Adaptation and validation of the Spanish version of NOSE-Perf questionnaire for septal perforations.

BACKGROUND AND OBJECTIVE: Septal perforation (SP) cause heterogeneous symptoms depending on the anatomical location, highlighting scabs, nasal obstruction and/or epistaxis. The use of questionnaires to determine the quality of life in different pathologies is increasing in sinonasal pathologies and in patients with SP the NOSE-Perf questionnaire was constructed, currently validated in English. The aim of this study is the translation, cross-cultural adaptation, and validation of the NOSE-Perf questionnaire into Spanish. MATERIAL AND METHODS: Prospective single-centre study of 81 patients (38 with SP and 43 controls), visited in the rhinology section of a tertiary hospital. Adaptation and translation NOSE-Perf into Spanish and validation using the NOSE and NOSE-Perf questionnaire in Spanish. RESULTS: Significant differences were found in the mean NOSE-Perf score and in the mean NOSE score (IC95% = 21.2-26.9; p < 0.001 and IC95% = 53.8-70.5; p < 0.001) between SP group and control group. Pearson's correlation between the two questionnaires NOSE-Perf and NOSE in the SP group was 0.74 (95% CI = 0.56-0.86; p < 0.001). In the control group it was r = 0.85 (95%CI = 0.73-0.91; p < 0.001). Cronbach's alpha coefficient of the NOSE-Perf was 0.95 (IC 95% = 0.93-0.96) for internal consistency. The reliability evaluation was carried out by test-retest, and a strong Pearson correlation was obtained between the questionnaires r = 0.94 (CI95% = 0.85-0.97; p < 0.001) and r = 0.89 (95%CI = 0.77-0.95; p < 0.001). CONCLUSIONS: The Spanish version of the NOSE-Perf is as reliable and valid as the English version, which makes it possible to assess the impact on quality of life that it causes in patients with perforations in the Spanish-speaking population.

Do We Drop the Ball When We Measure Ball Skills Using Standardized Motor Performance Tests?

BACKGROUND: Ball skill performance changes over time during childhood and depends on the child's physical and psychological characteristics, environmental opportunities, and task constraints. The aim of this study was to examine whether different standardized ball skill-items measure similar constructs and whether results differentiate among age groups. Methods: A total of 250 children (6-10 years) were administered the Movement Assessment Battery for children second edition (MABC-2), the subtest upper-limb coordination of the Bruininks-Oseretsky Test of Motor Proficiency second edition (BOT-2), the tennis ball throw of the Fitness Test Battery (FTB), and the ball skills and overhead throw of the Performance and Fitness test (PERF-FIT). Results: Correlations among scores of BOT-2, FTB, and PERF-FIT ranged from fair to moderate, but correlations were low with the MABC-2. Principal component analysis retrieved three components: the first component contained catch, dribble, bounce, and throw items (MABC-2, BOT-2-SF, and PERF-FIT, respectively); the second contained throwing for distance (PERF-FIT and FTB); the third contained aiming (MABC-2). Most ball skill scores differed significantly between 6-7 and 7-8 years, but less between 8-9 years; the PERF-FIT discriminated best between age groups. Conclusion: Most ball skill items in motor tests belong to a comparable construct containing throw, dribble, bounce, and catch skills. However, aiming tasks belong to a separate category. Additionally, throwing for distance is a task that requires predominantly explosive power.

Ecological validity of the PERF-FIT: correlates of active play, motor performance and motor skill-related physical fitness.

BACKGROUND: Active games are important health enhancing physical activities in children with and without developmental disorders and will help children to develop fundamental motor skills, while inactivity exacerbates coordination difficulties and increases the risk of obesity. Regular engagement in active play promotes physical, social and cognitive development. It is therefore important to know if children have the capabilities for healthy behavior. Motor skills and muscular fitness are both important components to participate in play, sport and leisure. The Performance and Fitness (PERF-FIT) test battery integrates motor skills (running, jumping, hopping, catching, bouncing, throwing, balance) and muscular fitness (explosive power and muscular endurance) needed in many forms of active play. AIM: To test the ecological validity of the PERF-FIT test battery; a field-based test integrating motor skill proficiency and muscular fitness. METHODS: Seventy-five children were assessed on the PERF-FIT, Movement Assessment Battery for Children (MABC)-2 and performance in 6 active games was scored. Of these children, 52 children scored in the normal range and 23 (or 30.3%) below the 16th percentile of the MABC-2. Association between the outcomes of the two tests and the 6 games was calculated. RESULTS: High to moderate associations were found between game scores and PERF-FIT items; moderate to low associations between game scores and MABC-2 items. Principle axes factor analysis with oblique rotation revealed communalities between the explosive power and agility items of the PERF-FIT and the running and ball catching games but not between the games and the balance items. CONCLUSIONS AND IMPLICATIONS: Scores on the PERF-FIT are significantly related to performance in active play. The tool is able to measure aspects of motor skills, muscle endurance and explosive power needed in children's active games and could be used as an additional tool to measure requirements for participation in everyday physical activity in children with and without developmental disorders .

Matrix Metalloproteinase Mediated Type I Collagen Degradation - An Independent Risk Factor for Mortality in Women.

Chronic fibro-proliferative diseases are associated with nearly 45% of all deaths in the developed world. Matrix metalloproteinase (MMP) mediated remodeling of the extracellular matrix (ECM) plays an important role in disease development. Degradation of type I collagen is considered having a major role in this matter. C1M is a biomarker measuring type I collagen degradation fragments in blood. The aim of the current study was to investigate whether MMP mediated type I collagen degradation (C1M) was predictive of mortality in a large prospective cohort of Danish women aged 48-89 (n = 5855). Subjects with high serum C1M showed significant increased mortality. The adjusted three year HR was 2.02 [95% CI: 1.48-2.76] for all-cause mortality, 2.32 [95% CI: 1.51-3.56] for cancer and 1.77 [95% CI: 0.98-3.17] for cardiovascular diseases. The adjusted nine year HR was 1.50 [95% CI: 1.28-1.75] for all-cause mortality, 1.49 [95% CI: 1.16-1.90] for cancer and 1.69 [95% CI: 1.27-2.24] for cardiovascular diseases. High MMP-mediated type I collagen degradation was associated with increased mortality. Subjects with high C1M had a 2-fold increase in mortality compared to subjects with low levels of this collagen degradation product.

Development and evaluation of RapTAT: a machine learning system for concept mapping of phrases from medical narratives.

Rapid, automated determination of the mapping of free text phrases to pre-defined concepts could assist in the annotation of clinical notes and increase the speed of natural language processing systems. The aim of this study was to design and evaluate a token-order-specific naïve Bayes-based machine learning system (RapTAT) to predict associations between phrases and concepts. Performance was assessed using a reference standard generated from 2860 VA discharge summaries containing 567,520 phrases that had been mapped to 12,056 distinct Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) concepts by the MCVS natural language processing system. It was also assessed on the manually annotated, 2010 i2b2 challenge data. Performance was established with regard to precision, recall, and F-measure for each of the concepts within the VA documents using bootstrapping. Within that corpus, concepts identified by MCVS were broadly distributed throughout SNOMED CT, and the token-order-specific language model achieved better performance based on precision, recall, and F-measure (0.95±0.15, 0.96±0.16, and 0.95±0.16, respectively; mean±SD) than the bag-of-words based, naïve Bayes model (0.64±0.45, 0.61±0.46, and 0.60±0.45, respectively) that has previously been used for concept mapping. Precision, recall, and F-measure on the i2b2 test set were 92.9%, 85.9%, and 89.2% respectively, using the token-order-specific model. RapTAT required just 7.2ms to map all phrases within a single discharge summary, and mapping rate did not decrease as the number of processed documents increased. The high performance attained by the tool in terms of both accuracy and speed was encouraging, and the mapping rate should be sufficient to support near-real-time, interactive annotation of medical narratives. These results demonstrate the feasibility of rapidly and accurately mapping phrases to a wide range of medical concepts based on a token-order-specific naïve Bayes model and machine learning.

Delayed perforation after percutaneous coronary intervention: rare and potentially lethal.

INTRODUCTION: Cardiac tamponade is a grave but fortunately uncommon complication of percutaneous coronary intervention (PCI). Few studies have specifically addressed angiographic characteristics and outcomes associated with delayed cardiac tamponade after PCI. With the current study we tried to define the incidence of this complication and to characterize the events in order to improve our understanding of the likely mechanisms. METHODS/RESULTS: We reviewed 23,399 PCIs performed at our institution during an 8-year period (1999-2006) and we present 10 cases of delayed tamponade. A brief description of each case is provided and findings from retrospective review of the coronary angiography, as well as features of PCI complexity are presented. Also, we summarize the procedural characteristics and outcomes. Delayed perforations are rare and possibly preventable. They usually occur after complex interventions and mostly attributed to distal wire perforations. Surgical intervention is needed less often today than before. Successful pericardiocentesis is of paramount importance. CONCLUSIONS: The potential lethal outcome associated with delayed tamponade emphasizes the importance of taking steps to prevent this complication. First, prevention and, second, prompt treatment should be the goal, with the use of appropriate technique, clinical awareness, and vigilance.

Estudo das indicações de parto cesáreo em primigestas no município de Barbalha-Ceará / Study of the indications for cesarean delivery in primiparous in the municipality of Barbalha-Ceara / Estudio de las indicaciones de parto por cesárea en primigestas en el município de Barbalha-Ceará

Objetivou-se analisar indicações de cesariana em primigestas usuárias do Sistema Único de Saúde. Estudo descritivo, documental e quantitativo realizado em prontuários hospitalares (n=123) dos partos ocorridos entre janeiro a dezembro de 2008 em um hospital de referência obstétrica em Barbalha/CE. Observou-se na amostra, faixa de idade entre 14 e 39 anos, sendo que 56,10% eram casadas, 73,98% residiam na zona urbana, 47,97% possuíam de 8 a 11 anos de estudo, 39,84% eram estudantes e 32,52% agricultoras. E ainda, que 58,54% realizaram no mínimo sete consultas de pré-natal e 90,24% tinham idade gestacional no momento do parto entre 37 e 41semanas. Dentre as indicações de parto cesáreo, a doença hipertensiva específica da gravidez representou 22,22%, sendo a complicação gestacional mais prevalente, e a desproporção cefalopélvica 36,67%, enquanto complicação do trabalho de parto. As indicações para cesárea foram coerentes com a literatura, fato que favorece o perfil de saúde materno-infantil do município.

It analyzes indications for cesarean section in primigravida e users of the Unified Health System. A descriptive, document and quantitative study was applied, and conducted with hospital records (N = 123) between January and December 2008 at a referral hospital in obstetrics in Barbalha / CE. We observed in the sample, ages between 14 and 39 years old, and 56.10% were married, 73.98% lived in urban areas,47.97% had between 8 and 11 years of study, 39.84% were students and 32.52% farmers. And yet, that 58.54% had at least seven prenatal care and 90.24% had gestational age at delivery between 37 and 41semanas. Among the indications for cesarean section, the hypertensive disorders of pregnancy accounted for 22.22% and the pregnancy complication prevalent, and cephalopelvic disproportion 36.67%, while complication of labor. The indications for cesarean section were consistent with the literature, a fact that favors the profile of maternal and child health in the city.

El objetivo fue analizar indicaciones de cesárea en primigestas usuarias del Sistema Único de Salud. Estudio descriptivo, documental y cuantitativo realizado en los historiales médicos hospitalarios (N = 123) de los partos ocurridos entre enero y diciembre de 2008 en un hospital de referencia obstétrica en Barbalha/CE. Se ha observado en la muestra, edades entre 14 y 39 años, siendo que un 56,10%estaba casada, un 73,98% vivía en la zona urbana, un 47,97% tenía de 8 a 11 años de estudio, un 39,84% era estudiante y un 32,52% campesinas. Y también, que un 58,54% realizó al menos siete consultas prenatales y un 90,24% tenía edad gestacional en el momento del parto entre las 37 y 41 semanas. Entre las indicaciones de cesárea, la hipertensión inducida por el embarazo representó un 22,22%, siendola complicación del embarazo más frecuente; y la desproporción céfalo- pélvica un 36,67%, como complicación del trabajo de parto. Las indicaciones para cesárea fueron coherentes con la literatura, lo que favorece el perfil de salud materno-infantil del municipio.

A Novel Human Lipid Binding Protein Coding Gene: PERF15, Sequence and Cloning.

INTRODUCTION: PERF15 is a testicular germ-cell specific fatty-acid binding protein (FABP) isolated from mammals, originally from rats. It encodes one of the most abundant proteins of rat spermatozoa localized in the perinuclear theca. Northern blot analysis has demonstrated that rat PERF15 mRNA is exclusively transcribed during meiosis and post-meiosis. In this study, we cloned and sequenced human PERF15 gene. MATERIALS AND METHODS: According to the open reading frame of automated computational analysis of Homo sapiens similar to testis fatty acid binding protein nine, two specific Primers were designed to amplify human PERF15 gene. To confirm the identity of the amplified gene, PCR products of PERF15 were cloned into appropriate plasmid vectors followed by sequencing of the inserts. RESULTS: A unique band of ∼3kb was obtained after PCR amplification. Restriction enzyme digestion using PvuII confirmed that the fragment was related to PERF15. Gene alignment, direct sequencing and application of specific primers to the gene showed 100% similarity between this gene and the computational data by gel extraction of the ∼3 kb band. The human PERF15 gene contained four exons and three introns. Exons one, two, three and four, respectively, coded for 24, 57, 34 and 17 amino acids. The existing three introns were composed of 2113, 461, and 168 nucleotides. CONCLUSION: In spite of the homology between exonic regions and exon-intron boundaries of human PERF15 gene and that of animals, human PERF15 gene is different in size and sequence from corresponding introns in rat and murine PERF15.