Navegando por Palavras-chave "Reproducibility of results"

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    Adaptação cultural e avaliação da reprodutibilidade do Duke Activity Status Index para pacientes com DPOC no Brasil
    (Sociedade Brasileira de Pneumologia e Tisiologia, 2012-12-01) Tavares, Livia dos Anjos; Barreto Neto, José; Jardim, José Roberto [UNIFESP]; Souza, George Márcio da Costa e [UNIFESP]; Hlatky, Mark A.; Nascimento, Oliver Augusto [UNIFESP]; Secretaria Estadual de Saúde Secretaria Municipal de Saúde; Universidade Federal de Sergipe Hospital Universitário Serviço de Pneumologia; Universidade Federal de São Paulo (UNIFESP); Associação de Assistência à Criança Deficiente; Universidade Estadual de Ciências da Saúde de Alagoas Núcleo de Propedêutica e Terapêutica; Stanford University School of Medicine
    OBJECTIVE: To cross-culturally adapt the Duke Activity Status Index (DASI) for use in Brazil and evaluate the reproducibility of the new (Brazilian Portuguese-language) version. METHODS: We selected stable patients with clinical and spirometric diagnosis of COPD. Initially, the DASI was translated into Brazilian Portuguese, and the cross-cultural adaptation was performed by an expert committee. Subsequently, 12 patients completed the questionnaire, so that their questions and difficulties could be identified and adjustments could be made. An independent translator back-translated the final version into English, which was then submitted to and approved by the original author. The final Brazilian Portuguese-language version of the DASI was applied to 50 patients at three distinct times. For the assessment of interobserver reproducibility, it was applied twice within a 30-min interval by two different interviewers. For the assessment of intraobserver reproducibility, it was applied again 15 days later by one of the interviewers. RESULTS: The mean age of the patients was 62.3 ± 10.0 years, the mean FEV1 was 45.2 ± 14.7% of the predicted value, and the mean body mass index was 26.8 ± 5.8 kg/m². The intraclass correlation coefficients for intraobserver and interobserver reproducibility were 0.95 and 0.90, respectively. The correlations between the DASI and the Saint George's Respiratory Questionnaire (SGRQ) domains were all negative and statistically significant. The DASI correlated best with the SGRQ activity domain (r = -0.70), the total SGRQ score (r = -0.66), and the six-minute walk distance (r = 0.55). CONCLUSIONS: The Brazilian Portuguese-language version of the DASI is reproducible, fast, and simple, correlating well with the SGRQ.
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    Adaptação cultural e reprodutibilidade do questionário para problemas respiratórios em pacientes portadores de DPOC no Brasil
    (Sociedade Brasileira de Pneumologia e Tisiologia, 2012-06-01) Silva, Patrícia Nobre Calheiros da; Jardim, José Roberto [UNIFESP]; Souza, George Márcio da Costa e [UNIFESP]; Hyland, Michael E; Nascimento, Oliver Augusto [UNIFESP]; Centro de Estudos Superiores de Maceió; Universidade Federal de São Paulo (UNIFESP); Associação de Assistência à Criança Deficiente; Universidade Estadual de Ciência da Saúde de Alagoas Núcleo de Propedêutica e Terapêutica; Universidade de Plymouth Departamento de Psicologia
    OBJECTIVE: To translate the Breathing Problems Questionnaire (BPQ) into Portuguese and adapt it to the Brazilian culture, as well as to evaluate its reproducibility in patients with COPD. METHODS: After the BPQ had been translated and adapted to the Brazilian culture, it was administered to a subgroup of 8 patients in order to identify their uncertainties and difficulties. The questionnaire was reviewed by an expert committee, and its final version was arrived at. A second translator back-translated the final version into English, which was sent to the original author in order to verify that the original meaning of the questionnaire had been maintained. After the approval of the original author, the final Portuguese-language version of the questionnaire was administered to 50 patients with COPD, in order to evaluate its reproducibility. RESULTS: The mean response time was 9.5 min. Of the 50 patients, 21 were female and 29 were male. The mean age was 65.8 ± 7.5 years. Most of the patients were classified as having moderate COPD (29.16%) or severe COPD (52%). The intraclass correlation coefficient (ICC) for the total score was 0.94. The ICCs for the eleven BPQ domains and its two subscales were also above 0.70. Moderate correlations were found between the BPQ domains and subscales. CONCLUSIONS: The translation and cultural adaptation of the BPQ for use in Brazil was deemed appropriate, because the patients could easily understand and answer the questions. In addition, the Brazilian version of the BPQ questionnaire was found to be reliable, showing good reproducibility.
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    Adaptação transcultural brasileira e evidência psicométrica da lista de eventos ameaçadores - questionário (LTEQ) II Levantamento Nacional de Álcool e Drogas
    (Universidade Federal de São Paulo (UNIFESP), 2017-11-10) Abreu, Patricia Bernardete de [UNIFESP]; Madruga, Clarice Sandi [UNIFESP]; http://lattes.cnpq.br/0659290459957967; http://lattes.cnpq.br/5444380730755902; Universidade Federal de São Paulo (UNIFESP)
    Abreu, P. B. Adaptação transcultural brasileira e validação da Lista de Eventos Ameaçadores - Questionário (LTE-Q). 2017. Dissertação (mestrado) – Universidade Federal de São Paulo - Escola Paulista de Medicina Objetivo: Adaptação transcultural e validação da Lista de Eventos Ameaçadores (LTE-Q), e sua associação com o uso de drogas em uma população probabilística brasileira. Métodos: Trata-se de uma análise secundária da Segunda Pesquisa Nacional sobre Álcool e Drogas (II LENAD), que utilizou uma adaptação transcultural da LTE-Q em uma amostra probabilística de 4.607 participantes com idade igual ou superior a 14 anos. A análise de classe latente foi utilizada para validar o traço latente Adversidade (que considerou o número de eventos da lista de 12 itens na LTE-Q experimentado pelo entrevistado no ano anterior) e regressão logística foi realizada para encontrar sua associação com beber em binge e uso de cocaína. Resultados: A análise fatorial confirmatória retornou um qui-quadrado de 108.341, média ponderada da raiz quadrado residual (WRMR) de 1.240, índice de ajuste confirmatório (CFI) de 0.970, índice de Tucker-Lewis (TLI) de 0.962, e aproximação de erro quadrático médio (RMSEA) de 1.000. A validação da LTE-Q mostrou que o traço latente Adversidade aumentou as chances de beber em binge em 1,31% e dobrou as chances de consumo de cocaína no ano anterior (ajustado por variáveis sociodemográficas). Conclusão: O uso da LTE-Q no Brasil deve ser encorajado em diferentes campos de pesquisa, incluindo grandes inquéritos epidemiológicos, uma vez que também é adequado quando o tempo e o orçamento são limitados. A LTE-Q pode ser uma ferramenta útil no desenvolvimento de estratégias de prevenção direcionadas e mais eficientes.
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    Adaptação transcultural e análise psicométrica da escala de valoración actual del riesgo de desarrollar úlceras por presión en cuidados intensivos (EVARUCI)
    (Universidade Federal de São Paulo (UNIFESP), 2016-06-29) Cremasco, Mariana Fernandes [UNIFESP]; Whitaker, Iveth Yamaguchi [UNIFESP]; http://lattes.cnpq.br/4954772252354513; http://lattes.cnpq.br/8476192792890695; Universidade Federal de São Paulo (UNIFESP)
    Objective: to culturally adapt to Portuguese and validate the Escala de Valoración Actual del Riesgo de desarrollar Úlceras por presión en Cuidados Intensivos (EVARUCI) to the Brazilian reality, as well as to analyse the psychometric properties of the adapted scale in the Intensive Care Unit (ICU) patients and the correlation of the severity of the patient with EVARUCI. Method: methodological research for EVARUCI?s transcultural adaptation and psychometric analysis. Internal consistency was verified by employing Cronbach?s Alpha Coefficient. The Braden Scale was used for concurrent converging validation, and SAPS 3(Simplified Acute Physiology Score) for correlation with the severity of the patient, both analysed through Spearman?s Correlation Test. EVARUCI?s predictive capacity was also analysed. To analyse interobserver reliability, the result of the simultaneous application of EVARUCI?s final version by three nurses was verified through the Intraclass Correlation Coefficient (ICC). Results: The translation of 107 items showed twelve (11.21%) disagreements among translators. In the back translation, five (4.67%) items brought different words from the original, though with similar meanings. In the specialist committee evaluation, two items (1.8%) did not achieve 90% concordance. EVARUCI?s internal consistency proved itself acceptable (?=0.782). One observed a strong significant correlation between Braden and EVARUCI scores (r = - 0.778 e p<0.001). EVARUCI?s ROC curve area reached 0.807 and Braden?s 0.798. In EVARUCI?s score 10, sensibility was 65.2%, specificity was 82%, positive predictive value was 34.3% and OR = 10. In Braden?s score 11, sensibility was 76.1%, specificity was 75.9%, positive predictive value was 34.3% and OR=10. EVARUCI?s values moderately and significantly correlated with those from SAPS 3 score (r = 0.508 e p<0.001). Interobserver reliability was excellent among evaluators (ICC=0.980). Conclusion: EVARUCI?s transcultural adaptation to Brazilian Portuguese was satisfactory regarding reliability and validity, revealing itself as a specific instrument for ICU, with rapid and fast application for PU risk evaluation in critical patients.
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    Adaptação transcultural e mensuração da validade e confiabilidade do Functional Capacity Index (FCI)
    (Universidade Federal de São Paulo (UNIFESP), 2015-08-31) Yamada, Marina Peixe [UNIFESP]; Whitaker, Iveth Yamaguchi [UNIFESP]; Zanei, Suely Sueko Viski [UNIFESP]; http://lattes.cnpq.br/8404189458594038; http://lattes.cnpq.br/4954772252354513; http://lattes.cnpq.br/7743557129893916; Universidade Federal de São Paulo (UNIFESP)
    Objetivo: adaptar culturalmente para o português e validar o instrumento de medida de capacidade funcional, o Functional Capacity Index (FCI), à realidade brasileira e verificar as propriedades psicométricas, confiabilidade e validade do instrumento adaptado em pacientes com lesões traumáticas um ano após o acidente de trânsito. Método: pesquisa metodológica que envolveu tradução/retrotradução, adaptação transcultural, incluindo-se avaliação semântica, idiomática, conceitual e cultural e validação do FCI. A versão final foi aplicada a um grupo de pacientes vítimas de trauma após um ano da alta hospitalar. Para verificar a confiabilidade foi utilizado o Coeficiente Alfa de Cronbach. Para a avaliação da validade de construto discriminante comparou-se dois grupos, caso e controle. Para a validação concorrente aplicou-se o índice de Katz e para a verificação da validade convergente, o questionário Injury Severity Score (ISS). Resultados: Após a tradução do instrumento, do total de 58 itens avaliados, oito (13,8%) não apresentaram concordância entre os tradutores. Na retrotradução, seis (10,3%) apresentaram palavras diferentes do original, porém com significados semelhantes. Na avaliação pelo comitê de especialistas, cinco itens (8,6%) não alcançaram a taxa de concordância maior que 90,0%. Após a aplicação do instrumento final, a consistência interna de todos os domínios que compõe o FCI, verificada pelo Alfa de Cronbach, mostrou-se aceitável (? ? 0,7); os valores do FCI correlacionaram-se de forma moderada e significante com os valores do índice de Katz (r = 0,387 e p = 0,006); observou-se que não houve correlação significante entre os escores ISS e FCI (r = - 0,118 e p = 0,415); os valores do FCI foram estatisticamente maiores no grupo caso em comparação ao grupo controle (p<0,001), confirmando a validade de critério discriminante. Conclusão: A adaptação transcultural do instrumento de avaliação da capacidade funcional, FCI, para o português do Brasil, aplicado às pessoas que sofreram acidente de trânsito um ano após a alta hospitalar, permitiu concluir que o instrumento final mostrou resultados satisfatórios quanto à confiabilidade. Em relação à validade, os resultados quanto à validade de critério concorrente e de construto discriminante indicaram resultados favoráveis a sua utilização.
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    Administration of the Autism Behavior Checklist: agreement between parents and professionals' observations in two intervention contexts
    (Associação Brasileira de Psiquiatria - ABP, 2008-09-01) Marteleto, Márcia Regina Fumagalli [UNIFESP]; Menezes, Camila Gioconda de Lima E [UNIFESP]; Tamanaha, Ana Carina [UNIFESP]; Chiari, Brasilia Maria [UNIFESP]; Perissinoto, Jacy [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To determine the agreement between responses on the Autism Behavior Checklist by mothers and healthcare professionals. METHOD: Twenty-three mothers of children from the autism spectrum (DSM-IV-TR, 2002) were interviewed. The children were part of an educational program of the Autistic Friends Association-SP. The healthcare professionals in charge of the children at the institution filled out a questionnaire regarding the method for observing behavior. For comparison purposes, an additional 15 mothers of children from the autism spectrum were interviewed at the speech therapy clinic of Universidade Federal de São Paulo (UNIFESP), and the speech therapists responsible for the children filled out the questionnaire on the observation method. The Kappa index was employed to obtain the frequency of agreement between mothers and healthcare professionals' observations on the overall Autism Behavior Checklist, as well as its individual components. The Student's t-test was used to assess differences or similarities between the Kappa results. RESULTS: The agreement index was low for the total score, with a statistically significant difference between both groups (p < 0.001). Agreement was also low for each Autism Behavior Checklist components, but there was greater agreement in the group treated at the public service in the Language, Body and Use of Objects components (p < 0.001). CONCLUSION: There was disagreement between the observations in both intervention contexts, but agreement was better at the public service than at Autistic Friends Association.
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    Alterações torácicas musculoesqueléticas no primeiro ano de vida em crianças nascidas prematuras: fatores associados e importância da fotogrametria para o seu diagnóstico
    (Universidade Federal de São Paulo (UNIFESP), 2009-04-29) Davidson, Josy [UNIFESP]; Dos Santos, Amelia Miyashiro [UNIFESP]; Yi, Liu Chiao [UNIFESP]; http://lattes.cnpq.br/9925075057283150; http://lattes.cnpq.br/6101587222452300; Universidade Federal de São Paulo (UNIFESP)
    Objective: To determine the frequency and factors associated with thoracic musculoskeletal alterations in infants born premature and to analyze the accuracy and the reproducibility of photogrammetry to detect these alterations. Methods: Cross sectional study with infants in the first year of life, born from February/2007 to December/2008, with gestational age <37 weeks, birth weight <2000g and followed at the Premature Clinic of the Federal University of São Paulo. Major malformation, intraventricular hemorrhage grade III/IV and/or periventricular leucomalacia were excluded. Physical exam was used as a reference standard to determine the frequency and factors associated with thoracic alterations and for accuracy analysis, by ROC curve. Photographs were analyzed by a computer program to detect shoulder elevation and thoracic retraction by the measurement of manubrium/acromion process/trapezius angle and the greatest thoracic retraction depth. The study was approved by the Ethical Committee of the Institution and parents/guardians signed terms of informed consent. Results: Of 121 studied infants (gestational age: 31.1+2.8 weeks, birth weight: 1400+338g), 81 (66.9%) presented thoracic alterations. By logistic regression, factors associated with thoracic alterations were: days of corrected age (OR=1.018, CI95%: 1.004-1.019) and days on oxygen therapy (OR=1.096, CI 95%: 1.031-1.164). Compared to physical exam, the manubrium/acromion process/trapezius angle presented: accuracy: 0.793, sensitivity: 71.4%, specificity: 78.4%, intraclass and interclass correlation coefficient (ICC): 0.922 and 0.947. The greatest thoracic retraction depth showed: accuracy: 0.895, sensitivity: 96.6%, specificity: 75.9%, (ICC): 0.841 and 0.838. Conclusions: The frequency of thoracic alterations was high and associated with higher corrected age and longer oxygen therapy. The photogrammetry provided an objective, accurate and reliable test to detect thoracic alterations in preterm infants.
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    Análise da reprodutibilidade do Doppler de amplitude tridimensional na avaliação da circulação do cérebro fetal
    (Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2010-12-01) Moron, Antonio Fernandes [UNIFESP]; Milani, Hérbene José Figuinha [UNIFESP]; Barreto, Enoch Quinderé de Sá [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Haratz, Karina Krajden [UNIFESP]; Rolo, Liliam Cristine [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate the intra- and interobserver reproducibility of three-dimensional power Doppler sonography (3D power Doppler) in the assessment of fetal brain blood flow in the middle cerebral artery territory. MATERIALS AND METHODS: A cross-sectional study was developed with 20 healthy pregnant women between 26 and 34 gestational weeks. The middle cerebral artery territory closest to the transducer was scanned and the blood flow volume was calculated with the method Virtual Organ Computer-aided AnaLysis. The following 3D power Doppler indices were later obtained: vascularization index (VI), flow index (FI) and vascularization-flow index (VFI). The intraclass correlation coefficient (ICC) and Bland-Altman plots were utilized for calculating the intra- and interobserver variability. RESULTS: A good intra- and interobserver agreement was observed, with ICC > 0.90 for all the 3D power Doppler indices: VI [ICC = 0.992 (CI 95%: 0.981-0.997)], FI [ICC = 0.999 (CI 95%: 0.998-0.999)], VFI [ICC = 0.995 (CI 95%: 0.987-0.998)]. Interobserver reproducibility: VI [ICC = 0.988 (CI 95%: 0.970-0.995)], FI [ICC = 0.999 (CI 95%: 0.997- 1.000)], VFI [ICC = 0.994 (CI 95%: 0.994-0.998)]. CONCLUSION: 3D power Doppler has shown to be a practical and easy method in the assessment of fetal brain blood flow, with good intra- and interobserver reproducibility. The FI presented the best intra- and interobserver agreement
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    Are distal radius fracture classifications reproducible? Intra and interobserver agreement
    (Associação Paulista de Medicina - APM, 2008-05-01) Belloti, Joao Carlos [UNIFESP]; Tamaoki, Marcel Jun Sugawara [UNIFESP]; Franciozi, Carlos Eduardo da Silveira [UNIFESP]; Santos, João Baptista Gomes dos [UNIFESP]; Balbachevsky, Daniel [UNIFESP]; Chap, Eduardo Chap [UNIFESP]; Albertoni, Walter Manna [UNIFESP]; Faloppa, Flávio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT AND OBJECTIVE: Various classification systems have been proposed for fractures of the distal radius, but the reliability of these classifications is seldom addressed. For a fracture classification to be useful, it must provide prognostic significance, interobserver reliability and intraobserver reproducibility. The aim here was to evaluate the intraobserver and interobserver agreement of distal radius fracture classifications. DESIGN AND SETTING: This was a validation study on interobserver and intraobserver reliability. It was developed in the Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina. METHOD: X-rays from 98 cases of displaced distal radius fracture were evaluated by five observers: one third-year orthopedic resident (R3), one sixth-year undergraduate medical student (UG6), one radiologist physician (XRP), one orthopedic trauma specialist (OT) and one orthopedic hand surgery specialist (OHS). The radiographs were classified on three different occasions (times T1, T2 and T3) using the Universal (Cooney), Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation (AO/ASIF), Frykman and Fernández classifications. The kappa coefficient (κ) was applied to assess the degree of agreement. RESULTS: Among the three occasions, the highest mean intraobserver k was observed in the Universal classification (0.61), followed by Fernández (0.59), Frykman (0.55) and AO/ASIF (0.49). The interobserver agreement was unsatisfactory in all classifications. The Fernández classification showed the best agreement (0.44) and the worst was the Frykman classification (0.26). CONCLUSION: The low agreement levels observed in this study suggest that there is still no classification method with high reproducibility.
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    Avaliação da capacidade de exercício em portadores de doença pulmonar obstrutiva crônica: comparação do teste de caminhada com carga progressiva com o teste de caminhada com acompanhamento
    (Sociedade Brasileira de Pneumologia e Tisiologia, 2006-04-01) Rosa, Fernanda Warken [UNIFESP]; Camelier, Aquiles Assunção [UNIFESP]; Mayer, Anamaria [UNIFESP]; Jardim, José Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate the applicability of the incremental (shuttle) walk test in patients with chronic obstructive pulmonary disease and compare the performance of those patients on the shuttle walk test to that of the same patients on the encouraged 6-minute walk test. METHODS: A cross-sectional study was conducted, in which 24 patients with chronic obstructive pulmonary disease were selected. In random order, patients were, after an initial practice period, submitted to a shuttle walk test and an encouraged 6-minute walk test. RESULTS: The patients obtained a higher heart rate (expressed as a percentage of that predicted based on gender and age) on the encouraged 6-minute walk test (84.1 ± 11.4%) than on the shuttle walk test (76.4 ± 9.7%) (p = 0.003). The post-test sensation of dyspnea (Borg scale) was also higher on the encouraged 6-minute walk test. On average, the patients walked 307.0 ± 89.3 meters on the shuttle walk test and 515.5 ± 102.3 meters on the encouraged 6-minute walk test (p < 0.001). There was a good correlation between the two tests in terms of the distance walked (r = 0.80, p < 0.001). CONCLUSION: The shuttle walk test is simple and easy to implement in patients with chronic obstructive pulmonary disease. The encouraged 6-minute walk test produced higher post-test heart rate and greater post-test sensation of dyspnea than did the shuttle walk test.
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    Avaliação da qualidade de vida pelo Questionário do Hospital Saint George na Doença Respiratória em portadores de doença pulmonar obstrutiva crônica: validação de uma nova versão para o Brasil
    (Sociedade Brasileira de Pneumologia e Tisiologia, 2006-04-01) Camelier, Aquiles Assunção [UNIFESP]; Rosa, Fernanda Warken [UNIFESP]; Salmi, Christine [UNIFESP]; Nascimento, Oliver Augusto [UNIFESP]; Cardoso, Fábio [UNIFESP]; Jardim, José Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: The objective of this study was to evaluate the applicability of a modified version of the Saint George's Respiratory Questionnaire. The version evaluated elicits agree and do not agree, rather than yes and no, responses. The intention is to facilitate the comprehension of double-negative questions and to promote better recollection of symptoms by patients by shortening their symptom histories from 12 months to 3 months. METHODS: A total of 30 clinically stable patients with chronic obstructive pulmonary disease were evaluated. The Saint George's Respiratory Questionnaire and the modified version of the same were administered 15 days apart. RESULTS: All of the patients presented health-related alterations in their quality of life. Comparing mean scores between the two questionnaires, the greatest difference was seen in the Symptoms domain. No significant differences were found in any of the remaining domains or in the total scores. In a subsequent analysis, significant correlations between the two questionnaires were found in all domains: Symptoms (r = 0.71; p < 0.001); Activity (r = 0.75; p < 0.001); Impact (r = 0.73; p < 0.001) and Total (r = 0.86; p < 0.001). CONCLUSION: The modified version of the Saint George's Respiratory Questionnaire is as effective as the original in gauging quality of life. However, various symptoms recollection time frames should be investigated in order to determine which would be the best time frame to employ in the analysis.
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    Avaliação da reprodutibilidade das medidas da camada de fibras nervosas retiniana e da cabeça do nervo óptico pela tomografia de coerência óptica
    (Soc Brasileira Oftalmologia, 2012-09-01) Rau, Ricardo [UNIFESP]; Silva, André Luiz de Freitas [UNIFESP]; Salame, André Luiz Alves [UNIFESP]; Melo Junior, Luiz Alberto Soares [UNIFESP]; Hosp Servidor Publ Estadual Sao Paulo Francisco M; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To determine the reproducibility of the peripapillary retinal nerve fiber layer thickness and optic nerve head parameters measured with the optical coherence tomography (SD-OCT) in normal eyes. Methods: Thirty-four eyes of 34 healthy patients were included in the study. The Cirrus OCT optic disc cube 200x200 protocol was used to obtain three scans from each eye to evaluate the reproducibility. Intraclass correlation coefficient (ICC) was calculated for the measurements of retinal nerve fiber layer thickness and optic nerve head parameters. Results: The correlation was excellent for all measures of retinal nerve fiber layer thickness (ICC between 0.87 and 0.98). The same happened with the optic nerve head parameters (ranging from 0.83 to 0.99), with the exception of E/D vertical ratio (0.56). Conclusion: Measurements of peripappilary retinal nerve fiber layer thickness and optic nerve head parameters showed excellent reproducibility with Cirrus OCT, indicating that this instrument may be useful in the study of glaucoma. This study has some limitations, including the small number of cases studied, further studies are needed to corroborate our findings.
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    Avaliação da reprodutibilidade e da validade de critério das versões em português do Brasil dos questionários: European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) associado ao Quality of Life Questionnaire Lung Cancer (QLQ-LC13) e Functional Assessment of Cancer Therapy-Lung (FACT-L) com o FACT-L Symptom Index (FLSI)
    (Universidade Federal de São Paulo (UNIFESP), 2010-02-24) Pereira, Juliana Franceschini [UNIFESP]; Santoro, Ilka Lopes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The assessment of quality of life in patients with lung cancer has become one of the main goal in current clinical trials. For lung cancer patients, the most common quality of life tools available are the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) + Quality of Life Questionnaire Lung Cancer (QLQ-LC13) and the Functional Assessment of Cancer Therapy-Lung (FACT-L). Despite the amount of data available about these questionnaires, there are no data on its performance in the Brazilian patients with lung cancer. The purpose of this study was to assess the reliability and the criterion validity of the Brazilian version of the EORTC QLQ-C30 + QLQ-LC13 and the FACT-L with the FACT-L Symptom Index (FLSI) questionnaires. Methods: The EORTC QLQ-C30 + QLQ-LC13 and FACT-L with the FLSI questionnaires were administered prospectively to 50 consecutive-stable-lung cancer outpatients. For the reliability study, the questionnaires were applied at baseline and 2 weeks. The criterion validity of the questionnaires was examined through correlation with clinical and functional parameters, Karnofsky scale and similar domains of SF-36. Results: The intraclass correlation coefficient between test and retest ranged from 0,64 to 1,0 for the QLQ-C30 and from 0,64 to 0,95 for the QLQ-LC13. For the FACT-L, it ranged from 0,79 to 0,96 and for the FLSI, it was 0,87. There was no correlation between these questionnaires dimensions and clinical or functional parameters. Several scores of the study questionnaires correlated well with Karnofsky scale. The EORTC QLQ-C30 + QLQ-LC13, and the FACT-L with the FLSI scales showed good correlation among their similar dimensions, moreover they had as well good correlation with the homologous SF-36 domains. Conclusions: The Brazilian version of the questionnaires EORTC QLQ-C30 + QLQ-LC13 and FACT-L with FLSI have good reliability, are simple, and have good correlation with the SF-36. These instruments can now be used to properly evaluate the quality of life of the Brazilian lung cancer patients.
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    Avaliação dos métodos biométricos do olho humano empregados no cálculo do poder dióptrico da lente intra-ocular
    (Universidade Federal de São Paulo (UNIFESP), 2010-01-27) Oliveira, Filipe de [UNIFESP]; Muccioli, Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objetivo: Avaliar os métodos biométricos do olho humano em pacientes portadores de catarata e com indicação de implante de lente intra-ocular. Métodos: Oitenta e quatro pacientes com média de idade de 58,82 ± 10,03 anos foram submetidos às biometrias óptica e ultra-sônica (imersão e contato) em ambos os olhos (n = 168). Os dados do comprimento axial, profundidade da câmara anterior, espessura do cristalino, profundidade da câmara vítrea e curvatura da córnea foram analisados. Foi avaliada a diferença das médias de cada método biométrico usado e a concordância foi investigada pela análise gráfica intra-individual de Bland-Altman de um método em relação ao outro. Resultados: Não houve diferença estatisticamente significante para as médias do comprimento axial (P=0,245), profundidade da câmara anterior (P=0,073), espessura do cristalino (P=0,8794) e profundidade da câmara vítrea (P=0,7640) entre os métodos usados. A diferença das médias da curvatura da córnea entre o IOLMaster® e o ceratômetro manual OM-4® foi estatisticamente significante (P<0,0001). Apesar da boa reprodutibilidade dos resultados, os gráficos de Bland- Altman mostraram algumas medidas fora dos limites de concordância estabelecidos em todas as variáveis analisadas. Houve menor concordância das medidas ceratométricas na comparação entre o IOLMaster® e o ceratômetro OM- 4®. Conclusões: Não houve diferença das médias dos métodos biométricos usados nesse estudo, exceto a curvatura da córnea que apresentou uma diferença estatisticamente significante entre as médias apresentadas. Os métodos demonstraram boa concordância, entretanto algumas medidas se apresentaram discordantes e podem ocasionar erros no cálculo do poder dióptrico da lente intraocular.
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    Biometrias óptica e ultra-sônica: comparação dos métodos usados para o cálculo da lente intra-ocular acomodativa
    (Conselho Brasileiro de Oftalmologia, 2004-12-01) Oliveira, Filipe de [UNIFESP]; Muccioli, Cristina [UNIFESP]; Lopes, Yara Cristina [UNIFESP]; Soriano, Eduardo Sone [UNIFESP]; Belfort, Rubens Junior [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To compare reproducibility, level of agreement and correlation of two ultrasonic biometers and one optical biometer for the calculation of accommodative intraocular lens. METHODS: Cataract patients were submitted to the examination with 3 different biometers (IOLMaster, Axis II and Humphrey Mod. 820) before the implant of the C&C Vision AT-45 accommodative silicone intraocular lens. The Axis II biometer was used for both contact and immersion biometry. Axial length, anterior chamber depth and keratometry were the analyzed biometric parameters. RESULTS: Thirty-four patients from 53 to 90 years old (mean 70.6 y) were submitted to the examination with the three different biometers. The lowest mean axial length (23.12 mm) was obtained with the Axis II/contact and the highest (23.21 mm) with the Humphrey biometer. The lowest mean anterior chamber depth (2.97mm) was obtained with the Humphrey and the highest (3.10mm) with the IOLMaster. Reproducibility for axial length was high for all the biometers tested (coefficient of variation: 3.02% for Humphrey and Axis II / immersion; 3.07 % for Axis II/contact and 3.19% for IOLMaster). All biometers presented nearly equal results of the analyzed parameters (99.01% for axial length and 94.77% for anterior chamber depth). Pearson's coefficient showed a high correlation between the biometers, regarding the axial length and anterior chamber depth measurements. CONCLUSION: The devices used in this study showed excellent reproducibility and high level of agreement and of the axial length, anterior chamber depth and keratometry measurements, making it possible to reduce errors of intraocular lens calculation and visual insatisfaction after cataract surgery.
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    The Brazilian Portuguese version of the Work Productivity and Activity Impairment: General Health (WPAI-GH) Questionnaire
    (Associação Paulista de Medicina - APM, 2006-11-01) Ciconelli, Rozana Mesquita [UNIFESP]; Soárez, Patrícia Coelho De [UNIFESP]; Kowalski, Clarissa Campos Guaragna [UNIFESP]; Ferraz, Marcos Bosi [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT AND OBJECTIVE: It is still difficult to measure work productivity losses caused by health problems. Despite the importance given to this issue over the last few years, most instruments for performing this task are available only in the English language. This study translated the Work Productivity and Activity Impairment _ General Health (WPAI-GH) Questionnaire into Brazilian Portuguese, adapted it cross-culturally and evaluated its reliability and validity. DESIGN AND SETTING: Cross-sectional survey to test scale reliability and validity, at São Paulo Hospital and the clinic of the Rheumatology division of Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina (UNIFESP-EPM). METHODS: Data were obtained from a survey that incorporated the WPAI-GH, short form-36 (SF-36) and some demographic questions. The questionnaires were administered by interview to 100 subjects. RESULTS: Descriptive statistics was used to characterize the subjects. The intraclass correlation coefficient and Cronbach's alpha were used to assess the reliability and internal consistency of the instrument. Intraclass correlation coefficients from 0.79 to 0.90 indicated good reliability. Cronbach's alpha of 0.74 indicated good internal consistency. Pearson's correlation coefficient was used to assess validity. There were significant positive relationships between the WPAI-GH and SF-36. CONCLUSION: The Brazilian Portuguese version of the WPAI-GH is a reliable and valid measurement tool and may be useful for those who seek to measure the impact on productivity of health problems among populations of Brazilian employees.
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    Capacidade física e reprodutibilidade do teste de caminhada de seis minutos em crianças e adolescentes após o transplante hepático
    (Universidade Federal de São Paulo (UNIFESP), 2011-05-25) Silva, Rosangela Maria da [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introdução: O transplante hepático pediátrico é um dos mais bem sucedidos transplantes de órgãos sólidos. Independente do tipo de transplante de órgãos, a fase pós-operatória representa um período de importante redução na capacidade de exercício do receptor. Unnitban et al., 2006, reportaram baixo nível de condicionamento cardiopulmonar, em crianças após o transplante hepático, quando comparadas a crianças saudáveis. O teste de esforço cardiopulmonar é o padrão-ouro para avaliação do condicionamento cardiopulmonar. No entanto, não é um procedimento disponível para avaliação diária, sobretudo na população pediátrica, pois requer equipamentos e habilidade técnica específica. Em contraste, o teste da caminhada de seis minutos (TC6’) é um teste prático, seguro, barato, de fácil execução, que reflete melhor as atividades de vida diária. Objetivo: Avaliar a reprodutibilidade e a capacidade física do TC6’, em crianças e adolescentes após o transplante hepático, comparando-as com valores de referência obtidos em crianças brasileiras saudáveis e, secundariamente, analisar a relação entre a distância caminhada em seis minutos (DC6’) com variáveis antropométricas e clínicas. Método: Estudo transversal prospectivo, realizado de Janeiro de 2009 a Dezembro de 2010. Amostra de conveniência de 23 crianças e adolescentes no pós- transplante hepático, entre seis a dezessete anos de idade, ambos os sexos, acompanhadas no ambulatório de transplante hepático, da Universidade Federal de São Paulo, UNIFESP/EPM, São Paulo (Brasil). Medidas antropométricas e de função pulmonar foram obtidas utilizando protocolos padrão. O TC6’ foi conduzido, de acordo com os critérios da ATS 2002, em um corredor de 20 metros. Dois testes foram realizados em intervalos de trinta minutos. Os critérios de interrupção ocorreram na presença de sintomas clínicos. As variáveis fisiológicas foram mensuradas no repouso e ao final do teste. A reprodutibilidade do TC6’ foi avaliada em todas as crianças do estudo. A relação entre a distância caminhada e o trabalho (produto da distância caminhada pelo peso corpóreo) foi avaliada com medidas antropométricas, clínicas e de função pulmonar.Resultados: 23 participantes (56,5%) foram do sexo feminino e média de idade (148,87 ± 34,58 meses). A reprodutibilidade do TC6’ (ICC= 0,63) foi boa na população do estudo. Comparada aos valores de referência de Aquino et al., 2010, a média da distância caminhada das crianças e adolescentes no póstransplante foi significantemente reduzida (p<0,001). A DC6’ apresentou moderada correlação com o volume corrente (r=0,5, p<0,015). O trabalho da distância caminhada mostrou significante correlação com a idade (r=0,6 p<0,004), peso (r=0,9 p<0,001), altura (r=0,8 p<0,001), IMC (r=0,6 p<0,002), CVF (r=0,7 p<0,001), pico de fluxo (r=0,6 p<0,002) e VM (r=0,4 p<0,038). Na análise de regressão múltipla as variáveis idade, CVF e VM influenciaram em 78,6% a variância do trabalho da distância caminhada (ω). Conclusão: O TC6’ é reprodutível em crianças e adolescentes após o transplante hepático. Estes pacientes apresentaram menor capacidade física, comparativamente aos valores de referência de crianças saudáveis. O trabalho da distância caminhada (ω) parece ser um parâmetro adicional na determinação da capacidade física destes pacientes, comparado à distância caminhada isoladamente.
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    Estudo da fórmula metatarsal em pacientes com metatarsalgia primária
    (Universidade Federal de São Paulo (UNIFESP), 2014-03-26) Arie, Eduardo Kenzo [UNIFESP]; Yi, Liu Chiao [UNIFESP]; http://lattes.cnpq.br/6106154677645509; http://lattes.cnpq.br/4983707270335833; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To verify the prevalence of types of metatarsal formula (FM) in patients with primary metatarsalgia, through x-rays. Assess the association between shortening of the first metatarsal and metatarsalgia in comparison to a control group (CG). Analyze the intra and interobserver reproducibility by methods of transverse lines (MLT) of Morton and arcs (MA) of Hardy & Clapham. Methods: a cross-sectional observational study was conducted in 112 radiographs of the feet, being 56 of GM and 56 of GC evaluated in the period between december 2012 and june 2013. The measurements were made by three third-year residents in orthopaedics, with previous training methods, using a template to decrease the chance of error and disagreement. Results: there was no agreement on any of the two methods by Bland-Altman graphs, but through the intraclass correlation coefficient was verified a greater intra and interobserver reproducibility by MLT (0,78 and 0,85) in relation to the MA (0,73 and 0,60). When comparing both groups, it was observed statistical difference (p ≤ 0,05) with a shortening of the first metatarsal (3,39mm) higher in GC in relation to GM (2,14mm). In patients with primary metatarsalgia, FM type index minus was more prevalent by MLT (62,5%) and the type zero plus by MA (71,4%). Conclusions: In this study, it was observed that the prevalence of FM depends on the method of measurement. When comparing both groups, there was association of the shortening of the first metatarsal with the GC. There were no intra and interobserver agreement in any of the proposed methods.
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    Fratura diafisária do fêmur: reprodutibilidade das classificações AO-ASIF e Winquist
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2010-01-01) Pires, Robinson Esteves Santos; Reis, Fernando Baldy dos [UNIFESP]; Simões, Christiano Esteves; Santos, Leandro Emílio Nascimento; Rodrigues, Vinícius Bicalho; Andrade, Marco Antônio Percope De; Pires Neto, Pedro José; Universidade Federal de Minas Gerais Hospitais Felício Rocho e da Baleia Departamento do Aparelho Locomotor; Universidade Federal de São Paulo (UNIFESP); Hospital Felício Rocho Serviço de Ortopedia e Traumatologia; Universidade Federal de Minas Gerais Departamento do Aparelho Locomotor
    OBJECTIVE: To evaluate inter-observer reproducibility of AO / ASIF and Winquist-Hansen classifications for shaft fractures of the femur in adults. METHODS: 50 anterior-posterior and profilelateral radiographs were randomly selected, of adult patients awith diaphyseal fracture of the femur. The radiographs were analyzed by 5 observers-a member of the Brazilian Society of Orthopedic Trauma, a radiologist and 3 residents. To assess the concordance between these classifications, we used the statistical index Kappa (K). RESULTS: In all analyses, we observed a statistically significant correlation coefficient between observers (p <0.05) and according to the criteria of Landis and Koch, they were ranked them as good (values of 0.61 to 0.80) or very good (values above 0.80). CONCLUSION: The AO rating and Winquist present a high rate of concordance between observers for shaft fractures of the femur in adults.
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    Functional Assessment of Cancer Therapy-Brain questionnaire: translation and linguistic adaptation to Brazilian Portuguese
    (Associação Paulista de Medicina - APM, 2011-01-01) Gazzotti, Mariana Rodrigues [UNIFESP]; Alith, Marcela Batan; Malheiros, Suzana Maria Fleury [UNIFESP]; Vidotto, Milena Carlos [UNIFESP]; Jardim, José Roberto [UNIFESP]; Nascimento, Oliver Augusto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Lar Escola São Francisco
    CONTEXT AND OBJECTIVE: Quality of life assessment among patients with brain tumors is important, given that new treatments have increased patient survival. The aim of this study was to translate the Functional Assessment of Cancer Therapy-Brain (FACT-Br) questionnaire (version 4) into Portuguese, carry out cross-cultural adaptation and assess its reproducibility. DESIGN AND SETTING: Cohort at the Universidade Federal de São Paulo (UNIFESP). METHODS: Forty patients with a brain tumor seen at the neuro-oncology outpatient clinic participated in the study. The process of translation and back-translation was carried out, along with adaptation to the Portuguese language and Brazilian culture. The intraclass correlation coefficient (ICC) was used to test the reproducibility of the FACT-Br (version 4). RESULTS: The reproducibility of the questionnaire was excellent (ICC = 0.95; 95% confidence interval, CI: 0.89-0.97). The ICC with a mean interval of 15 days between applications of the questionnaire was very good in all domains (ICC = 0.87 to 0.95). The mean time taken to answer the questionnaire was 6.27 ± 2.26 minutes, ranging from 3 to 11 minutes. CONCLUSION: The translated version of the FACT-Br questionnaire (version 4) adapted to the Portuguese language and Brazilian culture proved to be easily understood and achieved very good reproducibility among patients with diagnoses of brain tumors.