The Worst Itch Numeric Rating Scale for patients with moderate to severe plaque psoriasis or psoriatic arthritis

Plaque psoriasis (PP) and psoriatic arthritis (PsA) are autoinflammatory chronic conditions associated with skin involvement. Pruritus, or itching, is a prevalent and bothersome symptom in patients with PP and is associated with reduced health‐related quality of life. The Worst Itch Numeric Rating Scale (WI‐NRS) has been developed as a simple, single item with which to assess the patient‐reported severity of this symptom at its most intense during the previous 24‐hour period. Qualitative research was undertaken to assess the content validity of the WI‐NRS. Patients with moderate to severe PP and patients with PsA were recruited from clinical sites in the USA. The qualitative research entailed two‐part interviews, which began with concept elicitation to gain understanding of patients’ experiences of itching, followed by cognitive debriefing of the WI‐NRS to assess the instrument's understandability, clarity, and degree of appropriateness from the patient's perspective. Twelve patients with PP and 22 with PsA participated in the study. Patients reported that itching was an important and relevant symptom of their psoriatic disease. The WI‐NRS was reported to be complete and easy to understand; the recall period was considered appropriate, the response scale was familiar, and, overall, the instrument was found to be appropriate for assessing itching severity. Patient responses support the content validity of the WI‐NRS. The psychometric properties of the tool will be evaluated in future studies.     

Latex agglutination test for rubella antibodies: report based on data from the College of American Pathologists surveys, 1983 to 1985

In the College of American Pathologists (CAP) rubella survey program, 45% of laboratories rely on the latex agglutination (LA) card assay for detecting rubella immunoglobulin G (IgG) antibodies. By using CAP survey data over a 3-year period, we compared LA results with hemagglutination inhibition (HI) and enzyme immunoassay (EIA) results. EIA indices were used to classify results into three categories: nonimmune, EIA index of 0.300 or less; borderline, EIA index of 0.300 to 0.619; and immune, EIA index of 1.700 or greater. There was 91% or more agreement between LA, HI, and EIA for categories i and iii. In category ii, the response from LA users varied, depending on the level of antibody present in the survey samples; at an EIA index of 0.346, 81% reported nonimmune status, whereas at an EIA index of 0.619, 48% reported nonimmune status. Less than 10% indicated borderline status. In testing of samples in the same category, approximately 40%, using the HI method, reported titers of less than 1:8 (nonimmune status). Among EIA users, 97 to 99% regarded the specimens as nonimmune. On analysis of specimens in the borderline category, the LA test showed a pattern of sensitivity and specificity comparable to that reported with the HI technique, whereas the EIA method showed a greater degree of precision. The LA card assay provides a rapid screening test in which LA is read macroscopically, and the procedure differs considerably from the fully quantitative HI and EIA methods.(ABSTRACT TRUNCATED AT 250 WORDS)     

Increased dopamine transporter density in Parkinson's disease patients with Social Anxiety Disorder

Social Anxiety Disorder (SAD) is more common among PD patients than in the general population. This association may be explained by psychosocial mechanisms but it is also possible that neurobiological mechanism underlying PD can predispose to SAD. The aim of this study was to investigate a possible dopaminergic mechanism involved in PD patients with SAD, by correlating striatal dopamine transporter binding potential (DAT-BP) with intensity of social anxiety symptoms in PD patients using SPECT with TRODAT-1 as the radiopharmaceutical. Eleven PD patients with generalized SAD and 21 PD patients without SAD were included in this study; groups were matched for age, gender, disease duration and disease severity. SAD diagnosis was determined according to DSM IV criteria assessed with SCID-I and social anxiety symptom severity with the Brief Social Phobia Scale (BSPS). Demographic and clinical data were also collected. DAT-BP was significantly correlated to scores on BSPS for right putamen (r=0.37, p=0.04), left putamen (r=0.43, p=0.02) and left caudate (r=0.39, p=0.03). No significant correlation was found for the right caudate (r=0.23, p=0.21). This finding may reinforce the hypothesis that dopaminergic dysfunction might be implicated in the pathogenesis of social anxiety in PD.     

Bond Strength of Epiphany Sealer Prepared with Resinous Solvent

This study evaluated in vitro the bond strength of Epiphany sealer prepared with resinous solvent of Epiphany system (Thinning resin) by using a push-out test. Forty maxillary canines were sectioned transversally below the cementoenamel junction to provide 4-mm-thick dentin disks that were centered in aluminum rings and embedded in acrylic resin. Root canals were prepared with tapered diamond bur. Intraradicular dentin was treated with 1% NaOCl for 30 minutes, 17% ethylenediaminetetraacetic acid for 5 minutes, and flushed with distilled water for 1 minute. The specimens were randomly distributed into 4 groups (n = 10) according to the filling material: GI, Epiphany without photoactivation; GII, Epiphany prepared with solvent without photoactivation; GIII, Epiphany followed by photoactivation; and GIV, Epiphany prepared with solvent followed by photoactivation. After the setting time, the specimens were submitted to the push-out test. The highest mean value (14.91 ± 2.82 MPa) was obtained with Epiphany prepared with solvent followed by photoactivation (GIV), which was statistically different (P < .01) from the other groups. Groups I (8.15 ± 2.47 MPa), II (9.46 ± 2.38 MPa), and III (9.80 ± 2.51 MPa) had inferior bond strength values and were statistically similar among themselves (P > .01). The resinous solvent of Epiphany system increased the bond strength of Epiphany sealer to dentin walls when followed by photoactivation.     

Twelve years of MSOME and IMSI: a review

A promising method for observing spermatozoa, motile sperm organelle morphology examination (MSOME) enables the evaluation of the nuclear morphology of motile spermatozoa in real time at high magnification and has allowed the introduction of a modified microinjection procedure, intracytoplasmic morphologically selected sperm injection (IMSI). Since its development, several studies have intensively investigated the efficacy of MSOME and IMSI. The objective of the present study is to review the current literature on the MSOME and IMSI techniques.A promising method for observing spermatozoa, motile sperm organelle morphology examination (MSOME), enables the evaluation of the nuclear morphology of motile spermatozoa in real time at high magnification and has allowed the introduction of a modified microinjection procedure, intracytoplasmic morphologically selected sperm injection (IMSI). Since its development, several studies have intensively investigated the efficacy of MSOME and IMSI. The objective of the present study is to review the current literature on the MSOME and IMSI techniques.     

Superior Turbinectomy: Role for a Two-surgeon Technique in Endoscopic Endonasal Transsphenoidal Surgery—Technical Note

We describe a practical technique of superior turbinectomy followed by posterior ethmoidectomy as a less invasive procedure for two-surgeon technique on endoscopic endonasal transsphenoidal surgery. After identification of the superior turbinate and the sphenoid ostium, the inferior third portion of the superior turbinate was coagulated and resected. This partial superior turbinectomy procedure exposed the posterior ethmoidal sinus. Resection of the bony walls between the sphenoid and posterior ethmoid sinuses provided more lateral and superior exposure of the sphenoid sinus. This technique was performed in 56 patients with midline skull base lesions, including 49 pituitary adenomas and 7 other lesions. Meticulous manipulation of instruments was performed in all cases without surgical complications such as permanent hyposmia/anosmia or nasal bleeding. Our findings suggested that the partial superior turbinectomy followed by retrograde posterior ethmoidectomy is a simple and safe technique providing a sufficient surgical corridor for two-surgeon technique to approaching midline skull base regions, mainly involving pituitary adenomas.     

Magnetic resonance imaging of pulmonary nodules: accuracy in a granulomatous disease–endemic region

Objective

To estimate the diagnostic accuracy of signal intensity of the lesion-to-spinal cord ratio (LSR) and apparent diffusion coefficient (ADC) in diffusion-weighted (DW) magnetic resonance imaging of pulmonary nodules suspicious for lung cancer in granulomatous lung disease-endemic regions.

Methods

Forty-nine patients with indeterminate solitary pulmonary nodules detected by chest computed tomography and histopathologically confirmed diagnoses were included in the study. DW images were analysed semiquantitatively by focusing regions of interest on the lesion and spinal cord at the same level (for LSR calculation). ADCs were estimated from ratios of the two image signal intensities. Ratios of T1 and T2 signal intensity between nodules and muscle were calculated for comparison.

Results

Mean ADCs?±?standard deviations for lung cancer and benign lesions were 0.9?±?0.2 and 1.3?±?0.2?×?10^-3 mm²/s, respectively. Mean LSRs were 1.4?±?0.3 for lung cancer and 1?±?0.1 for benign lesions. ADCs and LSRs differed significantly between malignant and benign lesions (P?<?0.001). Mean T2 signal intensity ratios also differed significantly between benign and malignant lesions (0.8?±?0.2 vs. 1.6?±?0.2; P?<?0.05).

Conclusions

DWI can help to differentiate malignant from benign lesions according to ADC and the LSR with good accuracy.

Key Points

? DW imaging can help differentiate malignant from benign pulmonary nodules. ? ADC and LSR signal intensities had only small overlap between malignant and benign pulmonary nodules. ? Mean T2 signal intensity ratios differed significantly between benign and malignant lesions.