RESUMO
BACKGROUND: We have developed the Atopic Dermatitis Symptom Score (ADSS) by which patients or parents can easily assess and record AD symptoms on a daily basis in a smartphone application. The aim of this study was to evaluate the reliability and validity of the ADSS. METHODS: We enrolled 307 children and adolescents with AD. Parents or caregivers were asked to record daily symptoms of the patients (itching, sleep disturbance, erythema, dryness, oozing, and edema) using a scale of 0-4. Statistical analyses consisted of the test-retest reliability, concurrent validity, minimal clinically important difference (MCID), responsiveness, floor or ceiling effects, and screening accuracy. Receiver-operating characteristic analyses were conducted to evaluate the ADSS cutoff point for predicting severe AD (SCORing AD [SCORAD] ≥40). RESULTS: Test-retest reliability between daytime and night-time ADSS was good (intraclass correlation coefficient, 0.82 [95% CI: 0.70-0.90]). An increase in ADSS was significantly associated with an increase in SCORAD (r = 0.64, P < .0001) (concurrent validity). The MCID was 4.1 points for the ADSS. There was a significant association between changes in ADSS and SCORAD (r = 0.56, P < .0001), indicating good responsiveness. At the optimal ADSS cutoff value of 7.0, sensitivity, specificity, and positive and negative predictive values were 88.4%, 78.6%, 21.1%, and 99.1%, respectively (screening accuracy). CONCLUSIONS: The ADSS can be a useful tool for self-assessment of skin symptoms in children with AD.
Assuntos
Dermatite Atópica/diagnóstico , Programas de Rastreamento/métodos , Adolescente , Cuidadores , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Aplicativos Móveis , Pais , Curva ROC , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença , SmartphoneRESUMO
Recent years have seen a significant increase in the use of Interventional Radiology (IR) as an alternative to open surgery. A large number of IR procedures commences with needle puncture of a vessel to insert guidewires and catheters: these clinical skills are acquired by all radiologists during training on patients, associated with some discomfort and occasionally, complications. While some visual skills can be acquired using models such as the ones used in surgery, these have limitations for IR which relies heavily on a sense of touch. Both patients and trainees would benefit from a virtual environment (VE) conveying touch sensation to realistically mimic procedures. The authors are developing a high fidelity VE providing a validated alternative to the traditional apprenticeship model used for teaching the core skills. The current version of the CRaIVE simulator combines home made software, haptic devices and commercial equipments.
Assuntos
Competência Clínica , Física , Radiologia Intervencionista/educação , Interface Usuário-Computador , Humanos , Fenômenos Físicos , Radiologia Intervencionista/normas , Tato , Reino UnidoRESUMO
Central catecholamines (CA) are known to be involved in the regulation of synthesis and secretion of gonadotropin releasing hormone (GnRH) from the hypothalamus. However, no attempt has been yet made to determine whether CA affects GnRH gene expression. To this end, the effect of 6-hydroxydopamine (6-OHDA), a catecholaminergic neurotoxin, on GnRH mRNA level was examined. Hypothalamic tissues obtained from adult male rats were incubated with medium containing 6-OHDA. To ensure the effect of 6-OHDA on CA depleting action, CA levels in media and in postincubation tissues were determined. Increasing concentrations of 6-OHDA resulted in decrease in norepinephrine (NE) and dopamine (DA) contents in a dose dependent manner. Treatment with 6-OHDA (5 x 10(-4) M produced a time-dependent decrease in NE but not DA, when CA levels in media were determined at 30 min intervals during the incubation period. To determine changes in GnRH mRNA level in response to 6-OHDA treatment in vitro, for 2.5 h total cytoplasmic RNA fractions were isolated from postincubation hypothalamic tissues and used for RNA-blot hybridization with 32P-labeled GnRH riboprobe. A blockade of CA neurotransmission with 6-OHDA (5 x 10(-4) M) significantly reduced GnRH mRNA level by half over its control and internal control (actin mRNA) groups. Northern blot analysis revealed that addition of NE (1 x 10(-6) M) reversed the decreased GnRH mRNA level by 6-OHDA.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Catecolaminas/antagonistas & inibidores , Hormônio Liberador de Gonadotropina/genética , Hipotálamo/efeitos dos fármacos , RNA Mensageiro/metabolismo , Transmissão Sináptica/efeitos dos fármacos , Animais , Hipotálamo/metabolismo , Masculino , Oxidopamina , Ratos , Ratos Sprague-DawleyRESUMO
Chemiluminescent acridinium ester-labelled (AE)-DNA probes (Gen-Probe, Inc., San Diego, Calif.) for the identification of Mycobacterium tuberculosis complex (MTBC) and the M. avium-M. intracellulare complex (MAC) were evaluated using 184 mycobacterial isolates cultured in BACTEC 12B vials (Becton Dickinson and Co., Towson, Md.). A 1.5 mL aliquot from BACTEC 12B vials containing acid-fast bacilli and a Growth Index of > 200 was concentrated 15-fold using a centrifugation step prior to performing the test procedure. When 184 mycobacterial isolates were tested (42MTBC/142 nontuberculous mycobacteria) using the AE-MTBC probe, there was 100% sensitivity and specificity when compared with conventional identification procedures. Criteria for using the AE-MAC probe were defined to optimize results whilst minimizing laboratory costs. Ninety-one (64%) of AE-MTBC probe negative isolates failed to meet selection criteria and were not tested. When 51 (36%) of the AE-MTBC-probe negative mycobacterial isolates were tested, the AE-MAC probe was found to be 88% sensitive and 100% specific. The non-isotopic Gen-Probe test is a rapid and practical alternative to current procedures for differentiation of mycobacteria.
Assuntos
Técnicas Bacteriológicas , Complexo Mycobacterium avium/isolamento & purificação , Mycobacterium tuberculosis/isolamento & purificação , Sondas de DNA , Humanos , Medições Luminescentes , Sensibilidade e Especificidade , Especificidade da Espécie , Fatores de TempoRESUMO
A case of zygomycosis caused by Apophysomyces elegans in a patient having 25% full-thickness burns is described. Amputation of the leg was necessary to control rapid tissue invasion. The fungus was isolated from soil in the burn environment.
Assuntos
Queimaduras/complicações , Mucormicose/etiologia , Infecção dos Ferimentos/etiologia , Amputação Cirúrgica , Humanos , Perna (Membro) , Masculino , Pessoa de Meia-Idade , Mucorales/isolamento & purificação , Mucormicose/microbiologia , Mucormicose/cirurgia , Microbiologia do Solo , Infecção dos Ferimentos/microbiologia , Infecção dos Ferimentos/cirurgiaRESUMO
A 4-month trial involving 2,563 routine clinical specimens was conducted to compare the improved BACTEC TB system (12B medium) with the conventional Lowenstein-Jensen (LJ) media for the isolation, identification, and susceptibility testing of mycobacteria. One hundred sixty-two mycobacterial isolates were recovered, 147 (91%) with BACTEC and 118 (73%) with LJ media. Of these, 62 were Mycobacterium tuberculosis complex strains, 59 (95%) of which were isolated with BACTEC and 54 (87%) of which were isolated with LJ media. Of the remaining 100 isolates, which were mycobacteria other than tuberculosis (MOTT), BACTEC and LJ media detected 88 and 64%, respectively. The contamination rate was significantly higher in BACTEC (5%) than in LJ media (3.3%). The mean isolation time for M. tuberculosis complex with BACTEC was 15.5 days, compared with 25.6 days with LJ. For MOTT, the mean isolation times were 5.8 and 21.4 days, respectively. Identification of 32 M. tuberculosis complex isolates and 38 isolates of MOTT by the BACTEC NAP (p-nitro-alpha-acetylamino-beta-hydroxypropiophenone) inhibition test gave 100% agreement with conventional biochemical identifications. The results of susceptibility testing of 18 M. tuberculosis complex isolates with BACTEC agreed completely with those obtained by the resistance ratio method.
Assuntos
Meios de Cultura , Mycobacterium/isolamento & purificação , Tuberculose/epidemiologia , Animais , Antibacterianos/farmacologia , Austrália/epidemiologia , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/isolamento & purificação , Escarro/microbiologiaRESUMO
A young, previously healthy woman developed bilateral exudative tonsillitis that was associated with severe systemic symptoms. This was followed by evidence of multisystem disease with acute abdominal pain, raised liver enzyme levels, respiratory difficulty, increasing drowsiness and multiple vesicular skin lesions. Herpes simplex virus type-1 was isolated from skin lesions and a throat swab and herpes simplex virus type-1 antigen was detected in a liver biopsy sample. She recovered rapidly without any sequelae after treatment with intravenously administered acyclovir.