Comparison of Bod Pod and DXA in female collegiate athletes

PURPOSE: This study was designed to evaluate the reliability and validity of air displacement plethysmography (ADP) compared with dual energy x-ray absorptiometry (DXA) Hologic QDR 4500A (Waltham, MA) in female collegiate athletes. METHODS: Forty-seven females representing various Division II collegiate sports and 24 controls participated in the current study. All women underwent both methods of testing within a 30-min period. RESULTS: Comparison of means indicated that the ADP and DXA are not different when measuring body fat (BF%) in the athletes (ADP = 22.5 +/- 5.5%, DXA = 22.0 +/- 4.7%P = 1.0). Furthermore, this study determined that ADP is a reliable measure of body fat (BF%; r = 0.96, P < 0.001; 0.97, P < 0.001) in collegiate female athletes and nonathletes, respectively. CONCLUSION: The results from this study indicate that ADP is a valid measure of body composition in female athletes and nonathletes when compared with DXA.     

Health-related quality of life measurement in pediatric clinical practice: An appraisal and precept for future research and application

Health-related quality of life (HRQOL) measurement has emerged as an important health outcome in clinical trials, clinical practice improvement strategies, and healthcare services research and evaluation. HRQOL measures are also increasingly proposed for use in clinical practice settings to inform treatment decisions. In settings where HRQOL measures have been utilized with adults, physicians report such measures as useful, some physicians alter their treatment based on patient reports on such instruments, and patients themselves generally feel the instruments to be helpful. However, there is a dearth of studies evaluating the clinical utility of HRQOL measurement in pediatric clinical practice. This paper provides an updated review of the literature and proposes a precept governing the application of pediatric HRQOL measurement in pediatric clinical practice. Utilizing HRQOL measurement in pediatric healthcare settings can facilitate patient-physician communication, improve patient/parent satisfaction, identify hidden morbidities, and assist in clinical decision-making. Demonstrating the utility of pediatric HRQOL measurement in identifying children with the greatest needs, while simultaneously demonstrating the cost advantages of providing timely, targeted interventions to address those needs, may ultimately provide the driving force for incorporating HRQOL measurement in pediatric clinical practice.     

Diminished emotionality and social functioning in schizophrenia

There is indirect evidence to suggest that a subgroup of patients with schizophrenia exhibit a diminished capacity to experience both positive and negative emotions. To date however, no studies have focused specifically on this diminished emotionality (DE). The main objective of the present project was to determine whether patients with self-reported DE differed from other patients in level of social functioning, physical and social anhedonia, and negative/deficit symptoms. Seventy-three state hospital patients with DSM-IV diagnosed schizophrenia and 22 nonpsychiatric controls were examined. Results provided mixed support for the present hypotheses. Patients with self-reported DE (N = 10) versus those without (N = 63) had poorer social functioning, similar levels of physical and social anhedonia, and significantly less severe negative/deficit symptoms. Moreover, there was a substantial amount of discrepancy between patients' self-reported levels of emotionality and the ratings of their emotionality as made by trained observers. Implications of these results are discussed.     

Mifepristone medical abortion in Albania: results from a pilot clinical research study.

OBJECTIVE: To explore the acceptability and feasibility of introducing mifepristone-misoprostol for early medical abortion in home and clinic settings in Albania. METHODS: This was a prospective study testing a simplified mifepristone-misoprostol regimen in two tertiary-level government health facilities in Tirana, Albania. Women (n = 409) with amenorrhea of 8 weeks or less received 200 mg mifepristone in the clinic and then chose whether to take 400 microg of oral misoprostol 2 days later either at home or in the clinic. RESULTS: Nearly 97% of women successfully terminated their pregnancies using the simplified regimen. Almost all women found the method either satisfactory (49.4%) or highly satisfactory (41.1%). Almost all women who were given the option selected the home use protocol. Women choosing home administration of misoprostol were able to manage the medical abortion process on their own. CONCLUSION: A reduced dose mifepristone medical abortion regimen with home administration of misoprostol is feasible for introduction into healthcare facilities in Albania.     

The PedsQL™ in pediatric rheumatology: Reliability,validity, and responsiveness of the Pediatric Quality of Life Inventory™ generic core scales and rheumatology module

Objective

The Pediatric Quality of Life Inventory (PedsQL) is a modular instrument designed to measure health‐related quality of life (HRQOL) in children and adolescents ages 2–18 years. The 23‐item PedsQL 4.0 Generic Core Scales are multidimensional child self‐report and parent proxy‐report scales developed as the generic core measure to be integrated with the PedsQL disease‐specific modules. The 22‐item PedsQL 3.0 Rheumatology Module was designed to measure pediatric rheumatology–specific HRQOL. This study was undertaken to demonstrate the reliability, validity, and responsiveness of the PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 Rheumatology Module in pediatric rheumatology.

Methods

The 4 PedsQL 4.0 Generic Core Scales (physical, emotional, social, and school functioning) and the 5 PedsQL 3.0 Rheumatology Module scales (pain and hurt, daily activities, treatment, worry, and communication) were administered to 231 children and 244 parents (271 subjects accrued overall) recruited from a pediatric rheumatology clinic.

Results

Internal consistency reliability for the PedsQL Generic Core total scale score (α = 0.91 for child self report, α = 0.93 for parent proxy report), physical health summary score (α = 0.87 for child self report, α = 0.89 for parent proxy report), and psychosocial health summary score (α = 0.86 for child self report, α = 0.90 for parent proxy report) were acceptable for group comparisons. The Rheumatology Module scales also demonstrated acceptable reliability for group comparisons (α = 0.75–0.86 for child self report, α = 0.82–0.91 for parent proxy report). Validity was demonstrated using the known‐groups method. The PedsQL distinguished between healthy children and children with rheumatic diseases as a group. The responsiveness of the PedsQL was demonstrated through patient change over time as a result of clinical intervention.

Conclusion

The results demonstrate the reliability, validity, and responsiveness of the PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 Rheumatology Module in pediatric rheumatology.

     

College blues and hues

BACKGROUND: Vulvar ulcerations are an entity that practicing gynecologists frequently encounter in daily practice. CASE: A 21-year-old nulliparous college student presented with a 3-day history of itching to the genital area with associated tenderness and sore bumps. She was initially treated for vulvovaginal candidiasis and instructed to return several days later for follow-up. Repeat examination revealed multiple coalescent and necrotic-appearing ulcerations confined to the labia minora, vagina, and posterior fourchette. All of the lesions eventually resolved. CONCLUSION: This case reminds us to broaden our differential diagnosis when considering causes of genital tract ulcerations in reproductive-aged females.