Correction to: Ultrasound resistive index,power Doppler,and clinical parameters in established rheumatoid arthritis

Clinical Rheumatology - The original version of this article, unfortunately, contained an error. One of the author's name on this article was incorrectly spelled as “José Alexandre...     

Brazilian version of the Quality of Care Scale: the perspective of people with disabilities

OBJECTIVE

To analyze evidence of the validity and reliability of a Brazilian Portuguese version of the Quality of Care Scale from the perspective of people with physical and intellectual disabilities.

METHODS

There were 162 people with physical disabilities and 156 with intellectual disabilities from Porto Alegre and metropolitan region, who participated in the study in 2008. Classical psychometrics was used to independently analyze the two samples. Hypotheses for evidence of criterion validity (concurrent type) were tested with the Mann-Whitney test for non-normal distributions. Principal components analysis was used to explore factorial models. Evidence of reliability was calculated with Cronbach alpha for the scales and subscales. Test-retest reliability was analyzed for individuals with intellectual disabilities through intra-class correlation coefficient and the Willcoxon test.

RESULTS

The principal components in the group with physical disabilities replicated the original model presented as a solution to the international project data. Evidence of discriminant validity and test-retest reliability was found.

CONCLUSIONS

The transcultural factor model found within the international sample project seems appropriate for the samples investigated in this study, especially the physical disabilities group. Depression, pain, satisfaction with life and disability may play a mediating role in the evaluation of quality of care. Additional research is needed to add to evidence of the validity of the instruments.     

Loudness dependence of primary auditory-cortex-evoked activity as predictor of therapeutic outcome to prophylactic lithium treatment in affective disorders--a retrospective study

INTRODUCTION: Lithium has been found to be very effective in prophylactic treatment of affective disorders. However, approximately one-third of patients do not respond to this treatment, which does not become apparent until after a year or more of treatment. Therefore, predictors are needed to avoid a long and unsuccessful therapy with risk of severe side effects. Since lithium acts as a serotonin agonist in prophylactic treatment, a predictor of being able to identify patients with low serotonergic activity, who may be responders to lithium, is promising. To determine whether the loudness dependence (LDAEP) of primary, but not of secondary, auditory-cortex-evoked activity, which is inversely related to central serotonergic neurotransmission, could be such a predictor, responders and non-responders to prophylactic lithium treatment were compared. METHODS: Thirty patients with uni- and bipolar affective disorders, who have taken a prophylactic lithium medication continuously for at least 3 years, were included in the study. Patients were classified as responders if they had no hospitalization within the past 3 years. Dipole source analysis allowing us to separate evoked activity of the primary and secondary auditory cortex was used. RESULTS: The LDAEP of the primary, but not of the secondary, auditory cortex was significantly stronger in the responders to the lithium treatment than in the non-responders, implicating low serotonergic function in these patients. DISCUSSION: This finding, which is in line with previous studies, suggests that loudness dependence of primary auditory-cortex-evoked activity could be a clinically relevant predictor of prophylactic treatment with lithium in affective disorders.     

Raised serum S100B protein levels in neuropsychiatric lupus

OBJECTIVE: To test serum S100B protein levels in patients with and without neuropsychiatric systemic lupus erythematosus (NPSLE) and controls. METHODS: 87 patients with SLE, 23 with and 64 without neuropsychiatric involvement, and 25 control subjects were prospectively evaluated. NPSLE diagnosis was made according to the American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Serum S100B protein levels were determined with a luminescence immunoassay. Statistical analysis was performed using Mann-Whitney and Kruskal-Wallis tests. RESULTS: Among the patients with NPSLE, 9 presented psychosis; 4, cranial neuropathy; 3, cerebrovascular disease; 1, seizures; 1, chorea; 1, peripheral polyneuropathy; 1, multiplex mononeuropathy; 3, dementia. Serum concentrations of S100B protein were significantly higher in patients with NPSLE (median 0.164 ng/ml, interquartile range 0.113-0.332) than in non-NPSLE patients (0.062 ng/ml, 0.026-0.109) and controls (0.088 ng/ml, 0.013-0.124) (p<0.001). Patients with anti-dsDNA antibodies had higher S100B protein levels (p = 0.001). No significant associations were found of lupus activity (among non-NPSLE cases), antiphospholipid antibodies, and reduced complement levels with S100B concentration. CONCLUSIONS: Serum S100B protein level is raised in NPSLE, reflecting continuing neurological damage. The association of anti-dsDNA antibodies with higher S100B protein concentration deserves further study.     

Impact on the Quality of Life of an Educational Program for the Prevention of Work-Related Musculoskeletal Disorders: a randomized controlled trial

Background  

Work-related musculoskeletal disorders (WMSD) are a major cause for concern in public health and the main causes of sick leave. Treatments for WMSD have given disappointing results; prevention is the best strategy, but results of preventive measures have not been consistent. To the best of our knowledge there are few studies in literature that evaluated the impact of a specific program aimed at preventing WMSD on the quality of life of employed persons.     

Killer cell immunoglobulin-like receptor (KIR) genes in systemic sclerosis

A previous study has suggested that the combination KIR2DS2⁺/KIR2DL2^‐ was related to increased risk for systemic sclerosis (SSc), while others have failed to reproduce this finding. Our objective was to study this matter further and test the association of other KIR genes with SSc. One hundred and ten SSc patients and 115 healthy bone marrow donors were enrolled in a case–control study. Blood was collected for DNA extraction; typing of 15 KIR genes and human leucocyte antigen‐C (HLA‐C) was made by polymerase chain reaction with sequence specific primers (PCR–SSP), followed by electrophoresis on agarose gel. Patients underwent clinical evaluation, serology, Doppler echocardiography and chest high‐resolution computed tomography. The frequency of the inhibitory KIR2DL2 was significantly lower in patients [29·1% versus 65·2% in controls, P < 0·0001; odds ratio (OR) = 0·22, 95% confidence interval 0·12–0·40]. When combinations of activating and inhibitory KIR genes were analysed, the presence of KIR2DS2 in the absence of KIR2DL2 (KIR2DS2⁺/KIR2DL2^‐) was more frequent in patients than in controls (25·5% versus 1·7%, respectively; P < 0·0001; OR = 19·29, 4·24–122·26). However, the presence of both KIR2DS2 and KIR2DL2 (KIR2DS2⁺/KIR2DL2⁺) was more frequent in controls (57·4%) than in patients (28·2%, P < 0·0001), suggesting a preponderant protective effect of KIR2DL2 over KIR2DS2. Stratification for HLA‐C1 status did not change these results. No statistically significant associations were found between KIR phenotypes and clinical and laboratory features of SSc. Our results suggest a protective role of KIR2DL2⁺ phenotype and confirmed the association of the combination KIR2DS2⁺/KIR2DL2^‐ with increased risk for SSc.