Validation of the International Prostate Symptom Score in Chinese males and females with lower urinary tract symptoms

Objectives

To evaluate the translation of the IPSS (Hong Kong Chinese version 1) and to assess the applicability, validity, reliability and sensitivity of the instrument in both males and females with LUTS in Chinese population.

Methods

The translation of the IPSS (Hong Kong Chinese version 1) was reviewed through back translation. Modifications were made, resulting in the development of The IPSS (Hong Kong Chinese version 2). The content validity was assessed by contend validity index. 233 subjects with LUTS were recruited in Hong Kong primary care settings for pilot psychometric testing. The construct validity was assessed by corrected item-total correlation and Pearson’s correlation test against ICIQ-UI SF, IIQ-7 and SF-12 v2. The reliability was assessed by the internal consistency (Cronbach’s Alpha coefficient) and test –retest reliability (Intraclass correlation coefficient). The Sensitivity was determined by performing known group comparisons by independent T-test.

Results

The content validity index for all items could reach 1. Corrected item-total correlation scores were ≥0.4 for four symptom questions (feeling of incomplete bladder emptying, intermittency, weak stream and straining). Overall, the total symptom score moderately correlated with ICIQ-UI SF. The quality of life score moderately correlated with the IIQ-7 but weakly correlated with SF-12 v2. Overall, the reliability of the IPSS (Hong Kong Chinese version 2) was acceptable (Cronbach’s Alpha coefficient?=?0.71, ICC of the symptom questions =0.8, ICC of the quality of life question =0.7). The symptoms questions and quality of life questions of the IPSS (Hong Kong Chinese versions 2) were sensitive in detecting differences between groups.

Conclusions

The IPSS (Hong Kong Chinese version 2) is a valid, reliable and sensitive measure to assess Chinese females and males with lower urinary tract symptoms. The IPSS quality of life question is more sensitive than the generic quality of life measure to differentiate subgroups.     

Probiotic effects in allergic disease

The increasing prevalence of allergic disease has been linked to reduced microbial exposure in early life. Probiotics have recently been advocated for the prevention and treatment of allergic disease. This article summarises recent publications on probiotics in allergic disease, focusing on clinical studies of prevention or treatment of allergic disease. Studies employing the combined administration of pre‐natal and post‐natal probiotics suggest a role for certain probiotics (alone or with prebiotics) in the prevention of eczema in early childhood, with the pre‐natal component of treatment appearing to be important for beneficial effects. On the other hand, current data are insufficient to support the use of probiotics for the treatment of established allergic disease, although recent studies have highlighted new hope in this area. Probiotic bacteria continue to represent the most promising intervention for primary prevention of allergic disease, and well‐designed definitive intervention studies should now be a research priority.     

Intrathecal administration of nitroxides as potential contrast agents for MR imaging

The diagnosis of various disorders of the cerebrospinal fluid (CSF) with magnetic resonance (MR) imaging may require the intrathecal administration of a paramagnetic contrast agent. Furthermore, the CSF route provides direct access to the brain, circumventing the blood-brain barrier. Three nitroxides, two charged and one uncharged, were administered intrathecally to dogs to assess their potential as contrast agents for MR imaging of the CSF. Nitroxide concentrations and proton T1 values were measured in samples of CSF removed at various times after nitroxide administration, and pharmacokinetic curves were constructed. The charged nitroxides had considerably longer half-lives than the uncharged compound. On in vivo MR imaging of the CSF (surrounding the upper cervical cord and brain stem) in one dog, use of a charged nitroxide as contrast agent led to considerably higher CSF signal intensity than was observed in the nonenhanced, baseline T1-weighted images. This effect was achieved at low doses (20 mumol) and sustained for at least 90 minutes. The intrathecal use of nitroxides as contrast agents for MR imaging warrants continued investigation.     

An evalution of atopic diseases in relation to immediate skin test reactions among schoolchildren in the Sør-Varanger community

Aim To compare the frequency of questionnaire based diagnosis of atopic diseases to those of clinical findings and sensitization and to evaluate the reliability of self-reported reactions to allergens with those confirmed by skin prick tests. Background Not only airborne allergens but also environmental indoor and outdoor air pollution are regarded as risk factors for the development of respiratory diseases in children. Metals, soot, SO₂, passive smoking and pollution from new building materials irritate both the skin and the respiratory mucosa and also increase the risk of atopic sensitization. A strong indication that atopic diseases are common in Sør-Varanger community, an area heavily polluted by the nearby Russian smelting plants, prompted us to investigate this hypothesis. Subjects The clinical and immunological examination involved 424 out of 575 schoolchildren aged 7–12 years. Results A total of 36% of the subjects were atopic; i.e. atopic dermatitis was established in 23% and mucous membrane atopy in 18%. 44% were definite non-atopies, leaving 14% not classifiable in either group and 6% latent atopies. Sensitization was confirmed by positive prick tests in 69% of children with a history of pollen allergy and 11% of those with a history of allergy to animal dander. Conclusions Skin prick tests are of little value in the diagnosis of atopic dermatitis but of major importance for the confirmation of mucous membrane atopy. In cases of controversy between history, clinical findings and sensitization, it is difficult to decide between atopies and non-atopies. Allergological examinations may be restricted to individuals with a positive symptom-based diagnosis only.     

缺氧/复氧损伤人脐静脉内皮细胞黏附分子表达与新型植物雌激素α-玉米赤霉醇的影响

目的:探讨新型植物雌激素α-玉米赤霉醇对缺氧/复氧损伤后人脐静脉内皮细胞黏附分子表达的干预,并与内源性动物雌激素雌二醇的作用进行比较。方法:实验于2005-10/2006-01在首都医科大学完成。①健康产妇的婴儿脐带由首都医科大学附属宣武医院妇产科提供,产妇及其家属签署捐赠同意书。α-玉米赤霉醇(中国农业大学提纯,纯度99%以上,以乙醇作为溶剂),雌二醇(Sigma公司)。②脐静脉内皮细胞原代培养后,用质量浓度为1.25g/L的胰蛋白酶 0.1g/L的乙二胺四乙酸混合消化液进行传代,传至2～3代后用于实验。细胞以3×105/孔接种于24孔培养板,待生长至80%～90%融合后,设立10组:正常对照组、模型对照组、α-玉米赤霉醇1,10,100,1000nmol/L组、雌二醇1,10,100,1000nmol/L组,6孔/组。③除正常对照组外,其余各组细胞均复制缺氧/复氧损伤模型,置于体积分数为0.93的N2 0.05的CO2 0.02的O2缺氧环境中3h,然后恢复正常氧供应1h。α-玉米赤霉醇各组于造模前20min分别加入α-玉米赤霉醇,使细胞培养液中α-玉米赤霉醇终浓度分别达到1,10,100,1000nmol/L;雌二醇各组于造模前20min分别加入雌二醇,使细胞培养液中雌二醇终浓度分别达到1,10,100,1000nmol/L;正常对照组、模型对照组不予任何药物处理。④吸取各组上清液,按酶联免疫吸附试剂盒说明操作分别测定各孔可溶性E-选择素、细胞间黏附分子1、血管细胞黏附分子1的含量。结果:①缺氧/复氧后各组细胞E-选择素含量的比较:与正常对照组比较,缺氧3h/复氧1h后模型对照组脐静脉内皮细胞上清液中的E-选择素含量明显升高[(1.77±0.36),(5.62±0.74)pg/L,P<0.01]。与模型对照组比较,α-玉米赤霉醇1,10,100,1000nmol/L组E-选择素含量均明显降低[(5.62±0.74),(3.53±1.21),(3.16±0.94),(2.79±1.78),(2.18±0.75)pg/L,P<0.05或0.01],雌二醇1,10,100,1000nmol/L组E-选择素含量亦均明显降低[(5.62±0.74),(3.72±0.42),(2.99±0.61),(2.45±0.99),(2.34±0.70)pg/L,P<0.01],且呈剂量依赖性。相同质量浓度的α-玉米赤霉醇与雌二醇作用差异无显著性意义(P>0.05)。②缺氧/复氧后各组细胞间黏附分子1、血管细胞黏附分子1含量的比较:与E-选择素含量情况相似。结论:①人脐静脉内皮细胞给予α-玉米赤霉醇预处理后,可显著抑制由缺氧/复氧损伤所引起的黏附分子高表达,且呈剂量依赖性,保护内皮细胞免受炎症递质损伤。②与相同浓度的雌二醇抑制作用相似,是一种有一定应用前景的雌激素替代药物。     

Quality of life,work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil

BACKGROUND Inflammatory bowel diseases(IBD) have been associated with a low quality of life(QoL) and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn's disease(CD) or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin 200 μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria) and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5 D-5 L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher's exact and Student's t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(a=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6% female,38.3%/37.1% employed),44.7%/25.2% presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P 0.05).Median work productivity impairment was 20% and 5% for CD and UC patients,respectively,and activity impairment was 30 %,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0% vs 10.0%,P 0.001).For CD/UC patients,respectively,25.4%/2.8% had at least one surgery,38.3%/19.6% were hospitalized,and 70.7%/77.6% changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%) for CD patients and 5-AS A compounds(77.5%) for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil.