BACKGROUND & AIMS: OBJECTIVE:To compare the relative sensitivity of direct microscopy, fungal culture and nail plate biopsy in the diagnosis of onychomycosis. DESIGN:Cross-sectional study. PLACE AND DURATION OF STUDY:The Skin Department, Military Hospital, Rawalpindi from February 1998 to February 1999. PATIENTS AND METHODS:A total of 50 patients who were suffering from different clinical variants of onychomycosis, irrespective of their age, gender, with or without simultaneous presence of systemic diseases, were subjected to laboratory investigations including direct microscopy with 20% potassium hydroxide (KOH) for fungal hyphae, fungal cultures and nail plate biopsies. These patients were later categorized into two groups based upon the results of nail plate biopsies. RESULTS:Of 50 patients, 15 (30%) were positive for fungal elements in direct microscopy, 8 (16%) were positive for fungal culture and 16 (32%) revealed positive results in nail plate biopsies. Amongst nail plate biopsy positive cases, 10 (63%) were positive for direct microscopy and 6 (37.5%) were positive for fungal cultures. In biopsy negative cases, positive results for direct microscopy were seen in 5 (14.7%) patients and positive fungal culture was found in 2 (5.88%) patients. CONCLUSION:The clinical impression of onychomycosis is not true in all the cases. Nail scraping for direct microscopy with 20% KOH should be the first line screening test for all patients which should then be supplemented with fungal culture and/ or nail plate biopsy.

背景与目标：

BACKGROUND & AIMS: Calcitriol has been widely used in the management of osteoporosis, but its efficiency is a matter of controversy. It is not known whether combinations of calcitriol and antiresorptive agents such as etidronate and calcitonin are superior to calcitriol alone in the treatment of postmenopausal osteoporosis. To make this determination, 30 Turkish women with postmenopausal osteoporosis between 45 and 68 years of age were randomized to receive either intermittent cyclical etidronate (400 mg/day, for 14 days) followed by 60 days of cyclical calcitriol therapy 0.25 microg twice daily (group 1; n = 10), or calcitriol 0.25 microg twice daily (group 2; n = 10), or calcitriol 0.25 microg/day in combination with 100 IU intranasal salmon calcitonin taken every other day (group 3; n = 10) through a 1-year period. Bone mineral density (BMD) of lumbar spine (L2 to L4) was determined for each patient by dual-photon absorptiometry (153Gd) at baseline, after 6 months, and at the end of the study. There was no significant difference among groups with respect to mean spinal BMD at baseline, after 6, and after 12 months. No significant spinal BMD changes occurred in any group from baseline, after 6 months, and after 12 months. Four patients in groups 1 and 2 and five patients in group 3 developed hypercalcemia at least once during therapy. Hypercalciuria occurred at least once in 9, 10, and 7 patients in groups 1, 2, and 3, respectively. One patient in group 2 developed a renal stone at the end of the study. Mean urine hydroxyproline levels did not change significantly in any group with respect to baseline. The data suggest that one-year treatment with calcitriol, given either alone or in combination with antiresorptive agents, does not improve spinal BMD in Turkish women with postmenopausal osteoporosis, and is associated with a high rate of adverse events.

背景与目标： 骨化三醇已广泛用于骨质疏松症的治疗，但其效率仍存在争议。尚不清楚骨化三醇和抗吸收剂 (如依替膦酸盐和降钙素) 的组合在绝经后骨质疏松症的治疗中是否优于单独的骨化三醇。为了做出这一决定，30名年龄在45至68岁之间的绝经后骨质疏松症土耳其妇女被随机分配接受间歇性周期性依替膦酸盐 (400毫克/天，持续14天)，然后接受60天的周期性骨化三醇治疗，0.25每天两次 (组1; n = 10)，或骨化三醇0.25 microg每天两次 (组2; n = 10)，或骨化三醇0.25 microg/天与100 IU鼻内鲑鱼降钙素组合，每隔一天服用 (组3; n = 10)，持续1年。在基线，6个月后和研究结束时，通过双光子吸收法 (153Gd) 测定每位患者的腰椎 (L2至L4) 的骨矿物质密度 (BMD)。在基线，6个月后和12个月后，各组之间的平均脊柱BMD没有显着差异。从基线，6个月后和12个月后，任何组均未发生明显的脊柱BMD变化。第1组和第2组中的4名患者和第3组中的5名患者在治疗期间至少出现一次高钙血症。高钙尿症分别在第1、2和3组的9、10和7名患者中至少发生一次。第2组中的一名患者在研究结束时出现了肾结石。任何组的平均尿羟脯氨酸水平相对于基线没有明显变化。数据表明，单独或与抗吸收剂联合使用骨化三醇治疗一年不会改善土耳其绝经后骨质疏松症妇女的脊柱BMD，并且与不良事件的发生率很高有关。

BACKGROUND & AIMS: OBJECTIVE:The 24-hour creatinine clearance is the standard clinical technique for measuring kidney function; however, this measurement is cumbersome and inconvenient for patients. We hypothesized that a camera-based technetium-99m mercaptoacetyltriglycine (MAG3) clearance obtained simultaneously with a standard MAG3 scan would correlate well with the 24-hour creatinine clearance and could serve as a simple marker of kidney function. MATERIALS AND METHODS:Data were obtained from a retrospective analysis of 28 patients with varying degrees of kidney dysfunction and 85 subjects evaluated for kidney donation. The MAG3 clearance was calculated using a camera-based technique without blood or urine sampling. The creatinine clearance was measured using the plasma creatinine and a 24-hour urine collection. The MAG3 and creatinine clearances were corrected for body surface area, and clearance values in healthy subjects and patients were compared using the paired Student's t test. The linear association between the MAG3 and creatinine clearances was expressed by Pearson's correlation coefficient. RESULTS:The mean MAG3 clearance in the potential kidney donors was 321 +/- 95 mL/min/1.73 m2 (95% CI, 171-546 mL/min/1.73 m2), significantly higher than the mean creatinine clearance of 152 +/- 51 mL/min/1.73 m2 (79-278 mL/min/1.73 m2, p < 0.001). The mean MAG3 clearance in patients was 153 +/- 70 mL/min/1.73 m2 (32-316 mL/min/1.73 m2) and was also significantly higher than the mean creatinine clearance of 74 +/- 36 mL/min/1.73 m2 (21-138 mL/min/1.73 m2, p < 0.001). The ratio of the mean creatinine clearance to the mean MAG3 clearance was essentially the same for volunteers and patients, 0.47 and 0.48, respectively. The Pearson's correlation between the MAG3 and creatinine clearances was 0.80 (0.72-0.86). CONCLUSION:The camera-based 99mTc-MAG3 clearance correlates well with the 24-hour creatinine clearance and can provide a simple and convenient index of kidney function.

背景与目标：

BACKGROUND & AIMS: :Cognitive and learning styles research is limited by the lack of evidence supporting valid interpretations of style assessment scores. We sought evidence to support the validity of scores from 4 instruments: the Index of Learning Styles (ILS); the Learning Style Inventory (LSI); the Cognitive Styles Analysis (CSA), and the Learning Style Type Indicator (LSTI). The ILS assesses 4 domains: sensing-intuitive (SensInt), active-reflective (ActRefl), sequential-global (SeqGlob) and visual-verbal (VisVerb), each of which parallel a similar domain in at least 1 of the other instruments. We administered the ILS, LSI and CSA to family medicine and internal medicine residents and Year 1 and 3 medical students and applied the multitrait-multimethod matrix to evaluate convergence and discrimination. After 3 months participants repeated the ILS and completed the LSTI. A total of 89 residents and medical students participated. Multitrait-multimethod analysis showed evidence of both convergence and discrimination for ActRefl (ILS, LSI and LSTI) and SensInt (ILS and LSTI) scores. ILS SeqGlob and SensInt scores showed unanticipated correlation. No other domains met the criteria for convergence or discrimination. Test-retest reliabilities for ILS scores were 0.856 for SensInt, 0.809 for ActRefl, 0.703 for SeqGlob and 0.684 for VisVerb. Cronbach's alpha values were > or = 0.810 for LSI and 0.237-0.758 for LSTI. At least 9 participants misinterpreted the LSI instructions. These data support the validity of ILS active-reflective and sensing-intuitive scores, LSI active-reflective scores and LSTI sensing-intuitive scores for determining learning styles in this population. Cognitive style and learning style scores may not be interchangeable, even for constructs with similar definitions.

背景与目标： : 认知和学习风格研究受到缺乏支持风格评估分数有效解释的证据的限制。我们从4种工具中寻找证据来支持分数的有效性: 学习风格指数 (ILS); 学习风格清单 (LSI); 认知风格分析 (CSA) 和学习风格类型指标 (LSTI)。ILS评估4个域: 感知-直觉 (SensInt)，主动-反射 (ActRefl)，顺序-全局 (SeqGlob) 和视觉-言语 (VisVerb)，每个域在至少1个其他工具中都平行于一个相似的域。我们对家庭医学和内科住院医师以及1年级和3年级的医学生进行了ILS，LSI和CSA的管理，并应用了多性状-多方法矩阵来评估收敛和歧视。3个月后，参与者重复ILS并完成LSTI。共有89名居民和医学生参加。多性状-多方法分析显示了ActRefl (ILS，LSI和LSTI) 和SensInt (ILS和LSTI) 得分的收敛性和区分性。ILS SeqGlob和SensInt评分显示出意想不到的相关性。没有其他领域符合趋同或歧视的标准。对SensInt，ActRefl，SeqGlob，0.703和VisVerb，对0.809 0.856 ILS分数的重测可靠性。LSI的Cronbach α 值> 或 = 0.810，LSTI的0.237-0.758。至少有9名参与者误解了LSI指令。这些数据支持ILS主动反射和感知直觉分数，LSI主动反射分数和LSTI感知直觉分数用于确定该人群的学习方式的有效性。认知风格和学习风格得分可能不可互换，即使对于具有相似定义的结构也是如此。

BACKGROUND & AIMS: :We compared the in vitro activities of tigecycline to those of other agents against 300 nonduplicate isolates of Streptococcus pneumoniae (194 isolates), Haemophilus influenzae (60 isolates), and Moraxella catarrhalis (46 isolates) recovered from patients treated in three major hospitals in Taiwan from August through December, 2003. All of these isolates were inhibited at 0.5 mg/L of tigecycline. For S. pneumoniae isolates, 72% were not susceptible to penicillin (69% intermediate and 3% resistant) and 96% were not susceptible to azithromycin. Among the 178 isolates resistant to azithromycin, 53 isolates (30%) had the M phenotype and 70% had the cMLSB phenotype. The rate of nonsusceptibility to ertapenem, telithromycin, moxifloxacin, and quinupristindalfopristin in S. pneumoniae was 3%, 2%, 1%, and 57%, respectively. For H. influenzae, 36 (60%) were not susceptible to ampicillin, among which 31 possessed beta-lactamase. A high rate (8.3%) of H. influenzae isolates with beta-lactamase-negative and ampicillin-resistant phenotype was found. All H. influenzae isolates were susceptible to azithromycin, but 40% of them were not susceptible to clarithromycin. Ninety-eight percent (44 isolates) of M. catarrhalis possessed beta-lactamase. All three fluoroquinolones tested were highly active (MIC90 < or =0.12 mg/L) against H. influenzae and M. catarrhalis.

背景与目标： : 我们比较了替加环素与其他药物对300种非重复肺炎链球菌分离株 (194株)，流感嗜血杆菌 (60株) 和卡他莫拉菌 (46株) 的体外活性，这些分离株是从8月到2003年12月在台湾的三家主要医院中康复的。在0.5 mg/L替加环素的浓度下，所有这些分离株均被抑制。对于肺炎链球菌分离株，72% 对青霉素不敏感 (69% 中间体和3% 耐药)，96% 对阿奇霉素不敏感。在对阿奇霉素耐药的178株中，53株 (30% 株) 具有M表型，70% 株具有cMLSB表型。肺炎链球菌对厄他培南，泰利霉素，莫西沙星和奎奴普汀的不敏感性分别为3%，2%，1% 和57%。对于流感嗜血杆菌，36 (60%) 对氨苄青霉素不敏感，其中31具有 β-内酰胺酶。发现具有 β-内酰胺酶阴性和氨苄青霉素抗性表型的流感嗜血杆菌分离株率高 (8.3%)。所有流感嗜血杆菌分离株对阿奇霉素敏感，但其中40% 对克拉霉素不敏感。卡他氏杆菌的百分之九十八 (44个分离株) 具有 β-内酰胺酶。测试的所有三种氟喹诺酮类药物对流感嗜血杆菌和卡他氏杆菌具有高度活性 (MIC90 <或 = 0.12 mg/L)。

BACKGROUND & AIMS: BACKGROUND:Flow cytometric basophil activation tests have been developed as cellular tests for in vitro diagnosis of IgE-mediated reactions. Different activation markers (CD63 or CD203c) with distinct ways of regulation have been used after stimulation with various allergens. OBJECTIVE:It was the aim of the present study to compare basophil activation tests by measuring both CD63 and CD203c upregulation in patients with insect venom allergy. MATERIALS AND METHODS:43 patients with a history of insect venom anaphylaxis were examined. A careful allergy history was taken, and skin tests and determination of specific IgE-antibodies were performed. Basophil activation tests (BAT) using CD63 or CD203c expression were done after stimulation with different concentrations of bee and wasp venom extracts. 25 healthy subjects with negative history of insect venom allergy were studied as controls. RESULTS:The CD203c protocol showed a slightly higher sensitivity than the CD63 protocol (97% vs. 89%) with regard to patients' history. The magnitude of basophil response was higher with CD203c in comparison to CD63 for both insect venoms. Specificity was 100% for the CD63 protocol and 89% for the CD203c protocol with regard to controls with negative history and negative RAST. CONCLUSION:These results support the reliability of basophil activation tests using either CD63 or CD203c as cellular tests in the in vitro diagnosis of patients with bee or wasp venom allergy with a slightly higher sensitivity for the CD203c protocol.

背景与目标：

BACKGROUND & AIMS: The expression and localization of hepatocyte growth factor/scatter factor (HGF/SF) were examined immunohistochemically in 59 human coronary artery lesions retrieved by directional coronary atherectomy and compared with the localization of transforming growth factor beta isoforms (TGF-beta 1, -beta 2, and -beta 3). In 21 of the 59 specimens (35.6%) HGF-like immunoreactivity (HGF-IR) was revealed. The HGF immunopositivity rate of 45% (14/31) in thrombotic tissue was significantly (P < 0.05) higher than the rates of 7.3% (4/55), 7.1% (3/42), and 0% (0/14) in fibrous tissue, neointimal hyperplasia and atheromatous gruel, respectively. Immunoreactivity for HGF was much weaker than that for TGF-beta isoforms in these components except in thrombotic tissue. These cells exhibiting strong HGF-IR were inflammatory cells such as monocytes/macrophages in thrombotic tissue, in tissue lesions adjacent to a thrombus, and outside the capillary walls in a portion of the neovascularized lesions. Smooth muscle cells (SMCs) hardly demonstrated HGF-IR. In contrast, in control coronary arteries obtained at autopsy, the HGF-IR was strongly expressed in SMCs. These findings suggest that HGF produced by macrophages play a part in the process of coronary plaque formation attributable to thrombus in man.

背景与目标： 通过免疫组织化学检查了通过定向冠状动脉粥样斑块切除术检索的59例人冠状动脉病变中肝细胞生长因子/散射因子 (HGF/SF) 的表达和定位，并将其与转化生长因子 β 亚型 (tgf-β1，-β2和-β3) 的定位进行了比较。在59个标本中的21个 (35.6%) 中，HGF样免疫反应性 (hgf-ir) 被揭示。血栓组织中45% (14/31) 的HGF免疫阳性率显着 (P < 0.05) 高于纤维组织，新内膜增生和动脉粥样硬化稀粥中的7.3% (4/55)，7.1% (3/42) 和0% (0/14)。分别。除血栓形成组织外，这些成分中HGF的免疫反应性比TGF-β 同工型的免疫反应性弱得多。这些表现出强hgf-ir的细胞是炎性细胞，例如血栓形成组织中，与血栓相邻的组织病变以及部分新生血管病变的毛细血管壁外部的单核细胞/巨噬细胞。平滑肌细胞 (smc) 几乎不显示HGF-IR。相反，在尸检获得的对照冠状动脉中，hgf-ir在smc中强烈表达。这些发现表明，巨噬细胞产生的HGF在人类血栓形成引起的冠状动脉斑块形成过程中发挥了作用。

BACKGROUND & AIMS: BACKGROUND:A few prospective controlled trials comparing early functional rehabilitation after Achilles tendon repair and non-operative immobilization have been reported. HYPOTHESES:There is no difference in Achilles tendon elongation between early motion and immobilization after Achilles tendon repair. Tendon elongation does not correlate with the clinical outcome. STUDY DESIGN:Randomized clinical trial; Level of evidence, 2. METHODS:Fifty patients with acute Achilles tendon rupture were randomized postoperatively to receive either early movement of the ankle between neutral and plantar flexion in a brace for 6 weeks or immobilization in tension using a below-knee cast with the ankle in a neutral position for 6 weeks. Full weightbearing was allowed after 3 weeks in both groups. Standardized radiographs to measure previously placed radiographic markers were taken on the first day postoperatively and at 1, 3, 6, 12, 24 weeks postoperatively, with the final radiograph a mean of 60 (SD, 6.4) weeks postoperatively. The outcome was assessed at the 3-month and final checkups by the clinical scoring method described by Leppilahti et al and included subjective factors and objective factors. RESULTS:Tendon elongation occurred in both groups but was somewhat less in the early motion group (median 2 mm in the early motion group vs median 5 mm in the cast group a mean of 60 weeks postoperatively, P = .054). The elongation curves first rose and then slowly fell in both groups. The patients who had less elongation achieved a better clinical outcome (rho = -.42, P = .017). Tendon elongation did not correlate significantly with age, body mass index, or isokinetic peak torques. CONCLUSION:Achilles tendon elongation was somewhat less in the early motion group and correlated with the clinical outcome scores. We recommend early functional postoperative treatment after Achilles rupture repair.

背景与目标：

BACKGROUND & AIMS: BACKGROUND AND PURPOSE:Imaging of bisphosphonate-induced osteonecrosis of the jaw is essential for surgical planning. We compared the extent of BONJ on contrast-enhanced MR imaging, [(18)F] fluoride PET/CT, and panoramic views derived from standard conebeam CT with clinical pre- and intraoperative examinations. MATERIALS AND METHODS:Between February 2011 and January 2012, ten subjects with written informed consent (9 women; mean, 69.6 years; range, 53-88 years) were included in this prospective ethics-board-approved study. Patients underwent CEMR imaging, [(18)F] fluoride PET/CT, and CBCT and were clinically examined pre- and intraoperatively. Surgery was performed, and BONJ was histologically confirmed in 9 patients. Location and extent of BONJ on different modalities/examinations were graphically compared (0 = no pathologic finding, 1 = smallest, 5 = largest extent of BONJ). Rank tests were used to assess overall and paired differences of ratings in 9 patients. A P value <.05 was considered statistically significant. RESULTS:Significant differences in BONJ extent among different modalities and examinations were found (P < .001). The highest median rank was seen in PET/CT (4 ± 1.12) and CEMR imaging (4 ± 1.01), followed by intraoperative examinations (3 ± 0.71), CBCT (2 ± 0.33), and preoperative examinations (1 ± 0). No significant differences were found between PET/CT and CEMR imaging (P = .23), except when comparing PET/CT to either CBCT, pre- and intraoperative examinations (all P < .05). Preoperative examinations showed significantly less extensive disease than all other modalities/examinations (all P < .05). CONCLUSIONS:[(18)F] fluoride PET/CT and CEMR imaging revealed more extensive involvement of BONJ compared with panoramic views from CBCT and clinical examinations.

背景与目标：

BACKGROUND & AIMS: :The accurate design of new protein-protein interactions is a longstanding goal of computational protein design. However, most computationally designed interfaces fail to form experimentally. This investigation compares five previously described successful de novo interface designs with 158 failures. Both sets of proteins were designed with the molecular modeling program Rosetta. Designs were considered a success if a high-resolution crystal structure of the complex closely matched the design model and the equilibrium dissociation constant for binding was less than 10 μM. The successes and failures represent a wide variety of interface types and design goals including heterodimers, homodimers, peptide-protein interactions, one-sided designs (i.e., where only one of the proteins was mutated) and two-sided designs. The most striking feature of the successful designs is that they have fewer polar atoms at their interfaces than many of the failed designs. Designs that attempted to create extensive sets of interface-spanning hydrogen bonds resulted in no detectable binding. In contrast, polar atoms make up more than 40% of the interface area of many natural dimers, and native interfaces often contain extensive hydrogen bonding networks. These results suggest that Rosetta may not be accurately balancing hydrogen bonding and electrostatic energies against desolvation penalties and that design processes may not include sufficient sampling to identify side chains in preordered conformations that can fully satisfy the hydrogen bonding potential of the interface.

背景与目标： : 精确设计新的蛋白质-蛋白质相互作用是计算蛋白质设计的长期目标。但是，大多数计算设计的接口都无法通过实验形成。该调查比较了五个先前描述的成功的从头接口设计和158故障。两组蛋白质都是使用分子建模程序Rosetta设计的。如果配合物的高分辨率晶体结构与设计模型紧密匹配并且结合的平衡解离常数小于10μm，则认为设计是成功的。成功和失败代表了各种各样的界面类型和设计目标，包括异二聚体，同二聚体，肽-蛋白质相互作用，单面设计 (即仅其中一种蛋白质发生突变) 和双面设计。成功设计的最显着特征是，与许多失败的设计相比，它们在界面上的极性原子更少。试图创建广泛的跨界面氢键集的设计导致无法检测到结合。相反，极性原子占许多天然二聚体的界面面积的40% 以上，并且天然界面通常包含广泛的氢键网络。这些结果表明，Rosetta可能无法准确地平衡氢键和静电能免受去溶剂化的影响，并且设计过程可能不包括足够的采样来识别可以完全满足界面氢键电势的预定构象中的侧链。

BACKGROUND & AIMS: OBJECTIVES:There are no direct comparisons of blood glucose values in samples collected with barrier serum tubes (SST) and NaF/potassium oxalate (NaF/KOx) plasma tubes. Collection of samples in SST tubes can offer considerable savings and specimen processing advantages for national level surveys. DESIGN AND METHODS:Serum and plasma samples were collected under 'field conditions' from a single draw of 3692 individuals participating in the Canadian Health Measures Survey. The samples were analyzed retrospectively using the VITROS GLU Slide method (glucose oxidase-based). RESULTS:There was a high rate of hemolysis in the NaF/KOx tubes (86.2%) while hemolysis was infrequently observed with the SST tubes (2%). Comparing only blood draws where no hemolysis was observed in both tubes (n=495; paired t-test) showed no effect of tube type on serum/plasma glucose concentrations. This was also observed when data was restricted to cases when only SST samples were not hemolyzed (n=3546; paired t-test). CONCLUSIONS:These data show that both collection tubes can be used under survey collection and processing conditions to measure glucose with our assay system with no difference in reported results.

背景与目标：

BACKGROUND & AIMS: :Accurate muscle geometry (muscle length and moment arm) is required to estimate muscle function when using musculoskeletal modelling. In shoulder, muscles are often modelled as a collection of independent line segments, leading to non-physiological muscles trajectory, especially for the rotator cuff muscles. To prevent this, a surface mesh model was developed and validated against 7 MRI positions in one participant. Mean moment arm errors was 11.4% for the line vs. 8.8% for the mesh model. While the model with independent lines led to some non-physiological trajectories, the mesh model gave lower misestimations of muscle lengths and moment arms.

背景与目标： : 使用肌肉骨骼模型时，需要准确的肌肉几何形状 (肌肉长度和力矩臂) 来估计肌肉功能。在肩部，肌肉通常被建模为独立线段的集合，从而导致非生理肌肉轨迹，尤其是对于肩袖肌肉。为了防止这种情况，开发了一个表面网格模型，并针对一名参与者的7个MRI位置进行了验证。11.4% 直线的平均力矩臂误差与网格模型的8.8%。虽然具有独立线条的模型导致了一些非生理轨迹，但网格模型对肌肉长度和力矩臂的误判较低。

BACKGROUND & AIMS: PURPOSE:The purpose of this article was to investigate the accuracy of the WISC-IV short forms in estimating Full Scale Intelligence Quotient (FSIQ) and General Ability Index (GAI) in pediatric epilepsy. METHODS:One hundred and four children with epilepsy completed the WISC-IV as part of a neuropsychological assessment at a tertiary-level children's hospital. The clinical accuracy of eight short forms was assessed in two ways: (a) accuracy within +/- 5 index points of FSIQ and (b) the clinical classification rate according to Wechsler conventions. The sample was further subdivided into low FSIQ (≤ 80) and high FSIQ (> 80). RESULTS:All short forms were significantly correlated with FSIQ. Seven-subtest (Crawford et al. [2010] FSIQ) and 5-subtest (BdSiCdVcLn) short forms yielded the highest clinical accuracy rates (77%-89%). Overall, a 2-subtest (VcMr) short form yielded the lowest clinical classification rates for FSIQ (35%-63%). The short form yielding the most accurate estimate of GAI was VcSiMrBd (73%-84%). CONCLUSIONS:Short forms show promise as useful estimates. The 7-subtest (Crawford et al., 2010) and 5-subtest (BdSiVcLnCd) short forms yielded the most accurate estimates of FSIQ. VcSiMrBd yielded the most accurate estimate of GAI. Clinical recommendations are provided for use of short forms in pediatric epilepsy.

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BACKGROUND & AIMS: AIM:The aim of this study was to determine the relationship between parent and child Full-scale IQ (FSIQ) in children with epilepsy and in typically developing comparison children and to examine parent-child IQ differences by epilepsy characteristics. METHOD:The study participants were 97 children (50 males, 47 females; age range 8-18y; mean age 12y 3mo, SD 3y1mo) with recent-onset epilepsy including idiopathic generalized (n=43) and idiopathic localization-related epilepsies (n=54); 69 healthy comparison children (38 females, 31 males; age range 8-18y; mean age 12y 8mo, SD 3y 2mo), and one biological parent per child. All participants were administered the Wechsler Abbreviated Scale of Intelligence (WASI). FSIQ was compared in children with epilepsy and typically developing children; FSIQ was compared in the parents of typically developing children and the parents of participants with epilepsy; parent-child FSIQ differences were compared between the groups. RESULTS:FSIQ was lower in children with epilepsy than in comparison children (p<0.001). FSIQ of parents of children with epilepsy did not differ from the FSIQ of the parents of typically developing children. Children with epilepsy had significantly lower FSIQ than their parents (p<0.001), whereas comparison children did not. The parent-child IQ difference was significantly higher in the group with epilepsy than the comparison group (p=0.043). Epilepsy characteristics were not related to parent-child IQ difference. INTERPRETATION:Parent-child IQ difference appears to be a marker of epilepsy impact independent of familial IQ, epilepsy syndrome, and clinical seizure features. This marker is evident early in the course of idiopathic epilepsies and can be tracked over time.

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BACKGROUND & AIMS: INTRODUCTION:Fatigue after treatment for breast cancer (BC) is common, but poorly understood. We examined the fatigue levels during first year after radiotherapy (RT) according to the extent of RT (local or locoregional), hormonal therapy (HT) and chemotherapy (CT). The impact of comorbidity was also explored. Moreover, we compared fatigue levels in patients with the general population (GenPop) data. MATERIAL AND METHODS:BC patients (n = 250) referred for post-operative RT at St. Olavs Hospital, Trondheim, Norway, were enrolled. Fatigue was measured by the EORTC QLQ-C30-fatigue subscale, ranging from 0 to 100, before RT (baseline), after RT, and at three, six, and 12 months. Clinical and treatment-related factors were recorded at baseline. GenPop data was available from a previous survey (n = 652). Linear mixed models and analysis of covariance were applied. RESULTS:Compliance ranged from 87% to 98%. At baseline, mean value (SD) of fatigue in BC patients was 26.8 (23.4). The level increased during RT (mean change 8.3, 95% CI 5.5-11.1), but declined thereafter and did not differ significantly from pre-treatment levels at subsequent time points. In age-adjusted analyses, locoregional RT accounted for more overall fatigue than local RT (mean difference 6.6, 95% CI 1.2-12.0), but the association was weakened and not statistical significant when adjusting for CT and HT. Similar pattern was seen for CT and HT. The course of fatigue differed significantly by CT (p < 0.001, interaction test). At baseline, fatigue levels were higher in patients with than without CT, but at subsequent time points similar levels were evident, indicating a temporary adverse effect of CT. Comorbidity was significantly associated with increased level of fatigue, independent of other factors (mean difference 8.1, 95% CI 2.2-14.1). BC-patients were not significantly more fatigued than GenPop, except for immediately after ending RT, and then only among those without comorbidity (mean 35.9 vs. 25.8, p < 0.001). CONCLUSION:Comorbidity seems to be a more important determinant for fatigue levels than the cancer treatment.

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