Development of a Preference-Weighted Health Status Classification System in France: The Health Utilities Index 3

The Health Utilities Index is a generic multiattribute preference-based system for assessing health-related quality of life, devised by Torrance et al. It is being used in cost-effectiveness evaluations in North America and in international multicentre studies but was not available in France. Following adaptation of the HUI3 classification in France, the purpose of the reported investigation was to derive French preference weights. This article provides a reminder of the theoretical foundations used to model the multiattribute utility function. Within this framework, a multiattribute multiplicative aggregate utility function was constructed in accordance with the explicitly decomposed approach. The study took place in June 1999 over a sample of 365 persons from the French general population, aged between 20 and 65, and not suffering from any chronic or incapacitating illness. The recruitment procedure was based upon a random selection of individuals, using the phone book. Interviews took place in the homes of the interviewees. The methods of revelation (VAS and SG) were applied by setting the value of the best possible state of the HUI3 a priori at 1, and leaving a choice between two states (worst possible state, death) for 0. The aggregated individuals (person-mean and median) were calculated and the multiplicative utility functions constructed. A comparison of the calculated utilities with the observed ones provides a primary indicator of the validity of the person-mean or median functions constructed. The slight absolute differences obtained between observed and calculated utilities and the low RMSE scores lead us towards a favourable conclusion.     

Macro- and micro-nutrient intake of adolescent Greek female volleyball players

Adequate nutrition is critically important for the achievement of the adolescent athlete's optimal performance. The purpose of the present study was to evaluate the adequacy of macro- and micro-nutrients in the adolescent Greek female volleyball players' diet. The subjects of the study consisted of 16 players who were members of the Junior National Team (NP) and 49 players who participated in the Junior National Championship (CP). Dietary intake was assessed using a 3-day food record. Protein intake (16.0 +/- 4.9% of total energy intake) was satisfactory, whereas fat consumption (37.5 +/- 11.1%) was above recommended values and at the expense of carbohydrate intake (45.9 +/- 12.5%). There were no significant differences between NP and CP concerning the intake of macronutrients, except for the fat intake (when this is expressed in grams per day and grams per kilogram of body weight and the saturated fat intake, which were both higher in NP compared to CP players (p < .05). The mean energy intake was 2,013 +/- 971 and 1,529 +/- 675 kcal for NP and CP, respectively (p < .05). NP, in particular, consumed fat and especially saturated fatin orderto meet their energy needs. As for micronutrients, the volleyball players fell short of meeting the RDA values for calcium, iron, folic acid, magnesium, zinc, and vitamins A, B, B, and B2. There was no difference between NP and CP in micronutrient intake. In conclusion, subjects in the current study lacked proper nutrition in terms of quantity and quality.     

Long-term radiographic changes in cemented total hip arthroplasty with six designs of femoral components

Measurements were made from annual follow-up radiographs, obtained over 27.6 years, of 860 cemented total hip arthroplasties implanted by one surgeon. Femoral components were made of stainless steel or titanium alloy, were non-modular, and were all fixed with cement, and acetabular cups were all-polyethylene and were fixed with cement. Radiographic outcome was correlated with the shape and material of the femoral component. Specifically, throughout the follow-up, stems made of titanium alloy were at greater risk of developing bone-cement radiolucent lines than those made of stainless steel, the difference ranging from approximately 10-50 percent at 2-10 years of follow-up. Similarly, titanium alloy stems were at greater risk of developing endosteal scalloping, indicating osteolytic lesions. Among the stainless steel Charnley cobra and straight-narrow Charnley stems, none developed cement fracture, only one became radiographically loose and one developed endosteal scalloping. The differences in the risk of developing radiolucent lines, cement fracture and progressive loosening among these stems were correlated with the relative rigidity of the femoral stems, and were generally consistent with the predictions made heretofore using finite element models, although differences in stem surface finish and femoral ball size and material could have also influenced the results.     

Dexamethasone incorporating liposomes: an in vitro study of their applicability as a slow releasing delivery system of dexamethasone from covered metallic stents

Aim: To investigate the possibility of covering PET-covered commercially available metallic stents, with liposomal dexamethasone that will act as a slow releasing drug-depot at the site of interest. Methods: Large multilamellar (MLV), sonicated (SUV) and dried reconstituted (DRV) liposomes entrapping dexamethasone were prepared by thin film hydration, sonication and the DRV method, respectively, and applied on stents using a simple evaporation technique. Drug encapsulation and retention in liposomes were measured by HPLC. The presence of liposomes on the stent surface was confirmed by scanning electron microscopy, while the release of dexamethasone and lipid from the liposome-covered stent was evaluated under different conditions (flow rate, presence of plasma proteins), in an in vitro assembly that was developed to simulate in vivo conditions. Results: The release of dexamethasone from liposome-covered stents ranged from 25% to 50% after 48 h of incubation in buffer, depending on the type of liposome. The release was highest from stents covered with DRV liposomes. When increasing the flow rate from 2 to 6 ml/min a slight increase in release of drug was observed, while a higher release was measured when stents were incubated in plasma proteins. Liposome size does not affect liposome placement on stents. Conclusion: The basic characteristics that should be considered when preparing liposomes to cover stents should be their drug loading capacity and their stability under the conditions prevailing at the site of interest. By preparing the appropriate formulation, it is possible that liposomal drugs may be used to cover stents and serve as drug releasing depots at the site of interest. Further in vitro and in vivo studies are needed in order to exploit the possible applications of this methodology.     

Lifetime estrogen exposure versus age at menopause as mortality predictor

OBJECTIVES: The aim of this study was to evaluate the relation between lifetime estrogen exposure and mortality and compare this with menopausal age as exposure variable. METHODS: We studied a cohort of 1462 naturally postmenopausal women, aged 37-77 at enrollment in the Belgian Interuniversity Research on Nutrition and Health study. After a follow-up time of 10 years, 181 women had died, of whom 76 of cardiovascular causes. Logistic regression analysis was used to investigate the relations between lifetime estrogen exposure (calculated as menopausal age minus menarcheal age) and death as well as the relations between age at menopause and death. RESULTS: The risk of mortality was lower in women with a longer lifetime estrogen exposure as well as in women with higher menopausal ages. For women with a lifetime estrogen exposure of >or=40 years the odds ratio of all-cause mortality was 0.58 (95% confidence interval (CI) 0.35-0.93) compared to women who had a lifetime estrogen exposure of 相似文献   

Towards improved biomarker studies of cervical neoplasia: effects of precolposcopic procedures on gene expression patterns.

Among tumor sites, cervical cancer offers an ideal model for investigating differences in gene expression associated with transitions from normal to precancer and invasion to cancer. To evaluate the validity of assessing gene expression in cervical tissues acquired in a clinical setting, we investigated whether standard procedures, namely the application of acetic acid and/or Lugol's iodine, employed for the visualization of colposcopically directed biopsies, altered patterns in oligonucleotide (oligo) arrays. We compared microarray profiles from six women, each with three adjacent tissue samples removed from benign hysterectomy specimens and treated as follows: immediately frozen, acetic acid application only, acetic acid, and Lugol's iodine. Of the 22,464 original spots on the microarray, 4,850 spots were expressed at detectable levels for further evaluation upon data normalization and filtration. For each spot, the difference between topical applications was computed, and P values were calculated using a bivariate T2 test. Upon adjustment for multiple comparisons using both the Holm's and Hochberg's procedures as well as the False Discovery Rate (Benjamini-Hochberg and Benjamini-Yeuketili [BY]), we failed to identify genes differentially expressed and conclude that standard precolposcopic procedures do not substantially affect the overall gene expression patterns in the normal cervix.     

Frequency and effects of the apolipoprotein A-IV polymorphism

Plasma from 158 presumed healthy nuclear families has been analyzed by high-resolution, two-dimensional electrophoresis to study the frequency and effects of the genetic polymorphism in human apolipoprotein A-IV. Two common alleles, apo A-IV 1 and apo A-IV 2 were detected with relative frequencies of 0.943 and 0.057, respectively. Autosomal codominant transmission of these two alleles coded for by a single structural locus was demonstrated. Furthermore, we studied the effects of this apo A-IV variability on total plasma cholesterol, triglyceride, glucose levels and gamma-glutamyltransferase activity. Statistically significant differences among apo A-IV genotypes for the average glucose level were detected. The average effect of the apo A-IV 1 allele was to lower plasma glucose levels by 0.013 mmol/l, whereas the average effect of the apo A-IV 2 allele was to raise glucose levels by 0.213 mmol/l.     

Genetic relatedness of resistant and multiresistant Streptococcus pneumoniae strains,recovered in the Athens area,to international clones

The prevalence of resistance to antibiotics was examined among 318 Streptococcus pneumoniae strains isolated during 1998 and 1999 in a children's hospital in Athens. The rate of resistance to penicillin was 25.8% (intermediate 22%, resistant 3.8%); 42.5% of the strains were resistant to > or = 1 antibiotic and 20% were multidrug resistant. Resistance to penicillin was lowest in invasive strains (8.3%) and highest in ear isolates (31%). A review of the same microbiology laboratory's records revealed that there has been a gradual increase in penicillin resistance since 1988-1989, when it was 5%. Capsular types were determined for 77 strains resistant to > or = 1 antibiotic, and 69 (90%) of them belonged to the following five serotypes: 19F, 14, 9V, 23F, and 6B. Seventy-five strains were analyzed by pulsed-field gel electrophoresis (PFGE) and 59/75 (79%) shared five electrophoretic types. The largest cluster consisted of 19 serotype 19F strains, of which 18 were nonsusceptible to penicillin and most were multidrug resistant and shared a common and distinct electrophoretic pattern not resembling any known clone. A group of 17 strains that were nonsusceptible to penicillin belonged to serotypes 9V (10), 14 (6), and 19F (1) and shared a common PFGE type similar to the international clone Spain9V-3. Seven serotype 23F strains, of which five were multidrug resistant, belonged to the international clone Spain23F-1. Among the strains susceptible to penicillin but resistant to non-beta-lactam antibiotics, the largest cluster consisted of 13 isolates resistant to erythromycin that belonged to serotype 14 and shared an electrophoretic pattern characteristic of the clone England14-9. Finally, three serotype 6B strains were penicillin susceptible and multidrug resistant and had features similar to the Mediterranean 6B clone. The introduction and spread of several antibiotic-resistant international clones accounts at least in part for the increase in pneumococcal resistance observed in recent years in the Athens metropolitan area.     

Ultrastructural immunostaining of infiltrating ductal breast carcinomas with the monoclonal antibody H: a comparative study with cytokeratin 8

The monoclonal antibody H (mAbH) detects an epitope consisting of an O-linked N -acetyl glucosamine (O-GlcNAc) and neighboring amino acids. This epitope has been found by using extracts from the MCF-7 human breast carcinoma cell line in immunoblotting experiments, on cytokeratin 8 (CK8) and 5 other polypeptides. In the present study, a double immunogold method was applied for the colocalization of CK8 and mAbH epitope on epoxy thin sections in 18 cases of infiltrating ductal breast carcinomas (IDBC) and in 6 cases of fibroadenomas, to study the accurate subcellular distribution of CK8 in breast cancer cells, as compared to the 5 polypeptides, recognized by mAbH. Furthermore, a detailed quantitative evaluation of the double immunolocalization over the cellular compartments of cancer cells was undertaken with the aid of a computerized image analysis system and the results were assessed statistically. The distribution pattern of CK8 and the mAbH epitope in the neoplastic mammary epithelial cells was similar in IDBC as compared to fibroadenomas, while the gold labeling intensity of these epitopes differed over the cellular compartments between malignant and benign biopsies. The results reveal the significance of the role of CK8 and O-GlcNAc glycosylation in the biology of the neoplastic mammary cells in vivo, determining their malignant potential.