Cervical lesion proportion measure using a digital gridded imaging technique to assess cervical pathology in women with genital schistosomiasis.

Female genital schistosomiasis (FGS) is characterized by a pattern of lesions which manifest at the cervix and the vagina, such as homogeneous and grainy sandy patches, rubbery papules in addition to neovascularization. A tool for quantification of the lesions is needed to improve FGS research and control programs. Hitherto, no tools are available to quantify clinical pathology at the cervix in a standardized and reproducible manner. This study aimed to develop and validate a cervical lesion proportion (CLP) measure for quantification of cervical pathology in FGS. A digital imaging technique was applied in which a grid containing 424 identical squares was positioned on high resolution digital images from the cervix of 70 women with FGS. CLP was measured for each image by observers counting the total number of squares containing at least one type of FGS associated lesion. For assessment of inter- and intra-observer reliability, three different observers measured CLP independently. In addition, a rubbery papule count (RPC) was determined in a similar manner. The intraclass correlation coefficient was 0.94 (excellent) for the CLP inter-rater reliability and 0.90 (good) for intra-rater reliability and the coefficients for the RPC were 0.88 and 0.80 (good), respectively. The CLP facilitated a reliable and reproducible quantification of FGS associated lesions of the cervix. In the future, grading of cervical pathology by CLP may provide insight into the natural course of schistosome egg-induced pathology of the cervix and may have a role in assessing praziquantel treatment efficacy against FGS. Trial Registration: ClinicalTrials.gov, trial number NCT04115072; trial URL https://clinicaltrials.gov/ct2/show/NCT04115072?term=Female+genital+schistosomiasis+AND+Madagascar&draw=2&rank=1.

Correction to: Mathematical arterialisation of peripheral venous blood gas for obtainment of arterial blood gas values: a methodological validation study in the clinical setting.

The corresponding author has identified a calculation mistake in the original publication of the article. The corrected value is given in this Correction. Under the Results section, the median (range) age of the patients in the methodological study should read 76 (26-86) years instead of 56 (26-86) years.

Mathematical arterialisation of peripheral venous blood gas for obtainment of arterial blood gas values: a methodological validation study in the clinical setting.

Arterial blood gas (ABG) analysis is an essential tool in the clinical assessment of acutely ill patients. Venous to arterial conversion (v-TAC), a mathematical method, has been developed recently to convert peripheral venous blood gas (VBG) values to arterialized VBG (aVBG) values. The aim of this study was to test the validity of aVBG compared to ABG in an emergency department (ED) setting. Twenty ED patients were included in this study. ABG and three aVBG samples were collected from each patient. The aVBG samples were processed in three different ways to investigate appropriate sample handling. All VBG samples were arterialized using the v-TAC method. ABG and aVBG samples were compared using Lin's concordance correlation coefficient (CCC), Bland-Altman plots and misclassification analysis. Clinical acceptable threshold of aVBG value deviance from ABG values were ± 0.05 pH units, ± 0.88 kPa pCO2 and ± 0.88 kPa pO2. CCC revealed an agreement in pH and pCO2 parameters for both aVBG in comparison to ABG. In all aVBG samples, an overestimation of pO2 compared to ABG was observed. Bland-Altman plot revealed clinically acceptable mean difference and limits-of-agreement intervals between ABG and aVBG pH and pCO2, but not between ABG and aVBG pO2. Arterialization of VBG using v-TAC is a valid method for measuring pH and pCO2, but not for pO2. Larger clinical studies are required to evaluate the applicability of v-TAC in different patient subpopulations.

[Inhaled corticosteroid treatment increases the risk of pneumonia in patients with CPOD].

Clinical studies have suggested that inhaled corticosteroid (ICS) increases the frequency of pneumonia in patients with chronic obstructive pulmonary disease (COPD). This article summarizes the risk of pneumonia by reviewing the largest clinical studies addressing pneumonia as an adverse effect of ICS treatment. The collected data show that treatment of COPD patients with ICS increases the rate of pneumonia compared with b2-agonists or placebo. Physicians are recommended to follow guidelines and solely treat COPD patients with ICS if the patients are at high risk of exacerbations.