Feasibility and Diagnostic Value of Recording Smartwatch Electrocardiograms in Neonates and Children.

OBJECTIVE: The objective of this study was to evaluate the agreement of smartwatch-derived single-lead electrocardiogram (ECG) recordings with 12-lead ECGs for diagnosing electrocardiographic abnormalities. STUDY DESIGN: A 12-lead ECG and an ECG using Apple Watch were obtained in 110 children (aged 1 week to 16 years) with normal (n = 75) or abnormal (n = 35) 12-lead ECGs (atrioventricular block [7], supraventricular tachycardia [SVT] {5}, bundle branch block [12], ventricular preexcitation [6], long QT [5]). In children aged <6 years, the ECG recording was performed with the active participation of an adult who applied the neonate or child's finger to the crown of the watch. In older children, tracings were obtained after brief teaching without adult guidance. All 12-lead ECGs were independently evaluated by 2 blinded cardiologists. Apple Watch ECGs were independently evaluated by another blinded cardiologist. RESULTS: In 109 children (99.1%), the smartwatch tracing was of sufficient quality for evaluation. Smartwatch tracings were 84% sensitive and 100% specific for the detection of an abnormal ECG. All 75 normal tracings were correctly identified. Of the 35 children with abnormalities on 12-lead ECGs, 5 (14%) were missed, most often because of baseline wander and artifacts. Rhythm disorders (atrioventricular block or SVT) and bundle branch blocks were correctly detected in most cases (11 of 12 and 11 of 12, respectively); preexcitation and long QT was detected in 4 of 6 and 4 of 5, respectively. CONCLUSION: Smartwatch ECGs recorded with parental assistance in children aged up to 6 years and independently in older children have the potential to detect clinically relevant conditions.

Is vitamin D status relevant to psoriasis and psoriatic arthritis? A retrospective cross-sectional study

Abstract BACKGROUND: Psoriasis is a systemic, immune-mediated disease characterized by inflammatory manifestations in the skin and joints. Vitamin D deficiency is currently considered a pandemic and is associated with comorbidities including psoriasis and psoriatic arthritis (PsA). OBJECTIVES: To determine the prevalence of hypovitaminosis D [25(OH)D] in patients with plaque psoriasis, with and without PsA, and of independent predictors of serum 25(OH)D levels. DESIGN AND SETTING: Retrospective cross-sectional study conducted among 300 patients at an outpatient clinic in a university center in Juiz de Fora, Minas Gerais, Brazil. METHODS: Demographic and clinical data (psoriasis area and severity index [PASI], family history, age at onset, disease duration, and the presence of PsA according to Classification Criteria for Psoriatic Arthritis), skin phototype, and season of the year were reviewed. RESULTS: Hypovitaminosis D (< 30 ng/mL) was highly prevalent in patients with psoriasis with and without PsA (82.2% and 74.9%, respectively). An inverse correlation between PASI and vitamin D was found (without PsA r = -0.59 and, PsA r = -0.52, P < 0.001), and multivariate regression revealed that hypovitaminosis D was associated with disease severity, season, and phototype. It was confirmed by binary logistic regression between PASI and vitamin D deficiency (< 30 ng/mL), (odds ratio, OR 1.78 CI: -0.20-0.53, P < 0.001). CONCLUSION: Hypovitaminosis D (< 30 ng/mL) was highly prevalent in psoriatic patients with and without PsA. Season and skin phototype were associated with 25(OH)D levels. An inverse association between PASI and serum 25(OH)D levels was established.

Therapeutic failure in moderate and severe psoriasis patients in a health institution - a transversal study of prevalence and demographic determinants.

BACKGROUND: Psoriasis is a chronic disease that seriously impacts quality of life. There are known genetic and environmental factors that influence its onset and progression. Even though there is no cure for it, there are a variety of treatments available today to control its symptoms, although many of them fail to do so substantially. OBJECTIVE: To identify the association of multiple sociodemographic, clinical, and pharmacological factors with therapeutic failure. METHODS: Observational, descriptive, cross-sectional, retrospective, and analytical study of therapeutic failure in patients with moderate or severe psoriasis between 2020 and 2021 was performed. RESULTS: In total 1051 patients with moderate or severe psoriasis were evaluated. Gender (ORa: 0.579 CI 95%: 0.382-0.878), type of therapy (biologic or non-biologic; ORa: 1.939 CI 95%: 1.242-3.027), age (ORa: 1.018 CI 95%: 1.003-1.034), days of treatment (ORa: 1 CI 95%: 0.999-1) and DLQI (ORa: 1.212 CI 95%: 1.172-1.253) are significantly associated with therapeutic failure. CONCLUSION: Being male and receiving biologic therapy are associated with a higher incidence of therapeutic failure in the treatment of moderate or severe psoriasis. The increase in DLQI increase in the probability of failure, and mayor age or days of treatment decrease in the probability of failure.

Relationship between retinal sensitivity and disease activity in patients with psoriasis vulgaris

OBJECTIVES: Psoriasis is a hyperproliferative chronic inflammatory skin disease of unknown etiology and ocular structures and visual pathways can also be affected during the course of this disease. Subclinical optic neuritis has previously been observed in psoriatic patients in visual evoked potential studies. This trial was designed to evaluate retinal sensitivity in patients with psoriasis vulgaris. METHODS: A total of 40 eyes of 40 patients with chronic plaque-type psoriasis and 40 eyes of 40 age- and sex-matched control subjects were included in this study. The diagnosis of psoriasis was confirmed by skin biopsy. The severity was determined using the Psoriasis Area and Severity Index and the duration of the disease was recorded. After a full ophthalmological examination, including tests for color vision and pupil reactions, the visual field of each subject was assessed using both standard achromatic perimetry and short wavelength automated perimetry. RESULTS: The mean Psoriasis Area and Severity Index was 22.05±6.40′. There were no significant differences in the visual field parameters of subjects versus controls using either method. There were correlations between disease severity and the mean deviations in standard achromatic perimetry and short wavelength automated perimetry and between disease severity and the corrected pattern standard deviation and pattern standard deviation of short wavelength automated perimetry (r = -0.363, r = -0.399, r = 0.515 and r = 0.369, respectively). CONCLUSIONS: Retinal sensitivity appears to be affected by the severity of psoriasis vulgaris. .

Calidad de vida, actividad y severidad de la psoriasis en pacientes de un policlínico de La Habana - Cuba: enero-julio 2008 / Quality of life, activity and severity of psoriasis in patients from a policlinical of La Habana - Cuba: January-July 2008

ANTECEDENTES: Determinar la relación entre la actividad y severidad de la psoriasis con la calidad de vida en pacientes de un policlínico de La Habana-Cuba. MATERIAL Y MÉTODO: Se realizó un estudio descriptivo, prospectivo, en el que participaron 100 pacientes afectados de psoriasis en el Policlínico Docente: "Luís Li Tregent" de Güines, en el período comprendido de enero a julio del 2008. Se determinó el comportamiento de la severidad y actividad de la psoriasis; así como la calidad de vida. Se utilizaron dos instrumentos: uno específico para la psoriasis, el Índice de Actividad y Severidad de la Psoriasis (PASI) y otro no específico el Índice de Calidad de Vida Dermatológico (DLQI). RESULTADOS: El 52 por ciento de los pacientes fue del sexo femenino. En el 58 por ciento de ellos el eritema, la infiltración y la descamación eran moderados y el 89 por ciento tenia de 1-10 por ciento de superficie afectada. La calidad de vida se afectó en el 79 por ciento; de ellos, el 58.2 por ciento pertenecían al sexo femenino. No se encontró relación estadísticamente significativa entre el grado de actividad y severidad de la psoriasis y la afectación de la calidad de vida. CONCLUSIÓN: La severidad y actividad de la psoriasis fue leve en un alto porcentaje; sin embargo, más de la tercera parte de los pacientes presentó alteraciones en su calidad de vida.

OBJECTIVE: Knowing the relation between the Psoriasis Area and Severity (PASI) and Life Quality and the Dermatology Life Quality Index (DLQI) in those patients from one polyclinic of Havana-Cuba. PATIENTS AND METHODS: A descriptive, prospective study was carried out in the Güines polyclinic. 100 adult patients at random with psoriasis were included in the time period comprised between January and July 2008. The objective was to know the relation between the Psoriasis Area and Severity (PASI) and Life Quality and the Dermatology Life Quality Index (DLQI) in those patients. RESULTS. We find that 52 per cent of the patients belonged together with the feminine sex, in the 58 per cent of them the erythema, the infiltration and the desquamation were moderate and in the 89 per cent of patients only 1-10 per cent skin surface were affected, however the quality of life was affected in 79 per cent of the patients being in 39 epr cent in a minimum way and 46 per cent they belonged to the feminine sex. CONCLUSIONS: We conclde that the severity and intensity of the psoriasis was slight in a high percentage, however, more than the third part of the patients it presented alterations in its quality of life.