Impulsive and compulsive behaviors in Parkinson's disease: Impact on quality of and satisfaction with life,and caregiver burden

IntroductionTo disentangle the association between impulsive and compulsive behaviors (ICBs), health-related quality of life (HRQOL), satisfaction with life (SwL), and caregiver distress in dyads of people with Parkinson's disease (PwP) and caregivers.MethodsData used in this study were obtained from the ongoing Norwegian ParkWest study, a population-based longitudinal cohort study of the incidence, neurobiology and prognosis of PD in Western Norway. One hundred and one dyads of PwP free of dementia and their caregivers were included 5 years after PD diagnosis and inclusion in the ParkWest study. Standardized clinical rating scales were used to evaluate ICBs, HRQOL, SwL and caregiver distress.ResultsOf 101 PwP-caregiver dyads, self-reported ICBs were seen in 33% of PwP and only caregiver-reported ICBs in 12% of PwP. PwP-reported ICBs were associated with poorer HRQOL and SwL, whereas ICBs reported by caregivers only were associated with increased caregiver distress, but not poorer HRQOL or SwL in PwP.ConclusionsICBs have adverse effects on HRQOL, SwL and caregiver distress. These findings underpin the need for proper identification and management of ICBs in PwP.     

Relationship between MLH1, PMS2, MSH2 and MSH6 gene-specific alterations and tumor mutational burden in 1057 microsatellite instability-high solid tumors

Microsatellite instability-high (MSI-H) and tumor mutational burden (TMB) are predictive biomarkers for immune-checkpoint inhibitors (ICIs). Still, the relationship between the underlying cause(s) of MSI and TMB in tumors remains poorly defined. We investigated associations of TMB to mismatch repair (MMR) protein expression patterns by immunohistochemistry (IHC) and MMR mutations in a diverse sample of tumors. Hypothesized differences were identified by the protein/gene affected/mutated and the tumor histology/primary site. Overall, 1057 MSI-H tumors were identified from the 32 932 tested. MSI was examined by NGS using 7000+ target microsatellite loci. TMB was calculated using only nonsynonymous missense mutations sequenced with a 592-gene panel; a subset of MSI-H tumors also had MMR IHC performed. Analyses examined TMB by MMR protein heterodimer impacted (loss of MLH1/PMS2 vs. MSH2/MSH6 expression) and gene-specific mutations. The sample was 54.6% female; mean age was 63.5 years. Among IHC tested tumors, loss of co-expression of MLH1/PMS2 was more common (n = 544/705, 77.2%) than loss of MSH2/MSH6 (n = 81/705, 11.5%; P < .0001), and was associated with lower mean TMB (MLH1/PMS2: 25.03 mut/Mb vs MSH2/MSH6 46.83 mut/Mb; P < .0001). TMB also varied by tumor histology: colorectal cancers demonstrating MLH1/PMS2 loss had higher TMBs (33.14 mut/Mb) than endometrial cancers (20.60 mut/Mb) and other tumors (25.59 mut/Mb; P < .0001). MMR gene mutations were detected in 42.0% of tumors; among these, MSH6 mutations were most common (25.7%). MSH6 mutation patterns showed variability by tumor histology and TMB. TMB varies by underlying cause(s) of MSI and tumor histology; this heterogeneity may contribute to differences in response to ICI.     

Time to REST: epidemiology and burden

Restless legs syndrome (RLS) is a neurological disorder characterized by a compelling urge to move, accompanied by disturbing sensations within the legs. It is now recognized that RLS is a common condition that has a substantial impact on sleep, daily activities and quality of life. Recent data from the REST (RLS Epidemiology, Symptoms, and Treatment) general population study show that symptoms of RLS are present in approximately 7% of the general population, and that 2–3% experience moderate or severe symptoms at least twice a week. Amongst this RLS cohort, approximately 88% reported sensory disturbances and 76% reported sleep-related symptoms. These symptoms had a marked effect on everyday life, with up to 50% of the RLS cohort reporting disruption of everyday activities or personal relationships. Sleep disturbances in turn lead to impaired daytime functioning. RLS is associated with a significant impairment of quality of life, comparable with that seen in chronic medical conditions such as diabetes or depression. Given the significant burden of morbidity associated with RLS, there is a strong case for treatment in patients with troublesome symptoms.     

中国急性心肌梗塞的疾病经济负担

主要通过对急性心肌梗塞疾病经济负担的研究，总体描述进行二线预防的重要性。资料主要来源于中文文献检索、政府统计报表。主要利用直接医疗费用来计算疾病经济负担，而未考虑直接非医疗费用和间接费用。中日急性心肌梗塞的发病率约为45／10万。55／10万。城市高于农村，男性高于女性。在2000年，急性心肌梗塞的死亡率在城市为32．39／10万，农村为17．99／10万，其死亡率随年龄增长而相应增长。与发病率一样，城市高于农村，男性高于女性。25岁以上人群因急性心肌梗塞而损失的DALY在2000年为3．57DALYs／千人口。怎性心肌梗塞的直接医疗费用在国家卫生部部属医院为28257元／例，省级医院为8663元／例，县级医院为5447无／例。测算2000年急性心肌梗塞的疾病经济负担为13亿元。19亿元。但由于只有10．6％的急性心肌梗塞病人得到临床床治疗，因此，本测算结果可能低估了在中国实际发生的疾病经济负担。     

白云鄂博铁稀土共生矿矿工肺内钍沉积量及其对健康影响的研究

本文报道了白云矿矿工肺内天然钍沉积量及其对健康影响的10年(1982年～1991年)研究的结果。结果。本研究采用改进了的高灵敏度负高压静电收集氧子体装置,对该矿588名接尘矿工985人次和124名非钍尘作业人员的呼出气中作氧活度的测定，前者肺内钍的平均值为0.85Bp(23.06pCi)后者肺内钍的平均值为0.15Bp(4.05pCi).接尘矿工被检者中44.4Bq(120pCi)者5人;最高的1人为5.56Bp(150pCi),经修正最高值应为11.11Bp(300pCi)。     

三门峡结核病疾病经济负担调查报告

目的研究三门峡市结核病人的疾病经济负担。方法调查三门峡市结防所2004年治管的结核病人112例,其中初治病人90例,复治病人22例,利用经济学评价方法,探讨其疾病经济负担。结果例均家庭疾病经济负担为2731元。例均结核病人社会疾病经济负担为3486元。结论复治结核病人的疾病经济负担高于初治结核病人。     

农村贫困地区脑卒中危险因素及经济负担的病例对照研究

目的 研究农村贫困地区脑卒中危险因素及经济负担。方法 采用病例对照研究，在辽宁省彰武县农村选取脑卒中患者和对照农民各102人，进行问卷调查。结果 脑卒中的危险因素在彰武县农村农民中流行率较高，吸烟、饮酒、喝茶的比例分别达73．1％、64．7％、79．4％以上。很少吃水果、蛋类和动物性蛋白质者分别为61．8％、56．9％、61．8％以上。每人每天食盐和猪油摄入量分别为22．2g和31．3g，具有高血压和高血脂患病意识者仅为19．6％和20．6％。脑卒中患者中高血压家族史、饮酒、超重、低动物蛋白摄人率分别为31．4％、76．5％、23．5％和75．5％，显著高于对照组。脑卒中组人均年纯收人为。704．9元，对照组为959．4元，脑卒中患者医疗费用年平均为3120．6元。最多者每年医疗费用高达39000元，远远超出了其家庭纯收入。结论 高血压、饮酒、超重、低蛋白摄人、吸烟、高盐和高脂肪摄入可能是脑卒中的危险因素，脑卒中患病使患者家庭背负了沉重的经济负担。     

The surfaces of the parasitic nematodes Trichinella spiralis and Toxocara canis differ in the binding of post-C3 components of human complement by the alternative pathway

The binding of human complement components C3, C5 and C9 to the surface of the infective larvae of the nematode parasites Toxocara canis and Trichinella spiralis, by the alternative pathway, was examined by direct and indirect immunofluorescence on the intact parasites. This showed that although C3 bound to both nematodes, they differed markedly in the binding of C5 and C9; C5 bound only minimally to T. spiralis, and C9 binding to this parasite was barely detectable. In contrast, both early and late components bound to T. canis to a high density, comparable to, or in excess of, the binding of these components to the infective larvae of the trematode Schistosoma mansoni. The lack of binding of the post-C3 components to T. spiralis did not correlate with enhanced binding of the control protein, Factor H.     

城乡社区精神分裂症患者家属的家庭负担对照研究

为了了解城乡结合区精神分裂症患者家庭负担现状及城乡患者之间家庭负担的区别，采用ＦＩＳ和ＤＡＳ量表分别对病例组和对照组患者及其主要照顾者进行调查，分析，结果发现，病例组家庭负担明显高于对照组，经济负担农村高于城市，而主观负担城市高于农村，病例组ＦＩＳ与ＤＡＳ密切相关，某些ＦＩＳ单项分布与病程相关，表明精神分裂患者确实给家庭带来明显的客观和主观负担，客观负担与患者的社会功能密切相关，主观负担与家属的态