RESUMEN
A 2240 gram boy was born at 33.2 weeks gestation with nonblanching, deeply erythematous plaques and papules on the back, flanks, and scalp (Figure 1). His mother was GBS positive and on antibiotic suppression for prior cutaneous MRSA and urinary tract infections. Intrapartum intravenous Penicillin G was administered, and the amniotic sac was artificially ruptured 4 hours prior to delivery to facilitate labor. The delivery was uncomplicated without concern for chorioamnionitis, but the patient initially required CPAP for respiratory distress with 1-minute and 5-minute Apgar scores of 7 and 8, respectively. A skin punch biopsy is shown (Figure 2).
Asunto(s)
Antibacterianos/uso terapéutico , Impétigo/patología , Recien Nacido Prematuro , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Infecciones Estreptocócicas/transmisión , Puntaje de Apgar , Biopsia con Aguja , Femenino , Estudios de Seguimiento , Edad Gestacional , Humanos , Inmunohistoquímica , Impétigo/congénito , Impétigo/tratamiento farmacológico , Recién Nacido , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/microbiología , Síndrome de Dificultad Respiratoria del Recién Nacido/fisiopatología , Síndrome de Dificultad Respiratoria del Recién Nacido/terapia , Infecciones Estreptocócicas/tratamiento farmacológico , Resultado del TratamientoRESUMEN
STUDY OBJECTIVES: A single subjective question may be an effective screening tool for excessive daytime sleepiness. This study sought to determine whether the following single question about sleepiness can measure subjective sleepiness comparably to the Epworth Sleepiness Scale (ESS): "Please measure your sleepiness on a typical day: (0 = none, 10 is highest)." The relationship between this question and objective sleepiness as measured by the MSLT was also evaluated. METHODS: 303 subjects completed a sleep questionnaire, MSLT, and ESS within 2 months. ROC (receiver-operator characteristic) curves and contingency tables using Fisher's exact test were made using GraphPad Prism software. RESULTS: ESS and SS scores showed a significant association at all SS score cut-points. ESS and MSL showed significant associations only at ESS scores 11, 12, and 18. SS scores were significantly related to the MSL only in non-sleep apneics at SS scores 2, 5, 6, and 8, and in sleep apneics at SS score 9. ROC analysis showed the SS could distinguish subjects with an ESS > or = 11 from those with an ESS < 11 (area = 0.71, p < 0.0001). CONCLUSIONS: Neither the SS nor the ESS substitutes for the MSLT, which measures objective sleepiness and is not an appropriate screening tool. SS scores < or = 2 and > or = 9 reliably predict normal and abnormal ESS scores respectively. Since the ESS is not commonly used in non-sleep specialized practices, the SS may serve as a useful screening tool for patients with disorders of sleepiness.