Evaluation of health-related quality of life in patients candidate for spine and other musculoskeletal surgery

Introduction

Despite the high prevalence of musculoskeletal diseases, in Spain there are few data about how these conditions affect the quality of life of individuals. The objective of this study was to assess the quality of life (QOL) of patients candidate for orthopedic surgical treatment using an age–gender adjusted method of QOL scores.

Materials and methods

The SF-36 Health Survey was administered to 538 patients candidate for surgery between surgical treatment was classified in four groups (lumbar disease, cervical disease, knee arthroplasty, and hip arthroplasty). Associated morbidities were collected retrospectively for all cases using the Charlson co-morbidity index. Univariate, bivariate, and multivariate statistical analyses were done to compare the four groups to each other, to the general population mean, and to the age and gender-adjusted population mean.

Results

234 men and 304 women whose mean age was 58.78 years (19–89) were assessed. Patients candidate for some kind or lumbar surgery had the worst scores in all physical and mental scales as compared to the other disease groups. Patients candidate for knee arthroplasty, had the best quality of life scores in all scales, compared to the other disease groups. Medical conditions had no influence over the summary measures.

Conclusion

Presenting the results of SF-36 in standard deviations from the age- and gender-adjusted population mean (T values) leads to a better appreciation of the differences between the various diseases. Patients candidate for surgery of the lumbar spine had a worse QOL, while the QOL in patients candidate for knee arthroplasty was the least affected.     

C.E.R.A. maintains stable hemoglobin in Latin American patients on dialysis

Background

C.E.R.A. is a continuous erythropoietin receptor activator with characteristics that permit a once-monthly schedule of administration for the maintenance treatment for chronic kidney disease (CKD) patients. The main objective of this study was to assess the maintenance of Hb concentration with once-monthly intravenous and/or subcutaneous C.E.R.A. therapy in Latin American dialysis patients with chronic renal anemia previously treated with epoetin alfa s.c or i.v 1–3 times per week.

Methods

This was a single-arm, open-label, multicenter, 32-week study of anemic patients with CKD previously treated with epoetin alfa sc or iv 1–3 times per week. After a 4-week screening period, during which mean Hb levels were maintained between 10.5 and 12.5 g/dL on their previous erythropoiesis stimulating agent, eligible patients entered a 16-week C.E.R.A. dose titration period followed by a 4-week efficacy evaluation period (EEP) and a 28-week safety follow-up. The starting dose of C.E.R.A. was based on the previous dose of epoetin alfa. Doses of C.E.R.A. were then adjusted to maintain Hb levels within ±1.0 g/dL of the reference concentration and between 10.5 and 12.5 g/dL. The Hb reference concentration was defined as the mean of all Hb levels during screening. The primary end point was the proportion of patients maintaining a mean Hb concentration (g/dL) within ±1 g/dL of their reference Hb and between 10.5 and 12.5 g/dL during the EEP.

Results

A total of 163 patients from 27 centers in Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Peru, Uruguay, and Venezuela entered the treatment period and 102 completed the prescribed course of C.E.R.A. Forty-five patients (43.7 %) maintained a mean Hb concentration within ±1 g/dL of their reference Hb value and between 10.5 and 12.5 g/dL during the EEP. The median monthly dose remained constant at 120 μg during the titration period and during the EEP. On the average, there were only 2.3 dose changes per patient in 28 weeks of treatment, covering 7 C.E.R.A. scheduled administrations. 53 % of all dose changes were dose decreases, 47 % increases. A total of 10 AEs and 4 SAEs were considered to be related to the study treatment.

Conclusions

Once-monthly C.E.R.A. treatment effectively maintains stable Hb concentrations in patients with chronic renal anemia undergoing dialysis with a good safety and tolerability profile.     

Food is Never Enough: Nature and Nurture's Influence on Children's Food Dose Evaluation

This study investigated whether if socioeconomic factors and\or food palatability influence food amount evaluation among children. Ninety-four children, 10–15 years old, living in Mali in Africa, and 124 living in northern Italy were asked to evaluate an amount of palatable and non palatable candies. The evaluations were compared both to the real number of candies and to that given by the other group. Both Italian and Malian children underestimated the edible candies, interestingly however Malian children did not underestimate altered candies. The data suggest that food dose underestimation is a transcultural characteristic. Evaluation of palatable food is not influenced by socio cultural factors. Underestimation could be a biological protective factor against food shortage; in case of food abundance it could play a role in onset and maintenance of obesity.     

Pharmacokinetic drug evaluation of dolutegravir plus rilpivirine for the treatment of HIV

Introduction: The search for simple, potent, metabolic-friendly and nucleoside/nucleotide sparing antiretroviral regimens has led clinical investigators to move steps towards dual therapies. Among these the association of rilpivirine and dolutegravir is emerging as a twin randomized clinical trial (SWORD1&2) and at least three observational cohort describe it as a safe and highly effective regimen for switch from other therapies

Areas covered: We review the evidence supporting the use of dolutegravir plus rilpivirine for the treatment of HIV in virologically suppressed patients taking other antiretroviral regimens. The reasons for the switch in clinical practice may range from simplification to tolerability/toxicity issues, to the prevention of future metabolic damage, to predicted drug-drug interactions when treatment of HCV co-infection is planned. Articles searchable on MEDLINE/PubMed and from the main international congresses in the field of HIV therapy were reviewed to provide context for use of dolutegravir plus rilpivirine

Expert opinion: This treatment is highly effective in maintaining HIV-1 RNA <50 copies/mL. Although the studies up to date requested patient to switch to drugs they had no experience of, a predictable ‘radical change’ effect did not impact negatively on the results. Further data from these studies may help elucidate the possible advantage in terms of safety and metabolic effect in the next few months.     

Difficulties in Recognising Dynamic but not Static Emotional Body Movements in Autism Spectrum Disorder

Journal of Autism and Developmental Disorders - In this study, we investigated whether the difficulties in body motion (BM) perception may led to deficit in emotion recognition in Autism spectrum...     

Vesicle movements are governed by the size and dynamics of F-actin cytoskeletal structures in bovine chromaffin cells

Dense vesicles can be observed in live bovine chromaffin cells using fluorescent reflection confocal microscopy. These vesicles display a similar distribution, cytoplasmic density and average size as the chromaffin granules visualized by electron microscopy. In addition, the acidic vesicles labeled with Lysotracker Red comprised a subpopulation of the vesicles that are visualized by reflection fluorescence. A combination of fluorescence reflection and transmitted light images permitted the movements of vesicles in relation to the cortical cytoskeleton to be studied. The movement of vesicles located on the outside of this structure was restricted, with an apparent diffusion coefficient of 1.0+/-0.4 x 10(-4) microm(2)/s. In contrast, vesicles located in the interior moved much more freely and escaped from the visual confocal plane. Lysotracker labeling was more appropriate to study the movement of the faster moving vesicles, whose diffusion coefficient was five times higher. Using this type of labeling we confirmed the restriction on cortical movement and showed a clear relationship between vesicle mobility and the kinetics of cytoskeletal movement on both sides of the cortical cytoskeleton. This relationship was further emphasized by studying cytoskeletal organization and kinetics. Indeed, an estimate of the size of the cytoskeletal polygonal cages present in the cortical region and in the cell interior agreed well with the calculation of the theoretical radius of the cages imprisoning vesicle movement. Therefore, these data suggest that the structure and kinetics of the cytoskeleton governs vesicle movements in different regions of chromaffin cells.     

Correction to: In Vivo Modeling of Human Breast Cancer Using Cell Line and Patient-Derived Xenografts

Journal of Mammary Gland Biology and Neoplasia -     

PredyCLU: A prediction system for chronic leg ulcers based on fuzzy logic; part II—Exploring the arterial side

Peripheral arterial disease (PAD) and its most severe form, critical limb ischaemia (CLI), are very common clinical conditions related to atherosclerosis and represent the major causes of morbidity, mortality, disability, and reduced quality of life (QoL), especially for the onset of ischaemic chronic leg ulcers (ICLUs) and the subsequent need of amputation in affected patients. Early identification of patients at risk of developing ICLUs may represent the best form of prevention and appropriate management. In this study, we used a Prediction System for Chronic Leg Ulcers (PredyCLU) based on fuzzy logic applied to patients with PAD. The patient population consisted of 80 patients with PAD, of which 40 patients (30 males [75%] and 10 females [25%]; mean age 66.18 years; median age 67.50 years) had ICLUs and represented the case group. Forty patients (100%) (27 males [67.50%] and 13 females [32.50%]; mean age 66.43 years; median age 66.50 years) did not have ICLUs and represented the control group. In patients of the case group, the higher was the risk calculated with the PredyCLU the more severe were the clinical manifestations recorded. In this study, the PredyCLU algorithm was retrospectively applied on a multicentre population of 80 patients with PAD. The PredyCLU algorithm provided a reliable risk score for the risk of ICLUs in patients with PAD.