Validation of neuropathic pain assessment tools among Chinese patients with painful diabetic peripheral neuropathy

Objective:This study aims to evaluate the reliability and validity of neuropathic pain assessment tools among Chinese patients with painful diabetic peripheral neuropathy(PDPN).Methods:One hundred patients with PDPN and 70 patients with non-neuropathic pain were recruited from five grade III general hospitals in Guangzhou.Pain was assessed using the Leeds Assessment of Neuropathic Symptoms and Signs(LANSS),Douleur Neuropathique 4 questionnaire(DN4),and Brief Pain Inventory for Painful Diabetic Peripheral Neuropathy(BPI-DPN).Reliability was evaluated by internal consistency of the Cronbach's a coefficient and Guttman split-half.Construct validity was analyzed by factor analysis and Spearman correlation coefficients.Sensitivity and specificity were also assessed.Results:The Cronbach's a coefficients of the LANSS,DN4,and BPI-DPN were 0.735,0.750,and 0.898,respectively.The Guttman split-half coefficients of the LANSS,DN4,and BPIDPN were 0.660,0.726,and 0.849,respectively.The cumulative contributions of the LANSS,DN4,and BPI-DPN to the total variance were 61.945%,57.010%,and 66.056%,respectively.The items of the LANSS,DN4,and BPI-DPN presented high factorial loads,ranging from 0.387 to 0.841,0.137 to 0.948,and 0.487 to 0.953,respectively.The LANSS and DN4 exhibited sensitivities of 58.0%and 82.7%,respectively,and specificity of 97.1%.Conclusions:The LANSS or DN4 can be used to detect neuropathic pain in Chinese patients with PDPN.The BPI-DPN can be employed to monitor the effectiveness of pain intervention.

Lassa Fever Case Report: Challenges in Making Early Diagnosis

Introduction: Lassa fever is a disease of public health importance because of the associated morbidity and high case fatality rate among hospitalized patients. Even after recovery, there may be residual problems such as sensorineural hearing loss. The initial presentation of Lassa fever may be with non-specific symptoms similar to what is seen in the more common febrile illnesses such as malaria or typhoid fever. In such a setting therefore, timely diagnosis of Lassa fever may be difficult. Case Report: We report a case of Lassa fever that presented to our institution. She was a middle aged woman who had non-specific symptoms of febrile illness and who died in less than 48 hours of admission. She had a subtle bleeding on the lip just before death which was what raised the suspicion for Lassa fever. Laboratory confirmation of Lassa fever was made retrospectively. Conclusion: When the presenting symptoms are non-specific, a high index of suspicion is required for timely recognition of Lassa fever. Early diagnosis is important for prompt therapeutic intervention as well as for limiting the spread of the disease. This is the second case of Lassa fever presenting to our hospital, but the first published case of Lassa fever from our hospital.

Acupuncture treatment of lung-spleen Qi deficiency in stable chronic obstructive pulmonary disease: a randomized, open-label, controlled trial

OBJECTIVE:To evaluate the effectiveness and safety of acupuncture that reinforces the spleen to strengthen the lung in patients with stable chronic obstructive pulmonary disease(COPD).METHODS:This was a randomized,open-controlled trial in which the acupuncturist and the participants were not blinded,but the outcome evalu-ators and data analysts were blinded.One-hundred-and-two patients with stable COPD were randomly divided into two groups in a 1∶1 ratio.The acupuncture group received 30-minute sessions of acupuncture therapy at the same acupoints three times weekly for 6 weeks in addition to routine conventional Western Medicine treatment;the control group received routine conventional Western Medicine treatment alone.The primary outcome was the Borg scale score,which was assessed immediately after the 6-minute walk test.The secondary outcomes were the 6-minute walk distance,lung function,and oxygen saturation.Measurements were obtained at baseline and after 6 weeks of treatment.RESULTS:After 6 weeks of treatment,the Borg scale score in the acupuncture group was significantly better than that in the control group(2.02±0.71 versus 5.01±0.34,P<0.05).Furthermore,the post-treatment improvements in the 6-minute walk distance,lung function,and oxygen saturation were significantly greater in the acupuncture group than in the control group,showing that the acupuncture group had better exercise tolerance.CONCLUSION:The findings suggest that acupuncture that aims to reinforce the spleen to strengthen the lung is a safe and effective adjuvant therapy that effectively improves the exercise capacity of patients with stable COPD.