CARATkids questionnaire development process

Introdução: A asma e a rinite alérgica (ARA) são doenças inflamatórias crónicas das vias aéreas que frequentemente coexistem. O questionário para avaliação do controlo da asma e da rinite alérgica (CARAT) encontra‑se validado para o adulto. O objectivo foi desenvolver o questionário CARATkids para crianças entre os 4 e os 12 anos de idade, com o diagnóstico médico de ARA. Este trabalho pretende descrever o processo do desenvolvimento do questionário. Métodos: O desenvolvimento do questionário foi estruturado em três fases: 1) revisão da literatura sobre questionários pediátricos existentes; 2) realização de reuniões de consenso que permitiu a criação de uma versão preliminar do CARATkids, com duas versões (crianças e pais), composto por 17 itens. Para as crianças, as perguntas foram acompanhadas por ilustrações para cada questão, com formato de resposta dicotómica (sim / não). Para os pais o questionário manteve o formato de CARAT17, com questões com 4 pontos de Likert e outras questões com opção de resposta com escala dicotómica; 3) realização de um estudo transversal através de entrevistas cognitivas efectuadas a 29 crianças e respectivos pais. Resultados: Foram incluídas 29 crianças (11 do sexo feminino) e respectivos pais. A mediana de idades (P25‑P75) foi de 8 (6‑10) anos. As crianças com 4 a 5 anos não sabiam ler o questionário; com 6‑8 eram capazes de ler / compreender as perguntas, embora referindo dificuldades para algumas expressões. As crianças com mais de 9 anos consideraram o questionário muito simples e claro. O grau de concordância entre as crianças e seus pais foi de 61%, tendo ambos considerado as ilustrações muito claras e esclarecedoras quanto aos conceitos subjacentes. Os pais concordaram que a versão destinada aos pais estava muito completa, considerando a versão da criança muito clara e adequada. Consideraram ainda a escala dicotómica como mais apropriada para crianças, em comparação com a escala de Likert do questionário aplicado aos pais. As expressões identificadas como de difícil entendimento foram alteradas. Conclusão: O questionário CARATkids é o primeiro que avalia o controlo da asma e da rinite na criança. Os testes cognitivos demonstraram a sua aplicabilidade dos 6 aos 12 anos de idade.info:eu-repo/semantics/publishedVersio

Development Process and Cognitive Testing of CARATkids - Control of Allergic Rhinitis and Asthma Test for Children

Background: Allergic rhinitis and asthma (ARA) are chronic inflammatory diseases of the airways that often coexist in children. The only tool to assess the ARA control, the Control of Allergic Rhinitis and Asthma Test (CARAT) is to be used by adults. We aimed to develop the Pediatric version of Control of Allergic Rhinitis and Asthma Test (CARATkids) and to test its comprehensibility in children with 4 to 12 years of age. Methods: The questionnaire development included a literature review of pediatric questionnaires on asthma and/or rhinitis control and two consensus meetings of a multidisciplinary group. Cognitive testing was carried out in a cross-sectional qualitative study using cognitive interviews. Results: Four questionnaires to assess asthma and none to assess rhinitis control in children were identified. The multidisciplinary group produced a questionnaire version for children with 17 questions with illustrations and dichotomous (yes/no) response format. The version for caregivers had 4-points and dichotomous scales. Twenty-nine children, 4 to 12 years old, and their caregivers were interviewed. Only children over 6 years old could adequately answer the questionnaire. A few words/expressions were not fully understood by children of 6 to 8 years old. The drawings illustrating the questions were considered helpful by children and caregivers. Caregivers considered the questionnaire complete and clear and preferred dichotomous over the 4-points scales. The proportion of agreement between children and their caregivers was 61%. The words/expressions that were difficult to understand were amended. Conclusion: CARATkids, the first questionnaire to assess a child’s asthma and rhinitis control was developed and its content validity was assured. Cognitive testing showed that CARATKids is well-understood by children 6 to 12 years old. The questionnaire’s measurement properties can now be assessed in a validation study

Successful treatment of feline leishmaniosis using an association of allopurinol and N-methyl-glucamine antimoniate

This work describes the diagnosis and successful treatment of a 2-year-old domestic cat infected with Leishmania species and presenting fever, and ulcerative and nodular skin lesions after being treated for pyodermatitis for 1 year without clinical improvement. After anamnesis the cat was submitted to a complete clinical examination. Blood was collected for determination of haematological and biochemical parameters, detection of feline leukaemia virus (FeLV), feline immunodeficiency virus (FIV), feline coronavirus (FCoV) and Leishmania amastigotes. Fine-needle aspiration puncture from the skin nodules was also performed. After definitive diagnosis the animal was treated and followed up over a 2 year period. The animal tested negative for FIV-specific antibodies, FeLV antigen and feline coronavirus RNA. Leishmania amastigotes in the skin nodules were confirmed by cytology and molecular diagnosis. Treatment was initiated with allopurinol, resulting in a slight clinical improvement. Thus, N-methyl-glucamine antimoniate was added and administered for 30 days, with complete closure of the ulcerative lesions in the hindlimbs requiring a surgical approach. Close monitoring of the patient in the following 24 months indicated that combined therapy was safe and clinical cure was achieved without further relapses or side effects.publishersversionpublishe

Two-loop RGEs with Dirac gaugino masses

The set of renormalisation group equations to two loop order for general supersymmetric theories broken by soft and supersoft operators is completed. As an example, the explicit expressions for the RGEs in a Dirac gaugino extension of the (N)MSSM are presented.Comment: 10 pages + 24 pages of RGEs in appendix; no figure

Piperidinols that show anti-tubercular activity as inhibitors of arylamine N-acetyltransferase: an essential enzyme for mycobacterial survival inside macrophages

Latent M. tuberculosis infection presents one of the major obstacles in the global eradication of tuberculosis (TB). Cholesterol plays a critical role in the persistence of M. tuberculosis within the macrophage during latent infection. Catabolism of cholesterol contributes to the pool of propionyl-CoA, a precursor that is incorporated into cell-wall lipids. Arylamine N-acetyltransferase (NAT) is encoded within a gene cluster that is involved in the cholesterol sterol-ring degradation and is essential for intracellular survival. The ability of the NAT from M. tuberculosis (TBNAT) to utilise propionyl-CoA links it to the cholesterol-catabolism pathway. Deleting the nat gene or inhibiting the NAT enzyme prevents intracellular survival and results in depletion of cell-wall lipids. TBNAT has been investigated as a potential target for TB therapies. From a previous high-throughput screen, 3-benzoyl-4-phenyl-1-methylpiperidinol was identified as a selective inhibitor of prokaryotic NAT that exhibited antimycobacterial activity. The compound resulted in time-dependent irreversible inhibition of the NAT activity when tested against NAT from M. marinum (MMNAT). To further evaluate the antimycobacterial activity and the NAT inhibition of this compound, four piperidinol analogues were tested. All five compounds exert potent antimycobacterial activity against M. tuberculosis with MIC values of 2.3-16.9 µM. Treatment of the MMNAT enzyme with this set of inhibitors resulted in an irreversible time-dependent inhibition of NAT activity. Here we investigate the mechanism of NAT inhibition by studying protein-ligand interactions using mass spectrometry in combination with enzyme analysis and structure determination. We propose a covalent mechanism of NAT inhibition that involves the formation of a reactive intermediate and selective cysteine residue modification. These piperidinols present a unique class of antimycobacterial compounds that have a novel mode of action different from known anti-tubercular drugs

Validation of control of allergic rhinitis and asthma test for children (CARATKids)--a prospective multicenter study

BACKGROUND: Control of Allergic Rhinitis and Asthma Test for Children (CARATKids) is the first questionnaire that assesses simultaneously allergic rhinitis and asthma control in children. It was recently developed, but redundancy of questions and its psychometric properties were not assessed. This study aimed to (i) establish the final version of the CARATKids questionnaire and (ii) evaluate its reliability, responsiveness, cross-sectional validity, and longitudinal validity. METHODS: A prospective observational study was conducted in 11 Portuguese centers. During two visits separated by 6 wk, CARATKids, visual analog scale scales and childhood asthma control test were completed, and participant's asthma and rhinitis were evaluated by his/her physician without knowing the questionnaires' results. Data-driven item reduction was conducted, and internal consistency, responsiveness analysis, and associations with external measures of disease status were assessed. RESULTS: Of the 113 children included, 101 completed both visits. After item reduction, the final version of the questionnaire has 13 items, eight to be answered by the child and five by the caregiver. Its Cronbach's alpha was 0.80, the Guyatt's responsiveness index was -1.51, and a significant (p < 0.001) within-patient change of CARATKids score in clinical unstable patients was observed. Regarding cross-sectional validity, correlation coefficients of CARATKids with the external measures of control were between 0.45 and -0.69 and met the a priori predictions. In the longitudinal validity assessment, the correlation coefficients between the score changes of CARATKids and those of external measures of control ranged from 0.34 to 0.46