OAKHQOL: a new instrument to measure quality of live in knee and hip Osteoarthritis

in Journal of Clinical Epidemiology (2005), 58

To develop a questionnaire with which to measure quality of life (QoL) in patients with knee and hip osteoarthritis (OA). Study Design and Setting: Thirty-two caregivers and 96 OA patients were ... [more ▼]

To develop a questionnaire with which to measure quality of life (QoL) in patients with knee and hip osteoarthritis (OA). Study Design and Setting: Thirty-two caregivers and 96 OA patients were interviewed individually (using cognitive and face-to-face techniques) and in focus groups. A group of experts working independently at first and then consensually used the interview transcripts to generate a 46-item questionnaire. Results: Analysis of questionnaires completed by 263 patients with hip or knee OA resulted in the exclusion of three items (two because of low reliability and one because of a low response rate). Principal component analysis revealed four factors: physical activity, mental health, social functioning, and social support. A pain dimension was individualized. Preliminary testing showed the reliability of the five dimensions to be satisfactory (intraclass correlation coefficients: 0.70–0.85), construct validity was adequate when correlated with the SF36 (Spearman correlation coefficients: 0.43–0.75), and discrimination was satisfactory. The osteoarthritis knee and hip quality of life questionnaire (OAKHQOL) consists of 43 items in five dimensions and three independent items. Conclusion: TheOAKHQOLis the first specific knee and hipOAquality of life instrument. Its development followed an a priori structured strategy to ensure content validity. It meets psychometric requirements for validity and reliability. [less ▲]

An Observational Study of the Effect of Levodopa-Carbidopa Intestinal Gel on Activities of Daily Living and Quality of Life in Advanced Parkinson's Disease Patients.

in Advances in therapy (2017)

INTRODUCTION: Continuous delivery of levodopa-carbidopa intestinal gel (LCIG) by percutaneous endoscopic gastrojejunostomy (PEG-J) in advanced Parkinson's disease (PD) patients reduces variability in ... [more ▼]

INTRODUCTION: Continuous delivery of levodopa-carbidopa intestinal gel (LCIG) by percutaneous endoscopic gastrojejunostomy (PEG-J) in advanced Parkinson's disease (PD) patients reduces variability in plasma levels, providing better control of motor fluctuations ("on" and "off" states). The MONOTREAT study assessed the effect of LCIG on activities of daily living, motor and non-motor symptoms, and quality of life in advanced PD patients. METHODS: This prospective, observational study included patients with advanced, levodopa-responsive PD with either 2-4 h of "off" time or 2 h of dyskinesia daily. Patients received LCIG via PEG-J for 16 h continuously. Effectiveness was assessed using Unified PD Rating Scale parts II and III, the Non-Motor Symptom Scale, and the PD Questionnaire-8. RESULTS: The mean (SD) treatment duration was 275 (157) days. Patients experienced significant improvement from baseline in activities of daily living at final visit (p < 0.05) as well as at months 3 and 6 (p < 0.0001). Patients also experienced significant improvements from baseline in quality of life and non-motor symptoms at all time points (p < 0.001 for all). Specifically, patients manifested significant improvements in mean change from baseline at every study visit in five of nine non-motor symptom score domains: sleep/fatigue, mood/cognition, gastrointestinal tract, urinary, and miscellaneous. One-third of patients (32.8%) experienced an adverse event; 21.9% experienced a serious adverse event; 11.1% discontinued because of an adverse event. CONCLUSION: This study demonstrated significant and clinically relevant improvements in measures of activities of daily living, quality of life, and a specific subset of non-motor symptoms after treatment with LCIG. FUNDING: AbbVie Inc. [less ▲]

Of larks and hearts – morningness/eveningness, heart rate variability and cardiovascular stress response at different times of the day

in Physiology & Behavior (2012), 106 (2)

Inter-individual differences in the circadian period of physical and mental functions can be described on the dimension of morningness/eveningness. Previous findings support the assumption that ... [more ▼]

Inter-individual differences in the circadian period of physical and mental functions can be described on the dimension of morningness/eveningness. Previous findings support the assumption that eveningness is related to greater impulsivity and susceptibility to stress than morningness. Heart rate variability (HRV) serves as a physiological correlate of self- and emotional regulation and has not yet been investigated in relation to chronotypes. The study explores differences in HRV and other cardiovascular measures in morning- and evening-types at rest and under stress at different times of day (8-11 a.m. or 4-7 p.m.). Students (N = 471) were screened for chronotype and n = 55 females (27 morning- and 28 evening-types) were recruited for testing. These participants performed a mental arithmetic task while heart rate (HR) and blood pressure (BP) were recorded. Spectral components and a time-domain measure of HRV were calculated on HR data from resting and mental stress periods. Evening-types had significantly higher HR and systolic BP, but lower HRV than morning-types both at baseline and during stress. Stress induced in the evening had a significantly stronger impact on absolute and baseline corrected physiological measures in both chronotypes. The interaction of chronotype and testing time did not reach the level of significance for any of the dependent variables. The enhanced physiological arousal in evening-types might contribute to increased vulnerability to psychological distress. Hence, previous behavioral findings are supported by the physiological data of this study. [less ▲]

On a Family of Achievement and Shortfall Inequality Indices

in Health Economics (2016), 25

This paper identifies a family of absolute consistent inequality indices using a weakly decomposable postulate suggested by Ebert (2010). Since one member employs an Atkinson (1970) type aggregation we ... [more ▼]

This paper identifies a family of absolute consistent inequality indices using a weakly decomposable postulate suggested by Ebert (2010). Since one member employs an Atkinson (1970) type aggregation we refer to it as the Atkinson index of consistent inequality. A second member of this family parallels the Kolm (1976) index of inequality. Two innovative features of these indices are that no specific structure is imposed on the form of the index at the outset and no transformation of any existing index is considered to ensure consistency. Each of them regards an achievement distribution as equally unequal as the corresponding shortfall distribution. We apply these indices to study inequality in grip strength among 50+ year-old Europeans. [less ▲]

On the origin of interoception

in Frontiers in psychology (2016), 7

Over the course of a century, the meaning of interoception has changed from the restrictive to the inclusive. In its inclusive sense, it bears relevance to every individual via its link to emotion ... [more ▼]

Over the course of a century, the meaning of interoception has changed from the restrictive to the inclusive. In its inclusive sense, it bears relevance to every individual via its link to emotion, decision making, time-perception, health, pain, and various other areas of life. While the label for the perception of the body state changes over time, the need for an overarching concept remains. Many aspects can make any particular interoceptive sensation unique and distinct from any other interoceptive sensation. This can range from the sense of agency, to the physical cause of a sensation, the ontogenetic origin, the efferent innervation, and afferent pathways of the tissue involved amongst others. In its overarching meaning, interoception primarily is a product of the central nervous system, a construct based on an integration of various sources, not per se including afferent information. This paper proposes a definition of interoception as based on subjective experience, and pleas for the use of specific vocabulary in addressing the many aspects that contribute to it. [less ▲]

An Online Platform as a Tool for Surveys by Patient Associations

in Global Telemedicine and eHealth Updates: Knowledge Resources (2013), 6

Patients are increasingly interested in sharing their experiences and learning about their conditions, their prevention and treatments, and are more frequently turning into advocates. The connectivity and ... [more ▼]

Patients are increasingly interested in sharing their experiences and learning about their conditions, their prevention and treatments, and are more frequently turning into advocates. The connectivity and the wide availability of data have been shown to support this development enabling patients to play an active role in healthcare. The “Lumos!” platform is a web-based solution that has been designed to facilitate teams of researchers conducting multicentre studies, especially in countries and contexts with low research capacity. Nevertheless, it can be modified and tailored as a tool for research studies carried out by patient organisations. The aim of this study is to assess the feasibility of an online platform as a tool for anonymous surveys conducted by a patient organisation. Methods: A questionnaire is currently being distributed in the Region of Emilia Romagna (Italy) by the Regional Federation of Diabetics with the aim to study the needs of patients that use self-check-up devices. This observational study has been designed online with the use of the “Lumos!” platform, which enables the creation of the questionnaire with adjustable fields and variables, using the expertise of the participants and the creation of reports. Furthermore, a URL and a QR code linking to the questionnaire are being published on Social Networks and websites inviting people to participate in the study. Several data will be retrieved from the logs of the platform, such as the time required to complete a questionnaire by a patient, the number and types of errors, and the percentage of completed items. These variables will be analysed taking into account the demographic characteristics of the patients. Conclusions: By studying the indicators of the implementation and the characteristics of the participants, it will be possible to optimise participation rates and achieve higher engagement from the participants in the future. We expect that with the help of the online platform, patient associations will be supported in their quest to conduct surveys and, as a secondary outcome; they will empower their members to play a more active role in healthcare. [less ▲]

Opiate and cocaine related Fatal Overdoses in Luxembourg from 1985 to 2011: a time-stratified

in Health Issues and Populations in Health Promotion (2013)

To describe trends in the national prevalence of fatal overdose (FOD) cases related to opiates and cocaine use between 1985 and 2011. To analyse male/female differences in FOD victims according to various ... [more ▼]

To describe trends in the national prevalence of fatal overdose (FOD) cases related to opiates and cocaine use between 1985 and 2011. To analyse male/female differences in FOD victims according to various time periods. Methods. A triangulation approach was chosen to cross-examining data from national law enforcement sources, the national drug use surveillance system (RELIS) and of forensic and toxicological evidence. Data have been stratified according to 3 time periods covering each 9 successive years in order to increase the visibility of long term variations and trends. Statistical analysis of male/female differences according to socio-demographic and forensic data as well as drug use trajectories was performed. Results. National FOD prevalence has been decreasing from the beginning of this century to reach a historically low rate of 1.71 cases/100,000 inhabitants in 2011. The burden of deaths caused by FOD on the general national mortality showed to be higher for men compared with women. Furthermore, the pathways towards a FOD revealed to be different for male and female victims referred to various aspects including age of decedents, criminal records, drug use trajectories, drug use patterns and the involvement of psychotropic prescription drugs. Conclusions. The time window for intervention between the onset of drug use and its potential fatal outcome might be shorter for women compared with men. Further research should address dynamics between socio-economic status of victims and various cultural components to assess their possible impact on drug overdose induced mortality. Early intervention in female drug users and increased attention to poly and psychotropic prescription drugs use should be considered in health promotion programmes and relevant research outcomes routinely provided to first line general health care providers to accelerate access to appropriate treatment if required and eventually contribute to prevent premature death and reduce gender inequalities. [less ▲]

Optimisation and validation of a high throughput screening compatible assay to identify inhibitors of the plasma membrane calcium ATPase pump--a novel therapeutic target for contraception and malaria.

in Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques (2013), 16(2), 217-30

PURPOSE: ATPases, which constitute a major category of ion transporters in the human body, have a variety of significant biological and pathological roles. However, the lack of high throughput assays for ... [more ▼]

PURPOSE: ATPases, which constitute a major category of ion transporters in the human body, have a variety of significant biological and pathological roles. However, the lack of high throughput assays for ATPases has significantly limited drug discovery in this area. We have recently found that the genetic deletion of the ATP dependent calcium pump PMCA4 (plasma membrane calcium/calmodulin dependent ATPase, isoform 4) results in infertility in male mice due to a selective defect in sperm motility. In addition, recent discoveries in humans have indicated that a single nucleotide polymorphism (SNP) in the PMCA4 gene determines the susceptibility towards malaria plasmodium infection. Therefore, there is an urgent need to develop specific PMCA4 inhibitors. In the current study, we aim to optimise and validate a high throughput screening compatible assay using recombinantly expressed PMCA4 and the HTRF(R) Transcreener(R) ADP (TR-FRET) assay to screen a drug library. METHODS AND RESULTS: PMCA4 membrane microsomes were prepared from HEK293 cells overexpressing PMCA4. Western blot quantification revealed nearly nine-fold increased expression of PMCA4 compared to LacZ (control virus)-infected cells. Maximal PMCA4 microsomal activity was achieved in the TR-FRET assay with 15ng/mul microsomal concentration, 30-minute pre-incubation with compounds at 37 degrees C, and calcium buffering with 1mM EGTA providing 1muM free-calcium. Finally a dose-response curve for carboxyeosin (a non-specific PMCA inhibitor) under optimised conditions showed significant PMCA4 inhibition. Upon confirmation that the assay was suitable for high-throughput screening, we have screened the ChemBioNet small molecule library (~21,000 compounds) against the PMCA4 assay to identify those that are its apparent inhibitors. This screening yielded 1,494 primary hits. CONCLUSIONS: We have optimised the HTRF(R) Transcreener(R) ADP assay for high-throughput screening to identify PMCA4 inhibitors. The output of the screening campaign has provided preliminary chemical starting points that could be further developed to specific PMCA4 inhibitors for non-hormonal contraception or anti-malaria therapy. [less ▲]

Optimising patients’ medical care after prison in Luxembourg

in General Practice : The human side of medicine (2019)

Introduction : Passing through prison can be a health gain for the incarcerated population and release from prison can become a period of vulnerability where this potentially acquired gain is lost if the ... [more ▼]

Introduction : Passing through prison can be a health gain for the incarcerated population and release from prison can become a period of vulnerability where this potentially acquired gain is lost if the transition back to civil society in not anticipated. The main objective was the identification and analysis of the factors favor and oppose primary care practice for patients leaving prison in Luxembourg. The secondary objective was to develop recommendations based on the key findings through a literature’s review. Methods : A qualitative study using semi-structured interviews was conducted with general practitioners and patient-inmates. The questions from the two interview guides were similar so that the analysis allowed the results to be mirrored. Using the interviews’ transcripts, a categorical thematic content analysis of those was conducted based on the objectives. On the basis of verbatim, items were formulated and grouped into dimensions and then themes. Results : Our analysis has highlighted the lack of links between the prison and the outside world at each stage of medical and psychosocial care from the point of view of care and support proposed in prison until prison release. Recommendations for doable improvements have been proposed, such as the creation of a general practitioners’ network continuing the medical care as well as genuine cooperation with organisations dealing with drug addicts. Conclusion : Reforms concerning prison care should be considered between the system of prison release, the creation of socio-medical relays and alternatives to incarceration, in analogy to the transitions clinics found in the United States [less ▲]

Optimization and Pharmacological Validation of a Leukocyte Migration Assay in Zebrafish Larvae for the Rapid In Vivo Bioactivity Analysis of Anti-Inflammatory Secondary Metabolites

in PLoS ONE (2013), 8(10),

Over the past decade, zebrafish (Danio rerio) have emerged as an attractive model for in vivo drug discovery. In this study, we explore the suitability of zebrafish larvae to rapidly evaluate the anti ... [more ▼]

Over the past decade, zebrafish (Danio rerio) have emerged as an attractive model for in vivo drug discovery. In this study, we explore the suitability of zebrafish larvae to rapidly evaluate the anti-inflammatory activity of natural products (NPs) and medicinal plants used in traditional medicine for the treatment of inflammatory disorders. First, we optimized a zebrafish assay for leukocyte migration. Inflammation was induced in four days post-fertilization (dpf) zebrafish larvae by tail transection and co-incubation with bacterial lipopolysaccharides (LPS), resulting in a robust recruitment of leukocytes to the zone of injury. Migrating zebrafish leukocytes were detected in situ by myeloperoxidase (MPO) staining, and anti-inflammatory activity was semi-quantitatively scored using a standardized scale of relative leukocyte migration (RLM). Pharmacological validation of this optimized assay was performed with a panel of anti-inflammatory drugs, demonstrating a concentration-responsive inhibition of leukocyte migration for both steroidal and non-steroidal anti-inflammatory drugs (SAIDs and NSAIDs). Subsequently, we evaluated the bioactivity of structurally diverse NPs with well-documented anti-inflammatory properties. Finally, we further used this zebrafish-based assay to quantify the anti-inflammatory activity in the aqueous and methanolic extracts of several medicinal plants. Our results indicate the suitability of this LPS-enhanced leukocyte migration assay in zebrafish larvae as a front-line screening platform in NP discovery, including for the bioassay-guided isolation of anti-inflammatory secondary metabolites from complex NP extracts. © 2013 Cordero-Maldonado et al. [less ▲]