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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In recent years&#44; the long-term survival of many chronic progressive pulmonary diseases has improved&#59; with such progress&#44; the attention has also shifted from strictly focusing on physiological measurements of lung function and other physical characteristics to incorporating quality of life &#40;QOL&#41; assessments&#44; with the latter reflecting a degree of interdependency with the severity of the respiratory condition&#46; For example&#44; in patients with cystic fibrosis &#40;CF&#41;&#44; factors such as body mass index&#44; a correlate of nutritional status&#44; and FEV1&#44; a reporter of overall expiratory flow limitation and bronchial involvement&#44; have emerged as important factors contributing to QOL&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">1</span></a> Similarly&#44; the frequency of hospital admissions for pulmonary exacerbations&#44; sleep quality&#44; adherence&#44; depression&#44; and physical activity measures are also major contributors to QOL ratings in CF&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">2&#8211;7</span></a> As a corollary&#44; 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&#44;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">9&#8211;11</span></a> further reinforcing the importance of a comprehensive evaluation that attests to integrative functioning in the context of chronic illness&#44; while also potentially serving as an objective follow-up and longitudinal monitoring instrument&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">12</span></a> In this context&#44; Sarria et al&#46; now report their QOL findings among 34 children suffering from post-infectious bronchiolitis obliterans &#40;PIBO&#41; compared to 34 controls&#46;<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&#46; Despite its typical history and clinical examination&#44; 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&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">14&#44;15</span></a> Indeed&#44; since lung function tests are either not feasible or require specialized settings in young children&#44; implementation of such approaches for the diagnosis of PIBO is woefully inadequate at best&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">16&#8211;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&#44; as well as other functions during day and night&#44;<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&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">22</span></a> Thus&#44; the findings attest to the significant impact that this relatively rare&#44; yet important diagnostic entity imposes on living conditions&#46; Some limitations to this study deserve comment&#44; to instigate future research&#46; First&#44; it would have been of interest to explore potential associations between available spirometric measurements and QOL measures&#44; Secondly&#44; the inclusion of a physical activity test such as the six-minute walk test &#40;6-MWT&#41; would be highly desirable&#44; as would be the evaluation with overnight polysomnography &#40;PSG&#41;&#59; the potential independent contributions of 6-MWT performance and PSG findings to QOL could provide further insights as to the major determinants of QOL&#46; Finally&#44; and as raised by the investigators&#44; future longitudinal periodic and concurrent assessments of clinical&#44; radiological&#44; functional&#44; and QOL measures may shed some light as to the potentially important value of assessing QOL as a readily available&#44; yet easy to obtain score that provides insights into disease severity&#44; response to therapy&#44; and prognostic tracking&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In summary and unsurprisingly&#44; similar to many chronic respiratory diseases&#44; PIBO adversely affects QOL in children&#46; This interesting article should be a reminder to all of us pediatricians that the term &#8220;breath of life&#8221; is meaningful and should not be taken for granted&#46;</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&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Gozal D&#46; Post-infectious bronchiolitis obliterans in children&#58; is general quality of life the right measure&#63;&#46; J Pediatr &#40;Rio J&#41;&#46; 2018&#59;94&#58;340&#8211;1&#46;</p>"
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Editorial
Post-infectious bronchiolitis obliterans in children: is general quality of life the right measure?
Bronquiolite obliterante pós-infecciosa em crianças: a qualidade de vida geral é a medida certa?
David Gozal
University of Chicago, Biological Sciences Division, Pritzker School of Medicine, Department of Pediatrics, Sections of Pediatric Pulmonology and Sleep Medicine, Chicago, United States
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sleep quality&#44; adherence&#44; depression&#44; and physical activity measures are also major contributors to QOL ratings in CF&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">2&#8211;7</span></a> As a corollary&#44; 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&#44;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">9&#8211;11</span></a> further reinforcing the importance of a comprehensive evaluation that attests to integrative functioning in the context of chronic illness&#44; while also potentially serving as an objective follow-up and longitudinal monitoring instrument&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">12</span></a> In this context&#44; Sarria et al&#46; now report their QOL findings among 34 children suffering from post-infectious bronchiolitis obliterans &#40;PIBO&#41; compared to 34 controls&#46;<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&#46; Despite its typical history and clinical examination&#44; 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&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">14&#44;15</span></a> Indeed&#44; since lung function tests are either not feasible or require specialized settings in young children&#44; implementation of such approaches for the diagnosis of PIBO is woefully inadequate at best&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">16&#8211;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&#44; as well as other functions during day and night&#44;<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&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">22</span></a> Thus&#44; the findings attest to the significant impact that this relatively rare&#44; yet important diagnostic entity imposes on living conditions&#46; Some limitations to this study deserve comment&#44; to instigate future research&#46; First&#44; it would have been of interest to explore potential associations between available spirometric measurements and QOL measures&#44; Secondly&#44; the inclusion of a physical activity test such as the six-minute walk test &#40;6-MWT&#41; would be highly desirable&#44; as would be the evaluation with overnight polysomnography &#40;PSG&#41;&#59; the potential independent contributions of 6-MWT performance and PSG findings to QOL could provide further insights as to the major determinants of QOL&#46; Finally&#44; and as raised by the investigators&#44; future longitudinal periodic and concurrent assessments of clinical&#44; radiological&#44; functional&#44; and QOL measures may shed some light as to the potentially important value of assessing QOL as a readily available&#44; yet easy to obtain score that provides insights into disease severity&#44; response to therapy&#44; and prognostic tracking&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In summary and unsurprisingly&#44; similar to many chronic respiratory diseases&#44; PIBO adversely affects QOL in children&#46; This interesting article should be a reminder to all of us pediatricians that the term &#8220;breath of life&#8221; is meaningful and should not be taken for granted&#46;</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&#46;</p></span></span>"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Gozal D&#46; Post-infectious bronchiolitis obliterans in children&#58; is general quality of life the right measure&#63;&#46; J Pediatr &#40;Rio J&#41;&#46; 2018&#59;94&#58;340&#8211;1&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">See paper by Sarria et al&#46; in pages 374&#8211;9&#46;</p>"
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ISSN: 00217557
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