Incidence rate of falls and its risk factors in patients with rheumatoid arthritis compared to controls: Four years of the TOMORROW study

Objective: Patients with rheumatoid arthritis (RA) have been recognized to experience falls frequently due to functional disabilities. The aim of this study was to prospectively investigate factors influencing falls in patients with RA compared to controls.

Methods: We compared the frequency of falls in 208 RA patients and 205 age- and sex-matched volunteers for four years and analyzed risk factors for falls in RA patients using multivariate regression analysis.

Results: No significant difference in the incidence rate of falls (/person-year) between patients with RA (median [interquartile range]: 0 [0, 0.5]) and controls (0 [0, 0.5]) was evident during four years. Logistic regression analysis identified age, sex, body mass index, history of falls, and lower limb implant at baseline as significant risk factors for falls. The highest quartile of anti-CCP antibody level (>300.6?U/ml) was the strongest predictor for multiple falls (odds ratio, 2.97; 95% confidence interval, 1.12–7.91, p?=?0.029) among RA patients.

Conclusion: During four years we could not observe the higher incidence rate of falls in RA patients compared to controls in our cohort. Subjects with a higher titer of anti-CCP antibody might be at higher risk of frequent falls among RA patients.     

Sleep duration and remaining teeth among older people

BackgroundNo studies have examined the associations between the numbers of teeth and sleep disturbance. Therefore, we examined the associations between the number of teeth and sleep duration in older people, considering the evidence linking fewer teeth and sleep apnoea through changes in jaw position.MethodsFor this study we used information from a sample of 23,444 cohort participants, randomly selected from the Japan Gerontological Evaluation Study 2010 (N = 169,215). The outcome variable was self-reported sleep duration (h/day), and the explanatory variable was self-reported number of teeth (0, 1–9, 10–19, ≥20). We treated age, sex, body mass index, educational attainment, annual equalized household income, depressive symptoms, physical activity, activities of daily living, presence of diabetes, and smoking status as covariates. Multinomial logistic regression was used among the 20,548 eligible participants with all necessary information.ResultsThe mean age was 73.7 (standard deviation = 6.13) years. Most participants (28.1%) reported sleep duration of 7 h, while a small proportion of the participants reported short (≤4 h, 2.7%) or long (≥10 h, 4.7%) sleep duration. The proportion of edentulous participants was 14.7%. Taking the 7-h sleep duration as the reference category, edentulous participants (relative risk ratio (RRR) = 1.43, 95% confidence interval (CI) = 1.07–1.90) or one to nine teeth (RRR = 1.29, 95% CI = 1.02–1.63) had a significantly higher relative risk ratio for short sleep, independent of covariates. Furthermore, they had a higher relative risk ratio for long sleep duration (RRR = 1.75, 95% CI = 1.40–2.19; RRR = 1.48, 95% CI = 1.21–1.81, respectively).ConclusionsCompared to people with 20 or more teeth, older adults with fewer than 10 teeth have higher risks for short and long sleep durations.     

Blunted cardiovascular reactions are a predictor of negative health outcomes: A prospective cohort study

The study examined whether cardiovascular responses to psychological stress tests predict future anxiety and depression scores 40‐months later. Hemodynamic measures were obtained from 102 healthy adults before, during and after mental arithmetic, a speech task, and a cold pressor task. The 14‐item Hospital Anxiety and Depression Scale was administered at initial testing and at 40‐months follow‐up. At initial testing analyses revealed that high anxiety symptoms were characterized by blunted cardiovascular reactions to acute mental stress, particularly mental arithmetic. Furthermore, after adjustment for baseline blood pressure (BP ), baseline anxiety levels and traditional risk factors, attenuated systolic BP responses to mental arithmetic were associated with future anxiety levels (ΔR ² = .055). These findings suggest that blunted cardiovascular reactions to stress may be an independent risk factor for future anxiety levels.     

The preterm infant's use of triangular bids at three months,adjusted age: two case studies

This article focuses on preterm infants’ early triangular capacity, restricted to the use of triangular bids in interaction with their parents. An observational setting, the Lausanne Trilogue Play (LTP), is used for studying the patterns of interaction. This is an approach focusing on the family as a whole. These observations are part of a study consisting of video observations and interviews with the parents when the preterm infants are three and nine months, adjusted age. In this study, two out of nine infants were found to actively use triangular bids in interaction with their parents at three months, adjusted age. These two cases are presented to illustrate and discuss preterm infant's early use of triangular bids.     

齐刺阳陵泉对胆绞痛豚鼠IL-1β、IL-6的影响

目的:观察齐刺胆的下合穴阳陵泉对胆绞痛豚鼠血清白介素1β(1L-1β)和白介素6(IL-6)的影响以及镇痛效果。方法:将60只成年雄性豚鼠随机分为空白组(10只)、模型组(10只)、药物组(20只)和针刺组(20只),空白组正常饲养,模型组、药物组、针刺组造模成功后,药物组给予双氯芬酸钠盐酸利多卡因注射液腹腔注射,针刺组取双侧阳陵泉穴进行齐刺,每日1次。治疗5天后于腹主动脉采取新鲜血液,匀浆、离心后分离血清,采用酶联免疫吸附法(ELISE)测定IL-1β,IL-6的含量。结果:①与空白组比较,模型组豚鼠血清IL-1β、IL-6含量明显升高,差异有非常显著意义(P0.01);②与模型组比较,药物组、针刺组血清IL-1β、IL-6含量明显偏低,差异有非常显著意义(P0.01);与药物组比较,针刺组IL-1β、IL-6含量明显偏低,差异有显著意义(P0.05)。结论:针刺治疗对胆绞痛豚鼠有一定的镇痛作用,且针刺疗效明显优于药物组。     

Patient satisfaction with psychotropic drugs: Validation of the PAtient SAtisfaction with Psychotropic (PASAP) scale in patients with bipolar disorder

PurposeThe PAtient SAtisfaction with Psychotropic (PASAP) scale is a self-completed questionnaire measuring satisfaction with psychotropic medication. The aim of the study was to describe its development in French and its psychometric properties.Materials and methodsScale construction was based on an extensive search of the literature. The item reduction process required semi-structured interviews of psychiatric outpatients (n = 30). The final version of the PASAP is a 9-item, 5-point Likert-type scale, covering the scope of effectiveness and adherence. To assess the psychometric properties of the scale, French patients with an acute manic episode (n = 314) from a large European observational cohort completed the PASAP scale 3 months after psychotropic treatment initiation/change. Internal validity and reliability were assessed using principal component analysis (PCA). Concurrent validity was assessed using comparisons to physician-rated satisfaction with life, illness severity, mood relapse, compliance and side effects.ResultsParticipation rate was 68.4%. PCA was in favour of uni-dimensionality. Cronbach's α coefficient was 0.85 (95%CI 0.83–0.88). All five concurrent measures were significantly associated with the PASAP score.ConclusionThe PASAP scale showed good psychometric properties in a large bipolar population and thus seems adequate for evaluating treatment satisfaction. Its short length and good acceptability makes it suitable for clinical research.