ABSTRACT
INTRODUCTION: The modified Rankin Scale (mRS) is the main functional assessment tool used after stroke. The simplified mRS questionnaire (smRSq) has recently been validated in English, and represents a simpler, reliable scale with an excellent reproducibility via telephone. The present study aims to validate a Spanish-language version of the telephone smRSq. METHODS: We conducted a prospective cohort study, assessing 50 patients 3 months after they presented an ischaemic stroke. We assessed the Spanish-language smRSq by telephone and in person, the mRS with a structured interview, the Spanish-language smRSq, and the Stroke Impact Scale-16. Inter-rater reliability, test-retest reliability, construct validity, and criterion validity were assessed. RESULTS: Inter-rater reliability showed strong agreement (kâ¯=â¯0.810); test-retest reliability and criterion validity showed moderate agreement (kâ¯=â¯0.639 and kâ¯=â¯0.759, respectively), and construct validity showed moderate agreement (Spearman correlation coefficientâ¯=â¯-0.728). CONCLUSIONS: The Spanish-language telephone smRSq is reliable and simple, and saves time in the functional assessment after a stroke.
Subject(s)
Brain Ischemia , Stroke , Humans , Language , Prospective Studies , Reproducibility of Results , Stroke/diagnosis , Surveys and Questionnaires , TelephoneABSTRACT
El síndrome de atrapamiento del nervio cutáneo anterior (ACNES) con frecuencia no se tiene presente enel diagnóstico diferencial del dolor abdominal crónico(DAC).Presentamos el caso de un varón de 11 años conDAC estudiado previamente en servicios de urgencia ydigestivo sin detectar patología orgánica, sugiriéndoseun origen psicosomático. En la exploración mostró doloren la pared abdominal localizado en el área de la ramaterminal del nervio intercostal T11, con signo de Carnettpositivo y respuesta favorable a la inyección con anestésico local en el punto gatillo. Los potenciales evocadossomatosensoriales revelaron neuropatía del nervio delmúsculo recto anterior derecho. Se diagnosticó de ACNES. Como tratamiento se administró en el punto gatillouna inyección subfascial ecoguiada de lidocaína y dexametasona. Tras cuatro meses, permanece asintomático.Para el tratamiento de ACNES en población pediátrica, recomendamos una estrategia terapéutica escalonadacomenzando con inyecciones en el punto gatillo y reservar la neurectomía anterior para cuando estas fracasan.(AU)
Anterior cutaneous nerve entrapment syndrome(ACNES) is often overlooked in the differential diagnosis of chronic abdominal pain (CAP).An 11-year-old boy with CAP previously studied inemergency and digestive services without detectingorganic pathology, suggesting a psychosomatic origin.On examination, he showed pain in the abdominal walllocated to the area of the terminal branch of the T11intercostal nerve, with a positive Carnetts sign and afavorable response to injection with local anestheticat the trigger point. Somatosensory evoked potentialsrevealed right anterior rectus nerve neuropathy. Hewas diagnosed with ACNES. As treatment, an ultrasound-guided subfascial injection with lidocaine anddexamethasone into the trigger point was administered. After four months, he remains asymptomatic.For the treatment of ACNES in pediatrics patients,a step-up strategy should be applied, starting with trigger point injections of lidocaine and dexamethasoneand reserving anterior neurectomy for those cases withlimited effect of these injections.(AU)
Subject(s)
Humans , Male , Child , Abdominal Pain , Evoked Potentials, Somatosensory , Diagnosis, Differential , Inpatients , Physical Examination , Intercostal Nerves , Child Health , PainABSTRACT
Anterior cutaneous nerve entrapment syndrome (ACNES) is often overlooked in the differential diagnosis of chronic abdominal pain (CAP). An 11-year-old boy with CAP previously studied in emergency and digestive services without detecting organic pa-thology, suggesting a psychosomatic origin. On examination, he showed pain in the abdominal wall located to the area of the terminal branch of the Th11 intercostal nerve, with a positive Carnett's sign and a favorable response to injection with local anesthetic at the trigger point. Somatosensory evoked potentials revealed right anterior rectus nerve neuropathy. He was diagnosed with ACNES. As treatment, an ultrasound-guided subfascial injection with lidocaine and dexame-thasone into the trigger point was administered. After four months, he remains asymptomatic. For the treatment of ACNES in pediatrics patients, a step-up strategy should be applied, starting with trigger point in-jections of lidocaine and dexamethasone and reserving anterior neurectomy for those cases with limited effect of these injections.
Subject(s)
Abdominal Wall , Nerve Compression Syndromes , Abdominal Pain/etiology , Child , Humans , Intercostal Nerves , Lidocaine , Male , Nerve Compression Syndromes/diagnosisABSTRACT
INTRODUCTION: The modified Rankin Scale (mRS) is the main functional assessment tool used after stroke. The simplified mRS questionnaire (smRSq) has recently been validated in English, and represents a simpler, reliable scale with an excellent reproducibility via telephone. The present study aims to validate a Spanish-language version of the telephone smRSq. METHOD: We conducted a prospective cohort study, assessing 50 patients 3 months after they presented an ischaemic stroke. We assessed the Spanish-language smRSq by telephone and in person, the mRS with a structured interview, the Spanish-language smRSq, and the Stroke Impact Scale-16. Inter-rater reliability, test-retest reliability, construct validity, and criterion validity were assessed. RESULTS: Inter-rater reliability showed strong agreement (k=0.810); test-retest reliability and criterion validity showed moderate agreement (k=0.639 and k=0.759, respectively), and construct validity showed moderate agreement (Spearman correlation coefficient=-0.728). CONCLUSIONS: The Spanish-language telephone smRSq is reliable and simple, and saves time in the functional assessment after a stroke.
ABSTRACT
TITLE: Asociacion entre miastenia grave y lupus eritematoso sistemico: es seguro el uso de hidroxicloroquina?
Subject(s)
Hydroxychloroquine/therapeutic use , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/drug therapy , Myasthenia Gravis/complications , Adult , Female , Humans , Hydroxychloroquine/adverse effects , Retrospective StudiesABSTRACT
This study aims to evaluate the performance of a new vial (Myco/F Lytic) for the detection of mycobacteria from blood specimens. This vial is monitored in the BACTEC 9000 blood culture system. We compared it with the traditional method routinely used in our laboratory, which is a lysis-centrifugation based procedure. Of 275 samples tested in parallel by both methods, 23 from 20 patients grew mycobacteria (18 Mycobacterium avium complex, 4 M. tuberculosis and 1 M. simiae); 11 isolates were recovered using both systems, 12 were isolated with the Myco/F Lytic medium only, and none were isolated using the traditional method only (p < 0.05). Blood was the diagnostic sample for 12 patients with the Myco/F Lytic system and only 7 with the traditional system. The mean time to detection of mycobacteria with Myco/F Lytic medium was 17 days, whereas it was 44 days with the traditional method (p < 0.001). Identification by DNA probes was performed directly from the Myco/F Lytic bottle. Myco/F Lytic is a rapid, simple, safe and highly reliable diagnostic method for the detection of mycobacteria in blood.