| 1 | Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil显示文摘BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil. | Rogerio Serafim Parra Julio MF Chebli Heda MBS Amarante Cristina Flores Jose ML Parente Odery Ramos Milene Fernandes Jose JR Rocha Marley R Feitosa Omar Feres Antonio S Scotton Rodrigo B Nones Murilo M Lima Cyrla Zaltman Carolina D Goncalves Isabella M Guimaraes Genoile O Santana Ligia Y Sassaki Rogerio S Hossne Mauro Bafutto Roberto LK Junior Mikaell AG Faria Sender J Miszputen Tarcia NF Gomes Wilson R Catapani Anderson A Faria Stella CS Souza Rosana F Caratin Juliana T Senra Maria LA Ferrari | 2019 | World Journal of Gastroenterology2019,25,38: | 2 |
| 2 | Grain-size end-members and environmentally sensitive grain-size components: A comparative study in the mud shelf depocenters off southern Brazil显示文摘The current study aims to do a comparative analysis of the results obtained with two End-Member(EM)grain-size modeling techniques(AnalySize and BasEMMA)and the Environmental Sensitive Grain-Size(ESGS)modeling for sediment samples collected in the mudbelts of the southern Brazilian shelf.The methods were compared using grain-size data from the south Brazilian shelf,and the results are discussed here.It is the first time that the concept of ESGS,in its present form,is utilized outside China.The results show that despite its relative ease of use,the ESGS is not fully comparable to the EM analyses,and only two grain-size ESGS classes were recognized as analogous to EMs.The comparison of the AnalySize and BasEMMA procedures also revealed significant differences between the techniques.A comparative analysis between the two EM techniques revealed advantages in the BasEMMA,especially in the better correlation of the end-members with the original grain size distribution.The analysis of the geographical distribution of the EM abundances allowed point sources of sandy populations to be recognized as well as the contribution of the Rio de la Plata as a source of silty sediments to be inferred. | Michel Michaelovitch de Mahiques Samara Cazzoli y Goya Maria Carolina da Silva Nogueira de Matos Rodrigo Augusto Udenal de Oliveira Bianca Sung Mi Kim Paulo Alves de Lima Ferreira Rubens Cesar Lopes Figueira Marcia Caruso Bícego | 2021 | International Journal of Sediment Research2021,36,2: | 2 |