Experimental Dermatology, Volume 0, Issue ja, -Not available-.
Πέμπτη 19 Ιουλίου 2018
Development of psoriasis by continual neutrophil infiltration into the epidermis
Noninvasive analysis and minimally invasive in vivo experimental challenges of the skin barrier
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
Murine type VII collagen distorts outcome in human skin graft mouse model for dystrophic epidermolysis bullosa
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
Assessing the skin barrier via corneocyte morphometry
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
Maintenance of tight junction barrier integrity in cell turnover and skin diseases
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
Favre‐Racouchot disease: systematic review and possible therapeutic strategies
Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.
A randomized, intra‐individual, non‐inferiority, phase III study comparing daylight photodynamic therapy with BF‐200 ALA gel and MAL cream for the treatment of actinic keratosis
Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.
Development and validation of a new tool to assess the Burden of Sensitive Skin (BoSS)
Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.
Biofilm production and antibiotic susceptibility of Staphylococcus epidermidis strains from Hidradenitis Suppurativa lesions
Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.
First homozygous large deletion in EDARADD gene associated with a severe form of anhidrotic ectodermal dysplasia
Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.
Anxiety and depression in patients with moderate‐to‐severe psoriasis and comparison of change from baseline after treatment with guselkumab vs. adalimumab: results from the Phase 3 VOYAGE 2 study
Journal of the European Academy of Dermatology and Venereology, EarlyView.
Phaeohyphomycosis due to Pleurostomophora richardsiae: an uncommon cutaneous fungal infection
Journal of the European Academy of Dermatology and Venereology, EarlyView.
Laser‐assisted photodynamic therapy for superficial basal cell carcinoma and Bowen's disease: a randomized intrapatient comparison between a continuous and a fractional ablative CO2 laser mode
Journal of the European Academy of Dermatology and Venereology, EarlyView.
Photoacoustic imaging system visualizes restoration of peripheral oxygenation in psoriatic lesions
Journal of the European Academy of Dermatology and Venereology, EarlyView.
Azathioprine‐induced alopecia and leukopenia associated with NUDT15 polymorphisms
Journal of the European Academy of Dermatology and Venereology, EarlyView.
Katharsis of the skin: peeling applications and agents of chemical peelings in Greek medical textbooks of Graeco‐Roman antiquity
Journal of the European Academy of Dermatology and Venereology, EarlyView.
Acne at the Regional Dermatology Training Centre (RDTC), Tanzania: clinical, social and demographic characteristics of patients with focus on severity factors
Journal of the European Academy of Dermatology and Venereology, EarlyView.
Laser hair removal after surgery vs. surgery alone for the treatment of pilonidal cysts: a retrospective case–control study
Journal of the European Academy of Dermatology and Venereology, EarlyView.
Psoriasis and risk of myocardial infarction before and during an era with biological therapy: a population‐based follow‐up study
Journal of the European Academy of Dermatology and Venereology, EarlyView.
Survey of disease awareness, treatment behavior and treatment satisfaction in patients with atopic dermatitis in Korea: A multicenter study
The Journal of Dermatology, EarlyView.
Cutaneous lymphomatoid granulomatosis with long‐term absence of lung involvement
The Journal of Dermatology, EarlyView.
Bullous pemphigoid with hyperkeratosis and palmoplantar keratoderma: Three cases
The Journal of Dermatology, EarlyView.
Reflectance confocal microscopy for the noninvasive diagnosis of cutaneous juvenile xanthogranuloma
Skin Research and Technology, EarlyView.
Predicting Sequential Bilateral Cochlear Implantation Performance in Postlingually Deafened Adults; a Retrospective Cohort Study
Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.
Ecthyma contagiosum (Orf): Reflectance confocal microscopy and histopathological correlates
Skin Research and Technology, EarlyView.
Intrinsic and extrinsic regulation of human skin melanogenesis and pigmentation
International Journal of Cosmetic Science, EarlyView.
Standardized extract of wild apple fruit in alkyl‐polyglucoside‐based cosmetic cream – estimation of stability, safety, antioxidant activity and efficiency
International Journal of Cosmetic Science, Volume 40, Issue 3, Page 285-294, June 2018.
Preservative efficacy of selected antimicrobials of natural origin in a cosmetic emulsion
International Journal of Cosmetic Science, Volume 40, Issue 3, Page 276-284, June 2018.
Determination of fatty acid methyl esters in cosmetic castor oils by flow injection–electrospray ionization–high‐resolution mass spectrometry
International Journal of Cosmetic Science, Volume 40, Issue 3, Page 295-302, June 2018.
Hair colour and skin colour together influence perceptions of age, health and attractiveness in lightly pigmented young women
International Journal of Cosmetic Science, Volume 40, Issue 3, Page 303-312, June 2018.
Issue Information
International Journal of Cosmetic Science, Volume 40, Issue 3, Page i-iv, June 2018.
Ag Nanoparticles Connected to the Surface of TiO2 Electrostatically for Antibacterial Photoinactivation Studies
Photochemistry and Photobiology, Volume 0, Issue ja, -Not available-.
Occupational systemic allergic dermatitis in a football player sensitized to colophonium
Contact Dermatitis, EarlyView.
Acute localized exanthematous pustulosis caused by a herbal medicine, dai‐kenchu‐to
Contact Dermatitis, EarlyView.
Contamination of skin and surfaces by cobalt in the hard metal industry
Contact Dermatitis, EarlyView.
Allergic contact dermatitis caused by dexpanthenol—Probably a frequent allergen
Contact Dermatitis, EarlyView.
Drug reaction with eosinophilia and systemic symptoms caused by spironolactone: Case report
Contact Dermatitis, EarlyView.
Infiltration of abdominal striae distensae by Hodgkin's lymphoma
International Journal of Dermatology, EarlyView.
Postherpetic abdominal pseudohernia. Presentation of a clinical case and literature review
International Journal of Dermatology, EarlyView.
Pemphigus herpetiformis in South Tunisia: a clinical expression of pemphigus foliaceus?
International Journal of Dermatology, EarlyView.
The hunt for the earliest cases of AIDS‐related Kaposi sarcoma: a retrospective outbreak investigation
International Journal of Dermatology, EarlyView.
Clinical subtypes and molecular basis of epidermolysis bullosa in Kuwait
International Journal of Dermatology, EarlyView.
News and Notices
Clinical and Experimental Dermatology, Volume 43, Issue 6, Page 756-756, August 2018.
Issue Information
Clinical and Experimental Dermatology, Volume 43, Issue 6, Page i‐ii, 651-652, August 2018.
Actualización del tratamiento tópico en psoriasis: aportación de la combinación de calcipotriol y dipropionato de betametasona en espuma
Publication date: Available online 19 July 2018
Source: Actas Dermo-Sifiliográficas
Author(s): L. Puig, G. Carretero
Resumen
Los agentes tópicos representan la primera línea de tratamiento para la psoriasis leve y moderada. Sin embargo, factores como la frecuencia de administración, las características organolépticas o los resultados limitados a corto plazo pueden disminuir la adherencia al tratamiento y su efectividad.
Las innovaciones en los tratamientos tópicos se basan en descubrir nuevas moléculas, pero también en la reformulación de principios activos ya conocidos, mejorando su administración, características organolépticas, biodisponibilidad y comodidad de uso. La espuma en aerosol de calcipotriol y dipropionato de betametasona es una nueva formulación donde los principios activos están disueltos en una mezcla de propelentes volátiles que se evaporan rápidamente dejando una solución sobresaturada de calcipotriol y dipropionato de betametasona, que aumenta la penetración de los fármacos en la epidermis.
En este artículo se hace un breve repaso de las principales evidencias sobre los tratamientos tópicos disponibles para la psoriasis y de la nueva formulación en espuma de calcipotriol y dipropionato de betametasona.
Abstract
Topical agents are the first-line treatment for mild and moderate psoriasis, but factors such as frequency of administration, organoleptic properties, and the limited short term results can reduce treatment adherence and effectiveness.
Innovations in topical treatments are linked not only to the discovery of new molecules, but also to the reformulation of existing active ingredients based on improvements to administration, organoleptic properties, bioavailability, and ease of use. Calcipotriol and betamethasone dipropionate aerosol foam is a new formulation in which the active ingredients are dissolved in a mixture of volatile propellants that evaporate quickly, leaving a supersaturated solution of calcipotriol and betamethasone dipropionate that enhances penetration into the epidermis.
In this article, we take a look at the new calcipotriol and betamethasone dipropionate aerosol formulation and briefly review the main evidence supporting the use of topical treatments for psoriasis.
Graphical abstract
Treatment of synthetic dye baths by Fenton processes: evaluation of their environmental footprint through life cycle assessment
Abstract
Inorganic and organic constituents present in textile effluents have a noticeable effect on the performance of Fenton processes. However, studies have been focused on simple wastewater matrices that do not offer enough information to stakeholders to evaluate their real potential in large-scale facilities. Chemical auxiliaries, commonly present in textile wastewaters (NaCl = 30 g/L, Na2CO3 = 5 g/L, and CH3COONa = 1 g/L), affect both the economic and environmental performance of the process because they increase the treatment time (from 0.5 to 24 h) and the consumption of H2SO4 (657%) and NaOH (148%) during conditioning steps. The life cycle assessment (LCA) performed with the IPCC-2013 method revealed that dyeing auxiliaries increase from 1.06 to 3.73 (252%) the emissions of carbon dioxide equivalent (CO2-Eqv/m3). Electricity consumption can be considered an environmental hotspot because it represents 60% of the carbon footprint of the Fenton process. Also, the presence of auxiliaries is critical for the process because it results in the increase of the relative impact (between 50 and 80%) in all environmental categories considered by the ReCiPe-2008 method. Chemical auxiliaries increased the costs of the treatment process in 178% (US$2.22/m3) due to the higher energy consumption and the additional reagent requirements. It is worthwhile mentioning that the technical simplicity of the Fenton process and its low economic and environmental costs turn this process into an attractive alternative for the treatment of textile effluents in emerging economies.
A Scarless Repair Technique for the Lower Lip in Patients With Facial Palsy
This Surgical Pearl describes the vermilion-mucosal advancement flap, a technique that provides the benefits of surgery without the stigma of a surgical facial scar.
Psychometric Properties of the Standardized Cosmesis and Health Nasal Outcomes Survey
This analysis evaluates the ability of the Standardized Cosmesis and Health Nasal Outcomes Survey to discriminate among different symptom severities and its performance at different severity levels.
Computer-Assisted Bilateral Orbitozygomatic Reconstruction
This Teachable Moment describes the case of a 27-year-old man withTreacher Collins syndrome who underwent computer-assisted surgery using bicortical calvarial bone for the reconstruction of bilateral zygomatic aplasia.
Evaluation of the Noma Disease Burden Within the Noma Belt
This study estimates the disease burden of noma, an opportunistic infection of the face that occurs in the setting of extreme poverty.
Missing Video and Citation
In the Original Investigation titled "Association of Nasal Tip Rotation Outcome Estimation With the New Domes Technique in Primary Rhinoplasty," published online February 22, 2018, the video and citation to the video were missing. This article has been corrected online.
Evaluating Inferior Turbinate Reduction Techniques
This study uses computational fluid dynamics analysis to assess the effects of inferior turbinate resection techniques on nasal airflow in 5 patients.
Limitations, Transparency, and Conclusions—Reply
In Reply We thank Bornemann-Cimenti and Szilagyi for their interest in our study on complications related to anesthesia duration in head and neck microvascular reconstructive surgery. The intent of the study was to see if anesthesia duration was at all related to complications in long microvascular reconstructive surgical procedures involving the head and neck. We postulated that longer duration of anesthesia might be correlated with an increased rate of complications in this particular type of surgery.
Societal Identification of Facial Paralysis and Paralysis Location
This observational study examines the ability of casual observers to identify paralysis of varying degrees of severity and to localize the defect on the face.
Cosmetic Augmentation of the Nasal Tip and Nasal Dorsum With ePTFE
This randomized clinical trial investigates whether attaching the conchal cartilage as shield grafts at the distal end of the graft can prevent extrusion and whether the use of ePTFE in the nasal tip can achieve a stable aesthetic outcome.
Automated Facial Measurements in Facial Palsy
This Observation describes Emotrics, a software platform that uses machine learning techniques to enable automatic facial landmark localization and computation of facial measurements for use in the treatment of facial palsy.
Mental Health and Patient Satisfaction With Outcomes of Rhinoplasty
This case-control study compares satisfaction with the functional outcomes of rhinoplasty between patients with normal mental well-being and those with poor mental well-being.
Autologous Costal Cartilage Harvesting and Donor-Site Pain in Patients Undergoing Rhinoplasty—Reply
In Reply We read the letter by Lu and Fan regarding our recently published article. We are happy with the authors' interest, praise, and the discussions they've contributed. Although the technique has been widely used and reported by many influential authors, we agree with the opinion of Lu and Fan that monopolar electrocautery (ME) causes tissue damage and prolongs wound healing. Nevertheless, we don't think it is an interference factor for this study because the major aim of what we are investigating is the downside of ME in that aspect.
Nasal Tip Rotation Outcome With the New Domes Technique in Rhinoplasty
This analytic cohort study assesses whether the definitive outcome of the rotation angle of the nasal tip in patients undergoing primary rhinoplasty can be determined with the new domes technique.
Review of Aesthetic Nasal Reconstruction: Principles and Practice
There are a limited number of people in our relatively broad subspecialty who have devoted their entire careers to a focused area, truly pioneering the way we approach and manage specific clinical problems in facial plastic surgery. There are even fewer who are so passionate about a specific topic that they have taken it upon themselves to share their knowledge and vast experience through extensive writing and publication, allowing this information to perpetuate and help others in our field grow and learn from their successes and their mistakes.
The Multivector Gracilis Free Functional Muscle Flap for Facial Reanimation
This cohort study analyzes use of a double-paddle multivector gracilis flap for treatment of patients with complete facial paralysis.
Spanish Linguistic Validation of the VELO Instrument
This Research Letter describes the methodology of developing a Spanish translation of the VPI Effects on Life Outcomes (VELO) instrument through the linguistic validation.
Repair of the Lateral Nasal Wall in Nasal Airway Obstruction
This systematic review and meta-analysis examines the effectiveness of lateral wall repair in patients with nasal airway obstruction.
Nasal Distortion in Short-Distance Photographs
This study presents a mathematical model to describe the distortive effects of self-photographs, prove the increased perceived nasal size, and calculate the magnitude of this effect from different camera distances.
Data-Driven Surgical Decision Making in Nasal Airway Surgery
What are the factors that influence our surgical decision making in functional nasal airway surgery? Certainly, we rely on individual patient symptoms, medical history, and physical examination to help us determine the specific interventions that we believe will most benefit our patients. However, there is undoubtedly a great deal of variability in the specific approaches or techniques that we use. Our surgical decision making is based on our prior training, personal experiences, and in many cases, surgical dogma that has been passed down to us from mentors or conferences that we have attended. Unfortunately, surgical dogma is often pervasive but lacking in evidence or data to support it. With the emphasis on evidence-based medicine and patient outcomes over the past few decades, there is an increasing importance on data-driven surgical decision making.
Limitations, Transparency, and Conclusions
To the Editor With great interest, we read the recent article by Brady et al. The authors present an association of anesthesia duration in free flap surgery with postoperative complications. Based on their findings that anesthesia duration is an independent risk factor for complications, they conclude that "… reduced anesthesia time, particularly to less than 11 hours, should be the goal…." Everyone involved in the treatment of these patients will sign this statement. However, we want to raise some questions about why we are not entirely in accord that this suggestion is supported by the presented data.
Patient and Physician Assessment of Surgical Scars
This systematic review summarizes published studies assessing patient and physician ratings of surgical scars, rates of patient and physician agreement in scar assessment, and elements of cutaneous scar assessment that differ between patients and physicians.
Autologous Costal Cartilage Harvesting Technique and Donor-Site Pain in Patients Undergoing Rhinoplasty
To the Editor We read with great interest the article by Özücer et al. The authors did well to compare the postoperative donor-site pain in patients who underwent costal cartilage harvest, and the separated evaluation of resting pain and movement pain is thoughtful and exquisitely considered and worthy of praise. In this communication, we would like to propose some discussions with the authors.
Role of tyrosine residue (Y213) in nuclear retention of PCNA1 in human malaria parasite Plasmodium falciparum
Abstract
Proliferating Cell Nuclear Antigen (PCNA) undergoes several Post Translational Modifications including phosphorylation leading to its regulation in mammalian and yeast systems. Plasmodium falciparum possesses two PCNAs (PCNA1 & PCNA2) with an edge of PfPCNA1 over PfPCNA2 for DNA replication. Recent phosphoproteome data report phosphorylation of S191 residue without its functional implication. In mammalian cells, phosphorylation of HsPCNA at Y211 stabilizes chromatin bound PCNA. We find tyrosine (but not S191) to be conserved in PfPCNAs and it is important for its nuclear localization and foci formation of PfPCNA1. Further, a Y213F mutation in PfPCNA1 leads to its functional loss both in yeast and parasite. We highlight the importance of evolutionarily conserved tyrosine in PCNA from parasite to mammal linked with DNA replication and cell proliferation.A yeast for all seasons – is Pichia pastoris a suitable chassis organism for future bioproduction?
Abstract
The methylotrophic yeast Pichia pastoris (Komagataella spp.) is well established as a host for recombinant protein production. Since a few years it has also been subject to metabolic engineering to produce a diversity of biochemicals. Based on these developments we discuss here why P. pastoris is a suitable future chassis organism for synthetic biology, and we provide a roadmap for a community effort towards this aim.Characterisation and pure culture of putative health-associated oral bacterium BU063 (Tannerella sp. HOT-286) reveals presence of a potentially novel glycosylated S-layer
Abstract
Tannerella HOT-286 (phylotype BU063) is a recently identified novel filamentous Gram-negative anaerobic oral bacterium cultured for the first time recently in co-culture with Propionibacterium acnes. In contrast to the related periodontal disease associated pathobiont Tannerella forsythia it is considered a putative health-associated bacterium. In this paper we identified that this organism could be grown in pure culture if N-acetyl muramic acid (NAM) was provided in the media, although surprisingly the genetic basis of this phenomenon is not likely to be due to a lack of NAM synthesis genes. During further microbiological investigations we showed for the first time that Tannerella HOT-286 possesses a prominent extracellular S-layer with a novel morphology putatively made up of two proteins modified with an unknown glycan. This data furthers our knowledge of this poorly understood organism and genus that is an important part of the oral and human microbiome.Dysbiosis and early mortality in zebrafish larvae exposed to subclinical concentrations of streptomycin
Abstract
Exposure to low concentrations of antibiotics found in aquatic environments can increase susceptibility to infection in adult fish due microbiome disruption. However, little is known regarding the effect of antibiotic pollution on fish larvae. Here, we show that exposure to streptomycin, a common antibiotic used in medicine and aquaculture, disrupts the normal composition of zebrafish larvae microbiomes, significantly reducing the microbial diversity found in the fish. Exposure to streptomycin also significantly increased early mortality among fish larvae, causing full mortality within a few days of exposure at 10 μg/mL. Finally, we found that subclinical concentrations of streptomycin also increased the abundance of class 1 integrons, an integrase-dependent genetic system associated to the horizontal transfer of antibiotic resistance genes, in the larvae microbiomes. These results suggest that even low concentrations of streptomycin associated with environmental pollution could impact on fish populations and lead to the creation of antibiotic resistance reservoirs.Fully automatic cross-modality localization and labeling of vertebral bodies and intervertebral discs in 3D spinal images
Abstract
Purpose
We present a cross-modality and fully automatic pipeline for labeling of intervertebral discs and vertebrae in volumetric data of the lumbar and thoracolumbar spine. The main goal is to provide an algorithm that is applicable to a wide range of different sequences and acquisition protocols, like T1- and T2- weighted MR scans, MR Dixon data, and CT scans. This requires that the learned models generalize without retraining to modalities and scans with unseen image contrasts.
Methods
We address this challenge by automatically localizing the sacral region combining local entropy-optimized texture models with convolutional neural networks. For subsequent labeling, local three-disc entropy models are matched iteratively to the spinal column. Every model-matched position is further refined by an intensity-based template-matching approach, based solely on the reduced intensity scale provided by the entropy models.
Results
We evaluated our method on 161 publicly available scans, acquired on various scanners. We showed that our method can deal with a wide range of different MR protocols as well as with CT data. We achieved a sacrum detection rate of 93.6%. Mean center accuracies ranged from 2.5 ± 1.5 to 5.7 ± 3.8 mm for the different sets of scans.
Conclusion
We present a novel spine labeling framework that is applicable to a highly heterogeneous set of scans without retraining of the method. Our approach achieves high sacrum localization accuracy and shows promising labeling results. To the best of our knowledge, an algorithm able to deal with such a diverse set of MR and CT scans has not yet been presented in the literature.
Conscientious objection and person-centered care
Abstract
Person-centered care offers a promising way to manage clinicians' conscientious objection to providing services they consider morally wrong. Health care centered on persons, rather than patients, recognizes clinicians and patients on the same stratum. The moral interests of clinicians, as persons, thus warrant as much consideration as those of other persons, including patients. Interconnected moral interests of clinicians, patients, and society construct the clinician as a socially embedded and integrated self, transcending the simplistic duality of private conscience versus public role expectations. In this milieu of blurred boundaries, person-centered care offers a constructive way to accommodate conscientious objection by clinicians. The constitutionally social nature of clinicians commits and enables them, through care mechanisms such as self-care, to optimize the quality of health care and protect the welfare of patients. To advance these conditions, it is recommended that the medical profession develop a person-centered culture of care, along with clinician virtues and skills for person-centered communication.
Harming as making worse off
Abstract
A powerful argument against the counterfactual comparative account of harm is that it cannot distinguish harming from failing to benefit. In reply to this problem, I suggest a new account of harm. The account is a counterfactual comparative one, but it counts as harms only those events that make a person (rather than merely allow him to) occupy his level of well-being at the world at which the event occurs. This account distinguishes harming from failing to benefit in a way that accommodates our intuitions about the standard problem cases. In laying the groundwork for this account, I also demonstrate that rival accounts of harm are able to distinguish harming from failing to benefit only if, and because, they also appeal to the distinction between making upshots happen and allowing upshots to happen. One important implication of my discussion is that preserving the moral asymmetry between harming and failing to benefit requires a commitment to the existence of a metaphysical and moral distinction between making and allowing.
Sensory feedback and animal locomotion: perspectives from biology and biorobotics: An introduction to the symposium
Synopsis
The successful completion of many behaviors relies on sensory feedback. This symposium brought together researchers using novel techniques to study how different stimuli are encoded, how and where multimodal feedback is integrated, and how feedback modulates motor output in diverse modes of locomotion (aerial, aquatic, and terrestrial) in a diverse range of taxa (insects, fish, tetrapods), and in robots. Similar to biological organisms, robots can be equipped with integrated sensors and can rely on sensory feedback to adjust the output signal of a controller. Engineers often look to biology for inspiration on how animals have evolved solutions to problems similar to those experienced in robotic movement. Similarly, biologists too must proactively engage with engineers to apply computer and robotic models to test hypotheses and answer questions on the capacity and roles of sensory feedback in generating effective movement. Through a diverse group of researchers, including both biologists and engineers, the symposium attempted to catalyze new interdisciplinary collaborations and identify future research directions for the development of bioinspired sensory control systems, as well as the use of robots to test hypotheses in neuromechanics.4th ESO–ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 4)†
breast cancermetastaticadvancedguidelinesABCESO-ESMO
Editorial Board
Publication date: July 2018
Source: Annales de Chirurgie Plastique Esthétique, Volume 63, Issue 4
Author(s):
Τετάρτη 18 Ιουλίου 2018
Adult asthma scores - development and validation of multivariable scores to identify asthma in surveys
Publication date: Available online 18 July 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Ana Sá-Sousa, Ana Margarida Pereira, Rute Almeida, Luís Araújo, Mariana Couto, Tiago Jacinto, Alberto Freitas, Jean Bousquet, João A. Fonseca
Abstract
Background
One of the questions in epidemiology is the identification of adult asthma in studies.
Objective
We aim to 1) develop and validate multivariable scores for adult asthma identification in epidemiological studies; 2) explore cut-offs to rule-in/-out asthma, compared to asthma diagnosed by a physician after clinical examination and diagnostic tests, blinded to the self-administered questions.
Methods
We analyzed data (n=711 adults) from a nationwide population-based study. The predictors were self-administered questions identified in a literature review (A2-score) and from the GA2LEN questionnaire (GA2LEN-score). Scores were developed using exploratory factor analysis. Internal consistency, discriminative power and diagnostic accuracy were assessed.
Results
The A2-score comprises 8 questions (including "Did a physician confirm you had asthma?") and GA2LEN-score, 6 questions (including "Have you ever had asthma?"). Both had high Cronbach's alpha (0.89 and 0.85) and good AUC (90.4% and 89.0%). The scoring is the sum of positive answers. Asthma is present (rule-in) for scores≥4 (Specificity:99.2%; PPVs:93.3%, 91.7%; Accuracy:89.4%, 87.4%, respectively for A2-score and GA2LEN-score). Asthma is excluded (rule-out) for A2-scores of 0-1 and GA2LEN-score of 0 (Sensitivity:93.1%; NPV:98.2%, 98.0%; Accuracy:89.4%, 82.8%).
Conclusions
These practical scores can be used to rule-in/-out asthma in epidemiological studies and clinical screening/triage settings. They may help physicians in primary care or other specialties to screen asthmatics using a simple score with a high level of discrimination and to identify the best candidates to be referred for a diagnostic workup. Moreover, their use may contribute to reducing the inconsistencies of operational definitions of asthma across studies and surveys.
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A Case of Diprosopus Tetraophthalmos: Ocular Findings and Surgical Treatment of Exposure KeratopathyDiprosopus is a rare variation of conjoined twinning. In this report, ophthalmic findings in an infant with diprosopus tetraophthalmos are p...
