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A simple and quick way of discrimination between cardiac and pulmonary causes of dyspnea is essential in patients admitted to the emergency department. We aimed to assess the utility of easily applicable diagnostic tools in the differential diagnosis of cardiac and pulmonary causes of dyspnea in patients presenting with shortness of breath. Clinical and radiologic evaluation, peak expiratory flow (PEF), PaO2, PaCO2 measurements were performed in 94 patients admitted to the emergency room with dyspnea. All the patients were hospitalized for accurate diagnosis and later were categorized into cardiac and pulmonary dyspnea groups. PEF, %PEF (percent of predicted PEF), dyspnea differentiation index (DDI = PEF x PaO2/1000), %DDI (%PEF x PaO2/1000), PaO2 and PaCO2 measurements were compared between the two groups. When cardiac and pulmonary dyspnea groups were compared, considering 1.6 as the cut-off value for DDI, measurements above this value imply cardiac pathology with 76.7% sensitivity and 67.2% specificity. The sensitivity and specificity for cardiac dyspnea calculated according to the cut-off values were 96.7% and 40.6% for %DDI; 86.7% and 60.9% for PEF; 86.7% and 54.7% for %PEF; 66.7 and 68.7 for PaO2. Also for pulmonary dyspnea, sensitivity and specificity values for PaCO2 were 50% and 93%. We conclude that DDI, %DDI, PEF, %PEF, PaO2 and PaCO2 are simple and easily applicable tools for differential diagnosis of cardiac and pulmonary dyspnea. Adjunctive utility of these tests in the emergency department with clinical and radiologic evaluation contributes to this discrimination.

Pandemics are a global threat, with vaccination being the main weapon of control. Fear, an unpleasant emotional state caused by a threatening stimulus perception, is known to be behind inhibitory behaviours; being, with mistrust, the basis of anti-vaccine conspiracy theories (CTs). It would be appropriate to know the fear influence on these theories. In this way, a cross-sectional online survey was applied to 2.987 subjects, in a COVID-19 context, characterized by high levels of uncertainty and mistrust, with the aims of analyse the relationship between some anti-vaccine CTs and vaccination intention (VI), also the influence of fear to vaccination (VF) on TCs and VI in this context. As result, all CTs were positive predictors of VF and negative predictors of VI. The correlations were significant (p <0.001), from moderate to high, for all analysed variables, with a significant and moderate directionality and size of association. Regression analysis indicated a moderate and significant explained variance (r2 = 0.54) of CTs + VF in VI. The analysis also indicates that safety and security CTs were more strongly associated with VF (r2 = 0.347) and VI (r2 = 0.46) than other CTs. Obtained results were more significant than those found by other researchers. Knowing in each case the main anti-vaccine CTs and the associated fear can help to plan programs to increase vaccination levels.

This study was designed to check the psychometric properties of an online Catalan version of the Type D Personality Scale-14 (DS14). Participants were 600 subjects including university professors, service and administrative personnel (n = 419) and students (n = 181); in total 196 men (32.7%) and 404 women (67.3%) with a mean age of 36.99 (SD = 12.76). The sample was randomly split in two groups: calibration and validation. The structural validity was analyzed in the calibration group (n = 311) using exploratory factor analysis with oblique and orthogonal rotation procedures, showing two robust factor structure, corresponding to Negative Affectivity (NA) and Social Inhibition (SI). No differences were found comparing the two rotation methods. Confirmatory factor analysis was performed in the validation group (n = 289) and the two factor model was replicated, showing satisfactory goodness-of-fit indices as 2 /df = 2.40, RMSEA = 0.07, SRMR = 0.06, GFI = 0.92, TLI = 0.93, CFI = 0.93 and IFI = 0.94. The re-specified model correlating the error terms of four pairs of items mildly improved goodness-of-fit indexes. The Catalan DS14 obtained a satisfactory internal consistency for its two subscales NA and SI (Cronbach's alpha = 0.85/0.88), and demonstrates good psychometric properties, being a suitable instrument for use in research in the Catalan population.