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Objective To investigate the clinical and audiological characteristics of non-elder patients with relapsing polychondritis (RP).Methods Clinical and audiological data of patients with RP under 60 years old were collected consecutively and analyzed.The t-test and Mann-Whitney U test were used for statistical analysis between the two groups in quantitative data in normal distribution and non-normal distribution respectively,while Chi-square test was use for qualitative data analysis.Results One hundred and seventy four patients with complete data who fulfilled the Michet criteria were enrolled with a M∶F=1∶1.1.The mean age of disease onset was (39±13) (8-60) years;the median time of disease duration was 12 (1-480) months;the median relapsing polychondritis disease activity index (RPDAI) was 38(10-77) and the median RPODI was 2.4(0.1-56).Auricular chondritis (32.8％,57/174),ocular involvement (24.7％,43/174) and airway chonchritis (21.3％,37/174) were the top three onset-pattern.All parts of external,middle and inner ear were involved in RP.Inner-ear damage was the most common (95.4％,166/174) with insidious cochlea and vestibule equally distributed.Auricular chondritis was predominant in external ear involvement (55.2％,96/174);ET dysfunction was included in eardrum abnormalities of neglected middle-ear involvement (29.9％,52/174).Positive HL by active detection was 71.8％(125/174) with 14.3(25/174) HL fulfilled world health organization (WHO)-2006 criteria,including 52.0％(13/25) disabling HL.Sensorineural hearing loss (SNHL) was predominant in RP after 21 years old while 60.0％(6/10) was seen in childhood RP with non-SNHL.At least two parts of ear involvement were seen in almost all patients with heavy overlap.Conclusion All parts of ear are involved in non-elder RP with age related clinical characteristics.Active detection is a key to find insidious middle-and inner-ear involvement for early RP recognition.RPODI is a potential marker for RP evaluation.
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En el presente artículo se realiza un recorrido histórico de la Valoración del Daño Corporal, desde la época anterior a la escritura hasta nuestros días. La disciplina de Valoración del Daño Corporal es de gran utilidad en los Estados de Derecho donde se valoran consecuencias de diversos tipos de lesiones físicas y psicológicas, ya sea en materia penal o laboral, por lo que es de obligatorio manejo por parte de los Médicos Forenses y de al menos conocimiento básico de la comunidad médica en general. Con la premisa de la mejor forma de adentrarse en una disciplina es conocer su historia este artículo pretende abordar desde sus orígenes este tema, con las motivaciones de las que surgió y por tanto de su función actual en la sociedad civilizada.
The following article presents a historical journey of the corporal damage evaluation, beginning on the time prior to hand writting and until the present day. Corporal damage evaluation is an important tool when in a State of Rights, where the need of measuring the diverse types of physical o psycological traumas in labour issues o penal maters, become an escential subjet of knowledge for Forensic and General practitioners. Starting out from de premise that the best way to inmerse into a descipline is by knowing its origins, the present review was done in a way that we can approach the subject from its beginnings, the motivations of its creation and the final purpose it acomplishes in the present civilized society.
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Humanos , Medicina Legal , Historia de la MedicinaRESUMEN
Aceria guerreronis Keifer é importante praga do coqueiro no mundo. Dada a falta de métodos padronizados para a quantificação dos danos causados por esse eriofiídeo, uma escala diagramática com níveis de 1, 2, 4, 8, 16, 32, 48 e 70% de danos foi elaborada e testada para precisão e reprodutibilidade das estimativas. Para validar a escala, frutos com diferentes níveis de dano foram previamente avaliados com o programa Assess e submetidos à avaliação por 10 avaliadores inexperientes com e sem a escala (1ª avaliação) e sete dias após (2ª avaliação) com os mesmos avaliadores, empregandose as fotos digitalizadas dos mesmos frutos com seqüência diferente. A acurácia e a precisão de cada avaliador foram determinadas por regressão linear simples entre o dano observado e estimado. Sem a utilização da escala, sete de 10 avaliadores superestimaram o nível de dano, sendo pouco precisos. No entanto, avaliadores utilizando a escala obtiveram melhores níveis de acurácia e precisão. Osavaliadores apresentaram níveis mais elevados de reprodutibilidade das estimativas com a utilização da escala comparada às avaliações sem a escala. A escala foi utilizada para determinar a relação entre a infestação e o dano causado por A. guerreronis. A relação entre infestação e níveis de dano apresentou elevada precisão (R2 = 99,87%, P < 0,0001) pela equação lny = 4,948 - 0,121 x + 1,789 lnx. Portanto,os resultados comprovam que é possível estimar a população de A. guerreronis nos frutos de coco infestados com a utilização da escala diagramática.
Aceria guerreronis Keifer is an important pest of coconut worldwide. Due to the lack of standardized methods to quantify damage of this eryophyid, a diagrammatic scale with indices of 1, 2, 4, 8, 16, 32, 48 and 70% of damage caused by A. guerreronis was elaborated and tested to accuracy, precision and reproduction of the estimations. To validate the scale, fruits with different levels of damage were previously measured with the program Assess and submitted to 10 inexperienced evaluators with or without the scale (1ª evaluation) and seven days after (2ª evaluation) with the same evaluators, using digitized pictures of the same fruits in a different sequence. The accuracy and precision of each evaluator was determined through linear regression between observed and estimated damage. Without using the scale, evaluators were less precise as seven out of 10 overestimated the damage, while evaluators provided with the scale were much more accurate. Also, evaluations with the aid of the scale were much more reproducible than without the scale. The scale was used to determine the relationship between infestation and damage levels caused by A. guerrerronis. The relationshipbetween infestation and damage fi tted by the equation lny = 4.948 - 0.121x + 1.789 lnx (R2 = 99.87%, P < 0.0001). Therefore, these fi ndings show that it is possible to estimate A. guerreronis population density on infested coconut fruits by using the diagrammatic scale.