An Assessment of Maternal Quality of Life in the Postpartum Period in Southern Brazil: A Comparison of Two Questionnaires

OBJECTIVES

To assess maternal quality of life (QoL) during the postpartum period and to compare the performance of two QoL questionnaires across a sample of 101 women in southern Brazil. To our knowledge, this is the first study that measures maternal quality of life during the postpartum period in Brazil.

INTRODUCTION

There is limited information about postpartum maternal quality of life in Brazil. The are no Portuguese versions of instruments specifically designed to measure quality of life during the postpartum period.

METHODS

Research participants completed the Portuguese version of the World Health Organization Quality of Life Assessment-Bref (WHOQOL-BREF) and Multicultural Quality of Life Index (MQLI) questionnaires. The correlations between the MQLI and the discrete areas of WHOQOL-BREF were examined using Pearson Product-Moment Correlation Coefficients.

RESULTS

We report a significant correlation between the global MQLI and the four domains of the WHOQOL-BREF scores (p < 0.01). An analysis of variance revealed a significant difference in mean scores in the Psychological and Environment domains according to different socio-economic strata: F (3, 97) = 3.81, p = 0.012 and F (3, 97) = 4.03, p = 0.01, respectively.

DISCUSSION

The WHOQOL-BREF questionnaire may be more sensitive than the MQLI in detecting the impact of socioeconomic status on the QoL of postpartum women.

CONCLUSION

The sample of postpartum women evaluated in this study presented favorable QoL scores according to both the MQLI and WHOQOL-BREF questionnaires. Our results also indicate that the WHOQOL-BREF and the MQLI questionnaires have a significant correlation in terms of their assessments of postpartum mothers.     

The association between intron 4 VNTR, E298A and IVF 23+10 G/T polymorphisms of ecNOS gene and sildenafil responsiveness in patients with erectile dysfunction

The objective of the study was to determine the association between intron 4 variable number of tandem repeats (VNTR), E298A and IVF 23+10 G/T polymorphisms of ec-NOS gene and sildenafil responsiveness in patients with erectile dysfunction (ED). Ninety-six patients who were evaluated for ED between November 2003 and June 2004 and 167 healthy individuals representing the normal population as controls were included in the present study. The patients were evaluated by medical history, five-item version of International Index of Erectile Function, serum glucose, testosterone levels and lipid profiles. Sixty-seven patients received four consecutive doses of sildenafil from 25 to 100 mg according to the response. The ec-NOS gene intron 4 VNTR, E298A and IVF 23+10 G/T polymorphisms were evaluated in the isolated DNA blood samples obtained from the patient group with ED (n=96), from the group received sildenafil (n=67) and from the healthy group (n=167). Genotype distributions of ec-NOS gene intron 4, E298A and IVF 23+10 G/T polymorphisms in the patient group were similar to those in the healthy group. The frequency of the ec-NOS gene intron 4 genotype were found as bb=41.7%, ab=50% and aa=8.3% in the sildenafil responders and bb=93.5% and ba=6.5% in the sildenafil non-responders. This finding was statistically significant. Statistical analysis of ec-NOS gene E298A and IVF 23+10 G/T polymorphisms did not reveal any significant difference between sildenafil responders and non-responders. These findings may indicate that 'a' allele of ec-NOS gene intron 4 VNTR polymorphism associates with a better sildenafil response.     

Physician payment for 2007: a description of the process by which major changes in valuation of cardiothoracic surgical procedures occurred

Throughout the last 3 years, the Society of Thoracic Surgeons (STS) has put forth a major effort towards more accurate valuation of the work performed by cardiothoracic surgeons. The culmination of these efforts was realized on November 1, 2006, when the Centers for Medicare & Medicaid Services published the Final Rule which markedly increased the physician work values for the most frequently performed cardiothoracic surgery procedures. This article recounts the innovative approach taken by the STS during these extended efforts.     

Two novel human NUMB isoforms provide a potential link between development and cancer

Background

In the developing hindbrain, cranial motor axon guidance depends on diffusible repellent factors produced by the floor plate. Our previous studies have suggested that candidate molecules for mediating this effect are Slits, Netrin-1 and Semaphorin3A (Sema3A). It is unknown to what extent these factors contribute to floor plate-derived chemorepulsion of motor axons, and the downstream signalling pathways are largely unclear.

Results

In this study, we have used a combination of in vitro and in vivo approaches to identify the components of floor plate chemorepulsion and their downstream signalling pathways. Using in vitro motor axon deflection assays, we demonstrate that Slits and Netrin-1, but not Sema3A, contribute to floor plate repulsion. We also find that the axon pathways of dorsally projecting branchiomotor neurons are disrupted in Netrin-1 mutant mice and in chick embryos expressing dominant-negative Unc5a receptors, indicating an in vivo role for Netrin-1. We further demonstrate that Slit and Netrin-1 signalling are mediated by Rho-kinase (ROCK) and myosin light chain kinase (MLCK), which regulate myosin II activity, controlling actin retrograde flow in the growth cone. We show that MLCK, ROCK and myosin II are required for Slit and Netrin-1-mediated growth cone collapse of cranial motor axons. Inhibition of these molecules in explant cultures, or genetic manipulation of RhoA or myosin II function in vivo causes characteristic cranial motor axon pathfinding errors, including the inability to exit the midline, and loss of turning towards exit points.

Conclusions

Our findings suggest that both Slits and Netrin-1 contribute to floor plate-derived chemorepulsion of cranial motor axons. They further indicate that RhoA/ROCK, MLCK and myosin II are components of Slit and Netrin-1 signalling pathways, and suggest that these pathways are of key importance in cranial motor axon navigation.     

Coronavirus E protein forms ion channels with functionally and structurally-involved membrane lipids

Coronavirus (CoV) envelope (E) protein ion channel activity was determined in channels formed in planar lipid bilayers by peptides representing either the transmembrane domain of severe acute respiratory syndrome CoV (SARS-CoV) E protein, or the full-length E protein. Both of them formed a voltage independent ion conductive pore with symmetric ion transport properties. Mutations N15A and V25F located in the transmembrane domain prevented the ion conductivity. E protein derived channels showed no cation preference in non-charged lipid membranes, whereas they behaved as pores with mild cation selectivity in negatively-charged lipid membranes. The ion conductance was also controlled by the lipid composition of the membrane. Lipid charge also regulated the selectivity of a HCoV-229E E protein derived peptide. These results suggested that the lipids are functionally involved in E protein ion channel activity, forming a protein-lipid pore, a novel concept for CoV E protein ion channel entity.     

Age-related alterations of the CD19 complex and memory B cells in children with Down syndrome

Children with Down syndrome (DS) have a high incidence of recurrent respiratory tract infections, leukaemia and autoimmune disorders, suggesting immune dysfunction. The present study evaluated the role of the CD19 complex and memory B cells in the pathogenesis of immunodeficiency in children with DS. The expression levels (median fluorescein intensity—MFI) of CD19, CD21 and CD81 molecules on the surface of B cells and memory B cell subsets were studied in 37 patients and 39 healthy controls. Twenty-nine of the DS group had congenital cardiac disease. The B cell count was significantly low in children with DS compared with healthy age-matched controls for all three age groups (under 2 years; 2–6 years and older than 6 years). The MFI of CD19 was reduced in all the age groups, whereas that of CD21 was increased in those older than 2 years with DS. The expression level of CD81 was significantly increased in those older than 6 years. Age-related changes were also detected in memory B cell subsets. The frequency of CD27⁺IgD⁺IgM⁺ natural effector B cells was reduced in children with DS who had needed hospitalisation admission due to infections. The observed intrinsic defects in B cells may be responsible for the increased susceptibility of children with DS to severe respiratory tract infections.     

Does self-monitoring by means of symptom diaries improve asthma control in children?

Objective: Keeping symptom diaries on a regular basis may facilitate the execution of symptom-based action plans, enhance the patients’ adherence to treatment program and finally allow better asthma control. We hypothesize that disease control in children who keep symptom diaries regularly would be better compared to children who do not keep symptom diaries regularly. Methods: Asthmatic children, aged between 6 and 17 years, who were monitored at least 2 years at our outpatient clinic and examined at least twice within the last year, were enrolled in this study. The patients were assigned to the following two groups: group I included the patients who keep symptom diaries regularly and group II included the patients who do not keep symptom diaries regularly. Asthma control parameters of patients during the last year were investigated. The number of asthma attacks require systemic corticosteroid use, the frequency of emergency department (ED) admissions and the number of attacks requiring hospitalization, forced expiratory volume in 1?s (FEV₁) values and asthma control test (ACT) scores were compared. Results: 89 (26.2%) of 340 patients included in the study were identified to keep a symptom diary regularly. Although age (p?=?0.20) and sex (p?=?0.48) did not differ significantly between the groups, regular use of anti-inflammatory drug was found to be significantly higher in group I (p?1 did not differ significantly between the groups (p?>?0.05 in all of the parameters). Conclusions: Keeping a symptom diary on a regular basis in asthmatic children was shown to have neither beneficial effect on the day-to-day asthma control nor a decrease in the future risk of asthma control.     

Respiratory Complications Lead to the Diagnosis of Chronic Granulomatous Disease in Two Adult Patients

Chronic granulomatous disease (CGD) is a primary immunodeficiency associated to multiple life-threatening bacterial and fungal infections, beginning in childhood. There are rare cases of diagnosis in adulthood. We describe here two cases of late diagnosis in adults: a 45-year-old woman and 59-year-old-man. CGD diagnosis should be considered in adult patients with unexplained infectious diseases with tissue granuloma.