Determinación de la eficacia del score diagnóstico de apendicitis en el departamento de emergencia del Hospital Vicente Corral Moscoso de Cuenca en el período febrero - julio 2007

Se realizó un estudio trasversal en una población de 306 pacientes con diagnóstico de abdomen agudo no traumático, validación de la prueba diagnóstica y factores asociados en 129 con diagnóstico de apendicitis aguda; el grupo de estudio estuvo conformado por pacientes de edad comprendida entre los 16 y 75 años. Los datos fueron recolectados, por los autores, en un formulario estructurado y analizados con el software SPSS. Resultados: la prevalencia de apendicitis aguda, en la población de 306 pacientes, fue del 42(IC 9533.5-50.5). En los 129 con diagnóstico de apendicitis aguda, el Score dio positivo en el 92.2de los casos comparado con el resultado de anatomía patológica. La asociación entre apendicitis aguda con el sexo dio una razón de prevalencia (PR) de 0.98 IC 950.89-1.08), p=1.00; con el antecedente familiar de apendicitis una RP 0.94 (IC 950.78-1.14) p=0.36 y con alimentación de frutas con semilla RP 1.088 (IC 951.03-1.15) p=1.000 (test exacto de Fisher). La sensibilidad para la prueba diagnóstica, score para apendicitis, fue del 94.96, la especificidad del 60, el valor predictivo positivo del 96.6, el valor predictivo negativo del 50y el índice de Kappa del 0.5 con una p=0.000. Conclusiones: la prevalencia de apendicitis fue del 42; se encontró asociación significativa con alimentación con frutas con semilla. La sensibilidad del score para apendicitis fue del 94.96y la especificidad del 60

Comparison between CDC and WHO BMI z-score and their relation with metabolic risk markers in Northern Portuguese obese adolescents

Growth-curves are an important tool for evaluating the anthropometric development in pediatrics. The different growth-curves available are based in different populations, what leads to different cut-offs. Pediatric obesity tracks into adulthood and is associated with increased cardiovascular risk. The accurate assessment of a child nutritional status using growth-curves can indicate individuals that are either obese or in risk of becoming obese, allowing an early intervention. Moreover, the association between the data obtained from growth-curves with specific metabolic risk factors further highlights the importance of these charts. This study aimed to evaluate the associations between body mass index z-score (BMIzsc), determined using the growth-curves from the Centre for Disease Control and Prevention (CDC) and from the World Health Organization (WHO), with cardiovascular risk factors, represented here by metabolic syndrome (MS) and insulin resistance (IR) related parameters. The study involved 246 obese adolescents (10-18 years, 122 females). MS was defined according to the International Diabetes Federation. IR was considered for HOMA-IR greater than 2.5.

Influence of phosphine resistance genes on flight propensity and resource location in Tribolium castaneum (Herbst) (Coleoptera: Tenebrionidae): the landscape for selection

Phosphine resistance in Tribolium castaneum Herbst (Coleoptera: Tenebrionidae) has evolved through changes to enzymes involved in basic metabolic pathways. These changes impose metabolic stress and could affect energy-demanding behaviours. We therefore tested whether phosphine resistance alleles impact the movement of these insects in their quest for new resources. We measured walking and flight parameters of four T. castaneum genotypes: (1) a field-derived population, (2) a laboratory cultured, phosphine-susceptible reference strain, (3) a laboratory cultured, phosphine-resistant reference strain, and (4) a resistant introgressed strain that is almost identical genetically to the susceptible population. The temporal pattern of flight was identical across all populations, but resistant beetles took flight significantly less, walked more slowly, and located resources less successfully than did susceptible beetles. Also, the field-derived beetles (proved not to be carrying resistance genes) walked significantly faster and more directly towards food resources, and had a higher propensity for flight when compared to the susceptible laboratory beetles. These negative effects suggest survival of beetles with the resistance alleles will be compromised should they leave phosphine application sites. The field for selection therefore extends beyond the site at which phosphine fumigant imposed its effect, and other mutations are also likely to be affected in this way.

Validación de un score de neumonía bacteriana como métodos para predecir etiología en pacientes de 1 mes a 8 años de edad, ingresados en Hospital Nacional de Niños Benjamín Bloom, Mayo - Diciembre 2009.

Determinar la etiología de las neumonías para decidir su tratamiento, no es simple, sin una prueba confirmatoria los médicos se apoyan de evaluaciones clínicas, radiológicas, de laboratorio y edad de pacientes, es por ello, que se estudió una regla de predicción clínica que combinó varios elementos que incrementaron la capacidad diagnóstica de dicha patología. Objetivo: Se evaluó la capacidad diagnóstica de una escala de puntaje para predecir etiología en niños con neumonía (Bacterial Pneumonia Score), y otras variables no incluidas en el score que resultaron asociadas a las neumonías. Estudio descriptivo, transversal, retrospectivo de evaluación de prueba diagnóstica, en Hospital Benjamin Bloom, desde mayo a diciembre 2009, incluyendo ≥1 mes a 8 años de edad, hospitalizados por neumonía, con datos de temperatura, radiografía torácica, hemograma, hisopado nasofaríngeo, se excluyeron los pacientes que necesitaron cuidados en UCI o intermedios, con patologías respiratorias crónicas, cuerpo extraño o aspiración, enfermedades oncológicas, inmunodeficiencias o neumonía con radiografía 8 semanas previo al ingreso en estudio. Resultados: Se incluyeron 275 pacientes, de ellos 120 diagnosticados con patología viral y 180 con etiología bacteriana, se registraron datos del expediente clínico a través de un cuestionario que contempló variables del BPS además de otras que resultaron estadísticamente asociadas por Chi cuadrado. Según el score ≥ 4 puntos se calculó una sensibilidad de 79% (IC 95%: 75-82), especificidad de 91% (IC 95%: 85-96), valor predictivo positivo de 94% (IC 95% 90-97) y valor predictivo negativo de 69% (IC %: 61-78).y una eficacia diagnostica bajo curva ROC de 0.88. Conclusión: El BPS resultó tener buena capacidad para identificar la mayoría de pacientes con neumonía acteriana, pero se mostró más preciso para descartarla.

Modelação matemática para identificar o valor de T-Score

A osteoporose é uma patologia esquelética sistémica, caracterizada pela diminuição da massa óssea, provocando uma diminuição da resistência do osso e, consequentemente um aumento do risco de fraturas no indivíduo. Neste estudo pretende-se prever o valor que permite determinar se um paciente tem ou não osteoporose, denominado de T-Score. Normalmente este valor é obtido através de um exame de densitometria óssea, a absorciometria de raios-X de dupla energia (DEXA). Além disso, pretendeu-se converter os valores de T-Score e a densidade mineral óssea (DMO) (ou bone mineral density - BMD) para os vários equipamentos existentes para este exame. Para finalizar, criou-se um documento PDF com as previsões e as conversões alcançadas.

Rendimiento del score PIM 2 en una Unidad de Cuidados Intensivos Pediátricos

Objetivo: evaluar el rendimiento del score de predicción de mortalidad PIM 2 en una población de pacientes pediátricos críticos. Materiales y métodos: se realizó un estudio prospectivo, entre el 01 de enero y el 31 de diciembre de 2013. Se incluyeron todos los pacientes con una edad comprendida entre 29 días y 14 años que ingresaron a la Unidad de Cuidados Intensivos Pediátricos (CIP) de la Asociación Española. Fueron excluidos aquellos pacientes que fallecieron antes de las 12 horas, los que ingresaron para monitorización u observación luego de procedimientos endoscópicos o quirúrgicos menores o para realización de vías y los neonatos. Para evaluar el rendimiento del score PIM 2 se analizó tanto su calibración, como su discriminación, mediante la aplicación del test de bondad de ajuste de Hosmer-Lemeshow y la construcción de la curva ROC y el cálculo del área bajo la curva. Resultados: se incluyeron 184 pacientes para el análisis. La tasa de mortalidad de esta población fue de 5,4% (IC95% 1,88-8,98). La media de internación fue de 8,3 días (rango 12 horas a 27 días) y en el caso de los fallecidos fue de 11.3 días (rango 1-20). La aplicación del test de Hosmer-Lemeshow arrojó un valor de Chi cuadrado de 5,37 (p=0,71). El área bajo la curva ROC fue de 0,90. Para un punto de corte de 0,5 el rendimiento de la prueba evidenció una validez global del 96,7% (IC 95% entre 93,77-99,57), un valor predictivo positivo del 100% (87,50-100) y un valor predictivo negativo de 96,67% (93,77-99,57). La sensibilidad para este corte fue del 40% (4,64-75,36) y una especificidad del 100% (99,71-100). Conclusiones: el score PIM 2 ha presentado en la población estudiada una adecuada calibración y discriminación global. Por tanto, su utilidad como instrumento para medición y evaluación de la calidad asistencial permanece vigente. Pese a ello, su aplicabilidad práctica fue limitada en pacientes asignados a deciles de riesgo “bajo” en donde el score presentó problemas de discriminación y una alta tasa de falsos negativos.

Gender, Behavioral Assessment of Negative Reinforcement Driven Risk Taking Propensity, and Cigarette Smoking

Cigarette smoking remains the leading preventable cause of death and disability in the United States and most often is initiated during adolescence. An emerging body of research suggests that a negative reinforcement model may explain factors that contribute to tobacco use during adolescence and that negative reinforcement processes may contribute to tobacco use to a greater extent among female adolescents than among male adolescents. However, the extant literature both on the relationship between negative reinforcement processes and adolescent tobacco use as well as on the relationship between gender, negative reinforcement processes, and adolescent tobacco use is limited by the sole reliance on self-report measures of negative reinforcement processes that may contribute to cigarette smoking. The current study aimed to further disentangle the relationships between negative reinforcement based risk taking, gender and tobacco use during older adolescence by utilizing a behavioral analogue measure of negative reinforcement based risk taking, the Maryland Resource for the Behavioral Utilization of the Reinforcement of Negative Stimuli (MRBURNS). Specifically, we examined the relationship between pumps on the MRBURNS, an indicator of risk taking, and smoking status as well as the interaction between MRBURNS pumps and gender for predicting smoking status. Participants included 103 older adolescents (n=51 smokers, 50.5% female, Age (M(SD) = 19.41(1.06)) who all attended one experimental session during which they completed the MRBURNS as well as self-report measures of tobacco use, nicotine dependence, alcohol use, depression, and anxiety. We utilized binary logistic regressions to examine the relationship between MRBURNS pumps and smoking status as well as the interactive effect of MRBURNS pumps and gender for predicting smoking status. Controlling for relevant covariates, pumps on the MRBURNS did not significantly predict smoking status and the interaction between pumps on the MRBURNS and gender also did not significantly predict smoking status. These findings highlight the importance of future research examining various task modifications to the MRBURNS as well as the need for replications of this study with larger, more diverse samples.

Prediction of peptide and protein propensity for amyloid formation

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Relação entre o score de adesão à dieta mediterrânica e a hemoglobina glicosilada em pessoas com diabetes mellitus tipo 2

Poster apresentado no XIV Congresso de Nutrição e Alimentação. Centro de Congressos de Lisboa, 21-22 Maio de 2015

Development of an activity disease score in patients with uveitis (UVEDAI)

To develop a disease activity index for patients with uveitis (UVEDAI) encompassing the relevant domains of disease activity considered important among experts in this field. The steps for designing UVEDAI were: (a) Defining the construct and establishing the domains through a formal judgment of experts, (b) A two-round Delphi study with a panel of 15 experts to determine the relevant items, (c) Selection of items: A logistic regression model was developed that set ocular inflammatory activity as the dependent variable. The construct “uveitis inflammatory activity” was defined as any intraocular inflammation that included external structures (cornea) in addition to uvea. Seven domains and 15 items were identified: best-corrected visual acuity, inflammation of the anterior chamber (anterior chamber cells, hypopyon, the presence of fibrin, active posterior keratic precipitates and iris nodules), intraocular pressure, inflammation of the vitreous cavity (vitreous haze, snowballs and snowbanks), central macular edema, inflammation of the posterior pole (the presence and number of choroidal/retinal lesions, vascular inflammation and papillitis), and global assessment from both (patient and physician). From all the variables studied in the multivariate model, anterior chamber cell grade, vitreous haze, central macular edema, inflammatory vessel sheathing, papillitis, choroidal/retinal lesions and patient evaluation were included in UVEDAI. UVEDAI is an index designed to assess the global ocular inflammatory activity in patients with uveitis. It might prove worthwhile to motorize the activity of this extraarticular manifestation of some rheumatic diseases.

Correlacion entre hemoglobina glicosilada con hallazgos sintax score ii en pacientes con sospecha clínica de enfermedad coronaria, hospitalizados en la unidad coronaria del hospital San José centro en enero a septiembre del año 2015

Se realiza un estudio de corte transversal en el periodo de enero a septiembre del año 2016 en la unidad coronaria del Hospital San José Centro de la Ciudad de Bogotá; en pacientes con sospecha de enfermedad coronaria (Síndrome coronario agudo y angina estable) y antecedente de Diabetes Mellitus Tipo 2, se recolectaron 42 pacientes con los criterios de inclusión a quienes se realizó angiografía coronaria como parte del protocolo de estudio y manejo de la unidad, el objetivo primario fue demostrar la posible correlación entre niveles de hemoglobina glicosilada y la escala de severidad SYNTAX Score I y II de enfermedad coronaria, como objetivos secundarios; caracterizar las variables sociodemográficas, comorbilidades y posible relación con el tipo de presentación de enfermedad coronaria. Como hallazgos relevantes no se encontró correlación importante ni significativa entre niveles de hemoglobina glicosilada y la escala Syntax score II ni Syntax score I, a pesar de que la mayoría de pacientes mostraban mal control crónico de su diabetes mellitus tipo 2, con niveles mayores > 7%, como hallazgo positivo se encontro asociación estadísticamente significativa con niveles de LDL y las diferentes formas de presentación de enfermedad coronaria, a mayor niveles de LDL mayor probabilidad de IAM e IAM con elevación del segmento ST. Se considera que con estudios multicentricos en diferentes ciudades y unidades de cuidado cardiovascular con diferentes niveles de riesgo, se podría demostrar la posible correlación entre niveles de hemoglobina glicosilada y los grados de severidad de enfermedad coronaria representados por las escalas Syntax score I y II.

Proposal and Validation of a Scale of Composite Measure Reactivity Score to Characterize the Reactivity in Horses During Handling

This study aimed to identify the parameters related to the expression of the reactivity in horses during handling and based on that proposed and validated a scale of composite measure reactivity score to characterize horse's reactivity. To this end, the first stage (S1) proposed the scale and the second (S2) validated it. In S1, 364 Lusitano horses were evaluated, 188 were adult breeding mares (4–12 years old), and 176 were foals (males/females, aged from 2 months to 2 years). During hooves trimming, vermifuge application, palpation scores were assigned to behaviors of movement, ears and eyes position, breathing, vocalization, and urination. A response parameter called reactivity was attributed to each animal, ranging from score 1 (nonreactive/calm) to score 4 (very reactive/aggressive). The verification of the possible parameters (age, behavior), which explains the response parameter (reactivity), was taken using ordinal proportional odds model. Movement, breathing, ears and eyes position, vocalization, and age appear to explain the reactivity of horses during handling (P < .01). Therefore, based on these parameters, it was possible to propose two scales of composite measure reactivity score: one to characterize the mares and another the foals. On S2, the proposed scale was validated by the simultaneous application of Forced Human Approach Test, another commonly used test to evaluate the reactivity in horses, with a correlation of 0.97 (P < .05). The assessment of the reactivity of horses during handling by a composite measure reactivity score scale is valid, and easy to apply, without disrupting daily routine and override the impact of individual differences.

Portuguese Version of the Suicidal Behaviors Questionnaire-Revised: Validation Data and the Establishment of a Cut-Score for Screening Purposes

The aim of the present study is to provide validation data regarding the Portuguese version of the Suicidal Behaviors Questionnaire Revised in nonclinical individuals. Two studies were undertaken with two different nonclinical samples in order to demonstrate reliability, concurrent, predictive, and construct validity, and in order to establish an appropriate cut-score for nonclinical individuals. A sample of 810 community adults participated in Study 1. Results from this study provided information regarding scale internal consistency, exploratory and confirmatory factor analysis, and concurrent validity. Receiver operating characteristic curve analysis established a cut-off score to be used for screening purposes with nonclinical individuals. A sample of 440 young adults participated in Study 2, which demonstrated scale score internal consistency and 5-month predictive validity. Further, 5-month test-retest reliability was also evaluated and the correlations of SBQ-R scale scores with two other measures that assess constructs related to suicidality, depression and psychache, were also performed. In addition, confirmatory factor analysis was undertaken to demonstrate the robustness of the result obtained in Study 1. Overall, findings supported the psychometric appropriateness of the Portuguese Suicidal Behaviors Questionnaire-Revise

The Scored Patient-Generated Subjective Global Assessment (PG-SGA) and its Association with Quality of Life in Ambulatory Patients Receiving Radiotherapy

OBJECTIVE: To evaluate the scored Patient-generated Subjective Global Assessment (PG-SGA) tool as an outcome measure in clinical nutrition practice and determine its association with quality of life (QoL). DESIGN: A prospective 4 week study assessing the nutritional status and QoL of ambulatory patients receiving radiation therapy to the head, neck, rectal or abdominal area. SETTING: Australian radiation oncology facilities. SUBJECTS: Sixty cancer patients aged 24-85 y. INTERVENTION: Scored PG-SGA questionnaire, subjective global assessment (SGA), QoL (EORTC QLQ-C30 version 3). RESULTS: According to SGA, 65.0% (39) of subjects were well-nourished, 28.3% (17) moderately or suspected of being malnourished and 6.7% (4) severely malnourished. PG-SGA score and global QoL were correlated (r=-0.66, P<0.001) at baseline. There was a decrease in nutritional status according to PG-SGA score (P<0.001) and SGA (P<0.001); and a decrease in global QoL (P<0.001) after 4 weeks of radiotherapy. There was a linear trend for change in PG-SGA score (P<0.001) and change in global QoL (P=0.003) between those patients who improved (5%) maintained (56.7%) or deteriorated (33.3%) in nutritional status according to SGA. There was a correlation between change in PG-SGA score and change in QoL after 4 weeks of radiotherapy (r=-0.55, P<0.001). Regression analysis determined that 26% of the variation of change in QoL was explained by change in PG-SGA (P=0.001). CONCLUSION: The scored PG-SGA is a nutrition assessment tool that identifies malnutrition in ambulatory oncology patients receiving radiotherapy and can be used to predict the magnitude of change in QoL.

Work/Family Balance: HRM Policy and Practice in Australia

An employee's inability to balance work and family responsibilities has resulted in an increase in stress related illnesses. Historically, research into the nexus between work and family has primarily focused on the work/family conflict relationship, predominately investigating the impact of this conflict on parents, usually mothers. To date research has not sufficiently examined the human resource management practices that enable all parents to achieve a balance between their work and family lives. This paper explores the relationship between contemporary family friendly HRM policies and employed parents perceptions of work/family enhancement, work/family satisfaction, propensity to turnover, and work/family conflict. Self-report questionnaire data from 326 men and women is analysed and discussed to enable organisations to consider the use of family friendly policies and thus create a convergence between the well-being of employees and the effectiveness of the organisation.