Measuring health status with the Dartmouth COOP charts in low-functioning elderly. Do the illustrations affect the outcomes?

The Dartmouth COOP method consists of seven questions measuring seven domains of health status: physical fitness, feelings, daily activities, social activities, change in health status, current overall health perceptions and bodily pain. Each question has five response options and each option is accompanied by an illustration. In this paper, we present the results of a randomized study of the effects of the illustrations of the seven Dartmouth COOP charts in a low-functioning elderly sample. In addition, the subjective evaluation of the illustrations was examined. The results showed no significant differences between the outcomes obtained with the illustrated COOP charts and the unillustrated COOP charts: the mean scores, patterns of intercorrelations and associations with other measures for the research participants who filled in the illustrated COOP charts hardly differed from those obtained from the participants who filled in the unillustrated charts. Furthermore, the results showed that approximately three-quarters of the research participants considered the illustrations informative, while approximately 17% of the participants considered the pictures exaggerated. We conclude that, as long as there is no empirical support for the advantages of the COOP charts with respect to cross-cultural standardization or use in subjects who have, for example, difficulty in reading, there seems to be no need for the illustrated COOP charts. The results of our study showed that both types of COOP charts appear to be interchangeable.     

Adaptive responses among Dutch elderly: the impact of eight chronic medical conditions on health-related quality of life.

OBJECTIVES: This study analyzed the impact of eight common chronic medical conditions on functional, social, and affective domains of health-related quality of life among community-based Dutch elderly (n = 5279). METHODS: Health-related quality of life was measured with six domains of the MOS Short-Form General Health Survey. The impact of the selected chronic conditions on health-related quality of life was analyzed by means of Student's t tests, analyses of variance, and multiple regression analyses. RESULTS: Compared with other domains of health-related quality of life, mental health was the least affected by chronic medical conditions. Back problems and rheumatoid arthritis/other joint complaints accounted for relatively high proportions of the variance in health-related quality of life (from 35.5% to 68.3%), except for health perceptions (22.6%), indicating that health-related quality of life is most affected by these two conditions. CONCLUSIONS: Subjective well-being is by far the domain least affected by chronic medical conditions, while physical functioning and health perceptions are most affected. Back problems and rheumatoid arthritis/other joint complaints affect health-related quality of life strongly.     

A water-soluble cholesteryl-containing trisgalactoside: synthesis, properties, and use in directing lipid-containing particles to the liver

The synthesis of a trisgalactoside-terminated cholesterol derivative is described. Tris(galactosyloxymethyl)-aminomethane is coupled to cholesterol by using glycyl and succinyl as intermediate hydrophilic spacer moieties. The resulting cholesteryl ester dissolves easily in water, forming monodisperse micelles. When added to dispersions of liposomes or plasma lipoproteins in water, the substance becomes incorporated rapidly into these structures, causing an increase of their buoyant density. Liposomes or low-density lipoproteins, preloaded with the substance, are rapidly cleared from the circulation and taken up by the liver after intravenous injection in rats. This uptake is inhibited by N-acetylgalactosamine but not by N-acetylglucosamine, indicating the specificity of this process.     

Clinical use of the determination of serotonin in whole blood

Whole blood serotonin (5-hydroxytryptamine, 5-HT) was assayed, and factors possibly influencing 5-HT content were investigated in healthy controls. No significant circadian rhythm or effect of dexamethasone or meals was observed. After use of fluvoxamine, a specific 5-HT reuptake inhibitor, the whole-blood 5-HT concentration of patients was strongly reduced. After treatment with tranylcypromine, an unspecific monoamine oxidase inhibitor (MAOI), the 5-HT content was increased. Determination of whole blood 5-HT in patients treated with fluvoxamine presents a measure of drug compliance. Furthermore, the method may have clinical potential for finding an adequate dose when a 5-HT reuptake inhibitor or an MAOI is used.     

The CO2 conductivity electrode, a fast-responding CO2 microelectrode.

A fast-responding CO2 microelectrode system is presented; it consists of a double-lumen polyethylene catheter provided with a stainless steel catheter tip covered by a CO2-permeable membrane, and connected with each lumen separately to a conductivity cell. The catheter is flushed with bidistilled water at constant flow rate and conductivity of inflowing and outflowing water is measured. The change of conductivity in the water leaving the catheter after exposure of the electrode to a medium containing CO2 is related to the PCO2 of the medium. High sensitivity and fast response, both depending on the flow rate of the carrier water, are shown to oppose each other. When cells are placed at a distance of 45 cm from the membrane, response time for 90% deflection is about 10 sec (at flow rates of 5 ml/min), but when located inside the electrode tip at a distance of within 10 mm from the membrane response time is reduced to about 4 sec. Hydrodynamical aspects concerning dispersion of CO2 in the carrier water and reaction kinetics of CO2 hydration are discussed.     

Inflammation, proteases and cancer

Tumours are complex tissues composed of ever-evolving neoplastic cells, matrix proteins that provide structural support and sequester biologically active molecules, and a cellular stromal component. Reciprocal interactions between neoplastic cells, activated host cells and the dynamic micro-environment in which they live enables tumour growth and dissemination. It has become evident that early and persistent inflammatory responses observed in or around developing neoplasms regulates many aspects of tumour development (matrix remodelling, angiogenesis, malignant potential) by providing diverse mediators implicated in maintaining tissue homeostasis, e.g., soluble growth and survival factors, matrix remodelling enzymes, reactive oxygen species and other bioactive molecules. This review highlights recent insights into the role of chronic inflammation associated with cancer development and examines proteolytic pathways activated by infiltrating leukocytes during neoplastic programming of tissues.     

A single-unit carbon dioxide-oxygen sensing microelectrode system.

A membrane-covered CO2 microelectrode system is described; it consists of a platinum electrode surronded by a ring-shaped Ag-AgCl electrode, both in contact with an electrolyte layer composed 10 minus 3 M/l quinhydrone in 0.1 N KCl. The resulting oxidation-reduction potential is shown to vary linearly with the logarithm of the PCO2 of the medium. Response time for 95% deflection to a step change in PCO2 of 65 mm Hg is about 1 min i.e. considerably less than in the macroelectrode described previously, but stability is decreased at the same time. Since oxygen in concentrations up to about 21% (air) did not influence the CO2 response and the presence of both CO2 (10.33%) and quinhydrone (10 minus 3 M/l) did not alter the oxygen polarogran, this electorde may be used independently as an oxygen electrode as well. Stability and response time for oxygen were similar to those of the Clark electrode. Possibilities and limitations for in vivo estimation of PCO2 and PO2 are discussed.