Objective. This study assessed the impact of periodontal diseases on health-related quality of life of adult users of the Brazilian Unified Health System. Study Design. A cross-sectional study was conducted on an outpatient basis. The sample included 151 adults treated in the Periodontics section at Dental Specialty Centres of Juiz de Fora (Minas Gerais, Brazil). The Oral Health Impact Profile (OHIP-14) measured the impact of periodontal disease on quality of life. Participants were interviewed to obtain self-perception of general and oral health and socioeconomic data, and dental records were consulted to obtain periodontal status data. The values of central tendency of the OHIP-14 were compared with socioeconomic, demographic, and self-reported health predictors using nonparametric tests. The final analysis was performed using multiple linear regressions. Results. The results showed that psychological discomfort and physical disability exhibited a negative impact. The following variables can explain approximately 27% of the impact of oral health conditions on health-related quality of life in this group: periodontal disease, self-perceived oral health, and the need to use or replace dental prosthesis. Conclusion. The need for prosthetic rehabilitation and worse periodontal status are associated with health-related quality of life, which can be predicted by the self-perception of health.
BackgroundLymphedema is a highly prevalent condition in women who have undergone treatment for breast cancer. Lymphedema negatively affects the quality of life. The objective of this study was to estimate the prevalence of lymphedema and associated factors in women treated for breast cancer in the municipality of Juiz de Fora.MethodsWe performed a cross-sectional study that evaluated 250 women who were being treated for breast cancer. Pre-screening of the sample by analysis of medical records was performed to select women who met the inclusion criteria as follows: women who had an operation more than 6 months ago; absence of active disease, locoregional or distant; the absence of functional change in the affected limb before surgery, which could lead to swelling of the limb; and simulating or masking symptoms of lymphedema, such as bursitis, tendonitis, and work-related musculoskeletal disorders. Women with bilateral breast cancer, absence of axillary intervention (partial or complete axillary dissection and/or SLN biopsy), active disease in the region, or lympho-venous alteration of the limb before surgery were excluded. Data were collected from the medical records of the selected cases, and they subsequently underwent an interview and a physical assessment.ResultsThe prevalence of lymphedema was 44.8%. There were medical records on the presence of this condition in 5.4% of cases. With regard to shoulder joint mobility, restrictions on abduction movements, internal and external rotation, and anterior shoulder adduction were significantly associated with lymphedema. Variables, including the presence of seroma, vascular changes, time elapsed after surgery, episodes of redness in the extremities, and cuticle removal from the hand with pliers were considered as major associated factors for lymphedema (p<0.05).ConclusionsThe prevalence of 44.8% for lymphedema found in this study is considered to be relevant because it is a morbidity that produces psychological, physical, and functional damage in patients with this condition. The planning of health programs and services appropriate for the immediate postoperative treatment of women with breast cancer, and increasing the awareness of health professionals regarding the early diagnosis of lymphedema, can help minimize the morbidity of this disease.
The level of asthma control was related to QOL, but this association manifested mainly in the subjective control domains, such as nighttime and daytime symptoms and physical activity limitations. The objective domain for control classification, represented by pulmonary function, was not an independent predictor or determinant of the QOL of adolescent asthma patients.
There is much discussion about effective public policies that allow the proper treatment of asthma, providing care that is comprehensive and centered on asthma patients within their social context. Educating health professionals and asthma patients provides better recognition of symptoms and the triggers of asthma exacerbations, as well as disseminating strategies for avoiding such triggers, thereby ensuring better treatment and quality of life for asthma patients. Asthma imposes an ever-increasing burden on society, in terms of impaired quality of life, morbidity, and health care costs, making this a very important discussion in the field of public policy.Keywords: Health policy; Asthma; Consensus. ResumoPercebe-se que muito se discute sobre políticas públicas eficazes que possibilitem o tratamento adequado da asma, oferecendo um atendimento integral e centrado no paciente asmático dentro do seu contexto social. Educar profissionais de saúde e a população de asmáticos possibilita um melhor reconhecimento dos sintomas, dos fatores desencadeantes de exacerbações e das formas para evitá-los, garantindo melhor tratamento e qualidade de vida do paciente. A asma impõe crescente carga à sociedade em termos de redução da qualidade de vida, custos com cuidados de saúde e morbidade. Por isso, torna-se de suma importância sua discussão no campo das políticas públicas.
Objective: The aim of this study is to analyze subjectively, using the SWAL-QOL questionnaire, swallowing dysfunction and associated factors after treatment with radiotherapy and chemotherapy in patients treated for head and neck cancer. Material and Methods: This is a cross-sectional study, based on the selection of patients with tumors of the head and neck area, treated with radiotherapy with or without chemotherapy during the years 2000 to 2006 at the Oncology Institute of Juiz de Fora. The data were analyzed using SPSS 15.0 software, and were evaluated using the chi-square test to compare differences in proportions between groups. The statistical significance level was set at 5%. Results: It was observed that with respect to foods of solid consistency, there was a statistically significant difference for mouth tumors (p<0.01), with a tendency in this group to use softer foods, easier to chew (stews, boiled vegetables, creamy soups, canned fruit). With reference to the domains of the SWAL-QOL, the location of the tumor in the mouth was statistically associated with the lowest quality of life in the symptoms domain (p<0.05). The female gender variable was associated with the lowest perceived quality of life in several domains, namely swallowing (p=0.02); fatigue (p=0.008); symptoms (p=0.009). Age (split below and above 60 years) was not associated with differences in perceived quality of life in any domain. Conclusion: Tumor in the mouth and the total dose of radiation in the superior fossa were associated with the lowest quality of life in the symptoms domain. The female gender variable was associated with the lowest perceived quality of life in several domains This study shows that speech therapy should maintain a presence in the teams, to then guide the rehabilitation of organic dysphonia and mechanical dysphagia possibly afflicting patients after cancer treatment with radiation therapy and chemotherapy. Key words:Quality of life, dysphagia, head and neck neoplasms, rehabilitation.
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