RESUMO Contexto: A qualidade de vida relacionada à saúde é frequentemente usada como uma medida de resultado que melhora a qualidade da atenção à saúde. O SF-36 e o RAND-36 foram derivados do Medical Outcomes Study. Objetivo O presente estudo teve como objetivo validar o RAND-36 no Brasil, em indivíduos saudáveis e pacientes com doença hepática. Métodos: A análise fatorial confirmatória (AFC) foi realizada usando o software JASP. Os parâmetros do elemento foram estimados usando o método Robust Diagonally Weighted Least Squares (RDWLS). O índice de ajuste comparativo (CFI), o índice de adequação (GFI), o índice de Tucker-Lewis (TLI) e o erro quadrático médio de aproximação (RMSEA) foram avaliados. A consistência interna foi medida pelo índice de confiabilidade composta. A validade convergente foi realizada entre os domínios do RAND-36 e o Índice de Capacidade para o Trabalho (ICT). Resultados : Este estudo de validação incluiu 763 indivíduos, 400 (52,4%) com doença hepática crônica. As doenças hepáticas mais prevalentes foram hepatite C (13,9%), doença alcoólica do fígado (11,8%) e esteatose (12,1%). O modelo de medida testado com a AFC obteve os seguintes indicadores de ajuste: X2 (gl): 599,65 (498); CFI: 0,998; GFI: 0,998; TLI: 0,998; RMSEA: 0,016 (90%CI: 0,011-0,021). A validade convergente do RAND-36 e do ICT total variou de média a grande correlação. Conclusão: O RAND-36 é eficaz para medir a percepção da qualidade de vida relacionada à saúde em indivíduos com e sem doença hepática crônica. Os resultados do nosso estudo apoiam as afirmações dos desenvolvedores sobre a confiabilidade do RAND-36 versão 1 como uma medida de qualidade de vida relacionada à saúde. A evidência para a validade do construto do RAND-36 foi substancial.

ABSTRACT Background: Health-related quality of life is frequently used as an outcome measure that improves the quality of care. The SF-36 and RAND-36 were derived from the Medical Outcomes Study. Objective The present study aimed to validate the RAND-36 in Brazil, in healthy individuals and patients with liver disease. Methods: Confirmatory factor analysis (CFA) was conducted by using JASP Software. The parameters of the items were estimated using the Robust Diagonally Weighted Least Squares (RDWLS) approach. Comparative fit index (CFI), Goodness-of-fit index (GFI), Tucker-Lewis Index (TLI) and the root mean square error of approximation (RMSEA) were evaluated. Internal consistency was measured using the Composite reliability index. Convergent validity between RAND-36 domains and Work Ability Index (WAI) was conducted. Results: This validation study included 763 individuals, 400 (52.4%) with chronic liver disease. The most prevalent liver diseases were hepatitis C (13.9%), alcoholic liver disease (11.8%), and steatosis (12.1%). The measurement model tested using the CFA obtained the following adjustment indicators: X2 (df): 599.65 (498); CFI: 0.998; GFI: 0.998; TLI: 0.998; RMSEA: 0.016 (90%CI: 0.011-.021). Convergent validity of RAND-36 and total WAI ranged from medium to large correlation. Conclusion: The RAND-36 is effective in measuring the perception of health-related quality of life in individuals with and without chronic liver disease. The results of our study support the developer’s claims for the reliability of the RAND-36 version 1 as a measure of health-related quality of life. The evidence for the construct validity of the RAND-36 was substantial.

Background/Aims: to examine the relationship between the antioxidant potential and severity parameters of cirrhosis in humans. Methods: fifteen patients with hepatic cirrhosis (nine subjects - Child group B, and six subjects - Child group C) and nine control subjects were enrolled in the study. The main criteria taken into account to characterize the diagnosis of cirrhosis and its complications were the AST: ALT ratio, AST to platelet ratio index, Bonacini score, Meld score and Child classification. Those parameters were determined based on laboratory results and patient's clinical records. Se, Zn, ascorbic acid (AA) levels and oxidative stress parameters were measured in blood samples of cirrhotic patients. Results: the analysis of plasma levels of Se and AA showed low concentrations in cirrhotic patients compared with control subjects (P < 0.05). Though, there was a positive correlation between plasma of Se and severity parameters of cirrhosis in patients of Child group B and C. In the activity of the antioxidant enzymes only catalase was lower in patients of Child group C compared with control group. Conclusion: we found low plasma levels of Se and AA among cirrhotic patients. However, is not clear why selenium levels tend to increase with the severity of liver cirrhosis.

Introducción/Objetivos: examinar la relación entre los potenciales antioxidantes y los parámetros de gravedad de la cirrosis en los seres humanos. Métodos: quince pacientes con cirrosis hepática (nueve sujetos - grupo Child B, y seis sujetos - grupo Child C) y nueve sujetos control fueron incluidos en el estudio. Los principales criterios que se tuvieron en cuenta para caracterizar el diagnóstico de la cirrosis y sus complicaciones fueron la AST: relación de ALT, AST índice de la relación de plaquetas, clasificación Bonacini, clasificación MELD y clasificación de Child. Estos parámetros fueron determinados con base en los resultados de laboratorio y los registros clínicos del paciente. Se midieron los niveles de Zn, ácido ascórbico (AA) y los parámetros de estrés oxidativo en muestras de sangre de pacientes cirróticos. Resultados: el análisis de los niveles plasmáticos de Se y AA mostraron bajas concentraciones en los pacientes cirróticos en comparación con los sujetos control (P < 0,05); sin embargo, hubo una correlación positiva entre el plasma de Se y los parámetros de gravedad de la cirrosis en pacientes del grupo Child B y C. En la actividad de las enzimas antioxidantes catalasa solamente fue menor en los pacientes del grupo Child C, en comparación con el grupo control. Conclusión: se encontraron niveles bajos en plasma de Se y AA en pacientes cirróticos. Sin embargo, no está claro por qué los niveles de selenio tienden a aumentar con la gravedad de la cirrosis hepática.

The presence of Lutzomyia conviti Ramirez Perez, Martins & Ramirez, previously found only in Venezuela and Colombia, is recorded for the first time in Brazil. Lutzomyia conviti is now added to the 229 species of Lutzomyia already registered in Brazil and to the 44 identified in São Gabriel da Cachoeira, Amazonas state. Both sexes of L. conviti were collected in 2007 and 2008 with CDC light traps in an environment of primary vegetation represented by firm land forest. The distribution range of the species is cited and discussed.