Reliability of Visual Analog Scale and Numeric Rating Scale for the Assessment of Disease Activity in Systemic Lupus Erythematosus.

OBJECTIVE: To determine the reliability of SLE patients' disease activity measurements. METHODS: This was a cross-sectional study conducted (August 2016-December 2017) at 2 main public Peruvian hospitals, 1 with a comprehensive lupus care program. Patients assessed their disease activity with a visual analog scale (VAS) (0-100 mm) or a numerical rating scale (NRS) (0-4) before and after their physician's (MD's) assessment. Demographic and disease-related characteristics were recorded. Reliability of patients' disease activity before and after MD's assessment was determined using Spearman rank correlation. Factors possibly associated with this variability were examined with Spearman rank correlation and Mann-Whitney U test. RESULTS: Two hundred forty, mostly Mestizo, SLE patients were included; mean (SD) age and disease duration (diagnosis) were 34.9 (12.9) years and 10.1 (7.0) years, respectively. The Mexican version of the Systemic Lupus Erythematosus Disease Activity Index was 1.9 (2.7), and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index was 1.2 (1.5). The correlations between NRS and VAS before and after the MD's assessment were ρ = 0.839; p < 0.001; and ρ = 0.872; p < 0.001, respectively. Visual analog scale and NRS were higher before than after the MD's assessment (VAS 29.3 [26.5] and 26.5 [24.9], p = 0.052; and NRS (1.5 [1.2] and 1.3 [1.1], p = 0.003); only the comprehensive program explained this variability (p = 0.043). The reliability of VAS and NRS was ρ = 0.917 and ρ = 0.861, p < 0.001, before and after for the comprehensive program and ρ = 0.710 and ρ = 0.785, p < 0.001, for before and after for the regular program. CONCLUSIONS: Both VAS an NRS are highly reliable. Patients scored higher before than after their physicians' assessment but that these differences were smaller for the patients in the comprehensive care program than in the regular one.

Discrepant Perception of Lupus Disease Activity: A Comparison Between Patients' and Physicians' Disease Activity Scores.

OBJECTIVE: The aim of this study was to compare patient and physician (MD) assessment of disease activity in systemic lupus erythematosus patients. METHODS: This cross-sectional study was conducted between August 2016 and December 2017 at 2 Peruvian hospitals. One group assessed disease activity using a visual analog scale (VAS, 0-100 mm) and the other one using a numerical rating scale (NRS, 0-4), before and after their MD's visit. MDs assessed it with the Mexican Systemic Lupus Erythematosus Disease Activity (Mex-SLEDAI) (0-32) and with the SLICC/ACR Damage Index (SDI) for damage. Health-related quality of life was ascertained with the LupusQoL. Visual analog scale and NRS were compared using the Wilcoxon signed-rank test and the correlation between disease activity as assessed by the patient and the Mex-SLEDAI, SDI, and LupusQoL with the Spearman rank correlation. RESULTS: Two hundred forty patients were included; mean (SD) age at diagnosis was 34.9 (12.9) years; most patients were Mestizo. Disease duration was 10.1 (7.0) years. The Mex-SLEDAI was 1.9 (2.7) and the SDI 1.2 (1.5). Disease activity as assessed by the patient, either by VAS or NRS, did not correlate with the Mex-SLEDAI or the SDI. In contrast, patient assessment of disease activity, by VAS or NRS, significantly correlated with several components of the LupusQoL (physical health, pain, planning, emotional health, and fatigue). CONCLUSIONS: Physician's and patient's assessments of disease activity are discrepant; overall, patients score higher than their MDs. Patients score how they perceive the disease is affecting them, rather than disease activity per se. The VAS could be more useful than the NRS as a measurement of disease activity.

Ultrasound-assisted crystallization of lactose in the presence of whey proteins and κ-carrageenan.

The conventional process of lactose crystallization is prolonged, hardly controllable and the crystals have low quality. In this work, the effect of ultrasound on the crystallization of lactose in an aqueous system was assessed. Additionally, it was studied how the presence of whey proteins (which are a common impurity) and κ-carrageenan (that possess high water-binding capacity) could modify the process of lactose crystallization. Lactose solutions at 25% were sonicated in a continuous flow chamber at two different energy densities (9 and 50 J mL-1) before the start of crystallization. Some of these lactose solutions were previously added with κ-carrageenan (0, 150 and 300 mg L-1), with whey proteins (0.64%) or with both at the same time. Ultrasound sped up the rate of crystallization, decreased the crystal's size and narrowed the crystal size distribution (CSD). The presence of whey proteins accelerated the process of crystallization but induced the formation of amorphous lactose. Likewise, the rate of lactose crystallization was improved by the addition of 150 mg L-1 of carrageenan. Whereas, the combination of carrageenan and whey proteins generated the smallest crystals (6 µm), the narrowest CSD and minimized the formation of amorphous lactose.

Distribución dettortugas continentales del caribe Colombiano / Distribution of Tortoises and Freshwater Turtles of the Colombian Caribbean

Este estudio revisa la distribución para el Caribe colombiano de las especies Kinosternon scorpioides, Trachemys callirostris, Mesoclemmys dahli y Chelonoidis carbonaria y nuevas localidades en la distribución de dichas especies para la región. La especie K. scorpioides es registrada por primera vez en la cuenca del río Manzanares, en Santa Marta, Magdalena. Trachemys callirostris fue registrada en el río Cañas, La Guajira, constituyéndose en el primer registro para la especie en un riachuelo de la cara norte de la Sierra Nevada de Santa Marta. Chelonoidis carbonaria fue registrada en un humedal ubicado en la ciudad de Santa Marta. Se registró una hembra de M. dahli en el corregimiento Monterrubio, municipio Sabana de San Ángel, Magdalena. Tres de las cuatro especies incluidas en esta revisión se encuentran en alguna categoría de amenaza; la falta de conocimiento en la biología y distribución de estas especies podría incluirse como una amenaza para ellas, pues el desconocimiento impide conocer su estado de conservación y generar planes de manejo necesarios para su protección.

This research reviews the Colombian Caribbean distribution of the species Kinosternon scorpioides, Trachemys callirostris, Mesoclemmys dahli and Chelonoidis carbonaria, and to present new records for the region. The species K. scorpioides is reported for the first time in the Manzanares River drainage, Santa Marta, department of Magdalena. Trachemys callirostris was recorded in the Cañas River, department of La Guajira, being the first record for this species in a small river on the north side of the Sierra Nevada de Santa Marta. Chelonoidis carbonaria was recorded in a wetland in Santa Marta. We recorded a female M. dahli in the village of Monterrubio, municipality of Sabanas de San Angel, department of Magdalena. Three of the four species included in this account are listed in some category of threat. The lack of knowledge of the biology and distribution of these species could be considered a threat to them because ignorance precludes the establishment of their true conservation status and hinders the development of management plans required for their protection.