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  • Glasgow meningococcal septicemia prognostic score  (1)
  • Self-report  (1)
  • 1
    ISSN: 1432-1076
    Keywords: Key words Ultrasonography ; Heart failure ; Neisseria meningitidis ; Septic shock ; Shortening fraction ; Glasgow meningococcal septicemia prognostic score
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Heart failure is a life-threatening complication of fulminant meningococcal septic shock (MSS). Depression of left ventricular function, in particular, is thought to be due to circulating meningococcal endotoxin. Myocardial failure leads to ventricular dilation expressed by an increased left-ventricle end-diastolic diameter (LVED). With ultrasonography, LVED can be accurately measured as well as the shortening fraction (SF). In an evaluative study we investigated the accuracy of the SF and compared it to the accuracy of the Glasgow meningococcal septicemia prognostic score (GMSPS) in the prediction of mortality in children with fulminant MSS. In 27 children admitted in a 4-year period with a presumptive clinical diagnosis of fulminant MSS, hypotension persisted for more than 1 h despite volume loading and inotropic therapy. Seven of these children died (26%); all had an SF 〈0.30 and a GMSPS ≥10 (the sensitivity of both scores was 100%). Positive predictive values of the SF and GMSPS were 41% and 58% respectively. Conclusions SF can be used in addition to other severity scores in clinical decision-making and contribute to the selection of children with the worst prospects for inclusion in experimental treatment studies.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1434-9949
    Keywords: Joint count ; Rheumatoid arthritis ; Self-report
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to investigate the reliability and validity of the self-report Thompson articular index (ThAI) in Dutch patients with rheumatoid arthritis (RA). A rheumatologist assessed the ThAI in 43 patients with RA. Patients completed the self-report ThAI and the AIMS-2 questionnaire to assess physical function, pain, mood and level of tension. Blood samples were taken to measure the erythrocyte sedimentation rate (ESR). After 4 weeks, patients were sent a questionnaire for a repeat assessment of the self-report AI. The testretest reliability of the self-report ThAI was adequate (ICC=0.83). There was low agreement between ThAI scores from patients and AI scores assessed by the rheumatologist (ICC=0.44). Self-report ThAI scores (mean=230.5) were significantly higher than the rheumatologist's scores (mean=110.8). Levels of agreement between patients and rheumatologist for individual joints were disappointing, ranging from 49% to 74% (Cohen's kappa from −0.02 to 0.48). The rheumatologist's ThAI scores correlated significantly with ESR (r=0.55) and physical function (r=0.44), but not with pain, mood or level of tension. Patients' scores correlated significantly with physical function (r=0.51), pain (r=0.43), and mood (r=0.36) but not with ESR or level of tension. In regression analyses the only significant predictor of the rheumatologist's ThAI scores was ESR, and for patients' scores physical function, thus showing that patients' responses are not confounded by mood or level of tension. In conclusion, the self-report ThAI is a reliable measure, but the validity is questionable because of the non-significant correlation with ESR and the low level of agreement between patients and rheumatologist. The results indicate that self-reported joint involvement is more closely related to physical function than to arthritic activity.
    Type of Medium: Electronic Resource
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