Quality of life in caregivers of children with asthma: Validity and reliability of the IFABI-R questionnaire.

BACKGROUND: Parents'/caregivers' quality of life is an important aspect to consider when handling paediatric asthma, but there is a paucity of valid and reliable instruments to measure it. The Family Impact of Childhood Bronchial Asthma (IFABI-R) is a recently developed questionnaire to facilitate the assessment of asthma-related parents'/caregivers' quality of life. This study researches the psychometric properties of IFABI-R. METHODS: Parents/main caregivers of 462 children between 4 and 14 years of age with active asthma were included in the sample. IFABI-R was administered on two different occasions and a number of other variables related to the parents'/caregivers' quality of life were measured: child's asthma control, family functioning, and parents'/caregivers' perception of asthma symptoms in the child. IFABI-R evaluative and discriminative properties were analysed, and the minimal important change in the IFABI-R score was identified. RESULTS: IFABI-R showed high internal consistency (Cronbach's alpha=0.941), cross-sectional construct validity (correlation with the degree of child's asthma control, family functioning and parent/caregiver perception of the child's asthma symptoms), longitudinal construct validity (correlation of changes in the IFABI-R with changes in asthma control and changes in the perception of symptoms), sensitivity to change and test-retest reliability. An absolute change of 0.3 units in IFABI-R related to a minimal significant change in the parents'/caregivers' quality of life. CONCLUSIONS: IFABI-R is a reliable and valid instrument to study the quality of life of parents/caregivers of children with asthma.

Risk of adverse events in psoriasis patients receiving classic systemic drugs and biologics in a 5-year observational study of clinical practice: 2008-2013 results of the Biobadaderm registry.

BACKGROUND: Biobadaderm is the Spanish registry of psoriasis patients receiving systemic treatment in clinical practice. OBJECTIVE: To compare the safety of biologics and classic systemic treatment. METHODS: Prospective cohort of patients receiving biologics and classic systemic therapies between 2008 and 2013 in 12 hospitals are included. We registered demographic data, diagnoses, comorbidities, treatments and adverse events (AE). We obtained raw relative risks (RR) for specific AE. Multivariate analysis consisted of Cox models adjusting for age, gender, chronic hepatic disease and previous cancer. RESULTS: A total of 1030 patients received biologics (2061 AE in 3681 person-years), 926 patients classic systemic drugs (1015 AE in 1517 person-years). Ninety-three per cent of AE in both groups were non-serious, 6% serious and 0.003% fatal. The age- and gender-adjusted hazard ratio of AE was lower in the biologics group [hazard ratio 0.6 (95% CI: 0.5-0.7)].We found no differences in rates of serious and mortal AE. Some system organ class AE rates differed between both groups. As limitations: Prescription bias might affect the incidence of AE in both groups. Association of drug and AE was based on timing: associations might not be causal. CONCLUSION: Patients receiving biologics had lower risk of AE. We did not find differences in the risk of serious or fatal AE.

Mycoplasma hominis infection in three renal transplant patients.

We describe three cases of extragenital infection by Mycoplasma hominis in three patients transplanted with kidneys from cadaver donors. In two patients, the microorganism was isolated in the exudate from the surgical wound after 72 hrs. of culture on blood-agar (Columbia + 5% horse blood) in CO2 and under anaerobic conditions. In the remaining case, M. hominis was isolated in urine from a suprapubic catheter. All three patients responded satisfactorily to treatment with doxycycline. Mycoplasma hominis should be considered as the possible source of infection in patients at risk because of immunosuppressive therapy and manipulation of the urinary tract. Detection and identification of the organism are difficult without the appropriate techniques.

Quality of life in caregivers of children with asthma: Validity and reliability of the IFABI-R questionnaire

BACKGROUND: Parents'/caregivers' quality of life is an important aspect to consider when handling paediatric asthma, but there is a paucity of valid and reliable instruments to measure it. The Family Impact of Childhood Bronchial Asthma (IFABI-R) is a recently developed questionnaire to facilitate the assessment of asthma-related parents'/caregivers' quality of life. This study researches the psychometric properties of IFABI-R. METHODS: Parents/main caregivers of 462 children between 4 and 14 years of age with active asthma were included in the sample. IFABI-R was administered on two different occasions and a number of other variables related to the parents'/caregivers' quality of life were measured: child's asthma control, family functioning, and parents'/caregivers' perception of asthma symptoms in the child. IFABI-R evaluative and discriminative properties were analysed, and the minimal important change in the IFABI-R score was identified. RESULTS: IFABI-R showed high internal consistency (Cronbach's alpha = 0.941), cross-sectional construct validity (correlation with the degree of child's asthma control, family functioning and parent/caregiver perception of the child's asthma symptoms), longitudinal construct validity (correlation of changes in the IFABI-R with changes in asthma control and changes in the perception of symptoms), sensitivity to change and test-retest reliability. An absolute change of 0.3 units in IFABI-R related to a minimal significant change in the parents'/caregivers' quality of life. CONCLUSIONS: IFABI-R is a reliable and valid instrument to study the quality of life of parents/caregivers of children with asthma

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[Culture media for the detection and the identification of Streptococcus agalactiae]. / Medios de cultivo para la detección e identificación de Streptococcus agalactiae.

Streptococcus agalactiae, a Group B streptococcus, is the main cause of bacterial perinatal infection and is also an important opportunistic pathogen. Detection and identification of S. agalactiae are straight forward with special culture media, where Group B streptococci show a specific, typical pink or red pigment. To quickly and easily detect the pigment, culture media should contain: (i) starch; (ii) an inhibitor of the folate pathway; (iii) animal serum; (iv) a pepsic proteic hydrolysate; and (v) glucose, together with a high-capacity buffer. When selective antibiotics are added to culture media designed in this way, it is possible to detect S. agalactiae directly from clinical samples by observation of its pigment after less than 12 hours of aerobic incubation.

[Evaluation of the Vitek system in the identification and biotyping of Streptococcus agalactiae]. / Evaluación del sistema Vitek en la identificación y biotipia de Streptococcus agalactiae.

Using the Vitek card for identification of gram-positive agents, 244 strains of Streptococcus agalactiae were studied. Twenty five out of these strains were studied during 3 consecutive days. The study also involved 25 pairs of maternal and neonatal strains. The system gave correct identification of only 52 out of 244 strains of S. agalactiae. Due to the low reproducibility of the system it is suggested that the bionumbers used in the codification of a microorganism should be avoided.

[Isolation of Streptococcus agalactiae in adults: serotypes, adhesiveness to epithelial cells]. / Aislamientos de Streptococcus agalactiae en adultos: serotipos, adhesividad a células epiteliales.

Serotype distribution and adherence to epithelial cells (HeLa and Hep-2) were studied in 230 strains of Streptococcus agalactiae (GBS) isolated in adult patients with GBS infection or in asymptomatic carriers. In the population investigated, serotypes Ia and III predominated in the strains isolated from both carriers and patients. Adhesivity was significantly greater in strains isolated from the former, regardless of serotype. Thus in adults, serotype cannot be correlated with virulence of a given strain.

New Granada Medium for detection and identification of group B streptococci.

A methotrexate-containing medium for the detection of beta-hemolytic group B streptococci from clinical specimens on the basis of detection of pigment is described. The medium contained peptone, starch, serum, MgSO4, glucose, pyruvate, methotrexate (as pigment enhancer), phosphate-morpholine-propanesulfonic acid buffer, and selective agents. The recovery of beta-hemolytic group B streptococci was comparable to that obtained with selective broth.

[Prevalence of antibodies against CMV in Grenada]. / Prevalencia de anticuerpos frente a CMV en Granada.

The prevalence of anti-CMV antibodies was studied on 1,552 serum samples by means of latex passive haemagglutination method. Of all the sera studied, 1,084 were positive (69.8%). Amongst them, 523 samples came from women and 561 from men, which represent 74.7% and 65.8%, respectively. Regarding to age, 62.3% of the positive samples were from people under 30 years and 91.3% from subjects over that age. The screening of anti-CMV antibodies is especially important in blood and organ donors, where the high percentage of positivity makes it difficult to select negative blood donations. Thus, taking into account the cost-effectiveness, and the results of this study, the search for CMV-negative blood must be exerted preferentially on the group of blood donors under 30 years of age, regardless of sex.

Epilepsia parcial continua y un probable Síndrome de Rasmussen: Epilepsia parcial continua y síndrome de Rasmussen / Continua parcial epilepsy and a possible Rasmussen's Syndrome

El Síndrome de Rasmussen es una enfermedad neurológica poco frecuente que inicia en la infancia pero puede progresar hasta la edad adulta. Se caracteriza por la presencia de epilepsia parcial continua y el desarrollo de epilepsia refractoria, datos relevantes en la explotación clínica, alteraciones en los estudios de neuroimágenes especialmente en la resonancia magnética y hallazgos histopatológicos característicos en la biopsia cerebral. Se ha relacionado esta entidad con un episodio previo de encefalitis que predispone a ua reacción inmunológica contra algunos componentes del encéfalo, lo cual lleva a un atrofia de un sólo hemisterio cerebral. Actualmente el tratamiento más efectivo en controlar las crisis convulsivas es la hemisferectomía, aunque algunos pacientes pueden tener mejoría transitoria con el uso de inmunoglobulina intravenosa .Se reporta el caso de una paciente quien reúne los criterios clínicos y radiológicos que hacen suponer sufre de esta enfermedad. Al momento de terminar de redactar este artículo está recibiendo dosis semanales de inmunoglobulina intravenosa para valorar respuesta clínica a la misma. Ante eventual falla terapéutica será sometida a una hemisferectomía de la cual una vez realizado el análisis histopatológico será reportado el caso. Palabras Claves : Síndrome de Rasmussen - Epilepsia Parcial Continua -Epilepsia Refractoria -Hemisferectomía-Inmunoglobulina intravenosa-Resonancia Magnética.