Synaptic transmission depends on the regulated surface expression of neurotransmitter receptors, ... more Synaptic transmission depends on the regulated surface expression of neurotransmitter receptors, but many of the cellular processes required to achieve this remain poorly understood. To better define specific mechanisms for the GABAB receptor (GABABR) trafficking, we screened for proteins that bind to the carboxy-terminus of the GABAB1 subunit. We report the identification and characterization of a novel 130-kDa protein, GPCR interacting scaffolding protein (GISP), that interacts directly with the GABAB1 subunit via a coiled-coil domain. GISP co-fractionates with GABABR and with the postsynaptic density and co-immunoprecipitates with GABAB1 and GABAB2 from rat brain. In cultured hippocampal neurons, GISP displays a punctate dendritic distribution and has an overlapping localization with GABABRs. When co-expressed with GABABRs in human embryonic kidney cells, GISP promotes GABABR surface expression and enhances both baclofen-evoked extracellular signal-regulated kinase (ERK) phosphorylation and G-protein inwardly rectifying potassium channel (GIRK) currents. These results suggest that GISP is involved in the forward trafficking and stabilization of functional GABABRs.
Objectives To create a new tetanus score and compare it with the Phillips and Dakar scores.Metho... more Objectives To create a new tetanus score and compare it with the Phillips and Dakar scores.Methods We used prospectively acquired data from consecutive patients admitted to the Hospital for Tropical Diseases, Ho Chi Minh City, to create the Tetanus Severity Score (TSS) with multivariate logistic regression. We compared the new score with Phillips and Dakar scores by means of resubstituted and prospective data, assessing performance in terms of sensitivity, specificity and area under receiver operator characteristic curves.Results Resubstitution testing yielded a sensitivity of 77% (298/385) and a specificity of 82% (1183/1437) for the TSS; 89% (342/385) and 20% (281/1437) for the Phillips score; and 13% (49/385) and 98% (1415/1437) for the Dakar score. The TSS showed greatest discrimination with 0.89 area under the receiver operator characteristic curve (95% CI 0.88–0.90); this was 0.74 for the Dakar score and (95% CI 0.71–0.77) and 0.66 for the Phillips score (95% CI 0.63–0.70; P values <0.001). Prospective testing showed 65% (13/20) sensitivity and 91% (210/230) specificity for the TSS; 80% (16/20) and 51% (118/230) for the Phillips score; and 25% (5/20) and 96% (221/230) for the Dakar score. The TSS achieved the greatest area under TSS of 0.89 (95% CI 0.82–0.96), significantly greater than the Phillips score [0.74 (0.6–0.88), P = 0.049] but not the Dakar score [0.80, (0.71–0.90), P = 0.090].Conclusions The TSS is the first prospectively developed classification scheme for tetanus and should be adopted to aid clinical triage and management and as a basis for clinical research.Objectifs Créer un nouveau score de tétanos et le comparer à ceux de Philips et de Dakar.Méthodes Nous avons utilisé des données obtenues prospectivement de patients consécutifs admis à l'Hôpital des Maladies Tropicales de Ho Chi Minh, pour créer le Score de Sévérité de Tétanos avec une régression logistique multivariée. Nous avons comparé le nouveau score à ceux de Phillips et de Dakar au moyen de données re-substituées et prospectives, en évaluant la performance en terme de sensibilité, spécificité et aires sous la courbe.Résultats Le test de re-substitution a démontré une sensibilité de 77% (289/385) et une spécificité de 82% (1183/1437) pour le Score de Sévérité du Tétanos; 89% (342/385) et 20% (281/1437) pour le score de Phillips; 13% (49/385) et 98% (1415/1437) pour le score de Dakar. Le Score de Sévérité du Tétanos a démontré la plus haute discrimination avec une aire sous la courbe de 0.89 (IC95%: 0.88–0.90). Celle-ci était de 0.74 pour le score de Dakar (IC95%; 0.71–0.77) et 0.66 pour le score de Phillips (IC95%; 0.63–0.70) (P < 0.001). Le résultat du test prospectif a démontré une sensibilité de 65% (13/20) et une spécificité de 91% (210/230) pour le Score de Sévérité du Tétanos; 80% (16/20) et 51% (118/230) pour le score de Phillips; 25% (5/20) et 96% (221/230) pour le score de Dakar. Le Score de Sévérité du Tétanos atteignait la plus grande valeur de l'aire sous la courbe [0.89 (IC95%; 0.82–0.96)], significativement plus élevée que celle du score de Phillips [0.74 (0.6–0.88); P = 0.049] mais moins que celle de Dakar [0.80; (0.71–0.90); P = 0.090].Conclusions Le Score de Sévérité du Tétanos est le premier schéma prospectif développé pour la classification du tétanos et devrait être adopté pour aider au triage et à la prise en charge clinique et aussi comme base de recherche clinique.Objectifs Créer un nouveau score de tétanos et le comparer à ceux de Philips et de Dakar.Méthodes Nous avons utilisé des données obtenues prospectivement de patients consécutifs admis à l'Hôpital des Maladies Tropicales de Ho Chi Minh, pour créer le Score de Sévérité de Tétanos avec une régression logistique multivariée. Nous avons comparé le nouveau score à ceux de Phillips et de Dakar au moyen de données re-substituées et prospectives, en évaluant la performance en terme de sensibilité, spécificité et aires sous la courbe.Résultats Le test de re-substitution a démontré une sensibilité de 77% (289/385) et une spécificité de 82% (1183/1437) pour le Score de Sévérité du Tétanos; 89% (342/385) et 20% (281/1437) pour le score de Phillips; 13% (49/385) et 98% (1415/1437) pour le score de Dakar. Le Score de Sévérité du Tétanos a démontré la plus haute discrimination avec une aire sous la courbe de 0.89 (IC95%: 0.88–0.90). Celle-ci était de 0.74 pour le score de Dakar (IC95%; 0.71–0.77) et 0.66 pour le score de Phillips (IC95%; 0.63–0.70) (P < 0.001). Le résultat du test prospectif a démontré une sensibilité de 65% (13/20) et une spécificité de 91% (210/230) pour le Score de Sévérité du Tétanos; 80% (16/20) et 51% (118/230) pour le score de Phillips; 25% (5/20) et 96% (221/230) pour le score de Dakar. Le Score de Sévérité du Tétanos atteignait la plus grande valeur de l'aire sous la courbe [0.89 (IC95%; 0.82–0.96)], significativement plus élevée que celle du score de Phillips [0.74 (0.6–0.88); P = 0.049] mais moins que celle de Dakar [0.80; (0.71–0.90); P = 0.090].Conclusions Le Score de Sévérité du Tétanos est le premier schéma prospectif développé pour la classification du tétanos et devrait être adopté pour aider au triage et à la prise en charge clinique et aussi comme base de recherche clinique.Objetivos Crear una nueva escala para el tétano y compararla con las de Phillips y Dakar.Métodos Se utilizaron datos prospectivos de pacientes consecutivos admitidos en el Hospital de Enfermedades Tropicales de la ciudad de Ho Chi Minh, con el fin de crear la Escala de Severidad del Tétano utilizando regresión logística multivariada. Comparamos la nueva escala con las de Phillips y Dakar mediante datos resustituidos y prospectivos, evaluando el desempeño en términos de sensibilidad, especificidad y área bajo la curva característica operador-receptor.Resultados La prueba de resustitución tuvo una sensibilidad del 77% (298/385) y una especificidad del 82% (1183/1437) para la Escala de Severidad del Tétano; 89% (342/385) y 20% (281/1437) para la escala de Phillips; y 13% (49/385) y 98% (1415/1437) para la escala de Dakar. La Escala de Severidad del Tétano mostró una mayor discriminación con un área baja la curva característica operador-receptor de 0.89 (95% IC 0.88–0.90); para la escala de Dakar fue de 0.74 (95% IC 0.71–0.77) y de 0.66 para la escala de Phillips (95% IC 0.63–0.70) (P < 0.001).Las pruebas prospectivas mostraron un 65% (13/20) de sensibilidad y un 91% (210/230) de especificidad para la Escala de Severidad del Tétano; 80% (16/20) y 51% (118/230) para la escala de Phillips; y 25% (5/20) y 96% (221/230) para la de Dakar. La Escala de Severidad del Tétano alcanzó la mayor área bajo una escala de severidad del tétano de 0.89 (95% IC 0.82–0.96), significativamente mayor que para la escala de Phillips (0.74 (0.6–0.88), P = 0.049) pero no la de Dakar (0.80, (0.71–0.90), P = 0.090).Conclusiones La Escala de Severidad del Tétano es el primer sistema de clasificación desarrollado prospectivamente para el tétano y debería adoptarse con el fin de ayudar en la clasificación y el manejo clínico, así como una base para la investigación clínica.Objetivos Crear una nueva escala para el tétano y compararla con las de Phillips y Dakar.Métodos Se utilizaron datos prospectivos de pacientes consecutivos admitidos en el Hospital de Enfermedades Tropicales de la ciudad de Ho Chi Minh, con el fin de crear la Escala de Severidad del Tétano utilizando regresión logística multivariada. Comparamos la nueva escala con las de Phillips y Dakar mediante datos resustituidos y prospectivos, evaluando el desempeño en términos de sensibilidad, especificidad y área bajo la curva característica operador-receptor.Resultados La prueba de resustitución tuvo una sensibilidad del 77% (298/385) y una especificidad del 82% (1183/1437) para la Escala de Severidad del Tétano; 89% (342/385) y 20% (281/1437) para la escala de Phillips; y 13% (49/385) y 98% (1415/1437) para la escala de Dakar. La Escala de Severidad del Tétano mostró una mayor discriminación con un área baja la curva característica operador-receptor de 0.89 (95% IC 0.88–0.90); para la escala de Dakar fue de 0.74 (95% IC 0.71–0.77) y de 0.66 para la escala de Phillips (95% IC 0.63–0.70) (P < 0.001).Las pruebas prospectivas mostraron un 65% (13/20) de sensibilidad y un 91% (210/230) de especificidad para la Escala de Severidad del Tétano; 80% (16/20) y 51% (118/230) para la escala de Phillips; y 25% (5/20) y 96% (221/230) para la de Dakar. La Escala de Severidad del Tétano alcanzó la mayor área bajo una escala de severidad del tétano de 0.89 (95% IC 0.82–0.96), significativamente mayor que para la escala de Phillips (0.74 (0.6–0.88), P = 0.049) pero no la de Dakar (0.80, (0.71–0.90), P = 0.090).Conclusiones La Escala de Severidad del Tétano es el primer sistema de clasificación desarrollado prospectivamente para el tétano y debería adoptarse con el fin de ayudar en la clasificación y el manejo clínico, así como una base para la investigación clínica.
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2004
Unvaccinated individuals throughout the world are vulnerable to tetanus, but there are few data r... more Unvaccinated individuals throughout the world are vulnerable to tetanus, but there are few data regarding the impact of focused vaccination programmes and modern intensive care facilities on the disease, particularly in the developing world. The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam admitted 2422 patients with tetanus aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =1 year between April 1993 and December 2002, during which time vaccine coverage and treatment facilities improved. The proportion of children &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or =10 years old admitted with tetanus fell from 11.1 to 5.6% over the 10 year period (P = 0.002). The proportion of women aged 20-40 years fell from 10.1 to 1.2% (P…
Childhood asthma and atopy prevalence patterns in the developing world are only beginning to be d... more Childhood asthma and atopy prevalence patterns in the developing world are only beginning to be defined. No such information exists for Vietnam. Estimates would assist in anticipating health service needs as well as add to the growing database on global patterns of atopy. To estimate the prevalence of atopic symptoms in school children in Ha Noi, Vietnam, a cross-sectional survey was conducted of children aged 5- to 11-years-old in two schools using the parent self-administered International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The response rate was 66.4% (969 responses). The overall prevalence of selected symptoms were: ‘ever wheezed’ 24.9%, ‘wheezed in past 12 months’ 14.9%, ‘ever had asthma’ 12.1%, ‘doctor-diagnosed asthma’ 13.9%, ‘ever experienced allergic rhinitis (AR) symptoms’ 34.9%, ‘AR-conjunctivitis symptoms in past 12 months’ 10.7%, ‘ever had hay fever’ 7.8%, ‘doctor-diagnosed hay fever’ 11.2%, ‘ever had eczema’ 3.3% and ‘doctor-diagnosed eczema’ 3.2%. Kappa statistics demonstrated high within symptom category consistency for ‘ever had asthma/doctor-diagnosed asthma’ (0.728) and ‘ever had eczema/doctor-diagnosed eczema’ (0.906). Age and gender adjusted odds ratios (OR) were also consistently significant across wheeze and allergic rhinitis symptom categories [highest OR = 10.10 (95% CI 6.23–16.35) between allergic rhinoconjunctivitis and wheeze in past 12 months]. There is a high prevalence of ISAAC-based symptoms in school children in Ha Noi, Vietnam, often above global averages. The high level of association between atopic symptoms suggests some degree of reliability and validity. Childhood atopy symptom prevalence in Vietnam is more similar to that in developed countries rather than developing countries.
Synaptic transmission depends on the regulated surface expression of neurotransmitter receptors, ... more Synaptic transmission depends on the regulated surface expression of neurotransmitter receptors, but many of the cellular processes required to achieve this remain poorly understood. To better define specific mechanisms for the GABAB receptor (GABABR) trafficking, we screened for proteins that bind to the carboxy-terminus of the GABAB1 subunit. We report the identification and characterization of a novel 130-kDa protein, GPCR interacting scaffolding protein (GISP), that interacts directly with the GABAB1 subunit via a coiled-coil domain. GISP co-fractionates with GABABR and with the postsynaptic density and co-immunoprecipitates with GABAB1 and GABAB2 from rat brain. In cultured hippocampal neurons, GISP displays a punctate dendritic distribution and has an overlapping localization with GABABRs. When co-expressed with GABABRs in human embryonic kidney cells, GISP promotes GABABR surface expression and enhances both baclofen-evoked extracellular signal-regulated kinase (ERK) phosphorylation and G-protein inwardly rectifying potassium channel (GIRK) currents. These results suggest that GISP is involved in the forward trafficking and stabilization of functional GABABRs.
Objectives To create a new tetanus score and compare it with the Phillips and Dakar scores.Metho... more Objectives To create a new tetanus score and compare it with the Phillips and Dakar scores.Methods We used prospectively acquired data from consecutive patients admitted to the Hospital for Tropical Diseases, Ho Chi Minh City, to create the Tetanus Severity Score (TSS) with multivariate logistic regression. We compared the new score with Phillips and Dakar scores by means of resubstituted and prospective data, assessing performance in terms of sensitivity, specificity and area under receiver operator characteristic curves.Results Resubstitution testing yielded a sensitivity of 77% (298/385) and a specificity of 82% (1183/1437) for the TSS; 89% (342/385) and 20% (281/1437) for the Phillips score; and 13% (49/385) and 98% (1415/1437) for the Dakar score. The TSS showed greatest discrimination with 0.89 area under the receiver operator characteristic curve (95% CI 0.88–0.90); this was 0.74 for the Dakar score and (95% CI 0.71–0.77) and 0.66 for the Phillips score (95% CI 0.63–0.70; P values <0.001). Prospective testing showed 65% (13/20) sensitivity and 91% (210/230) specificity for the TSS; 80% (16/20) and 51% (118/230) for the Phillips score; and 25% (5/20) and 96% (221/230) for the Dakar score. The TSS achieved the greatest area under TSS of 0.89 (95% CI 0.82–0.96), significantly greater than the Phillips score [0.74 (0.6–0.88), P = 0.049] but not the Dakar score [0.80, (0.71–0.90), P = 0.090].Conclusions The TSS is the first prospectively developed classification scheme for tetanus and should be adopted to aid clinical triage and management and as a basis for clinical research.Objectifs Créer un nouveau score de tétanos et le comparer à ceux de Philips et de Dakar.Méthodes Nous avons utilisé des données obtenues prospectivement de patients consécutifs admis à l'Hôpital des Maladies Tropicales de Ho Chi Minh, pour créer le Score de Sévérité de Tétanos avec une régression logistique multivariée. Nous avons comparé le nouveau score à ceux de Phillips et de Dakar au moyen de données re-substituées et prospectives, en évaluant la performance en terme de sensibilité, spécificité et aires sous la courbe.Résultats Le test de re-substitution a démontré une sensibilité de 77% (289/385) et une spécificité de 82% (1183/1437) pour le Score de Sévérité du Tétanos; 89% (342/385) et 20% (281/1437) pour le score de Phillips; 13% (49/385) et 98% (1415/1437) pour le score de Dakar. Le Score de Sévérité du Tétanos a démontré la plus haute discrimination avec une aire sous la courbe de 0.89 (IC95%: 0.88–0.90). Celle-ci était de 0.74 pour le score de Dakar (IC95%; 0.71–0.77) et 0.66 pour le score de Phillips (IC95%; 0.63–0.70) (P < 0.001). Le résultat du test prospectif a démontré une sensibilité de 65% (13/20) et une spécificité de 91% (210/230) pour le Score de Sévérité du Tétanos; 80% (16/20) et 51% (118/230) pour le score de Phillips; 25% (5/20) et 96% (221/230) pour le score de Dakar. Le Score de Sévérité du Tétanos atteignait la plus grande valeur de l'aire sous la courbe [0.89 (IC95%; 0.82–0.96)], significativement plus élevée que celle du score de Phillips [0.74 (0.6–0.88); P = 0.049] mais moins que celle de Dakar [0.80; (0.71–0.90); P = 0.090].Conclusions Le Score de Sévérité du Tétanos est le premier schéma prospectif développé pour la classification du tétanos et devrait être adopté pour aider au triage et à la prise en charge clinique et aussi comme base de recherche clinique.Objectifs Créer un nouveau score de tétanos et le comparer à ceux de Philips et de Dakar.Méthodes Nous avons utilisé des données obtenues prospectivement de patients consécutifs admis à l'Hôpital des Maladies Tropicales de Ho Chi Minh, pour créer le Score de Sévérité de Tétanos avec une régression logistique multivariée. Nous avons comparé le nouveau score à ceux de Phillips et de Dakar au moyen de données re-substituées et prospectives, en évaluant la performance en terme de sensibilité, spécificité et aires sous la courbe.Résultats Le test de re-substitution a démontré une sensibilité de 77% (289/385) et une spécificité de 82% (1183/1437) pour le Score de Sévérité du Tétanos; 89% (342/385) et 20% (281/1437) pour le score de Phillips; 13% (49/385) et 98% (1415/1437) pour le score de Dakar. Le Score de Sévérité du Tétanos a démontré la plus haute discrimination avec une aire sous la courbe de 0.89 (IC95%: 0.88–0.90). Celle-ci était de 0.74 pour le score de Dakar (IC95%; 0.71–0.77) et 0.66 pour le score de Phillips (IC95%; 0.63–0.70) (P < 0.001). Le résultat du test prospectif a démontré une sensibilité de 65% (13/20) et une spécificité de 91% (210/230) pour le Score de Sévérité du Tétanos; 80% (16/20) et 51% (118/230) pour le score de Phillips; 25% (5/20) et 96% (221/230) pour le score de Dakar. Le Score de Sévérité du Tétanos atteignait la plus grande valeur de l'aire sous la courbe [0.89 (IC95%; 0.82–0.96)], significativement plus élevée que celle du score de Phillips [0.74 (0.6–0.88); P = 0.049] mais moins que celle de Dakar [0.80; (0.71–0.90); P = 0.090].Conclusions Le Score de Sévérité du Tétanos est le premier schéma prospectif développé pour la classification du tétanos et devrait être adopté pour aider au triage et à la prise en charge clinique et aussi comme base de recherche clinique.Objetivos Crear una nueva escala para el tétano y compararla con las de Phillips y Dakar.Métodos Se utilizaron datos prospectivos de pacientes consecutivos admitidos en el Hospital de Enfermedades Tropicales de la ciudad de Ho Chi Minh, con el fin de crear la Escala de Severidad del Tétano utilizando regresión logística multivariada. Comparamos la nueva escala con las de Phillips y Dakar mediante datos resustituidos y prospectivos, evaluando el desempeño en términos de sensibilidad, especificidad y área bajo la curva característica operador-receptor.Resultados La prueba de resustitución tuvo una sensibilidad del 77% (298/385) y una especificidad del 82% (1183/1437) para la Escala de Severidad del Tétano; 89% (342/385) y 20% (281/1437) para la escala de Phillips; y 13% (49/385) y 98% (1415/1437) para la escala de Dakar. La Escala de Severidad del Tétano mostró una mayor discriminación con un área baja la curva característica operador-receptor de 0.89 (95% IC 0.88–0.90); para la escala de Dakar fue de 0.74 (95% IC 0.71–0.77) y de 0.66 para la escala de Phillips (95% IC 0.63–0.70) (P < 0.001).Las pruebas prospectivas mostraron un 65% (13/20) de sensibilidad y un 91% (210/230) de especificidad para la Escala de Severidad del Tétano; 80% (16/20) y 51% (118/230) para la escala de Phillips; y 25% (5/20) y 96% (221/230) para la de Dakar. La Escala de Severidad del Tétano alcanzó la mayor área bajo una escala de severidad del tétano de 0.89 (95% IC 0.82–0.96), significativamente mayor que para la escala de Phillips (0.74 (0.6–0.88), P = 0.049) pero no la de Dakar (0.80, (0.71–0.90), P = 0.090).Conclusiones La Escala de Severidad del Tétano es el primer sistema de clasificación desarrollado prospectivamente para el tétano y debería adoptarse con el fin de ayudar en la clasificación y el manejo clínico, así como una base para la investigación clínica.Objetivos Crear una nueva escala para el tétano y compararla con las de Phillips y Dakar.Métodos Se utilizaron datos prospectivos de pacientes consecutivos admitidos en el Hospital de Enfermedades Tropicales de la ciudad de Ho Chi Minh, con el fin de crear la Escala de Severidad del Tétano utilizando regresión logística multivariada. Comparamos la nueva escala con las de Phillips y Dakar mediante datos resustituidos y prospectivos, evaluando el desempeño en términos de sensibilidad, especificidad y área bajo la curva característica operador-receptor.Resultados La prueba de resustitución tuvo una sensibilidad del 77% (298/385) y una especificidad del 82% (1183/1437) para la Escala de Severidad del Tétano; 89% (342/385) y 20% (281/1437) para la escala de Phillips; y 13% (49/385) y 98% (1415/1437) para la escala de Dakar. La Escala de Severidad del Tétano mostró una mayor discriminación con un área baja la curva característica operador-receptor de 0.89 (95% IC 0.88–0.90); para la escala de Dakar fue de 0.74 (95% IC 0.71–0.77) y de 0.66 para la escala de Phillips (95% IC 0.63–0.70) (P < 0.001).Las pruebas prospectivas mostraron un 65% (13/20) de sensibilidad y un 91% (210/230) de especificidad para la Escala de Severidad del Tétano; 80% (16/20) y 51% (118/230) para la escala de Phillips; y 25% (5/20) y 96% (221/230) para la de Dakar. La Escala de Severidad del Tétano alcanzó la mayor área bajo una escala de severidad del tétano de 0.89 (95% IC 0.82–0.96), significativamente mayor que para la escala de Phillips (0.74 (0.6–0.88), P = 0.049) pero no la de Dakar (0.80, (0.71–0.90), P = 0.090).Conclusiones La Escala de Severidad del Tétano es el primer sistema de clasificación desarrollado prospectivamente para el tétano y debería adoptarse con el fin de ayudar en la clasificación y el manejo clínico, así como una base para la investigación clínica.
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2004
Unvaccinated individuals throughout the world are vulnerable to tetanus, but there are few data r... more Unvaccinated individuals throughout the world are vulnerable to tetanus, but there are few data regarding the impact of focused vaccination programmes and modern intensive care facilities on the disease, particularly in the developing world. The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam admitted 2422 patients with tetanus aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =1 year between April 1993 and December 2002, during which time vaccine coverage and treatment facilities improved. The proportion of children &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or =10 years old admitted with tetanus fell from 11.1 to 5.6% over the 10 year period (P = 0.002). The proportion of women aged 20-40 years fell from 10.1 to 1.2% (P…
Childhood asthma and atopy prevalence patterns in the developing world are only beginning to be d... more Childhood asthma and atopy prevalence patterns in the developing world are only beginning to be defined. No such information exists for Vietnam. Estimates would assist in anticipating health service needs as well as add to the growing database on global patterns of atopy. To estimate the prevalence of atopic symptoms in school children in Ha Noi, Vietnam, a cross-sectional survey was conducted of children aged 5- to 11-years-old in two schools using the parent self-administered International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The response rate was 66.4% (969 responses). The overall prevalence of selected symptoms were: ‘ever wheezed’ 24.9%, ‘wheezed in past 12 months’ 14.9%, ‘ever had asthma’ 12.1%, ‘doctor-diagnosed asthma’ 13.9%, ‘ever experienced allergic rhinitis (AR) symptoms’ 34.9%, ‘AR-conjunctivitis symptoms in past 12 months’ 10.7%, ‘ever had hay fever’ 7.8%, ‘doctor-diagnosed hay fever’ 11.2%, ‘ever had eczema’ 3.3% and ‘doctor-diagnosed eczema’ 3.2%. Kappa statistics demonstrated high within symptom category consistency for ‘ever had asthma/doctor-diagnosed asthma’ (0.728) and ‘ever had eczema/doctor-diagnosed eczema’ (0.906). Age and gender adjusted odds ratios (OR) were also consistently significant across wheeze and allergic rhinitis symptom categories [highest OR = 10.10 (95% CI 6.23–16.35) between allergic rhinoconjunctivitis and wheeze in past 12 months]. There is a high prevalence of ISAAC-based symptoms in school children in Ha Noi, Vietnam, often above global averages. The high level of association between atopic symptoms suggests some degree of reliability and validity. Childhood atopy symptom prevalence in Vietnam is more similar to that in developed countries rather than developing countries.
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