficiency. Regarding the total sample, variables associated to the serum 25OHD concentration were: age (β=-0.55; CI95%-0.95;-0.17), sun exposure (β=1.22; CI95% 0.32; 2.10) and vitamin D intake (β=7.29; CI95% 2.10; 12.48). Among men, a significant association was observed for age (β=-0.82; CI95%-1.47;-0.17, p=0.015) and borderline for sun exposure (β=1.22; CI95% 0.32; 2.10, p=0.053). Among women, only vitamin D intake was significantly associated with serum concentration of this vitamin (β=8.74; CI95% 1.32; 16.17, p=0.022). Although the mean 25OHD concentration was greater than 50nmol/L, about 45% of this consecutive sample presented poor vitamin D nutritional status. Unadjusted for seasonality, factors associated with serum 25OHD concentration were age and sun exposure among men and vitamin D intake among women.

Perfil clínico-epidemiológico dos pacientes pediátricos portadores de anemia hemolítica autoimune em um serviço de referência

OBJECTIVES: The autoimmune hemolytic anemia (AIHA) is a group of diseases characterized by the presence of autoantibodies that bind to erythrocytes reducing the half-life of these cells. It is a rare condition that occurs in about 1-3 cases per 100,000 children per year, more common in males in ratio of 2:1 cases. This study aimed to obtain the clinical and epidemiological profile of pediatric patients diagnosed with autoimmune hemolytic anemia (AIHA), treated at the reference outpatient clinic. METHODS: Participated in the study through analysis of medical records and completion of the research protocol 24 children with AIHA attended at the reference outpatient clinic between 2009 and 2019, age from 0 to 18 years. Clinical, laboratory and outcome data were obtained from patients records. RESULTS: The results showed that most of the children are female (58%), receive early diagnosis until 2 years of age (58%). The direct antiglobulin test was positive in over 95% of cases. The patients presented cutaneous-mucous pallor (50%) as the initial symptom. However, the limitations inherent in the study, which had a small sample due to the rarity of the disease, should be evaluated. CONCLUSION: The diagnosis of AIHA must be made early, based on a detailed clinical history, suspected by the pediatrician through the characteristic signs of hemolysis and initiated treatment with corticotherapy, which shows high rates of remission and cure of the pathology.

Perfil clínico e funcional de idosos atendidos em centro de referência em um município do Amazonas

Objetivo: Traçar o perfil clínico e funcional de idosos atendidos em um centro de referência em saúde do idoso. Métodos: Trata-se de um estudo transversal, descritivo, retrospectivo e documental, envolvendo 74 prontuários de idosos atendidos em um ambulatório de referência em saúde do idoso, localizado em um município amazonense. Utilizou-se uma ficha de avaliação fisioterapêutica dos usuários, além do Índice de Katz e Índice de Lawton para avaliação da capacidade funcional. Resultados: Os prontuários mostraram um perfil com predomínio de indivíduos considerados idosos jovens, do sexo feminino, caracterizados como independentes tanto pela classificação do índice de Katz, quanto pelo Índice de Lawton, não inseridos no mercado de trabalho, com presença de pelo menos 2 comorbidades e prevalência de doenças reumáticas e traumato-ortopédicas. Conclusão: O perfil do idoso atendido no centro de referência mostra predomínio de idosos jovens, com maior grau de independência funcional e prevalência de doenças reumáticas e traumato-ortopédicas, além de outras comorbidades. Determinar as características da população assistida poderá contribuir para o desempenho efetivo de toda a equipe, além da elaboração de medidas preventivas, intervenções efetivas, assim como o planejamento de políticas públicas em saúde do idoso.

External validation of the recurrent falls risk scale in community-dwelling stroke individuals

ObjectiveTo externally validate the Recurrent Fall Risk Scale (ReFR) in community-dwelling stroke survivors. MethodsCohort of stroke survivors with independent gait ability recruited from a reference outpatient stroke clinic. Besides sociodemographic and clinical data, the following scales were used: Modified Barthel Index (mBI), ReFR scale and National Institutes of Health Stroke Scale (NIHSS). Participants were followed up for 12 months to record the incidence of falls. Accuracy of the ReFR scale was measured by the area under the ROC curve. ResultsOne hundred and thirteen individuals were recruited between April 2016 and November 2016: mean age 54 years (± 14), 55% women, median time since the last stroke 24 months (range 12 –48 months), posterior vascular territory affected in 35% of the sample. Median NIHSS was 3 (range 1 to 6), median mBI 49 (range 46–50), median ReFR 3 (range 2 to 5). During the follow-up period, 32 (33%) subjects had at least one fall and 18 (19%) were recurrent fallers (two or more falls). The accuracy of ReFR scale was 0.67 (95% CI = 0.54–0.79), p = 0.026. ConclusionThis study externally validated the ReFR as a tool to predict recurrent falls in individuals after stroke.

QUALITY OF LIFE OF PATIENTS FROM A MULTIDISCIPLINARY CLINIC OF INFLAMMATORY BOWEL DISEASE.

Inflammatory bowel disease encompasses pathological entities, the main being Crohn's disease and ulcerative rectocolitis. Both are characterized by chronic inflammation of the intestine. It affects young people of active age, compromising the situation of those patients, especially their quality of life, experiencing a strong deterioration in their clinical condition, from physical to social and emotional aspects. Evaluate the quality of life of patients assisted in the multidisciplinary reference outpatient clinic for the treatment of inflammatory bowel diseases, through sociodemographic data and specific questionnaires on the disease, evaluating the intestinal and systemic symptoms and the social and emotional aspects. Make a comparison between the two scales used to obtain the data. A cross-sectional study was carried out in which patients diagnosed with inflammatory bowel disease were evaluated and observed at a reference outpatient clinic for treatment from May 2017 through December 2018. The participants responded to the Socio-demographic and Clinical Protocol, the SF-36 general quality of life questionnaire and the specific Inflammatory Bowel Disease questionnaire, in addition the correlation between the two scales was performed using Pearson's Correlation (metric scale), which data were analyzed by means of descriptive statistics and the significance level adopted was 5% (P≤0.05). The population studied consisted of 71 patients, excluding pregnant or nursing women and patients under 18 years of age. Seventy-one patients participated in the study, with an average age of 46.5 years and standard deviation of ±13.8; 45 patients had Crohn's disease and 26 were diagnosed with ulcerative rectocolitis; 73.2% were women; 64.8% married; 8.4%, smokers; 50.7% reported practising some type of physical activity. A good distribution of patients was observed between the domains of each questionnaire; no low scores were found for quality of life, and systemic symptoms and emotional aspects were those with the lowest scores among the parameters of the Inflammatory Bowel Disease Questionnaire; physical (40.6±44.4) and emotional aspects (49.5±46.0) had lower scores among the Short Form-36 domains. The correlation between the two questionnaires proved to be significant. The clinical profile of the patients followed the characteristics of distribution and prevalence of these diseases. The impact of diseases on quality of life was observed in several aspects, especially those related to psychological components. Multidisciplinary follow-up, as well as psychological, social, nutritional and educational support should be considered important determinants to maintain or improve the quality of life of these patients.

Central auditory processing: behavioral and electrophysiological assessment of children and adolescents diagnosed with stroke

IntroductionCentral auditory processing refers to the efficiency and effectiveness with which the central nervous system uses auditory information: it may be altered in neurological disorders and brain injuries, such as strokes. However, despite evidence of probable alterations in the pediatric population, functional abilities and post-stroke limitations are still not well documented in the literature. ObjectiveTo analyze the findings of the electrophysiological and behavioral evaluations of central auditory processing of children and adolescents diagnosed with stroke from a reference outpatient clinic, as well as to investigate possible associations with the variables: type and location of the stroke and age group. MethodsThe present study is characterized as comparative cross-sectional. The sample, for convenience, included individuals aged 7–18 years divided into two groups: study group, composed of individuals with a diagnosis of stroke, and control group, composed of individuals with typical development. The evaluation consisted of the following procedures: anamnesis, basic audiological evaluation, behavioral evaluation of the auditory processing disorder (dichotic digit test, dichotic consonant-vowel, synthetic sentence identification/pediatric speech intelligibility, gaps in noise, pitch pattern sequence, masking level difference), and electrophysiological evaluation (P300 and mismatch negativity). ResultsNineteen children and adolescents were included in the study group. The control group was composed of 19 children and adolescents with typical development. In the comparison between the groups, a worse performance is observed for the study group in all the evaluated tests, behavioral and electrophysiological. In the behavioral evaluation of central auditory processing, there was a statistical difference for all tests, except for masking level difference and dichotic digit test, binaural separation step on the left. In the electrophysiological evaluation, there was a statistical difference in the latency of mismatch negativity and P300. No associations were found between the behavioral and electrophysiological findings and the location of the stroke and age group variables. ConclusionChildren and adolescents diagnosed with stroke present a worse performance in the electrophysiological and behavioral evaluations of central auditory processing when compared to a control group.