Expanded disability status scale by phone BR: Brazilian Portuguese validation.

BACKGROUND: The Expanded Disability Status Scale (EDSS) is widely used and accepted by regulatory agencies for the assessment of neurological disability secondary to Multiple Sclerosis. The "Expanded Disability Status Scale (EDSS) by phone" was developed to be a patient-reported telephone-based alternative for the assessment of EDSS functional system scores when a physical examination is not possible. The scale has been validated in multiple languages; however, its reliability has not been assessed in Brazilian Portuguese. METHODS: After cross-cultural translation and adaptation, 57 people with MS with a recent in-person visit (±6 months) were invited to answer the EDSS by phone scale on two occasions, 15 days apart. The agreement between scales (in-person and telephone-based) and between telephone-based assessments was evaluated using intraclass correlation coefficients (ICC) for absolute agreement and weighted Kappa coefficients. RESULTS: An excellent reliability was obtained for the agreement between the in-person and telephone assessments (ICC: 0.95, 95 %CI 0.92-0.97, Kappa: 0.83, 95 %CI 0.78-0.89) and between telephone-based assessments (ICC: 0.99, 95 %CI 0.98-0.99, Kappa: 0.93, 95 %CI 0.88-0.97). After stratification by disability level, the agreement between scales was less pronounced for subjects with an EDSS ≤ 4.0. CONCLUSION: this study offers evidence that supports the validity of the EDSS by phone questionnaire translated into Brazilian Portuguese, particularly for patients with higher EDSS scores.

Avaliação da frequência de pneumonia enzoótica suína em granja através da monitoria de abate, clínica e laboratorial / Evaluation of the frequency of swine enzootic pneumonia in one farm based on slaughterhouse, clinical and laboratory monitoring

Background: Swine enzootic pneumonia (SEP), caused by the bacterium Mycoplasma hyopneumoniae, is one of the main respiratorydiseases of pigs. The purpose of this study was to evaluate the frequency of SEP in one farm with an independent production system,low level of technification and high losses in the meat packing plant, based on slaughterhouse, clinical and laboratory monitoring.Materials, Methods & Results: This study consisted of three monitoring steps, divided into 3 periods: P1, P2 and P3. In the first step ofthe study, slaughterhouse reports were analyzed and slaughtering was monitored at one meatpacking plant in Santa Maria, RS, Brazil.The second step of the study started by drawing up a profile of the farm that supplied the pigs to the aforementioned slaughterhouse,after which clinical monitoring was performed on three occasions. The third step of the study (laboratory monitoring) involved collecting lung fragments containing suspected SEP lesions from the meatpacking plant and subjecting them analysis. The average measuredenzootic pneumonia (EP) in P3 was 38.54% (P < 0.05) higher than in P1 and 29.79 higher than in P2. The mean frequency of pulmonaryemphysema (PE) in P3 was 59.13% (P < 0.05) higher than in P1 and 48.04% higher than in P2. The mean number of lung adhesions(LA) did not differ statistically (P > 0.05) between P1, P2 and P3. As for the mean frequency of pulmonary hepatization (PH), P3 was48.80% higher (P < 0.05) than P1 and 41.78% higher than P2. With regard to the mean frequency of craniodorsal lung lesions (CLL), P3was 48.26% higher (P < 0.05) than P1 and 40.77% higher than P2. The mean frequency of disseminated lesions (DL) and the pneumoniaseverity index (PSI) showed no statistical difference (P > 0.05) between the 3 evaluated periods. On the other hand, in the finishingperiod (FP), the frequency of coughing and sneezing was 37.56% (P < 0.05) higher in P1 than in P3. The frequency of coughing and...(AU)

Avaliação da frequência de pneumonia enzoótica suína em granja através da monitoria de abate, clínica e laboratorial / Evaluation of the frequency of swine enzootic pneumonia in one farm based on slaughterhouse, clinical and laboratory monitoring

Background: Swine enzootic pneumonia (SEP), caused by the bacterium Mycoplasma hyopneumoniae, is one of the main respiratorydiseases of pigs. The purpose of this study was to evaluate the frequency of SEP in one farm with an independent production system,low level of technification and high losses in the meat packing plant, based on slaughterhouse, clinical and laboratory monitoring.Materials, Methods & Results: This study consisted of three monitoring steps, divided into 3 periods: P1, P2 and P3. In the first step ofthe study, slaughterhouse reports were analyzed and slaughtering was monitored at one meatpacking plant in Santa Maria, RS, Brazil.The second step of the study started by drawing up a profile of the farm that supplied the pigs to the aforementioned slaughterhouse,after which clinical monitoring was performed on three occasions. The third step of the study (laboratory monitoring) involved collecting lung fragments containing suspected SEP lesions from the meatpacking plant and subjecting them analysis. The average measuredenzootic pneumonia (EP) in P3 was 38.54% (P 0.05) between P1, P2 and P3. As for the mean frequency of pulmonary hepatization (PH), P3 was48.80% higher (P 0.05) between the 3 evaluated periods. On the other hand, in the finishingperiod (FP), the frequency of coughing and sneezing was 37.56% (P < 0.05) higher in P1 than in P3. The frequency of coughing and...

Clinical research monitoring: scenarios and challenges

Clinical research is essential for the development of new drugs, diagnostic tests and new devices. Clinical monitoring is implemented to improve the quality of research and attain high ethical and scientific standards. This review discusses the role of clinical monitors, taking into account the variety of scenarios in which medical research is developed, and highlights the challenges faced by research teams to ensure that patients rights are respected and that the social role of scientific research is preserved. Specific emphasis is given to the ethical dilemmas related to the multiple roles which clinical monitors play in the research framework, mainly those involving the delicate equilibrium between the loyalty to the sponsor and to the research subjects. The essential role of clinical monitoring for research developed in poor healthcare scenarios is highlighted as an approach to get the local infrastructure strengthening needed to achieve an adequate level of good clinical practices.