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"tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "340" "paginaFinal" => "341" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "David Gozal" "autores" => array:1 [ 0 => array:3 [ "nombre" => "David" "apellidos" => "Gozal" "email" => array:1 [ 0 => "dgozal@uchicago.edu" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "University of Chicago, Biological Sciences Division, Pritzker School of Medicine, Department of Pediatrics, Sections of Pediatric Pulmonology and Sleep Medicine, Chicago, United States" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Bronquiolite obliterante pós-infecciosa em crianças: a qualidade de vida geral é a medida certa?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In recent years, the long-term survival of many chronic progressive pulmonary diseases has improved; with such progress, the attention has also shifted from strictly focusing on physiological measurements of lung function and other physical characteristics to incorporating quality of life (QOL) assessments, with the latter reflecting a degree of interdependency with the severity of the respiratory condition. For example, in patients with cystic fibrosis (CF), factors such as body mass index, a correlate of nutritional status, and FEV1, a reporter of overall expiratory flow limitation and bronchial involvement, have emerged as important factors contributing to QOL.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">1</span></a> Similarly, the frequency of hospital admissions for pulmonary exacerbations, sleep quality, adherence, depression, and physical activity measures are also major contributors to QOL ratings in CF.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">2–7</span></a> As a corollary, reduced QOL is reported by children with non-CF bronchiectatic diseases<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">8</span></a> and disease-specific QOL tools have been developed for assessing asthmatic children,<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">9–11</span></a> further reinforcing the importance of a comprehensive evaluation that attests to integrative functioning in the context of chronic illness, while also potentially serving as an objective follow-up and longitudinal monitoring instrument.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">12</span></a> In this context, Sarria et al. now report their QOL findings among 34 children suffering from post-infectious bronchiolitis obliterans (PIBO) compared to 34 controls.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">13</span></a> PIBO is a frequently irreversible obstructive lung disease characterized by sub-epithelial inflammation and fibrotic narrowing of the smaller airways following a lower respiratory tract infection during early childhood. Despite its typical history and clinical examination, the diagnosis is characteristically confirmed by bioptic histopathological assessments along with pertinent radiological findings consisting of heterogeneous vascular perfusion alterations along with air trapping with or without bronchiectasis.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">14,15</span></a> Indeed, since lung function tests are either not feasible or require specialized settings in young children, implementation of such approaches for the diagnosis of PIBO is woefully inadequate at best.<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">16–20</span></a> As would be anticipated from patients suffering from chronic obstructive respiratory symptoms that are likely to affect their capacity for physical activity, as well as other functions during day and night,<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">21</span></a> the overall QOL was reduced in PIBO patients in both the health-related and school-related domains of the well-validated instrument that was used.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">22</span></a> Thus, the findings attest to the significant impact that this relatively rare, yet important diagnostic entity imposes on living conditions. Some limitations to this study deserve comment, to instigate future research. First, it would have been of interest to explore potential associations between available spirometric measurements and QOL measures, Secondly, the inclusion of a physical activity test such as the six-minute walk test (6-MWT) would be highly desirable, as would be the evaluation with overnight polysomnography (PSG); the potential independent contributions of 6-MWT performance and PSG findings to QOL could provide further insights as to the major determinants of QOL. Finally, and as raised by the investigators, future longitudinal periodic and concurrent assessments of clinical, radiological, functional, and QOL measures may shed some light as to the potentially important value of assessing QOL as a readily available, yet easy to obtain score that provides insights into disease severity, response to therapy, and prognostic tracking.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In summary and unsurprisingly, similar to many chronic respiratory diseases, PIBO adversely affects QOL in children. This interesting article should be a reminder to all of us pediatricians that the term “breath of life” is meaningful and should not be taken for granted.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0015" class="elsevierStylePara elsevierViewall">The author declares no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gozal D. Post-infectious bronchiolitis obliterans in children: is general quality of life the right measure?. J Pediatr (Rio J). 2018;94:340–1.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">See paper by Sarria et al. in pages 374–9.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib0115" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A systematic review of factors associated with health-related quality of life in adolescents and adults with cystic fibrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Habib A-RR" 1 => "J. Manji" 2 => "P.G. Wilcox" 3 => "A.R. Javer" 4 => "J.A. Buxton" 5 => "B.S. 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Year/Month | Html | Total | |
---|---|---|---|
2024 November | 7 | 6 | 13 |
2024 October | 31 | 26 | 57 |
2024 September | 47 | 23 | 70 |
2024 August | 42 | 33 | 75 |
2024 July | 39 | 28 | 67 |
2024 June | 25 | 10 | 35 |
2024 May | 31 | 14 | 45 |
2024 April | 27 | 20 | 47 |
2024 March | 31 | 19 | 50 |
2024 February | 15 | 25 | 40 |
2024 January | 20 | 20 | 40 |
2023 December | 16 | 23 | 39 |
2023 November | 23 | 31 | 54 |
2023 October | 21 | 38 | 59 |
2023 September | 23 | 32 | 55 |
2023 August | 13 | 20 | 33 |
2023 July | 16 | 8 | 24 |
2023 June | 14 | 9 | 23 |
2023 May | 20 | 15 | 35 |
2023 April | 16 | 8 | 24 |
2023 March | 19 | 15 | 34 |
2023 February | 8 | 17 | 25 |
2023 January | 23 | 15 | 38 |
2022 December | 26 | 20 | 46 |
2022 November | 24 | 28 | 52 |
2022 October | 36 | 29 | 65 |
2022 September | 25 | 43 | 68 |
2022 August | 27 | 38 | 65 |
2022 July | 29 | 36 | 65 |
2022 June | 19 | 33 | 52 |
2022 May | 28 | 32 | 60 |
2022 April | 30 | 26 | 56 |
2022 March | 33 | 38 | 71 |
2022 February | 21 | 25 | 46 |
2022 January | 22 | 27 | 49 |
2021 December | 19 | 26 | 45 |
2021 November | 20 | 17 | 37 |
2021 October | 21 | 21 | 42 |
2021 September | 15 | 11 | 26 |
2021 August | 19 | 13 | 32 |
2021 July | 18 | 6 | 24 |
2021 June | 25 | 8 | 33 |
2021 May | 28 | 15 | 43 |
2021 April | 98 | 9 | 107 |
2021 March | 34 | 17 | 51 |
2021 February | 22 | 7 | 29 |
2021 January | 23 | 14 | 37 |
2020 December | 34 | 9 | 43 |
2020 November | 24 | 17 | 41 |
2020 October | 17 | 10 | 27 |
2020 September | 25 | 14 | 39 |
2020 August | 26 | 6 | 32 |
2020 July | 17 | 8 | 25 |
2020 June | 15 | 2 | 17 |
2020 May | 28 | 5 | 33 |
2020 April | 22 | 18 | 40 |
2020 March | 19 | 4 | 23 |
2020 February | 32 | 12 | 44 |
2020 January | 41 | 17 | 58 |
2019 December | 24 | 4 | 28 |
2019 November | 18 | 6 | 24 |
2019 October | 28 | 16 | 44 |
2019 September | 39 | 14 | 53 |
2019 August | 37 | 16 | 53 |
2019 July | 43 | 17 | 60 |
2019 June | 41 | 14 | 55 |
2019 May | 48 | 11 | 59 |
2019 April | 39 | 17 | 56 |
2019 March | 36 | 11 | 47 |
2019 February | 15 | 9 | 24 |
2019 January | 21 | 11 | 32 |
2018 December | 17 | 8 | 25 |
2018 November | 16 | 5 | 21 |
2018 October | 31 | 15 | 46 |
2018 September | 29 | 12 | 41 |
2018 August | 42 | 39 | 81 |
2018 July | 20 | 15 | 35 |
2018 June | 6 | 2 | 8 |
2018 May | 1 | 4 | 5 |
2018 April | 1 | 3 | 4 |
2018 March | 0 | 18 | 18 |
2018 February | 0 | 3 | 3 |