1
|
Heaney A, de Oliveira RWR, Bizzi M, Correa RA, Corso Pereira M, Simao Mol S, Santana Soares B, McKenna SP, Ribeiro-Oliveira A. Assessment of the performance of the Brazilian Portuguese Nottingham Health Profile in adult growth hormone deficiency and pulmonary hypertension. F1000Res 2021; 9:1399. [PMID: 34621522 PMCID: PMC8447051 DOI: 10.12688/f1000research.27748.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/25/2022] Open
Abstract
Background: The Nottingham Health Profile (NHP) is a generic measure of perceived distress that has been used widely as an outcome measure in clinical practice and trials. The availability of two Brazilian datasets provided the opportunity to assess the psychometric performance of the NHP in different populations - adult growth hormone deficiency (GHD) and pulmonary hypertension (PH). The purpose of the study was to see how valuable the NHP could be in assessing outcomes in diseases where no disease-specific measures are available. Methods: Secondary analyses were performed with NHP data. Patients diagnosed with adult GHD or PH were administered the NHP during clinic visits on two occasions, two weeks apart. A disease-specific measure of quality of life (QoL) was also administered to the relevant sample of patients on each occasion. Results: The psychometric properties of the NHP were good for both disease groups. As expected, both samples reported high scores on energy level, the PH sample scored high on physical functioning and the GHD sample on emotional reactions. For both samples, most of the NHP sections were able to distinguish between groups of respondents with different ratings of perceived general health. While most sections of the NHP were relatively highly correlated with the QoL measures, pain and sleep did not seem to be important predictors of QoL in either of the samples. Conclusions: The use of the NHP in adult GHD and PH populations in Brazil is not recommended as there are high-quality disease-specific measures available for each disease. However, where no disease-specific measures are available, the NHP can provide good descriptive information of the impact of disease on different patient populations.
Collapse
Affiliation(s)
| | - Rafael W R de Oliveira
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Bizzi
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Amorim Correa
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Monica Corso Pereira
- Department of Internal Medicine, State University of Campinas, Campinas, Sao Paulo, Brazil
| | - Suelem Simao Mol
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Beatriz Santana Soares
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Stephen P McKenna
- Galen Research Ltd, Manchester, UK.,School of Health Sciences, University of Manchester, Manchester, UK
| | - Antonio Ribeiro-Oliveira
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | |
Collapse
|
2
|
Garmes HM, Boguszewski CL, Miranda PAC, Martins MRA, da Silva SRC, Abucham JZ, de Castro Musolino NR, Vilar L, Portari LHC, Gadelha MR, Kasuki L, Naves LA, Czepielewski MA, de Almeida TS, Duarte FHG, Glezer A, Bronstein MD. Management of hypopituitarism: a perspective from the Brazilian Society of Endocrinology and Metabolism. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:212-230. [PMID: 33905631 PMCID: PMC10065316 DOI: 10.20945/2359-3997000000335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Hypopituitarism is a disorder characterized by insufficient secretion of one or more pituitary hormones. New etiologies of hypopituitarism have been recently described, including head trauma, cerebral hemorrhage, and drug-induced hypophysitis. The investigation of patients with these new disorders, in addition to advances in diagnosis and treatment of hypopituitarism, has increased the prevalence of this condition. Pituitary hormone deficiencies can induce significant clinical changes with consequent increased morbidity and mortality rates, while hormone replacement based on current guidelines protects these patients. In this review, we will first discuss the different etiologies of hypopituitarism and then address one by one the clinical aspects, diagnostic evaluation, and therapeutic options for deficiencies of TSH, ACTH, gonadotropin, and GH. Finally, we will detail the hormonal interactions that occur during replacement of pituitary hormones.
Collapse
Affiliation(s)
- Heraldo Mendes Garmes
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia e Metabologia, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil,
| | - César Luiz Boguszewski
- Serviço de Endocrinologia e Metabologia, Departamento de Clínica Médica, Universidade Federal do Paraná (SEMPR), Curitiba, PR, Brasil,
| | | | | | - Silvia Regina Correa da Silva
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia e Metabolismo, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | - Julio Zaki Abucham
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia e Metabolismo, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | - Nina Rosa de Castro Musolino
- Unidade de Neuroendocrinologia, Divisão de Neurocirurgia Funcional, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, DP, Brasil
| | - Lucio Vilar
- Serviço de Endocrinologia, Hospital das Clínicas da Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - Luiz Henrique Corrêa Portari
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia e Metabolismo, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brasil
| | - Mônica Roberto Gadelha
- Unidade de Neuroendocrinologia, Instituto Estadual do Cérebro Paulo Niemeyer, Centro de Pesquisa de Neuroendocrinologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Leandro Kasuki
- Unidade de Neuroendocrinologia, Instituto Estadual do Cérebro Paulo Niemeyer, Centro de Pesquisa de Neuroendocrinologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Luciana Ansaneli Naves
- Serviço de Endocrinologia, Faculdade de Medicina da Universidade de Brasília, Brasília, DF, Brasil
| | - Mauro Antônio Czepielewski
- Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre; Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Tobias Skrebsky de Almeida
- Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre; Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | | | - Andrea Glezer
- Unidade de Neuroendocrinologia, Laboratório de Endocrinologia Celular e Molecular LIM-25, Divisão de Endocrinologia e Metabolismo, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Marcello Delano Bronstein
- Unidade de Neuroendocrinologia, Laboratório de Endocrinologia Celular e Molecular LIM-25, Divisão de Endocrinologia e Metabolismo, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| |
Collapse
|
3
|
Corrêa RA, Pereira MC, Bizzi MF, de Oliveira RWR, Rezende CF, de Oliveira BCMT, Heaney A, McKenna SP, Ribeiro-Oliveira A. Adaptation and validation of the quality of life assessment of the Cambridge pulmonary hypertension outcome review (CAMPHOR) for Brazil. J Patient Rep Outcomes 2020; 4:43. [PMID: 32504261 PMCID: PMC7275099 DOI: 10.1186/s41687-020-00209-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/26/2020] [Indexed: 12/21/2022] Open
Abstract
Background Pulmonary Hypertension (PH) impacts negatively on patients’ health-related quality of life (HRQoL). The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) was the first PH-specific and validated instrument for use in different languages worldwide. This report describes the adaptation and psychometric validation of the CAMPHOR into Brazilian Portuguese language. Methods The translation and validation process included a bilingual and lay panel translation; cognitive debriefing interviews; psychometric testing in two repeated times assessing internal consistency, reproducibility and validity of the questionnaire. The Nottingham Health Profile (NHP) questionnaire was used as a comparator to test for convergent validity. Results The translation captured the same concepts as the English questionnaire and produced a comprehensive instrument in a Brazilian-Portuguese version expressing common, natural language. The psychometric evaluation involved 102 patients (48.8 ± 14.5 years, 80,4% female]. Cronbach’s alpha coefficients were above 0.9 on all three CAMPHOR scales. There was excellent test-retest reliability (coefficients above 0.85 on all scales). CAMPHOR Symptoms scale and Activities scale correlated highly with Physical Mobility section and CAMPHOR QoL scale was strongly associated with the Emotional Reactions and Social Isolation sections of NHP. There was a significant association between gender and perceived general health (p < 0.05). There were significant differences in CAMPHOR scale scores between patients who differed according to their perceived disease severity and general health. Conclusions The present CAMPHOR version demonstrated good psychometric properties and provides a reliable instrument for assessing HRQL and QoL in Brazilian PH patients, addressing patients’ perspective of their illness in a comprehensive way.
Collapse
Affiliation(s)
- Ricardo Amorim Corrêa
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Mariana Ferreira Bizzi
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rafael W R de Oliveira
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camila Farnese Rezende
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Antonio Ribeiro-Oliveira
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| |
Collapse
|
4
|
Abstract
Over the last three decades, short- and long-term observational studies, clinical trials, systematic reviews, and meta-analyses have provided relevant information on the efficacy and safety of growth hormone (GH) replacement therapy in adults with GH deficiency (AGHD). The knowledge acquired during this time has been compiled into different guidelines that offer clinicians an evidence-based, practical approach for the management of AGHD. There are, however, still open questions in some key areas in which recommendations are supported by only moderate or weak evidence. In the last recent years, the development of long-acting GH preparations has created new therapeutic possibilities by decreasing injection frequency, improving adherence and thereby potentially maximizing clinical outcomes. The aims of this review are to advance our understanding on the diagnosis and treatment of AGHD and to present an update and future perspectives on the use of long-acting GH preparations.
Collapse
Affiliation(s)
- Cesar Luiz Boguszewski
- Endocrine Division (SEMPR), Department of Internal Medicine, Federal University of Parana, Curitiba, Brazil
| |
Collapse
|
5
|
Amaral RC, Inacio M, Brito VN, Bachega TASS, Domenice S, Arnhold IJP, Madureira G, Gomes L, Costa EMF, Mendonca BB. Quality of life of patients with 46,XX and 46,XY disorders of sex development. Clin Endocrinol (Oxf) 2015; 82:159-64. [PMID: 25040878 DOI: 10.1111/cen.12561] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 04/30/2014] [Accepted: 07/16/2014] [Indexed: 12/22/2022]
Abstract
Disorders of sex development (DSD) result from abnormalities in the complex process of sex determination and differentiation. An important consideration to guide the assignment of social sex in newborns with ambiguous genitalia is the quality of life (QoL) of these patients in adulthood. The rarity of most DSD conditions makes it difficult to conduct a long-term follow-up of affected patients through adulthood. This review of papers on the QoL of DSD patients evaluated in developing and developed countries by qualitative and quantitative instruments revealed a large spectrum of QoL, ranging from very poor to similar to, or even better than, the normal population. A more adequate QoL was found in patients from tertiary centres, indicating that the medical care of DSD patients should be multidisciplinary and carried out by specialized teams.
Collapse
MESH Headings
- 46, XX Disorders of Sex Development/epidemiology
- 46, XX Disorders of Sex Development/physiopathology
- 46, XX Disorders of Sex Development/psychology
- Adrenal Hyperplasia, Congenital/epidemiology
- Adrenal Hyperplasia, Congenital/physiopathology
- Adrenal Hyperplasia, Congenital/psychology
- Adult
- Disorder of Sex Development, 46,XY/epidemiology
- Disorder of Sex Development, 46,XY/physiopathology
- Disorder of Sex Development, 46,XY/psychology
- Disorders of Sex Development/epidemiology
- Disorders of Sex Development/physiopathology
- Disorders of Sex Development/psychology
- Female
- Humans
- Male
- Quality of Life
Collapse
Affiliation(s)
- Rita Cassia Amaral
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Disciplina de Endocrinologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | | | | | | | | | | | | |
Collapse
|