Discontinuation of disease-modifying treatments for multiple sclerosis in patients aged over 50 with disease Inactivity

Journal of Neurology - Treatments may become redundant in older patients with multiple sclerosis (MS). Our aim was to explore whether stopping treatments might be possible in patients aged over 50...     

Liver cysts in Congolese patients with autosomal dominant polycystic kidney disease follow a family pattern.

BACKGROUND: It is now well established that at least two genes are associated with autosomal dominant polycystic kidney disease (ADPKD). OBJECTIVE: To analyse the clinical expression of ADPKD in Congolese patients and to compare ADPKD expression between families. METHODS: Following informed consent, ADPKD patients admitted to Brazzaville University Hospital (Congo) were reviewed and their relatives aged 20 years and older were screened by means of a clinical examination, abdominal ultrasound, urinalysis and determination of serum creatinine. RESULTS: We found 7 patients with ADPKD, belonging to 7 distinct families, and identified 100 relatives of whom 50, aged from 20 to 68 years, were diagnosed as having ADPKD. Polycystic kidney disease was associated with polycystic liver in 4 families. In the remaining 3 families no liver cysts were found. No family had a mixture of members with kidney cysts only and members with kidney and liver cysts. This finding was age-independent. CONCLUSION: Liver cysts follow a family pattern in our ADPKD patients. We suggest that our patients may carry at least two different genes for ADPKD, one of which may be associated with renal cysts alone and other with both renal and liver cysts.     

Exploratory study of the impacts of Mutual Health Organizations on social dynamics in Benin

The primary aim of Mutual Health Organizations (MHOs) is the financial protection of their members. However, given their community-based, participative and voluntary nature, it is conceivable that MHOs, as social organizations, would affect social dynamics. In an exploratory study in Benin, we studied social dynamics related to mutual aid, relationships of trust, and empowerment. Four MHOs, as contrasted cases, were selected from among the 11 in the region. Focus groups (n = 20) and individual interviews (n = 29) were conducted with members, non-members, and elected leaders of the four MHOs, and with professionals from the health facilities concerned. We carried out a qualitative thematic analysis of the content.     

Contribution of taking part in sport to the association between physical activity and quality of life

Purpose

The purpose of this study was to investigate the contribution of sport to the association between physical activity (PA) and quality of life (QoL).

Methods

Cross-sectional data were gathered on 4,909 subjects (age 15–69) from the French National Barometer 2005 survey. The International Physical Activity Questionnaire (IPAQ) and the abbreviated version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) were administered. An additional question was used to assess sporting activity. All analyses used linear regression models and were adjusted on variables associated with QoL in a general population.

Results

The mean age of the participants (both men and women) decreased with increasing PA level. Sport was positively associated with QoL among men (β range from 4.2 [95 % CI 3.1–5.4] for physical health to 2.4 [95 % CI 1.1–3.8] for social relationship domains) and women (β range from 3.6 [95 % CI 2.6–4.5] for physical health to 1.6 [95 % CI 0.6–2.8] for social relationship domains). The association between sport and QoL was greater for low or high PA levels rather than moderate PA for men (physical and psychological health) and women (physical health only). For women, there was a dose–response association with psychological health and social relationships (contribution of sport to QoL increased with PA level).

Conclusions

These results showed that sport was nearly always associated with better QoL, even more so for people who had low or high PA levels (physical and psychological health for men and physical health for women). Prospective studies are necessary to confirm these findings.     

Involvement of calpain in the neuropathogenesis of Alzheimer’s disease

Alzheimer’s disease (AD) is the most common (60% to 80%) age-related disease associated with dementia and is characterized by a deterioration of behavioral and cognitive capacities leading to death in few years after diagnosis, mainly due to complications from chronic illness. The characteristic hallmarks of the disease are extracellular senile plaques (SPs) and intracellular neurofibrillary tangles (NFTs) with neuropil threads, which are a direct result of amyloid precursor protein (APP) processing to Aβ, and τ hyperphosphorylation. However, many indirect underlying processes play a role in this event. One of these underlying mechanisms leading to these histological hallmarks is the uncontrolled hyperactivation of a family of cysteine proteases called calpains. Under normal physiological condition calpains participate in many processes of cells’ life and their activation is tightly controlled. However, with an increase in age, increased oxidative stress and other excitotoxicity assaults, this regulatory system becomes impaired and result in increased activation of these proteases involving them in the pathogenesis of various diseases including neurodegeneration like AD. Reviewed here is a pool of data on the implication of calpains in the pathogenesis of AD, the underlying molecular mechanism, and the potential of targeting these enzymes for AD therapeutics.