1.Quality of Life in Children and Adolescents with Inflammatory Bowel Disease: Impact and Predictive Factors
Larissa Caetano SILVA ; Renata B.P. Melo SEIXAS ; Elisa de CARVALHO
Pediatric Gastroenterology, Hepatology & Nutrition 2020;23(3):286-296
Purpose:
Inflammatory bowel disease (IBD) in children and adolescents is associated with high morbidity and possibly has a significant negative impact on their quality of life. This study aimed to evaluate the quality of life of children and adolescents with IBD and define the variables that impact these individuals.
Methods:
We administered the Pediatric Quality of Life Questionnaire (PedsQL) to 35 children and adolescents diagnosed with IBD and with available quantitative data from clinical records on epidemiology, clinical evolution, complementary tests, medical interventions, and disease activity. Data were evaluated according to the IBD type and compared with a control group of healthy children.
Results:
The study group showed a significantly lower PedsQL score than the control group (p<0.01). Significant factors contributing to poor overall quality of life included female sex, Crohn's disease, surgery, and food restrictions. Symptoms such as diarrhea and the fear of using public toilets were associated with low physical scores. Feeling sick had a negative impact on the emotional PedsQL scores. Patients with a fear of using public toilets, anthropometric scores below the 3rd percentile, and greater disease activity scored lower in the social domain. Regarding school and psychosocial evaluations, younger children with symptom onset after the age of 2 years had lower scores than younger children with symptom onset before the age of 2 years.
Conclusion
IBD negatively affects the quality of life of children and adolescents based on its impact on the physical, emotional, social, and psychosocial statuses of these patients.
2.Pediatric Liver Transplantation: Caregivers’ Quality of Life
Ana Paula BASTOS TAVARES ; Lucas Belém Pessôa de MELO GUERRA SEIXAS ; Caren Lopes Wanderlei JAYME ; Gilda PORTA ; Renata Belém Pessôa de MELO SEIXAS ; Elisa de CARVALHO
Pediatric Gastroenterology, Hepatology & Nutrition 2022;25(6):489-499
Purpose:
The survival rate of pediatric patients undergoing liver transplantation has increased considerably. Despite this, the period after transplantation is still complex and poses several challenges to the recipient’s family, which is responsible for care management. Recently, more attention has been paid to the impact of this complex procedure on the quality of life of caregivers. Hence, this study is aimed at assessing the quality of life of caregivers of patients who have undergone liver transplantation and the aspects that influence it.
Methods:
This was an observational and cross-sectional study. From November 2020 to January 2021, short-form-36 questionnaires and additional questions were given to the main caregivers of children and adolescents who underwent pediatric liver transplantation.
Results:
Thirty-eight questionnaires were completed and the results revealed a lower quality of life in comparison to Brazilian standards, primarily in the mental domains (41.8±14.1 vs. 51.1±2.8; p<0.001). It did not show a significant association with socioeconomic or transplant-related factors, but it did show a negative impact on parents’ perception of the child’s health. Parents who reported worse health status for their children had a lower mental quality of life (44.1±13.8 vs. 33.3±12.6; p<0.05).
Conclusion
The caregivers of transplanted children have a lower quality of life than those of the local population. Psychological assistance should be routinely provided to parents for long-term follow-up to mitigate potential negative effects on the transplanted child’s care.
3.Cystic Fibrosis: Clinical Phenotypes in Children and Adolescents.
Ana Luiza Melo DOS SANTOS ; Helen DE MELO SANTOS ; Marina Bettiol NOGUEIRA ; Hugo Tadashi Oshiro TÁVORA ; Maria DE LOURDES JABORANDY PAIM DA CUN ; Renata Belém Pessoa DE MELO SEIXAS ; Luciana DE FREITAS VELLOSO MONTE ; Elisa DE CARVALHO
Pediatric Gastroenterology, Hepatology & Nutrition 2018;21(4):306-314
PURPOSE: The objective of this study was to describe the clinical phenotypes of children and adolescents with cystic fibrosis (CF); and to assess the role of pancreatic insufficiency and neonatal screening in diagnosis. METHODS: A cross-sectional study was conducted, which included 77 patients attending a reference center of CF between 2014 and 2016. Epidemiological data, anthropometric measurements, and the presence of pulmonary, pancreatic, gastrointestinal and hepatobiliary manifestations were evaluated based on clinical data and complementary examinations. RESULTS: Of the 77 patients, 51.9% were male, with a median age of 147 months (7.0-297.0 months), and the majority showed adequate nutritional status. The most common phenotype was pulmonary (92.2%), followed by pancreatic (87.0%), with pancreatic insufficiency in most cases. Gastrointestinal manifestation occurred in 46.8%, with constipation being the more common factor. Hepatobiliary disease occurred in 62.3% of patients. The group with pancreatic insufficiency was diagnosed earlier (5.0 months) when compared to the group with sufficiency (84.0 months) (p=0.01). The age of diagnosis was reduced following implementation of neonatal screening protocols for CF (6.0 months before vs. 3.0 months after, p=0.02). CONCLUSION: The pulmonary phenotype was the most common, although extrapulmonary manifestations were frequent and clinically relevant, and should mandate early detection and treatment. Neonatal screening for CF led to earlier diagnosis in patients with pancreatic failure, and therefore, should be adopted universally.
Adolescent*
;
Child*
;
Constipation
;
Cross-Sectional Studies
;
Cystic Fibrosis*
;
Diagnosis
;
Exocrine Pancreatic Insufficiency
;
Gastrointestinal Diseases
;
Humans
;
Infant, Newborn
;
Liver Diseases
;
Male
;
Neonatal Screening
;
Nutritional Status
;
Phenotype*