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        "titulo" => "Calidad de vida en pacientes con enfermedad de Beh&#231;et y su relaci&#243;n con los s&#237;ntomas cl&#237;nicos y la actividad de la enfermedad"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Beh&#231;et&#39;s disease is one of the rheumatologic disorders related to vasculitis which affects most commonly young adults&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a> It is more prevalent in Mediterranean countries such as Turkey&#44; Greece&#44; Israel&#59; Middle Eastern countries such as Iraq and Iran as well as Far Eastern countries such as Japan&#44; Korea&#44; and China&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">2&#44;3</span></a> Common symptoms include oral and genital ulcers&#44; skin lesions and arthritis&#44; which might be accompanied by ocular and vascular involvements&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a> These symptoms not only have negative effect on physical and mental health of patients&#44; but they also diminish their quality of life &#40;QoL&#41; by causing several physical impairments&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The QoL becomes as an important outcome variable in patients with chronic diseases&#46; Measurement of Health-Related Quality of Life &#40;HRQoL&#41; plays an important role in treatment decisions and assessing the course of the disease&#46; QoL is a concept that includes being able to satisfy one&#39;s own basic needs&#44; being satisfied with life&#44; showing enough social interaction&#44; allocating time to fun&#44; feeling good emotionally and physically&#44; being good at interpersonal relationships&#44; having self-esteem as well as previous experiences&#46; Therefore&#44; it could be defined as perception of people about life&#44; values&#44; goals&#44; standards&#44; and interests&#46; Recent studies indicated that QoL in patients with Beh&#231;et disease was negatively affected by the disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">6&#8211;13</span></a> According to previous investigations&#44; there is a stress factor in most patients with BD before the initial onset or relapse of the disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">14&#8211;16</span></a> Furthermore&#44; it has been reported that subjects with BD have higher anxiety and depression levels<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">14&#44;15</span></a> and lower quality of life &#40;QoL&#41; than healthy controls&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">7&#44;12</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">QoL evaluation could help in developing more detailed care plans that ensure a better understanding of the behaviors and the psychological reactions of the patients as well as the difficulties they experience with adjusting to the disease and developing effective coping mechanisms&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> Since BD is a chronic disease having a relapsing course therefore&#44; complaints associated with BD have adverse effects on physical and mental health and attenuates QoL by generating certain physical problems&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Short-Form-36 &#40;SF-36&#41; is the most commonly used international scale and is considered a valid instrument for measuring physical functioning and comparing different aspects of health related QoL in patients with rheumatologic diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">18</span></a> To the best of our knowledge&#44; there is no study evaluating QoL in Iranian Azeri Beh&#231;et patients using SF-36&#44; therefore this study aimed to assess the QoL in this population as well as evaluating the association between QoL and disease characteristics including disease activity and clinical symptoms&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Study design and participants</span><p id="par0025" class="elsevierStylePara elsevierViewall">In this cross-sectional study conducted in Tabriz&#44; the North-West of Iran&#44; a total of 123 BD patients aged 15&#8211;65 years fulfilling International Criteria for Behcet&#39;s Disease<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">19&#44;20</span></a> were recruited from the rheumatology outpatient clinic of Tabriz University of Medical Sciences&#46; The control group included 123 healthy subjects who were matched with regard to gender&#46; Individuals with chronic inflammatory and&#47;or degenerative diseases were excluded from the study&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The study protocol was approved by the Ethics Committee of Tabriz University of Medical Sciences &#40;Iran&#41; and performed according to the Helsinki humanity research declaration &#40;2008&#41;&#46; Written informed consent was obtained from all subjects before participating in the study&#46; Patients aged 15&#8211;18 years had the informed consent and consent of their parents for participation&#46; During the study&#44; all the personal information was kept confidential and other ethical and considerations of humanity were performed as well&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Evaluation of quality of life</span><p id="par0035" class="elsevierStylePara elsevierViewall">Short Form-36 Quality of Life Scale &#40;SF-36 QoL Scale&#41; was used to evaluate quality of life&#46; SF-36 is a scale for quality of life consists of the following 8 subcategories&#58; &#40;a&#41; Physical Functioning &#40;10 items&#41;&#44; &#40;b&#41; Social Functioning &#40;2 items&#41;&#44; &#40;c&#41; Role Physical &#40;4 items&#41;&#44; &#40;d&#41; Role Emotional &#40;3 items&#41;&#44; &#40;e&#41; Mental Health &#40;5 items&#41;&#44; &#40;f&#41; Vitality &#40;4 items&#41;&#44; &#40;g&#41; Bodily Pain &#40;2 items&#41;&#44; &#40;h&#41; General Health &#40;5 items&#41;&#46; The scale was evaluated taking the last 4 weeks into account&#46; All items except the third and fourth were rated on a Likert scale&#46; The third and fourth items were yes or no questions&#46; The scores assigned to each category ranged from 0 to 100&#44; where 0 and 100 represented the lowest and highest QoL&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">21</span></a> This scale was translated into Persian and assessed for validity and reliability by Montazeri et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a> The Iranian version of the SF-36 performed well and the results indicated that it was a reliable and valid measure of health related quality of life&#46; The internal consistency &#40;to test reliability&#41; showed that all eight SF-36 scales met the minimum reliability standard&#44; the Cronbach&#39;s <span class="elsevierStyleItalic">&#945;</span> coefficients ranging from 0&#46;77 to 0&#46;90 with the exception of the vitality scale &#40;<span class="elsevierStyleItalic">&#945;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;65&#41;&#46; Known groups comparison &#40;to test validity&#41; showed that in all scales the SF-36 discriminated between men and women&#44; and old and the young respondents as anticipated &#40;all <span class="elsevierStyleItalic">P</span> values<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Convergent validity &#40;to test scaling assumptions&#41; using each item correlation with its hypothesized scale showed satisfactory results &#40;all correlation above 0&#46;40 ranging from 0&#46;58 to 0&#46;95&#41;&#46; Also&#44; factor analysis identified two principal components that jointly accounted for 65&#46;9&#37; of the variance&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Clinical assessment</span><p id="par0040" class="elsevierStylePara elsevierViewall">Disease activity was measured by Behcet&#39;s Disease Current Activity Form &#40;BDCAF&#41; and the Iranian Behcet&#39;s Disease Dynamic Activity Measure &#40;IBDDAM&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">23&#44;24</span></a> In order to calculate IBDDAM&#44; points were given to the non-ophthalmic manifestations of BD according to its severity and duration and total scores are between 0 and 32&#46; Furthermore&#44; Vasculitis Damage Index &#40;VDI&#41;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">25</span></a> was used for the clinical assessment of damage in BD patients&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">Statistical analyses were conducted using the SPSS statistical package &#40;SPSS Inc&#46;&#44; version 16&#41;&#46; The normality of data was tested by Kolmogorov&#8211;Smirnov test&#46; Independent sample t-test for continuous variables and chi-square test for categorical variables were used to determine differences between two groups&#46; Correlations between variables were determined by Spearman correlation analysis&#46; <span class="elsevierStyleItalic">P</span>-values<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 were considered statistically significant&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents baseline characteristics of BD patients and controls&#46; The mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD age of BD patients and control group was 38&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;99 &#40;Min&#8211;Max&#58; 15&#8211;62&#41; and 33&#46;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;29 &#40;Min&#8211;Max&#58; 17&#8211;58&#41; years&#44; respectively&#46; Sixty-one percent of patients and 69&#46;1&#37; of control group were males&#46; Mean duration of disease in BD patients was 11&#46;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;39 years and the median &#40;Min&#8211;Max&#41; of BDCAF&#44; IBDDAM and VDI were 1 &#40;0&#8211;4&#41;&#44; 0&#46;3 &#40;0&#8211;6&#41; and 0 &#40;0&#8211;6&#41;&#44; respectively&#46; There was significant difference in mean age and education level between the two groups &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#59; whilst no significant difference was observed in gender and marital status between the two groups &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">As indicated in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#44; the Physical Health score as well as most of SF-36 domains including Role Physical&#44; Bodily Pain&#44; General Health&#44; Vitality&#44; and Mental Health were significantly lower in BD patients compared with the control group &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> depicts correlation between SF-36 scores with disease activity and VDI in patients with Beh&#231;et&#39;s disease&#46; According to <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#44; there was significant correlation between the Physical and Mental Health scores and most of SF-36 domains with disease activity &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#59; whilst significant correlation was only observed between VDI and Bodily Pain domain &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> presents correlation between SF-36 scores and clinical symptoms in patients with Beh&#231;et&#39;s disease&#46; As indicated in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#44; there was significant correlation between the Physical and Mental Health scores and some SF-36 domains with genital ulcers&#44; ophthalmic and central nervous system &#40;CNS&#41; involvement &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; No significant correlation was observed between the Physical and Mental Health scores and some SF-36 domains with oral aphthous ulcer&#44; skin lesions&#44; arthritis&#44; gastrointestinal and vascular involvement as well as pathergy test &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">Taking into account that BD is a chronic immunoinflammatory disease with periods of exacerbation and remission&#44; the quality of life can be affected negatively&#46; To the best of our knowledge&#44; this is the first study to examine the QoL in Iranian Azeri Beh&#231;et patients&#46; According to our study&#44; the Physical Health score as well as most of SF-36 domains were significantly lower in BD patients&#44; compared with the control group&#46; Furthermore&#44; significant correlation was observed between the Physical and Mental Health score and most of SF-36 domains with disease activity&#46; Our findings were in agreement with the results of previous studies which showed the impaired quality of life in BD patients &#40;6&#8211;13&#41;&#46; Ertam et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> demonstrated that overall SF-36 scores as well as their domains were significantly lower in BD patients&#44; compared with the control group&#46; In another study&#44; Mumcu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a> found that all SF-36 domains were significantly worse in BD patients than in controls&#46; They also found that impairment in quality of life was related with disease activity in BD&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a> Furthermore&#44; Bodur et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> investigated the relationship between the quality of life&#44; life satisfaction and disease activity in BD patients and compared with controls&#46; They found that life satisfaction index scores were significantly lower and Nottingham health profile scores were significantly worse in all dimensions in BD patients&#46; So they concluded that life satisfaction and quality were impaired in BD patients&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> Also&#44; Canpolat et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">21</span></a> found that QoL scores in patients with Beh&#231;et&#39;s disease were low and were affected by gender&#44; age&#44; work status&#44; education status as well as complaints of oral and genital ulcerations&#44; arthritis&#44; skin lesions and bodily pain&#46; In another study&#44; Tanriverdi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> showed that BD patients were more susceptible to mood and anxiety disorders&#44; and their QoL was lower than that of their healthy counterparts&#46; They also reported that chronic diseases like BD might be related to mood disorders&#44; which might have a negative effect on patient&#39;s daily life&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Our study also indicated significant correlation between the Physical and Mental Health scores and some SF-36 domains with genital ulcers&#44; ophthalmic and CNS involvement&#46; No significant correlation was observed between the Physical and Mental Health scores and some SF-36 domains with oral aphthous ulcer&#44; skin lesions&#44; arthritis&#44; gastrointestinal and vascular involvement as well as pathergy test&#46; Our findings were consistent with Tanriverdi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> study which reported mental status might have triggered the development of ocular attacks in BD and that BD patients with ocular involvement had significantly more susceptibility to anxiety and depression&#46; Similarly&#44; Ertam et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> found significantly lower scores in &#8220;Mental Health&#8221; domain of SF-36 scale in BD patients with eye involvement&#46; Moreover&#44; the negative effect of the genital ulcers on the quality of life in BD was shown by Blackford et al&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">26</span></a> In other previous study&#44; Bodur et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> reported that arthritis&#44; fatigue and genital ulcer scores of BDCAF were the most important factors impairing the quality of life in BD&#46; In contrast with present study&#44; Gur et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">9</span></a> reported that arthritis had a negative effect on the quality of life in BD patients&#46; Taner et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">27</span></a> used Beck depression and Beck anxiety inventory in BD patients and psoriasis patients&#46; Although the psoriatic skin lesions might be expected to deteriorate the quality of life considerably&#44; they reported that the quality of life of BD patients were even worse than that of the psoriasis patients&#46; Furthermore&#44; Ertam et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> indicated that presence of vascular involvement&#44; eye involvement and arthritis contributed considerably to impaired quality of life in BD&#46; However&#44; they could not show that genital ulcers impaired the quality of life in BD&#46; According to Kilin&#231; et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">28</span></a> patients with oral ulcer&#44; genital ulcer&#44; lesions that looks like erythema nodosum and gastrointestinal ulcer had lower emotional life&#44; daily activity&#44; symptom and sexual life scores&#46; This discrepancy between our results with previous studies might be due to differences in studied population&#46;</p><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Limitations and strengths</span><p id="par0080" class="elsevierStylePara elsevierViewall">The limitation of the current study was that although significant correlations were observed between SF-36 scores with disease activity and some clinical symptoms&#44; the correlations were low to moderate&#46; The strengths of present study included the relatively large sample size and that we had a control group and compared QoL between patients with BD and normal population&#46; Furthermore&#44; all study subjects had a high cooperation in this research&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusion</span><p id="par0085" class="elsevierStylePara elsevierViewall">In conclusion&#44; based on evaluation of SF-36 scores&#44; quality of life is impaired in BD&#44; and this impairment is related with disease severity&#46; Presence of arthritis&#44; eye involvement and vascular involvement seem to contribute the impairment of quality of life in BD&#46; These results highlight the importance of nursing interventions in managing the symptoms experienced by patients effectively so that the limited effects of the symptoms which decrease QoL can be eliminated&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Funding</span><p id="par0090" class="elsevierStylePara elsevierViewall">This study was supported by Connective Tissue Diseases Research Center of Tabriz University of Medical Sciences&#44; Tabriz&#44; Iran&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflict of interests</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare that there is no conflict of interests&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Beh&#231;et&#39;s disease&#40;BD&#41; is a systemic vasculitis which may affect the quality of life &#40;QoL&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Aims</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This study aimed to assess the QoL in Iranian Azeri BD patients as well as evaluating the association between QoL and disease characteristics including disease activity and clinical symptoms&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">In this cross-sectional study&#44; a total of 123 BD patients aged 15&#8211;65 years fulfilling International Criteria for BD and 123 healthy controls matched with regard to gender were included&#46; Patients aged 15&#8211;18 years had the informed consent and consent of their parents for participation&#46; Short Form-36 Quality of Life Scale &#40;SF-36&#41; was used to evaluate QoL&#46; Disease activity was measured by Behcet&#39;s Disease Current Activity Form and the Iranian Behcet&#39;s Disease Dynamic Activity Measure and Vasculitis Damage Index &#40;VDI&#41; was used for the clinical assessment of damage&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD age of BD patients and control group was 38&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;99 and 33&#46;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;29 years&#44; respectively&#46; The Physical Health score as well as most of SF-36 domains including Role Physical&#44; Bodily Pain&#44; General Health&#44; Vitality&#44; and Mental Health were significantly lower in BD patients compared with the control group &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; There was significant correlation between the Physical and Mental Health scores and most of SF-36 domains with disease activity and clinical symptoms including genital ulcers&#44; ophthalmic and central nervous system &#40;CNS&#41; involvement &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Significant correlation was only observed between VDI and Bodily Pain domain &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Quality of life is impaired in BD patients&#44; and this impairment is related with disease severity&#46; It seems that presence of genital ulcers&#44; eye and CNS involvement lead to the impairment of QoL in BD patients&#46; These results highlight the importance of nursing interventions in managing clinical symptoms in these patients&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La enfermedad de Beh&#231;et &#40;BD&#41; es una vasculitis sist&#233;mica que puede afectar la calidad de vida &#40;QoL&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Este estudio tuvo como objetivo evaluar la QoL en pacientes con BD azer&#237; iran&#237;&#44; as&#237; como evaluar la asociaci&#243;n entre la QoL y las caracter&#237;sticas de la enfermedad&#44; incluida la actividad de la enfermedad y los s&#237;ntomas cl&#237;nicos&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En este estudio transversal&#44; un total de 123 pacientes con BD de 15 a 65 a&#241;os de edad cumplieron con los criterios internacionales para BD y 123 controles sanos que fueron emparejados por g&#233;nero&#46; Los pacientes de 15 a 18 a&#241;os de edad ten&#237;an el consentimiento informado y el consentimiento de sus padres para participar en el estudio&#46; Se us&#243; la escala de calidad de vida corta-36 &#40;SF-36&#41; para evaluar la calidad de vida&#46; La actividad de la enfermedad se midi&#243; mediante el formulario de actividad actual de la BD y la medida de la actividad din&#225;mica de la BD iran&#237; y el &#237;ndice de da&#241;o de la vasculitis &#40;VDI&#41; se usaron para la evaluaci&#243;n cl&#237;nica del da&#241;o&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE de los pacientes con BD y el grupo control fue de 38&#44;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;99 y 33&#44;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;29 a&#241;os&#44; respectivamente&#46; La puntuaci&#243;n de Salud f&#237;sica&#44; as&#237; como la mayor&#237;a de los dominios SF-36&#44; incluyendo Rol f&#237;sico&#44; Dolor corporal&#44; Salud general&#44; Vitalidad y Salud mental&#44; fueron significativamente m&#225;s bajos en los pacientes con BD en comparaci&#243;n con el grupo control &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Hubo una correlaci&#243;n significativa entre los puntajes de Salud f&#237;sica y mental y la mayor&#237;a de los dominios SF-36 con actividad de la enfermedad y s&#237;ntomas cl&#237;nicos&#44; como &#250;lceras genitales&#44; compromiso del sistema oft&#225;lmico y del sistema nervioso central &#40;SNC&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Solo se observ&#243; una correlaci&#243;n significativa entre el VDI y el dominio del dolor corporal &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusi&#243;n</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La calidad de vida se ve afectada en los pacientes con BD&#44; y este deterioro est&#225; relacionado con la gravedad de la enfermedad&#46; Parece que la presencia de las &#250;lceras genitales&#44; la afectaci&#243;n ocular y del SNC conduce al deterioro de la QoL en pacientes con BD&#46; Estos resultados resaltan la importancia de las intervenciones de enfermer&#237;a en el manejo de los s&#237;ntomas cl&#237;nicos en estos pacientes&#46;</p></span>"
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diploma&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;3 &#40;0&#8211;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0 &#40;0&#8211;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">BD patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>123&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">87&#46;15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>22&#46;71&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Role Physical&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Mental Health&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">71&#46;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20&#46;35&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;026&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Physical Health&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">68&#46;68<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&#46;94&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">78&#46;90<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;59&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">69&#46;23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>22&#46;07&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">73&#46;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&#46;59&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;094&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span><a class="elsevierStyleCrossRef" href="#tblfn0015">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span><a class="elsevierStyleCrossRef" href="#tblfn0015">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span><a class="elsevierStyleCrossRef" href="#tblfn0015">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">0&#46;615&nbsp;\t\t\t\t\t\t\n
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                  """
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Role Physical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Bodily Pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">General Health&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Vitality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Social Functioning&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Role Emotional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mental Health&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Physical Health&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mental Health &#40;Total&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="11" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Oral aphthous ulcer</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">r</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;074&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;091&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;075&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;003&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;076&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0020">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;852&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;431&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;833&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;332&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;425&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;715&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;973&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;255&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;972&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;416&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="11" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="11" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Genital ulcer</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">r</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;162&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;122&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;028&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;186&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;208&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;199&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;181&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;156&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;215&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0020">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;082&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;193&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;769&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;371&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;046&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;025&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;052&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;095&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="11" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="11" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Ophthalmic</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">r</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;0&#46;209&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;074&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;319&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;0&#46;074&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;193&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;131&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">p</span><a class="elsevierStyleCrossRef" href="#tblfn0020">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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Original Article
Quality of Life in Patients With Behçet Disease and Its Relation With Clinical Symptoms and Disease Activity
Calidad de vida en pacientes con enfermedad de Behçet y su relación con los síntomas clínicos y la actividad de la enfermedad
Alireza Khabbazia, Vahideh Ebrahimzadeh Attarib, Mohammad Asghari Jafarabadic,d, Aida Malek Mahdavia,
Autor para correspondencia
aidamalek@gmail.com

Corresponding author.
a Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
b Maraghe University of Medical Sciences, Maraghe, Iran
c Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
d Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Calidad de vida en pacientes con enfermedad de Beh&#231;et y su relaci&#243;n con los s&#237;ntomas cl&#237;nicos y la actividad de la enfermedad"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Beh&#231;et&#39;s disease is one of the rheumatologic disorders related to vasculitis which affects most commonly young adults&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a> It is more prevalent in Mediterranean countries such as Turkey&#44; Greece&#44; Israel&#59; Middle Eastern countries such as Iraq and Iran as well as Far Eastern countries such as Japan&#44; Korea&#44; and China&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">2&#44;3</span></a> Common symptoms include oral and genital ulcers&#44; skin lesions and arthritis&#44; which might be accompanied by ocular and vascular involvements&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a> These symptoms not only have negative effect on physical and mental health of patients&#44; but they also diminish their quality of life &#40;QoL&#41; by causing several physical impairments&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The QoL becomes as an important outcome variable in patients with chronic diseases&#46; Measurement of Health-Related Quality of Life &#40;HRQoL&#41; plays an important role in treatment decisions and assessing the course of the disease&#46; QoL is a concept that includes being able to satisfy one&#39;s own basic needs&#44; being satisfied with life&#44; showing enough social interaction&#44; allocating time to fun&#44; feeling good emotionally and physically&#44; being good at interpersonal relationships&#44; having self-esteem as well as previous experiences&#46; Therefore&#44; it could be defined as perception of people about life&#44; values&#44; goals&#44; standards&#44; and interests&#46; Recent studies indicated that QoL in patients with Beh&#231;et disease was negatively affected by the disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">6&#8211;13</span></a> According to previous investigations&#44; there is a stress factor in most patients with BD before the initial onset or relapse of the disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">14&#8211;16</span></a> Furthermore&#44; it has been reported that subjects with BD have higher anxiety and depression levels<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">14&#44;15</span></a> and lower quality of life &#40;QoL&#41; than healthy controls&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">7&#44;12</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">QoL evaluation could help in developing more detailed care plans that ensure a better understanding of the behaviors and the psychological reactions of the patients as well as the difficulties they experience with adjusting to the disease and developing effective coping mechanisms&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> Since BD is a chronic disease having a relapsing course therefore&#44; complaints associated with BD have adverse effects on physical and mental health and attenuates QoL by generating certain physical problems&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Short-Form-36 &#40;SF-36&#41; is the most commonly used international scale and is considered a valid instrument for measuring physical functioning and comparing different aspects of health related QoL in patients with rheumatologic diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">18</span></a> To the best of our knowledge&#44; there is no study evaluating QoL in Iranian Azeri Beh&#231;et patients using SF-36&#44; therefore this study aimed to assess the QoL in this population as well as evaluating the association between QoL and disease characteristics including disease activity and clinical symptoms&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Study design and participants</span><p id="par0025" class="elsevierStylePara elsevierViewall">In this cross-sectional study conducted in Tabriz&#44; the North-West of Iran&#44; a total of 123 BD patients aged 15&#8211;65 years fulfilling International Criteria for Behcet&#39;s Disease<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">19&#44;20</span></a> were recruited from the rheumatology outpatient clinic of Tabriz University of Medical Sciences&#46; The control group included 123 healthy subjects who were matched with regard to gender&#46; Individuals with chronic inflammatory and&#47;or degenerative diseases were excluded from the study&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The study protocol was approved by the Ethics Committee of Tabriz University of Medical Sciences &#40;Iran&#41; and performed according to the Helsinki humanity research declaration &#40;2008&#41;&#46; Written informed consent was obtained from all subjects before participating in the study&#46; Patients aged 15&#8211;18 years had the informed consent and consent of their parents for participation&#46; During the study&#44; all the personal information was kept confidential and other ethical and considerations of humanity were performed as well&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Evaluation of quality of life</span><p id="par0035" class="elsevierStylePara elsevierViewall">Short Form-36 Quality of Life Scale &#40;SF-36 QoL Scale&#41; was used to evaluate quality of life&#46; SF-36 is a scale for quality of life consists of the following 8 subcategories&#58; &#40;a&#41; Physical Functioning &#40;10 items&#41;&#44; &#40;b&#41; Social Functioning &#40;2 items&#41;&#44; &#40;c&#41; Role Physical &#40;4 items&#41;&#44; &#40;d&#41; Role Emotional &#40;3 items&#41;&#44; &#40;e&#41; Mental Health &#40;5 items&#41;&#44; &#40;f&#41; Vitality &#40;4 items&#41;&#44; &#40;g&#41; Bodily Pain &#40;2 items&#41;&#44; &#40;h&#41; General Health &#40;5 items&#41;&#46; The scale was evaluated taking the last 4 weeks into account&#46; All items except the third and fourth were rated on a Likert scale&#46; The third and fourth items were yes or no questions&#46; The scores assigned to each category ranged from 0 to 100&#44; where 0 and 100 represented the lowest and highest QoL&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">21</span></a> This scale was translated into Persian and assessed for validity and reliability by Montazeri et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a> The Iranian version of the SF-36 performed well and the results indicated that it was a reliable and valid measure of health related quality of life&#46; The internal consistency &#40;to test reliability&#41; showed that all eight SF-36 scales met the minimum reliability standard&#44; the Cronbach&#39;s <span class="elsevierStyleItalic">&#945;</span> coefficients ranging from 0&#46;77 to 0&#46;90 with the exception of the vitality scale &#40;<span class="elsevierStyleItalic">&#945;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;65&#41;&#46; Known groups comparison &#40;to test validity&#41; showed that in all scales the SF-36 discriminated between men and women&#44; and old and the young respondents as anticipated &#40;all <span class="elsevierStyleItalic">P</span> values<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Convergent validity &#40;to test scaling assumptions&#41; using each item correlation with its hypothesized scale showed satisfactory results &#40;all correlation above 0&#46;40 ranging from 0&#46;58 to 0&#46;95&#41;&#46; Also&#44; factor analysis identified two principal components that jointly accounted for 65&#46;9&#37; of the variance&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Clinical assessment</span><p id="par0040" class="elsevierStylePara elsevierViewall">Disease activity was measured by Behcet&#39;s Disease Current Activity Form &#40;BDCAF&#41; and the Iranian Behcet&#39;s Disease Dynamic Activity Measure &#40;IBDDAM&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">23&#44;24</span></a> In order to calculate IBDDAM&#44; points were given to the non-ophthalmic manifestations of BD according to its severity and duration and total scores are between 0 and 32&#46; Furthermore&#44; Vasculitis Damage Index &#40;VDI&#41;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">25</span></a> was used for the clinical assessment of damage in BD patients&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0045" class="elsevierStylePara elsevierViewall">Statistical analyses were conducted using the SPSS statistical package &#40;SPSS Inc&#46;&#44; version 16&#41;&#46; The normality of data was tested by Kolmogorov&#8211;Smirnov test&#46; Independent sample t-test for continuous variables and chi-square test for categorical variables were used to determine differences between two groups&#46; Correlations between variables were determined by Spearman correlation analysis&#46; <span class="elsevierStyleItalic">P</span>-values<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 were considered statistically significant&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents baseline characteristics of BD patients and controls&#46; The mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD age of BD patients and control group was 38&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;99 &#40;Min&#8211;Max&#58; 15&#8211;62&#41; and 33&#46;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;29 &#40;Min&#8211;Max&#58; 17&#8211;58&#41; years&#44; respectively&#46; Sixty-one percent of patients and 69&#46;1&#37; of control group were males&#46; Mean duration of disease in BD patients was 11&#46;82<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;39 years and the median &#40;Min&#8211;Max&#41; of BDCAF&#44; IBDDAM and VDI were 1 &#40;0&#8211;4&#41;&#44; 0&#46;3 &#40;0&#8211;6&#41; and 0 &#40;0&#8211;6&#41;&#44; respectively&#46; There was significant difference in mean age and education level between the two groups &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#59; whilst no significant difference was observed in gender and marital status between the two groups &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">As indicated in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#44; the Physical Health score as well as most of SF-36 domains including Role Physical&#44; Bodily Pain&#44; General Health&#44; Vitality&#44; and Mental Health were significantly lower in BD patients compared with the control group &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> depicts correlation between SF-36 scores with disease activity and VDI in patients with Beh&#231;et&#39;s disease&#46; According to <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#44; there was significant correlation between the Physical and Mental Health scores and most of SF-36 domains with disease activity &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#59; whilst significant correlation was only observed between VDI and Bodily Pain domain &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> presents correlation between SF-36 scores and clinical symptoms in patients with Beh&#231;et&#39;s disease&#46; As indicated in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#44; there was significant correlation between the Physical and Mental Health scores and some SF-36 domains with genital ulcers&#44; ophthalmic and central nervous system &#40;CNS&#41; involvement &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; No significant correlation was observed between the Physical and Mental Health scores and some SF-36 domains with oral aphthous ulcer&#44; skin lesions&#44; arthritis&#44; gastrointestinal and vascular involvement as well as pathergy test &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">Taking into account that BD is a chronic immunoinflammatory disease with periods of exacerbation and remission&#44; the quality of life can be affected negatively&#46; To the best of our knowledge&#44; this is the first study to examine the QoL in Iranian Azeri Beh&#231;et patients&#46; According to our study&#44; the Physical Health score as well as most of SF-36 domains were significantly lower in BD patients&#44; compared with the control group&#46; Furthermore&#44; significant correlation was observed between the Physical and Mental Health score and most of SF-36 domains with disease activity&#46; Our findings were in agreement with the results of previous studies which showed the impaired quality of life in BD patients &#40;6&#8211;13&#41;&#46; Ertam et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> demonstrated that overall SF-36 scores as well as their domains were significantly lower in BD patients&#44; compared with the control group&#46; In another study&#44; Mumcu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a> found that all SF-36 domains were significantly worse in BD patients than in controls&#46; They also found that impairment in quality of life was related with disease activity in BD&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a> Furthermore&#44; Bodur et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> investigated the relationship between the quality of life&#44; life satisfaction and disease activity in BD patients and compared with controls&#46; They found that life satisfaction index scores were significantly lower and Nottingham health profile scores were significantly worse in all dimensions in BD patients&#46; So they concluded that life satisfaction and quality were impaired in BD patients&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> Also&#44; Canpolat et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">21</span></a> found that QoL scores in patients with Beh&#231;et&#39;s disease were low and were affected by gender&#44; age&#44; work status&#44; education status as well as complaints of oral and genital ulcerations&#44; arthritis&#44; skin lesions and bodily pain&#46; In another study&#44; Tanriverdi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> showed that BD patients were more susceptible to mood and anxiety disorders&#44; and their QoL was lower than that of their healthy counterparts&#46; They also reported that chronic diseases like BD might be related to mood disorders&#44; which might have a negative effect on patient&#39;s daily life&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Our study also indicated significant correlation between the Physical and Mental Health scores and some SF-36 domains with genital ulcers&#44; ophthalmic and CNS involvement&#46; No significant correlation was observed between the Physical and Mental Health scores and some SF-36 domains with oral aphthous ulcer&#44; skin lesions&#44; arthritis&#44; gastrointestinal and vascular involvement as well as pathergy test&#46; Our findings were consistent with Tanriverdi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> study which reported mental status might have triggered the development of ocular attacks in BD and that BD patients with ocular involvement had significantly more susceptibility to anxiety and depression&#46; Similarly&#44; Ertam et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> found significantly lower scores in &#8220;Mental Health&#8221; domain of SF-36 scale in BD patients with eye involvement&#46; Moreover&#44; the negative effect of the genital ulcers on the quality of life in BD was shown by Blackford et al&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">26</span></a> In other previous study&#44; Bodur et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> reported that arthritis&#44; fatigue and genital ulcer scores of BDCAF were the most important factors impairing the quality of life in BD&#46; In contrast with present study&#44; Gur et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">9</span></a> reported that arthritis had a negative effect on the quality of life in BD patients&#46; Taner et al&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">27</span></a> used Beck depression and Beck anxiety inventory in BD patients and psoriasis patients&#46; Although the psoriatic skin lesions might be expected to deteriorate the quality of life considerably&#44; they reported that the quality of life of BD patients were even worse than that of the psoriasis patients&#46; Furthermore&#44; Ertam et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> indicated that presence of vascular involvement&#44; eye involvement and arthritis contributed considerably to impaired quality of life in BD&#46; However&#44; they could not show that genital ulcers impaired the quality of life in BD&#46; According to Kilin&#231; et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">28</span></a> patients with oral ulcer&#44; genital ulcer&#44; lesions that looks like erythema nodosum and gastrointestinal ulcer had lower emotional life&#44; daily activity&#44; symptom and sexual life scores&#46; This discrepancy between our results with previous studies might be due to differences in studied population&#46;</p><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Limitations and strengths</span><p id="par0080" class="elsevierStylePara elsevierViewall">The limitation of the current study was that although significant correlations were observed between SF-36 scores with disease activity and some clinical symptoms&#44; the correlations were low to moderate&#46; The strengths of present study included the relatively large sample size and that we had a control group and compared QoL between patients with BD and normal population&#46; Furthermore&#44; all study subjects had a high cooperation in this research&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusion</span><p id="par0085" class="elsevierStylePara elsevierViewall">In conclusion&#44; based on evaluation of SF-36 scores&#44; quality of life is impaired in BD&#44; and this impairment is related with disease severity&#46; Presence of arthritis&#44; eye involvement and vascular involvement seem to contribute the impairment of quality of life in BD&#46; These results highlight the importance of nursing interventions in managing the symptoms experienced by patients effectively so that the limited effects of the symptoms which decrease QoL can be eliminated&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Funding</span><p id="par0090" class="elsevierStylePara elsevierViewall">This study was supported by Connective Tissue Diseases Research Center of Tabriz University of Medical Sciences&#44; Tabriz&#44; Iran&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflict of interests</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare that there is no conflict of interests&#46;</p></span></span>"
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        0 => array:4 [
          "clase" => "keyword"
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          "identificador" => "xpalclavsec1320040"
          "palabras" => array:4 [
            0 => "Enfermedad de Beh&#231;et"
            1 => "Calidad de vida"
            2 => "S&#237;ntomas cl&#237;nicos"
            3 => "Actividad de la enfermedad"
          ]
        ]
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    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Beh&#231;et&#39;s disease&#40;BD&#41; is a systemic vasculitis which may affect the quality of life &#40;QoL&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Aims</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This study aimed to assess the QoL in Iranian Azeri BD patients as well as evaluating the association between QoL and disease characteristics including disease activity and clinical symptoms&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">In this cross-sectional study&#44; a total of 123 BD patients aged 15&#8211;65 years fulfilling International Criteria for BD and 123 healthy controls matched with regard to gender were included&#46; Patients aged 15&#8211;18 years had the informed consent and consent of their parents for participation&#46; Short Form-36 Quality of Life Scale &#40;SF-36&#41; was used to evaluate QoL&#46; Disease activity was measured by Behcet&#39;s Disease Current Activity Form and the Iranian Behcet&#39;s Disease Dynamic Activity Measure and Vasculitis Damage Index &#40;VDI&#41; was used for the clinical assessment of damage&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD age of BD patients and control group was 38&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;99 and 33&#46;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;29 years&#44; respectively&#46; The Physical Health score as well as most of SF-36 domains including Role Physical&#44; Bodily Pain&#44; General Health&#44; Vitality&#44; and Mental Health were significantly lower in BD patients compared with the control group &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; There was significant correlation between the Physical and Mental Health scores and most of SF-36 domains with disease activity and clinical symptoms including genital ulcers&#44; ophthalmic and central nervous system &#40;CNS&#41; involvement &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Significant correlation was only observed between VDI and Bodily Pain domain &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Quality of life is impaired in BD patients&#44; and this impairment is related with disease severity&#46; It seems that presence of genital ulcers&#44; eye and CNS involvement lead to the impairment of QoL in BD patients&#46; These results highlight the importance of nursing interventions in managing clinical symptoms in these patients&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Aims"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Methods"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
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          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusion"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La enfermedad de Beh&#231;et &#40;BD&#41; es una vasculitis sist&#233;mica que puede afectar la calidad de vida &#40;QoL&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Este estudio tuvo como objetivo evaluar la QoL en pacientes con BD azer&#237; iran&#237;&#44; as&#237; como evaluar la asociaci&#243;n entre la QoL y las caracter&#237;sticas de la enfermedad&#44; incluida la actividad de la enfermedad y los s&#237;ntomas cl&#237;nicos&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En este estudio transversal&#44; un total de 123 pacientes con BD de 15 a 65 a&#241;os de edad cumplieron con los criterios internacionales para BD y 123 controles sanos que fueron emparejados por g&#233;nero&#46; Los pacientes de 15 a 18 a&#241;os de edad ten&#237;an el consentimiento informado y el consentimiento de sus padres para participar en el estudio&#46; Se us&#243; la escala de calidad de vida corta-36 &#40;SF-36&#41; para evaluar la calidad de vida&#46; La actividad de la enfermedad se midi&#243; mediante el formulario de actividad actual de la BD y la medida de la actividad din&#225;mica de la BD iran&#237; y el &#237;ndice de da&#241;o de la vasculitis &#40;VDI&#41; se usaron para la evaluaci&#243;n cl&#237;nica del da&#241;o&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE de los pacientes con BD y el grupo control fue de 38&#44;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;99 y 33&#44;65<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;29 a&#241;os&#44; respectivamente&#46; La puntuaci&#243;n de Salud f&#237;sica&#44; as&#237; como la mayor&#237;a de los dominios SF-36&#44; incluyendo Rol f&#237;sico&#44; Dolor corporal&#44; Salud general&#44; Vitalidad y Salud mental&#44; fueron significativamente m&#225;s bajos en los pacientes con BD en comparaci&#243;n con el grupo control &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Hubo una correlaci&#243;n significativa entre los puntajes de Salud f&#237;sica y mental y la mayor&#237;a de los dominios SF-36 con actividad de la enfermedad y s&#237;ntomas cl&#237;nicos&#44; como &#250;lceras genitales&#44; compromiso del sistema oft&#225;lmico y del sistema nervioso central &#40;SNC&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Solo se observ&#243; una correlaci&#243;n significativa entre el VDI y el dominio del dolor corporal &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusi&#243;n</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La calidad de vida se ve afectada en los pacientes con BD&#44; y este deterioro est&#225; relacionado con la gravedad de la enfermedad&#46; Parece que la presencia de las &#250;lceras genitales&#44; la afectaci&#243;n ocular y del SNC conduce al deterioro de la QoL en pacientes con BD&#46; Estos resultados resaltan la importancia de las intervenciones de enfermer&#237;a en el manejo de los s&#237;ntomas cl&#237;nicos en estos pacientes&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Antecedentes"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objetivos"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "M&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
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          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
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      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">BDCAF&#58; Behcet&#39;s Disease Current Activity Form&#59; IBDDAM&#58; Iranian Behcet&#39;s Disease Dynamic Activity Measure&#59; VDI&#58; Vasculitis Damage Index&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Data are presented as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#44; number &#40;&#37;&#41; or median &#40;Min&#8211;Max&#41;&#46;</p>"
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                  \t\t\t\t">38&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;99&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">75 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">48 &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">38 &#40;30&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">19 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">34 &#40;27&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">22 &#40;19&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">34 &#40;27&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Mental Health&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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Información del artículo
ISSN: 1699258X
Idioma original: Inglés
DOI:10.1016/j.reuma.2019.03.002
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