Development of the multi-attribute Pediatric Asthma Health Outcome Measure (PAHOM).

OBJECTIVE: To develop a multi-attribute outcome measure for children with asthma that allows for the calculation of quality-adjusted life years in cost-effectiveness studies and can also be used to assign preference weights to asthma-symptom-free days. STUDY DESIGN: A literature review and two interviewer-administered surveys. SETTING: Homes or community centers of participants in Seattle, United States. MAIN MEASURE: Visual analog scale (VAS), standard gamble (SG), and relative risk attitude equation techniques were used to estimate two sets of preference weights for 10 health states. The PAHOM was used to record health states of pediatric asthma patients. RESULTS: A total of 94 subjects provided complete responses without any illogical ratings to VAS questions and 101 provided the same to SG questions. The VAS preference weights of the health states range from a maximum of 1 for perfect health to a minimum of 0.03 for severe asthma symptoms, emotional problems, and activity limitations. Those based on the relative risk attitude equation constructed with both VAS and SG preference weights range from 1 to 0.06. The mean PAHOM scores of pediatric asthma patients based on VAS and converted SG preference weights were 0.70 and 0.83, respectively. CONCLUSIONS: The PAHOM calendar can be used to identify asthma patients' health outcomes, to calculate the preference weights of asthma patients' health states, and to estimate the number of symptom-free days. These factors make the PAHOM a promising instrument for use in effectiveness and cost-effectiveness studies in children with asthma.     

左旋四氢巴马汀对吗啡条件性位置偏爱的影响

目的探讨不同剂量的左旋四氢巴马汀(lTetrahydropalmatine,lTHP)对吗啡诱导的条件性位置偏爱(CPP)的影响以及自身能否产生CPP效应。方法本实验采用倾向性实验程序,①对♂SD大鼠sc吗啡(5.00mg·kg-1)或生理盐水(NS)训练8d,d9测定大鼠对伴药侧的偏爱效应或测试前40minipNS或不同剂量的lTHP(1.25～5.00mg·kg-1),观察这些预处理对该效应的影响;②测量不同剂量的lTHP(1.25～5.00mg·kg-1)慢性用药(每天1次,ip)对CPP效应消退的影响;③测试ipNS或lTHP(1.25～5.00mg·kg-1)能否诱导大鼠对伴药侧产生偏爱(方法同吗啡)。结果5.00mg·kg-1吗啡诱导大鼠对伴药盒产生明显的CPP;测试前ip2.50mg·kg-1或5.00mg·kg-1的lTHP明显降低吗啡诱导的CPP效应的表达(P<0.05),其慢性给药明显加速吗啡CPP效应的消退;3个剂量的lTHP均不能诱导大鼠形成CPP。结论lTHP能抑制吗啡的奖赏效应,可在吗啡成瘾的治疗中发挥一定的作用。     

吗啡依赖对大鼠不同脑区内神经甾体水平的影响

目的建立大鼠条件性位置偏爱(CPP)模型，探讨吗啡精神依赖对大鼠脑内神经甾体水平的影响。方法 大鼠连续10 d腹腔注射吗啡5 mg·kg^-1，诱导CPP形成。高效液相色谱-质谱法测定大鼠伏隔核、杏仁核、下丘脑和血浆中脱氢表雄酮、孕烯醇酮、别孕烯醇酮、脱氢表雄酮硫酸酯及孕烯醇酮硫酸酯的含量。结果经10 d吗啡训练后，吗啡组大鼠在伴药侧的停留时间显著长于对照组，吗啡诱导的大鼠CPP形成。与对照组相比，吗啡组大鼠下丘脑内孕烯醇酮明显降低，伏隔核和血浆中的脱氢表雄酮明显降低。结论吗啡诱导CPP形成，吗啡处理影响大鼠脑内某些神经甾体的水平，表明内源性神经甾体可能参与吗啡依赖的形成。     

多巴胺D_1受体参与吗啡介导的小鸡条件性位置偏爱的表达

目的 :利用条件性位置偏爱模型探求吗啡对小鸡的奖赏作用及其相关的多巴胺机制。方法 :ip 2mg·kg-1吗啡对小鸡进行 4次条件化训练后进行条件性位置偏爱测试 ,测试前 15min分别ip生理盐水、0 .2 5mg·kg-1多巴胺D1受体拮抗剂SCH2 3390或者等剂量的多巴胺D2 受体拮抗剂雷氯必利 (raclopride) ,观察其干预效果。结果 :吗啡诱导出小鸡的条件性位置偏爱 (P <0 .0 1) ,条件性位置偏爱的表达被SCH2 3390阻断 (P <0 .0 5 ) ,而不受雷氯必利的影响 (P >0 0 5 )。结论 :吗啡的奖赏作用在鸟类中也有体现 ,小鸡可以成为研究药物成瘾的合适的模型。多巴胺D1受体可能参与对吗啡药物渴求的形成。     

Physico-chemical characteristics,water absorption,soaking and cooking properties of some Sicilian populations of chickpea (Cicer arietinum L.)

The physical and physico-chemical properties of several Kabuli chickpeas originating from Sicily (South Italy) were determined. Twelve genotypes in all, including two controls (ILC484, of the ICARDA genebank, and ‘Calia’, a traditional Italian cultivar), were analysed. A large variability among genotypes was ascertained for swelling capacity (coefficient of variation [CV]=27.9%), swelling index (CV=30.5%) and calcium content (CV=39.3%). The lowest variability was observed for seed coat (CV=8.6%) and seed weight (CV=9.6%). Genotype statistically affected all traits, whose mean values were: seed weight, 0.340±0.03 g; seed coat, 4.47±0.38%; seed volume, 0.292±0.04 ml; seed density, 1.18±0.15 g/ml; hydration capacity, 0.361±0.09 g/seed; hydration index, 1.05±0.21; swelling capacity, 0.346±0.10 ml/seed; swelling index, 1.21±0.37; cooking texture, 2.61±0.38 kg/cm²; and calcium, 109.6±43.11 mg/100 g dry weight. Correlation coefficients among characteristics were also estimated. The genotype ‘44M33’ was found to be interesting having good seed weight and low seed coat incidence and calcium content, all important attributes affecting cooking quality.     

Ease of use of two autoinjectors in patients with multiple sclerosis treated with interferon beta-1a subcutaneously three times weekly: results of the randomized,crossover REDEFINE study

Background: For interferon beta-1a subcutaneously three times weekly (IFN β-1a SC tiw), administration options include manually injected prefilled syringes; a preassembled, single-use autoinjector; and a reusable autoinjector. This study evaluated patient-perceived ease of use of two injection devices.

Research design and methods: REDEFINE, a Phase IV, multicenter crossover study, randomized patients with multiple sclerosis and ≥5 weeks’ IFN β-1a 44 μg SC tiw use to 4 weeks using a single-use autoinjector, then 4 weeks using a reusable autoinjector, or vice versa. The primary endpoint was the proportion rating each ‘easy’ or ‘very easy’, with/without regard to previous device experience.

Results: Of 97 randomized patients, 29 had most recent experience with manual injection; 23 with single-use autoinjector; and 45 with reusable autoinjector. 68.4% found using the single-use autoinjector very easy or easy, versus 77.9% for the reusable device (difference ?9.5%; p = 0.200). 40.0% versus 29.5% found the respective devices very easy (difference 10.5%; p = 0.203).

Conclusions: Most patients found both autoinjectors easy or very easy to use. Having two viable options may help accommodate patient preferences. Ease of administration and patient satisfaction relates to adherence; satisfied patients may more likely be adherent.

Trial registration: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT02019550).