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Sample records for disease activity assessed

  1. Biomarkers in rheumatic diseases: how can they facilitate diagnosis and assessment of disease activity?

    Science.gov (United States)

    Mohan, Chandra; Assassi, Shervin

    2015-11-26

    Serological and proteomic biomarkers can help clinicians diagnose rheumatic diseases earlier and assess disease activity more accurately. These markers have been incorporated into the recently revised classification criteria of several diseases to enable early diagnosis and timely initiation of treatment. Furthermore, they also facilitate more accurate subclassification and more focused monitoring for the detection of certain disease manifestations, such as lung and renal involvement. These biomarkers can also make the assessment of disease activity and treatment response more reliable. Simultaneously, several new serological and proteomic biomarkers have become available in the routine clinical setting--for example, a protein biomarker panel for rheumatoid arthritis and a myositis antibody panel for dermatomyositis and polymyositis. This review will focus on commercially available antibody and proteomic biomarkers in rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis (scleroderma), dermatomyositis and polymyositis, and axial spondyloarthritis (including ankylosing spondylitis). It will discuss how these markers can facilitate early diagnosis as well as more accurate subclassification and assessment of disease activity in the clinical setting. The ultimate goal of current and future biomarkers in rheumatic diseases is to enable early detection of these diseases and their clinical manifestations, and to provide effective monitoring and treatment regimens that are tailored to each patient's needs and prognosis. © BMJ Publishing Group Ltd 2015.

  2. Validation of the "German Inflammatory Bowel Disease Activity Index (GIBDI)": An Instrument for Patient-Based Disease Activity Assessment in Crohn's Disease and Ulcerative Colitis.

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    Hüppe, Angelika; Langbrandtner, Jana; Häuser, Winfried; Raspe, Heiner; Bokemeyer, Bernd

    2018-05-09

    Assessment of disease activity in Crohn's disease (CD) and ulcerative colitis (UC) is usually based on the physician's evaluation of clinical symptoms, endoscopic findings, and biomarker analysis. The German Inflammatory Bowel Disease Activity Index for CD (GIBDI CD ) and UC (GIBDI UC ) uses data from patient-reported questionnaires. It is unclear to what extent the GIBDI agrees with the physicians' documented activity indices.  Data from 2 studies were reanalyzed. In both, gastroenterologists had documented disease activity in UC with the partial Mayo Score (pMS) and in CD with the Harvey Bradshaw Index (HBI). Patient-completed GIBDI questionnaires had also been assessed. The analysis sample consisted of 151 UC and 150 CD patients. Kappa coefficients were determined as agreement measurements.  Rank correlations were 0.56 (pMS, GIBDI UC ) and 0.57 (HBI, GIBDI CD ), with p < 0.001. The absolute agreement for 2 categories of disease activity (remission yes/no) was 74.2 % (UC) and 76.6 % (CD), and for 4 categories (none/mild/moderate/severe) 60.3 % (UC) and 61.9 % (CD). The kappa values ranged between 0.47 for UC (2 categories) and 0.58 for CD (4 categories).  There is satisfactory agreement of GIBDI with the physician-documented disease activity indices. GIBDI can be used in health care research without access to assessments of medical practitioners. In clinical practice, the index offers a supplementary source of information. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Assessment of disease activity in large-vessel vasculitis

    DEFF Research Database (Denmark)

    Aydin, Sibel Z.; Direskeneli, Haner; Merkel, Peter A.

    2017-01-01

    Objective. To arrive at consensus for candidate outcomes for disease activity assessment in largevessel vasculitis (LVV) in clinical trials. Methods.A Delphi survey including 99 items was circulated among international experts for 3 rounds. Results. Fifty-seven items were accepted for both giant ...

  4. Assessment of disease activity in juvenile idiopathic arthritis. The number and the size of joints matter

    DEFF Research Database (Denmark)

    Berntson, Lillemor; Wernroth, Lisa; Fasth, Anders

    2007-01-01

    Variables for assessment of disease activity of juvenile idiopathic arthritis (JIA) were studied, in order to develop a disease activity score for children with JIA.......Variables for assessment of disease activity of juvenile idiopathic arthritis (JIA) were studied, in order to develop a disease activity score for children with JIA....

  5. Comparison of Disease Activity Score in 28 joints with ESR (DAS28), Clinical Disease Activity Index (CDAI), Health Assessment Questionnaire Disability Index (HAQ-DI) & Routine Assessment of Patient Index Data with 3 measures (RAPID3) for assessing disease activity in patients with rheumatoid arthritis at initial presentation.

    Science.gov (United States)

    Kumar, B Siddhartha; Suneetha, P; Mohan, Alladi; Kumar, D Prabath; Sarma, K V S

    2017-11-01

    In patients with rheumatoid arthritis (RA), disease severity assessment is done using Disease Activity Score in 28 joints with ESR (DAS28). Computing DAS28 is time-consuming, requires laboratory testing and an online calculator. There is a need to validate rapid methods of disease severity assessment for routine daily use. This study was conducted to compare DAS28, Clinical Disease Activity Index (CDAI), Health Assessment Questionnaire Disability Index (HAQ-DI) and Routine Assessment of Patient Index Data with 3 measures (RAPID3) to assess the disease activity in patients with RA. We prospectively studied the utility of CDAI, HAQ-DI and RAPID3 scoring in 100 consecutive newly diagnosed, disease modifying antirheumatic drugs (DMARDs) naïve adult patients with RA seen during January 2013 and June 2014 at a tertiary care teaching hospital in south India. The mean age of the patients was 42.1±11.6 yr, there were 82 females. The median [interquartile range (IQR)] symptom duration was 6 (range 4-12) months. The median (IQR) DAS28, CDAI, HAQ-DI and RAPID3 scores at presentation were 7 (6-7), 36 (28-43), 2 (1-2) and 17 (13-19), respectively. A significant positive correlation was observed between DAS28 and CDAI (r=0.568; Pfair' agreement was observed in between DAS28 and CDAI (kappa-statistic=0.296). The agreement between DAS28 and HAQ-DI (kappa-statistic=0.007) and RAPID3 (kappa-statistic=0.072) was less robust. In adult patients with RA, in the setting where illiteracy is high, CDAI emerged as the preferred choice for rapid assessment of severity of disease at the time of initial presentation.

  6. Assessment of subclinical atherosclerosis in ankylosing spondylitis: correlations with disease activity indices

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    F.M. Perrotta

    2013-07-01

    Full Text Available The aim of the study was to evaluate atherosclerosis in ankylosing spondylitis (AS through the assessment of morphological and functional measures of subclinical atherosclerosis. Twenty patients [M/F=12/8, age (median/range 43.5/28-69 years; disease duration (median/range 9.7/1-36 years] with AS classified according to modified New York criteria and twenty age and sex related healthy controls with negative past medical history for cardiovascular events were enrolled in the study. In all patients and controls, the intima-media thickness (IMT of common carotid artery, carotid bulb and internal carotid artery, and the flow-mediated dilatation (FMD of non-dominant arm brachial artery were determined, using a sonographic probe Esaote GPX (Genoa, Italy. Furthermore, we assess the main disease activity and disability indices [bath ankylosing spondylitis disease activity index, ankylosing spondylitis disease activity score-eritrosedimentation rate (ASDAS-ESR, ASDAS-C-reactive protein (CRP, bath ankylosing spondylitis metrology index, bath ankylosing spondylitis functional index and acute phase reactants. Plasmatic values of total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride and homocysteine were carried out in all twenty patients. IMT at carotid bulb was significant higher in patients than in controls (0.67 mm vs 0.54 mm; P=0.03. FMD did not statistically differ between patients and controls (12.5% vs 15%; P>0.05. We found a correlation between IMT at carotid bulb and ESR (rho 0.43; P=0.04. No correlation was found between FMD and disease activity and disability indices. This study showed that in AS patients, without risk factors for cardiovascular disease, carotid bulb IMT, morphological index of subclinical atherosclerosis, is higher than in controls.

  7. Assessing the activity of perianal Crohn's disease: comparison of clinical indices and computer-assisted anal ultrasound.

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    Losco, Alessandra; Viganò, Chiara; Conte, Dario; Cesana, Bruno Mario; Basilisco, Guido

    2009-05-01

    Assessing perianal disease activity is important for the treatment and prognosis of Crohn's disease (CD) patients, but the diagnostic accuracy of the activity indices has not yet been established. The aim of this study was to determine the accuracy and agreement of the Fistula Drainage Assessment (FDA), Perianal Disease Activity Index (PDAI), and computer-assisted anal ultrasound imaging (AUS). Sixty-two consecutive patients with CD and perianal fistulae underwent clinical, FDA, PDAI, and AUS evaluation. Perianal disease was considered active in the presence of visible fistula drainage and/or signs of local inflammation (induration and pain at digital compression) upon clinical examination. The AUS images were analyzed by calculating the mean gray-scale tone of the lesion. The PDAI and gray-scale tone values discriminating active and inactive perianal disease were defined using receiver operating characteristics statistics. Perianal disease was active in 46 patients. The accuracy of the FDA was 87% (confidence interval [CI]: 76%-94%). A PDAI of >4 and a mean gray-scale tone value of 117 maximized sensitivity and specificity; their diagnostic accuracy was, respectively, 87% (CI: 76%-94%) and 81% (CI: 69%-90%). The agreement of the 3 evaluations was fair to moderate. The addition of AUS to the PDAI or FDA increased their diagnostic accuracy to respectively 95% and 98%. The diagnostic accuracy of the FDA, PDAI, and computer-assisted AUS imaging was good in assessing perianal disease activity in patients with CD. The agreement between the techniques was fair to moderate. Overall accuracy can be increased by combining the FDA or PDAI with AUS.

  8. Diffusion-weighed MR of the thyroid gland in Graves' disease: assessment of disease activity and prediction of outcome.

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    Abdel Razek, Ahmed Abdel Khalek; Sadek, Ahmed Galal; Gaballa, Gada

    2010-06-01

    To assess the activity and clinical course of Graves' disease with diffusion-weighted magnetic resonance (MR) imaging. Fifty-one patients with Graves' disease and 25 volunteers underwent diffusion MR imaging of the thyroid gland using a single shot echo-planar imaging with b-factor of 0, 300 and 600 second/mm(2). The apparent diffusion coefficient (ADC) values of the thyroid gland were calculated. Patients with active Graves' disease included untreated patients at initial diagnosis (n = 12), patients under antithyroid drugs (n = 11), and patients in relapse after withdrawal of therapy (n = 13). Patients with inactive disease had a remission of hyperthyroidism (n = 15). The mean ADC values of thyroid gland with active Graves' disease was 0.65 +/- 0.03 x 10(-3) mm(2)/second in patients at initial diagnosis, 0.81 +/- 0.02 x 10(-3) mm(2)/second in patients undergoing antithyroid drug and 0.72 +/- 0.07 x 10(-3) mm(2)/second in patients with relapse of hyperthyroidism. The mean ADC of patients with remission was 0.94 +/- 0.03 x 10(-3) mm(2)/second and for normal volunteer was 1.06 +/- 0.08 x 10(-3) mm(2)/second. There was significant difference in the ADC value of patients with active disease and remission (P = .001). The cutoff ADC value used for differentiating patients with active disease from patients with remission was 0.82 x 10(-3) mm(2)/second. The mean ADC value of thyroid gland had positive correlation with thyroid-stimulating hormone (r = 0.87, P = .001) and negative correlation with serum T4 (r = -0.82, P = .001) and serum T3 (r = -0.71, P = .001). The ADC value of the thyroid gland is a promising non invasive parameter for diagnosis of different clinical stages of Graves' disease. Hence it can be used to assess the activity and predict the outcome of patients during and after medical treatment. Crown Copyright (c) 2010. Published by Elsevier Inc. All rights reserved.

  9. Whole-Body MRI versus PET in assessment of multiple myeloma disease activity.

    LENUS (Irish Health Repository)

    Shortt, Conor P

    2009-04-01

    The purpose of this study was to compare FDG PET; whole-body MRI; and the reference standard, bone marrow aspiration and biopsy, to determine the best imaging technique for assessment of disease activity in multiple myeloma.

  10. Assessment of inflammatory activity in Crohn's disease by means of dynamic contrast-enhanced MRI.

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    Pupillo, V A; Di Cesare, E; Frieri, G; Limbucci, N; Tanga, M; Masciocchi, C

    2007-09-01

    Our aim was to perform a dynamic study of contrast enhancement of the intestinal wall in patients with Crohn's disease to quantitatively assess local inflammatory activity. We studied a population of 50 patients with histologically proven Crohn's disease. Magnetic resonance imaging (MRI) was performed using a 1.5-T magnet with a phased-array coil and acquisition of T2-weighted single-shot fast spin echo (SSFSE) half Fourier sequences before intravenous administration of gadolinium, and T1-weighted fast spoiled gradient (FSPGR) fat-saturated sequences before and after contrast administration. Before the examination, patents received oral polyethylene glycol (PEG) (1,000 ml for adults; 10 ml/Kg of body weight for children). Regions of interest (ROI) were placed on the normal and diseased intestinal wall to assess signal intensity and rate of increase in contrast enhancement over time. Data were compared with the Crohn's Disease Activity Index (CDAI). The diseased bowel wall showed early and intense uptake of contrast that increases over time until a plateau is reached. In patients in the remission phase after treatment, signal intensity was only slightly higher in diseased bowel loops than in healthy loops. There was a significant correlation between the peak of contrast uptake and CDAI. Dynamic MRI is a good technique for quantifying local inflammatory activity of bowel wall in patients with Crohn's disease.

  11. Assessment of inflammatory bowel disease activity by technetium 99m phagocyte scanning

    International Nuclear Information System (INIS)

    Pullman, W.E.; Sullivan, P.J.; Barratt, P.J.; Lising, J.; Booth, J.A.; Doe, W.F.

    1988-01-01

    Autologous technetium 99m-labeled phagocyte scanning has been used to assess disease activity in inflammatory bowel disease in 51 consecutive patients. Strong correlations were found between the 24-h fecal excretion of isotope and the histologic score of mucosal biopsy specimens (rS = 0.84, p less than 0.001, where rS is Spearman's rank correlation coefficient), and between the 24-h fecal excretion of isotope and a clinical inflammatory bowel disease activity index based on the Crohn's disease activity index (rS = 0.87, p less than 0.001). To develop a clinically useful and objective measure of inflammatory bowel disease activity that did not require a 24-h stool collection, the intensity of bowel uptake on scanning was graded visually from 0 to 4, a ratio of count rates for the region of interest to the iliac crest reference region was calculated, and the rapidity of labeled phagocyte uptake into inflamed bowel was measured as the peak uptake time. Visual grading of disease activity on the scans was validated by comparing it with the ratio of count rates from inflamed bowel regions of interest and those from the iliac crest reference region. The ratio of count rates showed a significant correlation with the clinical disease activity index (r = 0.75, p less than 0.001). The visual scan grade also correlated well with the clinical activity index (r = 0.87, p less than 0.001). Count rates from hourly scans were also used to calculate the time of peak uptake of counts for a given region of interest. There was a strong negative correlation between this peak uptake time and the fecal excretion of isotope (rS = -0.81, p less than 0.001), a clinical activity index (r = -0.60, p less than 0.001), and the histologic score of the mucosal biopsy specimens (r = -0.84, p less than 0.001)

  12. Magnetization transfer ratio for the assessment of perianal fistula activity in Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Pinson, C.; Dolores, M.; Cruypeninck, Y.; Koning, E.; Dacher, J.N.; Savoye-Collet, C. [Rouen University Hospital-Charles Nicolle, Department of Radiology, Rouen cedex (France); Savoye, G. [Rouen University Hospital-Charles Nicolle, Department of Gastroenterology, Rouen cedex (France)

    2017-01-15

    Assessment of perianal fistulas is important to guide management of Crohn's disease (CD). Our objectives were to analyze the feasibility of magnetization transfer (MT) imaging to assess fistulas and to evaluate its contribution in assessing disease activity. During 15 months, all patients referred for perianal fistulas in CD underwent 3T-MRI including diffusion, T2/T1-weighted gadolinium-enhanced sequences and MT sequences (one with an off-resonance saturation pulse of 800 and one with 1200 Hz). We collected Van Assche score, fistula activity signs by analyzing T2, diffusion and contrast enhancement. We calculated MT ratio (MTR) with a ROI in the largest fistula. Twenty-nine patients (mean 34.9 years, range 17-53) were included. Van Assche score was 11.7, range 4-21. In 22 patients, the fistula presented with a bright T2 and diffusion signal with contrast enhancement, and was characterized as active. Mean MTR was respectively 47.2 (range 12-68) and 34.3 (range 11-57) at 800 and 1200 Hz. MTR at 800 Hz was significantly lower in non-active (34, range 12-55) than in active fistulas (51, range 24-68) (p < 0.02). MTR is feasible for the assessment of fistulas in CD and in the future could be used to help identify active and non-active fistulas. (orig.)

  13. Nutritional status of Iranian women with rheumatoid arthritis: an assessment of dietary intake and disease activity.

    Science.gov (United States)

    Hejazi, Jalal; Mohtadinia, Javad; Kolahi, Soasan; Bakhtiyari, Mahmood; Delpisheh, Ali

    2011-09-01

    Long-standing chronic diseases such as rheumatoid arthritis are known to be associated with impairment of nutritional status to some degree. The present study aimed to assess nutritional status of women with rheumatoid arthritis and compare their ingestion of certain micronutrients with dietary reference intakes. In this cross-sectional study, 90 eligible women were recruited. After examination, all patients were evaluated on the basis of disease activity score, calculated using the number of tender and swollen joints, patient global assessment of pain and high sensitivity C-reactive protein (CRP). A three-day 24 h recall was completed and a 10 ml fasting blood sample was obtained to assess the plasma levels of malondialdehyde, total antioxidant and CRP. Despite normal BMI, intake of energy and micronutrients including calcium, folic acid, zinc, magnesium and vitamin B6 were considerably lower compared with the dietary reference intakes. There was no significant relationship between intake of different nutrients or food groups and disease activity score and the biochemical markers including malondialdehyde, CRP and total antioxidant. Intake of energy and some micronutrients were significantly lower than the recommended values. However, no relationship was found between intake of different food groups or nutrients with disease activity or serum antioxidant capacity.

  14. Interplay between patient global assessment, pain, and fatigue and influence of other clinical disease activity measures in patients with active rheumatoid arthritis

    DEFF Research Database (Denmark)

    Egsmose, Emilie Lund; Madsen, Ole Rintek

    2015-01-01

    The interplay between patient-reported outcome measures in rheumatology is not well clarified. The objective of the study was to examine associations on the group level and concordance on the individual patient level between patient global assessment (PaGl), pain, and fatigue as scored on visual...... analog scales (VAS) in the daily clinic by patients with active rheumatoid arthritis (RA). Associations with other measures of disease activity were also examined. Traditional disease activity data on 221 RA patients with active disease planned to initiate biological treatment were extracted from...... clinical measures of disease activity and were nearly identical on the group level. On the individual patient level, however, differences between the scores varied considerably. The findings highlight the challenge of understanding and dealing with traditional patient-reported VAS measures when it comes...

  15. Validity of a Questionnaire to Assess the Physical Activity Level in Coronary Artery Disease Patients

    Science.gov (United States)

    Guiraud, Thibaut; Granger, Richard; Bousquet, Marc; Gremeaux, Vincent

    2012-01-01

    The aim of the study is to compare, in coronary artery disease patients, physical activity (PA) assessed with the Dijon Physical Activity Questionnaire (DPAQ) and the true PA objectively measured using an accelerometer. Seventy patients wore an accelerometer (MyWellness Key actimeter) throughout 1 week after a cardiac rehabilitation program that…

  16. Role of Doppler ultrasonography evaluation of superior mesenteric artery flow volume in the assessment of Crohn's disease activity

    Directory of Open Access Journals (Sweden)

    Fabiana Paiva Martins

    2013-09-01

    Full Text Available Objective To investigate superior mesenteric artery flow measurement by Doppler ultrasonography as a means of characterizing inflammatory activity in Crohn's disease. Materials and Methods Forty patients were examined and divided into two groups – disease activity and remission – according to their Crohn's disease activity index score. Mean superior mesenteric artery flow volume was calculated for each group and correlated with Crohn's disease activity index score. Results The mean superior mesenteric artery flow volume was significantly greater in the patients with active disease (626 ml/min ± 236 × 376 ml/min ± 190; p = 0.001. As a cut off corresponding to 500 ml/min was utilized, the superior mesenteric artery flow volume demonstrated sensitivity of 83% and specificity of 82% for the diagnosis of Crohn's disease activity. Conclusion The present results suggest that patients with active Crohn's disease have increased superior mesenteric artery flow volume as compared with patients in remission. Superior mesenteric artery flow measurement had a good performance in the assessment of disease activity in this study sample.

  17. Disease activity in pregnant women with Crohn's disease and birth outcomes: a regional Danish cohort study

    DEFF Research Database (Denmark)

    Nørgård, Bente; Hundborg, Heidi H; Jacobsen, Bent Ascanius

    2007-01-01

    OBJECTIVES: CD is associated with increased risk of adverse birth outcomes, but existing studies have not assessed the impact of disease activity during pregnancy. We examined the impact of disease activity on birth outcomes: LBW, preterm birth, LBW at term, and CAs. METHODS: All births by CD wom...... disease activity). Further research is needed to assess the critical impact of disease activity in larger cohorts of CD women....

  18. Responsiveness of Endoscopic Indices of Disease Activity for Crohn's Disease

    NARCIS (Netherlands)

    Khanna, Reena; Zou, Guangyong; Stitt, Larry; Feagan, Brian G.; Sandborn, William J.; Rutgeerts, Paul; McDonald, John W. D.; Dubcenco, Elena; Fogel, Ronald; Panaccione, Remo; Jairath, Vipul; Nelson, Sigrid; Shackelton, Lisa M.; Huang, Bidan; Zhou, Qian; Robinson, Anne M.; Levesque, Barrett G.; D'Haens, Geert

    2017-01-01

    The Crohn's Disease Endoscopic Index of Severity (CDEIS) and the Simple Endoscopic Score for Crohn's Disease (SES-CD) are commonly used to assess Crohn's disease (CD) activity; however neither instrument is fully validated. We evaluated the responsiveness to change of the SES-CD and CDEIS using data

  19. STUDY OF CORRELATION AND SIGNIFICANCE OF BIOCHEMICAL PARAMETERS IN THE ASSESSMENT OF ACTIVE PHASE OF THYROID EYE DISEASE

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    Ashok Kumar P

    2016-08-01

    Full Text Available AIM Role of Interleukin-6 and HS-CRP Levels in the assessment of active thyroid eye disease. MATERIALS & METHODS A prospective observational study of 30 patients from the age group of 20-60 years with thyroid eye disease done at Regional Institute of Ophthalmology. All patients were subjected to detailed history, ocular examination, systemic examination, biochemical analysis and Imaging. Patients are categorised as mild, moderate and severe active disease based on clinical activity score. For the period of two years, patients are followed at regular periodic intervals according to the severity of disease and results were analysed. RESULTS Out of 30 patients studied, majority of the patients were females (60%, and 70% of the patients had bilateral disease. Among 30 patients, 83.33% in hyperthyroid state, 3.33% in Hypothyroid state, 13.33% in Euthyroid state (Table 3. Smoking being important risk factor in 30% among males. 50% of patients presented with mild disease, 30% with moderate disease, 0% with severe disease. IL-6, HS-CRP levels are increased only in patients with severe active disease (Table 6. Remission attained in all patients when treated earlier with steroids. CONCLUSION Identifying disease activity early and aggressive treatment with systemic steroids in active phase of moderate and severe disease has reduced the morbidity associated with disease. Correlation of IL-6, HS-CRP, TFT levels are significantly increased only in patients with active phase of severe thyroid eye disease but not significantly elevated in active phase of moderate disease. Another pitfall is IL-6 is an expensive ELISA based diagnosis. Thus, IL-6 & HS-CRP cannot be routinely used to screen patients with Thyroid eye disease.

  20. Chronic destructive pulmonary tuberculosis: assessment of disease activity by computed tomography

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    Nam, Kyung Jin; Jeong, Yeon Joo [Dept. of Radiology, Pusan National Univ. Hospital, Pusan National Univ. School of Medicine and Medical Research Inst., Pusan (Korea, Republic of)], E-mail: jeongyj@pusan.ac.kr; Kim, Yeong Dae; I, Hoseok [Thoracic and Cardiovascular Surgery, Pusan National Univ. Hospital, Pusan National Univ. School of Medicine and Medical Research Inst., Pusan (Korea, Republic of); Kim, Kun-Il; Lee, Jun Woo [Dept. of Radiology, Pusan National Univ. Yangsan Hospital, Pusan National Univ. School of Medicine, Pusan (Korea, Republic of); Park, Hye Kyung [Internal Medicine, and Pusan National Univ. Hospital, Pusan National Univ. School of Medicine and Medical Research Inst., Pusan (Korea, Republic of)

    2012-11-15

    Background Determination of disease activity of chronic destructive pulmonary tuberculosis (TB) on imaging studies can be difficult because several imaging findings due to disease chronicity such as a residual cavity can be misinterpreted as an active disease. Purpose To evaluate computed tomography (CT) findings to predict active disease in patients with chronic destructive pulmonary TB. Material and Methods CT findings of 36 patients with chronic active destructive pulmonary TB and 78 patients with chronic inactive destructive pulmonary TB were reviewed and their patterns of lung lesions were compared. Statistical comparisons were performed using chi-square and Student's T tests for univariate analyses, and a stepwise logistic regression method was used for multivariate analysis. Results Based on univariate analyses, cavitary destruction (P = 0.015), non-branching centrilobular nodules (P < 0.001), tree-in-bud pattern (P < 0.001), airspace nodules (P < 0.001), and cavities in other lobes (P = 0.001) were more frequently seen in chronic active destructive pulmonary TB. A stepwise logistic regression analysis demonstrated that tree-in-bud pattern (odds ratio, 52.3; 95% confidence interval, 6.2-437.2; P < 0.001) were significant CT findings associated with active disease. Conclusion Tree-in-bud pattern were the most characteristic CT findings to predict active disease in patients with chronic destructive pulmonary TB.

  1. Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes

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    Rossini Lucio

    2009-10-01

    Full Text Available Abstract Background Research has shown that fecal biomarkers are useful to assess the activity of inflammatory bowel disease (IBD. The aim of the study is: to evaluate the efficacy of the fecal lactoferrin and calprotectin as indicators of inflammatory activity. Findings A total of 78 patients presenting inflammatory bowel disease were evaluated. Blood tests, the Crohn's Disease Activity Index (CDAI, Mayo Disease Activity Index (MDAI, and Crohn's Disease Endoscopic Index of Severity (CDEIS were used for the clinical and endoscopic evaluation. Two tests were performed on the fecal samples, to check the levels of calprotectin and lactoferrin. The performance of these fecal markers for detection of inflammation with reference to endoscopic and histological inflammatory activity was assessed and calculated sensitivity, specificity, accuracy. A total of 52 patient's samples whose histological evaluations showed inflammation, 49 were lactoferrin-positive, and 40 were calprotectin-positive (p = 0.000. Lactoferrin and calprotectin findings correlated with C-reactive protein in both the CD and UC groups (p = 0.006; p = 0.000, with CDAI values (p = 0.043; 0.010, CDEIS values in DC cases (p = 0,000; 0.000, and with MDAI values in UC cases (p = 0.000. Conclusion Fecal lactoferrin and calprotectin are highly sensitive and specific markers for detecting intestinal inflammation. Levels of fecal calprotectin have a proportional correlation to the degree of inflammation of the intestinal mucosa.

  2. Habitual physical activity in mitochondrial disease.

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    Apabhai, Shehnaz; Gorman, Grainne S; Sutton, Laura; Elson, Joanna L; Plötz, Thomas; Turnbull, Douglass M; Trenell, Michael I

    2011-01-01

    Mitochondrial disease is the most common neuromuscular disease and has a profound impact upon daily life, disease and longevity. Exercise therapy has been shown to improve mitochondrial function in patients with mitochondrial disease. However, no information exists about the level of habitual physical activity of people with mitochondrial disease and its relationship with clinical phenotype. Habitual physical activity, genotype and clinical presentations were assessed in 100 patients with mitochondrial disease. Comparisons were made with a control group individually matched by age, gender and BMI. Patients with mitochondrial disease had significantly lower levels of physical activity in comparison to matched people without mitochondrial disease (steps/day; 6883±3944 vs. 9924±4088, p = 0.001). 78% of the mitochondrial disease cohort did not achieve 10,000 steps per day and 48% were classified as overweight or obese. Mitochondrial disease was associated with less breaks in sedentary activity (Sedentary to Active Transitions, % per day; 13±0.03 vs. 14±0.03, p = 0.001) and an increase in sedentary bout duration (bout lengths/fraction of total sedentary time; 0.206±0.044 vs. 0.187±0.026, p = 0.001). After adjusting for covariates, higher physical activity was moderately associated with lower clinical disease burden (steps/day; r(s) = -0.49; 95% CI -0.33, -0.63, Pphysical activity between different genotypes mitochondrial disease. These results demonstrate for the first time that low levels of physical activity are prominent in mitochondrial disease. Combined with a high prevalence of obesity, physical activity may constitute a significant and potentially modifiable risk factor in mitochondrial disease.

  3. Histologic scoring indices for evaluation of disease activity in Crohn's disease

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    Novak, Gregor; Parker, Claire E.; Pai, Rish K.; Macdonald, John K.; Feagan, Brian G.; Sandborn, William J.; D'Haens, Geert; Jairath, Vipul; Khanna, Reena

    2017-01-01

    Histologic assessment of mucosal disease activity has been increasingly used in clinical trials of treatment for Crohn's disease. However, the operating properties of the currently existing histologic scoring indices remain unclear. A systematic review was undertaken to evaluate the development and

  4. Habitual physical activity in mitochondrial disease.

    Directory of Open Access Journals (Sweden)

    Shehnaz Apabhai

    Full Text Available Mitochondrial disease is the most common neuromuscular disease and has a profound impact upon daily life, disease and longevity. Exercise therapy has been shown to improve mitochondrial function in patients with mitochondrial disease. However, no information exists about the level of habitual physical activity of people with mitochondrial disease and its relationship with clinical phenotype.Habitual physical activity, genotype and clinical presentations were assessed in 100 patients with mitochondrial disease. Comparisons were made with a control group individually matched by age, gender and BMI.Patients with mitochondrial disease had significantly lower levels of physical activity in comparison to matched people without mitochondrial disease (steps/day; 6883±3944 vs. 9924±4088, p = 0.001. 78% of the mitochondrial disease cohort did not achieve 10,000 steps per day and 48% were classified as overweight or obese. Mitochondrial disease was associated with less breaks in sedentary activity (Sedentary to Active Transitions, % per day; 13±0.03 vs. 14±0.03, p = 0.001 and an increase in sedentary bout duration (bout lengths/fraction of total sedentary time; 0.206±0.044 vs. 0.187±0.026, p = 0.001. After adjusting for covariates, higher physical activity was moderately associated with lower clinical disease burden (steps/day; r(s = -0.49; 95% CI -0.33, -0.63, P<0.01. There were no systematic differences in physical activity between different genotypes mitochondrial disease.These results demonstrate for the first time that low levels of physical activity are prominent in mitochondrial disease. Combined with a high prevalence of obesity, physical activity may constitute a significant and potentially modifiable risk factor in mitochondrial disease.

  5. Identification of laboratory markers of disease activity in rheumatoid arthritis abstract objective

    International Nuclear Information System (INIS)

    Naqi, N.; Ahmed, T.A.; Malik, J.M.

    2012-01-01

    To identify the laboratory markers of disease activity, by finding relationship of biochemical markers with clinical disease activity measurement in patients suffering from rheumatoid arthritis (RA). Study Design: Cross sectional analytical study. Place and duration of study: Department of Immunology, Armed Forces Institute of Pathology (AFIP), Rawalpindi from January 2009 to January 2010 in collaboration with Fauji Foundation Hospital and Military Hospital Rawalpindi. Patients and Methods: One hundred patients diagnosed as having rheumatoid arthritis (RA) as per American college of Rheumatology (ACR) revised criteria 1987 and fulfilling the study's inclusion criteria were studied. These patients were assessed clinically according to Simplified Disease Activity Index (SDAI) and divided into three groups which were mild, moderate and severe based on disease activity. These three groups were then assessed for disease activity by Rheumatoid factor (RA factor), Anti Cyclic Citrullinated Peptide antibodies (anti CCP antibodies), Erythrocyte Sedimentation Rate (ESR) and C- Reactive Proteins (CRP). The association of these laboratory markers with three groups of disease activity was analyzed to detect most sensitive disease activity markers for RA. Results: All the assessed laboratory markers that are RA factor, anti CCP antibodies, ESR and CRP are directly related with RA disease activity and any of them can be used to assess disease activity in RA. However a combination of the tests, analyzed in this study markers maybe used for better prediction of disease activity Conclusion: The identification of the laboratory markers of disease activity may help physician to diagnose aggressive disease early and evaluate prognosis in RA patients. (author)

  6. Assessment of Quality of Life, Psychological and Functional Status and Disease Activity in Patients with Ankylosing Spondylitis and Fibromyalgia

    Directory of Open Access Journals (Sweden)

    Mehmet Caglayan

    2016-03-01

    Full Text Available Objective: Anxiety and depression are psychological dis­orders which frequently accompany and affect the course of rheumatic diseases. Quality of life is also affected by psychological status. In this study, we aimed to assess psychological status and quality of life in patients with an­kylosing spondylitis (AS and fibromyalgia (FM and in­vestigate their association with functional status, disease activity and physical limitation. Method: Thirty-seven patients with AS and thirty-four patients with FM were included in this study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI and Bath Ankylosing Spondylitis Functional Index (BAS­FI were used for assessment of disease activity and physical functions respectively. The Ankylosing Spondy­litis Quality of Life (ASQoL questionnaire was used for disease-related quality of life in AS patients. Fibromyalgia Impact Questionnaire (FIQ was used for assessment of functional status in FM patients. Nottingham Health Pro­file (NHP and the Hospital Anxiety and Depression Scale (HADS were, respectively, used for assessment of qual­ity of life and psychological status in groups. Results: There was no significant difference between the groups in HADS-total, HADS-depression and HADS-anxiety scores (p>0.05. However, patients with FM had significantly higher NHP-total and NHP-pain scores com­pared to patients with AS (p<0.05. Conclusion: There was no significant difference be­tween the two groups in psychological distress. Higher NHP-pain scores in patients with FM might have been caused by lower pain threshold in these patients. The generalizability of our findings is also limited because of the relatively small sample size. J Clin Exp Invest 2016; 7 (1: 41-46

  7. The Role of MR Enterography in Assessing Crohn’s Disease Activity and Treatment Response

    Directory of Open Access Journals (Sweden)

    Matthew P. Moy

    2016-01-01

    Full Text Available MR enterography (MRE has become the primary imaging modality in the assessment of Crohn’s disease (CD in both children and adults at many institutions in the United States and worldwide, primarily due to its noninvasiveness, superior soft tissue contrast, and lack of ionizing radiation. MRE technique includes distention of the small bowel with oral contrast media with the acquisition of T2-weighted, balanced steady-state free precession, and multiphase T1-weighted fat suppressed gadolinium contrast-enhanced sequences. With the introduction of molecule-targeted biologic agents into the clinical setting for CD and their potential to reverse the inflammatory process, MRE is increasingly utilized to evaluate disease activity and response to therapy as an imaging complement to clinical indices or optical endoscopy. New and emerging MRE techniques, such as diffusion-weighted imaging (DWI, magnetization transfer, ultrasmall superparamagnetic iron oxide- (USPIO- enhanced MRI, and PET-MR, offer the potential for an expanded role of MRI in detecting occult disease activity, evaluating early treatment response/resistance, and differentiating inflammatory from fibrotic strictures. Familiarity with MR enterography is essential for radiologists and gastroenterologists as the technique evolves and is further incorporated into the clinical management of CD.

  8. Dynamic Measurement of Disease Activity in Acute Pancreatitis: The Pancreatitis Activity Scoring System.

    Science.gov (United States)

    Wu, Bechien U; Batech, Michael; Quezada, Michael; Lew, Daniel; Fujikawa, Kelly; Kung, Jonathan; Jamil, Laith H; Chen, Wansu; Afghani, Elham; Reicher, Sonya; Buxbaum, James; Pandol, Stephen J

    2017-07-01

    Acute pancreatitis has a highly variable course. Currently there is no widely accepted method to measure disease activity in patients hospitalized for acute pancreatitis. We aimed to develop a clinical activity index that incorporates routine clinical parameters to assist in the measurement, study, and management of acute pancreatitis. We used the UCLA/RAND appropriateness method to identify items for inclusion in the disease activity instrument. We conducted a systematic literature review followed by two sets of iterative modified Delphi meetings including a panel of international experts between November 2014 and November 2015. The final instrument was then applied to patient data obtained from five separate study cohorts across Southern California to assess profiles of disease activity. From a list of 35 items comprising 6 domains, we identified 5 parameters for inclusion in the final weighted clinical activity scoring system: organ failure, systemic inflammatory response syndrome, abdominal pain, requirement for opiates and ability to tolerate oral intake. We applied the weighted scoring system across the 5 study cohorts comprising 3,123 patients. We identified several distinct patterns of disease activity: (i) overall there was an elevated score at baseline relative to discharge across all study cohorts, (ii) there were distinct patterns of disease activity related to duration of illness as well as (iii) early and persistent elevation of disease activity among patients with severe acute pancreatitis defined as persistent organ failure. We present the development and initial validation of a clinical activity score for real-time assessment of disease activity in patients with acute pancreatitis.

  9. Magnetic resonance imaging assessed inflammation in the wrist is associated with patient-reported physical impairment, global assessment of disease activity and pain in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Glinatsi, Daniel; Baker, Joshua F; Hetland, Merete L

    2017-01-01

    metacarpophalangeal joints in the analyses did not strengthen the associations between MRI pathology and PROs. CONCLUSIONS: MRI-assessed inflammation, but not damage, in early RA wrists is associated with patient-reported physical impairment, global assessment of disease activity and pain and influences the physical...

  10. Histologic scoring indices for evaluation of disease activity in Crohn's disease.

    Science.gov (United States)

    Novak, Gregor; Parker, Claire E; Pai, Rish K; MacDonald, John K; Feagan, Brian G; Sandborn, William J; D'Haens, Geert; Jairath, Vipul; Khanna, Reena

    2017-07-21

    Histologic assessment of mucosal disease activity has been increasingly used in clinical trials of treatment for Crohn's disease. However, the operating properties of the currently existing histologic scoring indices remain unclear. A systematic review was undertaken to evaluate the development and operating characteristics of available histologic disease activity indices in Crohn's disease. Electronic searches of MEDLINE, EMBASE, PubMed, and the Cochrane Library (CENTRAL) databases from inception to 20 July 2016 were supplemented by manual reviews of bibliographies and abstracts submitted to major gastroenterology meetings (Digestive Disease Week, United European Gastroenterology Week, European Crohn's and Colitis Organisation). Any study design (e.g. randomised controlled trial, cohort study, case series) that evaluated a histologic disease activity index in patients with Crohn's disease was considered for inclusion. Study participants included adult patients (> 16 years), diagnosed with Crohn's disease using conventional clinical, radiographic or endoscopic criteria. Two authors independently reviewed the titles and abstracts of the studies identified from the literature search. The full text of potentially relevant citations were reviewed for inclusion and the study investigators were contacted as needed for clarification. Any disagreements regarding study eligibility were resolved by discussion and consensus with a third author.Two authors independently extracted and recorded data using a standard form. The following data were recorded from each eligible study: number of patients enrolled; number of patients per treatment arm; patient characteristics: age and gender distribution; description of histologic disease activity index utilized; and outcomes such as content validity, construct validity, criterion validity, responsiveness, intra-rater reliability, inter-rater reliability, and feasibility. Sixteen reports of 14 studies describing 14 different numerical

  11. A cross-sectional study of pain sensitivity, disease-activity assessment, mental health, and fibromyalgia status in rheumatoid arthritis.

    Science.gov (United States)

    Joharatnam, Nalinie; McWilliams, Daniel F; Wilson, Deborah; Wheeler, Maggie; Pande, Ira; Walsh, David A

    2015-01-20

    Pain remains the most important problem for people with rheumatoid arthritis (RA). Active inflammatory disease contributes to pain, but pain due to non-inflammatory mechanisms can confound the assessment of disease activity. We hypothesize that augmented pain processing, fibromyalgic features, poorer mental health, and patient-reported 28-joint disease activity score (DAS28) components are associated in RA. In total, 50 people with stable, long-standing RA recruited from a rheumatology outpatient clinic were assessed for pain-pressure thresholds (PPTs) at three separate sites (knee, tibia, and sternum), DAS28, fibromyalgia, and mental health status. Multivariable analysis was performed to assess the association between PPT and DAS28 components, DAS28-P (the proportion of DAS28 derived from the patient-reported components of visual analogue score and tender joint count), or fibromyalgia status. More-sensitive PPTs at sites over or distant from joints were each associated with greater reported pain, higher patient-reported DAS28 components, and poorer mental health. A high proportion of participants (48%) satisfied classification criteria for fibromyalgia, and fibromyalgia classification or characteristics were each associated with more sensitive PPTs, higher patient-reported DAS28 components, and poorer mental health. Widespread sensitivity to pressure-induced pain, a high prevalence of fibromyalgic features, higher patient-reported DAS28 components, and poorer mental health are all linked in established RA. The increased sensitivity at nonjoint sites (sternum and anterior tibia), as well as over joints, indicates that central mechanisms may contribute to pain sensitivity in RA. The contribution of patient-reported components to high DAS28 should inform decisions on disease-modifying or pain-management approaches in the treatment of RA when inflammation may be well controlled.

  12. Assessment of leg muscle activity using toe tapping in patients with Parkinson's disease: comparison of two types of toe tapping.

    Science.gov (United States)

    Taniguchi, Seira; Peper, Ferdinand; Shimokawa, Tetsuya

    2018-05-01

    [Purpose] This study investigates two types of toe tapping, i.e., "closed," with both feet on the floor, and "open," in which the foot does not touch the ground, and evaluates their usefulness in combination with monitoring of muscle activity during toe tapping. [Subjects and Methods] The study enrolled 11 patients with Parkinson's disease (PD) and 9 controls (Controls). The tibialis anterior (TA) and gastrocnemius (GS) muscle activity during toe tapping was measured using surface electromyography. [Results] In closed tapping, the minima in GS activation with the first tap was significantly higher in patients with PD than in Controls. In open tapping, the coefficient of variation (CV) of local maxima in TA activation was significantly higher in patients with PD than in Controls. In both types of tapping, the CV of extrema in GS activities increased with disease duration, but this may be due to the long-term administration of Levodopa, which itself tends to cause excessive GS activities. [Conclusion] Closed tapping is suitable for the assessment of GS activity and can detect excessive activities, which is observed as visible movement. Open tapping, on the other hand, is suitable for assessment of TA activity.

  13. Myocardial adrenergic nerve activity in valvular diseases assessed by iodine-123-metaiodobenzylguanidine myocardial scintigraphy

    International Nuclear Information System (INIS)

    Imamura, Yoshihiro; Fukuyama, Takaya

    1997-01-01

    Iodine-123-metaiodobenzylguanidine (MIBG) imaging was used to assess myocardial adrenergic nerve activity in patients with heart failure. MIBG planar images were obtained in 94 patients. The uptake of MIBG, calculated as the heart-to-mediastinum activity ratio in the immediate image (15 min), showed a significant decrease only in patients with severe heart failure due to cardiomyopathy, but was not changed in those with valvular diseases. Storage and release of MIBG, calculated as the percentage myocardial MIBG washout from 15 min to 4 hours after isotope injection, was substantially accelerated in both patients with cardiomyopathy and valvular diseases in proportion to the severity of heart failure. These data suggest that, in severe heart failure associated with cardiomyopathy, norepinephrine uptake is reduced. Also, myocardial adrenergic nerve activity is accelerated in proportion to the severity of heart failure independent of the underlying cause. MIBG images were analyzed in 20 patients with mitral stenosis with the same methods to clarify whether myocardial adrenergic nerve activity is different in patients with heart failure without left ventricular volume or pressure overload. Myocardial uptake of MIBG did not show any significant difference. The percentage myocardial MIBG washout was increased in patients with severe heart failure. The closest correlation was between myocardial washout and cardiac output. In heart failure due to mitral stenosis, myocardial adrenergic nerve activity is intensified. Decrease in cardiac output associated with mitral stenosis acts as a potent stimulus for this intensification. (author)

  14. Assessment of disease activity of idiopathic pulmonary fibrosis (IPF) using FDG PET and high-resolution computed tomography (HRCT)

    International Nuclear Information System (INIS)

    Kim, Bom Sahn; Kang, Won Jun; Oh, So Won; Lee, Jeong Won; Kang, Ji Yeon; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul

    2007-01-01

    Idiopathic pulmonary fibrosis (lPF) is induced by an uncontrolled accumulation and an activation of fibroblasts. The activity of IPF can be assessed according to the degrees of fibrosis and ground glass opacity (GGO) on HRCT. However, it has been thought that FDG PET reflects activity of inflammatory disease. The aim of this study was to compare the HRCT score and FDG uptake in patients with IPF. Six patients with IPF (M: F=4: 2, age 66.513.8 y) who underwent both FDG PET-CT and HRCT were enrolled (interval=33.042.6 d). The activity of IPF was scored at the level of the 1 cm above the diaphragm on HRCT, which was thought to be standard level of lower lobe. The degree of fibrosis was scored from 0 to 5 (0: no fibrosis, 1: interlobular septal wall thickening, 2: 75%). GGO was quantified from 0 to 5 (0: no GGO, 1: = 5 % of the lobe, 2: 5- 75%). Total score of HRCT was defined as the summed score of fibrosis and GGO. Standardized uptake value (SUV) was measured on same plane of FDG PET-CT by manual drawing of region of interest (ROI). SUV ratio of lung to liver was used as a metabolic marker of IPF activity. SUV ratio had a positive correlation with fibrosis score of HRCT (r=0.727, p=0.027), but did not have a significant correlation with GGO score (r=0.228, p=0.556). SUV ratio had a better correlation with total score of HRCT (r=0.895 and p<0.001). We demonstrated that SUV ratio might reflect disease activity of IPF. SUV ratio had a positive correlation with fibrosis score or total score on HRCT. FDG PET could be used to assess disease activity of IPF

  15. Measures of rheumatoid arthritis disease activity in Australian clinical practice.

    Science.gov (United States)

    Taylor, Andrew; Bagga, Hanish

    2011-01-01

    Objectives. To investigate which rheumatoid arthritis (RA) disease activity measures are being collected in patients receiving glucocorticoids, non-biologic or biologic disease-modifying antirheumatic drugs (DMARDs) in Australian rheumatology practice. Methods. A retrospective audit of medical records was conducted from eight rheumatology practices around Australia. Each rheumatologist recruited 30 consecutive eligible patients into the review, 10 of whom must have been receiving a biological agent for rheumatoid arthritis. Disease activity measures and radiographic assessments were collected from each patient's last consultation. For biologic patients, disease activity measures were also collected from when the patient was first initiated on the biological agent. Results. At last consultation, the disease measures that were recorded most often were ESR (89.2%), haemoglobin (87.5%), and CRP (84.2%). DAS28 was infrequently recorded (16.3%). The rate of recording disease activity measures for patients receiving biologic DMARDs decreased over time (mean 27 months). Conclusion. This review has shown inconsistency of RA activity measures being recorded in Australian rheumatology clinical practice. An accurate assessment of the disease process is necessary to effectively target rheumatoid arthritis patients to treat in order to achieve optimal outcomes.

  16. Development of a preliminary composite disease activity index in psoriatic arthritis.

    LENUS (Irish Health Repository)

    Mumtaz, Aizad

    2012-02-01

    OBJECTIVES: To develop a preliminary composite psoriatic disease activity index (CPDAI) for psoriasis and psoriatic arthritis. METHODS: Five domains were assessed and specific instruments were employed for each domain to determine the extent of domain involvement and the effect of that involvement on quality of life\\/function. Disease activity for each domain was then graded from 0 to 3 giving a CPDAI range of 0-15. Patient and physician global disease activity measures were also recorded and an independent physician was asked to indicate if treatment change was required. Bivariate correlation analysis was performed. Factor, tree analysis and standardised response means were also calculated. RESULTS: Significant correlation was seen between CPDAI and both patient (r = 0.834) and physician (r = 0.825) global disease activity assessments (p = 0.01). Tree analysis revealed that 96.3% of patients had their treatment changed when CPDAI values were greater than 6; no patient had their treatment changed when CPDAI values were less than 5. CONCLUSION: CPDAI correlates well with patient and physician global disease activity assessments and is an effective tool that clearly distinguishes those who require a treatment change from those who do not.

  17. Assessment of fall-related self-efficacy and activity avoidance in people with Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Drake Anna-Maria

    2010-10-01

    Full Text Available Abstract Background Fear of falling (FOF is common in Parkinson's disease (PD, and it is considered a vital aspect of comprehensive balance assessment in PD. FOF can be conceptualized differently. The Falls-Efficacy Scale (FES assesses fall-related self-efficacy, whereas the Survey of Activities and Fear of Falling in the Elderly (SAFFE assesses activity avoidance due to the risk of falling. This study aimed at investigating the validity and reliability of FES and SAFFE in people with PD. Methods Seventy-nine people with PD (mean age; 64 years, SD 7.2 completed the Swedish version of FES(S, SAFFE and the physical functioning (PF scale of the 36-Item Short-Form Health Survey (SF-36. FES(S and SAFFE were administered twice, with an 8.8 (SD 2.3 days interval. Assumptions for summing item scores into total scores were examined and score reliability (Cronbach's alpha and test-retest reliability were calculated. Construct validity was assessed by examining the pattern of Spearman correlations (rs between the FES(S/SAFFE and other variables, and by examining differences in FES(S/SAFFE scores between fallers and non-fallers, genders, and between those reporting FOF and unsteadiness while turning. Results For both scales, item mean scores (and standard deviations were roughly similar and corrected item-total correlations exceeded 0.4. Reliabilities were ≥0.87. FES(S-scores correlated strongest (rs, -0.74, p s, -0.76, p s ≤ 0.08. Experiencing falls, unsteadiness while turning, and FOF was associated with lower fall-related self-efficacy and higher activity avoidance. Conclusions This study provides initial support for the score reliability and validity of the FES(S and SAFFE in people with PD.

  18. Assessment of disease activity of idiopathic pulmonary fibrosis (IPF) using FDG PET and high-resolution computed tomography (HRCT)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bom Sahn; Kang, Won Jun; Oh, So Won; Lee, Jeong Won; Kang, Ji Yeon; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    Idiopathic pulmonary fibrosis (lPF) is induced by an uncontrolled accumulation and an activation of fibroblasts. The activity of IPF can be assessed according to the degrees of fibrosis and ground glass opacity (GGO) on HRCT. However, it has been thought that FDG PET reflects activity of inflammatory disease. The aim of this study was to compare the HRCT score and FDG uptake in patients with IPF. Six patients with IPF (M: F=4: 2, age 66.513.8 y) who underwent both FDG PET-CT and HRCT were enrolled (interval=33.042.6 d). The activity of IPF was scored at the level of the 1 cm above the diaphragm on HRCT, which was thought to be standard level of lower lobe. The degree of fibrosis was scored from 0 to 5 (0: no fibrosis, 1: interlobular septal wall thickening, 2: <25 % of the lobe, 3: 25-49 %, 4: 50-75 %, 5: >75%). GGO was quantified from 0 to 5 (0: no GGO, 1: = 5 % of the lobe, 2: 5-<25 %, 3: 25-49 %, 4: 50-75%, 5: >75%). Total score of HRCT was defined as the summed score of fibrosis and GGO. Standardized uptake value (SUV) was measured on same plane of FDG PET-CT by manual drawing of region of interest (ROI). SUV ratio of lung to liver was used as a metabolic marker of IPF activity. SUV ratio had a positive correlation with fibrosis score of HRCT (r=0.727, p=0.027), but did not have a significant correlation with GGO score (r=0.228, p=0.556). SUV ratio had a better correlation with total score of HRCT (r=0.895 and p<0.001). We demonstrated that SUV ratio might reflect disease activity of IPF. SUV ratio had a positive correlation with fibrosis score or total score on HRCT. FDG PET could be used to assess disease activity of IPF.

  19. Evaluation of rectus extraocular muscles using dynamic contrast-enhanced MR imaging in patients with Graves' ophthalmopathy for assessment of disease activity

    International Nuclear Information System (INIS)

    Jiang, Hong; Wang, Zhenchang; Xian, Junfang; Li, Jing; Chen, Qinghua; Ai, Likun

    2012-01-01

    Background. It is important to assess the activity of Graves' ophthalmopathy (GO) for planning optimal treatment strategy. Dynamic contrast-enhanced MR imaging (DCE-MRI) is a technique for assessment of microcirculation status. The correlation between disease activity and the microcirculation characteristics of extraocular muscles (EOMs) has been demonstrated in GO. Purpose. To investigate the changes of rectus EOMs in patients with active vs. inactive GO using DCE-MRI, and to evaluate the value of DCE-MRI in assessing the activity of GO. Material and Methods. Rectus EOMs of 20 healthy controls, 18 patients with active GO, and 16 patients with inactive GO were studied. The signal intensity (SI) of rectus EOMs on T 2 W images was evaluated. Regions of interest were placed on each rectus on DCE-MRI images. The DCE-MRI parameters including time to peak enhancement (T peak ), enhancement ratio (ER), and wash-out ratio (WR) were calculated. Results. There were significant differences in SI and T peak , ER and WR values among the three groups (P = 0.000). However, there was no significant difference in SI between the active and inactive groups (P = 0.07). Tpeak values of each rectus were significantly increased in inactive group compared with the active group (P peak ), maximum ER (maxER) and maximum WR (maxWR) (P peak , maxER and maxWR were 156.98s, 1.31 and 13.50% respectively, giving positive predictive values of 68.00%, 88.90%, and 94.44% for the assessment of disease activity. Conclusion. DCE-MRI could demonstrate the micro circulatory changes of rectus EOMs in both active and inactive GO, and this MRI method is a useful tool in differentiating active from inactive GO

  20. Remote Physical Activity Monitoring in Neurological Disease: A Systematic Review.

    Science.gov (United States)

    Block, Valerie A J; Pitsch, Erica; Tahir, Peggy; Cree, Bruce A C; Allen, Diane D; Gelfand, Jeffrey M

    2016-01-01

    To perform a systematic review of studies using remote physical activity monitoring in neurological diseases, highlighting advances and determining gaps. Studies were systematically identified in PubMed/MEDLINE, CINAHL and SCOPUS from January 2004 to December 2014 that monitored physical activity for ≥24 hours in adults with neurological diseases. Studies that measured only involuntary motor activity (tremor, seizures), energy expenditure or sleep were excluded. Feasibility, findings, and protocols were examined. 137 studies met inclusion criteria in multiple sclerosis (MS) (61 studies); stroke (41); Parkinson's Disease (PD) (20); dementia (11); traumatic brain injury (2) and ataxia (1). Physical activity levels measured by remote monitoring are consistently low in people with MS, stroke and dementia, and patterns of physical activity are altered in PD. In MS, decreased ambulatory activity assessed via remote monitoring is associated with greater disability and lower quality of life. In stroke, remote measures of upper limb function and ambulation are associated with functional recovery following rehabilitation and goal-directed interventions. In PD, remote monitoring may help to predict falls. In dementia, remote physical activity measures correlate with disease severity and can detect wandering. These studies show that remote physical activity monitoring is feasible in neurological diseases, including in people with moderate to severe neurological disability. Remote monitoring can be a psychometrically sound and responsive way to assess physical activity in neurological disease. Further research is needed to ensure these tools provide meaningful information in the context of specific neurological disorders and patterns of neurological disability.

  1. Remote Physical Activity Monitoring in Neurological Disease: A Systematic Review

    Science.gov (United States)

    Block, Valerie A. J.; Pitsch, Erica; Tahir, Peggy; Cree, Bruce A. C.; Allen, Diane D.; Gelfand, Jeffrey M.

    2016-01-01

    Objective To perform a systematic review of studies using remote physical activity monitoring in neurological diseases, highlighting advances and determining gaps. Methods Studies were systematically identified in PubMed/MEDLINE, CINAHL and SCOPUS from January 2004 to December 2014 that monitored physical activity for ≥24 hours in adults with neurological diseases. Studies that measured only involuntary motor activity (tremor, seizures), energy expenditure or sleep were excluded. Feasibility, findings, and protocols were examined. Results 137 studies met inclusion criteria in multiple sclerosis (MS) (61 studies); stroke (41); Parkinson's Disease (PD) (20); dementia (11); traumatic brain injury (2) and ataxia (1). Physical activity levels measured by remote monitoring are consistently low in people with MS, stroke and dementia, and patterns of physical activity are altered in PD. In MS, decreased ambulatory activity assessed via remote monitoring is associated with greater disability and lower quality of life. In stroke, remote measures of upper limb function and ambulation are associated with functional recovery following rehabilitation and goal-directed interventions. In PD, remote monitoring may help to predict falls. In dementia, remote physical activity measures correlate with disease severity and can detect wandering. Conclusions These studies show that remote physical activity monitoring is feasible in neurological diseases, including in people with moderate to severe neurological disability. Remote monitoring can be a psychometrically sound and responsive way to assess physical activity in neurological disease. Further research is needed to ensure these tools provide meaningful information in the context of specific neurological disorders and patterns of neurological disability. PMID:27124611

  2. Adult Congenital Heart Disease Patients Experience Similar Symptoms of Disease Activity.

    Science.gov (United States)

    Cedars, Ari M; Stefanescu Schmidt, Ada; Broberg, Craig; Zaidi, Ali; Opotowsky, Alexander; Grewal, Jasmine; Kay, Joseph; Bhatt, Ami B; Novak, Eric; Spertus, John

    2016-03-01

    There is a lack of objective data on the symptoms characterizing disease activity among adults with congenital heart disease (ACHD). The purpose of this study was to elicit the most important symptoms from patients across the spectrum of ACHD and to examine whether reported symptoms were similar across the spectrum of ACHD as a foundation for creating a patient-reported outcome measure(s). We constructed a 39-item survey using input from physicians specializing in ACHD to assess the symptoms patients associate with disease activity. Patients (n=124) prospectively completed this survey, and the results were analyzed based on underlying anatomy and disease complexity. A confirmatory cohort of patients (n=40) was then recruited prospectively to confirm the validity of the initial data. When grouped based on underlying anatomy, significant differences in disease-related symptom rankings were found for only 6 of 39 symptoms. Six symptoms were identified which were of particular significance to patients, regardless of underlying anatomy. Patients with anatomy of great complexity experienced greater overall symptom severity than those with anatomy of low or moderate complexity, attributable exclusively to higher ranking of 5 symptoms. The second patient cohort had symptom experiences similar to those of the initial cohort, differing in only 5 of 39 symptoms. This study identified 6 symptoms relevant to patients across the spectrum of ACHD and remarkable homogeneity of patient experience, suggesting that a single disease-specific patient-reported outcome can be created for quality and outcome assessments. © 2016 American Heart Association, Inc.

  3. Physical activity and cardiovascular disease risk factors among ...

    African Journals Online (AJOL)

    Background: Cardiovascular diseases (CVD) risk factors are increasing at an unprecedented rate in developing countries. However, fewer studies have evaluated the role of physical activity in preventing CVD in these countries. We assessed level physical activity and its relationship with CVD risk factors among young and ...

  4. Assessment of Diet and Physical Activity in Paediatric Non-Alcoholic Fatty Liver Disease Patients: A United Kingdom Case Control Study

    Directory of Open Access Journals (Sweden)

    Philippa S. Gibson

    2015-11-01

    Full Text Available Non-alcoholic fatty liver disease (NAFLD is the most common cause of chronic liver disease in children, with prevalence rising alongside childhood obesity rates. This study aimed to characterise the habitual diet and activity behaviours of children with NAFLD compared to obese children without liver disease in the United Kingdom (UK. Twenty-four biopsy-proven paediatric NAFLD cases and eight obese controls without biochemical or radiological evidence of NAFLD completed a 24-h dietary recall, a Physical Activity Questionnaire (PAQ, a Dutch Eating Behavior Questionnaire (DEBQ and a 7-day food and activity diary (FAD, in conjunction with wearing a pedometer. Groups were well matched for age and gender. Obese children had higher BMI z-scores (p = 0.006 and BMI centiles (p = 0.002 than participants with NAFLD. After adjusting for multiple hypotheses testing and controlling for differences in BMI, no differences in macro- or micronutrient intake were observed as assessed using either 24-h recall or 7-day FAD (p > 0.001. Under-reporting was prevalent (NAFLD 75%, Obese Control 87%: p = 0.15. Restrained eating behaviours were significantly higher in the NAFLD group (p = 0.005, who also recorded more steps per day than the obese controls (p = 0.01. In conclusion, this is the first study to assess dietary and activity patterns in a UK paediatric NAFLD population. Only a minority of cases and controls were meeting current dietary and physical activity recommendations. Our findings do not support development of specific dietary/ physical activity guidelines for children with NAFLD; promoting adherence with current general paediatric recommendations for health should remain the focus of clinical management.

  5. Assessment of Crohn's disease activity in the small bowel with MR and conventional enteroclysis: preliminary results

    International Nuclear Information System (INIS)

    Gourtsoyiannis, Nicholas; Papanikolaou, Nickolas; Grammatikakis, John; Papamastorakis, George; Prassopoulos, Panos; Roussomoustakaki, Maria

    2004-01-01

    Every single imaging finding that can be disclosed on conventional and MR enteroclysis was correlated with the Crohn's disease activity index (CDAI). Nineteen consecutive patients with Crohn's disease underwent colon endoscopy and both conventional and MR enteroclysis examinations. Seventeen MR imaging findings and seven conventional enteroclysis findings were ranked on a four-point grading scale and correlated with CDAI, with a value of 150 considered as the threshold for disease activity. Six patients had active disease in the colon according to colon endoscopy. In the remaining 13 patients, the presence of deep ulcers (P=0.002), small bowel wall thickening (P=0.022) and gadolinium enhancement of mesenteric lymph nodes (P=0.014) identified on MR enteroclysis images were strongly correlated to disease activity. The product of deep ulcers and enhancement of lymph node ranks identified on MR enteroclysis were the optimum combination for discriminating active from non-active disease (F-test: 55.95, P<0.001). Additionally, the ranking of deep ulcers on conventional enteroclysis provided statistically significant differences between active and non-active patients (F-test: 14.12, P=0.004). Abnormalities strongly suggestive of active Crohn's disease can be disclosed on MR enteroclysis examinations and may provide pictorial information for local inflammatory activity. (orig.)

  6. Active-learning implementation in an advanced elective course on infectious diseases.

    Science.gov (United States)

    Hidayat, Levita; Patel, Shreya; Veltri, Keith

    2012-06-18

    To describe the development, implementation, and assessment of an advanced elective course on infectious diseases using active-learning strategies. Pedagogy for active learning was incorporated by means of mini-lecture, journal club, and debate with follow-up discussion. Forty-eight students were enrolled in this 4-week elective course, in which 30% of course time was allocated for active-learning exercises. All activities were fundamentally designed as a stepwise approach in complementing each active-learning exercise. Achievement of the course learning objectives was assessed using a 5-point Likert scale survey instrument. Students' awareness of the significance of antimicrobial resistance was improved (p ≤ 0.05). Students' ability to critically evaluate the infectious-disease literature and its application in informed clinical judgments was also enhanced through these active-learning exercises (p ≤ 0.05). Students agreed that active learning should be part of the pharmacy curriculum and that active-learning exercises improved their critical-thinking, literature-evaluation, and self-learning skills. An elective course using active-learning strategies allowed students to combine information gained from the evaluation of infectious-disease literature, critical thinking, and informed clinical judgment. This blended approach ultimately resulted in an increased knowledge and awareness of infectious diseases.

  7. Assessing pediatric ileocolonic Crohn's disease activity based on global MR enterography scores

    Energy Technology Data Exchange (ETDEWEB)

    Pomerri, Fabio; Zuliani, Monica; Giorgi, Benedetta; Muzzio, Pier Carlo [University of Padova, Department of Medicine-DIMED, Padova (Italy); Al Bunni, Faise [Rovigo Hospital, Radiology Unit, S. Maria della Misericordia, Rovigo (Italy); Guariso, Graziella; Gasparetto, Marco; Cananzi, Mara [University of Padova, Department of Women and Child Health, Padova (Italy)

    2017-03-15

    This study was aimed at correlating a magnetic resonance index of activity (MaRIA) and a magnetic resonance enterography global score (MEGS) with activity indexes in a paediatric population with Crohn's disease (CD). This retrospective study included 32 paediatric patients (median age 14.5 years, 18 male) with proven CD who underwent magnetic resonance enterography (MRE). A correlation analysis was performed on the MRE-based scores, the simplified endoscopic score for CD (SES-CD), the paediatric Crohn's disease activity index (PCDAI), and C-reactive protein (CRP) levels. Based on PCDAI, comparison of both global MaRIA and MEGS was made between patients with mild and moderate/severe disease activity. Global MaRIA correlated with SES-CD (r = 0.70, p = 0.001) and PCDAI (r = 0.42, p = 0.016). MEGS correlated with PCDAI (r = 0.46, p = 0.007) and CRP levels (r = 0.35, p = 0.046). MEGS differed significantly (p = 0.027) between patients grouped by clinical disease severity. MRE-based global scores correlated with clinical indexes of CD activity. Therefore, they represent a potential useful tool to predict CD activity and severity, as well as a possible promising alternative to endoscopy, to monitor paediatric patients with CD during their follow-up. (orig.)

  8. Quantitative assessment of growth plate activity

    International Nuclear Information System (INIS)

    Harcke, H.T.; Macy, N.J.; Mandell, G.A.; MacEwen, G.D.

    1984-01-01

    In the immature skeleton the physis or growth plate is the area of bone least able to withstand external forces and is therefore prone to trauma. Such trauma often leads to premature closure of the plate and results in limb shortening and/or angular deformity (varus or valgus). Active localization of bone seeking tracers in the physis makes bone scintigraphy an excellent method for assessing growth plate physiology. To be most effective, however, physeal activity should be quantified so that serial evaluations are accurate and comparable. The authors have developed a quantitative method for assessing physeal activity and have applied it ot the hip and knee. Using computer acquired pinhole images of the abnormal and contralateral normal joints, ten regions of interest are placed at key locations around each joint and comparative ratios are generated to form a growth plate profile. The ratios compare segmental physeal activity to total growth plate activity on both ipsilateral and contralateral sides and to adjacent bone. In 25 patients, ages 2 to 15 years, with angular deformities of the legs secondary to trauma, Blount's disease, and Perthes disease, this technique is able to differentiate abnormal segmental physeal activity. This is important since plate closure does not usually occur uniformly across the physis. The technique may permit the use of scintigraphy in the prediction of early closure through the quantitative analysis of serial studies

  9. Comparison of Disease Activity Score in 28 joints with ESR (DAS28, Clinical Disease Activity Index (CDAI, Health Assessment Questionnaire Disability Index (HAQ-DI & Routine Assessment of Patient Index Data with 3 measures (RAPID3 for assessing disease activity in patients with rheumatoid arthritis at initial presentation

    Directory of Open Access Journals (Sweden)

    B Siddhartha Kumar

    2017-01-01

    Interpretation & conclusions: In adult patients with RA, in the setting where illiteracy is high, CDAI emerged as the preferred choice for rapid assessment of severity of disease at the time of initial presentation.

  10. Graves' disease: thyroid function and immunologic activity

    International Nuclear Information System (INIS)

    Gossage, A.A.; Crawley, J.C.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-01-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [/sup 99m/Tc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity--TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p less than 0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

  11. Graves' disease: thyroid function and immunologic activity

    International Nuclear Information System (INIS)

    Gossage, A.A.R.; Crawley, J.C.W.; Copping, S.; Hinge, D.; Himsworth, R.L.

    1982-01-01

    Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [ 9 -9μTc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity - TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p<0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

  12. Development of ACRODAT®, a new software medical device to assess disease activity in patients with acromegaly.

    Science.gov (United States)

    van der Lely, Aart J; Gomez, Roy; Pleil, Andreas; Badia, Xavier; Brue, Thierry; Buchfelder, Michael; Burman, Pia; Clemmons, David; Ghigo, Ezio; Jørgensen, Jens Otto Lunde; Luger, Anton; van der Lans-Bussemaker, Joli; Webb, Susan M; Strasburger, Christian J

    2017-12-01

    Despite availability of multimodal treatment options for acromegaly, achievement of long-term disease control is suboptimal in a significant number of patients. Furthermore, disease control as defined by biochemical normalization may not always show concordance with disease-related symptoms or patient's perceived quality of life. We developed and validated a tool to measure disease activity in acromegaly to support decision-making in clinical practice. An international expert panel (n = 10) convened to define the most critical indicators of disease activity. Patient scenarios were constructed based on these chosen parameters. Subsequently, a panel of 21 renowned endocrinologists at pituitary centers (Europe and Canada) categorized each scenario as stable, mild, or significant disease activity in an online validation study. From expert opinion, five parameters emerged as the best overall indicators to evaluate disease activity: insulin-like growth factor I (IGF-I) level, tumor status, presence of comorbidities (cardiovascular disease, diabetes, sleep apnea), symptoms, and health-related quality of life. In the validation study, IGF-I and tumor status became the predominant parameters selected for classification of patients with moderate or severe disease activity. If IGF-I level was ≤1.2x upper limit of normal and tumor size not significantly increased, the remaining three parameters contributed to the decision in a compensatory manner. The validation study underlined IGF-I and tumor status for routine clinical decision-making, whereas patient-oriented outcome measures received less medical attention. An Acromegaly Disease Activity Tool (ACRODAT) is in development that might assist clinicians towards a more holistic approach to patient management in acromegaly.

  13. Established and emerging biological activity markers of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Nielsen, O H; Vainer, B; Madsen, S M

    2000-01-01

    Assessment of disease activity in inflammatory bowel disease (IBD), i.e., ulcerative colitis (UC) and Crohn's disease (CD), is done using clinical parameters and various biological disease markers. Ideally, a disease marker must: be able to identify individuals at risk of a given disorder......, be disease specific, mirror the disease activity and, finally, be easily applicable for routine clinical purposes. However, no such disease markers have yet been identified for IBD. In this article, classical disease markers including erythrocyte sedimentation rate, acute phase proteins (especially...... orosomucoid and CRP), leukocyte and platelet counts, albumin, neopterin, and beta2-microglobulin will be reviewed together with emerging disease markers such as antibodies of the ANCA/ASCA type, cytokines (e.g., IL-1, IL-2Ralpha, IL-6, IL-8, TNF-alpha, and TNF-alpha receptors) and with various adhesion...

  14. Established and emerging biological activity markers of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Nielsen, O H; Vainer, B; Madsen, S M

    2000-01-01

    orosomucoid and CRP), leukocyte and platelet counts, albumin, neopterin, and beta2-microglobulin will be reviewed together with emerging disease markers such as antibodies of the ANCA/ASCA type, cytokines (e.g., IL-1, IL-2Ralpha, IL-6, IL-8, TNF-alpha, and TNF-alpha receptors) and with various adhesion......Assessment of disease activity in inflammatory bowel disease (IBD), i.e., ulcerative colitis (UC) and Crohn's disease (CD), is done using clinical parameters and various biological disease markers. Ideally, a disease marker must: be able to identify individuals at risk of a given disorder......, be disease specific, mirror the disease activity and, finally, be easily applicable for routine clinical purposes. However, no such disease markers have yet been identified for IBD. In this article, classical disease markers including erythrocyte sedimentation rate, acute phase proteins (especially...

  15. The Birmingham Vasculitis Activity Score as a Measure of Disease Activity in Patients with Giant Cell Arteritis

    Science.gov (United States)

    Kermani, TA; Cuthbertson, D; Carette, S; Hoffman, GS; Khalidi, NA; Koening, CL; Langford, CA; McKinnon-Maksimowicz, K; McAlear, CA; Monach, PA; Seo, P; Warrington, KJ; Ytterberg, SR; Merkel, PA; Matteson, EL

    2016-01-01

    Objective To evaluate the performance of the Birmingham Vasculitis Activity Score (BVAS) in the assessment of disease activity in giant cell arteritis (GCA). Methods Patients with GCA enrolled in a prospective, multicenter, longitudinal study with symptoms of active vasculitis during any visit were included. Spearman’s rank correlation was used to explore the association of the BVAS with other measures of disease activity. Results During a mean (SD) follow-up of 2.3 (1.6) years, symptoms of active GCA were present in 236 visits in 136 subjects (100 female, 74%). Median (range) BVAS1 (new/worse symptoms) was 1 (0–10) and median (range) BVAS2 (persistent symptoms) was 0 (0–5). Median (range) physician global assessment (PGA) was 4 (0–9) for disease activity in the past 28 days and 2 (0–9) for activity on the day of the visit. Important ischemic manifestations of active vasculitis not captured by the BVAS included tongue/jaw claudication (27%), upper extremity claudication (15%), lower extremity claudication (5%), carotidynia (7%), ischemic retinopathy (5%). During 25 visits (11%) with active disease, all symptoms of active vasculitis were captured in the “Other” category yet still resulted in a BVAS 1 and BVAS 2 of 0. BVAS1 moderately correlated with PGA for the past 28 days (Spearman’s correlation 0.50) and physician-rated disease activity for the past 28 days (Spearman’s correlation 0.46). Conclusions The BVAS has limited utility in GCA. Patients with active GCA can have a BVAS of 0. Many important ischemic symptoms attributable to active vasculitis are not captured in the composite score. PMID:27036388

  16. Quantitative assessment of integrated phrenic nerve activity.

    Science.gov (United States)

    Nichols, Nicole L; Mitchell, Gordon S

    2016-06-01

    Integrated electrical activity in the phrenic nerve is commonly used to assess within-animal changes in phrenic motor output. Because of concerns regarding the consistency of nerve recordings, activity is most often expressed as a percent change from baseline values. However, absolute values of nerve activity are necessary to assess the impact of neural injury or disease on phrenic motor output. To date, no systematic evaluations of the repeatability/reliability have been made among animals when phrenic recordings are performed by an experienced investigator using standardized methods. We performed a meta-analysis of studies reporting integrated phrenic nerve activity in many rat groups by the same experienced investigator; comparisons were made during baseline and maximal chemoreceptor stimulation in 14 wild-type Harlan and 14 Taconic Sprague Dawley groups, and in 3 pre-symptomatic and 11 end-stage SOD1(G93A) Taconic rat groups (an ALS model). Meta-analysis results indicate: (1) consistent measurements of integrated phrenic activity in each sub-strain of wild-type rats; (2) with bilateral nerve recordings, left-to-right integrated phrenic activity ratios are ∼1.0; and (3) consistently reduced activity in end-stage SOD1(G93A) rats. Thus, with appropriate precautions, integrated phrenic nerve activity enables robust, quantitative comparisons among nerves or experimental groups, including differences caused by neuromuscular disease. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. M-ficolin levels reflect disease activity and predict remission in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ammitzbøll, Christian Gytz; Thiel, Steffen; Jensenius, Jens Christian

    2013-01-01

    To assess plasma M-ficolin concentrations in disease-modifying antirheumatic drug (DMARD)-naive patients with early rheumatoid arthritis (RA), to investigate the correlation of M-ficolin concentrations with disease activity markers, and to determine the predictive value of M-ficolin with respect...... to the Disease Activity Score in 28 joints (DAS28)....

  18. Serum Renalase Levels Correlate with Disease Activity in Lupus Nephritis.

    Directory of Open Access Journals (Sweden)

    Chaojun Qi

    Full Text Available Lupus nephritis (LN is among the most serious complications of systemic lupus erythematosus (SLE, which causes significant morbidity and mortality. Renalase is a novel, kidney-secreted cytokine-like protein that promotes cell survival. Here, we aimed to investigate the relationship of serum renalase levels with LN and its role in the disease progression of LN.For this cross-sectional study, 67 LN patients and 35 healthy controls were enrolled. Seventeen active LN patients who received standard therapies were followed up for six months. Disease activity was determined by the SLE Disease Activity-2000 (SLEDAI-2K scoring system and serum renalase amounts were determined by ELISA. Predictive value of renalase for disease activity was assessed. Furthermore, the expression of renalase in the kidneys of patients and macrophage infiltration was assessed by immunohistochemistry.Serum renalase amounts were significantly higher in LN patients than in healthy controls. Moreover, patients with proliferative LN had more elevated serum renalase levels than Class V LN patients. In proliferative LN patients, serum renalase levels were significantly higher in patients with active LN than those with inactive LN. Serum renalase levels were positively correlated with SLEDAI-2K, 24-h urine protein excretion, ds-DNA and ESR but inversely correlated with serum albumin and C3. Renalase amounts decreased significantly after six-months of standard therapy. The performance of renalase as a marker for diagnosis of active LN was 0.906 with a cutoff value of 66.67 μg/ml. We also observed that the amount of renalase was significantly higher in glomerular of proliferative LN along with the co-expression of macrophages.Serum renalase levels were correlated with disease activity in LN. Serum renalase might serve as a potential indicator for disease activity in LN. The marked increase of glomerular renalase and its association with macrophages suggest that it might play an

  19. Mean platelet volume is decreased in adults with active lupus disease

    Directory of Open Access Journals (Sweden)

    Guillermo Delgado-García

    Full Text Available ABSTRACT Background: Only a few biomarkers are available for assessing disease activity in systemic lupus erythematosus (SLE. Mean platelet volume (MPV has been recently studied as an inflammatory biomarker. It is currently unclear whether MPV may also play a role as a biomarker of disease activity in adult patients with SLE. Objective: We investigated the association between MPV and disease activity in adult patients with SLE. Methods: In this retrospective study, we compared two groups of adult patients divided according to disease activity (36 per group. Subjects were age- and gender-matched. Results: MPV was significantly decreased with respect to those of inactive patients (7.16 ± 1.39 vs. 8.16 ± 1.50, p = 0.005. At a cutoff level of 8.32 fL, MPV has a sensitivity of 86% and a specificity of 41% for the detection of disease activity. A modest positive correlation was found between MPV and albumin (r = 0.407, p = 0.001, which in turn is inversely associated with disease activity. Conclusions: In summary, MPV is decreased in adult patients with active lupus disease, and positively correlated with albumin, another biomarker of disease activity. Prospective studies are needed to evaluate the prognostic value of this biomarker.

  20. Mean platelet volume is decreased in adults with active lupus disease.

    Science.gov (United States)

    Delgado-García, Guillermo; Galarza-Delgado, Dionicio Ángel; Colunga-Pedraza, Iris; Borjas-Almaguer, Omar David; Mandujano-Cruz, Ilse; Benavides-Salgado, Daniel; Martínez-Granados, Rolando Jacob; Atilano-Díaz, Alexandro

    Only a few biomarkers are available for assessing disease activity in systemic lupus erythematosus (SLE). Mean platelet volume (MPV) has been recently studied as an inflammatory biomarker. It is currently unclear whether MPV may also play a role as a biomarker of disease activity in adult patients with SLE. We investigated the association between MPV and disease activity in adult patients with SLE. In this retrospective study, we compared two groups of adult patients divided according to disease activity (36 per group). Subjects were age- and gender-matched. MPV was significantly decreased with respect to those of inactive patients (7.16±1.39 vs. 8.16±1.50, p=0.005). At a cutoff level of 8.32fL, MPV has a sensitivity of 86% and a specificity of 41% for the detection of disease activity. A modest positive correlation was found between MPV and albumin (r=0.407, p=0.001), which in turn is inversely associated with disease activity. In summary, MPV is decreased in adult patients with active lupus disease, and positively correlated with albumin, another biomarker of disease activity. Prospective studies are needed to evaluate the prognostic value of this biomarker. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  1. Systematic review: Use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn's disease

    OpenAIRE

    Panes , Julian; Bouzas , Rosa; García-Sánchez , Valle; Chaparro , María; Pérez-Gisbert , Javier; Martínez De Guereñu , Blanca; Mendoza , Juan Luis; Paredes , José María; Quiroga , Sergi; Ripollés , Tomás; Rimola , Jordi

    2011-01-01

    Abstract Backgroud: Cross-sectional imaging techniques, including ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI), are increasingly used for evaluation of Crohn?s disease (CD). Aim: To perform an assessment of the diagnostic accuracy of cross-sectional imaging techniques for diagnosis of CD, evaluation of disease extension and activity, and diagnosis of complications, and to provide recommendations for their optimal use. Methods: Relevant ...

  2. Computational representation of Alzheimer's disease evolution applied to a cooking activity.

    Science.gov (United States)

    Serna, Audrey; Rialle, Vincent; Pigot, Hélène

    2006-01-01

    This article presents a computational model and a simulation of the decrease of activities of daily living performances due to Alzheimer's disease. The disease evolution is simulated thanks to the cognitive architecture ACT-R. Activities are represented according to the retrieval of semantic units in declarative memory and the trigger of rules in procedural memory. The simulation of Alzheimer's disease decrease is simulated thanks to the variation of subsymbolic parameters. The model is applied to a cooking activity. Simulation of 100 hundred subjects shows results similar to those realised in a standardized assessment with human subjects.

  3. Cooking activity for patients with Alzheimer’s disease: a review

    Directory of Open Access Journals (Sweden)

    Shang-Qun Gong

    2017-07-01

    Full Text Available As a degenerative nervous system disease, Alzheimer’s disease (AD, can damage memory and cognitive function. Cooking activity, an instrumental activity of daily life, is one of the non-pharmacological therapies with positive effect on AD. Here, we review the effectiveness of cooking activity on AD. This paper shows that cooking activity can not only improve patient’s emotional state and alleviate the conduct disorder, but also ease the burden of professional caregiver. Cooking activity also has certain positive effects on patient’s cognition, autonomy and memory function. Now, as one of the instrumental activities of daily life, cooking activity has developed as a useful tool in the intervention trials, serious game, virtual reality training and assessment of daily living activities.

  4. Patient-Reported Disease Activity and Adverse Pregnancy Outcomes in Systemic Lupus Erythematosus and Rheumatoid Arthritis.

    Science.gov (United States)

    Harris, Nathaniel; Eudy, Amanda; Clowse, Megan

    2018-06-15

    While increased rheumatic disease activity during pregnancy has been associated with adverse pregnancy outcomes, this activity is typically assessed by the physician. Little is known, however, about the association between patient-reported measures of disease activity and pregnancy outcomes. Univariate and multivariable regression models were used to assess the relationship between patient and physician-reported measures of disease activity and adverse pregnancy outcomes in 225 patients with lupus or rheumatoid arthritis (RA) enrolled in a prospective registry at a single academic center from 2008-2016. In women with RA, patient-reported disease activity is associated with preterm birth (OR 5.9 (1.5-23.9)), and gestational age (beta -1.5 weeks (-2.6, -0.4 weeks)). The physician assessment of disease activity also predicted preterm (OR 2.1 (1.2-3.5)), small for gestational age births (OR 1.8 (1.03-3.1), and gestational age in weeks (beta -0.6 weeks (-0.9, -0.02 weeks)). On the other hand, SLE patient-reported disease activity measures, including the HAQ, pain or global health measures, are not associated with adverse pregnancy outcomes. However, physician measures of SLE disease activity are associated with preterm birth (OR 2.9 (1.-6.3)), cesarean delivery (OR 2.3 (1.0-5.3)), and preeclampsia (OR 2.8 (1.3-6.3)). The results do not appear to be driven by lupus nephritis or antiphospholipid syndrome. For women with RA, patient-reported measures of disease activity may be useful adjuncts to physician-reported measures in identifying pregnancies at greater risk. In contrast, in SLE, no patient-reported measures were associated with adverse outcomes while physician measures of disease activity helped predict several adverse pregnancy outcomes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  5. Joint assessment in von Willebrand disease : Validation of the Haemophilia Joint Health score and Haemophilia Activities List

    NARCIS (Netherlands)

    van Galen, Karin P. M.; Timmer, Merel A.; de Kleijn, Piet; Fischer, Kathelijn; Foppen, Wouter; Schutgens, Roger E. G.; Eikenboom, Jeroen; Meijer, Karina; Cnossen, Marjon H.; Fijnvandraat, Karin; van der Bom, Johanna G.; Laros-van Gorkom, Britta A. P.; Leebeek, Frank W. G.; Mauser-Bunschoten, Eveline P.

    Assessment of clinical outcome after joint bleeding is essential to identify joint damage and optimise treatment, to prevent disability. However, disease-specific tools to assess the musculoskeletal status in patients with von Willebrand disease (VWD) are lacking. We aimed to determine validity and

  6. Reevaluation of the role of duration of morning stiffness in the assessment of rheumatoid arthritis activity.

    Science.gov (United States)

    Khan, Nasim A; Yazici, Yusuf; Calvo-Alen, Jaime; Dadoniene, Jolanta; Gossec, Laure; Hansen, Troels M; Huisman, Margriet; Kallikorm, Riina; Muller, Raili; Liveborn, Margareth; Oding, Rolf; Luchikhina, Elena; Naranjo, Antonio; Rexhepi, Sylejman; Taylor, Peter; Tlustochowich, Witold; Tsirogianni, Afrodite; Sokka, Tuulikki

    2009-11-01

    To evaluate the utility of the duration of morning stiffness (MS), as a patient-reported outcome (PRO), in assessing rheumatoid arthritis (RA) disease activity. We acquired information on 5439 patients in QUEST-RA, an international database of patients with RA evaluated by a standard protocol. MS duration was assessed from time of waking to time of maximal improvement. Ability of MS duration to differentiate RA activity states, based on Disease Activity Score (DAS)28, was assessed by analysis of variance; and a receiver-operating characteristic (ROC) curve was plotted for discriminating clinically active (DAS28 > 3.2) from less active (DAS28 3.2). MS duration has a moderate correlation with RA disease activity. Assessment of MS duration may be clinically helpful in patients with low RAPID3 scores.

  7. Impact of gadolinium-based contrast agent in the assessment of Crohn's disease activity: Is contrast agent injection necessary?

    Science.gov (United States)

    Quaia, Emilio; Sozzi, Michele; Gennari, Antonio Giulio; Pontello, Michele; Angileri, Roberta; Cova, Maria Assunta

    2016-03-01

    To determine whether magnetic resonance enterography (MRE) performed without intravenous contrast injection is diagnostically noninferior to conventional contrast-enhanced MRE (CE-MRE) in patients with Crohn's disease (CD). This was an Institutional Review Board (IRB)-approved retrospective study. Ninety-six patients (52 male and 44 female; 47.18 years ± 13.6) with a diagnosis of CD underwent MRE at 1.5T including T2 -weighted single-shot turbo-spin-echo, T2 -weighted spectral fat presaturation with inversion recovery (SPAIR), T1 -weighted balanced fast-field-echo MR sequences, and CE-MRE consisting in T1 -weighted breath-hold THRIVE 3D MRI sequences after administration of gadobenate dimeglumine (0.2 mL/kg of body weight). Unenhanced MRE, CE-MRE, and unenhanced MRE plus CE-MRE were reviewed in separate sessions with blinding by two readers in consensus, and subsequently by two other readers independently considering a subgroup of 20 patients. Crohn's Disease Endoscopic Index of Severity (CDEIS) and/or histologic analysis of the surgical specimen were considered as reference standards for the assessment of inflammatory activity. Patients revealed prevalently active (n = 55 patients) or quiescent CD (n = 41 patients). The agreement between unenhanced MRE vs. CE-MRE in interpreting active bowel inflammation was 96% (123/128 bowel segments; one-sided 95% confidence interval [CI], >94.4%). Unenhanced MRE vs. CE-MRE vs. unenhanced MRE plus CE-MRE revealed a diagnostic accuracy of 93% [90/96] vs. 92% [88/96] vs. 97% [93/96] (P > 0.05) in the diagnosis of active CD. Interreader agreement was very good for all variables (κ value = 0.8-0.9) except for the measurement of the length of disease (κ value = 0.45). Unenhanced MRE was noninferior to CE-MRE in diagnosing active inflammation in patients with CD. © 2015 Wiley Periodicals, Inc.

  8. Motor assessment in Parkinson`s disease.

    Science.gov (United States)

    Opara, Józef; Małecki, Andrzej; Małecka, Elżbieta; Socha, Teresa

    2017-09-21

    Parkinson's disease (PD) is one of most disabling disorders of the central nervous system. The motor symptoms of Parkinson's disease: shaking, rigidity, slowness of movement, postural instability and difficulty with walking and gait, are difficult to measure. When disease symptoms become more pronounced, the patient experiences difficulties with hand function and walking, and is prone to falls. Baseline motor impairment and cognitive impairment are probable predictors of more rapid motor decline and disability. An additional difficulty is the variability of the symptoms caused by adverse effects of drugs, especially levodopa. Motor assessment of Parkinson`s Disease can be divided into clinimetrics, assessment of balance and posture, arm and hand function, and gait/walking. These are many clinimetric scales used in Parkinson`s Disease, the most popular being the Hoehn and Yahr stages of progression of the disease and Unified Parkinson's Disease Rating Scale. Balance and posture can be assessed by clinimetric scales like the Berg BS, Tinetti, Brunel BA, and Timed Up and Go Test, or measured by posturometric platforms. Among skill tests, the best known are: the Purdue Pegboard Test, Nine-Hole Peg Test, Jebsen and Taylor test, Pig- Tail Test, Frenchay Arm Test, Action Research Arm Test, Wolf FMT and Finger-Tapping Test. Among motricity scales, the most popular are: the Fugl-Meyer Motor Assessment Scale and Södring Motor Evaluation. Gait and walking can also be assessed quantitatively and qualitatively. Recently, the most popular is three-dimensional analysis of movement. This review article presents the current possibilities of motor assessment in Parkinson`s disease.

  9. Ileal Crohn disease: mural microvascularity quantified with contrast-enhanced US correlates with disease activity.

    Science.gov (United States)

    De Franco, Antonio; Di Veronica, Alessandra; Armuzzi, Alessandro; Roberto, Italia; Marzo, Manuela; De Pascalis, Barbara; De Vitis, Italo; Papa, Alfredo; Bock, Enrico; Danza, Francesco M; Bonomo, Lorenzo; Guidi, Luisa

    2012-02-01

    To quantitatively assess microvascular activation in the thickened ileal walls of patients with Crohn disease (CD) by using contrast-enhanced ultrasonography (US) and evaluate its correlation with widely used indexes of CD activity. This prospective study was approved by the ethics committee, and written informed consent was obtained from all patients. The authors examined 54 consecutively enrolled patients (mean age, 35.29 years; age range, 18-69 years; 39 men, 15 women) with endoscopically confirmed CD of the terminal ileum. Ileal wall segments thicker than 3 mm were examined with low-mechanical-index contrast-enhanced US and a second-generation US contrast agent. The authors analyzed software-plotted time-enhancement intensity curves to determine the maximum peak intensity (MPI) and wash-in slope coefficient (β) and evaluated their correlation with (a) the composite index of CD activity (CICDA), (b) the CD activity index (CDAI), and (c) the simplified endoscopic score for CD (SES-CD, evaluated in 37 patients) for the terminal ileum. Statistical analysis was performed with the Mann-Whitney test, Spearman rank test, and receiver operating characteristic (ROC) analysis. MPI and β coefficients were significantly increased in the 36 patients with a CICDA indicative of active disease (P<.0001 for both), the 33 patients with a CDAI of at least 150 (P<.032 and P<.0074, respectively), and the 26 patients with an SES-CD of at least 1 (P<.0001 and P<.002, respectively). ROC analysis revealed accurate identification (compared with CICDA) of active CD with an MPI threshold of 24 video intensity (VI) (sensitivity, 97%; specificity, 83%) and a β coefficient of 4.5 VI/sec (sensitivity, 86%; specificity, 83%). Contrast-enhanced US of the ileal wall is a promising method for objective, reproducible assessment of disease activity in patients with ileal CD. © RSNA, 2011

  10. Comparison of disease activity measures for anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis

    Science.gov (United States)

    Merkel, PA; Cuthbertson, DD; Hellmich, B; Hoffman, GS; Jayne, DRW; Kallenberg, CGM; Krischer, JP; Luqmani, R; Mahr, AD; Matteson, EL; Specks, U; Stone, JH

    2011-01-01

    Aim Currently, several different instruments are used to measure disease activity and extent in clinical trials of anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, leading to division among investigative groups and difficulty comparing study results. An exercise comparing six different vasculitis instruments was performed. Methods A total of 10 experienced vasculitis investigators from 5 countries scored 20 cases in the literature of Wegener granulomatosis or microscopic polyangiitis using 6 disease assessment tools: the Birmingham Vasculitis Activity Score (BVAS), The BVAS for Wegener granulomatosis (BVAS/WG), BVAS 2003, a Physician Global Assessment (PGA), the Disease Extent Index (DEI) and the Five Factor Score (FFS). Five cases were rescored by all raters. Results Reliability of the measures was extremely high (intraclass correlations for the six measures all=0.98). Within each instrument, there were no significant differences or outliers among the scores from the 10 investigators. Test/retest reliability was high for each measure: range=0.77 to 0.95. The scores of the five acute activity measures correlated extremely well with one another. Conclusions Currently available tools for measuring disease extent and activity in ANCA-associated vasculitis are highly correlated and reliable. These results provide investigators with confidence to compare different clinical trial data and helps form common ground as international research groups develop new, improved and universally accepted vasculitis disease assessment instruments. PMID:18664546

  11. Inflammatory activity in Crohn disease: ultrasound findings.

    Science.gov (United States)

    Migaleddu, Vincenzo; Quaia, Emilio; Scano, Domenico; Virgilio, Giuseppe

    2008-01-01

    Improvements in the ultrasound examination of bowel disease have registered in the last years the introduction of new technologies regarding high frequency probes (US), highly sensitive color or power Doppler units (CD-US), and the development of new non-linear technologies that optimize detection of contrast agents. Contrast-enhanced ultrasound (CE-US) most importantly increases the results in sonographic evaluation of Crohn disease inflammatory activity. CE-US has become an imaging modality routinely employed in the clinical practice for the evaluation of parenchymal organs due to the introduction of new generation microbubble contrast agents which persist in the bloodstream for several minutes after intravenous injection. The availability of high frequency dedicated contrast-specific US techniques provide accurate depiction of small bowel wall perfusion due to the extremely high sensitivity of non-linear signals produced by microbubble insonation. In Crohn's disease, CE-US may characterize the bowel wall thickness by differentiating fibrosis from edema and may grade the inflammatory disease activity by assessing the presence and distribution of vascularity within the layers of the bowel wall (submucosa alone or the entire bowel wall). Peri-intestinal inflammatory involvement can be also characterized. CE-US can provide prognostic data concerning clinical recurrence of the inflammatory disease and evaluate the efficacy of drugs treatments.

  12. Depressive symptoms predict future simple disease activity index scores and simple disease activity index remission in a prospective cohort of patients with early inflammatory polyarthritis.

    Science.gov (United States)

    Leblanc-Trudeau, Charlotte; Dobkin, Patricia L; Carrier, Nathalie; Cossette, Pierre; de Brum-Fernandes, Artur J; Liang, Patrick; Masetto, Ariel; Boire, Gilles

    2015-12-01

    To determine whether depressive symptoms assessed in treated patients with early inflammatory polyarthritis (EPA) influence disease activity during follow-up. Consecutively recruited EPA patients were actively treated to remission. Simple disease activity index (SDAI) and Center for Epidemiologic Studies Depression Scale (CES-D) scores were calculated at inclusion and up to 42 months into disease. SDAI scores were log-transformed to compute univariate and multivariate linear regressions. Parametric interval-censored Kaplan-Meier and survival regressions using Weibull distribution were used to assess time to and predictors of SDAI remission. A total of 275 EPA patients were recruited at a median of 4 months into disease. In multivariate linear regression models, accounting for baseline demographic, clinical, serological and functional variables and 12-month inflammation markers, CES-D scores at 12 months into disease were correlated (r(2) = 0.14) with subsequent SDAI scores. Patients with 12-month high CES-D (≥19; suggestive of depression) had a lower proportion of SDAI remission (31.3% vs 84.3%; P < 0.001) and reached SDAI remission less rapidly [hazard ratio = 0.25 (95% CI 0.12, 0.53); P < 0.001]. Each follow-up SDAI correlated significantly with 12-month depressive symptoms, a median of 7 months after initiation of treatment. CES-D scores suggestive of depression at 12 months were strongly correlated with delay and failure to reach remission later on. Depressive symptoms in treated EPA patients represent important clinical issues with long-term association with disease activity. Interventions to alleviate persistent depressive symptoms in treated EPA warrant careful evaluation of their potential to improve disease remission rates. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. 111In autologous leucocytes in the diagnosis and assessment of inflammatory bowel disease

    International Nuclear Information System (INIS)

    Saverymuttu, S.H.; Peters, A.M.; Reavy, H.J.; Danpure, H.J.; Osman, S.; Chadwick, V.S.; Hodgson, H.J.; Lavender, J.P.

    1982-01-01

    111 In-labelled leucocytes were used to obtain gamma camera images of inflamed of bowel in a wide variety of inflammatory bowel disease. No false positive scans were observed in the irritable bowel syndrome and in bowel malignancy. All patients with moderate or severely active disease had positive scans. Faecal excretion of 111 Indium increased with disease severity. 111 In-tropolone labelling appeared to offer the advantage over 111 In-acac labelling in localising inflamed bowel earlier. In many cases the bowel was imaged within 40 min of re-injection of the leucocytes. 111 In-leucocyte scanning provides a novel approach to the problem of diagnosis and assessment of inflammatory bowel disease. It is non-invasive, requires no bowel preparation and thus is safe in the acutely sick patient where conventional radiological imaging methods may be hazardous. 111 Indium faecal excretion provides an objective assessment of disease activity which should prove useful in evaluating treatment regimes

  14. Vectra DA for the objective measurement of disease activity in patients with rheumatoid arthritis.

    Science.gov (United States)

    Segurado, O G; Sasso, E H

    2014-01-01

    Quantitative and regular assessment of disease activity in rheumatoid arthritis (RA) is required to achieve treatment targets such as remission and to optimize clinical outcomes. To assess inflammation accurately, predict joint damage and monitor treatment response, a measure of disease activity in RA should reflect the pathological processes resulting in irreversible joint damage and functional disability. The Vectra DA blood test is an objective measure of disease activity for patients with RA. Vectra DA provides an accurate, reproducible score on a scale of 1 to 100 based on the concentrations of 12 biomarkers that reflect the pathophysiologic diversity of RA. The analytical validity, clinical validity, and clinical utility of Vectra DA have been evaluated for patients with RA in registries and prospective and retrospective clinical studies. As a biomarker-based instrument for assessing disease activity in RA, the Vectra DA test can help monitor therapeutic response to methotrexate and biologic agents and assess clinically challenging situations, such as when clinical measures are confounded by non-inflammatory pain from fibromyalgia. Vectra DA scores correlate with imaging of joint inflammation and are predictive for radiographic progression, with high Vectra DA scores being associated with more frequent and severe progression and low scores being predictive for non-progression. In summary, the Vectra DA score is an objective measure of RA disease activity that quantifies inflammatory status. By predicting risk for joint damage more effectively than conventional clinical and laboratory measures, it has the potential to complement these measures and optimise clinical decision making.

  15. Serum Immunoglobulin Free Light Chain Assessment in IgG4-Related Disease

    Directory of Open Access Journals (Sweden)

    Aurélie Grados

    2013-01-01

    Full Text Available Immunoglobulin free light chains are produced in excess during normal antibody synthesis. Their evaluation is commonly used in case of a monoclonal gammopathy. In polyclonal hypergammaglobulinemia related to the Sjögren syndrome or systemic lupus, erythematosus serum free light chain levels are increased and could correlate with disease activity. We show here that the κ ( and λ ( free light chains and the κ : λ ratio ( are increased in sixteen patients with IgG4-related disease when compared to healthy controls. The increase of κ and λ free light chains probably reflects the marked polyclonal B cell activation of the disease. We could not assess in this small cohort of patients a significative correlation of serum free light chain levels and disease activity or extension.

  16. Evaluation of technetium 99m-HMPAO leukocyte scanning in the assessment of disease extent and activity in inflammatory bowel disease

    International Nuclear Information System (INIS)

    Morelec, I.; Bracquemart, P.; Beades, E.; Bouvard, G.; Fellous, F.; Piquet, M.A.; Dao, T.; Verwaerde, J.C.; Coste, J.

    1993-01-01

    We have studied prospectively the usefulness of HMPAO 99m Tc leucocytes scan in patients with Crohn's disease and ulcerative colitis. Abdominal scans were performed 1 h and 2 h 30 after injection of an autologous leukocyte preparation containing 100-200 MBq of Technetium 99m. The extent of bowel involvement, evaluated on the 2 h 30 scan, was compared to X-rays and endoscopic findings. The disease activity was quantified by the intensity of intestinal radionuclide uptake on the 2 h 30 scan and compared with the Crohn's disease activity index (CDAI) sedimentation rate. Forty-five examinations were performed in 40 patients with Crohn's disease or ulcerative colitis. The correlation of the number of locations between leukocyte scan and other diagnosis procedures was good in 40 cases. CDAI was significantly correlated with radionuclide index. Two fistulae and one abscess and small bowel involvement were correctly visualized. This technique provides images of excellent quality, superior to those obtained with indium 111. Therefore, we believe that this test can be useful in the follow-up of patients with Crohn's disease and ulcerative colitis

  17. Contrast-enhanced ultrasonography for the determination of Crohn's disease activity - preliminary experience.

    Science.gov (United States)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn's disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn's disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI.

  18. Invasive pneumococcal and meningococcal disease : association with influenza virus and respiratory syncytial virus activity?

    NARCIS (Netherlands)

    Jansen, A G S C; Sanders, E A M; VAN DER Ende, A; VAN Loon, A M; Hoes, A W; Hak, E

    2008-01-01

    Few studies have examined the relationship between viral activity and bacterial invasive disease, considering both influenza virus and respiratory syncytial virus (RSV). This study aimed to assess the potential relationship between invasive pneumococcal disease (IPD), meningococcal disease (MD), and

  19. Validation of the Auto-Inflammatory Diseases Activity Index (AIDAI) for hereditary recurrent fever syndromes

    Science.gov (United States)

    Piram, Maryam; Koné-Paut, Isabelle; Lachmann, Helen J; Frenkel, Joost; Ozen, Seza; Kuemmerle-Deschner, Jasmin; Stojanov, Silvia; Simon, Anna; Finetti, Martina; Sormani, Maria Pia; Martini, Alberto; Gattorno, Marco; Ruperto, Nicolino

    2014-01-01

    Objectives To validate the Auto-Inflammatory Diseases Activity Index (AIDAI) in the four major hereditary recurrent fever syndromes (HRFs): familial Mediterranean fever (FMF), mevalonate kinase deficiency (MKD), tumour necrosis factor receptor-associated periodic syndrome (TRAPS) and cryopyrin-associated periodic syndromes (CAPS). Methods In 2010, an international collaboration established the content of a disease activity tool for HRFs. Patients completed a 1-month prospective diary with 12 yes/no items before a clinical appointment during which their physician assessed their disease activity by a questionnaire. Eight international experts in auto-inflammatory diseases evaluated the patient's disease activity by a blinded web evaluation and a nominal group technique consensus conference, with their consensus judgement considered the gold standard. Sensitivity/specificity/accuracy measures and the ability of the score to discriminate active from inactive patients via the best cut-off score were calculated by a receiver operating characteristic analysis. Results Consensus was achieved for 98/106 (92%) cases (39 FMF, 35 CAPS, 14 TRAPS and 10 MKD), with 26 patients declared as having inactive disease and 72 as having active disease. The median total AIDAI score was 14 (range=0–175). An AIDAI cut-off score ≥9 discriminated active from inactive patients, with sensitivity/specificity/accuracy of 89%/92%/90%, respectively, and an area under the curve of 98% (95% CI 96% to 100%). Conclusions The AIDAI score is a valid and simple tool for assessing disease activity in FMF/MKD/TRAPS/CAPS. This tool is easy to use in clinical practice and has the potential to be used as the standard efficacy measure in future clinical trials. PMID:24026675

  20. Quality of life and life satisfaction in patients with Behçet's disease: relationship with disease activity.

    Science.gov (United States)

    Bodur, Hatice; Borman, Pinar; Ozdemir, Yildiz; Atan, Ciğdem; Kural, Gülcan

    2006-05-01

    Quality of life (QoL) and life satisfaction (LS) are important outcome factors in chronic inflammatory conditions such as Behçet's disease (BD). The aim of this study was to investigate QoL and LS in patients with BD and determine the relationship with disease activity. Forty-one patients with BD and 40 control subjects were involved in the study. Demographic properties were obtained. Disease activity was assessed by Turkish version of BD Current Activity Form (BDCAF) in BD patients. QoL and psychological well-being were assessed by Nottingham Health Profile (NHP) and Life Satisfaction Index (LSI), respectively, in both patients and control groups. The related disease activity measures of QoL and LS were determined. Twenty-two male and 19 female BD patients with a mean age of 33.3+/-9.3 years and 20 male and 20 female control subjects with a mean age of 33.3+/-4.1 years were involved. According to BDCAF, no patient had central nervous system involvement. Thirty-four patients had headache, 33 patients had fatigue, 30 patients had articular involvement, 29 had mucocutaneous lesions, 27 had gastrointestinal involvement, 21 patients had ocular involvement, and 7 patients had vascular involvement. The scores of all dimensions of NHP were significantly higher and the mean score of LSI was significantly lower in BD patients than in control subjects (pimpression of disease activity and joint involvement. In conclusion, patients with BD have impaired QoL and disturbed psychological well-being. Current management strategies focusing on fatigue, arthralgia, mucocutaneous lesions, and efforts to measure psychosocial aspects and symptoms of the patients by their point of view will help to improve QoL and raise the LS in patients suffering from BD.

  1. Rheumatoid arthritis disease activity and vitamin D deficiency in an Asian resident population.

    Science.gov (United States)

    Quraishi, Mohammed K; Badsha, Humeira

    2016-04-01

    We aimed to assess the prevalence of vitamin D deficiency and its association with rheumatoid arthritis (RA) disease activity in a UAE population. Forty-five consecutive subjects were prospectively recruited during the early summer with their clinical examination and Health Assessment Questionnaire (HAQ) being recorded at a clinic appointment, along with their blood sample being taken for the 25-hydroxyvitamin D (25(OH)D) total test. Thirty-five (76%) patients claimed to be exposed to sunlight for Disease Activity Score (DAS28) or HAQ scores. A direct relationship was observed between HAQ scores and DAS28 scores (P culture. No association was observed between vitamin D and disease activity. However, the high prevalence of vitamin D deficiency may negatively impact on bone health of these patients in the future. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  2. Disparity in Physical Activity among Urban Youth: An Ecologically Guided Assessment

    Science.gov (United States)

    Lenhart, Clare M.; Patterson, Freda; Brown, Michael D.; O'Brien, Matthew J.; Nelson, Deborah B.

    2014-01-01

    Background: Insufficient physical activity among urban youth increases risk of chronic disease.Purpose:This study assessed reported physical activity to determine when disparities in participation emerge and what ecologically guided factors are linked with high activity. Methods:We administered a cross-sectional survey to a diverse sample of 321…

  3. Being active when you have heart disease

    Science.gov (United States)

    Heart disease - activity; CAD - activity; Coronary artery disease - activity; Angina - activity ... Getting regular exercise when you have heart disease is ... It may also help you be more active without chest pain or other ...

  4. Development and validation of modified disease activity scores in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Baker, Joshua F; Conaghan, Philip G; Smolen, Josef S

    2014-01-01

    -CDAI) were generated for each subject in the validation cohort. The M-DAS28, M-SDAI, and M-CDAI scores were compared to conventional scores of disease activity with regard to associations with MRI measures of synovitis and radiographic progression, assessed using Pearson's and Spearman's correlations, linear......OBJECTIVE: To develop and validate composite disease activity scores, based on widely available clinical measures, that would demonstrate improved correlation with detection of synovitis on magnetic resonance imaging (MRI) and radiographic progression, in comparison with conventional measures.......15 × SJC28 + 0.22 × EvGA + 1 and M-SDAI = CRP + SJC28 + EvGA. Both modified and conventional disease activity scores correlated significantly with MRI measures of synovitis. Modified scores showed superior correlation with synovitis, as compared to conventional scores, at all time points (P

  5. Quantifying daily physical activity and determinants in sedentary patients with Parkinson's disease

    NARCIS (Netherlands)

    Dontje, M. L.; de Greef, M. H. G.; Speelman, A. D.; van Nimwegen, M.; Krijnen, W. P.; Stolk, R. P.; Kamsma, Y. P. T.; Munneke, M.; van der Schans, C. P.; Bloem, Bastiaan R.

    2013-01-01

    Background: Although physical activity is beneficial for Parkinson's disease (PD) patients, many do not meet the recommended levels. The range of physical activity among sedentary PD patients is unknown, as are factors that determine this variability. Hence, we aimed to (1) assess daily physical

  6. 18F-Fluorodeoxyglucose positron emission tomography and serum cytokines and matrix metalloproteinases in the assessment of disease activity in Takayasu's arteritis

    Directory of Open Access Journals (Sweden)

    Anne E.D. Arraes

    Full Text Available ABSTRACT Objective: To evaluate 18F-fluorodeoxyglucose (18F-FDG uptake on positron emission tomography–computed tomography (PET–CT and serum levels of different cytokines and matrix metalloproteinases (MMPs in patients with Takayasu arteritis (TA and associations with disease activity. Methods: Serum levels of tumor necrosis factor-α (TNF-α, interleukin (IL-2, IL-6, IL-8, IL-12, IL-18, MMP-3 and MMP-9 were measured in 36 TA patients and 36 controls. Maximum standard uptake value (SUVmax of 18F-FDG in arterial walls was determined by PET–CT scans. TA patients were classified as active disease, inactive disease and possible active disease. Results: Serum IL-6 and MMP-3 levels were higher in TA patients than in controls (p < 0.001. Serum IL-6 was higher in patients with active disease and in patients with possible active disease than in inactive disease (p < 0.0001. Patients with active disease had higher serum TNFα levels than patients with inactive disease (p = 0.049 while patients with possible active disease presented higher IL-18 levels than patients with inactive disease (p = 0.046. Patients with active disease had higher SUVmax values than those with inactive disease (p = 0.042. By receiver operating characteristic (ROC curve SUVmax was predictive of active disease in TA and values ≥1.3 were associated with disease activity (p = 0.039. Serum TNF-α levels were higher in patients with SUVmax ≥ 1.3 than <1.3 (p = 0.045 and controls (p = 0.012. Serum IL-6 levels were higher in patients with SUVmax ≥ 1.3 than in controls (p < 0.001. No differences regarding other biomarkers were found between TA patients and controls. Conclusions: Higher serum IL-6 and TNFα levels as well as higher 18F-FDG uptake in arterial wall are associated with active TA.

  7. Evaluation of the Usability of Selected Questionnaires Assessing Physical Activity in the Prophylaxis of Cardiovascular Diseases.

    Science.gov (United States)

    Czeczelewska, Ewa; Czeczelewski, Jan; Wasiluk, Agnieszka; Saczuk, Jerzy

    2016-01-01

    The main health problem of the Polish population is posed by cardiovascular diseases (CDVD), coronary artery disease (CAD) in particular. Respectively higher physical activity linked with energy expenditure of at least 1000 kcal/week may significantly reduce the risk of CAD development. The protective effect of exercise applies not only to persons from high-risk groups and with diagnosed chronic diseases that increase the risk of the incidence of atherosclerosis and its complications, but also to healthy individuals. The aim of this study was to evaluate the usability of the Seven-Day Physical Activity Recall (SDPAR) and International Physical Activity Questionnaire (IPAQ) in research on the correlation between physical activity and risk factors of cardiovascular diseases. A screening survey, conducted in 2012, included students (n = 340) of the Division of the Academy of Physical Education in Biała Podlaska, aged 18-29 years. Total cholesterol, triglycerides and glucose levels were analyzed, and arterial blood pressure and heart rate were measured. The physical activity of the students was estimated using IPAQ and SDPAR questionnaires. The effect of physical activity on the biochemical blood markers, arterial blood pressure and heart rate was analyzed in groups differing in weekly energy expenditure (WEE). Along with increasing WEE values, calculated with IPAQ and SDPAR questionnaires, tangible descending tendencies were observed in cholesterol concentration in both genders. Significant differences were demonstrated in mean values of the resting heart rate between terciles of women ranked according to the increasing WEE values calculated using IPAQ (p physical activity; however the SDPAR seems to be a more useful tool in CDVD prevention screening.

  8. TGF-β1 and granulocyte elastase in the evaluation of activity of inflammatory bowel disease. A pilot study

    Directory of Open Access Journals (Sweden)

    Irena Ciećko-Michalska

    2014-01-01

    Full Text Available Introduction: The aim was to assess the usefulness of TGF-β1 and elastase in the evaluation of activity of ulcerative colitis (UC and Crohn’s disease (CD.Material and Methods: 32 patients diagnosed with UC, 31 with CD and 30 healthy volunteers were enrolled in this study. Diagnosis of the disease was confirmed by videocolonoscopy and histopathological evaluation of intestinal biopsies. Disease activity was assessed by use of the Mayo Scoring System for Assessment of Ulcerative Colitis Activity in UC patients and by CDAI in CD patients. hsCRP was determined by the immunonephelometric method, TGF-β1 and elastase plasma concentration by ELISA. The results of the study were analyzed using Statistica and R statistical language.Results: In UC a positive correlation between disease activity and platelet level, hsCRP and TGF-β1 concentration was noted. Elastase concentration in UC patients was significantly higher than in CD, but there was no correlation with the activity of the disease. In CD patients we observed a positive correlation between disease activity and leukocytes, platelet levels and elastase concentration, and a very low correlation with hsCRP and TGF-β1.Discussion: Determination of TGF-β1 can be used for evaluation of inflammatory activity in UC and it is connected with elevated concentrations of CRP and platelets. To a lower extent TGF-β1 can also be used for evaluation of inflammatory activity in CD. Examination of elastase concentration may be useful in the assessment of CD activity. Plasma elastase concentration may be helpful in UC and CD differentiation. The preliminary results of this investigation seem promising; nevertheless, more studies are necessary.

  9. Main determinants of physical activity levels in individuals with Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Raquel de Carvalho Lana

    2016-02-01

    Full Text Available ABSTRACT This study analyzed the relationship between patient characteristics, factors associated with Parkinson’s disease (PD, and physical activity level of individuals affected by the disease. Forty-six volunteers with mild-to-moderate idiopathic PD were assessed using sections II/III of the Unified Parkinson’s Disease Rating Scale and their motor functions were classified according to the modified Hoehn and Yahr (HY scale. Data such as age, disease duration, the Human Activity Profile (HAP, the Fatigue Severity Scale were collected. Lower limb bradykinesia and clinical subtypes of PD were defined. Two models that explained 76% of the variance of the HAP were used. The first comprised age, ability to perform activities of daily living (ADL, and the HY scale; the second comprised age, ability to perform ADL, and lower limb bradykinesia. Possible modifiable factors such as the ability to perform ADL and lower limb bradykinesia were identified as predictors of physical activity level of individuals with PD.

  10. Predictors of activity and participation across neurodegenerative conditions: a comparison of people with motor neurone disease, multiple sclerosis and Parkinson's disease.

    Science.gov (United States)

    Morley, David; Dummett, Sarah; Kelly, Laura; Fitzpatrick, Ray; Jenkinson, Crispin

    2018-02-17

    Comparisons between neurological conditions have the potential to inform service providers by identifying particular areas of difficulty experienced by affected individuals. This study aimed to identify predictors of activity and participation in people with motor neurone disease (MND), people with multiple sclerosis (MS) and people with Parkinson's Disease (PD). The Oxford Participation and Activities Questionnaire (Ox-PAQ) and Medical Outcomes Study 36-Item Short Form Survey (MOS SF-36) were administered by postal survey to 386 people with a confirmed diagnosis of MND, MS or PD. Data analyses focused on stepwise regression analyses in order to identify predictors of activity and participation in the three conditions assessed. Three hundred and thirty four participants completed the survey, a response rate of 86.5%. Regression analyses identified multiple predictors of activity and participation dependent on Ox-PAQ domain and disease group, the most prominent being social and physical functioning as measured by the MOS SF-36. Results indicate that the physical and social consequences of neurological illness are of greatest relevance to people experiencing the conditions assessed. Whilst the largely inevitable physical implications of disease take hold, emphasis should be placed on the avoidance of social withdrawal and isolation, and the maintenance of social engagement should become a significant priority.

  11. Behavioral and Locomotor Measurements Using an Open Field Activity Monitoring System for Skeletal Muscle Diseases

    OpenAIRE

    Tatem, Kathleen S.; Quinn, James L.; Phadke, Aditi; Yu, Qing; Gordish-Dressman, Heather; Nagaraju, Kanneboyina

    2014-01-01

    The open field activity monitoring system comprehensively assesses locomotor and behavioral activity levels of mice. It is a useful tool for assessing locomotive impairment in animal models of neuromuscular disease and efficacy of therapeutic drugs that may improve locomotion and/or muscle function. The open field activity measurement provides a different measure than muscle strength, which is commonly assessed by grip strength measurements. It can also show how drugs may affect other body sy...

  12. Physical Activity across Frailty Phenotypes in Females with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Kaitlyn P. Roland

    2012-01-01

    Full Text Available Females with Parkinson’s disease (PD are vulnerable to frailty. PD eventually leads to decreased physical activity, an indicator of frailty. We speculate PD results in frailty through reduced physical activity. Objective. Determine the contribution of physical activity on frailty in PD (n=15, 65 ± 9 years and non-PD (n=15, 73 ± 14 years females. Methods. Frailty phenotype (nonfrail/prefrail/frail was categorized and 8 hours of physical activity was measured using accelerometer, global positioning system, and self-report. Two-way ANCOVA (age as covariate was used to compare physical activity between disease and frailty phenotypes. Spearman correlation assessed relationships, and linear regression determined associations with frailty. Results. Nonfrail recorded more physical activity (intensity, counts, self-report compared with frail. Self-reported physical activity was greater in PD than non-PD. In non-PD, step counts, light physical activity time, sedentary time, and self-reported physical activity were related to frailty (R=0.91. In PD, only carbidopa-levodopa dose was related to frailty (r=0.61. Conclusion. Physical activity influences frailty in females without PD. In PD females, disease management may be a better indicator of frailty than physical activity. Further investigation into how PD associated factors contribute to frailty is warranted.

  13. Physiologic assessment of coronary artery disease: Focus on fractional flow reserve

    International Nuclear Information System (INIS)

    Hwang, Do Yeon; Koo, Bon Kwon; Lee, Joo Myung

    2016-01-01

    The presence of myocardial ischemia is the most important prognostic factor in patients with ischemic heart disease. Fractional flow reserve (FFR) is a gold standard invasive method used to detect the stenosis-specific myocardial ischemia. FFR-guided revascularization strategy is superior to angiography-guided strategy. The recently developed hyperemia-free index, instantaneous wave free ratio is being actively investigated. A non-invasive FFR derived from coronary CT angiography is now used in clinical practice. Due to rapid expansion of invasive and non-invasive physiologic assessment, comprehensive understanding of the role and potential pitfalls of each modality are required for its application. In this review, we focus on the basic and clinical aspects of physiologic assessment in ischemic heart disease

  14. Physiologic assessment of coronary artery disease: Focus on fractional flow reserve

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Do Yeon; Koo, Bon Kwon [Dept. of Radiology, Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul (Korea, Republic of); Lee, Joo Myung [Dept. of Internal Medicine and Cardiovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    The presence of myocardial ischemia is the most important prognostic factor in patients with ischemic heart disease. Fractional flow reserve (FFR) is a gold standard invasive method used to detect the stenosis-specific myocardial ischemia. FFR-guided revascularization strategy is superior to angiography-guided strategy. The recently developed hyperemia-free index, instantaneous wave free ratio is being actively investigated. A non-invasive FFR derived from coronary CT angiography is now used in clinical practice. Due to rapid expansion of invasive and non-invasive physiologic assessment, comprehensive understanding of the role and potential pitfalls of each modality are required for its application. In this review, we focus on the basic and clinical aspects of physiologic assessment in ischemic heart disease.

  15. Disease state fingerprint for fall risk assessment.

    Science.gov (United States)

    Similä, Heidi; Immonen, Milla

    2014-01-01

    Fall prevention is an important and complex multifactorial challenge, since one third of people over 65 years old fall at least once every year. A novel application of Disease State Fingerprint (DSF) algorithm is presented for holistic visualization of fall risk factors and identifying persons with falls history or decreased level of physical functioning based on fall risk assessment data. The algorithm is tested with data from 42 older adults, that went through a comprehensive fall risk assessment. Within the study population the Activities-specific Balance Confidence (ABC) scale score, Berg Balance Scale (BBS) score and the number of drugs in use were the three most relevant variables, that differed between the fallers and non-fallers. This study showed that the DSF visualization is beneficial in inspection of an individual's significant fall risk factors, since people have problems in different areas and one single assessment scale is not enough to expose all the people at risk.

  16. Definition and initial validation of a Lupus Low Disease Activity State (LLDAS).

    Science.gov (United States)

    Franklyn, Kate; Lau, Chak Sing; Navarra, Sandra V; Louthrenoo, Worawit; Lateef, Aisha; Hamijoyo, Laniyati; Wahono, C Singgih; Chen, Shun Le; Jin, Ou; Morton, Susan; Hoi, Alberta; Huq, Molla; Nikpour, Mandana; Morand, Eric F

    2016-09-01

    Treating to low disease activity is routine in rheumatoid arthritis, but no comparable goal has been defined for systemic lupus erythematosus (SLE). We sought to define and validate a Lupus Low Disease Activity State (LLDAS). A consensus definition of LLDAS was generated using Delphi and nominal group techniques. Criterion validity was determined by measuring the ability of LLDAS attainment, in a single-centre SLE cohort, to predict non-accrual of irreversible organ damage, measured using the Systemic Lupus International Collaborating Clinics Damage Index (SDI). Consensus methodology led to the following definition of LLDAS: (1) SLE Disease Activity Index (SLEDAI)-2K ≤4, with no activity in major organ systems (renal, central nervous system (CNS), cardiopulmonary, vasculitis, fever) and no haemolytic anaemia or gastrointestinal activity; (2) no new lupus disease activity compared with the previous assessment; (3) a Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI physician global assessment (scale 0-3) ≤1; (4) a current prednisolone (or equivalent) dose ≤7.5 mg daily; and (5) well tolerated standard maintenance doses of immunosuppressive drugs and approved biological agents. Achievement of LLDAS was determined in 191 patients followed for a mean of 3.9 years. Patients who spent greater than 50% of their observed time in LLDAS had significantly reduced organ damage accrual compared with patients who spent less than 50% of their time in LLDAS (p=0.0007) and were significantly less likely to have an increase in SDI of ≥1 (relative risk 0.47, 95% CI 0.28 to 0.79, p=0.005). A definition of LLDAS has been generated, and preliminary validation demonstrates its attainment to be associated with improved outcomes in SLE. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. MR imaging in adults with Gaucher disease type I: evulation of marrow involvement and disease activity

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, G. (Dept. of Radiology, Mount Sinai Medical Center, City Univ. of New York, NY (United States)); Shaprio, R.S. (Dept. of Radiology, Mount Sinai Medical Center, City Univ. of New York, NY (United States)); Abdelwahab, I.F. (Dept. of Radiology, Mount Sinai Medical Center, City Univ. of New York, NY (United States)); Grabowski, G. (Dept. of Pediatrics, Mount Sinai Medical Center, City Univ. of New York, NY (United States))

    1993-05-01

    An investigation was conducted to determine the usefulness of magnetic resonance imaging (MRI) in the evaluation of bone marrow involvement in patients with Gaucher disease type I. T1- and T2-weighted images were obtained of the lower extremities of 29 adult patients. Patients were classified into one of three groups based on marrow signal patterns on T1- and T2-weighted images as well as change in signal intensity from T1- to T2-weighted images. An increase in signal intensity from T1- to T2-weighted images was the criterion for an 'active process' within the bone marrow. Classification of the 29 patients produced the following results: Group A: Normal, 4 patients; group B: Marrow infiltration, 16 patients; group C: Marrow infiltration plus active marrow process, 9 patients. Correlation with clinical findings revealed that all nine patients with evidence of an active marrow process on MRI (group C) had acute bone pain. Conversely, only one of the remaining 20 patients (groups A and B) had bone pain. There was no correlation between disease activity and findings on conventional radiographs. We conclude the MRI provides an excellent noninvasive assessment of the extent and activity of marrow involvement in type I Gaucher disease. (orig.)

  18. MR imaging in adults with Gaucher disease type I: evulation of marrow involvement and disease activity

    International Nuclear Information System (INIS)

    Hermann, G.; Shaprio, R.S.; Abdelwahab, I.F.; Grabowski, G.

    1993-01-01

    An investigation was conducted to determine the usefulness of magnetic resonance imaging (MRI) in the evaluation of bone marrow involvement in patients with Gaucher disease type I. T1- and T2-weighted images were obtained of the lower extremities of 29 adult patients. Patients were classified into one of three groups based on marrow signal patterns on T1- and T2-weighted images as well as change in signal intensity from T1- to T2-weighted images. An increase in signal intensity from T1- to T2-weighted images was the criterion for an 'active process' within the bone marrow. Classification of the 29 patients produced the following results: Group A: Normal, 4 patients; group B: Marrow infiltration, 16 patients; group C: Marrow infiltration plus active marrow process, 9 patients. Correlation with clinical findings revealed that all nine patients with evidence of an active marrow process on MRI (group C) had acute bone pain. Conversely, only one of the remaining 20 patients (groups A and B) had bone pain. There was no correlation between disease activity and findings on conventional radiographs. We conclude the MRI provides an excellent noninvasive assessment of the extent and activity of marrow involvement in type I Gaucher disease. (orig.)

  19. An assessment of the relationship of physical activity, obesity, and chronic diseases/conditions between active/obese and sedentary/ normal weight American women in a national sample.

    Science.gov (United States)

    Pharr, J R; Coughenour, C A; Bungum, T J

    2018-03-01

    Obesity and physical inactivity are associated with increased rates of chronic diseases and conditions. However, the 'fit but fat' theory posits that cardiopulmonary fitness (or physical activity) can mitigate risks to health associated with obesity. The purpose of this study was to compare chronic diseases and conditions of highly active/obese women with inactive/normal weight women. This was a cross-sectional study of the 2015 Behavioral Risk Factor Surveillance System data. Weighted descriptive statistics were performed to describe the demographic characteristics of the two groups. We calculated odds ratios and adjusted odds ratios for chronic diseases and conditions comparing highly active/obese women with inactive/normal weight women. Highly active/obese women were more likely to report risk factors (hypertension, high cholesterol, and diabetes) for coronary heart disease (CHD) and cardiovascular disease (CVD) than inactive/normal weight women; however, they did not have increased rates of CVD, CHD, or heart attack and had decreased risk for stroke. Highly active/obese women had increased risk for asthma, arthritis, and depression, but not for cancer, kidney disease, or chronic obstructive pulmonary disease. Highly active/obese women appear to be staving off the actual development of CHD and CVD; however, further research is needed to understand the long-term health benefits of physical activity among obese women. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. ASSESSMENT OF THE RESPONSE OF PATIENTS WITH CROHN'S DISEASE TO BIOLOGICAL THERAPY USING NEW NON-INVASIVE MARKERS: lactoferrin and calprotectin

    Directory of Open Access Journals (Sweden)

    Islaine Martins NOGUEIRA

    2013-04-01

    Full Text Available Context The use of fecal markers to monitor Crohn's disease is crucial for assessing the response to treatment. Objective To assess the inflammatory activity of Crohn's disease by comparing fecal markers (calprotectin and lactoferrin, colonoscopy combined with biopsy, and the Crohn's disease activity index (CDAI, as well as serum markers, before treatment with infliximab, after the end of induction, and after the end of maintenance. Methods Seventeen patients were included who had been previously diagnosed with Crohn's disease and were using conventional treatment but required the introduction of biological therapy with infliximab. Each patient underwent a colonoscopy with biopsy, serum, and fecal (calprotectin and lactoferrin tests to assess inflammatory activity, and CDAI assessments before treatment with infliximab, after induction (week 8, and after maintenance (week 32. Results The calprotectin levels exhibited significant reductions (P = 0.04 between the assessment before treatment with infliximab and the end of induction, which did not occur after the end of the maintenance phase. Lactoferrin remained positive throughout the three phases of the study. Regarding the histological assessment, a significant difference was found only between the assessment before treatment and after the end of maintenance (P = 0.036, and 60% of the patients exhibited histological improvements after the completion of the follow-up period. The CDAI exhibited a significant difference between the assessment before treatment with infliximab and after induction, as well as before treatment and after maintenance (P<0.01. Conclusion Calprotectin and lactoferrin are not useful for monitoring inflammatory activity in Crohn's disease patients who are subjected to biological therapy.

  1. Occupational physical activity assessment for chronic disease prevention and management: A review of methods for both occupational health practitioners and researchers.

    Science.gov (United States)

    Scott, Kenneth A; Browning, Raymond C

    2016-01-01

    Occupational physical activity (OPA) is an occupational exposure that impacts worker health. OPA is amenable to measurement and modification through the hierarchy of controls. Occupational exposure scientists have roles in addressing inadequate physical activity, as well as excessive or harmful physical activity. Occupational health researchers can contribute to the development of novel OPA exposure assessment techniques and to epidemiologic studies examining the health impacts of physical activity at work. Occupational health practitioners stand to benefit from understanding the strengths and limitations of physical activity measurement approaches, such as accelerometers in smartphones, which are already ubiquitous in many workplaces and in some worksite health programs. This comprehensive review of the literature provides an overview of physical activity monitoring for occupational exposure scientists. This article summarizes data on the public health implications of physical activity at work, highlighting complex relationships with common chronic diseases. This article includes descriptions of several techniques that have been used to measure physical activity at work and elsewhere, focusing in detail on pedometers, accelerometers, and Global Positioning System technology. Additional subjective and objective measurement strategies are described as well.

  2. Disease activity score in rheumatoid arthritis with or without secondary fibromyalgia

    International Nuclear Information System (INIS)

    Zammurrad, S.; Munir, W.; Farooqi, A.

    2013-01-01

    Objective: To correlate disease activity score (DAS-28) in the patients with rheumatoid arthritis (RA) with and without secondary fibromyalgia. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad, from November 2011 to April 2012. Methodology: Patients aged above 16 years diagnosed to have rheumatoid arthritis according to ACR/EULAR criteria 2010 were included in the study. Fibromyalgia (FM) was diagnosed by ACR 1990 criteria. Patients of other autoimmune diseases or psychiatric illnesses were excluded. DAS was determined and compared using t-test with significance at p < 0.05. Results: The mean age of study subjects was 42.9 years. Thirty one out of total 138 patients had fibromyalgia (22.4%). Female gender was predominant (92.0%); being 96.8% in patients with and in 88.2% without fibromyalgia. The average DAS score was high (5.3 + 1.5) in fibromyalgia patients compared to those without fibromyalgia (3.9 + 1.2); this difference in mean value was statistically significant (p = < 0.001). Conclusion: DAS-28 is a useful tool for assessing rheumatoid arthritis disease status in outpatient setting, however, increased disease activity must be assessed for possible co-existence of fibromyalgia which can spuriously give high DAS value and adversely affect treatment decision. (author)

  3. Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease.

    Science.gov (United States)

    van der Valk, Eline S; Smans, Lisanne C C J; Hofstetter, Hedwig; Stubbe, Janine H; de Vries, Marieke; Backx, Frank J G; Hermus, Ad R M M; Zelissen, Pierre M J

    2016-09-01

    Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. The aim of this study was to investigate the quality of life in Dutch patients with Addison's disease particularly regarding the presence of fatigue and the ability to be physically active. In this cross-sectional study, a postal survey was performed among Dutch patients with Addison's disease on stable glucocorticoid replacement therapy with hydrocortisone or cortisone acetate. For quality of life and physical activity assessment, patients completed general and health-related quality of life and physical activity questionnaires, and scores were compared to Dutch controls. A total of 328 patients with Addison's disease were studied. In patients with Addison's disease, only 45·7% met the standard of physical activity (Combinorm) compared to 67·8% of Dutch controls (P < 0·01). Forty-eight per cent of patients showed abnormal fatigue, while 61% had severe fatigue. The CIS fatigue scores were significantly higher compared to controls (P < 0·01). We found reduced general subjective health-related QoL scores in both male and female patients, especially in younger patients <65 years of age. Physical activity is decreased in patients with Addison's disease, combined with a reduced subjective health-related QoL and increased fatigue. © 2016 John Wiley & Sons Ltd.

  4. Image registration for assessment of Crohn's disease severity

    NARCIS (Netherlands)

    Li, Z.

    2015-01-01

    Crohn’s disease (CD) is a chronic inflammatory bowel disease (IBD) that affects millions of people in Europe alone. It is important to accurately assess the disease severity in a safe and non-invasive manner in order to improve the treatment of patients with CD. Furthermore, the ideal assessment

  5. Accelerometer Cut Points for Physical Activity Assessment of Older Adults with Parkinson's Disease.

    Directory of Open Access Journals (Sweden)

    Håkan Nero

    Full Text Available To define accelerometer cut points for different walking speeds in older adults with mild to moderate Parkinson's disease.A volunteer sample of 30 older adults (mean age 73; SD 5.4 years with mild to moderate Parkinson's disease walked at self-defined brisk, normal, and slow speeds for three minutes in a circular indoor hallway, each wearing an accelerometer around the waist. Walking speed was calculated and used as a reference measure. Through ROC analysis, accelerometer cut points for different levels of walking speed in counts per 15 seconds were generated, and a leave-one-out cross-validation was performed followed by a quadratic weighted Cohen's Kappa, to test the level of agreement between true and cut point-predicted walking speeds.Optimal cut points for walking speeds ≤ 1.0 m/s were ≤ 328 and ≤ 470 counts/15 sec; for speeds > 1.3 m/s, they were ≥ 730 and ≥ 851 counts/15 sec for the vertical axis and vector magnitude, respectively. Sensitivity and specificity were 61%-100% for the developed cut points. The quadratic weighted Kappa showed substantial agreement: κ = 0.79 (95% CI 0.70-0.89 and κ = 0.69 (95% CI 0.56-0.82 for the vertical axis and the vector magnitude, respectively.This study provides accelerometer cut points based on walking speed for physical-activity measurement in older adults with Parkinson's disease for evaluation of interventions and for investigating links between physical activity and health.

  6. Cross-cultural adaptation and validation of the Behcet's Disease Current Activity Form in Korea.

    Science.gov (United States)

    Choi, Hyo Jin; Seo, Mi Ryoung; Ryu, Hee Jung; Baek, Han Joo

    2015-09-01

    This study was undertaken to perform a cross-cultural adaptation of the Behcet's Disease Current Activity Form (BDCAF, version 2006) questionnaire to the Korean language and to evaluate its reliability and validity in a population of Korean patients with Behcet's disease (BD). A cross-cultural study was conducted among patients with BD who attended our rheumatology clinic between November 2012 and March 2013. There were 11 males and 35 females in the group. The mean age of the participants was 48.5 years and the mean disease duration was 6.4 years. The first BDCAF questionnaire was completed on arrival and the second assessment was performed 20 minutes later by a different physician. The test-retest reliability was analyzed by computing κ statistics. Kappa scores of > 0.6 indicated a good agreement. To assess the validity, we compared the total BDCAF score with the patient's/clinician's perception of disease activity and the Korean version of the Behcet's Disease Quality of Life (BDQOL). For the test-retest reliability, good agreements were achieved on items such as headache, oral/genital ulceration, erythema, skin pustules, arthralgia, nausea/vomiting/abdominal pain, and diarrhea with altered/frank blood per rectum. Moderate agreement was observed for eye and nervous system involvement. We achieved a fair agreement for arthritis and major vessel involvement. Significant correlations were obtained between the total BDCAF score with the BDQOL and the patient's/clinician's perception of disease activity p < 0.05). The Korean version of the BDCAF is a reliable and valid instrument for measuring current disease activity in Korean BD patients.

  7. 99M-TC MIBI-an indicator of active disease in multiple myeloma

    International Nuclear Information System (INIS)

    Raluca Mititelu; Serban Ghita; Catalin Mazilu; George Marinescu

    2004-01-01

    Purpose: to evaluate the role of 99mTc-MIBI in the assessment of bone marrow involvement in patients with multiple myeloma and to demonstrate how different patterns of 99mTc-MIBI uptake are reflecting the activity of the disease. Material and method: 27 patients with documented MM were studied, 14M, 13 F, median age 62 years, range 31 - 78. 7 MPI (myocardial perfusion imaging) patients served as controle. Diagnosis and staging of the disease were based on standard criteria: 5 patients in stage I, 7 in stage II, 15 in stage III. The disease activity was determined by clinical and biological assessment and the aspect of bone marrow biopsy. 17 patients had active disease (2 patients in stage I, 4 in stage II, 11 in stage III), 10 patients had not' clinical and biological criteria of active disease. All patients included in the group of active disease underwent radiological examination, 99mTc-MDP whole-body scan and 99mTc-MIBI whole-body scan. MRI was performed in 5 patients with active disease (2 in stage I, 1 in stage II, 2 in stage lib - for evaluation of spine involvement. In the other group (patients with clinical and biological criteria of non-active disease), due to high cost of investigations, we performed whole-body 99mTc-MIBI scan, as the oncologist referred us the patient for monitoring therapeutic response. Whole-body 99mTc-MIBI scans were obtained 20 rain after iv injection of 740 MBq 99mTc-MIBI, in anterior and posterior views, with a dual-head gamma camera Philips -Axis. Results: In the group of patients with active disease (17 patients) we found three different patterns of pathologic 99mTc-MIBI uptake: focal uptake in different sites in 9 patients, diffuse uptake in 4, both focal and diffuse uptake in 3; no pathologic uptake was seen in 1 patient (probably due to overexpression of Pglycoprotein). In the other group, with non-active disease criteria (10 patients), we found normal aspect of 99mTc-MIBI uptake in 8 patients; 2 patients had diffuse increased

  8. Behavioral and locomotor measurements using an open field activity monitoring system for skeletal muscle diseases.

    Science.gov (United States)

    Tatem, Kathleen S; Quinn, James L; Phadke, Aditi; Yu, Qing; Gordish-Dressman, Heather; Nagaraju, Kanneboyina

    2014-09-29

    The open field activity monitoring system comprehensively assesses locomotor and behavioral activity levels of mice. It is a useful tool for assessing locomotive impairment in animal models of neuromuscular disease and efficacy of therapeutic drugs that may improve locomotion and/or muscle function. The open field activity measurement provides a different measure than muscle strength, which is commonly assessed by grip strength measurements. It can also show how drugs may affect other body systems as well when used with additional outcome measures. In addition, measures such as total distance traveled mirror the 6 min walk test, a clinical trial outcome measure. However, open field activity monitoring is also associated with significant challenges: Open field activity measurements vary according to animal strain, age, sex, and circadian rhythm. In addition, room temperature, humidity, lighting, noise, and even odor can affect assessment outcomes. Overall, this manuscript provides a well-tested and standardized open field activity SOP for preclinical trials in animal models of neuromuscular diseases. We provide a discussion of important considerations, typical results, data analysis, and detail the strengths and weaknesses of open field testing. In addition, we provide recommendations for optimal study design when using open field activity in a preclinical trial.

  9. Cognitive, functional and behavioral assessment: Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Márcia L.F. Chaves

    Full Text Available Abstract A review of the evidence on cognitive, functional and behavioral assessment for the diagnosis of dementia due to Alzheimer's disease (AD is presented with revision and broadening of the recommendations on the use of tests and batteries in Brazil for the diagnosis of dementia due to AD. A systematic review of the literature (MEDLINE, LILACS and SCIELO database was carried out by a panel of experts. Studies on the validation and/or adaptation of tests, scales and batteries for the Brazilian population were analyzed and classified according to level of evidence. There were sufficient data to recommend the IQCODE, DAFS-R, DAD, ADL-Q and Bayer scale for the evaluation of instrumental activities of daily living, and the Katz scale for the assessment of basic activities of daily living. For the evaluation of neuropsychiatric symptoms, the Neuropsychiatric Inventory (NPI and the CAMDEX were found to be useful, as was the Cornell scale for depression in dementia. The Mini-Mental State Examination has clinical utility as a screening test, as do the multifunctional batteries (CAMCOG-R, ADAS-COG, CERAD and MDRS for brief evaluations of several cognitive domains. There was sufficient evidence to recommend the CDR scale for clinical and severity assessment of dementia. Tests for Brazilian Portuguese are recommended by cognitive domain based on available data.

  10. The role of 18F-FDG PET in characterising disease activity in Takayasu arteritis

    International Nuclear Information System (INIS)

    Webb, Myles; Chambers, Anthony; AL-Nahhas, Adil; Maudlin, Lucy; Rahman, Lucy; Frank, John; Mason, Justin C.

    2004-01-01

    Takayasu arteritis (TA) is a rare, sporadic and chronic inflammatory arteritis, which predominantly affects the aorta and its branches. Diagnosis can be difficult and there are limitations to the current diagnostic work-up. By detecting areas of active glucose metabolism present in active vasculitis, imaging with fluorine-18 fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) could potentially have a role in the management of TA. Our aim was to assess this role by reviewing 28 18 F-FDG PET scans performed on 18 patients suspected of having TA. All patients had full clinical and laboratory assessment, cross-sectional imaging and angiography, and 16/18 satisfied the American College of Rheumatologists' criteria for TA. 18 F-FDG PET achieved a sensitivity of 92%, a specificity of 100%, and negative and positive predictive values of 85% and 100% respectively in the initial assessment of active vasculitis in TA. We conclude that 18 F-FDG PET can be used to diagnose early disease, to detect active disease (even within chronic changes) and to monitor the effectiveness of treatment. (orig.)

  11. Impact of hepatitis C virus infection on disease activity, functional status and ultrasonography findings in Egyptian rheumatoid arthritis patients

    Directory of Open Access Journals (Sweden)

    Nabila Abd EI-Hamid Gohar

    2018-04-01

    Full Text Available Background: Hepatitis C virus (HCV infection is one of the most frequently encountered public health problems in Egypt. It is associated with many autoimmune diseases such as rheumatoid arthritis. Aim of the work: To assess the impact of HCV infection in rheumatoid arthritis (RA Egyptian patients; its relation to disease activity, functional status and ultrasonography findings. Patients and methods: The study included 155 RA patients further classified according to the presence of concomitant HCV infection into 2 groups; rheumatoid arthritis (RA and rheumatoid arthritis/hepatitis C virus (RA/HCV groups. All patients were subjected to full history taking, thorough clinical examination, laboratory investigations, assessment of disease activity using the disease activity score 28 (DAS28 and assessment of functional status using the modified health assessment questionnaire (MHAQ. Ultrasonography (US assessment was done using the German US7 score. Results: Both DAS28 and MHAQ scores showed significant differences between both the RA and the RA/HCV groups (p < 0.001, with higher mean values observed in the RA/HCV group (5.4 ± 1.1 and 1.05 ± 0.79 respectively. Significantly higher US7 synovitis scores were found in the RA/HCV group compared to the RA group (p = 0.03. US7 synovitis tenosynovitis scores revealed significant correlations with DAS28 and US7 synovitis scores correlated with MHAQ in both groups. Conclusion: Concomitant HCV infection in RA patients had an impact on disease activity. RA patients with concomitant HCV infection (RA/HCV had higher DAS28 and MHAQ scores, with higher US7 synovitis scores compared to RA patients. US7 score is a valuable objective tool for the assessment of RA disease activity. Keywords: Rheumatoid arthritis, HCV infection, Ultrasonography, DAS28, MHAQ

  12. Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA study.

    Science.gov (United States)

    Sokka, Tuulikki; Toloza, Sergio; Cutolo, Maurizio; Kautiainen, Hannu; Makinen, Heidi; Gogus, Feride; Skakic, Vlado; Badsha, Humeira; Peets, Tõnu; Baranauskaite, Asta; Géher, Pál; Ujfalussy, Ilona; Skopouli, Fotini N; Mavrommati, Maria; Alten, Rieke; Pohl, Christof; Sibilia, Jean; Stancati, Andrea; Salaffi, Fausto; Romanowski, Wojciech; Zarowny-Wierzbinska, Danuta; Henrohn, Dan; Bresnihan, Barry; Minnock, Patricia; Knudsen, Lene Surland; Jacobs, Johannes Wg; Calvo-Alen, Jaime; Lazovskis, Juris; Pinheiro, Geraldo da Rocha Castelar; Karateev, Dmitry; Andersone, Daina; Rexhepi, Sylejman; Yazici, Yusuf; Pincus, Theodore

    2009-01-01

    Gender as a predictor of outcomes of rheumatoid arthritis (RA) has evoked considerable interest over the decades. Historically, there is no consensus whether RA is worse in females or males. Recent reports suggest that females are less likely than males to achieve remission. Therefore, we aimed to study possible associations of gender and disease activity, disease characteristics, and treatments of RA in a large multinational cross-sectional cohort of patients with RA called Quantitative Standard Monitoring of Patients with RA (QUEST-RA). The cohort includes clinical and questionnaire data from patients who were seen in usual care, including 6,004 patients at 70 sites in 25 countries as of April 2008. Gender differences were analyzed for American College of Rheumatology Core Data Set measures of disease activity, DAS28 (disease activity score using 28 joint counts), fatigue, the presence of rheumatoid factor, nodules and erosions, and the current use of prednisone, methotrexate, and biologic agents. Women had poorer scores than men in all Core Data Set measures. The mean values for females and males were swollen joint count-28 (SJC28) of 4.5 versus 3.8, tender joint count-28 of 6.9 versus 5.4, erythrocyte sedimentation rate of 30 versus 26, Health Assessment Questionnaire of 1.1 versus 0.8, visual analog scales for physician global estimate of 3.0 versus 2.5, pain of 4.3 versus 3.6, patient global status of 4.2 versus 3.7, DAS28 of 4.3 versus 3.8, and fatigue of 4.6 versus 3.7 (P < 0.001). However, effect sizes were small-medium and smallest (0.13) for SJC28. Among patients who had no or minimal disease activity (0 to 1) on SJC28, women had statistically significantly higher mean values compared with men in all other disease activity measures (P < 0.001) and met DAS28 remission less often than men. Rheumatoid factor was equally prevalent among genders. Men had nodules more often than women. Women had erosions more often than men, but the statistical significance

  13. Contrast-enhanced ultrasonography for the determination of Crohn’s disease activity – preliminary experience

    Science.gov (United States)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Summary Background Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn’s disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Material/Methods Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Results Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. Conclusions CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn’s disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI. PMID:24723988

  14. Contrast-enhanced ultrasonography for the determination of Crohn’s disease activity – preliminary experience

    International Nuclear Information System (INIS)

    Białecki, Marcin; Białecka, Agnieszka; Laskowska, Katarzyna; Kłopocka, Maria; Liebert, Ariel; Lemanowicz, Adam; Serafin, Zbigniew

    2014-01-01

    Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn’s disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD. Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR). Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation. CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn’s disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI

  15. Disease activity in and quality of life of patients with psoriatic arthritis mutilans

    DEFF Research Database (Denmark)

    Lindqvist, U; Gudbjornsson, B; Iversen, L.

    2017-01-01

    capacity with little or no ability to perform self-care or everyday tasks was reported by 21% of the patients. Patients between 45 and 60 years of age reported the most impaired quality of life in comparison to the control group. Conclusion: PAM seriously affects social functioning. Whether early......-assessed disease activity, and patient’s education and work status were recorded. Data from the 36-item Short Form Health Survey, Health Assessment Questionnaire and Dermatology Life Quality Index questionnaire were gathered and correlated with disease duration, pain, and general well-being (visual analogue scale...

  16. Relationship between leptin concentrations and disease activity in patients with rheumatoid arthritis.

    Science.gov (United States)

    Batún-Garrido, José Antonio de Jesús; Salas-Magaña, Marisol; Juárez-Rojop, Isela Esther; Hernández-Núñez, Eúfrates; Olán, Francisco

    2018-05-11

    Multiple studies have found a direct relationship between leptin concentrations and disease activity in rheumatoid arthritis. We studied 77 patients with the diagnosis of rheumatoid arthritis; the leptin determination was through an enzyme immunoassay. Disease activity was assessed by the DAS-28 CRP. A multivariate logistic regression model was used to determine the association between significant variables and leptin concentrations. 40.3% of the patients were in remission, 41.6% were mildly active, 11.7% were moderately active and 6.5% were severely active. The results show an independent association between higher concentrations of leptin and disease activity (OR 1.7; 95% CI 1.4-3.2; p .03), the number of swollen joints (OR 4.6; 95% CI 1.7-8.3; p .000), the number of painful joints (OR 3.4; 95% CI 1.6-4.6; p .000), and the presence of metabolic syndrome (OR 1.3; 95% IC 1.2-1,9; p .045). The data suggest that serum leptin is elevated in patients with active RA. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  17. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults ... on Screening for Peripheral Artery Disease (PAD) and Cardiovascular Disease (CVD) Risk Assessment with Ankle Brachial Index (ABI) ...

  18. Active Vaccines for Alzheimer Disease Treatment.

    Science.gov (United States)

    Sterner, Rosalie M; Takahashi, Paul Y; Yu Ballard, Aimee C

    2016-09-01

    Vaccination against peptides specific to Alzheimer disease may generate an immune response that could help inhibit disease and symptom progression. PubMed and Scopus were searched for clinical trial articles, review articles, and preclinical studies relevant to the field of active Alzheimer disease vaccines and raw searches yielded articles ranging from 2016 to 1973. ClinicalTrials.gov was searched for active Alzheimer disease vaccine trials. Manual research and cross-referencing from reviews and original articles was performed. First generation Aβ42 phase 2a trial in patients with mild to moderate Alzheimer disease resulted in cases of meningoencephalitis in 6% of patients, so next generation vaccines are working to target more specific epitopes to induce a more controlled immune response. Difficulty in developing these vaccines resides in striking a balance between providing a vaccine that induces enough of an immune response to actually clear protein sustainably but not so much of a response that results in excess immune activation and possibly adverse effects such as meningoencephalitis. Although much work still needs to be done in the field to make this a practical possibility, the enticing allure of being able to treat or even prevent the extraordinarily impactful disease that is Alzheimer disease makes the idea of active vaccination for Alzheimer disease very appealing and something worth striving toward. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  19. Vigorous-intensity leisure-time physical activity and risk of major chronic disease in men.

    Science.gov (United States)

    Chomistek, Andrea K; Cook, Nancy R; Flint, Alan J; Rimm, Eric B

    2012-10-01

    Although studies have shown health benefits for moderate-intensity physical activity, there is limited evidence to support beneficial effects for high amounts of vigorous activity among middle-age and older men. The objective of this study was to examine the relationship between vigorous-intensity physical activity, compared with moderate-intensity activity, and risk of major chronic disease in men. We prospectively examined the associations between vigorous- and moderate-intensity physical activity and risk of major chronic disease among 44,551 men age 40-75 yr in 1986. Leisure-time physical activity was assessed biennially by questionnaire. During 22 yr of follow-up, we documented 14,162 incident cases of major chronic disease, including 4769 cardiovascular events, 6449 cancer events, and 2944 deaths from other causes. The HR of major chronic disease comparing ≥ 21 to 0 MET.h.wk(-1) of exercise was 0.86 (95% confidence interval (CI), 0.81-0.91) for vigorous-intensity activity and 0.85 (95% CI, 0.80-0.90) for moderate activity. For cardiovascular disease (CVD), the corresponding HRs were 0.78 (95% CI, 0.70-0.86) and 0.80 (95% CI, 0.72-0.88), respectively. When examined separately, running, tennis, and brisk walking were inversely associated with CVD risk. Furthermore, more vigorous activity was associated with lower disease risk; the HR comparing >70 to 0 MET.h.wk(-1) of vigorous-intensity exercise was 0.79 (95% CI, 0.68-0.92; P < 0.0001 for trend) for major chronic disease and 0.73 (95% CI, 0.56-0.96; P < 0.0001 for trend) for CVD. Vigorous- and moderate-intensity physical activities were associated with lower risk of major chronic disease and CVD. Increasing amounts of vigorous activity remained inversely associated with disease risk, even among men in the highest categories of exercise.

  20. Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Dirven Linda

    2012-07-01

    Full Text Available Abstract Objective To determine the prevalence of vertebral fractures (VFs after 5 years of disease activity score (DAS-steered treatment in patients with early rheumatoid arthritis (RA and to investigate the association of VFs with disease activity, functional ability and bone mineral density (BMD over time. Methods Five-year radiographs of the spine of 275 patients in the BeSt study, a randomized trial comparing four treatment strategies, were used. Treatment was DAS-steered (DAS ≤ 2.4. A height reduction >20% in one vertebra was defined a vertebral fracture. With linear mixed models, DAS and Health Assessment Questionnaire (HAQ scores over 5 years were compared for patients with and without VFs. With generalized estimating equations the association between BMD and VFs was determined. Results VFs were observed in 41/275 patients (15%. No difference in prevalence was found when stratified for gender, prednisone use and menopausal status. Disease activity over time was higher in patients with VFs, mean difference 0.20 (95% CI: 0.05-0.36, and also HAQ scores were higher, independent of disease activity, with a mean difference of 0.12 (95% CI: 0.02-0.2. Age was associated with VFs (OR 1.06, 95% CI: 1.02-1.09, mean BMD in spine and hip over time were not (OR 95% CI, 0.99: 0.78-1.25 and 0.94: 0.65-1.36, respectively. Conclusion After 5 years of DAS-steered treatment, 15% of these RA patients had VFs. Higher age was associated with the presence of VFs, mean BMD in hip and spine were not. Patients with VFs have greater functional disability over time and a higher disease activity, suggesting that VFs may be prevented by optimal disease activity suppression.

  1. Validity of a short questionnaire to assess physical activity in 10 European countries

    NARCIS (Netherlands)

    Feskens, E.J.M.

    2012-01-01

    To accurately examine associations of physical activity (PA) with disease outcomes, a valid method of assessing free-living activity is required. We examined the validity of a brief PA questionnaire (PAQ) used in the European Prospective Investigation into Cancer and Nutrition (EPIC). PA energy

  2. Antioxidant activity of wine assessed by different in vitro methods

    Directory of Open Access Journals (Sweden)

    Di Lorenzo Chiara

    2017-01-01

    Full Text Available Epidemiological studies have suggested that a diet rich in antioxidant compounds could help in counteracting the effects of reactive oxygen species, reducing the risk factors for chronic diseases. The moderate consumption of wine, especially red wine, has been associated with the reduction in mortalities from cardiovascular diseases. One of the possible reasons for the protective effect of wine can be identified in the high content of polyphenols (mainly flavonoids, which have significant antioxidant activity. Even though several in vitro tests have been developed for the measure of the antioxidant property, no method has showed a satisfactory correlation with the in vivo situation. On these bases, the aim of this study was the application and comparison of different in vitro methods to assess the antioxidant activity of red, rosé and white wines. The methods were: 1 Folin-Cocalteau's assay for the quantification of total polyphenol content; 2 the DPPH (1,1-diphenyl-2-picrylhydrazyl spectrophotometric assay and the Trolox Equivalent Antioxidant Capacity (TEAC spectrophotometric assay for measuring the antioxidant activity of samples; 3 High Performance Thin Layer Chromatography for separation of phenolic substances and assessment of the associated antioxidant activity; 4 electrochemical detection by using a biosensor. Although all the approaches show some limitations, this battery of tests offers a more reliable body of data on the antioxidant activity of vine derivatives.

  3. Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice.

    Science.gov (United States)

    Anderson, Jaclyn; Caplan, Liron; Yazdany, Jinoos; Robbins, Mark L; Neogi, Tuhina; Michaud, Kaleb; Saag, Kenneth G; O'Dell, James R; Kazi, Salahuddin

    2012-05-01

    Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Group (WG) to comprehensively evaluate the validity, feasibility, and acceptability of available RA disease activity measures and derive recommendations for their use in clinical practice. The Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures. Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created. A survey was administered to rheumatologists soliciting input. The WG used these survey results in conjunction with the psychometric analyses to derive final recommendations. Systematic review of the literature resulted in identification of 63 RA disease activity measures. Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation. Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible. From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of ACR-recommended RA disease activity measures. We recommend the Clinical Disease Activity Index, Disease Activity Score with 28-joint counts (erythrocyte sedimentation rate or C-reactive protein), Patient Activity Scale (PAS), PAS-II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings. Copyright © 2012 by the American College of Rheumatology.

  4. Vessel Wall Inflammation of Takayasu Arteritis Detected by Contrast-Enhanced Magnetic Resonance Imaging: Association with Disease Distribution and Activity.

    Directory of Open Access Journals (Sweden)

    Yoko Kato

    Full Text Available The assessment of the distribution and activity of vessel wall inflammation is clinically important in patients with Takayasu arteritis. Magnetic resonance imaging (MRI is a useful tool, but the clinical utility of late gadolinium enhancement (LGE in Takayasu arteritis has yet to be determined. The aim of the present study was to evaluate the utility of LGE in assessing vessel wall inflammation and disease activity in Takayasu arteritis.We enrolled 49 patients with Takayasu arteritis who had undergone 1.5 T MRI. Patients were divided into Active (n = 19 and Inactive disease (n = 30 groups. The distribution of vessel wall inflammation using angiography and LGE was assessed by qualitative analysis. In 79% and 63% of patients in Active and Inactive groups, respectively, greater distribution of vessel wall inflammation was observed with LGE than with conventional angiography. MRI values of pre- and post-contrast signal-to-noise ratios (SNR, SNR increment (post-SNR minus pre-SNR, pre- and post-contrast contrast-to-noise ratios (CNR, and CNR increment (post-CNR minus pre-CNR were evaluated at arterial wall sites with the highest signal intensity using quantitative analysis of post-contrast LGE images. No statistically significant differences in MRI parameters were observed between Active and Inactive groups. Contrast-enhanced MRI was unable to accurately detect active disease.Contrast-enhanced MRI has utility in detecting the distribution of vessel wall inflammation but has less utility in assessing disease activity in Takayasu arteritis.

  5. Diagnostic performance of PET/MR in the evaluation of active inflammation in Crohn disease.

    Science.gov (United States)

    Catalano, Onofrio Antonio; Wu, Vincent; Mahmood, Umar; Signore, Alberto; Vangel, Mark; Soricelli, Andrea; Salvatore, Marco; Gervais, Debra; Rosen, Bruce R

    2018-01-01

    This study investigates the performance of PET/MR versus each sub-modality alone in the assessment of active inflammation in patients with Crohn disease, when compared to surgery as standard of reference. Sensitivity for detecting active inflammation was 91.5% for PET, 80% for MR, and 88% for PET/MR. Specificity for active inflammation was 74% for PET, 87% for MR, and 93% for PET/MR. Diagnostic accuracy was 84% for PET, 83% for MR, and 91% for PET/MR. In conclusion, PET/MR is significantly more accurate than either sub-modality alone and more specific than PET alone in the detection of active inflammation in patients with Crohn disease.

  6. The correlation of serum bilirubin levels with disease activity in patients with rheumatoid arthritis.

    Science.gov (United States)

    Peng, You-Fan; Wang, Jun-Li; Pan, Guo-Gang

    2017-06-01

    We investigated the relationship between serum bilirubin and disease activity in patients with rheumatoid arthritis (RA). We included a total of 173 consecutive RA patients without steroid treatment and 346 healthy subjects; the disease activity score in 28 joints (DAS28) was used to assess disease activity in patients with RA. Serum bilirubin concentrations were significantly lower in RA patients than in controls. Serum bilirubin was found to be negatively correlated with C-reactive protein (CRP) concentration and erythrocyte sedimentation rate (ESR) (r=-0.165, P=0.030; r=-192, P=0.012) in patients with RA. There was a negative correlation between the serum bilirubin and DAS28 score (r=-0.331, Pbilirubin was independently associated with the DAS28 score (b=-0.225, P=0.001) in the multiple linear regression analysis. Serum bilirubin concentrations are lower in patients with RA compared to controls and correlate with disease activity in patients with RA. Copyright © 2017. Published by Elsevier B.V.

  7. Clinical significance of fibromyalgia syndrome in different rheumatic diseases: Relation to disease activity and quality of life.

    Science.gov (United States)

    El-Rabbat M, Sarah; Mahmoud, Nermeen K; Gheita, Tamer A

    2017-04-11

    To describe the frequencies of fibromyalgia syndrome (FMS) in various rheumatic diseases; rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and Behçets disease (BD) patients and to study the relation to clinical manifestations and quality of life (QoL). 160 patients (50 RA, 50 SLE, 30 SSc and 30 BD) and matched corresponding healthy controls were included. Disease activity was assessed using disease activity score in 28 joints (DAS28) for RA, SLE Disease Activity index (SLEDAI), modified Rodnan skin score for SSc and BD Current Activity Form (BDCAF). The QoL was also recorded. Severity in FMS cases was estimated using the revised Fibromyalgia Impact Questionnaire score. In the RA, SLE, SSc and BD patients, FMS was found in 14%, 18%, 6.67% and 3.33% respectively compared to 2.1%, 3%, 3.3% and 0% in their corresponding controls. In RA patients, DAS28 was significantly higher in those with FMS (p=0.009) and significantly correlated with both Widespread Pain Index (WPI) (p=0.011) and Symptom Severity (SS) scale (p=0.012). The QoL scale in those with FMS was significantly worse (62.3±7.9) compared to those without (71.7±14.4) (p=0.023). In SLE patients, The WPI and SS both significantly correlated with the presence of thrombosis (r=0.28, p=0.049 and r=0.43, p=0.002 respectively). The SS scale tended to correlate with the SLEDAI (r=0.28, p=0.05). In BD patients, BDCAF and WPI significantly correlated (p=0.03). Fibromyalgia syndrome is more frequent in rheumatic diseases, could be related to the disease activity in RA and BD patients and to thrombosis in SLE and affected the QoL in RA. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  8. Physical and Psychosocial Factors Associated With Physical Activity in Patients With Chronic Obstructive Pulmonary Disease

    NARCIS (Netherlands)

    Hartman, Jorine E.; Boezen, H. Marike; de Greef, Mathieu H.; ten Hacken, Nick H.

    2013-01-01

    Objectives: To assess physical activity and sitting time in patients with chronic obstructive pulmonary disease (COPD) and to investigate which physical and psychosocial factors are associated with physical activity and sitting time. Design: Cross-sectional study. Setting: Patients were recruited at

  9. The role of {sup 18}F-FDG PET in characterising disease activity in Takayasu arteritis

    Energy Technology Data Exchange (ETDEWEB)

    Webb, Myles; Chambers, Anthony; AL-Nahhas, Adil; Maudlin, Lucy; Rahman, Lucy; Frank, John [Department of Nuclear Medicine, Hammersmith Hospital, Du Cane Road, W12 0HS, London (United Kingdom); Mason, Justin C. [Department of Rheumatology, Hammersmith Hospital, London (United Kingdom)

    2004-05-01

    Takayasu arteritis (TA) is a rare, sporadic and chronic inflammatory arteritis, which predominantly affects the aorta and its branches. Diagnosis can be difficult and there are limitations to the current diagnostic work-up. By detecting areas of active glucose metabolism present in active vasculitis, imaging with fluorine-18 fluorodeoxyglucose positron emission tomography ({sup 18}F-FDG PET) could potentially have a role in the management of TA. Our aim was to assess this role by reviewing 28 {sup 18}F-FDG PET scans performed on 18 patients suspected of having TA. All patients had full clinical and laboratory assessment, cross-sectional imaging and angiography, and 16/18 satisfied the American College of Rheumatologists' criteria for TA. {sup 18}F-FDG PET achieved a sensitivity of 92%, a specificity of 100%, and negative and positive predictive values of 85% and 100% respectively in the initial assessment of active vasculitis in TA. We conclude that {sup 18}F-FDG PET can be used to diagnose early disease, to detect active disease (even within chronic changes) and to monitor the effectiveness of treatment. (orig.)

  10. Progranulin Is Associated with Disease Activity in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Lucie Andrés Cerezo

    2015-01-01

    Full Text Available Objective. Progranulin (PGRN is implicated in the pathogenesis of rheumatoid arthritis (RA. The aim of this study was to assess the relationship between PGRN and disease activity in RA. Methods. PGRN levels were evaluated in patients with RA (n=47 and OA (n=42 and healthy controls (n=41. Immunohistochemical analysis of PGRN in synovial tissues was performed. The association between PGRN and C-reactive protein (CRP, disease activity score (DAS28-CRP, and health assessment questionnaire (HAQ was studied. Results. Circulating PGRN was elevated in patients with RA and OA compared to healthy controls (227.1±100.2 and 221.5±102.5 versus 128.1±34.7 ng/mL; P<0.001. Synovial fluid levels of PGRN were higher in patients with RA compared to OA (384.5±275.3 versus 241.4±165.2 ng/mL; P=0.002. PGRN expression was significantly upregulated in the synovial tissue of RA patients particularly in the inflammatory infiltrates. Serum PGRN levels correlated with DAS28 (r=0.327, P=0.049 and HAQ score (r=0.323, P=0.032, while synovial fluid PGRN correlated only with HAQ (r=0.310, P=0.043 in patients with RA. PGRN levels were not associated with CRP or autoantibodies. Conclusions. This study demonstrates increased PGRN expression at local sites of inflammation and association between PGRN levels, disease activity, and functional impairment in patients with RA.

  11. Self-efficacy for exercise, more than disease-related factors, is associated with objectively assessed exercise time and sedentary behaviour in rheumatoid arthritis.

    Science.gov (United States)

    Huffman, K M; Pieper, C F; Hall, K S; St Clair, E W; Kraus, W E

    2015-01-01

    Until recently, reports of physical activity in rheumatoid arthritis (RA) were limited to self-report methods and/or leisure-time physical activity. Our objectives were to assess, determine correlates of, and compare to well-matched controls both exercise and sedentary time in a typical clinical cohort of RA. Persons with established RA (seropositive or radiographic erosions; n = 41) without diabetes or cardiovascular disease underwent assessments of traditional and disease-specific correlates of physical activity and 7 days of triaxial accelerometry. Twenty-seven age, gender, and body mass index (BMI)-matched controls were assessed. For persons with RA, objectively measured median (25th-75th percentile) exercise time was 3 (1-11) min/day; only 10% (n = 4) of participants exercised for ≥ 30 min/day. Time spent in sedentary activities was 92% (89-95%). Exercise time was not related to pain but was inversely related to disease activity (r = -0.3, p self-efficacy for endurance activity (r = 0.4, p self-efficacy for endurance activity (r = -0.4, p self-efficacy for physical activity but similar amounts of exercise and sedentary time. For persons with RA and without diabetes or cardiovascular disease, time spent in exercise was well below established guidelines and activity patterns were predominantly sedentary. For optimal care in RA, in addition to promoting exercise, clinicians should consider assessing sedentary behaviour and self-efficacy for exercise. Future interventions might determine whether increased self-efficacy can increase physical activity in RA.

  12. Chitotriosidase activity as additional biomarker in the diagnosis of lysosomal storage diseases

    Directory of Open Access Journals (Sweden)

    N. V. Olkhovych

    2016-02-01

    Full Text Available To date, several genetic variants that lead to a deficiency of chitotriosidase activity have been described. The duplication of 24 bp (dup24bp in exon 10 of the CHIT1 gene, which causes a complete loss of enzymatic activity of the gene product, is the most common among the European population. The aim of the study was to evaluate the possibility of using chitotriosidase activity as an additional biomarker in diagnosis of lysosomal storage diseases (LSDs in Ukraine, to determine this parameter in blood plasma of the patients with various lysosomal diseases and to assess the effect of the presence of dup24bp in the CHIT1 gene on this parameter. It has been shown that chitotriosidase activity in blood plasma is a convenient additional biochemical marker in the diagnosis of some LSDs, namely Gaucher disease, Niemann-Pick disease A, B, C and GM1-gangliosidosis. Reference ranges of the normal chitotriosidase activity were determined in blood plasma of Ukrainian population and found to be 8.0-53.1 nmol 4-methylumbelliferone/h·ml of plasma. The total allele frequency of the dup24bp in the CHIT1 gene in Ukrainian population was determined, which amounted to 0.26 (323/1244 that is higher than in European population. It was indicated that molecular-genetic screening of dup24bp in the CHIT1 gene is a necessary stage in a protocol for the laboratory diagnosis of Gaucher disease, Niemann-Pick disease A, B, C as well as GM1-gangliosidosis to avoid incorrect diagnosis.

  13. Disease activity, obesity, functional disability, and depression in patients with rheumatoid arthritis : Impact on lipid status, glycoregulation, and risk for coronary heart disease.

    Science.gov (United States)

    Ostojic, P; Bartolovic, D

    2016-09-01

    This study aims to estimate the impact of disease activity, obesity, functional disability, and depression on lipid status, glycoregulation, and risk for coronary heart disease (CHD) in patients with rheumatoid arthritis (RA). A total of 36 patients with RA (30 women and 6 men, mean age 54.9 years, mean disease duration 7.9 years) were included in this study. We estimated the impact of age, body mass index, disease activity [assessed by DAS28 index and C-reactive protein (CRP) value], functional ability (estimated using the HAQ disability index), and depression [assessed using the Beck Depression Inventory (BDI)] on glycoregulation, lipid status, and risk for CHD in our patients. Glycoregulation was assessed by measuring insulin resistance, insulin, and glucose in blood. Lipids tested in blood included total cholesterol, HDL and LDL cholesterol, and triglycerides (TG). The 10-year risk for CHD was estimated using the Framingham risk score. Of 36 patients, 11 (30.6 %) fulfilled the criteria for metabolic syndrome (MS). Ten of 11 patients (90.1 %) with MS have a 10-year risk for CHD greater than 10 % compared to only 3 of 25 patients (12 %) without MS (p = 0.0001). Patients with high disease activity had lower HDL values than patients with mild or moderate disease activity (1.4 vs. 1.7 mmol/l, p = 0.04). Significant correlations were observed between CRP level and insulinemia (ρ = 0.57, p = 0.003), as well as CRP level and the HOMA index (ρ = 0.59, p = 0.002). The body mass index (BMI) correlated significantly with total cholesterol (r = 0.46, p = 0.02), LDL (ρ = 0.41, p = 0.04), and TG (ρ = 0.65, p Obesity was found to be an independent risk factor for increased total cholesterol, LDL cholesterol, and TG. Depressed patients with RA tend to be overweight or obese and, therefore, have an unfavorable lipid profile.

  14. Magnetic resonance imaging of the small bowel in children with idiopathic inflammatory bowel disease: evaluation of disease activity

    International Nuclear Information System (INIS)

    Alexopoulou, Efthymia; Loggitsi, Dimitra; Economopoulos, Nikos; Papakonstantinou, Olympia; Kelekis, Nikolaos L.; Roma, Eleftheria; Panagiotou, Ioanna; Pahoula, Ioanna

    2009-01-01

    Examinations using ionizing radiation are frequently used in the evaluation of disease activity in children affected by idiopathic inflammatory bowel disease (IBD). To develop an MR imaging protocol without the need for fluoroscopic insertion of an enteral tube and to assess the disease activity in children with IBD. Included in the study were 37 children (22 girls and 15 boys; age range 7-15 years, mean 11.67 years) with IBD who underwent MR imaging of the small bowel. Of these 37 children, 32 had Crohn disease and 5 had indeterminate colitis. A water solution containing herbal fibres was administered orally or through a nasogastric tube. Patients were imaged on a 1.5-T MR scanner with T1-weighted and Τ2-weighted sequences followed by a dynamic study using 3-D T1-W images after intravenous administration of gadolinium. The percentage enhancement of the bowel wall was significantly increased in patients with abnormal C-reactive protein (CRP) values compared to patients with CRP values in the normal range (P<0.001). A relatively weak but significant correlation between percentage enhancement of the bowel wall and CRP values was noted during all phases of enhancement. This MR imaging protocol is a safe and well-tolerated method for evaluating disease activity and extraintestinal manifestations of IBD in children. (orig.)

  15. Magnetic resonance imaging of the small bowel in children with idiopathic inflammatory bowel disease: evaluation of disease activity

    Energy Technology Data Exchange (ETDEWEB)

    Alexopoulou, Efthymia; Loggitsi, Dimitra; Economopoulos, Nikos; Papakonstantinou, Olympia; Kelekis, Nikolaos L. [National and Kapodistrian University of Athens, General University Hospital, Second Department of Radiology, Athens (Greece); Roma, Eleftheria; Panagiotou, Ioanna; Pahoula, Ioanna [National and Kapodistrian University of Athens, Aghia Sofia Children' s Hospital, First Department of Paediatrics, Athens (Greece)

    2009-08-15

    Examinations using ionizing radiation are frequently used in the evaluation of disease activity in children affected by idiopathic inflammatory bowel disease (IBD). To develop an MR imaging protocol without the need for fluoroscopic insertion of an enteral tube and to assess the disease activity in children with IBD. Included in the study were 37 children (22 girls and 15 boys; age range 7-15 years, mean 11.67 years) with IBD who underwent MR imaging of the small bowel. Of these 37 children, 32 had Crohn disease and 5 had indeterminate colitis. A water solution containing herbal fibres was administered orally or through a nasogastric tube. Patients were imaged on a 1.5-T MR scanner with T1-weighted and {tau}2-weighted sequences followed by a dynamic study using 3-D T1-W images after intravenous administration of gadolinium. The percentage enhancement of the bowel wall was significantly increased in patients with abnormal C-reactive protein (CRP) values compared to patients with CRP values in the normal range (P<0.001). A relatively weak but significant correlation between percentage enhancement of the bowel wall and CRP values was noted during all phases of enhancement. This MR imaging protocol is a safe and well-tolerated method for evaluating disease activity and extraintestinal manifestations of IBD in children. (orig.)

  16. Cardiovascular Disease and Cancer: Student Awareness Activities.

    Science.gov (United States)

    Meyer, James H., Comp.

    Awareness activities pertaining to cancer and cardiovascular disease are presented as a supplement for high school science classes. The exercises can be used to enrich units of study dealing with the circulatory system, the cell, or human diseases. Eight activities deal with the following topics: (1) cardiovascular disease risk factors; (2)…

  17. Assessment of physical activity and energy expenditure: an overview of objective measures

    OpenAIRE

    Andrew P Hills; Andrew P Hills; Najat eMokhtar; Nuala M Byrne

    2014-01-01

    The ability to assess energy expenditure and estimate physical activity in free-living individuals is extremely important in the global context of non-communicable diseases including malnutrition, overnutrition (obesity) and diabetes. It is also important to appreciate that physical activity and energy expenditure are different constructs with physical activity defined as any bodily movement that results in energy expenditure and accordingly, energy is expended as a result of physical activit...

  18. Preconception risk assessment for thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease.

    Science.gov (United States)

    Hussein, Norita; Weng, Stephen F; Kai, Joe; Kleijnen, Jos; Qureshi, Nadeem

    2018-03-14

    Globally, about five per cent of children are born with congenital or genetic disorders. The most common autosomal recessive conditions are thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease, with higher carrier rates in specific patient populations. Identifying and counselling couples at genetic risk of the conditions before pregnancy enables them to make fully informed reproductive decisions, with some of these choices not being available if genetic counselling is only offered in an antenatal setting. This is an update of a previously published review. To assess the effectiveness of systematic preconception genetic risk assessment to improve reproductive outcomes in women and their partners who are identified as carriers of thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease in healthcare settings when compared to usual care. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Trials Registers. In addition, we searched for all relevant trials from 1970 (or the date at which the database was first available if after 1970) to date using electronic databases (MEDLINE, Embase, CINAHL, PsycINFO), clinical trial databases (National Institutes of Health, Clinical Trials Search portal of the World Health Organization, metaRegister of controlled clinical trials), and hand searching of key journals and conference abstract books from 1998 to date (European Journal of Human Genetics, Genetics in Medicine, Journal of Community Genetics). We also searched the reference lists of relevant articles, reviews and guidelines and also contacted subject experts in the field to request any unpublished or other published trials.Date of latest search of the registers: 20 June 2017.Date of latest search of all other sources: 16 November 2017. Any randomised or quasi-randomised controlled trials (published or unpublished) comparing reproductive outcomes of systematic preconception genetic risk assessment for thalassaemia, sickle

  19. Serum IP-10 is useful for identifying renal and overall disease activity in pediatric systemic lupus erythematosus.

    Science.gov (United States)

    Zhang, Chen-Xing; Cai, Li; Shao, Kang; Wu, Jing; Zhou, Wei; Cao, Lan-Fang; Chen, Tong-Xin

    2018-05-01

    Traditional serological biomarkers often fail to assess systemic lupus erythematosus (SLE) disease activity and discriminate lupus nephritis (LN). The aim of this study was to identify novel markers for evaluating renal and overall disease activity in Chinese patients with pediatric systemic lupus erythematosus (pSLE). The study included 46 patients with pSLE (35 girls, 11 boys; average age 13.3 ± 2.6 years) and 31 matched healthy controls (22 girls, 9 boys; average age 12.3 ± 2.4 years). The SLE Disease Activity Index (SLEDAI) and renal SLEDAI were used to assess disease activity. Nine different soluble mediators in plasma, including tumor necrosis factor alpha (TNF-α), platelet-derived growth factor-BB (PDGF-BB), interferon (IFN) gamma inducible protein 10 (IP-10), interleukin (IL)-1β, IFN-γ, IL-17A, IL-2, Fas and Fas ligand, were measured by Luminex assay and compared between patients with active and inactive pSLE as well as between patients with pSLE with active and inactive renal disease. Receiver operating characteristic curve analysis was used to measure the discrimination accuracy. Of the 46 patients with pSLE, 30 (65.2%) had LN. These patients had significantly elevated levels of serum TNF-α, PDGF-BB, IP-10 and Fas. The serum levels of IP-10 were also significantly higher in patients with active pSLE. We found that IP-10 was also more sensitive and specific than conventional laboratory parameters, including anti-double-stranded DNA and complement components C3 and C4, for distinguishing active lupus from quiescent lupus. The serum level of IP-10 was also significantly increased in children with pSLE with active renal disease relative to those with inactive renal disease. There was also a positive correlation between serum IP-10 levels and renal SLEDAI scores as well as with 24 h urine protein. Serum IP-10 is useful for identifying renal and overall disease activity in children with pSLE.

  20. Cross-cultural adaptation and validation of the Behcet’s Disease Current Activity Form in Korea

    Science.gov (United States)

    Choi, Hyo Jin; Seo, Mi Ryoung; Ryu, Hee Jung; Baek, Han Joo

    2015-01-01

    Background/Aims: This study was undertaken to perform a cross-cultural adaptation of the Behcet’s Disease Current Activity Form (BDCAF, version 2006) questionnaire to the Korean language and to evaluate its reliability and validity in a population of Korean patients with Behcet’s disease (BD). Methods: A cross-cultural study was conducted among patients with BD who attended our rheumatology clinic between November 2012 and March 2013. There were 11 males and 35 females in the group. The mean age of the participants was 48.5 years and the mean disease duration was 6.4 years. The first BDCAF questionnaire was completed on arrival and the second assessment was performed 20 minutes later by a different physician. The test-retest reliability was analyzed by computing κ statistics. Kappa scores of > 0.6 indicated a good agreement. To assess the validity, we compared the total BDCAF score with the patient’s/clinician’s perception of disease activity and the Korean version of the Behcet’s Disease Quality of Life (BDQOL). Results: For the test-retest reliability, good agreements were achieved on items such as headache, oral/genital ulceration, erythema, skin pustules, arthralgia, nausea/vomiting/abdominal pain, and diarrhea with altered/frank blood per rectum. Moderate agreement was observed for eye and nervous system involvement. We achieved a fair agreement for arthritis and major vessel involvement. Significant correlations were obtained between the total BDCAF score with the BDQOL and the patient’s/clinician’s perception of disease activity p < 0.05). Conclusions: The Korean version of the BDCAF is a reliable and valid instrument for measuring current disease activity in Korean BD patients. PMID:26354066

  1. Complement Activation in Inflammatory Skin Diseases

    Directory of Open Access Journals (Sweden)

    Jenny Giang

    2018-04-01

    Full Text Available The complement system is a fundamental part of the innate immune system, playing a crucial role in host defense against various pathogens, such as bacteria, viruses, and fungi. Activation of complement results in production of several molecules mediating chemotaxis, opsonization, and mast cell degranulation, which can contribute to the elimination of pathogenic organisms and inflammation. Furthermore, the complement system also has regulating properties in inflammatory and immune responses. Complement activity in diseases is rather complex and may involve both aberrant expression of complement and genetic deficiencies of complement components or regulators. The skin represents an active immune organ with complex interactions between cellular components and various mediators. Complement involvement has been associated with several skin diseases, such as psoriasis, lupus erythematosus, cutaneous vasculitis, urticaria, and bullous dermatoses. Several triggers including auto-antibodies and micro-organisms can activate complement, while on the other hand complement deficiencies can contribute to impaired immune complex clearance, leading to disease. This review provides an overview of the role of complement in inflammatory skin diseases and discusses complement factors as potential new targets for therapeutic intervention.

  2. The Tie2 receptor antagonist angiopoietin-2 in systemic lupus erythematosus: its correlation with various disease activity parameters.

    Science.gov (United States)

    Salama, Maysa K; Taha, Fatma M; Safwat, Miriam; Darweesh, Hanan E A; Basel, Mohamed El

    2012-01-01

    Systemic lupus erythematosus is one of the autoimmune diseases characterized by multisystem involvement associated with autoantibody and immune complex vasculitis along with endothelial cell damage. to study the possible role of Angiopoietin- 2 (Ang-2) as a recently highlighted inflammatory and angiogenic mediator in the pathogenesis of SLE and its correlation with the state of another inflammatory marker, P-Selectin, as well as with various markers of the disease activity. The present study included 3 main groups: active SLE patients (group I), inactive SLE patients (group II) and healthy normal control subjects (group III). Groups I and II were subjected to disease activity assessment using the SLEDAI scoring system and measurement of plasma Ang-2 and P-Selectin by ELISA in addition to various laboratory investigations to assess disease activity as: Complete blood count, ESR, serum creatinine, C3, C4 and 24-h urinary proteins. The mean level of Plasma Ang-2 and P-selectin showed a high significant increase in active group compared to inactive SLE patients and control subjects (p < 0.001).There was a significant positive correlation between Ang-2, P-Selectin, and each of SLEDAI score and 24-h urinary proteins in all SLE patients as well as in the active group, and Ang-2 was a significant independent marker for proteinuria. A significant negative correlation was found between Ang-2, P-Selectin and each of C3, C4. Ang-2 and P-Selectin showed a high sensitivity and specificity in the patients with SLE. Our study suggests that Ang-2 may be a more useful marker than P-Selectin, C3 and C4 in the assessment of disease activity.

  3. Assessment of adrenal function in liver diseases

    Directory of Open Access Journals (Sweden)

    Sandeep Kharb

    2013-01-01

    Full Text Available Background: In recent times, there are reports of adrenal dysfunction in whole spectrum of liver disease. Adrenal insufficiency (AI has been shown to correlate with progression of liver disease. Hence this study was conducted to assess adrenal function in subjects with acute liver disease (ALD, chronic liver disease (CLD and post liver transplantation (LT. Material and Methods: This study included 25 healthy controls, 25 patients of ALD, 20 subjects of CLD with Child-Pugh stage A (CLD-1 and 30 with Child-Pugh stage B or C (CLD-2, and 10 subjects with LT. All subjects were assessed clinically, biochemically and for adrenal functions. Results: AI was present in 9 (34.6% patients with ALD, 20 (40% patients with CLD and 4 (40% in subjects with LT. AI was more common in CLD-2 (18 patients - 60% than CLD-1 (2 patients - 10%. All patients with chronic liver disease had significantly lower basal cortisol (8.8±4.8, P=0.01, stimulated cortisol (18.2±6.3, P <0.00001 and incremental cortisol (9.4±4.6, P <0.00001 as compared to controls. There was increase in percentage of subjects with adrenal dysfunction with progression of liver disease as assessed by Child-Pugh staging. AI was predicted by lower levels of serum protein, serum albumin, total cholesterol and HDL cholesterol and higher levels of serum bilirubin and INR. Adrenal functions showed recovery following liver transplantation. Conclusions: AI forms important part of spectrum of acute and chronic liver disease. Deterioration of synthetic functions of liver disease predicts presence of AI, and these patients should be evaluated for adrenal dysfunction periodically.

  4. Neuropsychological assessment of driving safety risk in older adults with and without neurologic disease.

    Science.gov (United States)

    Anderson, Steven W; Aksan, Nazan; Dawson, Jeffrey D; Uc, Ergun Y; Johnson, Amy M; Rizzo, Matthew

    2012-01-01

    Decline in cognitive abilities can be an important contributor to the driving problems encountered by older adults, and neuropsychological assessment may provide a practical approach to evaluating this aspect of driving safety risk. The purpose of the present study was to evaluate several commonly used neuropsychological tests in the assessment of driving safety risk in older adults with and without neurological disease. A further goal of this study was to identify brief combinations of neuropsychological tests that sample performances in key functional domains and thus could be used to efficiently assess driving safety risk. A total of 345 legally licensed and active drivers over the age of 50, with no neurologic disease (N = 185), probable Alzheimer's disease (N = 40), Parkinson's disease (N = 91), or stroke (N = 29), completed vision testing, a battery of 10 neuropsychological tests, and an 18-mile drive on urban and rural roads in an instrumented vehicle. Performances on all neuropsychological tests were significantly correlated with driving safety errors. Confirmatory factor analysis was used to identify 3 key cognitive domains assessed by the tests (speed of processing, visuospatial abilities, and memory), and several brief batteries consisting of one test from each domain showed moderate corrected correlations with driving performance. These findings are consistent with the notion that driving places demands on multiple cognitive abilities that can be affected by aging and age-related neurological disease, and that neuropsychological assessment may provide a practical off-road window into the functional status of these cognitive systems.

  5. [Assessment of invalidity as a result of infectious diseases].

    Science.gov (United States)

    Čeledová, L; Čevela, R; Bosák, M

    2016-01-01

    The article features the new medical assessment paradigm for invalidity as a result of infectious disease which is applied as of 1 January 2010. The invalidity assessment criteria are regulated specifically by Regulation No. 359/2009. Chapter I of the Annexe to the invalidity assessment regulation addresses the area of infectious diseases with respect to functional impairment and its impact on the quality of life. Since 2010, the invalidity has also been newly categorized into three groups. The new assessment approach makes it possible to evaluate a persons functional capacity, type of disability, and eligibility for compensation for reduced capacity for work. In 2010, a total of 170 375 invalidity cases were assessed, and in 2014, 147 121 invalidity assessments were made. Invalidity as a result of infectious disease was assessed in 177 persons in 2010, and 128 invalidity assessments were made in 2014. The most common causes of invalidity as a result of infectious disease are chronic viral hepatitis, other spirochetal infections, tuberculosis of the respiratory tract, tick-borne viral encephalitis, and HIV/AIDS. The number of assessments of invalidity as a result of infectious disease showed a declining trend between 2010 and 2014, similarly to the total of invalidity assessments. In spite of this fact, the cases of invalidity as a result of infectious disease account for approximately half percent of all invalidity assessments made in the above-mentioned period of time.

  6. Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease

    NARCIS (Netherlands)

    van der Valk, Eline S.; Smans, Lisanne C C J; Hofstetter, Hedwig; Stubbe, Janine H.; de Vries, Marieke; Backx, Frank J G; Hermus, Ad R M M; Zelissen, Pierre M J

    BACKGROUND: Health related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. OBJECTIVE: The aim of this study was to

  7. Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease

    NARCIS (Netherlands)

    Valk, E.S. Van der; Smans, L.C.C.J.; Hofstetter, H.; Stubbe, J.H.; Vries, M de; Backx, F.J.; Hermus, A.R.M.M.; Zelissen, P.M.J.

    2016-01-01

    BACKGROUND: Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. OBJECTIVE: The aim of this study was to

  8. Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease

    NARCIS (Netherlands)

    Valk, E.S. van der; Smans, L.C.C.J.; Hofstetter, H.; Stubbe, J.H.; Vries, M. de; Backx, F.J.G.; Hermus, A.R.M.M.; Zelissen, P.M.J.

    2016-01-01

    Background: Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. Objective: The aim of this study was to

  9. Assessment of Climate Change and Vector-borne Diseases in the United States

    Science.gov (United States)

    Monaghan, A. J.; Beard, C. B.; Eisen, R. J.; Barker, C. M.; Garofalo, J.; Hahn, M.; Hayden, M.; Ogden, N.; Schramm, P.

    2016-12-01

    Vector-borne diseases are illnesses that are transmitted by vectors, which include mosquitoes, ticks, and fleas. The seasonality, distribution, and prevalence of vector-borne diseases are influenced significantly by climate factors, primarily high and low temperature extremes and precipitation patterns. In this presentation we summarize key findings from Chapter 5 ("Vector-borne Diseases") of the recently published USGCRP Scientific Assessment of the Impacts of Climate Change on Human Health in the United States. Climate change is expected to alter geographic and seasonal distributions of vectors and vector-borne diseases, leading to earlier activity and northward range expansion of ticks capable of carrying the bacteria that cause Lyme disease and other pathogens, and influencing the distribution, abundance and prevalence of infection in mosquitoes that transmit West Nile virus and other pathogens. The emergence or reemergence of vector-borne pathogens is also likely.

  10. Prospective assessment of disease-specific quality of life in adults with eosinophilic esophagitis.

    Science.gov (United States)

    Stern, E; Taft, T; Zalewski, A; Gonsalves, N; Hirano, I

    2017-10-27

    Eosinophilic esophagitis (EoE) is an important cause of upper gastrointestinal dysfunction in children and adults. The EoE-quality of life (QOL)-A was validated as a disease-specific measure of quality of life in EoE. This study characterized the extent of QOL concerns in a cohort of adult EoE patients and delineated the relationships between QOL and other disease activity measures. One hundred sixty-seven patients enrolled in this prospective cohort study. Patients with established and suspected EoE undergoing endoscopy at a single university-based medical center were recruited. EoE was diagnosed on the basis of the clinical criteria and histologic demonstration of ≥15 eos/hpf while on proton pump inhibition therapy. Sixty five patients undergoing repeat endoscopy during the enrollment period participated twice. Patients provided demographic information and completed symptom assessments and the EoE-QOL-A. Analyses included comparisons with overall QOL as well as QOL subscales. Outcome measures included endoscopic activity using a validated instrument, the EoE Endoscopic Reference Score, and histology. Overall QOL was significantly correlated with dysphagia frequency, intensity, and severity (P food impaction in the last 30 days had significantly worse overall QOL (P = 0.009). There was no correlation between overall QOL and years since diagnosis, symptom duration, endoscopic features, or histologic findings. Patient symptoms correlated with endoscopic features of edema, rings, and stricture severity. Histologic activity was highly correlated with severity of endoscopic features. Patients who underwent repeat endoscopy with histologic response demonstrated improved eating and social QOL; however, overall QOL was unchanged. In adults with EoE, patient reported QOL is associated with symptom severity but not endoscopic or histologic features. Disease-specific QOL may complement parameters of biologic activity in the assessment of overall disease burden in EoE.

  11. Validity of the rheumatoid arthritis impact of disease (RAID) score and definition of cut-off points for disease activity states in a population-based European cohort of patients with rheumatoid arthritis.

    Science.gov (United States)

    Salaffi, Fausto; Di Carlo, Marco; Vojinovic, Jelena; Tincani, Angela; Sulli, Alberto; Soldano, Stefano; Andreoli, Laura; Dall'Ara, Francesca; Ionescu, Ruxandra; Simić Pašalić, Katarina; Balčune, Ineta; Ferraz-Amaro, Iván; Tlustochowicz, Malgorzata; Butrimienė, Irena; Punceviciene, Egle; Toroptsova, Natalia; Grazio, Simeon; Morović-Vergles, Jadranka; Masaryk, Pavol; Otsa, Kati; Bernardes, Miguel; Boyadzhieva, Vladimira; Cutolo, Maurizio

    2017-05-24

    To assess the validity of the rheumatoid arthritis impact of disease (RAID) for measuring disease activity of rheumatoid arthritis (RA) and to determine cut-off values for defining the disease activity states. A total of 622 RA patients from an European database have been included. Cross-validation was based on assessment of convergent and discriminant validity. Optimal cut-offs were determined against external criteria by calculating the respective 25th and 75th percentiles mean values of RAID. External criteria included definitions for remission (REM), low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA), cut-offs of the 28-joint disease activity score-C-reactive protein (DAS28-CRP) score. The RAID showed a moderate degree of correlation with respect to DAS28-CRP (rho=0.417; Pdisease was very good with an area under the curve (AUC) of 0.847 (95% confidence interval [CI]: 0.816 to 0.878; Pdisease activity groups, we propose the following cut-off values for REM: RAID ≤3; for LDA: RAID >3 and ≤4; for MDA: RAID >4 and ≤6; for HDA: RAID >6. Mean RAID differed significantly between patients classified as REM, LDA, MDA or HDA (P=0.001). The cut-offs revealed good measurement characteristics in cross-validation analysis, had great discriminatory performance in distinguishing patients with different levels of disease activity and are suited for widespread use in everyday practice application and research. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  12. Disease activity and damage accrual during the early disease course in a multinational inception cohort of patients with systemic lupus erythematosus

    DEFF Research Database (Denmark)

    Nossent, J.; Kiss, Adrian Emil; Rozman, B.

    2010-01-01

    An inception cohort of patients with systemic lupus erythematosus from 14 European centres was followed for up to 5 years in order to describe the current early disease course. At inclusion patients (n = 200, 89% female, mean age 35 years, 97% Caucasian, mean SLEDAI 12.2) fulfilled a mean of 6......% respectively. During the mean follow-up of 4.1 years 25% entered a state of early disease quiescence by global physician assessment, but the overall risk of subsequent flare was 60%. Maximum SLEDAI scores decreased over time, but 45% of patients accrued damage (SDI >= 1) for which baseline presence...... of proteinuria and persistent disease activity were independent predictors. The results indicate minor differences in SLE presentation and treatment within various regions of Europe and a high diagnostic reliance on anti-dsDNA Ab. Despite early reductions in disease activity and improved mortality, the risk...

  13. In vitro data combined with human disease data to improve toxicological hazard assessment: the ASAT Knowledge Base

    NARCIS (Netherlands)

    Venhorst, J; Aarts, Jac; Boorsma, Andre; Caiment, Florian; Soeteman-Hernandez, Lya G.; van der Veen, J; Tsamou, Maria; Russel, Frans G. M.; Groothuis, Genoveva; Stierum, Rob

    2014-01-01

    In line with the Assuring Safety Without Animal Testing (ASAT) principle, risk assessment may ultimately become feasible without the use of animals (Fentem et al., 2004). ASAT assumes that activation of human disease mechanisms in in vitro models can be used for toxicological assessment. Therefore,

  14. Increased visfatin levels are associated with higher disease activity in anti-Jo-1-positive myositis patients.

    Science.gov (United States)

    Hulejová, Hana; Kryštůfková, Olga; Mann, Heřman; Klein, Martin; Pavlíčková, Klára; Zámečník, Josef; Vencovský, Jiří; Šenolt, Ladislav

    2016-01-01

    The aim of this study was to evaluate serum levels of visfatin in anti-Jo-1-positive myositis patients, its expression in muscle tissue and to investigate potential relationships between visfatin, B-cell activating factor of the TNF family (BAFF), disease activity and anti-Jo-1 autoantibody levels. Serum levels of visfatin and BAFF were measured in 38 anti-Jo-1 positive myositis patients and 35 healthy subjects. Disease activity was evaluated by myositis disease activity assessment tool (MYOACT) using visual analogue scales (VAS) and by serum muscle enzymes. Visfatin expression was evaluated by immunohistochemistry in muscle tissue of myositis patients (n=10) and compared with non-inflammatory control muscle tissue samples from patients with myasthenia gravis (n=5). Serum visfatin and BAFF levels were significantly higher in myositis patients compared to healthy subjects and were associated with clinical muscle activity assessed by VAS. Only serum BAFF levels, but not visfatin levels, positively correlated with muscle enzyme concentrations and anti-Jo1 antibody levels. There was a positive correlation between visfatin and BAFF serum levels in myositis patients but a negative correlation was observed in healthy subjects. Visfatin expression was up-regulated in endomysial and perimysial inflammatory infiltrates of muscle tissue from myositis patients. Up-regulation of visfatin in myositis muscle tissue and an association between increased visfatin levels and muscle disease activity evaluated by MYOACT in anti-Jo-1 positive myositis patients could support possible role of visfatin in the pathogenesis of myositis.

  15. Patient and Disease Characteristics Associated with Activation for Self-Management in Patients with Diabetes, Chronic Obstructive Pulmonary Disease, Chronic Heart Failure and Chronic Renal Disease: A Cross-Sectional Survey Study

    Science.gov (United States)

    Bos-Touwen, Irene; Schuurmans, Marieke; Monninkhof, Evelyn M.; Korpershoek, Yvonne; Spruit-Bentvelzen, Lotte; Ertugrul-van der Graaf, Inge; de Wit, Niek; Trappenburg, Jaap

    2015-01-01

    A substantial proportion of chronic disease patients do not respond to self-management interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for self-management and to evaluate whether these are disease-transcending. A cross-sectional survey study was conducted in primary and secondary care in patients with type-2 Diabetes Mellitus (DM-II), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and Chronic Renal Disease (CRD). Using multiple linear regression analysis, we analyzed associations between self-management activation (13-item Patient Activation Measure; PAM-13) and a wide range of socio-demographic, clinical, and psychosocial determinants. Furthermore, we assessed whether the associations between the determinants and the PAM were disease-transcending by testing whether disease was an effect modifier. In addition, we identified determinants associated with low activation for self-management using logistic regression analysis. We included 1154 patients (53% response rate); 422 DM-II patients, 290 COPD patients, 223 HF patients and 219 CRD patients. Mean age was 69.6±10.9. Multiple linear regression analysis revealed 9 explanatory determinants of activation for self-management: age, BMI, educational level, financial distress, physical health status, depression, illness perception, social support and underlying disease, explaining a variance of 16.3%. All associations, except for social support, were disease transcending. This study explored factors associated with varying levels of activation for self-management. These results are a first step in supporting clinicians and researchers to identify subpopulations of chronic disease patients less likely to be engaged in self-management. Increased scientific efforts are needed to explain the greater

  16. Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: a cross-sectional survey study.

    Science.gov (United States)

    Bos-Touwen, Irene; Schuurmans, Marieke; Monninkhof, Evelyn M; Korpershoek, Yvonne; Spruit-Bentvelzen, Lotte; Ertugrul-van der Graaf, Inge; de Wit, Niek; Trappenburg, Jaap

    2015-01-01

    A substantial proportion of chronic disease patients do not respond to self-management interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for self-management and to evaluate whether these are disease-transcending. A cross-sectional survey study was conducted in primary and secondary care in patients with type-2 Diabetes Mellitus (DM-II), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and Chronic Renal Disease (CRD). Using multiple linear regression analysis, we analyzed associations between self-management activation (13-item Patient Activation Measure; PAM-13) and a wide range of socio-demographic, clinical, and psychosocial determinants. Furthermore, we assessed whether the associations between the determinants and the PAM were disease-transcending by testing whether disease was an effect modifier. In addition, we identified determinants associated with low activation for self-management using logistic regression analysis. We included 1154 patients (53% response rate); 422 DM-II patients, 290 COPD patients, 223 HF patients and 219 CRD patients. Mean age was 69.6±10.9. Multiple linear regression analysis revealed 9 explanatory determinants of activation for self-management: age, BMI, educational level, financial distress, physical health status, depression, illness perception, social support and underlying disease, explaining a variance of 16.3%. All associations, except for social support, were disease transcending. This study explored factors associated with varying levels of activation for self-management. These results are a first step in supporting clinicians and researchers to identify subpopulations of chronic disease patients less likely to be engaged in self-management. Increased scientific efforts are needed to explain the greater

  17. Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: a cross-sectional survey study.

    Directory of Open Access Journals (Sweden)

    Irene Bos-Touwen

    Full Text Available A substantial proportion of chronic disease patients do not respond to self-management interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for self-management and to evaluate whether these are disease-transcending. A cross-sectional survey study was conducted in primary and secondary care in patients with type-2 Diabetes Mellitus (DM-II, Chronic Obstructive Pulmonary Disease (COPD, Chronic Heart Failure (CHF and Chronic Renal Disease (CRD. Using multiple linear regression analysis, we analyzed associations between self-management activation (13-item Patient Activation Measure; PAM-13 and a wide range of socio-demographic, clinical, and psychosocial determinants. Furthermore, we assessed whether the associations between the determinants and the PAM were disease-transcending by testing whether disease was an effect modifier. In addition, we identified determinants associated with low activation for self-management using logistic regression analysis. We included 1154 patients (53% response rate; 422 DM-II patients, 290 COPD patients, 223 HF patients and 219 CRD patients. Mean age was 69.6±10.9. Multiple linear regression analysis revealed 9 explanatory determinants of activation for self-management: age, BMI, educational level, financial distress, physical health status, depression, illness perception, social support and underlying disease, explaining a variance of 16.3%. All associations, except for social support, were disease transcending. This study explored factors associated with varying levels of activation for self-management. These results are a first step in supporting clinicians and researchers to identify subpopulations of chronic disease patients less likely to be engaged in self-management. Increased scientific efforts are needed to explain

  18. Effects of eHealth physical activity encouragement in adolescents with complex congenital heart disease

    DEFF Research Database (Denmark)

    Klausen, Susanne Hwiid; Andersen, Lars L; Søndergaard, Lars

    2016-01-01

    OBJECTIVE: To assess benefit and harms of adding an eHealth intervention to health education and individual counseling in adolescents with congenital heart disease. DESIGN: Randomized clinical trial. SETTING: Denmark. PATIENTS: A total of 158 adolescents aged 13-16years with no physical activity...... restrictions after repaired complex congenital heart disease. INTERVENTIONS: PReVaiL consisted of individually tailored eHealth encouragement physical activity for 52weeks. All patients received 45min of group-based health education and 15min of individual counseling involving patients' parents. OUTCOMES......·kg(-1)·min(-1) (95% CI -2.66 to 1.36). Between-group differences at 1year in physical activity, generic health-related quality of life, and disease-specific quality of life were not statistically significant. CONCLUSIONS: Adding a tailored eHealth intervention to health education and individual...

  19. Serum levels of beta2-microglobulin and free light chains of immunoglobulins are associated with systemic disease activity in primary Sjögren's syndrome. Data at enrollment in the prospective ASSESS cohort.

    Directory of Open Access Journals (Sweden)

    Jacques-Eric Gottenberg

    Full Text Available To analyze the clinical and immunological characteristics at enrollment in a large prospective cohort of patients with primary Sjögren's syndrome (pSS and to investigate the association between serum BAFF, beta2-microglobulin and free light chains of immunoglobulins and systemic disease activity at enrollment.Three hundred and ninety five patients with pSS according to American-European Consensus Criteria were included from fifteen centers of Rheumatology and Internal Medicine in the "Assessment of Systemic Signs and Evolution of Sjögren's Syndrome" (ASSESS 5-year prospective cohort. At enrollment, serum markers were assessed as well as activity of the disease measured with the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI.Patient median age was 58 (25(th-75(th: 51-67 and median disease duration was 5 (2-9 years. Median ESSDAI at enrollment was 2 (0-7 with 30.9% of patients having features of systemic involvement. Patients with elevated BAFF, beta2-microglobulin and kappa, lambda FLCS had higher ESSDAI scores at enrollment (4 [2]-[11] vs 2 [0-7], P = 0.03; 4 [1]-[11] vs 2 [0-7], P< 0.0001; 4 [2]-[10] vs 2 [0-6.6], P< 0.0001 and 4 [2-8.2] vs 2 [0-7.0], P = 0.02, respectively. In multivariate analysis, increased beta2-microglobulin, kappa and lambda FLCs were associated with a higher ESSDAI score. Median BAFF and beta2-microglobulin were higher in the 16 patients with history of lymphoma (1173.3(873.1-3665.5 vs 898.9 (715.9-1187.2 pg/ml, P = 0.01 and 2.6 (2.2-2.9 vs 2.1 (1.8-2.6 mg/l, P = 0.04, respectively.In pSS, higher levels of beta2-microglobulin and free light chains of immunoglobulins are associated with increased systemic disease activity.

  20. The Localized Scleroderma Skin Severity Index and Physician Global Assessment of Disease Activity: A Work in Progress Toward Development of Localized Scleroderma Outcome Measures

    Science.gov (United States)

    ARKACHAISRI, THASCHAWEE; VILAIYUK, SOAMARAT; LI, SUZANNE; O’NEIL, KATHLEEN M.; POPE, ELENA; HIGGINS, GLORIA C.; PUNARO, MARILYNN; RABINOVICH, EGLA C.; ROSENKRANZ, MARGALIT; KIETZ, DANIEL A.; ROSEN, PAUL; SPALDING, STEVEN J.; HENNON, TERESA R.; TOROK, KATHRYN S.; CASSIDY, ELAINE; MEDSGER, THOMAS A.

    2013-01-01

    Objective To develop and evaluate a Localized Scleroderma (LS) Skin Severity Index (LoSSI) and global assessments’ clinimetric property and effect on quality of life (QOL). Methods A 3-phase study was conducted. The first phase involved 15 patients with LS and 14 examiners who assessed LoSSI [surface area (SA), erythema (ER), skin thickness (ST), and new lesion/extension (N/E)] twice for inter/intrarater reliability. Patient global assessment of disease severity (PtGA-S) and Children’s Dermatology Life Quality Index (CDLQI) were collected for intrarater reliability evaluation. The second phase was aimed to develop clinical determinants for physician global assessment of disease activity (PhysGA-A) and to assess its content validity. The third phase involved 2 examiners assessing LoSSI and PhysGA-A on 27 patients. Effect of training on improving reliability/validity and sensitivity to change of the LoSSI and PhysGA-A was determined. Results Interrater reliability was excellent for ER [intraclass correlation coefficient (ICC) 0.71], ST (ICC 0.70), LoSSI (ICC 0.80), and PhysGA-A (ICC 0.90) but poor for SA (ICC 0.35); thus, LoSSI was modified to mLoSSI. Examiners’ experience did not affect the scores, but training/practice improved reliability. Intrarater reliability was excellent for ER, ST, and LoSSI (Spearman’s rho = 0.71–0.89) and moderate for SA. PtGA-S and CDLQI showed good intrarater agreement (ICC 0.63 and 0.80). mLoSSI correlated moderately with PhysGA-A and PtGA-S. Both mLoSSI and PhysGA-A were sensitive to change following therapy. Conclusion mLoSSI and PhysGA-A are reliable and valid tools for assessing LS disease severity and show high sensitivity to detect change over time. These tools are feasible for use in routine clinical practice. They should be considered for inclusion in a core set of LS outcome measures for clinical trials. PMID:19833758

  1. Disease activity in longstanding ankylosing spondylitis: a correlation of clinical and magnetic resonance imaging findings.

    Science.gov (United States)

    Goh, L; Suresh, P; Gafoor, A; Hughes, P; Hickling, P

    2008-04-01

    We evaluated magnetic resonance imaging (MRI) changes in ankylosing spondylitis (AS) patients with longstanding disease and investigated whether there is any relationship between MRI findings and validated methods of disease assessment. A total of 34 AS patients with disease duration greater than 10 years were included in this observational cross-sectional study (26 men, 8 women). The main outcome measures were Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Global assessment (BASG), Bath Ankylosing Spondylitis Metrology Index (BASMI), MRI of the thoracic and lumbar spine (AS spi MRI A) and measurement of serum erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), plasma viscosity (PV) and immunoglobulin A (Ig A). The median scores for the acute lesions based on AS spi MRI A scoring system was 2.5 (0-4.12). The respective mean ESR and CRP were 36 (SD, 24.00) mm/h and 14.19 (SD, 24.00) mg/l with the median PV of 1.8 (1.75-1.87). The median BASG, BASFI and BASDAI were 4.55 (2.37-5.55), 4.40(2.31-5.47) and 4.32 (3.07-6.48), respectively. No significant correlations were found between the acute MRI scores and each of the clinical instruments and laboratory markers of inflammation. In this study, majority of AS patients with longstanding disease had very low AS spi MRI A scores or no evidence of spinal inflammatory lesions. Our study would suggest that MRI should be used along with other measures of disease activity in the assessment of symptomatic AS patients with longstanding disease.

  2. Assessing the Impact and Social Perception of Self-Regulated Music Stimulation with Patients with Alzheimer's Disease

    Science.gov (United States)

    Lancioni, Giulio E.; O'Reilly, Mark F.; Singh, Nirbhay N.; Sigafoos, Jeff; Grumo, Gianluca; Pinto, Katia; Stasolla, Fabrizio; Signorino, Mario; Groeneweg, Jop

    2013-01-01

    We assessed the impact and social rating of an active and a passive music condition implemented with six patients with Alzheimer's disease. In the active condition, the patients used a simple hand response and a microswitch to self-regulate music stimulation inputs. In the passive condition, music stimulation was automatically presented throughout…

  3. Differentiation between active and chronic Crohn's disease using MRI small-bowel motility examinations — Initial experience

    International Nuclear Information System (INIS)

    Bickelhaupt, S.; Froehlich, J.M.; Cattin, R.; Patuto, N.; Tutuian, R.; Wentz, K.U.; Culmann, J.L.; Raible, S.; Bouquet, H.; Bill, U.; Patak, M.A.

    2013-01-01

    Aim: To evaluate the influence of locally active Crohn's disease on systemic small-bowel motility in patients with chronic Crohn's disease compared to healthy individuals. Material and methods: Fifteen healthy individuals (11 men, four women; mean age 37 years) and 20 patients with histopathologically proven active (n = 15; 10 women, 5 men; mean age 45 years) or chronic (n = 5; four women, one man; mean age 48 years) Crohn's disease were included in this institutional review board-approved, retrospective study. Magnetic resonance imaging (MRI; 1.5 T) was performed after standardized preparation. Two-dimensional (2D) cine sequences for motility acquisition were performed in apnoea (27 s). Motility assessment was performed using dedicated software in three randomly chosen areas of the small-bowel outside known Crohn's disease-affected hotspots. The main quantitative characteristics (frequency, amplitude, occlusion rate) were compared using Student's t-test and one-way analysis of variance (ANOVA). Results: Three randomly chosen segments were analysed in each participant. Patients with active Crohn's disease had significantly (p < 0.05) reduced contraction frequencies (active Crohn's disease: 2.86/min; chronic: 4.14/min; healthy: 4.53/min) and luminal occlusion rates (active: 0.43; chronic: 0.70; healthy: 0.73) compared to healthy individuals and patients with chronic Crohn's disease. Contraction amplitudes were significantly reduced during active Crohn's disease (6.71 mm) compared to healthy participants (10.14 mm), but this only reached borderline significance in comparison to chronic Crohn's disease (8.87 mm). Mean bowel lumen diameter was significantly (p = 0.04) higher in patients with active Crohn's disease (16.91 mm) compared to healthy participants (14.79 mm) but not in comparison to patients with chronic Crohn's disease (13.68). Conclusion: The findings of the present study suggest that local inflammatory activity of small-bowel segments in patients with

  4. Assessment of the quality of life of patients with peripheral vascular diseases

    International Nuclear Information System (INIS)

    Wohlgemuth, W.A.; Bayreuth Univ.; Niechzial, M.; Nagel, E.; Bohndorf, K.

    2003-01-01

    The Medical Outcome Short Form 36 is commonly used as a generic quality of life measure in the assessment of vascular disease. The Claudication Scale CLAU-S, the PAVK-86 Fragebogen, and the Walking Impairment Questionnaire WIQ are validated disease-specific questionnaires for intermittent claudication. A disease specific tool for critical ischaemia is lacking. Quality of life of patients with peripheral arterial occlusive disease is not only impaired in the physical functioning domains (mobility, self care, activities of daily living), but moreover in their social and emotional wellbeing. This situation worsens under conservative treatment. Angioplasty and operation procedure similar improvements in all dimensions of hrQOL. As radiological interventional procedures just aim to improve hrQOL and do not bring a definite cure for the underlying disease, patients perception of their quality of life should be taken into account both in the indication for angioplasty and for the scientific evaluation of new treatment modalities. (orig.) [de

  5. Effect of psychological therapy on disease activity, psychological comorbidity, and quality of life in inflammatory bowel disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Gracie, David J; Irvine, Andrew J; Sood, Ruchit; Mikocka-Walus, Antonina; Hamlin, P John; Ford, Alexander C

    2017-03-01

    versus control at the end of therapy for patients with quiescent disease. However, these beneficial effects were lost at final point of follow-up (depression scores -0·11 [-0·27 to 0·05], p=0·17, I 2 =0%, eight trials, 593 patients; quality of life 0·15 [-0·05 to 0·34], p=0·14, I 2 =22%, ten trials, 577 patients). When we assessed the effect of individual physiological therapies on quality of life, only cognitive behavioural therapy had any significant beneficial effect (0·37 [0·02-0·72]). We noted no effect on disease activity indices or other psychological wellbeing scores when compared with control in patients with quiescent disease. Dichotomous data for induction of remission and continuous data for change in clinical disease activity indices, depression, anxiety, and perceived stress scores were only reported in one RCT of patients with active disease. Quality of life was assessed in two RCTs of patients with active disease, but was not significantly different between intervention and control groups (0·27 [-0·05 to 0·59]). Psychological therapies, and cognitive behavioural therapy in particular, might have small short-term beneficial effects on depression scores and quality of life in patients with inflammatory bowel disease. Further RCTs of these interventions in patients with coexistent psychological distress are required. None. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Arterial properties in acromegaly: relation to disease activity and associated cardiovascular risk factors.

    Science.gov (United States)

    Yaron, Marianna; Izkhakov, Elena; Sack, Jessica; Azzam, Ibrahim; Osher, Etty; Tordjman, Karen; Stern, Naftali; Greenman, Yona

    2016-06-01

    Acromegaly is associated with increased cardiovascular morbidity and mortality when inadequately treated, which may be secondary to associated comorbidities or to direct IGF-1 effects on the cardiovascular system. By using a control group carefully matched for traditional cardiovascular risk factors, we aimed to assess the direct contribution of disease activity and IGF-1 levels to arterial damage as assessed by measurements of arterial stiffness and endothelial function. Twenty-nine subjects with acromegaly (11 males, 52 ± 14 year; 15 active acromegaly) and 24 matched controls underwent evaluation of large and small artery compliance using applanation tonometry, pulse wave velocity (PWV), augmentation index (Alx), carotid ultrasonography intima-media thickness, (IMT) and flow-mediated dilatation (FMD). IGF-1 expressed as times the upper limit of the normal range (x ULN) was 2.2 ± 1.1 in patients with active disease versus 0.7 ± 0.2 in patients in remission. Irrespective of disease activity, FMD was lower in patients with acromegaly than in control subjects, (3.4 ± 2.7 % in active acromegaly, 4.4 ± 3.3 % in controlled acromegaly and 7.5 ± 3.8 % in controls; p = 0.004). There were no significant differences in PWV, Alx, and IMT between groups. A positive correlation was found between IGF-1× ULN and IMT (r = 0.4; P = 0.02). Asymmetric dimethylarginine (ADMA), a novel cardiovascular risk factor, was positively correlated to arterial stiffness (r = 0.46; p = 0.017) and negatively with small vessel compliance (r = -0.44, p = 0.02). Patients with acromegaly have significantly impaired endothelial function as assessed by FMD, but other tested vascular parameters were similar to a control group that was adequately matched for cardiovascular risk factors.

  7. Assessment of the Item Selection and Weighting in the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis

    Science.gov (United States)

    MAHR, ALFRED D.; NEOGI, TUHINA; LAVALLEY, MICHAEL P.; DAVIS, JOHN C.; HOFFMAN, GARY S.; MCCUNE, W. JOSEPH; SPECKS, ULRICH; SPIERA, ROBERT F.; ST.CLAIR, E. WILLIAM; STONE, JOHN H.; MERKEL, PETER A.

    2013-01-01

    Objective To assess the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis (BVAS/WG) with respect to its selection and weighting of items. Methods This study used the BVAS/WG data from the Wegener's Granulomatosis Etanercept Trial. The scoring frequencies of the 34 predefined items and any “other” items added by clinicians were calculated. Using linear regression with generalized estimating equations in which the physician global assessment (PGA) of disease activity was the dependent variable, we computed weights for all predefined items. We also created variables for clinical manifestations frequently added as other items, and computed weights for these as well. We searched for the model that included the items and their generated weights yielding an activity score with the highest R2 to predict the PGA. Results We analyzed 2,044 BVAS/WG assessments from 180 patients; 734 assessments were scored during active disease. The highest R2 with the PGA was obtained by scoring WG activity based on the following items: the 25 predefined items rated on ≥5 visits, the 2 newly created fatigue and weight loss variables, the remaining minor other and major other items, and a variable that signified whether new or worse items were present at a specific visit. The weights assigned to the items ranged from 1 to 21. Compared with the original BVAS/WG, this modified score correlated significantly more strongly with the PGA. Conclusion This study suggests possibilities to enhance the item selection and weighting of the BVAS/WG. These changes may increase this instrument's ability to capture the continuum of disease activity in WG. PMID:18512722

  8. Lesion activity assessment

    DEFF Research Database (Denmark)

    Ekstrand, K R; Zero, D T; Martignon, S

    2009-01-01

    in response to cariogenic plaque as well as lesion arrest. Based on this understanding, different clinical scoring systems have been developed to assess the severity/depth and activity of lesions. A recent system has been devised by the International Caries Detection and Assessment System Committee...

  9. Ambulatory motor assessment in Parkinson's disease.

    NARCIS (Netherlands)

    Keijsers, N.L.W.; Horstink, M.W.I.M.; Gielen, S.C.A.M.

    2006-01-01

    We developed an algorithm that distinguishes between on and off states in patients with Parkinson's disease during daily life activities. Twenty-three patients were monitored continuously in a home-like situation for approximately 3 hours while they carried out normal daily-life activities. Behavior

  10. Activity enhances dopaminergic long-duration response in Parkinson disease

    Science.gov (United States)

    Auinger, Peggy; Fahn, Stanley; Oakes, David; Shoulson, Ira; Kieburtz, Karl; Rudolph, Alice; Marek, Kenneth; Seibyl, John; Lang, Anthony; Olanow, C. Warren; Tanner, Caroline; Schifitto, Giovanni; Zhao, Hongwei; Reyes, Lydia; Shinaman, Aileen; Comella, Cynthia L.; Goetz, Christopher; Blasucci, Lucia M.; Samanta, Johan; Stacy, Mark; Williamson, Kelli; Harrigan, Mary; Greene, Paul; Ford, Blair; Moskowitz, Carol; Truong, Daniel D.; Pathak, Mayank; Jankovic, Joseph; Ondo, William; Atassi, Farah; Hunter, Christine; Jacques, Carol; Friedman, Joseph H.; Lannon, Margaret; Russell, David S.; Jennings, Danna; Fussell, Barbara; Standaert, David; Schwarzschild, Michael A.; Growdon, John H.; Tennis, Marsha; Gauthier, Serge; Panisset, Michel; Hall, Jean; Gancher, Stephen; Hammerstad, John P.; Stone, Claudia; Alexander-Brown, Barbara; Factor, Stewart A.; Molho, Eric; Brown, Diane; Evans, Sharon; Clark, Jeffrey; Manyam, Bala; Simpson, Patricia; Wulbrecht, Brian; Whetteckey, Jacqueline; Martin, Wayne; Roberts, Ted; King, Pamela; Hauser, Robert; Zesiewicz, Theresa; Gauger, Lisa; Trugman, Joel; Wooten, G. Frederick; Rost-Ruffner, Elke; Perlmutter, Joel; Racette, Brad A.; Suchowersky, Oksana; Ranawaya, Ranjit; Wood, Susan; Pantella, Carol; Kurlan, Roger; Richard, Irene; Pearson, Nancy; Caviness, John N.; Adler, Charles; Lind, Marlene; Simuni, Tanya; Siderowf, Andrew; Colcher, Amy; Lloyd, Mary; Weiner, William; Shulman, Lisa; Koller, William; Lyons, Kelly; Feldman, Robert G.; Saint-Hilaire, Marie H.; Ellias, Samuel; Thomas, Cathi-Ann; Juncos, Jorge; Watts, Ray; Partlow, Anna; Tetrud, James; Togasaki, Daniel M.; Stewart, Tracy; Mark, Margery H.; Sage, Jacob I.; Caputo, Debbie; Gould, Harry; Rao, Jayaraman; McKendrick, Ann; Brin, Mitchell; Danisi, Fabio; Benabou, Reina; Hubble, Jean; Paulson, George W.; Reider, Carson; Birnbaum, Alex; Miyasaki, Janis; Johnston, Lisa; So, Julie; Pahwa, Rajesh; Dubinsky, Richard M.; Wszolek, Zbigniew; Uitti, Ryan; Turk, Margaret; Tuite, Paul; Rottenberg, David; Hansen, Joy; Ramos, Serrano; Waters, Cheryl; Lew, Mark; Welsh, Mickie; Kawai, Connie; O'Brien, Christopher; Kumar, Rajeev; Seeberger, Lauren; Judd, Deborah; Barclay, C. Lynn; Grimes, David A.; Sutherland, Laura; Dawson, Ted; Reich, Stephen; Dunlop, Rebecca; Albin, Roger; Frey, Kirk; Wernette, Kristine; Fahn, Stanley; Oakes, David; Shoulson, Ira; Kieburtz, Karl; Rudolph, Alice; Marek, Kenneth; Seibyl, John; Lang, Anthony; Olanow, C. Warren; Tanner, Caroline; Schifitto, Giovanni; Zhao, Hongwei; Reyes, Lydia; Shinaman, Aileen; Comella, Cynthia L.; Goetz, Christopher; Blasucci, Lucia M.; Samanta, Johan; Stacy, Mark; Williamson, Kelli; Harrigan, Mary; Greene, Paul; Ford, Blair; Moskowitz, Carol; Truong, Daniel D.; Pathak, Mayank; Jankovic, Joseph; Ondo, William; Atassi, Farah; Hunter, Christine; Jacques, Carol; Friedman, Joseph H.; Lannon, Margaret; Russell, David S.; Jennings, Danna; Fussell, Barbara; Standaert, David; Schwarzschild, Michael A.; Growdon, John H.; Tennis, Marsha; Gauthier, Serge; Panisset, Michel; Hall, Jean; Gancher, Stephen; Hammerstad, John P.; Stone, Claudia; Alexander-Brown, Barbara; Factor, Stewart A.; Molho, Eric; Brown, Diane; Evans, Sharon; Clark, Jeffrey; Manyam, Bala; Simpson, Patricia; Wulbrecht, Brian; Whetteckey, Jacqueline; Martin, Wayne; Roberts, Ted; King, Pamela; Hauser, Robert; Zesiewicz, Theresa; Gauger, Lisa; Trugman, Joel; Wooten, G. Frederick; Rost-Ruffner, Elke; Perlmutter, Joel; Racette, Brad A.; Suchowersky, Oksana; Ranawaya, Ranjit; Wood, Susan; Pantella, Carol; Kurlan, Roger; Richard, Irene; Pearson, Nancy; Caviness, John N.; Adler, Charles; Lind, Marlene; Simuni, Tanya; Siderowf, Andrew; Colcher, Amy; Lloyd, Mary; Weiner, William; Shulman, Lisa; Koller, William; Lyons, Kelly; Feldman, Robert G.; Saint-Hilaire, Marie H.; Ellias, Samuel; Thomas, Cathi-Ann; Juncos, Jorge; Watts, Ray; Partlow, Anna; Tetrud, James; Togasaki, Daniel M.; Stewart, Tracy; Mark, Margery H.; Sage, Jacob I.; Caputo, Debbie; Gould, Harry; Rao, Jayaraman; McKendrick, Ann; Brin, Mitchell; Danisi, Fabio; Benabou, Reina; Hubble, Jean; Paulson, George W.; Reider, Carson; Birnbaum, Alex; Miyasaki, Janis; Johnston, Lisa; So, Julie; Pahwa, Rajesh; Dubinsky, Richard M.; Wszolek, Zbigniew; Uitti, Ryan; Turk, Margaret; Tuite, Paul; Rottenberg, David; Hansen, Joy; Ramos, Serrano; Waters, Cheryl; Lew, Mark; Welsh, Mickie; Kawai, Connie; O'Brien, Christopher; Kumar, Rajeev; Seeberger, Lauren; Judd, Deborah; Barclay, C. Lynn; Grimes, David A.; Sutherland, Laura; Dawson, Ted; Reich, Stephen; Dunlop, Rebecca; Albin, Roger; Frey, Kirk; Wernette, Kristine; Mendis, Tilak

    2012-01-01

    Objective: We tested the hypothesis that dopamine-dependent motor learning mechanism underlies the long-duration response to levodopa in Parkinson disease (PD) based on our studies in a mouse model. By data-mining the motor task performance in dominant and nondominant hands of the subjects in a double-blind randomized trial of levodopa therapy, the effects of activity and dopamine therapy were examined. Methods: We data-mined the Earlier versus Later Levodopa Therapy in Parkinson's Disease (ELLDOPA) study published in 2005 and performed statistical analysis comparing the effects of levodopa and dominance of handedness over 42 weeks. Results: The mean change in finger-tapping counts from baseline before the initiation of therapy to predose at 9 weeks and 40 weeks increased more in the dominant compared to nondominant hand in levodopa-treated subjects in a dose-dependent fashion. There was no significant difference in dominant vs nondominant hands in the placebo group. The short-duration response assessed by the difference of postdose performance compared to predose performance at the same visit did not show any significant difference between dominant vs nondominant hands. Conclusions: Active use of the dominant hand and dopamine replacement therapy produces synergistic effect on long-lasting motor task performance during “off” medication state. Such effect was confined to dopamine-responsive symptoms and not seen in dopamine-resistant symptoms such as gait and balance. We propose that long-lasting motor learning facilitated by activity and dopamine is a form of disease modification that is often seen in trials of medications that have symptomatic effects. PMID:22459675

  11. EULAR Sjögren's syndrome disease activity index (ESSDAI)

    DEFF Research Database (Denmark)

    Seror, Raphaèle; Bowman, Simon J; Brito-Zeron, Pilar

    2015-01-01

    The EULAR Sjögren's syndrome (SS) disease activity index (ESSDAI) is a systemic disease activity index that was designed to measure disease activity in patients with primary SS. With the growing use of the ESSDAI, some domains appear to be more challenging to rate than others. The ESSDAI is now...

  12. Safety and Feasibility of Using the Second-Generation Pillcam Colon Capsule to Assess Active Colonic Crohn's Disease

    NARCIS (Netherlands)

    D'Haens, Geert; Löwenberg, Mark; Samaan, Mark A.; Franchimont, Denis; Ponsioen, Cyriel; van den Brink, Gijs R.; Fockens, Paul; Bossuyt, Peter; Amininejad, Leila; Rajamannar, Gopalan; Lensink, Elsemieke M.; van Gossum, Andre M.

    2015-01-01

    The second-generation Pillcam Colon Capsule Endoscope (PCCE-2; Given Imaging Ltd, Yoqneam, Israel) is an ingestible capsule for visualization of the colon. We performed a multicenter pilot study to assess its safety and feasibility in evaluating the severity of Crohn's disease (CD). In a prospective

  13. Assessment of Motor Units in Neuromuscular Disease.

    Science.gov (United States)

    Henderson, Robert D; McCombe, Pamela A

    2017-01-01

    The motor unit comprises the anterior horn cell, its axon, and the muscle fibers that it innervates. Although the true number of motor units is unknown, the number of motor units appears to vary greatly between different muscles and between different individuals. Assessment of the number and function of motor units is needed in diseases of the anterior horn cell and other motor nerve disorders. Amyotrophic lateral sclerosis is the most important disease of anterior horn cells. The need for an effective biomarker for assessing disease progression and for use in clinical trials in amyotrophic lateral sclerosis has stimulated the study of methods to measure the number of motor units. Since 1970 a number of different methods, including the incremental, F-wave, multipoint, and statistical methods, have been developed but none has achieved widespread applicability. Two methods (MUNIX and the multipoint incremental method) are in current use across multiple centres and are discussed in detail in this review, together with other recently published methods. Imaging with magnetic resonance and ultrasound is increasingly being applied to this area. Motor unit number estimates have also been applied to other neuromuscular diseases such as spinal muscular atrophy, compression neuropathies, and prior poliomyelitis. The need for an objective measure for the assessment of motor units remains tantalizingly close but unfulfilled in 2016.

  14. Assessment of physical activity and energy expenditure: an overview of objective measures

    Directory of Open Access Journals (Sweden)

    Andrew P Hills

    2014-06-01

    Full Text Available The ability to assess energy expenditure and estimate physical activity in free-living individuals is extremely important in the global context of non-communicable diseases including malnutrition, overnutrition (obesity and diabetes. It is also important to appreciate that physical activity and energy expenditure are different constructs with physical activity defined as any bodily movement that results in energy expenditure and accordingly, energy is expended as a result of physical activity. However, total energy expenditure, best assessed using the criterion doubly labelled water technique, includes components in addition to physical activity energy expenditure, namely resting energy expenditure and the thermic effect of food. Given the large number of assessment techniques currently used to estimate physical activity in humans, it is imperative to understand the relative merits of each. The goal of this review is to provide information on the utility and limitations of a range of objective measures of physical activity and their relationship with energy expenditure. The measures discussed include those based on energy expenditure or oxygen uptake including doubly labelled water, activity energy expenditure, physical activity level, and metabolic equivalent; those based on heart rate monitoring and motion sensors; and because of their widespread use, selected subjective measures.

  15. The effect of vitamin D on clinical manifestations and activity of Behçet’s disease

    Directory of Open Access Journals (Sweden)

    Nurşad Aslan

    2017-02-01

    Full Text Available Introduction: Immune mechanisms have been implemented to have a role in the pathogenesis of Behçet’s disease (BD and vitamin D has been shown to have a regulatory role in the immune system function. Aim: To evaluate the vitamin D levels of BD patients and its relationship between clinical findings and disease activity of BD. Material and methods: Sixty-eight patients with BD and 70 age- and sex-matched controls were examined retrospectively. Demographic features, vitamin D levels for both groups and clinical findings, disease activity, drug usage for BD patients were examined from their medical reports. Disease activity was calculated for each patient according to Krause’s BD activity assessment. Results: Mean vitamin D levels of patients and controls were 15.35 ±7.18 ng/ml and 18.44 ±5.79 ng/ml, respectively. Vitamin D levels were significantly lower in BD patients than in controls (p = 0.006. Mean vitamin D levels of active and inactive BD cases were 15.68 ±7.31 ng/ml and 15.08 ±7.17 ng/ml, respectively (p = 0.73. Disease activity of patients using and not using vitamin D was similar (p = 0.51. Conclusions : Significantly lower levels of vitamin D were observed in BD patients. Our results indicate that there is no correlation between BD activity and a vitamin D level. Together with these, vitamin D replacement treatment was found to have no effect on disease activity.

  16. Dealing with uncertainties in environmental burden of disease assessment

    Directory of Open Access Journals (Sweden)

    van der Sluijs Jeroen P

    2009-04-01

    Full Text Available Abstract Disability Adjusted Life Years (DALYs combine the number of people affected by disease or mortality in a population and the duration and severity of their condition into one number. The environmental burden of disease is the number of DALYs that can be attributed to environmental factors. Environmental burden of disease estimates enable policy makers to evaluate, compare and prioritize dissimilar environmental health problems or interventions. These estimates often have various uncertainties and assumptions which are not always made explicit. Besides statistical uncertainty in input data and parameters – which is commonly addressed – a variety of other types of uncertainties may substantially influence the results of the assessment. We have reviewed how different types of uncertainties affect environmental burden of disease assessments, and we give suggestions as to how researchers could address these uncertainties. We propose the use of an uncertainty typology to identify and characterize uncertainties. Finally, we argue that uncertainties need to be identified, assessed, reported and interpreted in order for assessment results to adequately support decision making.

  17. Assessment and management of refractory breathlessness in interstitial lung disease.

    Science.gov (United States)

    Speakman, Lucy; Walthall, Helen

    2017-09-02

    Interstitial lung disease (ILD) refers to a cluster of fibroinflammatory conditions. There are limited treatment options and most patients have severe dyspnoea. The prognosis is poor. This study aims to evaluate current literature on the assessment and management of refractory breathlessness in ILD. Few tools are available to assess dyspnoea in advanced respiratory disease. Holistic assessment requires a combination of tools but there are few disease specific tools. The role of opioids is well established in the reduction of breathlessness, but there is insufficient evidence that benzodiazepines are beneficial. Non-pharmcolological breathlessness intervention services can give patients mastery of their disease, reduced distress due to breathlessness and were more cost effective. More research on holistic interventions for use in advanced disease needs to be done. Patient-reported outcome measures could elicit valuable evidence to describe the benefit of breathlessness management services in advanced respiratory disease.

  18. The effects of different physical activities on atrial fibrillation in patients with hypertension and chronic kidney disease

    OpenAIRE

    Kiuchi, M?rcio Galindo; Chen, Shaojie; Hoye, Neil Alexander

    2017-01-01

    Background: Atrial fibrillation (AF) is highly common, and is most frequently observed in individuals with hypertension and structural cardiac disease. Sympathetic hyperactivity plays a fundamental role in the progression, maintenance and aggravation of arrhythmia. Endurance exercise training clearly lowers sympathetic activity in sympathoexcitatory disease states, and is well-tolerated by patients with chronic kidney disease (CKD). Methods: We assessed 50 CKD patients with hypertension. Each...

  19. USE OF MULTIPARAMETER ANALYSIS OF LABORATORY BIOMARKERS TO ASSESS RHEUMATOID ARTHRITIS ACTIVITY

    Directory of Open Access Journals (Sweden)

    A. A. Novikov

    2015-01-01

    Full Text Available The key component in the management of patients with rheumatoid arthritis (RA is regular control of RA activity. The quantitative assessment of a patient’s status allows the development of standardized indications for anti-rheumatic therapy.Objective: to identify the laboratory biomarkers able to reflect RA activity.Subjects and methods. Fifty-eight patients with RA and 30 age- and sex-matched healthy donors were examined. The patients were divided into high/moderate and mild disease activity groups according to DAS28. The serum concentrations of 30 biomarkers were measured using immunonephelometric assay, enzyme immunoassay, and xMAP technology.Results and discussion. Multivariate analysis could identify the factors mostly related to high/moderate RA activity according to DAS28, such as fibroblast growth factor-2, monocyte chemoattractant protein-1, interleukins (IL 1α, 6, and 15, and tumor necrosis factor-α and could create a prognostic model for RA activity assessment. ROC analysis has shown that this model has excellent diagnostic efficiency in differentiating high/moderate versus low RA activity.Conclusion. To create a subjective assessment-independent immunological multiparameter index of greater diagnostic accuracy than the laboratory parameters routinely used in clinical practice may be a qualitatively new step in assessing and monitoring RA activity.

  20. Symptoms in Inflammatory Bowel Disease: pathophysiologic aspects and their relation with disease activity

    NARCIS (Netherlands)

    Minderhoud, I.M.

    2007-01-01

    Symptoms in Inflammatory Bowel Disease: pathophysiologic aspects and their relation with disease activity Inflammatory bowel disease (IBD) comprises ulcerative colitis (UC) and Crohn's disease (CD). IBD patients frequently complain of fatigue, and a substantial proportion of the patients have

  1. Total cardiovascular disease risk assessment: a review.

    LENUS (Irish Health Repository)

    Cooney, Marie Therese

    2011-09-01

    The high risk strategy for the prevention of cardiovascular disease (CVD) requires an assessment of an individual\\'s total CVD risk so that the most intensive risk factor management can be directed towards those at highest risk. Here we review developments in the assessment and estimation of total CVD risk.

  2. Down-titration and discontinuation strategies of tumor necrosis factor-blocking agents for rheumatoid arthritis in patients with low disease activity.

    Science.gov (United States)

    van Herwaarden, Noortje; den Broeder, Alfons A; Jacobs, Wilco; van der Maas, Aatke; Bijlsma, Johannes W J; van Vollenhoven, Ronald F; van den Bemt, Bart J F

    2014-09-29

    Anti-tumor necrosis factor (TNF) agents are effective in treating patients with rheumatoid arthritis (RA), but they are associated with (dose-dependent) adverse effects and high costs. To prevent overtreatment, several trials have assessed the effectiveness of down-titration compared with continuation of the standard dose. To evaluate the benefits and harms of down-titration (dose reduction, discontinuation or disease activity guided dose tapering) of anti-TNF agents (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab) on disease activity, functioning, costs, safety and radiographic damage compared with usual care in patients with RA and low disease activity. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Issue 8, 2013; Ovid MEDLINE (1946 to 8 September 2013); EMBASE (1947 to 8 September 2013); Science Citation Index (Web of Science); and conference proceedings of the American College of Rheumatology (2005 to 2012) and European League against Rheumatism (2005 to 2013). We contacted authors of the seven included studies to ask for additional information on their study; five responded. Randomised controlled trials (RCTs) and controlled clinical trials (CCTs) comparing down-titration (dose reduction, discontinuation, disease activity-guided dose tapering) of anti-TNF agents (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab) to usual care/no down-titration in patients with RA and a low disease activity state. Two review authors independently selected studies, assessed risk of bias and extracted data. Six RCTs and one CCT (total 1203 participants), reporting anti-TNF down-titration, were included. Three studies (559 participants) reported anti-TNF dose reduction compared with anti-TNF continuation. Five studies (732 participants) reported anti-TNF discontinuation compared with anti-TNF continuation (two studies assessed both anti-TNF discontinuation and dose reduction), and one study assessed disease activity

  3. Altered expression of signalling lymphocyte activation molecule receptors in T-cells from lupus nephritis patients-a potential biomarker of disease activity.

    Science.gov (United States)

    Stratigou, Victoria; Doyle, Anne F; Carlucci, Francesco; Stephens, Lauren; Foschi, Valentina; Castelli, Marco; McKenna, Nicola; Cook, H Terence; Lightstone, Liz; Cairns, Thomas D; Pickering, Matthew C; Botto, Marina

    2017-07-01

    The aim was to investigate whether the signalling lymphocyte activation molecule (SLAM) signalling pathways contribute to LN and whether SLAM receptors could be valuable biomarkers of disease activity. Peripheral blood mononuclear cells from 30National Research Ethics Service SLE patients with biopsy-proven LN were analysed by flow cytometry. Clinical measures of disease activity were assessed. The expression of the SLAM family receptors on T-cell subpopulations [CD4, CD8 and double negative (DN) T cells] was measured and compared between lupus patients with active renal disease and those in remission. The frequency of CD8 T cells expressing SLAMF3, SLAMF5 and SLAMF7 was significantly lower in LN patients who were in remission. In contrast, these subsets were similar in patients with active renal disease and in healthy individuals. Patients with active nephritis had an increased percentage of circulating monocytes, consistent with a potential role played by these cells in glomerular inflammation. Changes in the frequency of DN T cells positive for SLAMF2, SLAMF4 and SLAMF7 were observed in lupus patients irrespective of the disease activity. We detected alterations in the cellular expression of the SLAM family receptors, but these changes were less obvious and did not reveal any specific pattern. The percentage of DN T cells expressing SLAMF6 could predict the clinical response to B-cell depletion in patients with LN. Our study demonstrates altered expression of the SLAM family receptors in SLE T lymphocytes. This is consistent with the importance of the SLAM-associated pathways in lupus pathogenesis. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology.

  4. Active living in rural Appalachia: Using the rural active living assessment (RALA tools to explore environmental barriers

    Directory of Open Access Journals (Sweden)

    Adam Hege

    2017-12-01

    Full Text Available People residing in rural communities are more likely to be physically inactive and subsequently have elevated risks for chronic disease. Recent evidence has shown this could stem from environmental barriers, inadequate programming and policies directed at the promotion of physical activity (PA in rural settings. The objective of this research was to assess active living features in rural towns and townships (n=16 across seven counties in northwestern North Carolina (NC. The study utilized the Town-Wide and Street Segment components of the Rural Active Living Assessment (RALA as well as the 2014 American Community Survey results. The assessments were conducted in the summer of 2016 in the rural Appalachia region of NC. Using the RALA town-wide assessment scoring system (0−100, the range of scores was 18–84, with the mean being 50.06. Three towns had no sidewalks, nine towns had sidewalks on only one side of the main streets, and four had sidewalks on both sides of the main streets. One town was rated as highly walkable, seven towns as moderately walkable, five towns as moderately unwalkable, and three towns as highly unwalkable. The rural Appalachia region of NC offers unique topographic, geographic and environmental barriers to PA. However, our findings indicate many rural towns offer common PA amenities. Future research should utilize qualitative methods and a community-based participatory research approach to more fully understand the challenges with increasing PA in the rural and often isolated Appalachia communities. Keywords: Rural active living assessment (RALA, Health disparities, Physical activity, Rural Appalachia

  5. U.K. Foot and Mouth Disease: A Systemic Risk Assessment of Existing Controls.

    Science.gov (United States)

    Delgado, João; Pollard, Simon; Pearn, Kerry; Snary, Emma L; Black, Edgar; Prpich, George; Longhurst, Phil

    2017-09-01

    This article details a systemic analysis of the controls in place and possible interventions available to further reduce the risk of a foot and mouth disease (FMD) outbreak in the United Kingdom. Using a research-based network analysis tool, we identify vulnerabilities within the multibarrier control system and their corresponding critical control points (CCPs). CCPs represent opportunities for active intervention that produce the greatest improvement to United Kingdom's resilience to future FMD outbreaks. Using an adapted 'features, events, and processes' (FEPs) methodology and network analysis, our results suggest that movements of animals and goods associated with legal activities significantly influence the system's behavior due to their higher frequency and ability to combine and create scenarios of exposure similar in origin to the U.K. FMD outbreaks of 1967/8 and 2001. The systemic risk assessment highlights areas outside of disease control that are relevant to disease spread. Further, it proves to be a powerful tool for demonstrating the need for implementing disease controls that have not previously been part of the system. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  6. /sup 99m/Tc radionuclide angioscintigraphic perfusion analysis in the assessment and follow-up of peripheral vascular diseases of the lower limbs

    International Nuclear Information System (INIS)

    Bencini, C.; Mazzuca, N.; Bertelli, P.; Pulera, N.; Mariani, G.

    1986-01-01

    Peripheral arterial diseases (PADs) of the lower limbs such as thromboangitis obliterans (TAO) (Buerger's disease), arteriosclerosis obliterans (ASO) and diabetes mellitus, produce trophic disturbances occurring most often in the toes. Perfusion analysis of the foot and toes was previously reported. The analysis utilized radionuclide arteriography (RNA) during reactive hyperaemia to obtain peak activity in RNA time-activity curves (TACs). RNA was also used to assess healing capability of skin ulcers of the calf and ankle, which depends on localized enhancement of capillary blood flow. On these bases, detection of capillary blood flow assumes primary importance in the assessment of peripheral vascular disease (PVD). The purpose of this study was to determine whether RNA of the toes at rest could provide adequate assessment of microcirculation in PVD and of microcirculatory changes induced by lumbar sympathectomy (LS)

  7. Validation of Visual Caries Activity Assessment

    DEFF Research Database (Denmark)

    Guedes, R S; Piovesan, C; Ardenghi, T M

    2014-01-01

    We evaluated the predictive and construct validity of a caries activity assessment system associated with the International Caries Detection and Assessment System (ICDAS) in primary teeth. A total of 469 children were reexamined: participants of a caries survey performed 2 yr before (follow-up rate...... of 73.4%). At baseline, children (12-59 mo old) were examined with the ICDAS and a caries activity assessment system. The predictive validity was assessed by evaluating the risk of active caries lesion progression to more severe conditions in the follow-up, compared with inactive lesions. We also...... assessed if children with a higher number of active caries lesions were more likely to develop new lesions (construct validity). Noncavitated active caries lesions at occlusal surfaces presented higher risk of progression than inactive ones. Children with a higher number of active lesions and with higher...

  8. Dynamic contrast-enhanced 3-T magnetic resonance imaging: a method for quantifying disease activity in early polyarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Navalho, Marcio [Faculdade de Medicina da Universidade de Lisboa, Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon (Portugal); Hospital da Luz, Radiology Department, Lisbon (Portugal); Hospital da Luz, Centro de Imagiologia, Lisbon (Portugal); Resende, Catarina [Hospital da Luz, Rheumatology Department, Lisbon (Portugal); Hospital de Santa Maria, Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Lisbon (Portugal); Rodrigues, Ana Maria; Fonseca, Joao Eurico; Canhao, Helena [Faculdade de Medicina da Universidade de Lisboa, Rheumatology Research Unit, Instituto de Medicina Molecular, Lisbon (Portugal); Hospital de Santa Maria, Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Lisbon (Portugal); Gaspar, Augusto [Hospital da Luz, Radiology Department, Lisbon (Portugal); Campos, Jorge [Hospital de Santa Maria, Radiology Department, Centro Hospitalar de Lisboa Norte, EPE, Lisbon (Portugal)

    2012-01-15

    To determine whether measurement of synovial enhancement and thickness quantification parameters with 3.0-Tesla magnetic resonance imaging (3-T MRI) can reliably quantify disease activity in patients with early polyarthritis. Eighteen patients (16 women, 2 men; mean age 46 years) with early polyarthritis with less than 12 months of symptoms were included. MRI examination using 3-T device was performed by a new approach including both wrists and hands simultaneously in the examination field-of-view. MRI scoring of disease activity included quantification of synovial enhancement with simple measurements such as rate of early enhancement (REE; REE{sub 57} = S{sub 57}/S{sub 200}, where S{sub 57} and S{sub 200} are the signal intensities 57 s and 200 s after gadolinium injection) and rate of relative enhancement (RE; RE = S{sub 200} - S{sub 0}). Both wrists and hands were scored according to the Rheumatoid Arthritis MRI Scoring System (RAMRIS) for synovitis. Disease activity was clinically assessed by the 28-joint Disease Activity Score (DAS28). DAS28 score was strongly correlated with RE (r = 0.8331, p < 0.0001), REE (r = 0.8112, p < 0.0001), and RAMRIS score for synovitis (r = 0.7659, p < 0.0002). An REE score above 0.778 accurately identified patients with clinically active disease (sensitivity 92%; specificity 67%; p < 0.05). A statistically significant difference was observed in the RE, REE, and RAMRIS scores for synovitis between patients with active and inactive disease (p < 0.05). Our findings support the use of 3-T dynamic contrast-enhanced MRI for precise quantification of disease activity and for discriminating active disease from inactive disease in early polyarthritis. (orig.)

  9. Influence of anti-cyclic citrullinated peptide on disease activity, structural severity, and bone loss in Moroccan women with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Imad Ghozlani

    2018-04-01

    Full Text Available Aim of the work: The aim of this study was to assess the influence of anti-cyclic citrullinated peptide (anti-CCP on disease activity, radiological severity, functional disability and bone loss in Moroccan women with rheumatoid arthritis (RA. Patients and methods: One hundred and thirty-six women with RA were recruited. Age, weight, height, disease duration and steroids cumulative dose were identified. Anti-CCP and Rheumatoid factor (RF were determined. Disease activity score (DAS28 was assessed and functional repercussion measured by the Health Assessment Questionnaire-disability index (HAQ-DI. Radiological status was assessed by the Sharp/van der Heijde (SvH erosion and narrowing score. Bone mineral density was determined by a Lunar Prodigy Vision Dual-energy X-ray absorptiometry and vertebral fracture assessment was classified using a combination of Genant semi-quantitative approach and morphometry. Results: Patients mean age was 49.6 ± 7.4 years and disease duration 7.7 ± 5 years. 109 (80.1% patients were anti-CCP positive. There was no significant difference in DAS28 between patients with and without anti-CCP. Nevertheless, weight, erythrocyte sedimentation rate (ESR, rheumatoid factor titer and positivity, SvH narrowing and erosion score and osteoporosis were significantly higher in patients with positive anti-CCP. Stepwise regression analysis showed that the presence of anti-CCP was independently associated with osteoporosis and SvH erosion score. Conclusions: Anti-CCP antibodies are strongly predictive for the development of osteoporosis and erosions in Moroccan RA patients. They not only have a valuable role in the disease prognosis prediction but also may be a relevant determinant of bone loss in RA. The presence of these antibodies warrants special attention. Keywords: Rheumatoid arthritis, Anti-cyclic citrullinated peptide, Disease activity, Joint damage, Bone loss

  10. MCID/Low Disease Activity State Workshop: low disease activity state in rheumatoid arthritis.

    NARCIS (Netherlands)

    Wells, G.A.; Boers, M.; Shea, B.; Anderson, J.; Felson, D.T.; Johnson, K.; Kirwan, J.; Lassere, M.N.; Robinson, V.; Simon, L.S.; Strand, V.; Riel, P.L.C.M. van; Tugwell, P.S.

    2003-01-01

    The MCID (minimal clinically important difference) module of OMERACT 5 developed a research agenda that led to the conclusion that a state of low disease activity for rheumatoid arthritis (RA) would need to be defined. To develop such a definition the various concepts and terminologies, the process

  11. Multiparametric magnetic resonance imaging for the assessment of non-alcoholic fatty liver disease severity.

    Science.gov (United States)

    Pavlides, Michael; Banerjee, Rajarshi; Tunnicliffe, Elizabeth M; Kelly, Catherine; Collier, Jane; Wang, Lai Mun; Fleming, Kenneth A; Cobbold, Jeremy F; Robson, Matthew D; Neubauer, Stefan; Barnes, Eleanor

    2017-07-01

    The diagnosis of non-alcoholic steatohepatitis and fibrosis staging are central to non-alcoholic fatty liver disease assessment. We evaluated multiparametric magnetic resonance in the assessment of non-alcoholic steatohepatitis and fibrosis using histology as standard in non-alcoholic fatty liver disease. Seventy-one patients with suspected non-alcoholic fatty liver disease were recruited within 1 month of liver biopsy. Magnetic resonance data were used to define the liver inflammation and fibrosis score (LIF 0-4). Biopsies were assessed for steatosis, lobular inflammation, ballooning and fibrosis and classified as non-alcoholic steatohepatitis or simple steatosis, and mild or significant (Activity ≥2 and/or Fibrosis ≥2 as defined by the Fatty Liver Inhibition of Progression consortium) non-alcoholic fatty liver disease. Transient elastography was also performed. Magnetic resonance success rate was 95% vs 59% for transient elastography (Pliver inflammation and fibrosis (r s =.51, Pliver inflammation and fibrosis for the diagnosis of cirrhosis was 0.85. Liver inflammation and fibrosis score for ballooning grades 0, 1 and 2 was 1.2, 2.7 and 3.5 respectively (Pliver inflammation and fibrosis (1.3) compared to patients with non-alcoholic steatohepatitis (3.0) (PLiver inflammation and fibrosis scores for patients with mild and significant non-alcoholic fatty liver disease were 1.2 and 2.9 respectively (Pliver inflammation and fibrosis for the diagnosis of significant non-alcoholic fatty liver disease was 0.89. Multiparametric magnetic resonance is a promising technique with good diagnostic accuracy for non-alcoholic fatty liver disease histological parameters, and can potentially identify patients with non-alcoholic steatohepatitis and cirrhosis. © 2017 The Authors Liver International Published by John Wiley & Sons Ltd.

  12. Health assessment of environmental pollutants: proliferative and degenerative diseases

    International Nuclear Information System (INIS)

    Stuart, B.O.

    1988-01-01

    In order to achieve a balanced approach to risk assessment between carcinogenic and non-carcinogenic health effects one must examine the risk of disease or death in the general population exposed to a particular air pollutant that can be related quantitatively to intensity and duration of exposures (National Academy of Sciences, 1983). Such risk assessment should be based upon careful evaluation of scientific findings of dose-response relationships in the chronically exposed population. Quantitative assessment of environmentally produced disease in man has proven to be complex and demanding. A variety of factors play important roles in this task. As an example, there are induction-latency periods for chronic diseases, including cancer, which may range from five to twenty-five years. The diseases themselves, whether proliferative or degenerative, may follow several stages of progression. There is only sparse epidemiological data on serious health effects that may be due to environmental as compared to occupational exposures. Exposures to chemical or radiological air contaminants do not occur singly but to a multiplicity of agents, and disease processes are frequently markedly affected by the interaction of a variety of factors, particularly that of cigarette smoking. There is growing recognition of potentially sensitive subpopulations, including the elderly and the very young, but adequate techniques for assessing the magnitude of increased risks to these groups have not yet been developed

  13. Disease activity in and quality of life of patients with psoriatic arthritis mutilans: the Nordic PAM Study.

    Science.gov (United States)

    Lindqvist, U; Gudbjornsson, B; Iversen, L; Laasonen, L; Ejstrup, L; Ternowitz, T; Ståhle, M

    2017-11-01

    To describe the social status and health-related quality of life of patients with psoriatic arthritis mutilans (PAM) in the Nordic countries. Patients with at least one mutilated joint confirmed by radiology were studied. Disease activity involving joints and skin, physician-assessed disease activity, and patient's education and work status were recorded. Data from the 36-item Short Form Health Survey, Health Assessment Questionnaire and Dermatology Life Quality Index questionnaire were gathered and correlated with disease duration, pain, and general well-being (visual analogue scale). The controls were 58 Swedish patients with long-standing psoriatic arthritis sine PAM. Sixty-seven patients were included. Patients with PAM had a protracted disease history (33 ± 14 years) and disease onset at a relatively early age (30 ± 12 years). Overall inflammatory activity at inclusion was mild to moderate. The mean number of mutilated joints was 8.2 and gross deformity was found in 16% of patients. Forty per cent were treated with biological and 32% with conventional synthetic disease-modifying anti-rheumatic drugs. Forty-two per cent had retired early or were on sick leave. Impaired functional capacity with little or no ability to perform self-care or everyday tasks was reported by 21% of the patients. Patients between 45 and 60 years of age reported the most impaired quality of life in comparison to the control group. PAM seriously affects social functioning. Whether early recognition of PAM and new forms of therapy can improve disease outcome and quality of life remains to be studied.

  14. Impact of Falls on Physical Activity in People with Parkinson's Disease.

    Science.gov (United States)

    Hiorth, Ylva Hivand; Larsen, Jan Petter; Lode, Kirsten; Tysnes, Ole-Bjørn; Godfrey, Alan; Lord, Sue; Rochester, Lynn; Pedersen, Kenn Freddy

    2016-01-01

    A complex relationship exists between motor impairment, physical activity (sedentary behavior, standing and ambulatory activity) and falls in people with Parkinson's disease (PD). To explore associations between recent fall history and the ability to retain an active lifestyle as determined by the volume, pattern and variability of physical activity in people with PD. Forty-eight participants with PD were recruited from the Norwegian ParkWest study. Body posture and ambulatory activity were monitored objectively over 7 days using the activPAL3 accelerometer. Clinical assessments included the Hoehn and Yahr stage, Unified Parkinson's Disease Rating Scale motor section and Falls Efficacy Scale-International. Structured interviews were performed to obtain information about demographics, fall history last 6 months, mobility and dementia. Participants with a fall history (n = 20) spent more time sedentary and less time standing than non-falling participants (n = 28). There were no significant differences regarding pattern or variability of sedentary behavior, standing or ambulatory activity in falling versus non-falling participants. Confidence in being able to get up from floor contributed significantly to time spent in sedentary behavior and ambulatory activity in participants with fall history, whereas motor impairment was significantly associated with time spent in all facets of physical activity for non-falling participants. Fall history in our PD cohort was associated with a more sedentary lifestyle, but not less ambulatory activity. More emphasis on improving the capacity to safely complete activities of daily living and increase confidence in getting up from floor may reduce sedentary behavior in people with PD.

  15. Role of physical activity in the management and assessment of rheumatoid arthritis patients.

    Science.gov (United States)

    Hernández-Hernández, María Vanesa; Díaz-González, Federico

    Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting diarthrodial joints, in which patients tend to perform less physical activity (PA) than recommended. This review focuses on the existing evidence about the relationship of PA and RA, specifically how the former influences joint inflammation, disability, quality of life and pain in RA patients, and also how disease activity potentially impacts PA in these patients. A literature search of EMBASE and MEDLINE databases from January 2000 to January 2015. The evidence indicating that PA in RA patients is safe and the benefits from regularly performing, both aerobic and resistance exercises, in these patients include improvement in: quality of life, functionality, pain and number of swollen joints. Interestingly, recent studies suggest that changes in disease activity in RA patients inversely correlate with variations in PA, as assessed by accelerometry. The regular monitoring of PA in RA patients might facilitate a more objective evaluation of variations in disease activity, helping physicians to make general and therapeutic recommendations that will improve both the health status and the joint functionality of these patients. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  16. Radiological assessement of Crohn's disease

    International Nuclear Information System (INIS)

    Florio, F.; Palladino, M.; Stella, P.; Barbi, E.

    1987-01-01

    Fifty-eight consecutive cases of patients affected by Crohn's disease, with ileum (23/58), colon (10/58) and ileo-colic (25/58) involvement were studied. A good overall sensitivity was reached by the radiological procedures employed (barium meal, barium enema, enterclysis). Enterclysis is proposed as a second-step method for the study of ileum involvement, because it provides a quite precise assessement of disease stage and extent. Some criteria for a rational use of current radiological procedures in follow-up of both surgically and medically treated patients are proposed. Moreover it is suggested that better coordination of anatomo-radiological and clinical aspects could improve the therapeutic approach and prognostic judgement in such cases

  17. Developing an active implementation model for a chronic disease management program.

    Science.gov (United States)

    Smidth, Margrethe; Christensen, Morten Bondo; Olesen, Frede; Vedsted, Peter

    2013-04-01

    Introduction and diffusion of new disease management programs in healthcare is usually slow, but active theory-driven implementation seems to outperform other implementation strategies. However, we have only scarce evidence on the feasibility and real effect of such strategies in complex primary care settings where municipalities, general practitioners and hospitals should work together. The Central Denmark Region recently implemented a disease management program for chronic obstructive pulmonary disease (COPD) which presented an opportunity to test an active implementation model against the usual implementation model. The aim of the present paper is to describe the development of an active implementation model using the Medical Research Council's model for complex interventions and the Chronic Care Model. We used the Medical Research Council's five-stage model for developing complex interventions to design an implementation model for a disease management program for COPD. First, literature on implementing change in general practice was scrutinised and empirical knowledge was assessed for suitability. In phase I, the intervention was developed; and in phases II and III, it was tested in a block- and cluster-randomised study. In phase IV, we evaluated the feasibility for others to use our active implementation model. The Chronic Care Model was identified as a model for designing efficient implementation elements. These elements were combined into a multifaceted intervention, and a timeline for the trial in a randomised study was decided upon in accordance with the five stages in the Medical Research Council's model; this was captured in a PaTPlot, which allowed us to focus on the structure and the timing of the intervention. The implementation strategies identified as efficient were use of the Breakthrough Series, academic detailing, provision of patient material and meetings between providers. The active implementation model was tested in a randomised trial

  18. An open randomized active-controlled clinical trial with low-dose SKA cytokines versus DMARDs evaluating low disease activity maintenance in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Martin-Martin LS

    2017-03-01

    Full Text Available LS Martin-Martin,1 F Giovannangeli,2 E Bizzi,2 U Massafra,2 E Ballanti,2 M Cassol,3 A Migliore2 1Department of Internal Medicine, Regina Apostolorum Hospital, 2Operative Unit of Rheumatology, 3Department of Internal Medicine, San Pietro Fatebenefratelli Hospital, Rome, Italy Background: Biologic agents are currently the strongest immunosuppressive drugs able to induce remission in rheumatoid arthritis (RA. One of the objectives of the medical scientific community now is how to maintain remission or low disease activity (LDA. The aim of this trial is to evaluate the contribution of low-dose sequential kinetic activation (SKA IL-4, IL-10, and anti-IL-1 antibodies (10 fg/mL in patients affected by RA in maintaining LDA or remission obtained after biological therapy. Method: This is a randomized, open, active-controlled, prospective, Phase IV trial. Disease activity score (DAS28, clinical disease activity index, simplified disease activity index, erythrocyte sedimentation rate and C-reactive protein levels, global health assessment, and pain visual analog scale were evaluated at baseline visit and then every 3 months together with an assessment of side effects till 12 months. Thirty-nine RA patients were enrolled and randomized to continue disease-modifying antirheumatic drugs (DMARDs therapy or to receive a combination of SKA low-dose cytokines formulated in concentration of 10 fg/mL orally administered at a dose of 20 drops/d for 12 consecutive months. Results: The rate of maintenance of LDA at 12 months was superior in the group treated with low-dose cytokines compared with patients treated with DMARDs, 66.7% and 42.1%, respectively; however, the difference between the groups was not statistically significant. No side effects were reported in both groups. Conclusion: This is the first study using a combination of three low-dose cytokines in RA, after data published on psoriasis. These data suggest that the use of a combination of low-dose SKA

  19. Ultrasound-detected bone erosion is a relapse risk factor after discontinuation of biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis whose ultrasound power Doppler synovitis activity and clinical disease activity are well controlled.

    Science.gov (United States)

    Kawashiri, Shin-Ya; Fujikawa, Keita; Nishino, Ayako; Okada, Akitomo; Aramaki, Toshiyuki; Shimizu, Toshimasa; Umeda, Masataka; Fukui, Shoichi; Suzuki, Takahisa; Koga, Tomohiro; Iwamoto, Naoki; Ichinose, Kunihiro; Tamai, Mami; Mizokami, Akinari; Nakamura, Hideki; Origuchi, Tomoki; Ueki, Yukitaka; Aoyagi, Kiyoshi; Maeda, Takahiro; Kawakami, Atsushi

    2017-05-25

    In the present study, we explored the risk factors for relapse after discontinuation of biologic disease-modifying antirheumatic drug (bDMARD) therapy in patients with rheumatoid arthritis (RA) whose ultrasound power Doppler (PD) synovitis activity and clinical disease activity were well controlled. In this observational study in clinical practice, the inclusion criteria were based on ultrasound disease activity and clinical disease activity, set as low or remission (Disease Activity Score in 28 joints based on erythrocyte sedimentation rate Ultrasound was performed in 22 joints of bilateral hands at discontinuation for evaluating synovitis severity and presence of bone erosion. Patients with a maximum PD score ≤1 in each joint were enrolled. Forty patients with RA were consecutively recruited (November 2010-March 2015) and discontinued bDMARD therapy. Variables at the initiation and discontinuation of bDMARD therapy that were predictive of relapse during the 12 months after discontinuation were assessed. The median patient age was 54.5 years, and the median disease duration was 3.5 years. Nineteen (47.5%) patients relapsed during the 12 months after the discontinuation of bDMARD therapy. Logistic regression analysis revealed that only the presence of bone erosion detected by ultrasound at discontinuation was predictive of relapse (OR 8.35, 95% CI 1.78-53.2, p = 0.006). No clinical characteristics or serologic biomarkers were significantly different between the relapse and nonrelapse patients. The ultrasound synovitis scores did not differ significantly between the groups. Our findings are the first evidence that ultrasound bone erosion may be a relapse risk factor after the discontinuation of bDMARD therapy in patients with RA whose PD synovitis activity and clinical disease activity are well controlled.

  20. Active Crohn's disease is associated with low vitamin D levels

    DEFF Research Database (Denmark)

    Jørgensen, Søren Peter; Hvas, Christian Lodberg; Agnholt, Jørgen

    2013-01-01

    activity is associated with low vitamin D levels. METHODS: In a cross-sectional study of 182 CD patients and 62 healthy controls, we measured serum 25-OH vitamin D. Stratified analysis was used to compare 25-OH vitamin D levels with Crohn's disease activity index, C-reactive protein, smoking status, intake...... of oral vitamin D supplements and seasonal variation in CD patients and healthy controls. RESULTS: Serum 25-OH vitamin D was inversely associated with disease activity: Median 25-OH vitamin D levels of Crohn's disease in remission, mildly, and moderately active diseases evaluated by Crohn's disease...... D levels (51nmol/l) than patients who did not smoke (76nmol/l), plevels. CONCLUSIONS: Active Crohn's disease was associated with low serum 25-OH vitamin D. Patients who smoked had lower 25-OH...

  1. Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity.

    Science.gov (United States)

    Haliloglu, Sema; Carlioglu, Ayse; Akdeniz, Derya; Karaaslan, Yasar; Kosar, Ali

    2014-09-01

    Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain and the presence of specific tender points. The prevalence of FM has been estimated at 2-7 % of the general global population. The presence of FM in several rheumatic diseases with a structural pathology has been reported as 11-30 %. The objectives of this study were to determine the prevalence of FM and to evaluate the possible relationship between FM existence and disease activity among rheumatic diseases. The study group included 835 patients--197 rheumatoid arthritis (RA), 67 systemic lupus erythematosus (SLE), 119 ankylosing spondylitis (AS), 238 osteoarthritis (OA), 14 familial Mediterranean fever (FMF), 53 Behçet's disease (BD), 71 gout, 25 Sjögren's syndrome (SS), 20 vasculitis, 29 polymyalgia rheumatica (PMR), and two polymyositis (PM)--with or without FM. Recorded information included age, gender, laboratory parameters, presence of fatigue, and disease activity indexes. The prevalence of FM in patients with rheumatologic diseases was found to be 6.6 % for RA, 13.4 % for SLE, 12.6 % for AS, 10.1 % for OA, 5.7 % for BD, 7.1 % for FMF, 12 % for SS, 25 % for vasculitis, 1.4 % for gout, and 6.9 % for PMR. One out of two patients with PM was diagnosed with FM. Some rheumatologic cases (AS, OA) with FM were observed mostly in female patients (p = 0.000). Also, there were significant correlations between disease activity indexes and Fibromyalgia Impact Questionnaire scores for most rheumatologic patients (RA, AS, OA, and BD) (p diseases, and its recognition is important for the optimal management of these diseases. Increased pain, physical limitations, and fatigue may be interpreted as increased activity of these diseases, and a common treatment option is the prescription of higher doses of biologic agents or corticosteroids. Considerations of the FM component in the management of rheumatologic diseases increase the likelihood of the success of the treatment.

  2. Auditing the Physical Activity and Parkinson Disease Literature Using the Behavioral Epidemiologic Framework.

    Science.gov (United States)

    Swank, Chad; Shearin, Staci; Cleveland, Samantha; Driver, Simon

    2017-06-01

    Motor and nonmotor symptoms associated with Parkinson disease place individuals at greater risk of sedentary behaviors and comorbidities. Physical activity is one modifiable means of improving health and reducing the risk of morbidity. We applied a behavioral framework to classify existing research on physical activity and Parkinson disease to describe the current evolution and inform knowledge gaps in this area. Research placed in phase 1 establishes links between physical activity and health-related outcomes; phase 2 develops approaches to quantify physical activity behavior; phase 3 identifies factors associated with implementation of physical activity behaviors; phase 4 assesses the effectiveness of interventions to promote activity; and phase 5 disseminates evidence-based recommendations. Peer-reviewed literature was identified by searching PubMed, Google Scholar, and EBSCO-host. We initially identified 287 potential articles. After further review, we excluded 109 articles, leaving 178 included articles. Of these, 75.84% were categorized into phase 1 (n = 135), 10.11% in phase 2 (n = 18), 9.55% into phase 3 (n = 17), 3.37% into phase 4 (n = 6), and 1.12% into phase 5 (n = 2). By applying the behavioral framework to the physical activity literature for people with Parkinson disease, we suggest this area of research is nascent with more than 75% of the literature in phase 1. III. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  3. The prosurvival activity of ascites against TRAIL is associated with a shorter disease-free interval in patients with ovarian cancer

    Directory of Open Access Journals (Sweden)

    Lane Denis

    2010-01-01

    Full Text Available Abstract Background The production of ascites is a common complication of ovarian cancer. Ascites constitute a unique tumor microenvironment that may affect disease progression. In this context, we recently showed that ovarian cancer ascites may protect tumor cells from TRAIL-induced apoptosis. In this study, we sought to determine whether the prosurvival effect of ascites affects disease-free intervals. Methods Peritoneal fluids were obtained from 54 women undergoing intra-abdominal surgery for suspected ovarian cancer (44 cancers and 10 benign diseases. The ability of peritoneal fluids to protect from TRAIL was assessed in the ovarian cancer cell line CaOV3, and IC50 were determined. The anti-apoptotic activity of 6 ascites against cisplatin, paclitaxel, doxorubicin, etoposide and vinorelbine was also assessed in CaOV3 cells, and the prosurvival activity of two ascites was assessed in 9 primary ovarian cancer cultures. Results Among the 54 peritoneal fluids tested, inhibition of TRAIL cytotoxicity was variable. Fluids originating from ovarian cancer were generally more protective than fluids from non-malignant diseases. Most of the 44 ovarian cancer ascites increased TRAIL IC50 and this inhibitory effect did not correlate strongly with the protein concentration in these ascites or the levels of serum CA125, a tumor antigen which is used in the clinic as a marker of tumor burden. The effect of ascites on cisplatin- and paclitaxel-induced cell death was assessed with 4 ascites having inhibitory effect on TRAIL-induced cell death and 2 that do not. The four ascites with prosurvival activity against TRAIL had some inhibitory on cisplatin and/or paclitaxel. Two ovarian cancer ascites, OVC346 and OVC509, also inhibited TRAIL cytotoxicity in 9 primary cultures of ovarian tumor and induced Akt activation in three of these primary cultures. Among a cohort of 35 patients with ascites, a threshold of TRAIL IC50 with ascites/IC50 without ascites > 2 was

  4. Antibacterial Activity of Marine and Black Band Disease Cyanobacteria against Coral-Associated Bacteria

    Science.gov (United States)

    Gantar, Miroslav; Kaczmarsky, Longin T.; Stanić, Dina; Miller, Aaron W.; Richardson, Laurie L.

    2011-01-01

    Black band disease (BBD) of corals is a cyanobacteria-dominated polymicrobial disease that contains diverse populations of heterotrophic bacteria. It is one of the most destructive of coral diseases and is found globally on tropical and sub-tropical reefs. We assessed ten strains of BBD cyanobacteria, and ten strains of cyanobacteria isolated from other marine sources, for their antibacterial effect on growth of heterotrophic bacteria isolated from BBD, from the surface mucopolysaccharide layer (SML) of healthy corals, and three known bacterial coral pathogens. Assays were conducted using two methods: co-cultivation of cyanobacterial and bacterial isolates, and exposure of test bacteria to (hydrophilic and lipophilic) cyanobacterial cell extracts. During co-cultivation, 15 of the 20 cyanobacterial strains tested had antibacterial activity against at least one of the test bacterial strains. Inhibition was significantly higher for BBD cyanobacteria when compared to other marine cyanobacteria. Lipophilic extracts were more active than co-cultivation (extracts of 18 of the 20 strains were active) while hydrophilic extracts had very limited activity. In some cases co-cultivation resulted in stimulation of BBD and SML bacterial growth. Our results suggest that BBD cyanobacteria are involved in structuring the complex polymicrobial BBD microbial community by production of antimicrobial compounds. PMID:22073011

  5. Vitamin D is not useful as a biomarker for disease activity in rheumatoid arthritis.

    Science.gov (United States)

    de la Torre Lossa, Paola; Moreno Álvarez, Mario; González Guzmán, María Del Carmen; López Martínez, Rafael; Ríos Acosta, Carlos

    2018-05-17

    To determine whether there is an association between serum vitamin D levels and the Disease Activity Index in patients with rheumatoid arthritis (RA). An analytical, retrospective, cross-sectional study was performed at the Hospital Luis Vernaza and Center for Rheumatology and Rehabilitation. We included 18 to 75-year-old patients with a diagnosis of RA according to the 2010 classification criteria, and with a 25-hydroxyvitamin D (25 [OH] D) test within the last 3 months. The activity of the disease was assessed with the 28-joint Disease Activity Score (DAS28) and C-reactive protein (CRP) as an acute-phase reactant. Spearman's rank correlation coefficient was used to establish association between the variables. A total of 100 RA patients were studied. The mean vitamin D levels were 32.9 ± 11.5 ng/mL. In all, 45% showed insufficient 25 (OH) D and 55% had normal levels; no deficient vitamin D values were found. According to the DAS28-CRP, patients with low, moderate and high activity had an average vitamin D level of 30.4 ± 10.7, 31.9 ± 10.7, and 31.8 ± 12.1 ng/mL, respectively. There were no significant correlations between the disease activity and the serum vitamin D level (P=.60). In our group of RA patients, there was no statistically significant correlation between the levels of vitamin D and the activity of the disease, nor were other determining variables associated with vitamin D levels. Copyright © 2018 Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Bacterial colonization of colonic crypt mucous gel and disease activity in ulcerative colitis.

    LENUS (Irish Health Repository)

    Rowan, Fiachra

    2012-02-01

    OBJECTIVE: To optimize total bacterial 16S rRNA quantification in microdissected colonic crypts in healthy controls and patients with ulcerative colitis (UC) and to characterize the findings with disease activity. BACKGROUND: Microscopic and molecular techniques have recently converged to allow bacterial enumeration in remote anatomic locations [eg, crypt-associated mucous gel (CAMG)]. The aims of this study were to combine laser capture microdissection (LCM) and 16S rRNA-based quantitative polymerase chain reaction (qPCR) to determine total bacterial copy number in CAMG both in health and in UC and to characterize the findings with disease activity. METHODS: LCM was used to microdissect CAMG from colonic mucosal biopsies from controls (n = 20) and patients with acute (n = 10) or subacute (n = 10) UC. Pan-bacterial 16S rRNA copy number per millimeter square in samples from 6 locations across the large bowel was obtained by qPCR using Desulfovibrio desulfuricans as a reference strain. Copy numbers were correlated with the UC disease activity index (UCDAI) and the simple clinical colitis activity index (SCCAI). RESULTS: Bacterial colonization of CAMG was detectable in all groups. Copy numbers were significantly reduced in acute UC. In subacute colitis, there was a positive correlation between copy number and UCDAI and SCCAI in the ascending, transverse and sigmoid colon. CONCLUSIONS: This study describes a sensitive method of quantitatively assessing bacterial colonization of the colonic CAMG. A positive correlation was found between CAMG bacterial load and subacute disease activity in UC, whereas detectable bacterial load was reduced in acute UC.

  7. Chronic Active Epstein-Barr Virus Disease.

    Science.gov (United States)

    Kimura, Hiroshi; Cohen, Jeffrey I

    2017-01-01

    Chronic active Epstein-Barr virus (CAEBV) disease is a rare disorder in which persons are unable to control infection with the virus. The disease is progressive with markedly elevated levels of EBV DNA in the blood and infiltration of organs by EBV-positive lymphocytes. Patients often present with fever, lymphadenopathy, splenomegaly, EBV hepatitis, or pancytopenia. Over time, these patients develop progressive immunodeficiency and if not treated, succumb to opportunistic infections, hemophagocytosis, multiorgan failure, or EBV-positive lymphomas. Patients with CAEBV in the United States most often present with disease involving B or T cells, while in Asia, the disease usually involves T or NK cells. The only proven effective treatment for the disease is hematopoietic stem cell transplantation. Current studies to find a cause of this disease focus on immune defects and genetic abnormalities associated with the disease.

  8. Chronic Active Epstein–Barr Virus Disease

    Directory of Open Access Journals (Sweden)

    Hiroshi Kimura

    2017-12-01

    Full Text Available Chronic active Epstein–Barr virus (CAEBV disease is a rare disorder in which persons are unable to control infection with the virus. The disease is progressive with markedly elevated levels of EBV DNA in the blood and infiltration of organs by EBV-positive lymphocytes. Patients often present with fever, lymphadenopathy, splenomegaly, EBV hepatitis, or pancytopenia. Over time, these patients develop progressive immunodeficiency and if not treated, succumb to opportunistic infections, hemophagocytosis, multiorgan failure, or EBV-positive lymphomas. Patients with CAEBV in the United States most often present with disease involving B or T cells, while in Asia, the disease usually involves T or NK cells. The only proven effective treatment for the disease is hematopoietic stem cell transplantation. Current studies to find a cause of this disease focus on immune defects and genetic abnormalities associated with the disease.

  9. Lung disease associated with progressive systemic sclerosis. Assessment of interlobar variation by bronchoalveolar lavage and comparison with noninvasive evaluation of disease activity

    International Nuclear Information System (INIS)

    Miller, K.S.; Smith, E.A.; Kinsella, M.; Schabel, S.I.; Silver, R.M.

    1990-01-01

    Progressive systemic sclerosis (PSS), or scleroderma, is a disease of unknown etiology that involves many organ systems, including the lungs. The interstitial lung disease of systemic sclerosis is becoming an increasing cause of morbidity and mortality. This process has been previously evaluated with single-site bronchoalveolar lavage (BAL), gallium scanning, pulmonary function testing, and, occasionally, by open lung biopsy. As BAL has been shown to correlate well with open lung biopsy in systemic sclerosis, we sought to determine if single-site BAL accurately reflects alveolitis in a second site in the lung, and if BAL results correlate with other noninvasive tests of lung inflammation: gallium uptake, chest radiography, or arterial blood gas analysis. We performed 17 studies in 13 patients with scleroderma and found no significant lobar differences in lavage results or gallium scanning. By our criteria for normal versus active alveolitis, only two of 17 patient lavages would have been classified as normal by one side and abnormal by the other side. Although percent gallium uptake was equal bilaterally and supported the concept of alveolitis uniformity, gallium uptake intensity did not correlate with activity as measured by BAL. Furthermore, chest radiograph and arterial blood gas analysis did not correlate with BAL results or gallium scanning. We believe these data support the suitability of single-site lavage in the investigation of systemic-sclerosis-associated alveolitis and diminish the importance of gallium scanning in the investigation of systemic sclerosis pulmonary disease

  10. Plasma chitotriosidase activity versus CCL18 level for assessing type I Gaucher disease severity: protocol for a systematic review with meta-analysis of individual participant data.

    Science.gov (United States)

    Raskovalova, Tatiana; Deegan, Patrick B; Yang, Ruby; Pavlova, Elena; Stirnemann, Jérome; Labarère, José; Zimran, Ari; Mistry, Pramod K; Berger, Marc

    2017-04-20

    Gaucher disease (GD) is an autosomal recessive lysosomal storage disorder caused by deficiency in acid beta-glucosidase. GD exhibits a wide clinical spectrum of disease severity with an unpredictable natural course. Plasma chitotriosidase activity and CC chemokine ligand 18 (CCL18) have been exchangeably used for monitoring GD activity and response to enzyme replacement therapy in conjunction with clinical assessment. Yet, a large-scale head-to-head comparison of these two biomarkers is currently lacking. We propose a collaborative systematic review with meta-analysis of individual participant data (IPD) to compare the accuracy of plasma chitotriosidase activity and CCL18 in assessing type I (i.e., non-neuropathic) GD severity. Eligible studies include cross-sectional, cohort, and randomized controlled studies recording both plasma chitotriosidase activity and CCL18 level at baseline and/or at follow-up in consecutive children or adult patients with type I GD. Pre-specified surrogate outcomes reflecting GD activity include liver and spleen volume, hemoglobin concentration, platelet count, and symptomatic bone events with imaging confirmation. Primary studies will be identified by searching Medline (1995 onwards), EMBASE (1995 onwards), and Cochrane Central Register of Controlled Trials (CENTRAL). Electronic search will be complemented by contacting research groups in order to identify unpublished relevant studies. Where possible, IPD will be extracted from published articles. Corresponding authors will be invited to collaborate by supplying IPD. The methodological quality of retrieved studies will be appraised for each study outcome, using a checklist adapted from the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The primary outcome will be a composite of liver volume >1.25 multiple of normal (MN), spleen volume >5 MN, hemoglobin concentration <11 g/dL, or platelet count <100 × 10 9 /L. Effect size estimates for biomarker comparative accuracy in

  11. Pulmonary MR imaging with ultra-short TEs: Utility for disease severity assessment of connective tissue disease patients

    International Nuclear Information System (INIS)

    Ohno, Yoshiharu; Nishio, Mizuho; Koyama, Hisanobu; Takenaka, Daisuke; Takahashi, Masaya; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Obara, Makoto; Cauteren, Marc van; Sugimura, Kazuro

    2013-01-01

    Purpose: To evaluate the utility of pulmonary magnetic resonance (MR) imaging with ultra-short echo times (UTEs) at a 3.0 T MR system for pulmonary functional loss and disease severity assessments of connective tissue disease (CTD) patients with interstitial lung disease (ILD). Materials and methods: This prospective study was approved by the institutional review board, and written informed consent was obtained from 18 CTD patients (eight men and ten women) and eight normal subjects with suspected chest disease (three men and five women). All subjects underwent thin-section MDCT, pulmonary MR imaging with UTEs, pulmonary function test and serum KL-6. Regional T2* maps were generated from each MR data set, and mean T2* values were determined from ROI measurements. From each thin-section MDCT data set, CT-based disease severity was evaluated with a visual scoring system. Mean T2* values for normal and CTD subjects were statistically compared by using Student's t-test. To assess capability for pulmonary functional loss and disease severity assessments, mean T2* values were statistically correlated with pulmonary functional parameters, serum KL-6 and CT-based disease severity. Results: Mean T2* values for normal and CTD subjects were significantly different (p = 0.0019) and showed significant correlations with %VC, %DL CO , serum KL-6 and CT-based disease severity of CTD patients (p < 0.05). Conclusion: Pulmonary MR imaging with UTEs is useful for pulmonary functional loss and disease severity assessments of CTD patients with ILD

  12. Pulmonary MR imaging with ultra-short TEs: Utility for disease severity assessment of connective tissue disease patients

    Energy Technology Data Exchange (ETDEWEB)

    Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.jp [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Nishio, Mizuho [Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Koyama, Hisanobu [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Takenaka, Daisuke [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Department of Radiology, Hyogo Cancer Center, Akashi, Hyogo (Japan); Takahashi, Masaya [Advanced Imaging Research Center, Department of Radiology, University of Texas Southwestern Medical Center, Houston, TX (United States); Yoshikawa, Takeshi; Matsumoto, Sumiaki [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Obara, Makoto; Cauteren, Marc van [Philips Electronics Japan, Tokyo (Japan); Sugimura, Kazuro [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan)

    2013-08-15

    Purpose: To evaluate the utility of pulmonary magnetic resonance (MR) imaging with ultra-short echo times (UTEs) at a 3.0 T MR system for pulmonary functional loss and disease severity assessments of connective tissue disease (CTD) patients with interstitial lung disease (ILD). Materials and methods: This prospective study was approved by the institutional review board, and written informed consent was obtained from 18 CTD patients (eight men and ten women) and eight normal subjects with suspected chest disease (three men and five women). All subjects underwent thin-section MDCT, pulmonary MR imaging with UTEs, pulmonary function test and serum KL-6. Regional T2* maps were generated from each MR data set, and mean T2* values were determined from ROI measurements. From each thin-section MDCT data set, CT-based disease severity was evaluated with a visual scoring system. Mean T2* values for normal and CTD subjects were statistically compared by using Student's t-test. To assess capability for pulmonary functional loss and disease severity assessments, mean T2* values were statistically correlated with pulmonary functional parameters, serum KL-6 and CT-based disease severity. Results: Mean T2* values for normal and CTD subjects were significantly different (p = 0.0019) and showed significant correlations with %VC, %DL{sub CO}, serum KL-6 and CT-based disease severity of CTD patients (p < 0.05). Conclusion: Pulmonary MR imaging with UTEs is useful for pulmonary functional loss and disease severity assessments of CTD patients with ILD.

  13. The Harvard Automated Phone Task: new performance-based activities of daily living tests for early Alzheimer's disease.

    Science.gov (United States)

    Marshall, Gad A; Dekhtyar, Maria; Bruno, Jonathan M; Jethwani, Kamal; Amariglio, Rebecca E; Johnson, Keith A; Sperling, Reisa A; Rentz, Dorene M

    2015-12-01

    Impairment in activities of daily living is a major burden for Alzheimer's disease dementia patients and caregivers. Multiple subjective scales and a few performance-based instruments have been validated and proven to be reliable in measuring instrumental activities of daily living in Alzheimer's disease dementia but less so in amnestic mild cognitive impairment and preclinical Alzheimer's disease. To validate the Harvard Automated Phone Task, a new performance-based activities of daily living test for early Alzheimer's disease, which assesses high level tasks that challenge seniors in daily life. In a cross-sectional study, the Harvard Automated Phone Task was associated with demographics and cognitive measures through univariate and multivariate analyses; ability to discriminate across diagnostic groups was assessed; test-retest reliability with the same and alternate versions was assessed in a subset of participants; and the relationship with regional cortical thickness was assessed in a subset of participants. Academic clinical research center. One hundred and eighty two participants were recruited from the community (127 clinically normal elderly and 45 young normal participants) and memory disorders clinics at Brigham and Women's Hospital and Massachusetts General Hospital (10 participants with mild cognitive impairment). As part of the Harvard Automated Phone Task, participants navigated an interactive voice response system to refill a prescription (APT-Script), select a new primary care physician (APT-PCP), and make a bank account transfer and payment (APT-Bank). The 3 tasks were scored based on time, errors, and repetitions from which composite z-scores were derived, as well as a separate report of correct completion of the task. We found that the Harvard Automated Phone Task discriminated well between diagnostic groups (APT-Script: p=0.002; APT-PCP: pHarvard Automated Phone Task and executive function (APT-PCP: pHarvard Automated Phone Task, which

  14. Chagas disease. A new pathophysiological assessment

    International Nuclear Information System (INIS)

    Redruello, M.; Masoli, O.; Hasson, I.; Cragnolino, D.; Traverso, S.; Perez Balino, N.; Sarmiento, R.; Lazzari, J.; Luluaga, E.

    2002-01-01

    Background: There is scarce information on myocardial perfusion abnormalities and on the coronary vasomotor condition in Chagas disease patients. Aims: To assess regional perfusion abnormalities and the coronary vasomotor response of patients in the chronic phase of Chagas disease. Methods: With the use of 99mTc-sestamibi SPECT imaging and cold pressor test and intracoronary acetylcoline (ACH) perfusion, we studied 9 patients aged 42,6±12 years, 4 males, in the chronic stage of Chagas disease (5 with the indeterminate form and 4 with heart lesion) with normal coronary arteries. Vasomotor responses to intracoronary increasing doses of ACH and to a single dose of nitroglycerine (NTG) were assessed with digital quantitative angiography. Regional myocardial perfusion was evaluated at rest and after cold pressor test by a semi quantitative score analysis in an 18-segment model with 99mTc-sestamibi SPECT images. Results were expressed as mean ± 2SD. Differences between continuous variables were measured by two tails Student's t test for paired variables and the significance level was set at 5 %. Results: All patients had regional perfusion defects and abnormal vasomotor response. The diameter of the left anterior descending artery decreased 34% from a basal diameter of 3.66∫0.95 mm down to 2.42±0.74 mm after maximal response to ACH (p<0.002). NTG infusion augmented its diameter to 3.86±0.77 mm (p<0.0002) that is a 60% increase from post ACH diameter. Myocardial perfusion score was 1∫2.66 at rest and 6.22±3.6 after cold pressor test (p<0.0001). Conclusions: This group of patients in the chronic phase of Chagas disease showed an abnormal vasoconstrictive response to intracoronary ACH and cold-induced perfusion defects suggesting that endothelial dysfunction plays a role in the pathophysiology of chronic Chagas heart disease

  15. [Musical Inactivity - A Risk Factor? A Short Questionnaire to Assess Musical Activity (MusA)].

    Science.gov (United States)

    Fernholz, Isabel; Menzel, Juliane; Jabusch, Hans-Christian; Gembris, Heiner; Fischer, Felix; Kendel, Friederike; Kreutz, Gunter; Schmidt, Alexander; Willich, Stefan N; Weikert, Cornelia

    2018-02-27

    There is only a limited number of studies on associations between musical activity and health issues. It seems that musical activity has physiological and psychological benefits, as well as effects on the mental capacity, but this has been studied only in a few clinical and epidemiological studies. One reason might be that no appropriate survey instrument assessing musical activity is available. Here we provide an overview of survey instruments that assess musicality and musical activity. One focus is the presentation of a newly developed German questionnaire (MusA), which assesses musical activity (active music making and music reception) and was specifically developed for the "German National Cohort", a German health study. Through literature research, questionnaires were identified that assess musicality and / or musical activity. A new German questionnaire was developed from a panel of experts and tested in a small study (n=121, women and men age 18-70 years). In the literature research, 3 questionnaires were identified which focus on musicality and musical activity with different aspects (Gold-MSI, MUSE, MEQ). All 3 instruments may be characterized as large psychometric scales, which especially assess aspects of musicality in the English language. The Gold-MSI is additionally available in German. None of the existing questionnaires covers musical activities in detail. A new short German questionnaire consisting of 9 questions with a maximum filling time of 3-5 min has been developed. There are few questionnaires available for assessing musicality and musical activity with different aspects. The newly developed MusA in the German language focuses on the assessment of musical activity and is intended to be used in larger, population-based as well as clinical studies, to examine music activities and listening to music as independent factors in connection with prevention and therapy of chronic diseases. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Can Diet and Physical Activity Limit Alzheimer's Disease Risk?

    Science.gov (United States)

    Rege, Shraddha D; Geetha, Thangiah; Broderick, Tom L; Babu, Jeganathan Ramesh

    2017-01-01

    Alzheimer's disease (AD) is a progressive neurodegenerative disease affecting elderly individuals at an alarming rate. It has become a global health crisis imposing tremendous social and economic burden on society. Although there is no cure for AD, it is important to identify and implement preventive strategies that may delay or prevent the symptoms, limit the burden, and improve the quality of life of those afflicted. Adequate nutrition and physical activity are the two potential lifestyle modifiable factors that have gained considerable interest for their potential in the prevention or management of this challenging disease. In this review, we discuss the beneficial effects of physical activity and adequate nutrition on minimizing the risk of developing AD. The research question was initially formulated in a structured and explicit way. Relevant studies were identified using a wide range of scientific databases. Their potential relevance was based on the criteria for inclusion and exclusion. The quality of selected studies was subjected to a more precise quality assessment using standard tools. A detailed description of the implemented intervention and how it differed from what the control group received was outlined. The effects of intervention on measurable outcomes for the study sample were applied. One hundred and sixty-four references were included in the review comprising of epidemiological, longitudinal, cross-sectional, intervention and randomized controlled studies. This review highlighted the effect of various nutrient diet supplements on cognitive performance in humans as well as animals with AD and mild cognitive impairment (MCI). Moreover, the effect of physical exercise on the cognitive function in animal models with AD was outlined. The findings of this review highlight the therapeutic potential of combination of nutritionally adequate diet and physical activity in preventing or delaying the symptoms associated with AD pathology.

  17. Physical activity, obesity and cardiovascular diseases.

    Science.gov (United States)

    Lakka, T A; Bouchard, C

    2005-01-01

    Sedentary lifestyle and overweight are major public health, clinical, and economical problems in modern societies. The worldwide epidemic of excess weight is due to imbalance between physical activity and dietary energy intake. Sedentary lifestyle, unhealthy diet, and consequent overweight and obesity markedly increase the risk of cardiovascular diseases. Regular physical activity 45-60 min per day prevents unhealthy weight gain and obesity, whereas sedentary behaviors such as watching television promote them. Regular exercise can markedly reduce body weight and fat mass without dietary caloric restriction in overweight individuals. An increase in total energy expenditure appears to be the most important determinant of successful exercise-induced weight loss. The best long-term results may be achieved when physical activity produces an energy expenditure of at least 2,500 kcal/week. Yet, the optimal approach in weight reduction programs appears to be a combination of regular physical activity and caloric restriction. A minimum of 60 min, but most likely 80-90 min of moderate-intensity physical activity per day may be needed to avoid or limit weight regain in formerly overweight or obese individuals. Regular moderate intensity physical activity, a healthy diet, and avoiding unhealthy weight gain are effective and safe ways to prevent and treat cardiovascular diseases and to reduce premature mortality in all population groups. Although the efforts to promote cardiovascular health concern the whole population, particular attention should be paid to individuals who are physically inactive, have unhealthy diets or are prone to weight gain. They have the highest risk for worsening of the cardiovascular risk factor profile and for cardiovascular disease. To combat the epidemic of overweight and to improve cardiovascular health at a population level, it is important to develop strategies to increase habitual physical activity and to prevent overweight and obesity in

  18. IL-8 as antibody therapeutic target in inflammatory diseases: Reduction of clinical activity in palmoplantar pustulosis

    DEFF Research Database (Denmark)

    Skov, L.; Beurskens, F.J.; Reitamo, S.

    2008-01-01

    IL-8 is a chemokine that has been implicated in a number of inflammatory diseases involving neutrophil activation. HuMab 10F8 is a novel fully human mAb against IL-8, which binds a discontinuous epitope on IL-8 overlapping the receptor binding site, and which effectively neutralizes IL-8-dependent...... human neutrophil activation and migration. We investigated whether interference in the cytokine network by HuMab 10F8 might benefit patients suffering from palmoplantar pustulosis, a chronic inflammatory skin disease. Treatment of patients with HuMab 10F8 was well tolerated and significantly reduced...... clinical disease activity at all five endpoints, which included a >= 50% reduction in the formation of fresh pustules. IL-8 neutralization was monitored at the site of inflammation by assessing exudates of palmoplantar pustulosis lesions. HuMab 10F8 sequestered IL-8 in situ, as observed by rapid dose...

  19. The potential of volatile organic compounds for the detection of active disease in patients with ulcerative colitis.

    Science.gov (United States)

    Smolinska, A; Bodelier, A G L; Dallinga, J W; Masclee, A A M; Jonkers, D M; van Schooten, F-J; Pierik, M J

    2017-05-01

    To optimise treatment of ulcerative colitis (UC), patients need repeated assessment of mucosal inflammation. Current non-invasive biomarkers and clinical activity indices do not accurately reflect disease activity in all patients and cannot discriminate UC from non-UC colitis. Volatile organic compounds (VOCs) in exhaled air could be predictive of active disease or remission in Crohn's disease. To investigate whether VOCs are able to differentiate between active UC, UC in remission and non-UC colitis. UC patients participated in a 1-year study. Clinical activity index, blood, faecal and breath samples were collected at each out-patient visit. Patients with clear defined active faecal calprotectin >250 μg/g and inactive disease (Simple Clinical Colitis Activity Index Non-UC colitis was confirmed by stool culture or radiological evaluation. Breath samples were analysed by gas chromatography time-of-flight mass spectrometry and kernel-based method to identify discriminating VOCs. In total, 72 UC (132 breath samples; 62 active; 70 remission) and 22 non-UC-colitis patients (22 samples) were included. Eleven VOCs predicted active vs. inactive UC in an independent internal validation set with 92% sensitivity and 77% specificity (AUC 0.94). Non-UC colitis patients could be clearly separated from active and inactive UC patients with principal component analysis. Volatile organic compounds can accurately distinguish active disease from remission in UC and profiles in UC are clearly different from profiles in non-UC colitis patients. VOCs have demonstrated potential as new non-invasive biomarker to monitor inflammation in UC. © 2017 John Wiley & Sons Ltd.

  20. Vitamin D insufficiency and deficiency in mexican patients with systemic lupus erythematosus: Prevalence and relationship with disease activity.

    Science.gov (United States)

    García-Carrasco, Mario; Mendoza-Pinto, Claudia; Etchegaray-Morales, Ivet; Soto-Santillán, Pamela; Jiménez-Herrera, Erick Alejandro; Robles-Sánchez, Viridiana; Rodríguez-Gallegos, Alma; Ramos-Varela, Araceli; Muñoz-Guarneros, Margarita; Ruiz-Argüelles, Alejandro

    To determine and compare the prevalence of vitamin D insufficiency and deficiency in patients with systemic lupus erythematosus (SLE) with and without disease activity. We made a comparative, observational, cross-sectional, prospective study of 137 women with SLE according to American College of Rheumatology criteria. Patients with chronic kidney disease, cancer, hyperparathyroidism, pregnancy, and lactation were excluded. Disease activity was assessed using the MEX-SLEDAI score: a score of ≥3 was considered as disease activity. Data were collected on diabetes mellitus, the use of corticosteroids, chloroquine, and immunosuppressants, photoprotection and vitamin D supplementation. Vitamin D levels were measured by chemiluminescent immunoassay: insufficiency was defined as serum 25-hydroxyvitamin D <30ng/ml and deficiency as <10ng/ml. 137 women with SLE (mean age 45.9±11.6 years, disease duration 7.7±3.4 years) were evaluated. Mean disease activity was 2 (0-8): 106 patients had no disease activity and 31 had active disease (77.4% versus 22.6%). Vitamin D insufficiency and deficiency was found in 122(89.0%) and 4 (2.9%) patients, respectively. There was no significant difference in vitamin D levels between patients with and without active disease (19.3±4.5 versus 19.7±6.8; P=.75). No correlation between the MEX-SLEDAI score (P=.21), photosensitivity, photoprotection, prednisone or chloroquine use and vitamin D supplementation was found. Women with SLE had a high prevalence of vitamin D insufficient. No association between vitamin D levels and disease activity was found. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  1. Usefulness of {sup 18}F FDG PET/CT in evaluating disease activity at different times in a patient with chronic periaortitis

    Energy Technology Data Exchange (ETDEWEB)

    Treglia, Giorgio; Stefanelli, Antonella; Mattoli, Maria Vittoria; Leccisotti, Lucia; Muoio, Barbara [Catholic Univ. of the Sacred Heart, Rome (Italy); Bertagna, Francesco [Univ. of Brescia, Brescia (Italy)

    2012-03-15

    We report the case of a 53 year old man with a chronic periaortitis (CP) in whom Fluorine 18 Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has been useful in assessing the disease extent at diagnosis, in evaluating the treatment response, in diagnosing the relapse, and in monitoring the disease activity during follow up. This case highlights the usefulness of FDG PET/CT at different times in patients with CP. CP is a rare inflammatory disorder that affects the abdominal aorta and the retroperitoneum. Imaging procedures are essential to diagnose and monitor the disease course. Ultrasonography may be used as first line screening test, and is particularly useful to monitor patients with hydronephrosis and aortic aneurysms. However, CT or magnetic resonance imaging (MRI) of the abdomen are currently considered the investigations of choice to diagnose CP. In active CP, the periaortic mass usually enhances on CT and MRI. Both these methods can be used to monitor the disease course of CP and to evaluate response to treatment. A note of caution: signs of vasculitis seen on MRI and CT may persist for some time, despite achievement of clinical remission. A further limitation of abdominal CT and MRI is that neither technique can detect vasculitis in vessels other than the abdominal aorta, which has been described in 43% of patients with CP. FDG PET/CT has been proposed as useful tool in inflammatory diseases, such as aortitis, because metabolic changes assessed by FDG PET/CT usually precede morphological changes assessed by conventional imaging methods. Our case highlights the usefulness of FDG PET/CT at different times in patients with CP. This method may be useful in assessing disease activity and extent at diagnosis, in evaluating the treatment response, in diagnosing the relapse, and in monitoring the disease during follow up.

  2. Cochlear Implants and Psychiatric Assessments: a Norrie Disease Case Report.

    Science.gov (United States)

    Jacques, Denis; Dubois, Thomas; Zdanowicz, Nicolas; Gilain, Chantal; Garin, Pierre

    2017-09-01

    It is important to perform psychiatric assessments of adult patients who are candidates for cochlear implants both to screen them for psychiatric disorders and to assess their understanding and compliance with the procedure. Deafness is a factor of difficulty for conducting in-depth psychiatric interviews, but concomitant blindness may make it impossible. After a description of Norrie disease, a rare disease in which blindness and deafness may occur together, we propose a case report of a patient suffering from the disease and who consulted in view of a cochlear implant. Early information on cochlear implants appears to be necessary before total deafness occurs in patients suffering from Norrie disease. An inventory of digital communication tools that can be used by the patient is also highly valuable. Research should be supported for a more systematic use of psychiatric assessments prior to cochlear implants. In the special case of Norrie disease, we recommend early screening for mental retardation and related psychotic disorders and, depending on the patient's level of understanding, preventive information on the benefits and limits of cochlear implants before total deafness occurs.

  3. Thrombin-activatable fibrinolysis inhibitor activity in healthy and diseased dogs

    DEFF Research Database (Denmark)

    Jessen, Lisbeth Rem; Wiinberg, Bo; Kjelgaard-Hansen, Mads

    2010-01-01

    Background: In people, increased thrombin-activatable fibrinolysis inhibitor (TAFI) antigen has been associated with increased risk of thrombosis, and decreased TAFI may contribute to bleeding diathesis. TAFI activity in dogs has been described in experimental models, but not in dogs...... with spontaneous disease. Objective: The aim of this study was to compare TAFI activity in healthy dogs with TAFI activity in dogs with spontaneous disease. Methods: Plasma samples from 20 clinically healthy Beagles and from 35 dogs with various diseases were analyzed using a commercial chromogenic assay...... that measured TAFI activity relative to activity in standardized pooled human plasma. Results: Median TAFI activity for the 20 Beagles was 46.1% (range 32.2-70.8%) compared with 62.6% (29.1-250%) for the 35 diseased dogs, and 14/35 (40%) had TAFI activities >the upper limit for controls. The highest individual...

  4. Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog): Normative Data for the Portuguese Population.

    Science.gov (United States)

    Nogueira, Joana; Freitas, Sandra; Duro, Diana; Tábuas-Pereira, Miguel; Guerreiro, Manuela; Almeida, Jorge; Santana, Isabel

    2018-02-28

    The Alzheimer's Disease Assessment Scale - Cognitive Subscale is a brief battery developed to assess cognitive functioning in Alzheimer's disease that encompasses the core characteristics of cognitive decline (e.g. memory, language, praxis, constructive ability and orientation). The early detection, as well as the monitoring of cognitive decline along disease progression, is extremely important in clinical care and interventional research. The main goals of the present study were to analyze the psychometric properties of the Portuguese version of the Alzheimer's Disease Assessment Scale - Cognitive Subscale, and to establish normative values for the Portuguese population. The Portuguese version of Alzheimer's Disease Assessment Scale - Cognitive Subscale was administered to 223 cognitively healthy participants according to a standard assessment protocol consisting of the Mini-Mental State Examination, the Montreal Cognitive Assessment and the Adults and Older Adults Functional Assessment Inventory. Normal performance on the assessment protocol was the inclusion criteria for the study. The Alzheimer's Disease Assessment Scale - Cognitive Subscale revealed good psychometric properties when used in the Portuguese population. Age was the main predictor of the Alzheimer's Disease Assessment Scale - Cognitive Subscale total score (R2 = 0.123), whereas the influence of education level was lower (R2 = 0.027). These two variables explained 14.4% of the variance on the Alzheimer's Disease Assessment Scale - Cognitive Subscale scores and were used to stratify the normative values for the Portuguese population presented here. On the total sample, the average total score in the Alzheimer's Disease Assessment Scale - Cognitive Subscale was 6 points. The normative data were determined according to age and educational level as these were the sociodemographic variables that significantly contributed to the prediction of the Alzheimer's Disease Assessment Scale - Cognitive Subscale

  5. Non-invasive assessment determine the swallowing and respiration dysfunction in early Parkinson's disease.

    Science.gov (United States)

    Wang, Chin-Man; Shieh, Wann-Yun; Weng, Yi-Hsin; Hsu, Yi-Hsuan; Wu, Yih-Ru

    2017-09-01

    Dysphagia is common among patients with Parkinson's disease. Swallowing and its coordination with respiration is extremely important to achieve safety swallowing. Different tools have been used to assess this coordination, however the results have been inconsistent. We aimed to investigate this coordination in patients with Parkinson's disease using a non-invasive method. Signals of submental muscle activity, thyroid cartilage excursion, and nasal airflow during swallowing were recorded simultaneously. Five different water boluses were swallowed three times, and the data were recorded and analyzed. Thirty-seven controls and 42 patients with early-stage Parkinson's disease were included. The rates of non-expiratory/expiratory pre- and post-swallowing respiratory phase patterns were higher in the patients than in the controls (P Parkinson's disease, and safety compensation mechanisms were used more than efficiency during swallowing. The results of this study may serve as a baseline for further research into new treatment regimens and to improve the management of swallowing in patients with Parkinson's disease. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Dose assessment activities in the Republic of the Marshall Islands.

    Science.gov (United States)

    Simon, S L; Graham, J C

    1996-10-01

    Dose assessments, both retrospective and prospective, comprise one important function of a radiological study commissioned by the Republic of the Marshall Islands (RMI) government in late 1989. Estimating past or future exposure requires the synthesis of information from historical data, results from a recently completed field monitoring program, laboratory measurements, and some experimental studies. Most of the activities in the RMI to date have emphasized a pragmatic rather than theoretical approach. In particular, most of the recent effort has been expended on conducting an independent radiological monitoring program to determine the degree of deposition and the geographical extent of weapons test fallout over the nation. Contamination levels on 70% of the land mass of the Marshall Islands were unknown prior to 1994. The environmental radioactivity data play an integral role in both retrospective and prospective assessments. One recent use of dose assessment has been to interpret environmental measurements of radioactivity into annual doses that might be expected at every atoll. A second use for dose assessment has been to determine compliance with a dose action level for the rehabilitation of Rongelap Island. Careful examination of exposure pathways relevant to the island lifestyle has been necessary to accommodate these purposes. Examples of specific issues studied include defining traditional island diets as well as current day variations, sources of drinking water, uses of tropical plants including those consumed for food and for medicinal purposes, the nature and microvariability of plutonium particles in the soil and unusual pathways of exposure, e.g., that which might be associated with cooking and washing outdoors and inadvertent soil ingestion. A study on the prevalence of thyroid disease is also being conducted and the geographic pattern of disease may be useful as a bioindicator of the geographic pattern of exposure to radioiodine. Finally, an

  7. [Valvular heart disease: preoperative assessment and postoperative care].

    Science.gov (United States)

    Nägele, Reto; Kaufmann, Beat A

    2013-10-30

    Patients with valvular heart disease or with a prosthetic heart valve replacement are seen with increasing frequency in clinical practice. The medical care and evaluation of patients with valvular heart disease before valve surgery, but also the post-operative treatment is complex and managed by general practitioners, cardiologists and cardiac surgeons. In this mini-review we will first discuss the preoperative assessment of the two most common valvulopathies, aortic stenosis and mitral regurgitation. Then we will discuss the post-operative care, which includes the management of anticoagulation, serial follow up and as well as the diagnostic assessment of complications such as thromboembolism, hemolysis, endocarditis and valve dysfunction.

  8. Positive correlation between disease activity index and matrix metalloproteinases activity in a rat model of colitis.

    Science.gov (United States)

    Oliveira, Luiz Gustavo de; Cunha, André Luiz da; Duarte, Amaury Caiafa; Castañon, Maria Christina Marques Nogueira; Chebli, Júlio Maria Fonseca; Aguiar, Jair Adriano Kopke de

    2014-01-01

    Inflammatory bowel disease, including ulcerative colitis and Crohn's disease, comprising a broad spectrum of diseases those have in common chronic inflammation of the gastrointestinal tract, histological alterations and an increased activity levels of certain enzymes, such as, metalloproteinases. Evaluate a possible correlation of disease activity index with the severity of colonic mucosal damage and increased activity of metalloproteinases in a model of ulcerative colitis induced by dextran sulfate sodium. Colitis was induced by oral administration of 5% dextran sulfate sodium for seven days in this group (n=10), whereas control group (n=16) received water. Effects were analyzed daily by disease activity index. In the seventh day, animals were euthanized and hematological measurements, histological changes (hematoxylin and eosin and Alcian Blue staining), myeloperoxidase and metalloproteinase activities (MMP-2 and MMP-9) were determined. Dextran sulfate sodium group showed elevated disease activity index and reduced hematological parameters. Induction of colitis caused tissue injury with loss of mucin and increased myeloperoxidase (Pcorrelation with the degree of histopathological changes after induction of colitis, and this result may be related mainly to the increased activity of MMP-9 and mieloperoxidase.

  9. PET/CT colonography: a novel non-invasive technique for assessment of extent and activity of ulcerative colitis

    Energy Technology Data Exchange (ETDEWEB)

    Das, Chandan J.; Sharma, Raju [All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi (India); Makharia, Govind K.; Tiwari, Rajeew P. [All India Institute of Medical Sciences, Department of Gastroenterology and Human Nutrition, New Delhi (India); Kumar, Rakesh; Kumar, Rajender; Malhotra, Arun [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India)

    2010-04-15

    Extent of involvement and activity of ulcerative colitis (UC) is best evaluated by colonoscopy. Colonoscopy however carries risk during acute exacerbation. We investigated the utility of PET/CT colonography for assessment of extent and activity of UC. Within a 1-week window, 15 patients with mild to moderately active UC underwent colonoscopy and PET/CT colonography 60 min after injection of 10 mCi of {sup 18}F-fluorodeoxyglucose (FDG). PET activity score based on the amount of FDG uptake and endoscopic mucosal activity in seven colonic segments of each patient was recorded. The mean maximum standardized uptake value (SUV{sub max}) of seven segments was compared with activity in liver. A PET activity grade of 0, 1, 2 or 3 was assigned to each region depending upon their SUV{sub max} ratio (colon segment to liver). The extent of disease was left-sided colitis in five and pancolitis in ten. The mean Ulcerative Colitis Disease Activity Index (UCDAI) was 7.6. The number of segments involved as per colonoscopic evaluation and PET/CT colonography was 67 and 66, respectively. There was a good correlation for extent evaluation between the two modalities (kappa 55.3%, p = 0.02). One patient had grade 0 PET activity, nine had grade 2 and five had grade 3 PET activity. In six patients, there was one to one correlation between PET activity grades with that of endoscopic grade. One patient showed activity in the sacroiliac joint suggesting active sacroiliitis. PET/CT colonography is a novel non-invasive technique for the assessment of extent and activity of the disease in patients with UC. (orig.)

  10. Coping with Stress in Patients with Inflammatory Bowel Disease and Its Relationship with Disease Activity, Psychological Disorders, and Quality of Life

    Directory of Open Access Journals (Sweden)

    Manizheh Danesh

    2015-09-01

    Full Text Available Background: Inflammatory bowel diseases (IBD are chronic diseases with significant impact on patients’ well-being. The aim of this study was to determine stress coping strategies in IBD patients and their association with disease activity, psychological health, and quality of life (QOL.Methods: This cross-sectional study was conducted on IBD patients referred to a gastroenterology clinic in Isfahan city (Iran. Disease activity, severity of anxiety and depression symptoms, stress coping strategies, and QOL were assessed using self-administered questionnaires. Coping strategies in IBD patients were compared to an unaffected control group.Results: In the present study, 80 patients with mean age of 52.9 years (57.5% female and mean disease duration of 6.5 years were studied. Compared to the controls, IBD patients had higher scores in the maladaptive coping styles (evasive and palliative (P < 0.05. Association between coping strategies and disease activity was not significant. Severity of anxiety and depression was directly correlated with the maladaptive strategies (fatalistic and emotional (r = 0.283 to 0.468 and inversely correlated with the adaptive strategies (confrontive, optimistic, and self-reliant (r = -0.320 to -0.534. In addition, QOL was inversely correlated with the maladaptive strategies (fatalistic and emotional (r = -0.278 to -0.327 and directly correlated with the adaptive strategies (confrontive and optimistic (r = 0.262 to 0.355.Conclusion: Patients with IBD use more maladaptive and less adaptive stress coping strategies which are associated with their psychological health and QOL. Larger and prospective studies on the dynamic and interactive network of biopsychosocial factors in IBD patients are required.

  11. /sup 111/In autologous leucocytes in the diagnosis and assessment of inflammatory bowel disease. [Tropolone

    Energy Technology Data Exchange (ETDEWEB)

    Saverymuttu, S.H.; Peters, A.M.; Chadwick, V.S.; Hodgson, H.J.; Lavender, J.P. (Hammersmith Hospital, London (UK))

    1982-01-01

    Indium-111 autologous leukocyte scanning is now established as an effective method of localising sepsis (Ascher and others, 1980). In view of the extensive leucocyte infiltration of the intestinal wall in inflammatory bowel disease, the authors have prospectively studied the use of indium-111 labelled white cells in a variety of inflammatory bowel disorders. Leukocytes were labelled in 68 patients using /sup 111/In acetylacetonate and in 18 patients /sup 111/In tropolone. Crude mixed leukocytes preparations were used in 74 patients and pure neutrophil preparation used in 12 patients. Gamma scans over the abdomen were performed from 40 min later after re-injection of the labelled cells and assessed. /sup 111/In-tropolone labelling appeared to offer the advantage over /sup 111/In-acac labelling in localising inflamed bowel earlier. The technique of /sup 111/In-leukocyte scanning offers several advantages over the alternative technique of imaging diseased bowel using gallium-67 citrate. Indium-111 leukocyte scanning provides a novel approach to the problem of diagnosis and assessment of inflammatory bowel disease. It is non-invasive, requires no bowel preparation and this is safe in the acutely sick patient where conventional radiological imaging methods may be hazardous. /sup 111/In faecal excretion provides an objective assessment of disease activity which should prove useful in evaluating treatment regimes.

  12. COAGULATION ACTIVITY IN LIVER DISEASE

    Directory of Open Access Journals (Sweden)

    Dr. Sheikh Sajjadieh Mohammad Reza

    2009-07-01

    Full Text Available Patients with advanced hepatic failure may present with the entire spectrum of coagulation factor deficiencies. This study was designed to determine laboratory abnormalities in coagulation in chronic liver disease and the association of these abnormalities with the extent of chronic hepatitis and cirrhosis. Coagulation markers were assayed in 60 participants: 20 patients with chronic hepatitis, 20 patients with cirrhosis, and 20 healthy individuals (control. Plasma levels of anti-thrombin III were determined by a chromogenic substrate method, and plasma concentrations of fibrinogen were analyzed by the Rutberg method. Commercially available assays were used for laboratory coagulation tests. The levels of coagualation activity markers in patients with chronic liver disease were significantly different in comparison to those in healthy participants. These results indicate the utility of measuring markers for coagulation activity in determining which cirrhosis patients are more susceptible to disseminated intravascular coagulation.

  13. Dynamic 3D-MR-angiography for assessing rheumatoid disease of the hand—A feasibility study

    International Nuclear Information System (INIS)

    Notohamiprodjo, Mike; Glaser, Christian; Horng, Annie; Helck, Andreas; Bauner, Kerstin U.; Reiser, Maximilian F.; Hatz, Hans J.; Weckbach, Sabine

    2012-01-01

    Purpose: To investigate highly temporally resolved MR-angiography (MRA) with time-resolved imaging with stochastic trajectories (TWIST) of the hand as supplementary tool for dynamic assessment of synovitis and vascular pathologies in rheumatoid diseases. Material and methods: A coronal dynamic TWIST–MRA-sequence (0.7 mm × 0.7 mm × 1.4 mm, temporal resolution 2.5 s, time of acquisition 4 min) of the predominantly affected hand of 17 patients with suspected rheumatoid disease was acquired after contrast administration (Multihance, Bracco Imaging SpA) at 3 T (Magnetom VERIO, 8-channel-knee-coil, Siemens Healthcare). As standard of reference, contrast enhanced non fat-saturated coronal and fat-saturated axial T1-w sequences were acquired. These static sequences and the dynamic TWIST–MRA–maximum-intensity-projections (MIP) were separately assessed by two readers in consensus, recording the number of synovial lesions (wrist, intercarpal, metacarpophaleangal/proximal/distal interphalangeal joints), signs of tenosynovitis and vasculitis. Diagnostic confidence was rated (4-point-scale: 4 = excellent; 1 = non-diagnostic). Statistical significance was tested using the Wilcoxon-rank-sum-test. Results: An insignificantly lower number of synovial lesions (n = 72 vs. 89; p = 0.1) and only 3/9 cases with tenosynovitis were identified by the TWIST–MRA. For detected lesions, diagnostic confidence was comparable (MRA: 3.64; static T1-w post contrast: 3.47). In patients with high clinical activity dynamic MRA showed very early synovial enhancement. Only dynamic MRA detected 3 cases of vasculitis (subsequently confirmed with digital-subtraction-angiography). Conclusion: TWIST–MRA facilitates fast detection of synovitis. Although dynamic MRA of the hand is inferior to static contrast enhanced sequences in assessing the number of synovitic and tenosynovitic lesions, its high temporal resolution allows for fast visual grading of disease activity and assessment of vasculitis

  14. Contrast-enhanced MRI compared with the physical examination in the evaluation of disease activity in juvenile idiopathic arthritis

    International Nuclear Information System (INIS)

    Hemke, Robert; Maas, Mario; Veenendaal, Mira van; Kuijpers, Taco W.; Dolman, Koert M.; Rossum, Marion A.J. van; Berg, J.M. van den

    2014-01-01

    To assess the value of magnetic resonance imaging (MRI) in discriminating between active and inactive juvenile idiopathic arthritis (JIA) patients and to compare physical examination outcomes with MRI outcomes in the assessment of disease status in JIA patients. Consecutive JIA patients with knee involvement were prospectively studied using an open-bore MRI. Imaging findings from 146 JIA patients were analysed (59.6 % female; mean age, 12.9 years). Patients were classified as clinically active or inactive. MRI features were evaluated using the JAMRIS system, comprising validated scores for synovial hypertrophy, bone marrow oedema, cartilage lesions and bone erosions. Inter-reader reliability was good for all MRI features (intra-class correlation coefficient [ICC] = 0.87-0.94). No differences were found between the two groups regarding MRI scores of bone marrow oedema, cartilage lesions or bone erosions. Synovial hypertrophy scores differed significantly between groups (P = 0.016). Nonetheless, synovial hypertrophy was also present in 14 JIA patients (35.9 %) with clinically inactive disease. Of JIA patients considered clinically active, 48.6 % showed no signs of MRI-based synovitis. MRI can discriminate between clinically active and inactive JIA patients. However, physical examination is neither very sensitive nor specific in evaluating JIA disease activity compared with MRI. Subclinical synovitis was present in >35 % of presumed clinically inactive patients. (orig.)

  15. Gender, body mass index and rheumatoid arthritis disease activity: results from the QUEST-RA Study.

    Science.gov (United States)

    Jawaheer, D; Olsen, J; Lahiff, M; Forsberg, S; Lähteenmäki, J; da Silveira, I G; Rocha, F A; Magalhães Laurindo, I M; Henrique da Mota, L M; Drosos, A A; Murphy, E; Sheehy, C; Quirke, E; Cutolo, M; Rexhepi, S; Dadoniene, J; Verstappen, S M M; Sokka, T

    2010-01-01

    To investigate whether body mass index (BMI), as a proxy for body fat, influences rheumatoid arthritis (RA) disease activity in a gender-specific manner. Consecutive patients with RA were enrolled from 25 countries into the QUEST-RA program between 2005 and 2008. Clinical and demographic data were collected by treating rheumatologists and by patient self-report. Distributions of Disease Activity Scores (DAS28), BMI, age, and disease duration were assessed for each country and for the entire dataset; mean values between genders were compared using Student's t-tests. An association between BMI and DAS28 was investigated using linear regression, adjusting for age, disease duration and country. A total of 5,161 RA patients (4,082 women and 1,079 men) were included in the analyses. Overall, women were younger, had longer disease duration, and higher DAS28 scores than men, but BMI was similar between genders. The mean DAS28 scores increased with increasing BMI from normal to overweight and obese, among women, whereas the opposite trend was observed among men. Regression results showed BMI (continuous or categorical) to be associated with DAS28. Compared to the normal BMI range, being obese was associated with a larger difference in mean DAS28 (0.23, 95% CI: 0.11, 0.34) than being overweight (0.12, 95% CI: 0.03, 0.21); being underweight was not associated with disease activity. These associations were more pronounced among women, and were not explained by any single component of the DAS28. BMI appears to be associated with RA disease activity in women, but not in men.

  16. Functional Performance and Associations between Performance Tests and Neurological Assessment Differ in Men and Women with Parkinson's Disease.

    Science.gov (United States)

    Medijainen, Kadri; Pääsuke, Mati; Lukmann, Aet; Taba, Pille

    2015-01-01

    Neurological assessment of a patient with Parkinson's disease (PD) is expected to reflect upon functional performance. As women are known to report more limitations even for same observed functional performance level, present study was designed to examine whether associations between neurological assessments and functional performance differ across genders. 14 men and 14 women with PD participated. Functional performance was assessed by measuring walking speeds on 10-meter walk test (10MWT) and by performing timed-up-and-go-test (TUG). Neurological assessment included Hoehn and Yahr Scale (HY), Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Schwab and England Activities of Daily Living Scale (S-E), and Mini Mental State Examination (MMSE). In women with PD, Kendall's tau-b correlation analyses revealed significant correlations between functional performance tests and neurological assessment measures, with the exception in MMSE. No corresponding associations were found for men, although they demonstrated better functional performance, as expected. Men in similar clinical stage of the PD perform better on functional tests than women. Disease severity reflects upon functional performance differently in men and women with PD. Results indicate that when interpreting the assessment results of both functional performance and neurological assessment tests, the gender of the patient should be taken into consideration.

  17. The Harvard Automated Phone Task: new performance-based activities of daily living tests for early Alzheimer’s disease

    Science.gov (United States)

    Marshall, Gad A.; Dekhtyar, Maria; Bruno, Jonathan M.; Jethwani, Kamal; Amariglio, Rebecca E.; Johnson, Keith A.; Sperling, Reisa A.; Rentz, Dorene M.

    2015-01-01

    Background Impairment in activities of daily living is a major burden for Alzheimer’s disease dementia patients and caregivers. Multiple subjective scales and a few performance-based instruments have been validated and proven to be reliable in measuring instrumental activities of daily living in Alzheimer’s disease dementia but less so in amnestic mild cognitive impairment and preclinical Alzheimer’s disease. Objective To validate the Harvard Automated Phone Task, a new performance-based activities of daily living test for early Alzheimer’s disease, which assesses high level tasks that challenge seniors in daily life. Design In a cross-sectional study, the Harvard Automated Phone Task was associated with demographics and cognitive measures through univariate and multivariate analyses; ability to discriminate across diagnostic groups was assessed; test-retest reliability with the same and alternate versions was assessed in a subset of participants; and the relationship with regional cortical thickness was assessed in a subset of participants. Setting Academic clinical research center. Participants One hundred and eighty two participants were recruited from the community (127 clinically normal elderly and 45 young normal participants) and memory disorders clinics at Brigham and Women’s Hospital and Massachusetts General Hospital (10 participants with mild cognitive impairment). Measurements As part of the Harvard Automated Phone Task, participants navigated an interactive voice response system to refill a prescription (APT-Script), select a new primary care physician (APT-PCP), and make a bank account transfer and payment (APT-Bank). The 3 tasks were scored based on time, errors, and repetitions from which composite z-scores were derived, as well as a separate report of correct completion of the task. Results We found that the Harvard Automated Phone Task discriminated well between diagnostic groups (APT-Script: p=0.002; APT-PCP: pHarvard Automated Phone

  18. Development of an integral assessment approach of health status in patients with obstructive airway diseases: the CORONA study

    Directory of Open Access Journals (Sweden)

    van den Akker EF

    2015-11-01

    Full Text Available Edmée FMM van den Akker,1 Alex J van ‘t Hul,2 Niels H Chavannes,3 Gert-Jan Braunstahl,1 Alie van Bruggen,1 Maureen PMH Rutten-van Mölken,4 Johannes CCM in ‘t Veen1 1Department of Pulmonary Diseases, STZ Center of Excellence for Asthma & COPD, Sint Franciscus Gasthuis, Rotterdam, 2Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, 3Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, 4Department of Health Care Policy and Management, Institute of Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, the Netherlands Background: Traditional assessment of patients with obstructive lung diseases (asthma and chronic obstructive pulmonary disease; COPD relies on physiological tests. The COPD and Asthma Rotterdam Integrated Care Approach (CORONA study aims to develop a diagnostic pathway with a more comprehensive approach to the assessment of patients with asthma and COPD in secondary care.Methods: An eight-step method was used to develop and implement the pathway for patients with asthma or COPD referred to an outpatient hospital setting.Results: The diagnostic pathway consists of an evidence-based set of measurements prioritized by a Delphi procedure. The pathway incorporates three innovative diagnostics: the metronome-paced hyperventilation test to measure dynamic hyperinflation, an activity monitor to objectively evaluate physical activity in daily life, and the Nijmegen Clinical Screening Instrument as a comprehensive assessment tool to acquire detailed insight into symptoms, functional limitations, and quality of life.Conclusion: An innovative diagnostic pathway was developed and implemented for patients with obstructive lung diseases referred to secondary care. As this pathway aims to provide a comprehensive analysis of health status, it focuses on biomedical aspects and also reviews behavioral aspects that further elucidate the patient’s health status. The

  19. Oxygen-enhanced MRI for patients with connective tissue diseases: Comparison with thin-section CT of capability for pulmonary functional and disease severity assessment

    Energy Technology Data Exchange (ETDEWEB)

    Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.jp [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Nishio, Mizuho [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Koyama, Hisanobu [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Yoshikawa, Takeshi; Matsumoto, Sumiaki [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Seki, Shinichiro [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Tsubakimoto, Maho [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan); Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nakagami-Gun, Okinawa (Japan); Sugimura, Kazuro [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Hyogo (Japan)

    2014-02-15

    Purpose: To prospectively and directly compare oxygen-enhanced (O{sub 2}-enhanced) MRI with thin-section CT for pulmonary functional loss and disease severity assessment in connective tissue disease (CTD) patients with interstitial lung disease (ILD). Materials and methods: Thin-section CT, O{sub 2}-enhanced MRI, pulmonary function test and serum KL-6 were administered to 36 CTD patients with ILD (23 men, 13 women; mean age: 63.9 years) and nine CTD patients without ILD (six men, and three women; mean age: 62.0 years). A relative-enhancement ratio (RER) map was generated from O{sub 2}-enhanced MRI and mean relative enhancement ratio (MRER) for each subject was calculated from all ROI measurements. CT-assessed disease severity was evaluated with a visual scoring system from each of the thin-section CT data. MRER and CT-assessed disease severities of CTD patients with and without ILD were then statistically compared. To assess capability for pulmonary functional loss and disease severity assessment in CTD patients, correlations of MRER and CT-assessed disease severity with pulmonary functional parameters and serum KL-6 in all subjects were statistically determined. Results: MRER and CT-assessed disease severity showed significant differences between CTD patients with (MRER: 0.15 ± 0.08, CT-assessed disease severity: 13.0 ± 7.4%) and without ILD (MRER: 0.25 ± 0.06, p = 0.0011; CT-assessed disease severity: 1.6 ± 1.6%, p < 0.0001). MRER and CT-assessed disease severity correlated significantly with pulmonary functional parameters and serum KL-6 in all subjects (0.61 ≤ r ≤ 0.79, p < 0.05). Conclusion: O{sub 2}-enhanced MRI was found to be as useful as thin-section CT for pulmonary functional loss and disease severity assessment of CTD patients with ILD.

  20. Oxygen-enhanced MRI for patients with connective tissue diseases: Comparison with thin-section CT of capability for pulmonary functional and disease severity assessment

    International Nuclear Information System (INIS)

    Ohno, Yoshiharu; Nishio, Mizuho; Koyama, Hisanobu; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Seki, Shinichiro; Tsubakimoto, Maho; Sugimura, Kazuro

    2014-01-01

    Purpose: To prospectively and directly compare oxygen-enhanced (O 2 -enhanced) MRI with thin-section CT for pulmonary functional loss and disease severity assessment in connective tissue disease (CTD) patients with interstitial lung disease (ILD). Materials and methods: Thin-section CT, O 2 -enhanced MRI, pulmonary function test and serum KL-6 were administered to 36 CTD patients with ILD (23 men, 13 women; mean age: 63.9 years) and nine CTD patients without ILD (six men, and three women; mean age: 62.0 years). A relative-enhancement ratio (RER) map was generated from O 2 -enhanced MRI and mean relative enhancement ratio (MRER) for each subject was calculated from all ROI measurements. CT-assessed disease severity was evaluated with a visual scoring system from each of the thin-section CT data. MRER and CT-assessed disease severities of CTD patients with and without ILD were then statistically compared. To assess capability for pulmonary functional loss and disease severity assessment in CTD patients, correlations of MRER and CT-assessed disease severity with pulmonary functional parameters and serum KL-6 in all subjects were statistically determined. Results: MRER and CT-assessed disease severity showed significant differences between CTD patients with (MRER: 0.15 ± 0.08, CT-assessed disease severity: 13.0 ± 7.4%) and without ILD (MRER: 0.25 ± 0.06, p = 0.0011; CT-assessed disease severity: 1.6 ± 1.6%, p < 0.0001). MRER and CT-assessed disease severity correlated significantly with pulmonary functional parameters and serum KL-6 in all subjects (0.61 ≤ r ≤ 0.79, p < 0.05). Conclusion: O 2 -enhanced MRI was found to be as useful as thin-section CT for pulmonary functional loss and disease severity assessment of CTD patients with ILD

  1. Minimal Residual Disease Assessment in Lymphoma: Methods and Applications.

    Science.gov (United States)

    Herrera, Alex F; Armand, Philippe

    2017-12-01

    Standard methods for disease response assessment in patients with lymphoma, including positron emission tomography and computed tomography scans, are imperfect. In other hematologic malignancies, particularly leukemias, the ability to detect minimal residual disease (MRD) is increasingly influencing treatment paradigms. However, in many subtypes of lymphoma, the application of MRD assessment techniques, like flow cytometry or polymerase chain reaction-based methods, has been challenging because of the absence of readily detected circulating disease or canonic chromosomal translocations. Newer MRD detection methods that use next-generation sequencing have yielded promising results in a number of lymphoma subtypes, fueling the hope that MRD detection may soon be applicable in clinical practice for most patients with lymphoma. MRD assessment can provide real-time information about tumor burden and response to therapy, noninvasive genomic profiling, and monitoring of clonal dynamics, allowing for many possible applications that could significantly affect the care of patients with lymphoma. Further validation of MRD assessment methods, including the incorporation of MRD assessment into clinical trials in patients with lymphoma, will be critical to determine how best to deploy MRD testing in routine practice and whether MRD assessment can ultimately bring us closer to the goal of personalized lymphoma care. In this review article, we describe the methods available for detecting MRD in patients with lymphoma and their relative advantages and disadvantages. We discuss preliminary results supporting the potential applications for MRD testing in the care of patients with lymphoma and strategies for including MRD assessment in lymphoma clinical trials.

  2. Systematic review: questionnaires for assessment of gastroesophageal reflux disease.

    Science.gov (United States)

    Bolier, E A; Kessing, B F; Smout, A J; Bredenoord, A J

    2015-01-01

    Numerous questionnaires with a wide variety of characteristics have been developed for the assessment of gastroesophageal reflux disease (GERD). Four well-defined dimensions are noticeable in these GERD questionnaires, which are symptoms, response to treatment, diagnosis, and burden on the quality of life of GERD patients. The aim of this review is to develop a complete overview of all available questionnaires, categorized per dimension of the assessment of GERD. A systematic search of the literature up to January 2013 using the Pubmed database and the Embase database, and search of references and conference abstract books were conducted. A total number of 65 questionnaires were extracted and evaluated. Thirty-nine questionnaires were found applicable for the assessment of GERD symptoms, three of which are generic gastrointestinal questionnaires. For the assessment of response to treatment, 14 questionnaires were considered applicable. Seven questionnaires with diagnostic purposes were found. In the assessment of quality of life in GERD patients, 18 questionnaires were found and evaluated. Twenty questionnaires were found to be used for more than one assessment dimension, and eight questionnaires were found for GERD assessment in infants and/or children. A wide variety of GERD questionnaires is available, of which the majority is used for assessment of GERD symptoms. Questionnaires differ in aspects such as design, validation and translations. Also, numerous multidimensional questionnaires are available, of which the Reflux Disease Questionnaire is widely applicable. We provided an overview of GERD questionnaires to aid investigators and clinicians in their search for the most appropriate questionnaire for their specific purposes. © 2013 International Society for Diseases of the Esophagus.

  3. Fall-related activity avoidance in relation to a history of falls or near falls, fear of falling and disease severity in people with Parkinson's disease.

    Science.gov (United States)

    Kader, Manzur; Iwarsson, Susanne; Odin, Per; Nilsson, Maria H

    2016-06-02

    There is limited knowledge concerning fall-related activity avoidance in people with Parkinson's disease (PD); such knowledge would be of importance for the development of more efficient PD-care and rehabilitation. This study aimed to examine how fall-related activity avoidance relates to a history of self-reported falls/near falls and fear of falling (FOF) as well as to disease severity in people with PD. Data were collected from 251 (61 % men) participants with PD; their median (min-max) age and PD duration were 70 (45-93) and 8 (1-43) years, respectively. A self-administered postal survey preceded a home visit which included observations, clinical tests and interview-administered questionnaires. Fall-related activity avoidance was assessed using the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) as well as by using a dichotomous (Yes/No) question. Further dichotomous questions concerned: the presence of FOF and the history (past 6 months) of falls or near falls, followed by stating the number of incidents. Disease severity was assessed according to the Hoehn and Yahr (HY) stages. In the total sample (n = 251), 41 % of the participants reported fall-related activity avoidance; the median mSAFFE score was 22. In relation to a history of fall, the proportions of participants (p fall-related activity avoidance were: non-fallers (30 %), single fallers (50 %) and recurrent fallers, i.e. ≥ 2 falls (57 %). Among those that reported near falls (but no falls), 51 % (26 out of 51) reported fall-related activity avoidance. Of those that reported FOF, 70 % reported fall-related activity avoidance. Fall-related activity avoidance ranged from 24 % in the early PD-stage (HY I) to 74 % in the most severe stages (HY IV-V). Results indicate that fall-related activity avoidance may be related to a history of self-reported falls/near falls, FOF and disease severity in people with PD. Importantly, fall-related activity avoidance is

  4. Quantitative MR characterization of disease activity in the knee in children with juvenile idiopathic arthritis: a longitudinal pilot study

    International Nuclear Information System (INIS)

    Workie, Dagnachew W.; Graham, T.B.; Laor, Tal; Racadio, Judy M.; Rajagopal, Akila; O'Brien, Kendall J.; Bommer, Wendy A.; Shire, Norah J.; Dardzinski, Bernard J.

    2007-01-01

    The development of a quantifiable and noninvasive method of monitoring disease activity and response to therapy is vital for arthritis management. The purpose of this study was to investigate the utility of quantitative dynamic contrast-enhanced MRI (DCE-MRI) based on pharmacokinetic (PK) modeling to evaluate disease activity in the knee and correlate the results with the clinical assessment in children with juvenile idiopathic arthritis (JIA). A group of 17 children with JIA underwent longitudinal clinical and laboratory assessment and DCE-MRI of the knee at enrollment, 3 months, and 12 months. A PK model was employed using MRI signal enhancement data to give three parameters, K trans ' (min -1 ), k ep (min -1 ), and V p ' and to calculate synovial volume. The PK parameters, synovial volumes, and clinical and laboratory assessments in most children were significantly decreased (P < 0.05) at 12 months when compared to the enrollment values. There was excellent correlation between the PK and synovial volume and the clinical and laboratory assessments. Differences in MR and clinical parameter values in individual subjects illustrate persistent synovitis when in clinical remission. A decrease in PK parameter values obtained from DCE-MRI in children with JIA likely reflects diminution of disease activity. This technique may be used as an objective follow-up measure of therapeutic efficacy in patients with JIA. MR imaging can detect persistent synovitis in patients considered to be in clinical remission. (orig.)

  5. Vascular endothelial growth factor in systemic lupus erythematosus - correlations with disease activity and nailfold capillaroscopy changes.

    Science.gov (United States)

    Bărbulescu, Andreea Lili; Vreju, Ananu Florentin; Bugă, Ana Maria; Sandu, Raluca Elena; Criveanu, Cristina; Tudoraşcu, Diana Rodica; Gheonea, Ioana Andreea; Ciurea, Paulina Lucia

    2015-01-01

    Our study aimed to quantify serum VEGF (vascular endothelial growth factor) and its inter-relation with the severity of microvascular damage, assessed by nailfold capillaroscopy (NC), and to establish the possible relationship with disease activity score. We included 18 patients, diagnosed with systemic lupus erythematosus (SLE) and 17 gender and age-matched control subjects. For determining serum VEGF, we used a Human VEGF Assay kit-IBL. NC was performed, according to the standard method, using a video-capillaroscope Videocap 3.0, DS Medica, by the same examiner, blinded to clinical and laboratory data. Serum VEGF registered a mean value of 68.99±71.06 pg/mL for SLE patients and 31.84±11.74 pg/mL for controls, differences statistically significant; depending on disease activity, we found a mean value of 60.11±57.74 pg/mL, for patients with moderate disease activity vs. 30.96±11.51 pg/mL for the ones with a low activity (p=0.014). We found a moderately positive correlation, statistically significant (p=0.015), between serum level of VEGF and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Performing NC, we found changes in 88.88% of the patients; the most frequent were increased tortuosity, dilated capillaries, an increased length and a prominent subpapillary plexus. The presence of nailfold capillaroscopy changes and serum level of VEGF, correlated moderately, positive. Since serum levels of VEGF are higher in SLE patients, compared to controls, significantly different according to disease activity degree, and directly inter-related to abnormal NC patterns and a more active disease, we can include these accessible parameters in the routine evaluation, in order to better quantify the systemic damage, individualize the treatment, improve the outcome and life quality for these patients.

  6. DOE site performance assessment activities

    International Nuclear Information System (INIS)

    1990-07-01

    Information on performance assessment capabilities and activities was collected from eight DOE sites. All eight sites either currently dispose of low-level radioactive waste (LLW) or plan to dispose of LLW in the near future. A survey questionnaire was developed and sent to key individuals involved in DOE Order 5820.2A performance assessment activities at each site. The sites surveyed included: Hanford Site (Hanford), Idaho National Engineering Laboratory (INEL), Los Alamos National Laboratory (LANL), Nevada Test Site (NTS), Oak Ridge National Laboratory (ORNL), Paducah Gaseous Diffusion Plant (Paducah), Portsmouth Gaseous Diffusion Plant (Portsmouth), and Savannah River Site (SRS). The questionnaire addressed all aspects of the performance assessment process; from waste source term to dose conversion factors. This report presents the information developed from the site questionnaire and provides a comparison of site-specific performance assessment approaches, data needs, and ongoing and planned activities. All sites are engaged in completing the radioactive waste disposal facility performance assessment required by DOE Order 5820.2A. Each site has achieved various degrees of progress and have identified a set of critical needs. Within several areas, however, the sites identified common needs and questions

  7. Risk assessment for heart disease and workplace ETS exposure among nonsmokers.

    OpenAIRE

    Steenland, K

    1999-01-01

    In 1994 the U.S. Occupational Health and Safety Administration (OSHA) published a study of risk assessment for heart disease and lung cancer resulting from workplace exposure to environmental tobacco smoke (ETS) among nonsmokers. This assessment is currently being revised. The present article considers different possible approaches to a risk assessment for heart disease among nonsmokers resulting from workplace ETS exposure, reviews the approach taken by OSHA in 1994, and suggests some modifi...

  8. Rheumatoid arthritis disease activity and disability affect the risk of serious infection events in RADIUS 1.

    Science.gov (United States)

    Weaver, Arthur; Troum, Orrin; Hooper, Michele; Koenig, Andrew S; Chaudhari, Sandeep; Feng, Jingyuan; Wenkert, Deborah

    2013-08-01

    To determine whether disease activity and disability independently correlate with serious infection event (SIE) risk in a large rheumatoid arthritis (RA) cohort. The associations between SIE and Clinical Disease Activity Index (CDAI) and Health Assessment Questionnaire-Disability Index (HAQ-DI) in the Rheumatoid Arthritis Disease-Modifying Antirheumatic Drug Intervention and Utilization Study (RADIUS 1) cohort were evaluated using the Andersen-Gill model (a proportional HR model allowing > 1 event per patient). Of 4084 patients with 347 SIE, 271 patients experienced ≥ 1 SIE. A 5-unit CDAI increase and 0.4-unit HAQ-DI increase corresponded to an increase in SIE risk with and without covariate adjustments. A 5-unit CDAI increase corresponded with a 7.7% increased SIE risk (adjusted HR 1.077, 95% CI 1.044-1.112, p < 0.0001) and a 0.4-unit HAQ-DI increase with a 30.1% increased risk (adjusted HR 1.301, 95% CI 1.225-1.381, p < 0.0001). Categorical analysis showed that more severe RA activity (even after controlling for disability) and disability were associated with an increased SIE risk. Increased RA disease activity and disability were each associated with a significantly increased SIE risk in the RADIUS 1 cohort, which could not be completely accounted for by disability.

  9. The Association between Dry Eye Disease and Physical Activity as well as Sedentary Behavior: Results from the Osaka Study

    OpenAIRE

    Kawashima, Motoko; Uchino, Miki; Yokoi, Norihiko; Uchino, Yuichi; Dogru, Murat; Komuro, Aoi; Sonomura, Yukiko; Kato, Hiroaki; Nishiwaki, Yuji; Kinoshita, Shigeru; Tsubota, Kazuo

    2014-01-01

    Purpose. To assess the association of dry eye disease (DED) with physical activity and sedentary behavior. Methods. The cross-sectional survey conducted included Japanese office workers who use visual display terminals (n = 672). DED was assessed according to the Japanese Dry Eye Diagnostic Criteria, and participants were categorized into “definite DED,” “probable DED,” or “non-DED” groups based on the results of DED examinations. Physical activity and sedentary behavior of participants were ...

  10. Disease activity indices in coeliac disease: systematic review and recommendations for clinical trials.

    Science.gov (United States)

    Hindryckx, Pieter; Levesque, Barrett G; Holvoet, Tom; Durand, Serina; Tang, Ceen-Ming; Parker, Claire; Khanna, Reena; Shackelton, Lisa M; D'Haens, Geert; Sandborn, William J; Feagan, Brian G; Lebwohl, Benjamin; Leffler, Daniel A; Jairath, Vipul

    2018-01-01

    Although several pharmacological agents have emerged as potential adjunctive therapies to a gluten-free diet for coeliac disease, there is currently no widely accepted measure of disease activity used in clinical trials. We conducted a systematic review of coeliac disease activity indices to evaluate their operating properties and potential as outcome measures in registration trials. MEDLINE, EMBASE and the Cochrane central library were searched from 1966 to 2015 for eligible studies in adult and/or paediatric patients with coeliac disease that included coeliac disease activity markers in their outcome measures. The operating characteristics of histological indices, patient-reported outcomes (PROs) and endoscopic indices were evaluated for content and construct validity, reliability, responsiveness and feasibility using guidelines proposed by the US Food and Drug Administration (FDA). Of 19 123 citations, 286 studies were eligible, including 24 randomised-controlled trials. Three of five PROs identified met most key evaluative criteria but only the Celiac Disease Symptom Diary (CDSD) and the Celiac Disease Patient-Reported Outcome (CeD PRO) have been approved by the FDA. All histological and endoscopic scores identified lacked content validity. Quantitative morphometric histological analysis had better reliability and responsiveness compared with qualitative scales. Endoscopic indices were infrequently used, and only one index demonstrated responsiveness to effective therapy. Current best evidence suggests that the CDSD and the CeD PRO are appropriate for use in the definition of primary end points in coeliac disease registration trials. Morphometric histology should be included as a key secondary or co-primary end point. Further work is needed to optimise end point configuration to inform efficient drug development. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Performance-based assessment of activities of daily living (ADL) ability among women with chronic widespread pain

    DEFF Research Database (Denmark)

    Wæhrens, Eva Elisabet Ejlersen; Amris, Kirstine; Fisher, Anne G

    2010-01-01

    Functional ability, including the ability to perform activities of daily living (ADL), is considered a core outcome domain in chronic pain clinical trials and is usually assessed through generic or disease-specific self-report questionnaires. Research, however, indicates that self...

  12. Quality and Toxicity Assessments of Foot and Mouth Disease Virus ...

    African Journals Online (AJOL)

    The quality and toxicity assessment of foot and mouth disease virus vaccine was carried out in inoculated guinea pigs. ... could be used for the control and prevention of foot and mouth disease in Nigerian livestock. Keyword: Foot and Mouth Disease ... 2 blended with Incomplete. Seepic Adjuvant (ISA) montanide 206, which.

  13. Is impact of fatigue an independent factor associated with physical activity in patients with idiopathic Parkinson's disease?

    NARCIS (Netherlands)

    Elbers, R.; Wegen, van E.E.H.; Rochester, L.; Hetherington, V.; Nieuwboer, A.; Willems, A.M.; Jones, D.; Kwakkel, G.

    2009-01-01

    To investigate the longitudinal association between fatigue and physical activity in Parkinson's disease (PD) and determine whether this association is distorted by potential confounders. Data from baseline, 3, 6, and 12 week assessments in a single blind randomized clinical trial with cross-over

  14. CD4 T cell activation and disease activity at onset of multiple sclerosis

    DEFF Research Database (Denmark)

    Jensen, J; Langkilde, Annika Reynberg; Fenst, C

    2004-01-01

    We studied CD4 T cell activation in patients with clinically isolated syndromes (CIS) suggesting an initial attack of multiple sclerosis. The percentage of blood CD26+ CD4 T cells was increased in these patients, and correlated with magnetic resonance imaging disease activity and clinical disease...... severity. In contrast, the percentage of CD25+ CD4 T cells in cerebrospinal fluid correlated negatively with the cerebrospinal fluid concentration of myelin basic protein and the presence of IgG oligoclonal bands. These results suggest that distinct systemic and intrathecal T cell activation states...

  15. Natriuretic peptides and integrated risk assessment for cardiovascular disease

    DEFF Research Database (Denmark)

    Willeit, Peter; Kaptoge, S; Welsh, P.

    2016-01-01

    samples and collection of data from studies identified through a systematic search of the literature (PubMed, Scientific Citation Index Expanded, and Embase) for articles published up to Sept 4, 2014, using search terms related to natriuretic peptide family members and the primary outcomes......BACKGROUND: Guidelines for primary prevention of cardiovascular diseases focus on prediction of coronary heart disease and stroke. We assessed whether or not measurement of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentration could enable a more integrated approach than at present...... by predicting heart failure and enhancing coronary heart disease and stroke risk assessment. METHODS: In this individual-participant-data meta-analysis, we generated and harmonised individual-participant data from relevant prospective studies via both de-novo NT-proBNP concentration measurement of stored...

  16. Physical Activity and Characteristics of the Carotid Artery Wall in High-Risk Patients-The SMART (Second Manifestations of Arterial Disease) Study.

    Science.gov (United States)

    Boss, H Myrthe; van der Graaf, Yolanda; Visseren, Frank L J; Van den Berg-Vos, Renske M; Bots, Michiel L; de Borst, Gert Jan; Cramer, Maarten J; Kappelle, L Jaap; Geerlings, Mirjam I

    2017-07-23

    Physical activity reduces the risk of vascular disease. This benefit is not entirely explained through an effect on vascular risk factors. We examined the relationship of physical activity and characteristics of the carotid artery wall in patients with vascular disease or risk factors. Cross-sectional analyses were performed in 9578 patients from the SMART (Second Manifestations of Arterial Disease) study, a prospective cohort study among patients with vascular disease or risk factors. Physical activity was assessed using questionnaires. Carotid intima-media thickness and carotid artery stenosis of both common carotid arteries was measured. In a subset of 3165 participants carotid diastolic diameter and distension were assessed. Carotid stiffness was expressed as the distensibility coefficient and Young's elastic modulus. Regression analyses adjusted for vascular risk factors showed that physical activity was inversely associated with diastolic diameter (fifth versus first quintile B=-0.13 mm; 95% CI, -0.21 to -0.05) and decreased risk of carotid artery stenosis (relative risk, 0.58; 95% CI, 0.48-0.69). A light level of physical activity was associated with less carotid stiffness (second versus first quintile; Young's elastic modulus B=-0.11 kPa -1 ×10 -3 ; 95% CI, -0.16 to -0.06; distensibility coefficient B=0.93 kPa×10 3 ; 95% CI, 0.34-1.51), but there was no additional benefit with increasing levels of physical activity. In patients with vascular disease, physical activity was inversely associated with common carotid intima-media thickness, but not in patients with vascular risk factors. In patients with vascular disease or risk factors, increased physical activity was associated with smaller carotid diastolic diameter, decreased risk of carotid artery stenosis, and less carotid stiffness, but it only showed benefits on carotid intima-media thickness in patients with vascular disease. © 2017 The Authors. Published on behalf of the American Heart

  17. Lupus nephritis: prolonged immunoadsorption (IAS) reduces proteinuria and stabilizes global disease activity.

    Science.gov (United States)

    Stummvoll, Georg H; Schmaldienst, Sabine; Smolen, Josef S; Derfler, Kurt; Biesenbach, Peter

    2012-02-01

    Systemic lupus erythematosus (SLE) is characterized by pathogenic autoantibodies, which can be removed by extracorporeal procedures. While previous studies have shown short-term efficacy of immunoadsorption (IAS) in SLE, no information on long-term benefit and safety is available. IAS was offered to patients with highly active renal disease when conventional therapy had failed. Eleven patients entered the prolonged IAS programme and were followed for up to 10 years (mean 6.4 ± 3.5). Efficacy of IAS was determined by reduction in proteinuria (primary outcome), global disease activity [SLE Disease Activity Index (SLEDAI)] and anti-double-stranded DNA (anti-dsDNA) levels (secondary outcomes). Full/partial remission was defined as ≤ 0.5/≤ 1.0 g/day for proteinuria, ≤ 5/≤ 8 for SLEDAI and ≤ 25/≤ 50 IU/mL for anti-dsDNA levels. We further assessed flares, infections, malignancies and procedure-related adverse events. Short-term IAS (≤ 1 year) resulted in a significant reduction of proteinuria (9.2 ± 3.7 to 2.3 ± 2.4, P = 0.0001), disease activity (SLEDAI 19 ± 8 to 4 ± 2, P = 0.0004) and dsDNA levels (168 ± 205 to 45 ± 34, P = 0.001). In patients without remission after 1 year (n = 5), prolonged IAS decreased proteinuria from 4.3 ± 2.4 to 0.5 ± 0.4 g/day, P = 0.02. At the end of observation, complete remission in proteinuria was achieved in seven patients (64%) and partial remission in two (18%) additional patients. One patient flared and was discontinued; in all other patients, disease activity and anti-dsDNA stabilized at remission levels. Flares (0.28 ± 0.30) and infections (0.66 ± 0.70 per patient/year) were relatively uncommon; no malignancies, anaphylactic or orthostatic adverse events were observed. IAS is effective in short-term use but prolonged IAS can provide additional therapeutic benefit while showing an acceptable safety profile. The vast majority of initially therapy-refractory patients met the remission criteria at the end of

  18. Chromium 51-ethylenediaminetetraacetate test: a useful test in the assessment of inflammatory bowel disease

    International Nuclear Information System (INIS)

    O'Morain, C.A.; Abelow, A.C.; Chervu, L.R.; Fleischner, G.M.; Das, K.M.

    1986-01-01

    We evaluated the usefulness of urinary excretion values in assessing mucosal damage in inflammatory bowel disease after administration of chromium 51-labeled EDTA either orally or rectally. In the oral study, 19 controls, 18 patients with Crohn's disease, and 13 patients with ulcerative colitis were given 100 microCi 51 Cr-EDTA by mouth. The amount of 51 Cr-EDTA in a 24-hour urine collection was expressed as a percentage of the ingested dose. The patients with Crohn's disease of the small bowel excreted 6.3% +/- 4.3%, which was significantly (P less than 0.001) higher than the percentage in patients with ulcerative colitis (1.7% +/- 1.1%) and controls (1.4% +/- 0.6%). In the enema study, 19 patients with ulcerative colitis, two with Crohn's disease, two with radiation colitis, and four controls (spastic colitis, lactose intolerance) were given 100 microCi 51 Cr-EDTA by retention enema. The patients with active colonic inflammation excreted 8.4% +/- 3.9% of the dose given by enema, which was significantly (P less than 0.01) higher than in other controls (1.9% +/- 0.91%) or patients with inactive colitis (2.2% +/- 1.9%). The 51 Cr-EDTA excretion test is a safe, inexpensive test useful in evaluating patients with inflammatory bowel disease. It can be given orally to screen patients with abdominal complaints who are suspected of having Crohn's disease involving the small intestine, and when given by enema it provides additional objective assessment of idiopathic ulcerative colitis or proctitis

  19. Chromium 51-ethylenediaminetetraacetate test: a useful test in the assessment of inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    O' Morain, C.A.; Abelow, A.C.; Chervu, L.R.; Fleischner, G.M.; Das, K.M.

    1986-11-01

    We evaluated the usefulness of urinary excretion values in assessing mucosal damage in inflammatory bowel disease after administration of chromium 51-labeled EDTA either orally or rectally. In the oral study, 19 controls, 18 patients with Crohn's disease, and 13 patients with ulcerative colitis were given 100 microCi /sup 51/Cr-EDTA by mouth. The amount of /sup 51/Cr-EDTA in a 24-hour urine collection was expressed as a percentage of the ingested dose. The patients with Crohn's disease of the small bowel excreted 6.3% +/- 4.3%, which was significantly (P less than 0.001) higher than the percentage in patients with ulcerative colitis (1.7% +/- 1.1%) and controls (1.4% +/- 0.6%). In the enema study, 19 patients with ulcerative colitis, two with Crohn's disease, two with radiation colitis, and four controls (spastic colitis, lactose intolerance) were given 100 microCi /sup 51/Cr-EDTA by retention enema. The patients with active colonic inflammation excreted 8.4% +/- 3.9% of the dose given by enema, which was significantly (P less than 0.01) higher than in other controls (1.9% +/- 0.91%) or patients with inactive colitis (2.2% +/- 1.9%). The /sup 51/Cr-EDTA excretion test is a safe, inexpensive test useful in evaluating patients with inflammatory bowel disease. It can be given orally to screen patients with abdominal complaints who are suspected of having Crohn's disease involving the small intestine, and when given by enema it provides additional objective assessment of idiopathic ulcerative colitis or proctitis.

  20. Dietary patterns, involvement in physical activity and body mass index of Romanian adults having cardio-vascular diseases

    Directory of Open Access Journals (Sweden)

    Lucia Maria Lotrean

    2016-05-01

    Full Text Available Promotion of a healthy diet, an active lifestyle and appropriate body weight are important components of cardio-vascular disease prevention and control. This study aimed to assess several dietary patterns, involvement in physical activity and body mass index (BMI of Romanian adults hospitalized because of diagnoses of cardio-vascular diseases (CVD. The study was performed in 2014 in 1 hospital setting from Cluj-Napoca, Romania. It involved 80 adult patients (45 to 78 years old hospitalized with diagnoses of CVD. Anonymous questionnaire assessing several lifestyle related behaviours were filled in by the participants; based on their weight and height, the BMI was calculated. The results show that 76.2% of the participants recognize the role of consumption of fruits and vegetables for cardio-vascular diseases prevention and control, but only 5% meet the recommendations of eating at least 5 portions of fruits and vegetables (around 400 g daily. The majority of the subjects know that the consumption of animal fat increases the risk for cardio-vascular diseases, but, only one out of two patients declared their constant preoccupation for avoiding products rich in saturated fatty acids, such as animal fat, high fat dairy products and high fat meat. Around 80% of the participants know the risk of obesity for cardio-vascular diseases, but 81.2% have a BMI higher than 25. A percentage of 60% of the patients declared that they received general information from health care professionals about diet, physical activity and cardio-vascular disease prevention, while one quarter followed an educational program for this issue and only one out of ten patients followed a personalized program for loosing weight. Comprehensive educational and counselling programs for promoting healthy nutrition and achievement of an appropriate body weight are needed for Romanian adults having CVD

  1. Effectiveness of physical activity on patients with depression and Parkinson's disease: A systematic review.

    Directory of Open Access Journals (Sweden)

    Pei-Ling Wu

    Full Text Available In this paper we aimed to systematically review the literature on physical activity's effect on depressive symptoms in Parkinson disease.Depression is a common symptom of Parkinson's disease and is associated with increased disability, rapid progression of motor symptoms, mortality, and adverse effects on Quality of Life.A systematic review of primary research was undertaken and conducted according to the Preferred Reporting Items for Systematic Reviews.Databases Scopus, Psycho-info, CINAHL, PubMed, and ProQuest Cochrance were searched from January 2006 to June 2017. The language was restricted to English.Abstracts were screened and reviewed against the eligibility criteria (participants' mean age were ≥ 60 with PD, PA interventions, depression as one of outcome variables, and Randomized Control Trail or quasi-experimental design. Two reviewers appraised the quality of the data extracted. The modified Jadad scale assessed the quality of the methodology of the published papers.The database search yielded 769 abstracts, 11 of which were included in this review and awarded scores ranging from 3 to 8 (Scale scores range from 0 to 8 points, higher scores indicated better quality by the raters. These 11 studies included 342 patients and executed 17 kinds of physical activity programs. Results of this review show empirical evidence to support the efficacy of physical activity for the population with Parkinson's disease. Aerobic training exercise significantly improved the participants' scores on the Unified Parkinson's Disease Rating Scale, the Beck Depression Inventory, and the Quality of Life of the patients. Qigong improved scores in UPDRS-III and decreased incidences of multiple non-motor symptoms and depression. Furthermore, a balance-training program, such as Tai Chi, can improve postural stability and Quality of Life.Physical activity may assuage the degeneration of motor skills and depression as well as increase the Quality of Life of

  2. Assessments of plasma ghrelin levels in the early stages of parkinson's disease.

    Science.gov (United States)

    Song, Ning; Wang, Weiwei; Jia, Fengjv; Du, Xixun; Xie, Anmu; He, Qing; Shen, Xiaoli; Zhang, Jing; Rogers, Jack T; Xie, Junxia; Jiang, Hong

    2017-10-01

    Gastrointestinal symptoms are early events in Parkinson's disease (PD). The gastrointestinal hormone ghrelin was neuroprotective in the nigrostriatal dopamine system. The objective of this study was to assess ghrelin levels in the early stages of PD. Plasma was collected in the fasting state in 291 PD patients in stages 1-3 and 303 age- and sex-matched healthy controls. Additional samples were taken in the glucose response test to assess nutrition-related ghrelin levels in 20 PD patients and 20 healthy controls. The enzyme-linked immunosorbent assay was used to measure total and active plasma ghrelin levels. We reported that total and active plasma ghrelin levels were decreased in PD, although there was no difference across progressive PD stages. Postprandial ghrelin suppression and preprandial peak responses were both attenuated in PD. Plasma ghrelin levels were decreased in PD; however, this event might be irrelevant to PD progression. Ghrelin responses to meals were also impaired in PD. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  3. Correlation between Epstein-Barr Virus Infection and Disease Activity of Systemic Lupus Erythematosus: a Cross-Sectional Study

    Science.gov (United States)

    Piroozmand, Ahmad; Haddad Kashani, Hamed; Zamani, Batool

    2017-02-01

    Background: Systemic lupus erythematosus (SLE) is an autoimmune disease for whose pathogenesis viral infections are important. The Epstein-Barr virus (EBV) is the main infectious etiological agent. This study aimed to quantitative evaluation of EBV in SLE patients. Materials and Methods: In this cross-sectional study, 40 patients with SLE diagnosed based on American College of Rheumatology criteria were selected using purposive sampling. All were included in the study after obtaining informed consent for participation. Whole blood samples were taken and buffy coat preparations were isolated to determine viral load using the real-time polymerase chain reaction method and assessment with the SLE disease activity index (SLE-DAI). Results: From a total of 40 patients, 37 cases (92.5%) were women. The EBV test was positive in 67.5% and mean viral load was 5396 ± 1891.9 copy/ml. Twenty of forty patients had active and 50% inactive disease, mean EBV viral loads being 6798 and 28.25 copy/ml, respectively (P-value = 0.003). In terms of the severity of disease activity, 17.5 % of female patients had mild to moderate activity, whilst 32.5% of them had severe activity, with respective viral loads of 5,803.3 and 29.73 copy/ml (P-value = 0.003). Conclusion: The Epstein-Barr viral load in SLE patients with active disease was found to be markedly higher than in inactive cases. Thus, EBV may have an important role in the pathogenesis and activity of SLE. Creative Commons Attribution License

  4. Effects of enteral nutritional support on malnourished patients with inflammatory bowel disease by subjective global assessment.

    Science.gov (United States)

    Sökülmez, Pınar; Demirbağ, Ali Eba; Arslan, Perihan; Dişibeyaz, Selçuk

    2014-10-01

    To investigate the prevalence of malnutrition in patients with inflammatory bowel disease (IBD) by subjective global assessment (SGA) and the effects of oral nutritional support on the clinical parameters, consumption of energy, macronutrients and fiber intake in the Study and Control groups, prospectively. A total of 38 (28 Male; 10 Female) hospitalized patients with moderate or severe IBD (13 with Crohn's disease (CD); 25 with Ulcerative colitis (UC)) were included. At stage 1, the disease severity, clinical symptoms and, signs, food consumption and nutritional status by using subjective global assessment (SGA) were recorded. At stage 2, the patients were blindly randomized into a Study Group and Controls. In the Study Group, a standard enteral product was added into the regulated hospital diets, but for the Controls, deficits were regulated by only hospital diets for 3 weeks. the independent variables were the group, the disease and its activity, age, Body body mass index (BMI), weight loss history, the hospitalization period; the dependent variables were SGA, bowel movements, change in nutritional status, disease severity, clinical findings, and also consumption of macronutrients. Prevalance of malnutrition (SGA-B or SGA-C) for all the patients was 92.1% at the beginning and 71.1% at the end of study. Improvements in disease activity score for the patients with UC were statistically significant in both the Study Group and the Controls (p=0.006 for the Study Group and p=0.001 for the Controls, respectively). Macronutrients, total and water soluble fiber consumption levels improved, with statistically significant differences for all the groups. The prevalence of malnutrition is a major problem in patients with IBD. Not only the regulation of hospital food, but also enteral nutritional support, improved their levels of malnutrition, as well as their energy, macronutrients, and fiber consumption, and SGA is an easy method for nutritional monitoring.

  5. Chromium-51-EDTA and technetium-99m-DTPA excretion for assessment of small bowel Crohn's disease

    International Nuclear Information System (INIS)

    O'Morain, C.; Chervu, L.; Milstein, D.M.; Das, K.M.

    1984-01-01

    In the present study, 4 patients with radiologically documented Crohn's disease were given 100 μCi of Cr-51-EDTA and 5 mCi of Tc-99m-DTPA together orally in 10ml of water, and urine was collected during the following 24 hr period. Sequential imaging of the stomach and the GI tract was done with a LFOV gamma camera at 10 min intervals until the activity cleared the small bowel. The images failed to show any localization of the activity in any disease process and no extraintestinal accumulation site was observed scintigraphically. Mean 24 hr urinary excretion for Tc-99m-DTPA was 4.8 +- 2.6% comparable to that of Cr-51-EDTA in these patients. This study suggests that a comparable oral dose of Tc-99m-DTPA could be substituted for Cr-51-EDTA as a far more readily available agent for documenting small bowel Crohn's disease by quantitative assessment of its urinary excretion

  6. Assessment of airway lesion in obstructive lung diseases by CT

    International Nuclear Information System (INIS)

    Niimi, Akio; Matsumoto, Hisako; Ueda, Tetsuya; Mishima, Michiaki

    2002-01-01

    Airway lesion in obstructive pulmonary diseases, such as asthma or chronic obstructive pulmonary disease (COPD), has recently been assessed quantitatively. Especially in asthma, wall thickening of central airways, and its relation to the severity of disease or airflow obstruction has been clarified. Pathophysiologic importance of peripheral airway lesion has also been highlighted by pathologic or physiologic studies. However, direct evaluation of peripheral airway lesion is beyond resolutional limitation of CT. To assess airway trapping, an indirect CT finding of peripheral airway disease, by quantitative and semiquantitative measures and compare them with clinical indices such as pulmonary function, airway responsiveness, or airway inflammation. Patients with stable asthma (n=20) were studied. HRCT at 3 levels of both lungs were scanned. Low attenuation area (LAA)% and mean lung density were quantitatively assessed by an automatic method. Distribution of mosaic pattern was visually scored semiquantitatively. LAA% and mean lung density at full expiratory phase correlated with the degree of airflow obstruction. Mosaic score at full inspiratory phase correlated with the severity of disease and airflow obstruction. Expiratory/inspiratory ratio of mean lung density was also associated with airway responsiveness or residual volume/total lung capacity (RV/TLC). These CT findings may be useful as markers of asthma pathophysiology. (author)

  7. What role does rheumatoid arthritis disease activity have in cardiovascular risk.

    Science.gov (United States)

    Ramírez Huaranga, Marco Aurelio; Mínguez Sanchez, María Dolores; Zarca Diaz de la Espina, Miguel Ángel; Espinosa Prados, Pedro José; Romero Aguilera, Guillermo

    2017-04-21

    Rheumatoid arthritis (RA) is associated with a 1.3 to 3-fold increase in mortality, being the major cause of death from cardiovascular complications (40%-50%). Therefore, the initial approach should include cardiovascular risk (CVR) assessment using algorithms adapted for this population. Although, SCOREM is an important advance, there are data indicating that subclinical atherosclerosis may be underdiagnosed. To estimate the strength of association between carotid ultrasound and SCOREM in this population, as well as the implication of disease activity. Cross-sectional, observational, analytical study performed at the General Hospital of Ciudad Real, Spain, between June 2013 and May 2014. The evaluation of CVR was performed and, according to SCOREM, the population was divided into low and high (medium, high and very high) risk. We studied the presence of subclinical atherosclerosis in low-risk patients. Of the total of 119 RA patients, 73.1% had traditional risk factors. Thirty-eight patients were excluded because of a previous cardiovascular event, diabetes mellitus and/or nephropathy. Atheromatous plaque was observed in 14.63% of the low-risk population. The factor with the strongest association to the presence of subclinical atherosclerosis was a moderate or high activity of RA measured by the simplified disease activity index with an odds ratio of 4.95 (95% CI: 1.53-16.01). Although there was an acceptable correlation between the presence of subclinical atherosclerosis and SCOREM, there was a considerable proportion of atheromatous plaques in low-risk patients. Disease activity was the risk factor most closely associated with increased CVR. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  8. Hepatic and erythrocytic glutathione peroxidase activity in liver diseases.

    Science.gov (United States)

    Cordero, R; Ortiz, A; Hernández, R; López, V; Gómez, M M; Mena, P

    1996-09-01

    Hepatic and erythrocytic glutathione peroxidase activity, together with malondialdehyde levels, were determined as indicators of peroxidation in 83 patients from whom liver biopsies had been taken for diagnostic purposes. On histological study, the patients were classified into groups as minimal changes (including normal liver), steatosis, alcoholic hepatitis, hepatic cirrhosis, light to moderately active chronic hepatitis, and severe chronic active hepatitis. The glutathione peroxidase activity in erythrocytes showed no significant changes in any liver disease group. In the hepatic study, an increased activity was observed in steatosis with respect to the minimal changes group, this increased activity induced by the toxic agent in the initial stages of the alcoholic hepatic disease declining as the hepatic damage progressed. There was a negative correlation between the levels of hepatic malondialdehyde and hepatic glutathione peroxidase in subjects with minimal changes. This suggested the existence of an oxidative equilibrium in this group. This equilibrium is broken in the liver disease groups as was manifest in a positive correlation between malondialdehyde and glutathione peroxidase activity.

  9. Promoting Physical Activity in Elementary Schools: Needs Assessment and a Pilot Study of Brain Breaks

    Science.gov (United States)

    Perera, Thushanthi; Frei, Simone; Frei, Balz; Bobe, Gerd

    2015-01-01

    A sedentary life style contributes to many chronic diseases and poor educational performance. Since elementary school-aged children spend most wakeful hours in school, classroom teachers are essential for providing physical activity (PA) breaks during school. As first objective, we assessed current PA levels for Oregon public elementary schools…

  10. Physical activity assessed in routine care predicts mortality after a COPD hospitalisation

    Directory of Open Access Journals (Sweden)

    Marilyn L. Moy

    2016-03-01

    Full Text Available The independent relationship between physical inactivity and risk of death after an index chronic obstructive pulmonary disease (COPD hospitalisation is unknown. We conducted a retrospective cohort study in a large integrated healthcare system. Patients were included if they were hospitalised for COPD between January 1, 2011 and December 31, 2011. All-cause mortality in the 12 months after discharge was the primary outcome. Physical activity, expressed as self-reported minutes of moderate to vigorous physical activity (MVPA, was routinely assessed at outpatient visits prior to hospitalisation. 1727 (73% patients were inactive (0 min of MVPA per week, 412 (17% were insufficiently active (1–149 min of MVPA per week and 231 (10% were active (≥150 min of MVPA per week. Adjusted Cox regression models assessed risk of death across the MVPA categories. Among 2370 patients (55% females and mean age 73±11 years, there were 464 (20% deaths. Patients who were insufficiently active or active had a 28% (adjusted HR 0.72 (95% CI 0.54–0.97, p=0.03 and 47% (adjusted HR 0.53 (95% CI 0.34–0.84, p<0.01 lower risk of death, respectively, in the 12 months following an index COPD hospitalisation compared to inactive patients. Any level of MVPA is associated with lower risk of all-cause mortality after a COPD hospitalisation. Routine assessment of physical activity in clinical care would identify persons at high risk for dying after COPD hospitalisation.

  11. North American Pediatric Gastroenterology Fellowship Needs Assessment in Inflammatory Bowel Disease: Trainee and Program Director Perspectives.

    Science.gov (United States)

    Dotson, Jennifer L; Falaiye, Tolulope; Bricker, Josh B; Strople, Jennifer; Rosh, Joel

    2016-07-01

    Pediatric inflammatory bowel disease (IBD) care is complex and rapidly evolving. The Crohn's and Colitis Foundation of America and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition cosponsored a needs assessment survey of pediatric gastroenterology trainees and program directors (PDs) to inform on educational programming. A Web-based, self-completed survey was provided to North American trainees and PDs during the 2013-2014 academic year. Standard descriptive statistics summarized demographics and responses. One hundred sixty-six of 326 (51%) trainees (62% female) and 37 of 74 (50%) PDs responded. Median trainees per program = 5 and median total faculty = 10 (3 IBD experts); 15% of programs did not have a self-identified "IBD expert" faculty member. Sixty-nine percent of trainees were confident/somewhat confident in their IBD inpatient training, whereas 54% were confident/somewhat confident in their outpatient training. Trainees identified activities that would most improve their education, including didactics (55%), interaction with national experts (50%), trainee-centered IBD Web resources (42%), and increased patient exposure (42%). Trainees were most confident in managing inpatient active Crohn's disease/ulcerative colitis, phenotype classification, managing biological therapies, and using clinical disease activity indices. They were least confident in managing J-pouch complications, performing pouchoscopy, managing extraintestinal manifestations, and ostomy-related complications. Eighty-five percent would like an IBD-focused training elective. Most directors (86%) would allow trainees to do electives at other institutions. This IBD needs assessment survey of pediatric gastroenterology trainees and PDs demonstrated a strong resource commitment to IBD training and clinical care. Areas for educational enrichment emerged, including pouch and ostomy complications.

  12. FTO genotype, physical activity, and coronary heart disease risk in Swedish men and women.

    Science.gov (United States)

    Gustavsson, Jaana; Mehlig, Kirsten; Leander, Karin; Lissner, Lauren; Björck, Lena; Rosengren, Annika; Nyberg, Fredrik

    2014-04-01

    Variants in the fat mass- and obesity-associated gene (FTO) predisposing to obesity and diabetes mellitus have also been associated with cardiovascular disease. Physical activity has been suggested to attenuate the FTO effect on obesity, but it is unknown whether this is also true for cardiovascular disease. Therefore, we explored whether physical activity modifies the FTO association with coronary heart disease (CHD). FTO rs9939609 (T>A) polymorphism was genotyped in 2 Swedish population-based case-control studies with 1743 CHD cases and 4402 population controls (25-74 years of age; 41% women). Leisure time physical activity was assessed by questionnaires, and 3 levels were defined: low, medium, and high. Overall, carriers of the FTO A allele had an increased risk of CHD (odds ratio, 1.20; 95% confidence interval, 1.06-1.37) adjusted for age, sex, study, and body mass index. Although A-allele carriers with low physical activity had the highest CHD risk (odds ratio, 3.30; 95% confidence interval, 2.44-4.46) compared with those with TT genotype and high activity, the effects of FTO genotype and physical activity on CHD risk were approximately additive, indicating the absence of additive interaction. The stratum-specific relative risks of CHD from the A allele in subjects with low, medium, and high physical activity were odds ratio 1.11 (95% confidence interval, 0.77-1.60), 1.22 (1.04-1.44), and 1.38 (1.06-1.80), respectively, but the suggested multiplicative interaction was not significant. FTO rs9939609 A-allele carriers have an increased CHD risk, and the association is not counteracted by increased physical activity.

  13. Comparison of simultaneous 99mTc-HMPAO and 111In oxine labelled white cell scans in the assessment of inflammatory bowel disease

    International Nuclear Information System (INIS)

    Allan, R.A.; Bassingham, S.; Lazarus, C.; Clarke, S.E.M.; Fogelman, I.; Sladen, G.E.

    1993-01-01

    Forty-seven patients, 29 with chronic inflammatory bowel disease (IBD) and 18 with presumed irritable bowel syndrome, including one with uncomplicated diverticular disease, were studied with simultaneous technetium-99m hexamethylpropylene amine oxime and indium-III oxine labelled leucocyte scans performed at 1, 3 and 24 h. Twenty-seven patients with IBD had active disease as judged by clinical and laboratory criteria and all of these had positive scans with both agents. No false positive studies were obtained. The 1-h 99m Tc-HMPAO WBC scans showed the same distribution to disease as the 3-h 111 -In WBC scans, with no difference in intensity (P 111 -In scans. The 3-h 99m Tc-HMPAO WBC scans showed more extensive disease (P 111 In WBC scans. Physiological bowel activity on 3-h 99m Tc-HMPAO WBC scans was present in 12 patients but was faint and did not interfere with assessment of disease extent and activity. It is concluded that in terms of isotope availability, radiation dosimetry and image quality, 99m Tc-HMPAO is the agent of choice in detecting active IBD, with localization of disease possible at 1-h after re-injection and optimal resolution and definition of disease extent at 3 h. A negative scan reliably excludes active disease. (orig.)

  14. The Multiple Object Test as a Performance Based Tool to Assess Cognitive Driven Activity of Daily Living Function in Parkinson's Disease.

    Science.gov (United States)

    Glonnegger, Hannah; Beyle, Aline; Cerff, Bernhard; Gräber, Susanne; Csoti, Ilona; Berg, Daniela; Liepelt-Scarfone, Inga

    2016-07-06

    There is need for multidimensional quantitative assessment of cognitive driven activities of daily living (ADL) functions in Parkinson's disease (PD). To determine whether there is an ADL profile related to cognitive impairment in PD assessed by the Multiple Object Test (MOT). We assumed MOT performance to be lower in PD patients versus controls and in PD patients with more severe cognitive impairment. 50 PD patients with no cognitive impairment (PD-NC), 54 patients with PD-mild cognitive impairment (PD-MCI), 29 with Parkinson's disease dementia (PDD), and 40 healthy controls (HC) were investigated. Besides comprehensive cognitive testing, the MOT, a performance based test consisting of five routine tasks (e.g., preparing a cup of coffee), was applied. Quantitative (total errors and time) and qualitative (error type) MOT parameters were analyzed. Total time and number of MOT errors was increased in PD patients compared to controls (p < 0.001). These parameters also differentiated PDD patients from other cognitive groups (p < 0.05). No control subject had ≥ 4 errors in the MOT, but 30% of PD patients, especially PDD, scored above this cut-off. Omission (p < 0.001) and mislocation (p < 0.03) errors were more prominent in PDD than other cognitive groups. Perplexity errors did not differ between PD-MCI and PDD but between PD-NC and PDD (p = 0.01). MOT parameters discriminating between cognitive groups correlated mainly with lower test performance in psychomotor speed and executive function. Performance based testing is promising to identify quantitative and qualitative ADL aspects differentiating between different cognitive groups which might be helpful for an early detection of PDD.

  15. Physical activity assessment tools for use in overweight and obese children.

    Science.gov (United States)

    Ellery, C V L; Weiler, H A; Hazell, T J

    2014-01-01

    The prevalence of excess weight in children and adults worldwide has increased rapidly in the last 25 years. Obesity is positively associated with increased risk for many health issues such as type 2 diabetes, cardiovascular disease and psychosocial problems. This review focuses on child populations, as it is known that the sedentary behaviors of overweight/obese youth often endure into adulthood. Assessment of physical activity (PA), among other factors such as diet and socio-economic status, is important in understanding weight variation and in designing interventions. This review highlights common subjective and objective PA assessment tools, the validity of these methods and acceptable ways of collecting and interpreting PA data. The aim is to provide an update on PA assessment in overweight/obese children, highlighting current knowledge and any gaps in the literature, in order to facilitate the use of PA assessments and interventions by health-care professionals as well as suggest future research in this area.

  16. Cooking activity for patients with Alzheimer’s disease: a review

    OpenAIRE

    Shang-Qun Gong; Chu-Yun Cui; Hui Zhang; Fan-Jie Meng

    2017-01-01

    As a degenerative nervous system disease, Alzheimer’s disease (AD), can damage memory and cognitive function. Cooking activity, an instrumental activity of daily life, is one of the non-pharmacological therapies with positive effect on AD. Here, we review the effectiveness of cooking activity on AD. This paper shows that cooking activity can not only improve patient’s emotional state and alleviate the conduct disorder, but also ease the burden of professional caregiver. Cooking activity also ...

  17. Grading of Crohn's disease activity using CT, MRI, US and scintigraphy: a meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Puylaert, C.A.J.; Tielbeek, J.A.W.; Bipat, S.; Stoker, J. [University of Amsterdam, Academic Medical Center, Department of Radiology, Amsterdam (Netherlands)

    2015-11-15

    To assess the grading of Crohn's disease activity using CT, MRI, US and scintigraphy. MEDLINE, EMBASE and Cochrane databases were searched (January 1983-March 2014) for studies evaluating CT, MRI, US and scintigraphy in grading Crohn's disease activity compared to endoscopy, biopsies or intraoperative findings. Two independent reviewers assessed the data. Three-by-three tables (none, mild, frank disease) were constructed for all studies, and estimates of accurate, over- and under-grading were calculated/summarized by fixed or random effects models. Our search yielded 9356 articles, 19 of which were included. Per-patient data showed accurate grading values for CT, MRI, US and scintigraphy of 86 % (95 % CI: 75-93 %), 84 % (95 % CI: 67-93 %), 44 % (95 % CI: 28-61 %) and 40 % (95 % CI: 16-70 %), respectively. In the per-patient analysis, CT and MRI showed similar accurate grading estimates (P = 0.8). Per-segment data showed accurate grading values for CT and scintigraphy of 87 % (95 % CI: 77-93 %) and 86 % (95 % CI: 80-91 %), respectively. MRI and US showed grading accuracies of 67-82 % and 56-75 %, respectively. CT and MRI showed comparable high accurate grading estimates in the per-patient analysis. Results for US and scintigraphy were inconsistent, and limited data were available. (orig.)

  18. Sarcoidosis: assessment of disease severity using HRCT

    Energy Technology Data Exchange (ETDEWEB)

    Drent, Marjolein [Department of Respiratory Medicine, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Nutrition and Toxicology Research Institute Maastricht (NUTRIM), P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Sarcoidosis Management Center, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Vries, Jolanda De [Department of Clinical Health Psychology, Tilburg University, P.O. Box 90153, 5000, LE Tilburg (Netherlands); Lenters, Merinke; Wouters, Emiel F.M. [Department of Respiratory Medicine, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Nutrition and Toxicology Research Institute Maastricht (NUTRIM), P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Lamers, Rob J.S. [Department of Radiology, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Rothkranz-Kos, Snjezana; Dieijen-Visser, Marja P. van [Nutrition and Toxicology Research Institute Maastricht (NUTRIM), P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Department of Clinical Chemistry, University Hospital of Maastricht, P.O. Box 5800, 6202, AZ Maastricht (Netherlands); Verschakelen, Johny A. [Department of Radiology, Catholic University, 3000, Leuven (Belgium)

    2003-11-01

    The value of high-resolution computed tomography (HRCT) in diagnosing and assessing inflammatory activity in sarcoidosis is well established. The aim of the present study was to address the intra- and inter-observer agreements of the HRCT score by Oberstein et al. [8], and to evaluate the relationship between HRCT findings and disease severity expressed in respiratory functional impairment in sarcoidosis. The clinical records of 80 known sarcoidosis patients visiting the outpatient clinic between January 2000 and August 2001, who underwent a HRCT as well as lung function tests (including exercise testing), were reviewed. Two readers scored the first 60 HRCT images twice. Weighted kappa and intra-class correlation coefficient were used to assess the reliability of the HRCT scoring system. Spearman's rank correlation coefficients and multiple regression analyses were performed to evaluate the relationship between HRCT findings (first reading, reader A) and respiratory functional impairment. Intra- and inter-reader reliability demonstrated good agreement. All HRCT subscores, except enlargement of lymph nodes, were correlated to the FEV{sub 1}, FVC, DLco, Pao{sub 2}max (all p<0.05) and A-aPo{sub 2}max (p <0.001). Furthermore, HRCT abnormalities, but not the chest radiographic stage, were strongly associated with functional parameters. Abnormal changes of lung parenchyma, established by HRCT features, were associated with respiratory functional impairment in sarcoidosis. Moreover, compared with the radiographic stages, HRCT findings appeared to be much more sensitive in depicting respiratory disability, especially abnormal gas exchange. (orig.)

  19. Sarcoidosis: assessment of disease severity using HRCT

    International Nuclear Information System (INIS)

    Drent, Marjolein; Vries, Jolanda De; Lenters, Merinke; Wouters, Emiel F.M.; Lamers, Rob J.S.; Rothkranz-Kos, Snjezana; Dieijen-Visser, Marja P. van; Verschakelen, Johny A.

    2003-01-01

    The value of high-resolution computed tomography (HRCT) in diagnosing and assessing inflammatory activity in sarcoidosis is well established. The aim of the present study was to address the intra- and inter-observer agreements of the HRCT score by Oberstein et al. [8], and to evaluate the relationship between HRCT findings and disease severity expressed in respiratory functional impairment in sarcoidosis. The clinical records of 80 known sarcoidosis patients visiting the outpatient clinic between January 2000 and August 2001, who underwent a HRCT as well as lung function tests (including exercise testing), were reviewed. Two readers scored the first 60 HRCT images twice. Weighted kappa and intra-class correlation coefficient were used to assess the reliability of the HRCT scoring system. Spearman's rank correlation coefficients and multiple regression analyses were performed to evaluate the relationship between HRCT findings (first reading, reader A) and respiratory functional impairment. Intra- and inter-reader reliability demonstrated good agreement. All HRCT subscores, except enlargement of lymph nodes, were correlated to the FEV 1 , FVC, DLco, Pao 2 max (all p 2 max (p <0.001). Furthermore, HRCT abnormalities, but not the chest radiographic stage, were strongly associated with functional parameters. Abnormal changes of lung parenchyma, established by HRCT features, were associated with respiratory functional impairment in sarcoidosis. Moreover, compared with the radiographic stages, HRCT findings appeared to be much more sensitive in depicting respiratory disability, especially abnormal gas exchange. (orig.)

  20. The impact of physical activity on non-motor symptoms in Parkinson’s disease: a systematic review

    Directory of Open Access Journals (Sweden)

    Melanie Elizabeth Cusso

    2016-08-01

    Full Text Available Parkinson’s disease (PD is a neurological disorder that is associated with both motor and non-motor symptoms. The management of PD is primarily via pharmaceutical treatment, however non-pharmaceutical interventions have become increasingly recognised in the management of motor and non-motor symptoms (NMS. In this review, the efficacy of physical activity, including physiotherapy and occupational therapy, as an intervention in NMS will be assessed. The papers were extracted between the 20th to 22th of June 2016 from Pubmed, Web of Science, Medline, Ovid, SportsDiscuss and Scopus using the MeSH search terms ‘Parkinson’s’, ‘Parkinson’ and ‘Parkinsonism’ in conjunction with ‘exercise’, ‘physical activity’, ‘physiotherapy’, ‘occupational therapy’, ‘physical therapy’, ‘rehabilitation’, ‘dance’ and ‘martial arts’. Twenty studies matched inclusion criteria of having ten or more participants with diagnosed idiopathic PD participating in the intervention as well as having to evaluate the effects of physical activity on NMS in PD as controlled, randomized intervention studies. The outcomes of interest were NMS, including depression, cognition, fatigue, apathy, anxiety and sleep. Risk of bias in the studies was evaluated using the Cochrane Collaboration’s tool for assessing risk of bias. Comparability of the various intervention methods however was challenging due to demographic variability and methodological differences. Nevertheless, physical activity can positively impact the global NMS burden including depression, apathy, fatigue, day time sleepiness, sleep and cognition, thus supporting its therapeutic potential in neurodegenerative conditions such as PD. It is recommended that further adequately powered studies are conducted to assess the therapeutic role of physical activity on both motor and non-motor aspects of PD. These studies should be optimally designed to assess non-motor elements of disease

  1. Reevaluation of the role of duration of morning stiffness in the assessment of rheumatoid arthritis activity

    DEFF Research Database (Denmark)

    Khan, Nasim A; Yazici, Yusuf; Calvo-Alen, Jaime

    2009-01-01

    OBJECTIVE: To evaluate the utility of the duration of morning stiffness (MS), as a patient-reported outcome (PRO), in assessing rheumatoid arthritis (RA) disease activity. METHODS: We acquired information on 5439 patients in QUEST-RA, an international database of patients with RA evaluated by a s...

  2. Evaluation of learned helplessness, self-efficacy and disease activity, functional capacity and pain in Argentinian patients with rheumatoid arthritis.

    Science.gov (United States)

    Vergara, F; Rosa, J; Orozco, C; Bertiller, E; Gallardo, M A; Bravo, M; Catay, E; Collado, V; Gómez, G; Sabelli, M; García, M V; Rosemffet, M G; Citera, G; Schneeberger, E E; Catoggio, L J; Soriano, E R

    2017-01-01

    To evaluate the association between learned helplessness (LH) and self-efficacy (SE) with disease activity, functional capacity, and level of pain in patients with rheumatoid arthritis (RA) and to compare LH and SE between patients in remission and patients with active disease. This multicentre, cross-sectional study included consecutive patients (aged ≥ 18 years) with RA according to 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria. LH was measured by the Rheumatology Attitude Index (RAI), Spanish version; SE with the Arthritis Self-efficacy Scale (ASES), Spanish version; functional capacity with the Health Assessment Questionnaire, Argentinian version (HAQ-A); and perceived pain by the visual analogue scale (VAS). Disease activity was measured by the Clinical Disease Activity Index (CDAI). A total of 115 patients (82% females) with a mean (± sd) age of 58 ± 13 years were included. We found a significantly positive correlation between LH and perceived pain (p < 0.001), HAQ-A score (p < 0.001), and CDAI (p < 0.001) and a significantly negative correlation between SE and perceived pain (p < 0.001), HAQ-A score (p < 0.001), and CDAI (p < 0.001). We found greater levels of SE and lower grades of LH in patients in remission compared to those with active disease (median 76 vs. 58; p < 0.001 and 6 vs. 11; p < 0.001, respectively). LH and SE correlated significantly with disease activity, functional capacity, and perceived pain. Levels of SE were higher in patients in remission compared to those with active disease as opposed to levels of LH, which were lower in patients in remission compared to those with active disease. These results show that cognitive factors are related to disease activity and their modifications may have importance in the management of RA.

  3. Associations between diet and disease activity in ulcerative colitis patients using a novel method of data analysis

    Directory of Open Access Journals (Sweden)

    Curno Richard

    2005-02-01

    Full Text Available Abstract Background The relapsing nature and varying geographical prevalence of ulcerative colitis (UC implicates environmental factors such as diet in its aetiology. Methods In order to determine which foods might be related to disease activity in UC a new method of dietary analysis was developed and applied. Eighty-one UC patients were recruited at all stages of the disease process. Following completion of a 7 d diet diary, clinical assessment including a sigmoidoscopic examination (scale 0 (normal mucosa to 6 (very active disease was conducted. Food weights for each person were adjusted (divided by the person's calorific intake for the week. Each food consumed was given a food sigmoidoscopy score (FSS calculated by summing the products of the (adjusted weight of food consumed and sigmoidoscopy score for each patient and occurrence of food and dividing by the total (adjusted weight of the food consumed by all 81 patients. Thus, foods eaten in large quantities by patients with very active disease have high FSSs and vice versa. Foods consumed by Results High FSS foods were characterized by high levels of the anti-thiamin additive sulfite (Mann-Whitney, p Conclusions The dietary analysis method described provides a new tool for establishing relationships between diet and disease and indicates a potentially therapeutic diet for UC.

  4. Detection of active alveolar bone destruction in human periodontal disease by analysis of radiopharmaceutical uptake after a single injection of 99m-Tc-methylene diphosphonate

    International Nuclear Information System (INIS)

    Jeffcoat, M.K.; Williams, R.C.; Holman, B.L.; English, R.; Goldhaber, P.

    1986-01-01

    Previous studies have shown that, following a single injection of 99m-Tc-MDP, measurement of bone-seeking radiopharmaceutical uptake can detect ''active'' alveolar bone loss due to periodontal disease in beagle dogs, as determined by radiographs taken at the time of, and several months after, the nuclear medicine procedure. The efficacy of this diagnostic test, however, had not been assessed in human periodontal disease. The ability of a single boneseeking radiopharmaceutical uptake examination to detect ''active'' alveolar bone loss due to periodontal disease in human patients was assessed by comparing a single uptake measurement to the rate of bone loss determined from serial radiographs taken over a 6-month period. Uptake was expressed as a ratio of the cpm from the alveolar bone divided by the cpm from the non-tooth supporting bone of the nuchal crest. High uptake ratios were associated with ''active'' loss and low uptake ratios were associated with little if any change in alveolar bone height (p<0.001). The nuclear medicine examination was an accurate detector of periodontal disease activity in nearly 80% of the individual teeth studied. These data indicate that high bone-seeking radiopharmaceutical uptake ratios may be pathognomonic of active bone loss in human periodontal disease. (author)

  5. A Randomized, Double-blind, Placebo-controlled Clinical Trial Examining the Effects of Green Tea Extract on Systemic Lupus Erythematosus Disease Activity and Quality of Life.

    Science.gov (United States)

    Shamekhi, Z; Amani, R; Habibagahi, Z; Namjoyan, F; Ghadiri, Ata; Saki Malehi, A

    2017-07-01

    Antiinflammatory and immunomodulatory benefit of green tea (Camellia sinensis) in autoimmune disease has been proven in recent studies. The objective of this study was to assess the effects of green tea on disease activity and quality of life in systemic lupus erythematosus patients. A randomized controlled trial on subjects with lupus was conducted, and 68 patients in the age range of 39.1 ± 10.3 years and body mass index of 25.7 ± 5.21 kg/m 2 completed the 12-week study. Patients were randomly divided into two groups of intervention (1000 mg green tea extract, two capsules/day) and control (1000 mg of starch, two capsules/day). Main outcome measure, systemic lupus erythematosus disease activity, was assessed by the systemic lupus erythematosus disease activity index at the first and after 3 months of intervention. In addition, patient's quality of life was evaluated by short form of quality-of-life questionnaire at baseline and after 3 months. Green tea extract supplementation significantly reduced disease activity in lupus patients (p tea extracts for 12 weeks improves the systemic lupus erythematosus disease activity as well as some aspects of quality of life. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  6. Disease activity, quality of life and indirect costs of reduced productivity at work, generated by Polish patients with ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Paweł Kawalec

    2016-02-01

    Full Text Available Objectives: The aim of the study was to investigate the association between activity of ankylosing spondylitis (AS and decrease in quality of life as well as productivity loss of affected patients in a specified group of patients in the Polish setting. Material and methods : An questionnaire survey was conducted using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI to assess disease activity, as well as the Work Productivity and Activity Impairment Questionnaires to assess productivity loss; quality of life was presented as utility calculated using the EuroQol 5 questionnaire and also measured on a visual analogue scale (VAS. Indirect costs were assessed with the human capital approach implying gross domestic product per capita or gross value added per worker in Poland in 2014 and were expressed in Polish zlotys (PLN as well as in euros. Correlation was presented using Spearman’s rank correlation coefficient. Results : We performed our analysis based on 78 full questionnaires collected. A mean BASDAI score of 5.91 in the analysed group of patients was detected and mean utility of 0.5135 was observed. Average quality of life measured on the visual analogue scale was 46.55. Mean number of days off work was 45.26 days per year and mean on-the-job productivity loss was 49.29%. Average annual indirect costs per patient were €4241 (17 686 PLN calculated using gross domestic product and €10 172 (42 417 PLN estimated using gross value added. Total productivity loss was significantly correlated with disease activity (strong correlation of 0.6005 and utility (moderate correlation of –0.3698. Conclusions : Ankylosing spondylitis causes a great decrease in quality of life as well as patients’ productivity loss associated with both absenteeism and presenteeism. The greater the disease activity is, the lower is the utility, the lower is the quality of life measured on the VAS, and the greater are the total annual indirect costs. Total

  7. Validity of Montreal Cognitive Assessment in non-english speaking patients with Parkinson's disease.

    Science.gov (United States)

    Krishnan, Syam; Justus, Sunitha; Meluveettil, Radhamani; Menon, Ramshekhar N; Sarma, Sankara P; Kishore, Asha

    2015-01-01

    The Montreal Cognitive Assessment is a brief and easy screening tool for accurately testing cognitive dysfunction in Parkinson's disease. We tested its validity for use in non-English (Malayalam) speaking patients with Parkinson's disease. We developed a Malayalam (a south-Indian language) version of Montreal Cognitive Assessment and applied to 70 patients with Parkinson's disease and 60 age- and education-matched healthy controls. Metric properties were assessed, and the scores were compared with the performance in validated Malayalam versions of Mini Mental Status Examination and Addenbrooke's Cognitive Examination. The Montreal Cognitive Assessment-Malayalam showed good internal consistency and test-retest reliability and its scores correlated with Mini Mental Status Examination (patients: R = 0.70; P speaking Parkinson's disease patients for early screening and potential future interventions for cognitive dysfunction.

  8. Alteration of matrix metalloproteinase-3 O-glycan structure as a biomarker for disease activity of rheumatoid arthritis.

    Science.gov (United States)

    Takeshita, Masaru; Kuno, Atsushi; Suzuki, Katsuya; Matsuda, Atsushi; Shimazaki, Hiroko; Nakagawa, Tomomi; Otomo, Yuki; Kabe, Yasuaki; Suematsu, Makoto; Narimatsu, Hisashi; Takeuchi, Tsutomu

    2016-05-21

    biomarker using glycan change at a local lesion to assess disease activity in autoimmune diseases. Differences in the degree of serum MMP-3 α-2,6-sialylation may be a useful index for estimating disease activity.

  9. The costs of preventive activities for exotic contagious diseases - A Danish case study of foot and mouth disease and swine fever

    DEFF Research Database (Denmark)

    Denver, Sigrid; Alban, Lis; Boklund, Anette

    2016-01-01

    The present paper provides an overview of the costs of preventive activities, currently undertaken in Denmark, related to foot and mouth disease (FMD) and classical and African swine fever (SF). Only costs held between outbreaks were included. Costs were divided into public costs and costs paid...... in a group of experts from universities, industry, and public authorities. The costs of each preventive activity were related to the type of activity, the number of times the activity was carried out and the share of costs that could be associated with FMD or SF. Uncertainty about parameters was incorporated...... by the pig and cattle industries, respectively. Data were retrieved from multiple sources such as databases, legal documents, official statistics, yearly reports and expert opinions. As no previous studies have assessed such costs, data collection and estimation procedures were discussed and decided upon...

  10. Pain intensity in patients with juvenile idiopathic arthritis with respect to the level of their activity and disease acceptance

    Directory of Open Access Journals (Sweden)

    Grażyna Cepuch

    2014-11-01

    Full Text Available Objectives: Being diagnosed with a chronic disease, such as juvenile idiopathic arthritis (JIA, may adversely affect the activity of a young person. Additionally, the pain associated with the disease may cause difficulty accepting it. The aim was to assess the intensity of pain as well as the degree of activity and acceptance of the disease in young people aged 14–18 years with JIA. Material and methods : The study group consisted of youth of both genders suffering from JIA aged 14–18 years during remission of the disease. The study included 50 people and used the following: numerical rating scale (NRS 0–10, Cantril ladder, activity scale of own authorship (grouped items of the questionnaire form subscales of: tiredness, physical activity, social and intellectual activity and Acceptance of Illness Scale (AIS. Statistical analysis included the following tests: Mann-Whitney U test, Wilcoxon’s, χ2 test, Fisher’s, and Spearman rank correlation. The statistical significance level was set as p value below 0.05. Results : The majority of the respondents observed currently do not feel pain or feel pain of low intensity. The young people are physically, psychologically and socially active. The majority of patients accept their illness. The patients who suffer from pain on the NRS scale within 4–7 points do not adapt to living with the disease as do patients without pain or experiencing pain of low intensity. There was a strong correlation between acceptance of the disease at the time of the study determined by the Cantril ladder and AIS. Conclusions : 1. The pain suffered by patients with juvenile idiopathic arthritis (JIA has undoubtedly a negative impact on their activity and acceptance of the disease. 2. It seems to be crucial to recognize pain as a significant determinant of acceptance of the disease.

  11. Validity and reliability of the Physical Activity Questionnaire for Children (PAQ-C) and Adolescents (PAQ-A) in individuals with congenital heart disease

    OpenAIRE

    Voss, Christine; Dean, Paige H.; Gardner, Ross F.; Duncombe, Stephanie L.; Harris, Kevin C.

    2017-01-01

    Objective To assess the criterion validity, internal consistency, reliability and cut-point for the Physical Activity Questionnaire for Children (PAQ-C) and Adolescents (PAQ-A) in children and adolescents with congenital heart disease?a special population at high cardiovascular risk in whom physical activity has not been extensively evaluated. Methods We included 84 participants (13.6?2.9 yrs, 50% female) with simple (37%), moderate (31%), or severe congenital heart disease (27%), as well as ...

  12. Circulating fibroblast activation protein activity and antigen levels correlate strongly when measured in liver disease and coronary heart disease

    NARCIS (Netherlands)

    S.U. de Willige; Keane, F.M. (Fiona M.); Bowen, D.G. (David G.); J.J.M.C. Malfliet (Joyce); Zhang, H.E. (H. Emma); Maneck, B. (Bharvi); G. McCaughan (Geoff); F.W.G. Leebeek (Frank); D.C. Rijken (Dingeman); Gorrell, M.D. (Mark D.)

    2017-01-01

    textabstractBackground and aim: Circulating fibroblast activation protein (cFAP) is a constitutively active enzyme expressed by activated fibroblasts that has both dipeptidyl peptidase and endopeptidase activities. We aimed to assess the correlation between cFAP activity and antigen levels and to

  13. Quantifying the inflammatory activity in Crohn's disease using CE dynamic MRI

    International Nuclear Information System (INIS)

    Pauls, S.; Schmidt, S.A.; Brambs, H.J.; Gabelmann, A.; Kratzer, W.; Mittrach, C.; Adler, G.; Rieber, A.

    2003-01-01

    Purpose: Evaluation of dynamic contrast enhanced MRI in patients with Crohn's disease to assess local inflammatory activity. Material and Methods: Prospective study of 13 patients with histologically proven Crohn's disease. Axial and coronal slices were acquired by a 1.5 T MR (Magnetom Vision, Siemens, Germany): T1 flash 2 D (TR 72.5 ms, TE 4.1 ms), T2 (TR 2730 ms, TE 138 ms), turbo-flash sequences T1 (TR 94.2 ms, TE 4.1 ms) post contrast media fat saturated (Magnevist circledR , 0.2 ml/kg, flow 4 ml/s). In area of maximal thickening of terminal ileal wall, axial dynamic T1 sequences (TR 11 ms, TE 4.2 ms) were acquired every 1.5 s post contrast media application for a total duration of 1 min. Contrast uptake was subjectively measured by semiquantitative score and computed assisted ROI evaluation. MR parameters were correlated with CDAI (Crohn's disease activity index) and SAI (severe activity index). Results: Contrast uptake in the intestinal wall occurred after 18.5 s (range: 3.0-28.0), contrast upslope until plateau phase lasted for 16.1 s (range: 8.0-50.0). Maximum contrast enhancement into the bowel wall was 266% (105-450%) of baseline. After maximum contrast uptake, we observed a plateau phase in all cases for the total duration of measurement. A significant correlation existed for maximum contrast uptake to CDAI (r = 0.591; p = 0.033), for beginning of contrast upslope to the time until plateau phase (r = 0.822; p = 0.001), and for the time until plateau phase to CDAI (r = 0.562; p = 0.046). CDAI was on average 108, median 106; SAI was on average 114, median 115. SAI correlated significantly to CDAI (r = 0.874). Maximum contrast uptake, beginning of contrast upslope, and time until plateau phase were independent to creeping fat, local lymphadenitis, laboratory parameters, temperature, body mass index, heart frequency and systolic blood pressure. Conclusion: Dynamic MRI enables to quantify local inflammatory activity of bowel wall in patients with Crohn

  14. Longitudinal patterns of predominant asthma disease activity in pediatric patients enrolled in an asthma-specific disease management program.

    Science.gov (United States)

    Scott, Lyne; Nichols, Breck; Choi Kwong, Kenny Yat; Morphew, Tricia; Jones, Craig A

    2008-08-01

    To determine if patterns of predominant asthma disease activity are more closely related than baseline asthma severity to measures of morbidity (acute asthma attack, emergency room visit/hospitalization, missed school days, and/or steroid burst). Retrospective analysis was performed for inner-city Los Angeles asthmatic children (3 to 18 years of age) during their first year of enrollment in an asthma-specific disease management program. All measures of morbidity were more closely related to patterns of predominant disease activity than baseline severity. We conclude that patterns of predominant disease activity are a more significant predictor of asthma morbidity than is baseline severity.

  15. Functional Performance and Associations between Performance Tests and Neurological Assessment Differ in Men and Women with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Kadri Medijainen

    2015-01-01

    Full Text Available Background. Neurological assessment of a patient with Parkinson’s disease (PD is expected to reflect upon functional performance. As women are known to report more limitations even for same observed functional performance level, present study was designed to examine whether associations between neurological assessments and functional performance differ across genders. Methods. 14 men and 14 women with PD participated. Functional performance was assessed by measuring walking speeds on 10-meter walk test (10MWT and by performing timed-up-and-go-test (TUG. Neurological assessment included Hoehn and Yahr Scale (HY, Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS, Schwab and England Activities of Daily Living Scale (S-E, and Mini Mental State Examination (MMSE. Results. In women with PD, Kendall’s tau-b correlation analyses revealed significant correlations between functional performance tests and neurological assessment measures, with the exception in MMSE. No corresponding associations were found for men, although they demonstrated better functional performance, as expected. Conclusion. Men in similar clinical stage of the PD perform better on functional tests than women. Disease severity reflects upon functional performance differently in men and women with PD. Results indicate that when interpreting the assessment results of both functional performance and neurological assessment tests, the gender of the patient should be taken into consideration.

  16. Antibacterial Activity of Hawaiian Corals: Possible Protection from Disease?

    Science.gov (United States)

    Gochfeld, D. J.; Aeby, G. S.; Miller, J. D.

    2006-12-01

    Reports of coral diseases in the Caribbean have appeared with increasing frequency over the past two decades; however, records of coral diseases in the Pacific have lagged far behind. Recent surveys of coral disease in the Hawaiian Islands indicate relatively low, but consistent, levels of disease throughout the inhabited Main and uninhabited Northwestern Hawaiian Islands, and demonstrate variation in levels of disease among the major genera of Hawaiian corals. Although little is known about immune defense to disease in corals, one potential mechanism of defense is the production of antimicrobial compounds that protect corals from pathogens. A preliminary survey of antibacterial chemical defenses among three dominant species of Hawaiian corals was undertaken. Crude aqueous extracts of Porites lobata, Pocillopora meandrina and Montipora capitata were tested against nine strains of bacteria in a growth inhibition assay. Inhibitory extracts were further tested to determine whether their effects were cytostatic or cytotoxic. The bacteria selected included known coral pathogens, potential marine pathogens found in human waste and strains previously identified from the surfaces of Hawaiian corals. Extracts from all three species of coral exhibited a high degree of antibacterial activity, but also a high degree of selectivity against different bacterial strains. In addition, some extracts were stimulatory to some bacteria. In addition to interspecific variability, extracts also exhibited intraspecific variability, both within and between sites. Hawaiian corals have significant antibacterial activity, which may explain the relatively low prevalence of disease in these corals; however, further characterization of pathogens specifically responsible for disease in Hawaiian corals is necessary before we can conclude that antibacterial activity protects Hawaiian corals from disease.

  17. IgG4-Related Disease: Baseline clinical and laboratory features in 125 patients with biopsy-proven disease

    Science.gov (United States)

    Wallace, Zachary S.; Deshpande, Vikram; Mattoo, Hamid; Mahajan, Vinay S.; Kulikova, Maria; Pillai, Shiv; Stone, John H.

    2015-01-01

    Purpose IgG4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition that can affect nearly any organ. No detailed clinical and laboratory assessments have been reported in large numbers of patients with IgG4-RD diagnoses established by strict clinicopathological correlation. Methods We reviewed the baseline features of 125 patients with biopsy-proven disease. The diagnosis was confirmed by pathology review according to consensus diagnostic criteria. Disease activity and damage were assessed by the IgG4-RD Responder Index (RI). Flow cytometry was used to assess levels of circulating plasmablasts. Results Of the 125 patients, 103 had active disease and 86 were on no treatment. Only 51% of the patients with active disease had elevated serum IgG4 concentrations. However, patients with active disease and elevated serum IgG4 concentrations were older, had a higher RI, a greater number of organs involved, lower complement levels, higher absolute eosinophil counts, and higher IgE levels compared to those with active disease but normal serum IgG4 (PIgG4+ plasmablast level and RI (R=0.45, P=0.003) was stronger than that of total plasmablasts and RI. Seventy-six (61%) of the patients were male, but no significant differences according to gender were observed with regard to disease severity, organ involvement, or serum IgG4 concentrations. Glucocorticoids failed to produce sustained remission in the majority of patients. Conclusion Nearly 50% of this patient cohort with biopsy-proven, clinically-active IgG4-RD had normal serum IgG4 concentrations. Serum IgG4 elevation identify a subset with more inflammatory features. IgG4+ plasmablasts correlate well with disease activity. PMID:25988916

  18. Time estimation in Parkinson's disease and degenerative cerebellar disease

    NARCIS (Netherlands)

    Beudel, Martijin; Galama, Sjoukje; Leenders, Klaus L.; de Jong, Bauke M.

    2008-01-01

    With functional MRI, we recently identified fronto-cerebellar activations in predicting time to reach a target and basal ganglia activation in velocity estimation, that is, small interval assessment. We now tested these functions in patients with Parkinson's disease (PD) and degenerative cerebellar

  19. EULAR Sjögren's syndrome disease activity index (ESSDAI) : a user guide

    NARCIS (Netherlands)

    Seror, Raphaèle; Bowman, Simon J; Brito-Zeron, Pilar; Theander, Elke; Bootsma, Hendrika; Tzioufas, Athanasios; Gottenberg, Jacques-Eric; Ramos-Casals, Manel; Dörner, Thomas; Ravaud, Philippe; Vitali, Claudio; Mariette, Xavier; Asmussen, Karsten; Jacobsen, Soren; Bartoloni, Elena; Gerli, Roberto; Bijlsma, Johannes Wj; Kruize, Aike A; Bombardieri, Stefano; Bookman, Arthur; Kallenberg, Cees; Meiners, Petra; Brun, Johan G; Jonsson, Roland; Caporali, Roberto; Carsons, Steven; De Vita, Salvatore; Del Papa, Nicoletta; Devauchelle, Valerie; Saraux, Alain; Fauchais, Anne-Laure; Sibilia, Jean; Hachulla, Eric; Illei, Gabor; Isenberg, David; Jones, Adrian; Manoussakis, Menelaos; Mandl, Thomas; Jacobsson, Lennart; Demoulins, Frederic; Montecucco, Carlomaurizio; Ng, Wan-Fai; Nishiyama, Sumusu; Omdal, Roald; Parke, Ann; Praprotnik, Sonja; Tomsic, Matjia; Price, Elizabeth; Scofield, Hal; L Sivils, Kathy; Smolen, Josef; Laqué, Roser Solans; Steinfeld, Serge; Sutcliffe, Nurhan; Sumida, Takayuki; Valesini, Guido; Valim, Valeria; Vivino, Frederick B; Vollenweider, Cristina

    2015-01-01

    The EULAR Sjögren's syndrome (SS) disease activity index (ESSDAI) is a systemic disease activity index that was designed to measure disease activity in patients with primary SS. With the growing use of the ESSDAI, some domains appear to be more challenging to rate than others. The ESSDAI is now in

  20. A new integrative model of cerebral activation, deactivation and default mode function in Alzheimer's disease

    International Nuclear Information System (INIS)

    Wermke, Marc; Sorg, Christian; Wohlschlaeger, Afra M.; Drzezga, Alexander

    2008-01-01

    Functional imaging methods such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) allow in vivo assessment of cerebral metabolism at rest and cerebral responses to cognitive stimuli. Activation studies with different cognitive tasks have deepened the understanding of underlying pathology leading to Alzheimer disease (AD) and how the brain reacts to and potentially compensates the imposed damage inflicted by this disease. The aim of this manuscript study was to summarize current findings of activation studies in healthy people at risk for AD, in people with mild cognitive impairment (MCI) as a possible progenitor of AD and finally in patients with manifest AD, adding recent results about impaired deactivation abilities and default mode function in AD. A new comprehensive model will be introduced integrating these heterogeneous findings and explaining their impact on cognitive performance. (orig.)

  1. Imaging popliteal artery disease in young adults with claudication: self-assessment module.

    Science.gov (United States)

    Chew, Felix S; Bui-Mansfield, Liem T

    2007-09-01

    The educational objectives of this self-assessment module on imaging popliteal artery disease in young adults with intermittent claudication are for the participant to exercise, self-assess, and improve his or her knowledge of the imaging and clinical features of popliteal artery entrapment syndrome, cystic adventitial disease,and masses associated with popliteal artery obstruction.

  2. Validation of the Actiheart Activity Monitor for Measurement of Activity Energy Expenditure in Children and Adolescents with Chronic Disease.

    OpenAIRE

    2010-01-01

    Abstract Introduction: The purpose of this study was to develop an activity energy expenditure (AEE) prediction equation for the Actiheart activity monitor (AH) for use in children with chronic disease. Methods: 63 children, aged 8-18 years with different types of chronic disease (Juvenile Arthritis, Hemophilia, Dermatomyositis, neuromuscular disease, Cystic Fibrosis or Congenital Heart Disease) participated in an activity testing session which consisted of a resting protocol, ...

  3. Cartilage oligomeric matrix protein (COMP) in rheumatoid arthritis and its correlation with sonographic knee cartilage thickness and disease activity.

    Science.gov (United States)

    Sakthiswary, Rajalingham; Rajalingam, Shamala; Hussein, Heselynn; Sridharan, Radhika; Asrul, Abdul Wahab

    2017-12-01

    The aim of the study is to investigate the correlation of serum cartilage oligomeric matrix protein (COMP) levels with articular cartilage damage based on sonographic knee cartilage thickness (KCT) and disease activity in rheumatoid arthritis (RA). A total of 61 RA patients and 27 healthy controls were recruited in this study. Serum samples were obtained from all subjects to determine the serum COMP levels. All subjects had bilateral ultrasound scan of their knees. The KCT was based on the mean of measurements at three sites: the medial condyle, lateral condyle and intercondylar notch. Besides, the RA patients were assessed for their disease activity based on 28-joint-based Disease Activity Score (DAS 28). Serum COMP concentrations were significantly elevated in the RA patients compared to the controls (p = 0.001). The serum COMP levels had an inverse relationship with bilateral KCT in RA subjects and the healthy controls. COMP correlated significantly with disease activity based on DAS 28 (r = 0.299, p = 0.010), disease duration (r = 0.439, p = correlation between serum COMP and DAS 28 scores was comparable to the traditional markers of inflammation: erythrocyte sedimentation rate (ESR) (r = 0.372, p = 0.003) and C-reactive protein (CRP) (r = 0.305, p = 0.017). The serum COMP is a promising biomarker in RA which reflects disease activity and damage to the articular cartilage.

  4. Nailfold capillaroscopic changes in patients with systemic lupus erythematosus: correlations with disease activity, skin manifestation and nephritis.

    Science.gov (United States)

    Shenavandeh, S; Habibi, S

    2017-08-01

    Introduction The clinical expression of systemic lupus erythematosus (SLE) is the consequence of endothelial cell damage leading to serious multiple organ dysfunction. The aim of this study was to assess the association between nailfold capillaroscopic changes and disease activity, skin and renal involvement in patients with SLE. Methods Demographic variables, clinical manifestations and laboratory data of 108 patients with SLE were investigated. Nailfold capillaroscopy (NFC) was performed in all patients. Result Morphological changes in NFC were observed in 102 out of 108 (94.4%) SLE patients. Minor changes were found in 33 (30.6%) and major changes in 69 (63.9%) cases. The disease activity was significantly higher in the patients with major changes ( p  0.05), except for the elongated capillary loops, which were seen more often in patients with renal involvement than in patients without it ( p < 0.03). Conclusion The results of the study showed that capillary changes (abnormal capillaroscopy) were very common in patients with SLE, although there were no specific patterns like the ones in scleroderma patients, and some changes may be associated with disease activity, especially in patients with active skin involvement.

  5. Can the CERAD neuropsychological battery be used to assess cognitive impairment in Parkinson's disease?

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Ferreira Camargo

    Full Text Available ABSTRACT The Consortium to Establish a Registry for Alzheimer's Disease (CERAD neuropsychological battery was created to assess cognitive impairment in Alzheimer's disease (AD but it is widely-used for various dementias. The aim of this study was to analyze the efficacy of using the CERAD battery in the assessment of patients with Parkinson's disease. Forty-nine patients with Parkinson's disease were divided into two groups (one with dementia and one without using the Movement Disorder Society criteria for Parkinson's disease dementia. Cognitive deficits were assessed with the Clinical Dementia Rating Scale as the gold standard, and the CERAD. The ROC curve for the CERAD battery had an area under the curve = 0.989 (95% CI = 0.967 – 1, p<0.0001. Among the CERAD subtests, verbal fluency had the worst accuracy, and word list learning had the best accuracy. Despite the limits of this study, the CERAD battery can be efficient for assessment of cognitive deficits in Parkinson's disease patients.

  6. A Randomized Trial of Pocket-Echocardiography Integrated Mobile Health Device Assessments in Modern Structural Heart Disease Clinics.

    Science.gov (United States)

    Bhavnani, Sanjeev P; Sola, Srikanth; Adams, David; Venkateshvaran, Ashwin; Dash, P K; Sengupta, Partho P

    2018-04-01

    This study sought to determine whether mobile health (mHealth) device assessments used as clinical decision support tools at the point-of-care can reduce the time to treatment and improve long-term outcomes among patients with rheumatic and structural heart diseases (SHD). Newly developed smartphone-connected mHealth devices represent promising methods to diagnose common diseases in resource-limited areas; however, the impact of technology-based care on long-term outcomes has not been rigorously evaluated. A total of 253 patients with SHD were randomized to an initial diagnostic assessment with wireless devices in mHealth clinics (n = 139) or to standard-care (n = 114) in India. mHealth clinics were equipped with point-of-care devices including pocket-echocardiography, smartphone-connected-electrocardiogram blood pressure and oxygen measurements, activity monitoring, and portable brain natriuretic peptide laboratory testing. All individuals underwent comprehensive transthoracic echocardiography to assess the severity of SHD. The primary endpoint was the time to referral for therapy with percutaneous valvuloplasty or surgical valve replacement. Secondary endpoints included the probability of a cardiovascular hospitalization and/or death over 1 year. An initial mHealth assessment was associated with a shorter time to referral for valvuloplasty and/or valve replacement (83 ± 79 days vs. 180 ± 101 days; p Mobile Health Device Assessments in Modern Structural Heart Disease Clinics; NCT02881398). Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  7. Blood Monocyte Subsets and Selected Cardiovascular Risk Markers in Rheumatoid Arthritis of Short Duration in relation to Disease Activity

    Directory of Open Access Journals (Sweden)

    Ewa Klimek

    2014-01-01

    Full Text Available Objectives. To evaluate blood monocyte subsets and functional monocyte properties in patients with rheumatoid arthritis (RA of short duration in the context of cardiovascular (CV risk and disease activity. Methods. We studied conventional markers of CV risk, intima media thickness (IMT, and blood monocyte subsets in 27 patients aged 41 ± 10 years with RA of short duration (median 12 months and 22 healthy controls. The RA subjects were divided into low (DAS28: 2.6–5.1 and high (DAS28 > 5.1 disease activity. Results. RA patients exhibited increased levels of intermediate (CD14++CD16+ monocytes with decreased CD45RA expression compared to controls, increased counts of classical (CD14++CD16− monocytes, and decreased percentages of nonclassical (CD14+CD16++ monocytes. Patients with high disease activity had lower HLA DR expression on classical monocytes compared to low disease activity patients. There were no differences in monocyte subsets between subjects with DAS > 5.1 and DAS ≤ 5.1. There were no significant intergroup differences in IMT and the majority of classical CV risk factors. Conclusions. Patients with RA of short duration show alteration in peripheral blood monocyte subsets despite the fact that there is no evidence of subclinical atherosclerosis. Disease activity assessed with DAS28 was associated with impaired functional properties but not with a shift in monocyte subpopulations.

  8. Immunohistochemical expression of AQP-3 in vitiligo: a new potential guide for disease activity.

    Science.gov (United States)

    Hodeib, Abeer; Hegab, Doaa; Rizk, Omnia; Mohammed, Shahdan

    2017-08-01

    Vitiligo is a depigmenting skin disorder, with disappearance of functioning epidermal melanocytes. Aquaporin-3 (AQP-3) is an aquaglyceroporin expressed in epidermal keratinocytes, where it shares in regulating their proliferation and differentiation, and so it might affect melanocytes indirectly. So far, little is known regarding its possible role in vitiligo. This work aimed to study the changes in immunohistochemical expression of AQP-3 protein in vitiligo to detect its possible role in disease pathogenesis. Skin biopsies were taken from lesional skin of 30 vitiligo patients in addition to 20 normal controls. Epidermal immunohistochemical expression of AQP-3 was assessed as: +3 = strong expression, +2 = moderate, +1= weak and 0= negative expression. AQP-3 was significantly less expressed in vitiligo epidermis than control (PVitiligo Index of Disease Activity (r =-0.505, P=0.004). Reduced epidermal AQP-3 may have a role in impaired melanocyte survival in vitiligo, and might be a potential negative biological marker for vitiligo activity. Larger trials should further elucidate the effect of changes in epidermal AQP-3 expression in development of vitiligo, and that might pave the road for discovering new therapeutic modalities for the disease.

  9. Temporomandibular Joint Involvement in Association With Quality of Life, Disability, and High Disease Activity in Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    Frid, Paula; Nordal, Ellen; Bovis, Francesca; Giancane, Gabriella; Larheim, Tore A; Rygg, Marite; Pires Marafon, Denise; De Angelis, Donato; Palmisani, Elena; Murray, Kevin J; Oliveira, Sheila; Simonini, Gabriele; Corona, Fabrizia; Davidson, Joyce; Foster, Helen; Steenks, Michel H; Flato, Berit; Zulian, Francesco; Baildam, Eileen; Saurenmann, Rotraud K; Lahdenne, Pekka; Ravelli, Angelo; Martini, Alberto; Pistorio, Angela; Ruperto, Nicolino

    2017-05-01

    To evaluate the demographic, disease activity, disability, and health-related quality of life (HRQOL) differences between children with juvenile idiopathic arthritis (JIA) and their healthy peers, and between children with JIA with and without clinical temporomandibular joint (TMJ) involvement and its determinants. This study is based on a cross-sectional cohort of 3,343 children with JIA and 3,409 healthy peers, enrolled in the Pediatric Rheumatology International Trials Organisation HRQOL study or in the methotrexate trial. Potential determinants of TMJ involvement included demographic, disease activity, disability, and HRQOL measures selected through univariate and multivariable logistic regression. Clinical TMJ involvement was observed in 387 of 3,343 children with JIA (11.6%). Children with TMJ involvement, compared to those without, more often had polyarticular disease course (95% versus 70%), higher Juvenile Arthritis Disease Activity Score (odds ratio [OR] 4.6), more disability, and lower HRQOL. Children with TMJ involvement experienced clearly more disability and lower HRQOL compared to their healthy peers. The multivariable analysis showed that cervical spine involvement (OR 4.6), disease duration >4.4 years (OR 2.8), and having more disability (Childhood Health Assessment Questionnaire Disability Index >0.625) (OR 1.6) were the most important determinants for TMJ involvement. Clinical TMJ involvement in JIA is associated with higher disease activity, higher disability, and impaired HRQOL. Our findings indicate the need for dedicated clinical and imaging evaluation of TMJ arthritis, especially in children with cervical spine involvement, polyarticular course, and longer disease duration. © 2016, American College of Rheumatology.

  10. Magnetic resonance imaging for evaluation of disease activity in Crohn's disease: a systematic review

    NARCIS (Netherlands)

    Horsthuis, Karin; Bipat, Shandra; Stokkers, Pieter C. F.; Stoker, Jaap

    2009-01-01

    To systematically review the evidence on the accuracy of MRI for grading disease activity in Crohn's disease (CD). The MEDLINE, EMBASE, CINAHL and Cochrane databases were searched for studies on the accuracy of MRI in grading CD compared to a predefined reference standard. Two independent observers

  11. A Critical Assessment of Research on Neurotransmitters in Alzheimer's Disease.

    Science.gov (United States)

    Reddy, P Hemachandra

    2017-01-01

    The purpose of this mini-forum, "Neurotransmitters and Alzheimer's Disease", is to critically assess the current status of neurotransmitters in Alzheimer's disease. Neurotransmitters are essential neurochemicals that maintain synaptic and cognitive functions in mammals, including humans, by sending signals across pre- to post-synaptic neurons. Authorities in the fields of synapses and neurotransmitters of Alzheimer's disease summarize the current status of basic biology of synapses and neurotransmitters, and also update the current status of clinical trials of neurotransmitters in Alzheimer's disease. This article discusses the prevalence, economic impact, and stages of Alzheimer's dementia in humans.

  12. Environmental Impact Assessment and Space Activities

    Science.gov (United States)

    Viikari, L.

    Environmental Impact Assessment (EIA) is a common tool for environment a l protection and management on Earth today, as prior assessment of the environmental consequences of planned activities. It is meant to provide the decision-makers with as comprehensive as possible information about the different environmental effects the proposed activity would entail, including alternative courses of action and the zero-alternative (i.e. the no action alternative). Additionally, plans for mitigation in respect of each alternative are to be outlined. The assessments take account of i.a. environmental impacts on ecosystems, diminution of aesthetic and scientific values, long-term or cumulative effects, as well as transfrontier implications. They also consider issues such as pollution control, environmental protection measures, reporting, post-project analysis, rehabilitation and so on. Also uncertainties in the assessment process are to be expressly presented. Most importantly, a common requirement also is that the results of the impact studies are presented in a way comprehensible to the g neral public,e too. Although the central aspect of the EIA is to provide the decision-makers with scientific information, the process also has other important implications. One of the most relevant of them is the involvement of those people potentially affected in some way by the proposed activity: most EIA systems require in some way the participation of the public, alongside with the relevant governmental authorities and other stake-holders. Such public involvement has various aims and goals: it may serve as a testimony to good governance in general, or be considered in more practical terms as improved planning, due to the concrete contribution of the public to the decision-making process. Obviously, it also is a tool for reducing conflict and developing wider support for the eventual decisions. In short, it enables the public to gain information about planned activities and influence

  13. Validation study of the Alzheimer's disease assessment scale-cognitive subscale (ADAS-Cog) for the Portuguese patients with mild cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Nogueira, Joana; Freitas, Sandra; Duro, Diana; Almeida, Jorge; Santana, Isabel

    2018-03-23

    The Alzheimer's disease assessment scale-Cognitive Subscale (ADAS-Cog) is a battery to assess cognitive performance in Alzheimer's disease (AD) and was developed according to the core characteristics of cognitive decline in AD: memory, language, praxis, constructive ability, and orientation. The aim of this study was to explore the diagnostic accuracy and discriminative capacity of the ADAS-Cog for Mild Cognitive Impairment (MCI) and AD, using cut-off points for the Portuguese population. The European Portuguese version of the ADAS-Cog was administrated to 650 participants, divided into a control group (n = 210), an MCI group (n = 240), and an AD group (n = 200). The clinical groups fulfilled standard international diagnostic criteria. Controls were healthy cognitive participants actively integrated in the community. The neuropsychological assessment protocol included the ADAS-Cog, the Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Adults and Older Adults Functional Assessment Inventory (IAFAI). The ADAS-Cog revealed good psychometric indicators, and the total scores were significantly different between the three groups (p  9 points (AUC = .835; sensitivity = 58% and specificity = 91%) and AD > 12 points (AUC = .996; sensitivity = 94% and specificity = 98%). Our findings confirmed the capacity of the ADAS-Cog total score to identify cognitive impairment in AD patients, with poor sensitivity for MCI, in a Portuguese cohort.

  14. Assessment of Physical Activity and Active Transport Among School ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Assessment of Physical Activity and Active Transport Among School Children in Kenya, Nigeria, and Mozambique ... International Water Resources Association, in close collaboration with IDRC, is holding a webinar titled “Climate change and adaptive water management: Innovative solutions from the Global South”.

  15. Changes in spontaneous brain activity in early Parkinson's disease.

    Science.gov (United States)

    Yang, Hong; Zhou, Xiaohong Joe; Zhang, Min-Ming; Zheng, Xu-Ning; Zhao, Yi-Lei; Wang, Jue

    2013-08-09

    Resting state brain activity can provide valuable insights into the pathophysiology of Parkinson's disease (PD). The purpose of the present study was (a) to investigate abnormal spontaneous neuronal activity in early PD patients using resting-state functional MRI (fMRI) with a regional homogeneity (ReHo) method and (b) to demonstrate the potential of using changes in abnormal spontaneous neuronal activity for monitoring the progression of PD during its early stages. Seventeen early PD patients were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS), the Hoehn and Yahr disability scale and the Mini-mental State Examination (MMSE) were compared with seventeen gender- and age-matched healthy controls. All subjects underwent MRI scans using a 1.5T General Electric Signa Excite II scanner. The MRI scan protocol included whole-brain volumetric imaging using a 3D inversion recovery prepared (IR-Prep) fast spoiled gradient-echo pulse sequence and 2D multi-slice (22 axial slices covering the whole brain) resting-state fMRI using an echo planar imaging (EPI) sequence. Images were analyzed in SPM5 together with a ReHo algorithm using the in-house software program REST. A corrected threshold of pbrain regions, including the left cerebellum, left parietal lobe, right middle temporal lobe, right sub-thalamic nucleus areas, right superior frontal gyrus, middle frontal gyrus (MFG), right inferior parietal lobe (IPL), right precuneus lobe, left MFG and left IPL. Additionally, significantly reduced ReHo was also observed in the early PD patients in the following brain regions: the left putamen, left inferior frontal gyrus, right hippocampus, right anterior cingulum, and bilateral lingual gyrus. Moreover, in PD patients, ReHo in the left putamen was negatively correlated with the UPDRS scores (r=-0.69). These results indicate that the abnormal resting state spontaneous brain activity associated with patients with early PD can be revealed by Reho analysis. Copyright

  16. Serum Epstein-Barr virus DNA, detected by droplet digital PCR, correlates with disease activity in patients with rheumatoid arthritis.

    Science.gov (United States)

    Kuusela, Elina; Kouri, Vesa-Petteri; Olkkonen, Juri; Koivuniemi, Riitta; Äyräväinen, Leena; Rajamäki, Kristiina; Valleala, Heikki; Nordström, Dan; Leirisalo-Repo, Marjatta; Ainola, Mari; Eklund, Kari K

    2018-03-20

    To study the prevalence of asymptomatic activation of Epstein-Barr virus (EBV) in patients with rheumatoid arthritis (RA) and to analyse the correlation of serum EBV DNA with the disease activity. The level of EBV DNA was determined by droplet digital PCR assay from the serum of 46 DMARD naive early RA (ERA) and 22 chronic RA (CRA)-patients at study onset. Follow-up samples from 31 ERA and 16 CRA patients were obtained after starting or modifying the anti-rheumatic treatment. EBV DNA was also measured from 33 healthy controls and 9 patients with adult onset Still's disease (AOSD). Disease activity was assessed by the disease activity score (DAS28). At baseline, EBV DNA was detected in the serum of 7 of the 46 ERA patients all of whom had moderate or high disease activity. In the follow-up samples, 11 of 31 patients were EBV DNA positive. At baseline EBV positive patients had significantly higher disease activity (p=0.036) and the concentration of EBV DNA correlated significantly with DAS28 (rs=0.333, p=0.024). EBV DNA was detected in 3 of 22 CRA patients at study onset and in 8 of 16 in the follow-up samples. At follow-up EBV positive patients had significantly higher DAS28 (p=0.027) and the concentration of EBV DNA correlated significantly with DAS28 (rs=0.724, p=0.002). Only one of the healthy controls and none of the AOSD patients were positive for EBV DNA. Active RA is associated with a lytic EBV infection which may have a role in the pathogenesis of RA.

  17. Education, leisure activities and cognitive and functional ability of Alzheimer's disease patients: A follow-up study.

    Science.gov (United States)

    Sobral, Margarida; Paúl, Constança

    2013-01-01

    Education and participation in leisure activities appear to be highly relevant variables in Alzheimer's disease (AD) and usually form the basis of the Cognitive Reserve construct. [A] To determine the association between education, cognitive and functional ability of AD patients; [B] To determine the association between participation in leisure activities and cognitive and functional ability of AD patients; [C] To evaluate the association of education and participation in leisure activities in the course of AD. Functional and neuropsychological abilities of 120 outpatients with probable AD were evaluated at baseline, at 36 and 54 months. Data collected at baseline included socio-demographics, clinical variables, education and frequency of participation in leisure activities throughout life. All participants and/or caregivers answered the questionnaire, "Participation in leisure activities throughout life" while patients completed the MMSE, the Clinical Dementia Rating scale, neuropsychological tests from the Lisbon Screening for Dementia Assessment, Barthel Index and Lawton and Brody's Index. AD patients with higher levels of education achieved better results on cognitive tests. The participants with higher participation in leisure activities exhibited better results on cognitive and functional tests than those with lower participation. The disease progression was linear and progressed similarly regardless of the level of education of participants. However, the results suggest a slower disease progression in patients with a higher level of participation in leisure activities throughout their lives. AD patients with high education and high participation in leisure activities may benefit from a slower cognitive and functional decline after diagnosis of AD.

  18. Education, leisure activities and cognitive and functional ability of Alzheimer's disease patients: A follow-up study

    Science.gov (United States)

    Sobral, Margarida; Paúl, Constança

    2013-01-01

    Education and participation in leisure activities appear to be highly relevant variables in Alzheimer's disease (AD) and usually form the basis of the Cognitive Reserve construct. OBJECTIVE [A] To determine the association between education, cognitive and functional ability of AD patients; [B] To determine the association between participation in leisure activities and cognitive and functional ability of AD patients; [C] To evaluate the association of education and participation in leisure activities in the course of AD. METHODS Functional and neuropsychological abilities of 120 outpatients with probable AD were evaluated at baseline, at 36 and 54 months. Data collected at baseline included socio-demographics, clinical variables, education and frequency of participation in leisure activities throughout life. All participants and/or caregivers answered the questionnaire, "Participation in leisure activities throughout life" while patients completed the MMSE, the Clinical Dementia Rating scale, neuropsychological tests from the Lisbon Screening for Dementia Assessment, Barthel Index and Lawton and Brody's Index. RESULTS AD patients with higher levels of education achieved better results on cognitive tests. The participants with higher participation in leisure activities exhibited better results on cognitive and functional tests than those with lower participation. The disease progression was linear and progressed similarly regardless of the level of education of participants. However, the results suggest a slower disease progression in patients with a higher level of participation in leisure activities throughout their lives. CONCLUSION AD patients with high education and high participation in leisure activities may benefit from a slower cognitive and functional decline after diagnosis of AD. PMID:29213838

  19. The Association of Anti-CCP and Disease Activity in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Raouf Rahim Merza

    2014-08-01

    Conclusion: A highly significant correlation was found between Anti-CCP value and disease activity in rheumatoid arthritis, smoker patients had higher value of Anti-CCP compared to non-smoker patients. Smokers demonstrated a more active and severe disease activity compared to non-smokers. [Cukurova Med J 2014; 39(4.000: 743-751

  20. In vivo neutron activation analysis: body composition studies in health and disease

    International Nuclear Information System (INIS)

    Ellis, K.J.; Cohn, S.H.

    1984-01-01

    In vivo analysis of body elements by neutron activation is an important tool in medical research. It has provided a direct quantitative measure of body composition of human beings in vivo. Basic physiological differences related to age, sex, race, and body size have been assessed by this noninvasive technique. The diagnosis and management of patients with various metabolic disorders and diseases has also been demonstrated. Two major facilities at Brookhaven are being utilized exclusively for in vivo neutron activation analysis (IVNAA) of calcium, phosphorus, sodium, chlorine, nitrogen, hydrogen, and potassium. These elements serve as the basis for a four compartment model of body composition: protein, water, mineral ash, and fat. Variations in these compartments are demonstrated in clinical research programs investigating obesity, anorexia, cancer, renal failure, osteoporosis, and normal aging. IVNAA continues to provide a unique approach to the evaluation of clinical diagnosis, efficacy of therapeutic regimens, and monitoring of the aging process. Classical balance studies usually require the patient to be admitted to a hospital for extended periods of confinement. IVNAA, however, allows for clinical management of the patient on an out-patient basis, an important aspect for treatment of chronic diseases. 25 references, 3 figures, 5 tables

  1. In vivo neutron activation analysis: body composition studies in health and disease

    Energy Technology Data Exchange (ETDEWEB)

    Ellis, K.J.; Cohn, S.H.

    1984-01-01

    In vivo analysis of body elements by neutron activation is an important tool in medical research. It has provided a direct quantitative measure of body composition of human beings in vivo. Basic physiological differences related to age, sex, race, and body size have been assessed by this noninvasive technique. The diagnosis and management of patients with various metabolic disorders and diseases has also been demonstrated. Two major facilities at Brookhaven are being utilized exclusively for in vivo neutron activation analysis (IVNAA) of calcium, phosphorus, sodium, chlorine, nitrogen, hydrogen, and potassium. These elements serve as the basis for a four compartment model of body composition: protein, water, mineral ash, and fat. Variations in these compartments are demonstrated in clinical research programs investigating obesity, anorexia, cancer, renal failure, osteoporosis, and normal aging. IVNAA continues to provide a unique approach to the evaluation of clinical diagnosis, efficacy of therapeutic regimens, and monitoring of the aging process. Classical balance studies usually require the patient to be admitted to a hospital for extended periods of confinement. IVNAA, however, allows for clinical management of the patient on an out-patient basis, an important aspect for treatment of chronic diseases. 25 references, 3 figures, 5 tables.

  2. Assessement of rheumatic diseases with computational radiology: current status and future potential

    DEFF Research Database (Denmark)

    Peloschek, Philipp; Boesen, Mikael; Donner, Rene

    2009-01-01

    In recent years, several computational image analysis methods to assess disease progression in rheumatic diseases were presented. This review article explains the basics of these methods as well as their potential application in rheumatic disease monitoring, it covers radiography, sonography...

  3. Detection of active alveolar bone destruction in human periodontal disease by analysis of radiopharmaceutical uptake after a single injection of 99m-Tc-methylene diphosphonate

    Energy Technology Data Exchange (ETDEWEB)

    Jeffcoat, M.K.; Williams, R.C.; Holman, B.L.; English, R.; Goldhaber, P.

    1986-01-01

    Previous studies have shown that, following a single injection of 99m-Tc-MDP, measurement of bone-seeking radiopharmaceutical uptake can detect ''active'' alveolar bone loss due to periodontal disease in beagle dogs, as determined by radiographs taken at the time of, and several months after, the nuclear medicine procedure. The efficacy of this diagnostic test, however, had not been assessed in human periodontal disease. The ability of a single boneseeking radiopharmaceutical uptake examination to detect ''active'' alveolar bone loss due to periodontal disease in human patients was assessed by comparing a single uptake measurement to the rate of bone loss determined from serial radiographs taken over a 6-month period. Uptake was expressed as a ratio of the cpm from the alveolar bone divided by the cpm from the non-tooth supporting bone of the nuchal crest. High uptake ratios were associated with ''active'' loss and low uptake ratios were associated with little if any change in alveolar bone height (p<0.001). The nuclear medicine examination was an accurate detector of periodontal disease activity in nearly 80% of the individual teeth studied. These data indicate that high bone-seeking radiopharmaceutical uptake ratios may be pathognomonic of active bone loss in human periodontal disease.

  4. Ratio of Circulating Estrogen Receptors Beta and Alpha (ERβ/ERα) Indicates Endoscopic Activity in Patients with Crohn's Disease.

    Science.gov (United States)

    Linares, Pablo M; Algaba, Alicia; Urzainqui, Ana; Guijarro-Rojas, Mercedes; González-Tajuelo, Rafael; Garrido, Jesús; Chaparro, María; Gisbert, Javier P; Bermejo, Fernando; Guerra, Iván; Castellano, Víctor; Fernández-Contreras, María-Encarnación

    2017-10-01

    Data supporting a role of female hormones and/or their receptors in inflammatory bowel disease (IBD) are increasing, but most of them are derived from animal models. Estrogen receptors alpha (ERα) and beta (ERβ) participate in immune and inflammatory response, among a variety of biological processes. Their effects are antagonistic, and the net action of estrogens may depend on their relative proportions. To determine the possible association between the balance of circulating ERβ and ERα (ERβ/ERα) and IBD risk and activity. Serum samples from 145 patients with IBD (79 Crohn's disease [CD] and 66 ulcerative colitis [UC]) and 39 controls were retrospectively studied. Circulating ERα and ERβ were measured by ELISA. Disease activities were assessed by clinical and endoscopic indices specific for CD and UC. Low values of ERβ/ERα ratio were directly associated with clinical (p = 0.019) and endoscopic (p = 0.002) disease activity. Further analyses by type of IBD confirmed a strong association between low ERβ/ERα ratio and CD clinical (p = 0.011) and endoscopic activity (p = 0.002). The receiver operating curve (ROC) analysis showed that an ERβ/ERα ratio under 0.85 was a good marker of CD endoscopic activity (area under the curve [AUC]: 0.84; p = 0.002; sensitivity: 70%; specificity: 91%). ERβ/ERα ratio was not useful to predict UC activity. An ERβ/ERα ratio under 0.85 indicated CD endoscopic activity. The determination of serum ERβ/ERα might be a useful noninvasive screening tool for CD endoscopic activity.

  5. Physical activity as a remedy for "cheerful" aging which prevents from chronic diseases

    Directory of Open Access Journals (Sweden)

    Alicja Rzepka

    2016-12-01

    Full Text Available Purpose. According to GUS, only 3.6% of the elderly declare active leisure activities. The objective of this study was to evaluate the effect of motor function improvement program implemented in sanatorium on functional condition and functional status of patients suffered from spinal degenerative diseases. Methods. The studies were carried out once in a group of 46 patients aged above 60 in Solanki Inowrocław health resort. The assessment was made based on a questionnaire. Moreover, assessment of pain in the lumbar spine according to thee VAS was made along with evaluation of lumbar spine mobility using Zebris MLS. Results. Evaluation of patients in terms of free time spending have showed that more than half of patients spent their free time actively (57%. The intensity of pain according to the VAS, during flexion, extension, rotation in both direction and lateral flexion of the spine, was decreased at the end of therapy. Flexion, extension and rotation in the right sight increase when Zebris MLS was used before and after therapy. Rotation to the left and lateral flexion to the left were not change. Conclusion. Rehabilitation in sanatorium mobilizes physical activity of patients. It improves the physical activity by significant increase in the motion range of the spine. It exerts a significant analgesic effect.

  6. Patient satisfaction with a chronic kidney disease risk assessment service in community pharmacies.

    Science.gov (United States)

    Gheewala, Pankti A; Peterson, Gregory M; Zaidi, Syed Tabish R; Jose, Matthew D; Castelino, Ronald L

    2018-04-01

    Patient satisfaction is an important determinant of the feasibility and sustainability of community pharmacy screening services. However, few studies have evaluated this, with no such study performed for a chronic kidney disease risk assessment service. The aim was to determine patient satisfaction with a chronic kidney disease risk assessment service performed in community pharmacies. Community pharmacies in the state of Tasmania, Australia. An anonymous nine-item satisfaction survey, with Likert-type scales, was developed following a literature review of existing surveys. Reliability of the nine-item scale was determined using Cronbach's alpha. Patients were asked an additional question on willingness to pay, with choices of amount from $5 to $25. The satisfaction survey was mailed to 389 patients who participated in the chronic kidney disease risk assessment study. Patient level of satisfaction with and willingness to pay for the chronic kidney disease service. Responses from 143 participants were included in the final analysis. Cronbach's alpha for the nine-item satisfaction scale was 0.87. The majority of participants agreed that the time required to undergo the risk assessment process was justified (90.2%); overall, they were satisfied with the chronic kidney disease risk assessment service (90.0%) and they felt comfortable with the pharmacist referring their results to their doctor (88.9%). Of 136 participants who answered the question on willingness to pay, 62.9% indicated that they would pay for the chronic kidney disease service. Of these, 29.2, 25.8 and 19.1% were willing to pay $20, $10 and $5, respectively. Patient satisfaction with the community pharmacy-based chronic kidney disease risk assessment was high. These findings provide support for the implementation of the service within community pharmacy practice.

  7. Perceived Preparedness of Health Care Students for Providing Cardiovascular Disease Risk Assessment and Management

    Directory of Open Access Journals (Sweden)

    Monica Zolezzi

    2017-02-01

    Full Text Available Early assessment and management of risk factors is known to have significant impact in preventing cardiovascular disease (CVD and its associated burden. Cardiovascular disease risk assessment and management (CVDRAM is best approached by teamwork across health care professionals. This study aimed at assessing health care students’ (HCSs knowledge about the parameters needed for estimating CVD risk, their self-assessed preparedness/confidence and perceived barriers for the provision of CVDRAM services through a survey administered to third and fourth year pharmacy, medical, and nursing students in Qatar. Although all student cohorst achieved similar knowledge scores, less than half (n = 38, 47% were able to identify all of the six main risk factors necessary to estimate absolute CVD risk, and a third (32% were unable to identify total cholesterol as an independent risk factor necessary to estimate CVD risk. Training on the use of CVD risk assessment tools differed among the three student cohorts. All student cohorts also perceived similar levels of preparedness in CVDRAM. However, pharmacy students reported the highest preparedness/confidence with the use of the latest CVDRAM guidelines. The majority of statements listed under the barriers scale were perceived by the students as being moderate (median score = 3. Poor public acceptance or unawareness of importance of estimating CVD risk was the only barrier perceived as major by nursing students. Future integration of interprofessional educational (IPE activities in the CVDRAM curricula of HCSs may be a suitable strategy to minimize barriers and foster collaborative practice for the provision of CVDRAM services in Qatar.

  8. Perceived Preparedness of Health Care Students for Providing Cardiovascular Disease Risk Assessment and Management.

    Science.gov (United States)

    Zolezzi, Monica; Abdallah, Oraib; Aden, Suad; Major, Stella; White, Diana; El-Awaisi, Alla

    2017-02-21

    Early assessment and management of risk factors is known to have significant impact in preventing cardiovascular disease (CVD) and its associated burden. Cardiovascular disease risk assessment and management (CVDRAM) is best approached by teamwork across health care professionals. This study aimed at assessing health care students' (HCSs) knowledge about the parameters needed for estimating CVD risk, their self-assessed preparedness/confidence and perceived barriers for the provision of CVDRAM services through a survey administered to third and fourth year pharmacy, medical, and nursing students in Qatar. Although all student cohorts achieved similar knowledge scores, less than half ( n = 38, 47%) were able to identify all of the six main risk factors necessary to estimate absolute CVD risk, and a third (32%) were unable to identify total cholesterol as an independent risk factor necessary to estimate CVD risk. Training on the use of CVD risk assessment tools differed among the three student cohorts. All student cohorts also perceived similar levels of preparedness in CVDRAM. However, pharmacy students reported the highest preparedness/confidence with the use of the latest CVDRAM guidelines. The majority of statements listed under the barriers scale were perceived by the students as being moderate (median score = 3). Poor public acceptance or unawareness of importance of estimating CVD risk was the only barrier perceived as a major by nursing students. Future integration of interprofessional educational (IPE) activities in the CVDRAM curricula of HCSs may be a suitable strategy to minimize barriers and foster collaborative practice for the provision of CVDRAM services in Qatar.

  9. Muscle Activation During Grasping With and Without Motor Imagery in Healthy Volunteers and Patients After Stroke or With Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Manuela Kobelt

    2018-04-01

    Full Text Available Introduction: The present study assessed whether motor imagery (MI produces electromyographic activation in specific muscles of the upper limb during a hand grasping and arm-lifting task in healthy volunteers, patients after stroke, or with Parkinson's disease. Electromyographic (EMG activation was compared under three conditions: MI, physical execution (PE, and rest. The task is clinically relevant unilateral executed movement using open muscle chains.Methods: In a cross-sectional study EMG activation was measured in four muscles: M. deltoideus pars clavicularis, M. biceps brachii, M. extensor digitorum, M. flexor carpi radialis. MI ability was evaluated with mental rotation, mental chronometry and the Kinaesthetic and Visual Imagery Questionnaire. Cognitive performance was screened with the Mini-Mental State Examination.Results: Twenty-two participants (11 females, age 52.6 ±15.8, age range 21 to 72 were included: ten healthy volunteers, seven patients after stroke (time after stroke onset 16.3 ± 24.8 months, and five patients with Parkinson's disease (disease duration 60.4 ± 24.5 months. Overall Mini-Mental State Examination scores ranged between 27 and 30. An increased EMG activation during MI compared to rest condition was observed in M. deltoideus pars clavicularis and M. biceps brachii across all participants (p-value = 0.001, p = 0.007. Seven participants (two healthy volunteers, three patients after stroke and two patients with Parkinson's disease showed a EMG activation during MI of the hand grasping and arm-lifting task in at least one of the target muscles. No correlation between EMG activation during MI and scores of three MI ability assessments were found.Conclusions: The findings suggest that MI can yield subliminal EMG activation. However, that might vary on individual basis. It remains unclear what parameters contribute to or inhibit an EMG activation during MI. Future investigations should determine factors that influence

  10. Initial evaluation of an ultrasound measure for assessing the activity of skin lesions in juvenile localized scleroderma.

    Science.gov (United States)

    Li, S C; Liebling, M S; Haines, K A; Weiss, J E; Prann, A

    2011-05-01

    To evaluate the construct validity of 2 proposed measures (the Ultrasound Disease Activity [U-DA] and the Tissue Thickness Score [TTS]) for evaluating sonographic differences in juvenile localized scleroderma skin lesions. We conducted a retrospective review of juvenile localized scleroderma patients who had ultrasound scans of their skin lesions between October 2005 and February 2009. Imaged lesions were classified as active or inactive based upon clinical assessment. Lesions had to have been imaged within 1 month of a clinic visit or have the same clinical assessment during both the visit before and the visit after the scan. Two physicians scored the scans using the U-DA, which scores for differences in lesion echogenicity and vascularity compared with normal tissue. Tissue thickness differences were evaluated by percent differences and by using the TTS. Wilcoxon's rank sum test was performed to assess differences. We studied 52 scans from 21 patients, 32 scans of active skin lesions and 20 scans of inactive skin lesions. Features reported by clinicians as indicative of active disease included erythema, warmth, violaceous color, new lesion, expansion of lesion, and induration. The U-DA was significantly different between active and inactive skin lesions (P = 0.0010) with significant differences found for the parameters of total echogenicity, hypodermis echogenicity, and deep tissue layer vascularity (P = 0.0014, P = 0.0023, and P = 0.0374, respectively). No significant differences were found for tissue layer thickness or TTS. The U-DA may be a useful tool in the identification of localized scleroderma activity. Further study is needed to prospectively evaluate the validity, reliability, and sensitivity of this potential monitoring tool. Copyright © 2011 by the American College of Rheumatology.

  11. [Serum anticholinergic activity: relationship with clinical symptoms in Alzheimer's disease and proposal of new biological marker].

    Science.gov (United States)

    Hori, Koji; Konishi, Kimiko; Hachisu, Mitsugu

    2011-06-01

    We reviewed the importance of measuring serum anticholinergic activity (SAA) in patients with Alzheimer's disease (AD). Since Tune and Coyle reported a simple method for assessing SAA using radioreceptor-binding assay, SAA is assumed to be the cumulative activity of parent medications and their metabolites and its relationship with delirium and cognitive functions has been debated. However, we evaluated the SAA in AD patients and SAA was correlated with prescription of antipsychotic medications, cognitive dysfunctions, severity of AD and psychotic symptoms, especially, with delusion and diurnal rhythm disturbance. From these results, we should not only pay attention to avoiding the prescription of medications with anticholinergic activity but also we speculated that AA appeared endogenously in AD and accelerated AD pathology. Moreover, there might be the possibility that SAA has predictive value for assessing the progressiveness of AD and as a biological marker for AD.

  12. Utility analysis and calibration of QOL assessment in disease management.

    Science.gov (United States)

    Liu, Mo

    2018-05-02

    In clinical trials, the assessment of health-related quality of life (QOL) (or patient-reported outcome [PRO] measure) has become very popular especially for clinical studies conducted for evaluating clinical benefits of patients with chronic, severe, and/or life threatening diseases. Health-related QOL information and PRO measures are useful for disease management for achieving best clinical practice. In this article, we will focus on health-related QOL assessment. The concept, design, and analysis of health-related QOL in clinical trials are reviewed. Validation of the use of health-related QOL instrument in terms of some key performance characteristics such as accuracy, reliability, sensitivity, and responsibility for assuring quality, integrity, and validity of collected QOL data are discussed. The concept of utility analysis and calibration (e.g., with respect to life events) for achieving the optimization of disease management are proposed. The change of the QOL could be translated into different life events for effective disease management. These translations could evaluate the treatment effect by more directly displaying the change of the QOL.

  13. Impact of valvular heart disease on activities of daily living of nonagenarians: the Leiden 85-plus study a population based study.

    Science.gov (United States)

    van Bemmel, Thomas; Delgado, Victoria; Bax, Jeroen J; Gussekloo, Jacobijn; Blauw, Gerard J; Westendorp, Rudi G; Holman, Eduard R

    2010-04-01

    Data on the prevalence of valvular heart disease in very old individuals are scarce and based mostly on in-hospital series. In addition, the potential detrimental effect of valvular heart disease on the activities of daily living is unknown. The present study evaluated the prevalence of significant valvular heart disease and the impact of valvular heart disease on the activities of daily living in community dwelling nonagenarians. Nested within the Leiden 85-plus study, a population based follow-up study of the oldest old, a sample of 81 nonagenarians was recruited. The left ventricular (LV) dimensions, function and the presence and severity of heart valvular disease were evaluated by echocardiography. Significant valvular heart disease included any mitral or aortic stenosis severity, moderate or severe mitral regurgitation, moderate or severe aortic regurgitation and moderate or severe tricuspid regurgitation. Activities of daily living were assessed using the Groningen Activity Restriction Scale (GARS). LV cavity diameters (end-diastolic diameter 47 +/- 8 mm, end-systolic diameter 30 +/- 8 mm) and systolic LV function (LV ejection fraction 66 +/- 13%) were within normal for the majority of the participants. Significant valvular disease was present in 57 (70%) individuals, with mitral regurgitation and aortic regurgitation as the most frequent valve diseases (49% and 28% respectively). The GARS score between individuals with and without significant valvular heart disease was similar (36.2 +/- 9.2 vs. 34.4 +/- 13.2, p = 0.5). Nonagenarian, outpatient individuals have a high prevalence of significant valvular heart disease. However, no relation was observed between the presence of significant valvular heart disease and the ability to perform activities of daily living.

  14. The Diagnostic Role of Magnetic Resonance Enterography as a Complementary Test to Colonoscopy in Active Crohn?s Disease

    OpenAIRE

    Aryan, Arvin; Azizi, Zahra; Teimouri, Azam; Ebrahimi Daryani, Nasser; Aletaha, Najme; Jahanbakhsh, Ali; Nouritaromlou, Mohammad Kazem; Alborzi, Forough; Mami, Masoud; Basirat, Vahid; Javid Anbardan, Sanam

    2016-01-01

    BACKGROUND According to recent studies comparing magnetic resonance enterography (MRE) with ileocolonoscopy for assessing inflammation of small bowel and colonic segments in adults with active Crohn?s disease (CD), we aimed to compare the accuracy of these two diagnostic methods in Iranian population. METHODS During 2013-2014 a follow-up study was done on 30 patients with active CD in a gastroenterology clinic affiliated to Tehran University of Medical Sciences. MRE and ileocolonoscopy were p...

  15. Subjective Word-Finding Difficulty Reduces Engagement in Social Leisure Activities in Alzheimer’s Disease

    Science.gov (United States)

    Farrell, Meagan T.; Zahodne, Laura B.; Stern, Yaakov; Dorrejo, Jhedy; Yeung, Philip; Cosentino, Stephanie

    2014-01-01

    Objectives To assess the influence of subjective word-finding difficulty on Alzheimer’s disease (AD) patients’ likelihood of engaging in social leisure activities. Design Analysis of data collected from the second cohort of the Multicenter Study of Predictors of Disease Course in Alzheimer’s disease. Setting Four study sites in the U.S. and France. Participants Individuals diagnosed with mild to moderate AD (N = 236) Measurements On separate questionnaires, patients were asked to 1) report whether had trouble finding the right word when speaking (subjective word-finding difficulty), and 2) rate their frequency and enjoyment of both social and nonsocial leisure activities. Objective language measures included object naming and verbal fluency. Measures of dependence, depression, cognitive status, age, sex, and education were also included as covariates in regression analyses. Results Over half (52%) of the sample reported word-finding difficulty, and subjective complaints were correlated with poorer verbal fluency scores. Subjective word-finding difficulty was uniquely related to social activity measures. Endorsers of word-finding difficulty reported reduced frequency and enjoyment of social leisure activities, controlling for covariates. In contrast, engagement in nonsocial activities was associated with higher age and depression scores, but was not related to word-finding complaints. These results were corroborated by the caregivers’ reports, and occurred above and beyond the effect of objective word-finding ability. Conclusion AD patients who are aware of increasing word-finding failures are less likely to participate in and enjoy socially-oriented leisure activities. This finding may have significant implications for clinical and health outcomes in AD. A failure to evaluate subjective language complaints could result in social withdrawal symptoms, thereby threatening the patient’s quality of life as well as increasing caregiver burden. Importantly

  16. Episodic memory impairment in Addison's disease: results from a telephonic cognitive assessment.

    Science.gov (United States)

    Henry, Michelle; Thomas, Kevin G F; Ross, Ian L

    2014-06-01

    Patients with Addison's disease frequently self-report memory and attention difficulties, even when on standard replacement therapy. However, few published studies examine, using objective measures and assessing across multiple domains, the cognitive functioning of Addison's disease patients relative to healthy controls. The primary aim of this study was to investigate whether the previously reported subjective cognitive deficits in Addison's disease are confirmed by objective measures. Conducting comprehensive neuropsychological assessments of patients with relatively rare clinical disorders, such as Addison's disease, is challenging because access to those patients is often limited, and because their medical condition might prevent extended testing sessions. Brief telephonic cognitive assessments are a useful tool in such circumstances. Hence, we administered the Brief Test of Adult Cognition by Telephone to 27 Addison's disease patients and 27 matched healthy controls. The instrument provides objective assessment of episodic memory, working memory, executive functioning, reasoning, and speed of processing. Statistical analyses confirmed that, as expected, patients performed significantly more poorly than controls on the episodic memory subtest. There were, however, no significant between-group differences on the attention, executive functioning, reasoning, and speed of processing subtests. Furthermore, patients with a longer duration of illness performed more poorly across all domains of cognition. We conclude that, for Addison's disease patients, previously reported subjective cognitive deficits are matched by objective impairment, but only in the domain of episodic memory. Future research might investigate (a) whether these memory deficits are material-specific (i.e., whether non-verbal memory is also affected), and (b) the neurobiological mechanisms underlying these deficits.

  17. Lyme Disease in West Virginia: An Assessment of Distribution and Clinicians' Knowledge of Disease and Surveillance.

    Science.gov (United States)

    Singh, Sarah; Parker, David; Mark-Carew, Miguella; White, Robert; Fisher, Melanie

    2016-01-01

    Lyme disease case misclassification, a top public health concern, may be attributed to the current disconnect between clinical diagnosis and surveillance. This study examines Lyme disease distribution in West Virginia (WV) and determines clinicians' knowledge of both disease and surveillance. Lyme disease surveillance data for 2013 were obtained from the WV Bureau for Public Health. A validated survey, distributed to clinicians at an academic medical center, assessed clinicians' knowledge of disease diagnosis and surveillance. There were 297 adult Lyme disease cases of which 83 were confirmed. Clinician survey responses resulted in a correct response rate of 70% for Lyme disease knowledge questions. Fewer than half of all clinicians were aware of the surveillance criteria for confirming Lyme disease cases. Neither medical specialty nor previous treatment of patients with Lyme disease were significantly associated with clinicians' knowledge of the disease. Clinicians in WV are familiar with symptoms and clinical management of Lyme disease. However, they are less knowledgeable about diagnosis and public health surveillance comprising reporting and confirming cases of the disease. Clinicians and public health authorities should collaborate more closely to promote education and awareness as a key step to successfully reducing the burden of Lymne disease.

  18. Quality of life in patients with coronary heart disease-I: Assessment tools

    Directory of Open Access Journals (Sweden)

    Yu Cheuk-Man

    2003-09-01

    Full Text Available Abstract Health-related quality of life (HRQL assessment is an important measure of the impact of the disease, effect of treatment and other variables affecting people's lives. The review focused on the assessment of HRQL in patient with coronary heart disease (CHD by appropriate tools. Although no consensus exists about the precise definition of HRQL, a plethora of instruments have been developed to assess it. Two broad types – generic and disease-specific – have been developed but there is some debate about their relative merits. There is a wide selection of instruments available but choice should be based on a careful consideration of an instrument's psychometric properties, the breadth and depth with which it addresses relevant health domains and the specific clinical or research purpose for which it is intended.

  19. Assessing arthropod pests and disease occurrence in cassava ...

    African Journals Online (AJOL)

    On-station trials were conducted at CSIR-Crops Research Institute's research farms at Kwadaso and Ejura, Ashanti Region, Ghana, during 2010/2011 cropping season, to assess the pests and disease occurrence in cassava-cowpea intercrop farming systems and their effect on yield of produce. Three improved cassava ...

  20. Assessing nutritional status in children with chronic liver disease.

    Science.gov (United States)

    Taylor, Rachel M; Dhawan, Anil

    2005-12-01

    The metabolic changes compounded by anorexia associated with chronic liver disease adversely affect growth in children. In many cases, this requires the administration of artificial nutritional support. It is important in this group of patients that those who are becoming nutritionally depleted are identified quickly and in those receiving artificial nutritional support, the effectiveness is monitored. The current review is an examination of methods available to assess nutritional status. These include anthropometry, methods available in the laboratory and a selection of less commonly used methods undergoing evaluation at research level. A brief discussion accompanies each technique, outlining the limitations of its use in children with chronic liver disease. The review concludes with an outline of how nutritional status should be assessed in this group of children, and suggests further research.

  1. Antistress activation therapy for cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Miroshnik E.V.

    2016-12-01

    Full Text Available The cohort pilot study had been done. Aim: to study the effectiveness of an antistress activation therapy on the functional state of human with the purpose of formation of adaptive reactions of activation and training high levels of reactivity among the two groups of patients with cardiovascular problems, ranks first among causes of death population: arterial hypertension (AH and coronary heart disease (CHD. Material and methods. From the sub-sample of the Moscow population (396 were allocated to 2 groups of patients of 30 people in each (a control group and a group for anti-stress therapy for persons with hypertension and coronary artery disease that within 1 month took adaptogens (tincture of ginseng, Eleutherococcus, etc. is minimized by a specially developed algorithm. For stress diagnosis international integrated questionnaire Perceived Stress (PSS; as well as Hospital Anxiety and Depression Scale (HADS were used. Blood pressure, heart rate, body mass index, waist circumference were measured. In addition we used new methods "Antistress activation health improvement". Results. The average age in the intervention group was 59.4 years, and in the control group was 58.3 years, p>0.05. In compliance with results of the study has been marked that persons who were treated by methods "Antistress activation health improvement" sensed general and "internal" dumping, improving of duration and quality of sleeping. Irritability, level of stress, depression, and fatigability became rather less. Dynamics of emotions locked in psychometric scales showed distinct improvement of mood, decrease of fear, sorrow, anxiety, anger, emotional instability, increase of self-reliance, activity. Conclusion. The treatment of stress, anxiety, and depression must be complexes based on biological and psychological approaches.

  2. Scale-Dependent Assessment of Relative Disease Resistance to Plant Pathogens

    Directory of Open Access Journals (Sweden)

    Peter Skelsey

    2014-03-01

    Full Text Available Phenotyping trials may not take into account sufficient spatial context to infer quantitative disease resistance of recommended varieties in commercial production settings. Recent ecological theory—the dispersal scaling hypothesis—provides evidence that host heterogeneity and scale of host heterogeneity interact in a predictable and straightforward manner to produce a unimodal (“humpbacked” distribution of epidemic outcomes. This suggests that the intrinsic artificiality (scale and design of experimental set-ups may lead to spurious conclusions regarding the resistance of selected elite cultivars, due to the failure of experimental efforts to accurately represent disease pressure in real agricultural situations. In this model-based study we investigate the interaction of host heterogeneity and scale as a confounding factor in the inference from ex-situ assessment of quantitative disease resistance to commercial production settings. We use standard modelling approaches in plant disease epidemiology and a number of different agronomic scenarios. Model results revealed that the interaction of heterogeneity and scale is a determinant of relative varietal performance under epidemic conditions. This is a previously unreported phenomenon that could provide a new basis for informing the design of future phenotyping platforms, and optimising the scale at which quantitative disease resistance is assessed.

  3. Assessment of listing and categorisation of animal diseases within the framework of the Animal Health Law (Regulation (EU) No 2016/429): Borna disease

    DEFF Research Database (Denmark)

    EFSA Panel on Animal Health and Welfare; More, Simon J.; Bøtner, Anette

    2017-01-01

    Borna disease has been assessed according to the criteria of the Animal Health Law (AHL), in particular criteria of Article 7 on disease profile and impacts, Article 5 on the eligibility of Borna disease to be listed, Article 9 for the categorisation of Borna disease according to disease prevention...... at collective level. The output is composed of the categorical answer, and for the questions where no consensus was reached, the different supporting views are reported. Details on the methodology used for this assessment are explained in a separate opinion. According to the assessment performed, Borna disease...

  4. Elevated tissue transglutaminase antibodies in juvenile idiopathic arthritis children: Relation to neutrophil-to-lymphocyte ratio and disease activity

    Directory of Open Access Journals (Sweden)

    Rasha E. Gheith

    2017-10-01

    Full Text Available Background: Subclinical gut inflammation is described in juvenile idiopathic arthritis (JIA, so has joint involvement been related to celiac disease (CD. The well-known involvement of tissue transglutaminase (tTG in the pathogenesis of CD stimulated progress in the field of autoimmune diseases. Aim of the work: To screen JIA children for tTG antibodies and to detect its relation to the neutrophil-lymphocyte ratio (NLR and disease activity. Patients and methods: The study included 44 JIA children with 44 matched controls. All subjects had no GIT symptoms suggestive of CD. Disease activity was assessed using the juvenile arthritis disease activity score in 27 joints (JADAS-27. The tTG antibodies (IgA and IgG were assessed. Results: The patients mean age was 12.5 ± 2.8 years and disease duration 5.01 ± 2.9 years; Female:Male 3.4:1. The mean JADAS-27 score was 12.6 ± 2.04. tTG antibodies were positive in 43.2% of the patients compared to 18.2% control (p = 0.01. Antibodies positivity was comparable according to gender and subtypes. The NLR in JIA children (1.62 ± 0.58 was significantly higher than in control (1.3 ± 0.5 (p = 0.006. Those with positive tTG antibodies had a significantly reduced body mass index (p = 0.02 and increased NLR (p = 0.02 compared to those with negative tTG. Only NLR and JADAS-27 would significantly predict antibodies positivity (p = 0.037 and p = 0.04, respectively. Conclusion: Increased tTG antibodies are frequent in JIA children raising the possibility of an associated subclinical CD. Markedly reduced BMI and increased NLR could forecast the presence of these antibodies. In addition to the JADAS-27, the NLR is a simple test that could predict this association and could be a useful biomarker.

  5. PET activation in basal ganglia disorders: Parkinson's disease and dystonia

    International Nuclear Information System (INIS)

    Ceballos-Baumann, A.O.; Boecker, H.; Conrad, B.

    1997-01-01

    This article reviews PET activation studies with performance of different motor paradigms (joy-stick movements, imagination of movement, writing) in patients with movement disorders. The focus will be on Parkinson's disease (PD) and dystonia. PET findings will be related to clinical and electrophysiological observations. PET activation studies before and after therapeutic interventions such as pallidotomy in Parkinson's disease and botulinum toxin in writer's cramp are described. The contribution of PET activation studies to the understanding of the pathophysiology of dystonia and PD is discussed. (orig.) [de

  6. Sarcopenia in rheumatoid arthritis: prevalence, influence of disease activity and associated factors.

    Science.gov (United States)

    Ngeuleu, Ange; Allali, F; Medrare, L; Madhi, A; Rkain, H; Hajjaj-Hassouni, N

    2017-06-01

    Evaluate the prevalence of sarcopenia on patients with rheumatoid arthritis (RA), the influence of sarcopenia on disease activity and factors associated with sarcopenia. One hundred and twenty-three patients aged over 18 years with RA based on the 1987 ACR/EULAR classification criteria were enrolled. We performed a whole body DXA scan using a dual-energy X-ray absorptiometry (DXA) scanner lunar prodigy to measure fat mass, lean mass, and bone mass in the whole body and body parts. According to the anthropometric equation by Baumgartner et al., sarcopenia was defined as Relative skeletal mass index (RSMI) sarcopenia with the r of Pearson and Spearman. Factors associated and related to sarcopenia were assessed using multiple regression analysis and t independent test. We included 123 patients (107 women). 49 subjects (39.8%) where suffering from sarcopenia, of which 40 women. Most of the sarcopenic patients were between 41 and 50 years old. Sarcopenia on female subjects was not related to parameters of disease activity evaluated by DAS 28, CDAI and SDAI. Most of the sarcopenic patients had normal BMI and abnormal waist circumference. In simple regression analysis sarcopenia was related to BMI, DAS 28 ESR, bone erosion, waist circumference and HAQ. In multiple regression analysis, sarcopenia was positively related to an increase cardiometabolic risk [p = 0.025, OR 0.176, CI (0.038-0.980)], normal BMI [p = 0.004, OR 12.3, CI (2.27-67.6)], over fat BMI [p = 0.004, OR 12.3, CI (2.27-67.6)] and bone erosion [p = 0.012, OR 0.057 CI (0.006-0.532)]. No statistical difference was found according to disease duration and steroids use between sarcopenic and non sarcopenic patients. Sarcopenia is prevalent and related to age, bone erosion, normal/over fat BMI and high cardiometabolic risk according to waist circumference but not with disease activity.

  7. Circulating ACE2 activity correlates with cardiovascular disease development

    Directory of Open Access Journals (Sweden)

    Katalin Úri

    2016-12-01

    Full Text Available It was shown recently that angiotensin-converting enzyme activity is limited by endogenous inhibition in vivo, highlighting the importance of angiotensin II (ACE2 elimination. The potential contribution of the ACE2 to cardiovascular disease progression was addressed. Serum ACE2 activities were measured in different clinical states (healthy, n=45; hypertensive, n=239; heart failure (HF with reduced ejection fraction (HFrEF n=141 and HF with preserved ejection fraction (HFpEF n=47. ACE2 activity was significantly higher in hypertensive patients (24.8±0.8 U/ml than that in healthy volunteers (16.2±0.8 U/ml, p=0.01. ACE2 activity further increased in HFrEF patients (43.9±2.1 U/ml, p=0.001 but not in HFpEF patients (24.6±1.9 U/ml when compared with hypertensive patients. Serum ACE2 activity negatively correlated with left ventricular systolic function in HFrEF, but not in hypertensive, HFpEF or healthy populations. Serum ACE2 activity had a fair diagnostic value to differentiate HFpEF from HFrEF patients in this study. Serum ACE2 activity correlates with cardiovascular disease development: it increases when hypertension develops and further increases when the cardiovascular disease further progresses to systolic dysfunction, suggesting that ACE2 metabolism plays a role in these processes. In contrast, serum ACE2 activity does not change when hypertension progresses to HFpEF, suggesting a different pathomechanism for HFpEF, and proposing a biomarker-based identification of these HF forms.

  8. Assessment of Physical Activity and Active Transport Among School ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This study will assess physical activity and active transportation levels among ... the Neighbourhood Environment Walkability Scale instrument (NEWS) for use in ... prix de la diplomatie scientifique de la part du gouvernement de l'Afrique du Sud. ... Dans le dernier numéro du bulletin de BRAS, lisez un message d'adieu de ...

  9. Automatic and objective assessment of alternating tapping performance in Parkinson's disease.

    Science.gov (United States)

    Memedi, Mevludin; Khan, Taha; Grenholm, Peter; Nyholm, Dag; Westin, Jerker

    2013-12-09

    This paper presents the development and evaluation of a method for enabling quantitative and automatic scoring of alternating tapping performance of patients with Parkinson's disease (PD). Ten healthy elderly subjects and 95 patients in different clinical stages of PD have utilized a touch-pad handheld computer to perform alternate tapping tests in their home environments. First, a neurologist used a web-based system to visually assess impairments in four tapping dimensions ('speed', 'accuracy', 'fatigue' and 'arrhythmia') and a global tapping severity (GTS). Second, tapping signals were processed with time series analysis and statistical methods to derive 24 quantitative parameters. Third, principal component analysis was used to reduce the dimensions of these parameters and to obtain scores for the four dimensions. Finally, a logistic regression classifier was trained using a 10-fold stratified cross-validation to map the reduced parameters to the corresponding visually assessed GTS scores. Results showed that the computed scores correlated well to visually assessed scores and were significantly different across Unified Parkinson's Disease Rating Scale scores of upper limb motor performance. In addition, they had good internal consistency, had good ability to discriminate between healthy elderly and patients in different disease stages, had good sensitivity to treatment interventions and could reflect the natural disease progression over time. In conclusion, the automatic method can be useful to objectively assess the tapping performance of PD patients and can be included in telemedicine tools for remote monitoring of tapping.

  10. Fecal Calprotectin during Pregnancy in Women with Moderate-Severe Inflammatory Bowel Disease

    DEFF Research Database (Denmark)

    Kammerlander, Heidi; Nielsen, Jan; Kjeldsen, Jens

    2018-01-01

    Background Fecal calprotectin (FC) is a biomarker used for assessing disease activity among IBD patients. Sparse knowledge exists as to whether FC correlates with clinical disease activity during pregnancy. Our aim was to assess FC and selected biomarkers in women with moderate-severe IBD...... and correlate them with clinical disease activity scores in pregnant women. Methods We identified a nationwide cohort of 219 singleton pregnancies in women with moderate-severe disease (all treated with anti-tumor recrosis factor-α [anti-TNF-α] therapy during pregnancy), and we reviewed the medical records....../kg in women with clinically inactive, mild, and moderate-severe disease activity, respectively, and were significantly higher among the women with clinical disease activity. ROC curves for disease activity were computed according to the preconception period: 0.81 (95% confidence interval [CI], 0...

  11. CCR5 delta32, matrix metalloproteinase-9 and disease activity in multiple sclerosis

    DEFF Research Database (Denmark)

    Sellebjerg, Finn; Madsen, Hans O; Jensen, Claus V

    2000-01-01

    Chemokines and matrix metalloproteinases (MMPs) appear to be crucial in leukocyte recruitment to the central nervous system in multiple sclerosis (MS). CCR5 delta32, a truncated allele of the CC chemokine receptor CCR5 gene encoding a non-functional receptor, did not confer protection from MS. CCR5...... delta32 was, however, associated with a lower risk of recurrent clinical disease activity. High CSF levels of MMP-9 activity were also associated with recurrent disease activity. These results directly link intrathecal inflammation to disease activity in patients with MS, suggesting that treatments...... targeting CCR5 or treatment with MMP inhibitors may attenuate disease activity in MS...

  12. Nonketotic hyperglycinemia: Functional assessment of missense variants in GLDC to understand phenotypes of the disease.

    Science.gov (United States)

    Bravo-Alonso, Irene; Navarrete, Rosa; Arribas-Carreira, Laura; Perona, Almudena; Abia, David; Couce, María Luz; García-Cazorla, Angels; Morais, Ana; Domingo, Rosario; Ramos, María Antonia; Swanson, Michael A; Van Hove, Johan L K; Ugarte, Magdalena; Pérez, Belén; Pérez-Cerdá, Celia; Rodríguez-Pombo, Pilar

    2017-06-01

    The rapid analysis of genomic data is providing effective mutational confirmation in patients with clinical and biochemical hallmarks of a specific disease. This is the case for nonketotic hyperglycinemia (NKH), a Mendelian disorder causing seizures in neonates and early-infants, primarily due to mutations in the GLDC gene. However, understanding the impact of missense variants identified in this gene is a major challenge for the application of genomics into clinical practice. Herein, a comprehensive functional and structural analysis of 19 GLDC missense variants identified in a cohort of 26 NKH patients was performed. Mutant cDNA constructs were expressed in COS7 cells followed by enzymatic assays and Western blot analysis of the GCS P-protein to assess the residual activity and mutant protein stability. Structural analysis, based on molecular modeling of the 3D structure of GCS P-protein, was also performed. We identify hypomorphic variants that produce attenuated phenotypes with improved prognosis of the disease. Structural analysis allows us to interpret the effects of mutations on protein stability and catalytic activity, providing molecular evidence for clinical outcome and disease severity. Moreover, we identify an important number of mutants whose loss-of-functionality is associated with instability and, thus, are potential targets for rescue using folding therapeutic approaches. © 2017 Wiley Periodicals, Inc.

  13. Test–retest reliability of the Disease Activity Score 28 CRP (DAS28-CRP), the Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI) in rheumatoid arthritis when based on patient self-assessment of tender and swollen joints

    DEFF Research Database (Denmark)

    Heegaard, Cecilie; Dreyer, Lene; Egsmose, Charlotte

    2013-01-01

    and physician-derived scores. Thirty out-clinic RA patients with stable disease were included. A joint count was performed two times 1 week apart by the patient and by an experienced physician. Test-retest reliability was expressed as the least significant difference (LSD), as the LSD in percent of the mean...... score (%LSD) and as intra-individual coefficients of variation (CVi). Mean scores based on physician vs. patient joint counts (visit 1) were: DAS28-CRP(4v) 3.5 ± 1.0 vs. 3.6 ± 1.1 (not significant (NS)), DAS28-CRP(3v) 3.4 ± 0.9 vs. 3.5 ± 0.9 (NS), SDAI 14.2 ± 9.4 vs.14.1 ± 9.4 (NS) and CDAI 13.4 ± 9.......3 vs. 13.3 ± 9.4 (NS). The LSDs (%LSD) for duplicate assessments of patient-derived scores (visit 2 vs. 1) were: DAS28-CRP(4v) 0.8 (23.2), DAS28-CRP(3v) 0.9 (25.2), SDAI 8.3 (59.9) and CDAI 8.4 (63.8). Similar LSDs were found for differences between duplicate assessments of physician-derived scores...

  14. MCP-1 in urine as biomarker of disease activity in Systemic Lupus Erythematosus.

    Science.gov (United States)

    Barbado, Julia; Martin, Debora; Vega, Luisa; Almansa, Raquel; Gonçalves, Lisbeth; Nocito, Mercedes; Jimeno, Antonio; Ortiz de Lejarazu, Raúl; Bermejo-Martin, Jesus F

    2012-11-01

    Conventional clinical parameters are not sensitive or specific enough for detecting ongoing disease activity in the Systemic Lupus Erythematosus (SLE). Measurement of cytokines in urine is an encouraging approach to detection of early flares in this disease. Here we have profiled 27 different cytokines, chemokines and celular growth factors in the urine of 48 patients previously diagnosed of SLE as potential biomarkers of disease activity. Correlation analysis with Bonferroni correction showed that MCP-1 was the only immune mediator which levels in urine correlated directly with the SLE Disease Activity Index 2000 (SLEDAI-2K) score (correlation coefficient, p): MCP-1 (0.45,0.003). MCP-1 correlated inversely with levels of C3 complement protein in serum (-0.50,0.001). MCP-1 showed significant higher levels in patients with severe disease activity in comparison with those exhibiting mild activity. Levels of this chemokine were also higher in patients with severe disease activity in comparison with patients with inactive disease and healthy controls. Areas under receiver operating characteristic curves (AUROC) for detection of severe disease (SLEDAI⩾8) was as follows for MCP-1: [AUROC, (IC95%), p]: [0.81 (0.65-0.96) 0.003]. In addition, MCP-1 showed a good result in the AUROC analysis for detecting renal involvement [0.70 (0.52-0.87) 0.050]. When correlation analysis were repeated excluding those patients with active renal disease (n=14), levels of MCP-1 in urine kept on showing a significant positive association with SLEDAI-2K score. In conclusion, multiplex-based cytokine profiling in urine demonstrated the superiority of MCP-1 over a wide range of cytokines as biomarker of disease activity in SLE. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Health-related quality of life in relation to disease activity in adults with hereditary angioedema in Sweden.

    Science.gov (United States)

    Nordenfelt, Patrik; Nilsson, Mats; Lindfors, Anders; Wahlgren, Carl-Fredrik; Björkander, Janne

    2017-11-30

    Health-related quality of life (HR-QoL) is impaired in patients with hereditary angioedema (HAE) but has not yet been satisfactorily described. To study HR-QoL in patients with HAE by combining different HR-QoL instruments with disease activity assessment. All adults in the Swedish HAE registry were invited to take part in this questionnaire study, which used the generic HR-QoL instruments, EuroQol 5 Dimensions 5 Level (EQ-5D-5L) and the RAND Corporation Short Form 36 (RAND-36), the disease-specific Angioedema Quality of Life instrument (AE-QoL), the recently introduced Angioedema Activity Score (AAS) form, and questionnaires on sick leave and prophylactic medication. Sixty-four of 133 adults (26 men, 38 women) between 18 and 91 years old responded. The most affected HR-QoL dimensions in the EQ-5D-5L were pain/discomfort and anxiety/depression; in the RAND-36, energy/fatigue, general health, pain; and, in the AE-QoL, fears/shame and fatigue/mood. Women had lower HR-QoL in the RAND-36 for general health and energy/fatigue (p 0 had significantly impaired HR-QoL. There were significant associations (p depression, and fatigue/mood are important aspects of HAE but the AE-QoL disregards pain. HR-QoL was not significantly affected by prophylaxis. Increased disease activity was associated with impaired HR-QoL, which justifies more active disease management.

  16. Associations between objectively measured physical activity intensity in childhood and measures of subclinical cardiovascular disease in adolescence

    DEFF Research Database (Denmark)

    Ried-Larsen, Mathias; Grøntved, Anders; Møller, Niels Christian

    2014-01-01

    BACKGROUND AND AIM: No prospective studies have investigated the association between physical activity (PA) and carotid subclinical cardiovascular disease across childhood. Therefore, the primary aim was to investigate the association between PA intensity across childhood and carotid intima media......-and-vigorous and vigorous PA intensity were measured using the Actigraph activity monitor. Subclinical cardiovascular disease was expressed as cIMT, carotid arterial stiffness and secondarily as a metabolic risk z-score including the homoeostasis model assessment score of insulin resistance, triglycerides, total......-and-vigorous nor vigorous) nor mean minutes of moderate-and-vigorous PA intensity was associated to the metabolic risk z-score in adolescence (p>0.05). However, a significant inverse association was observed between mean minutes of vigorous PA and the metabolic risk z-score in adolescence independent of gender...

  17. Comparison of CT enterography and MR enterography imaging features of active Crohn disease in children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Gale, Heather I. [The Warren Alpert Medical School of Brown University, Department of Diagnostic Imaging, Rhode Island Hospital/Hasbro Children' s Children' s Hospital/Women and Infants Hospital, Providence, RI (United States); Sharatz, Steven M.; Nimkin, Katherine; Gee, Michael S. [MassGeneral Hospital for Children, Division of Pediatric Imaging, Department of Radiology, Harvard Medical School, Boston, MA (United States); Taphey, Mayureewan [Bumrungrad International Hospital, Bangkok (Thailand); Bradley, William F. [Cambridge Mobile Telematics, Cambridge, MA (United States)

    2017-09-15

    Assessment for active Crohn disease by CT enterography and MR enterography relies on identifying mural and perienteric imaging features. To evaluate the performance of established imaging features of active Crohn disease in children and adolescents on CT and MR enterography compared with histological reference. We included patients ages 18 years and younger who underwent either CT or MR enterography from 2007 to 2014 and had endoscopic biopsy within 28 days of imaging. Two pediatric radiologists blinded to the histological results reviewed imaging studies and scored the bowel for the presence or absence of mural features (wall thickening >3 mm, mural hyperenhancement) and perienteric features (mesenteric hypervascularity, edema, fibrofatty proliferation and lymphadenopathy) of active disease. We performed univariate analysis and multivariate logistic regression to compare imaging features with histological reference. We evaluated 452 bowel segments (135 from CT enterography, 317 from MR enterography) from 84 patients. Mural imaging features had the highest association with active inflammation both for MR enterography (wall thickening had 80% accuracy, 69% sensitivity and 91% specificity; mural hyperenhancement had 78%, 53% and 96%, respectively) and CT enterography (wall thickening had 84% accuracy, 72% sensitivity and 91% specificity; mural hyperenhancement had 76%, 51% and 91%, respectively), with perienteric imaging features performing significantly worse on MR enterography relative to CT enterography (P < 0.001). Mural features are predictors of active inflammation for both CT and MR enterography, while perienteric features can be distinguished better on CT enterography compared with MR enterography. This likely reflects the increased conspicuity of the mesentery on CT enterography and suggests that mural features are the most reliable imaging features of active Crohn disease in children and adolescents. (orig.)

  18. Assessement of rheumatic diseases with computational radiology: Current status and future potential

    International Nuclear Information System (INIS)

    Peloschek, Philipp; Boesen, Mikael; Donner, Rene; Kubassova, Olga; Birngruber, Erich; Patsch, Janina; Mayerhoefer, Marius; Langs, Georg

    2009-01-01

    In recent years, several computational image analysis methods to assess disease progression in rheumatic diseases were presented. This review article explains the basics of these methods as well as their potential application in rheumatic disease monitoring, it covers radiography, sonography as well as magnetic resonance imaging in quantitative analysis frameworks.

  19. Assessment of Antibody-based Drugs Effects on Murine Bone Marrow and Peritoneal Macrophage Activation.

    Science.gov (United States)

    Kozicky, Lisa; Sly, Laura M

    2017-12-26

    Macrophages are phagocytic innate immune cells, which initiate immune responses to pathogens and contribute to healing and tissue restitution. Macrophages are equally important in turning off inflammatory responses. We have shown that macrophages stimulated with intravenous immunoglobulin (IVIg) can produce high amounts of the anti-inflammatory cytokine, interleukin 10 (IL-10), and low levels of pro-inflammatory cytokines in response to bacterial lipopolysaccharides (LPS). IVIg is a polyvalent antibody, primarily immunoglobulin Gs (IgGs), pooled from the plasma of more than 1,000 blood donors. It is used to supplement antibodies in patients with immune deficiencies or to suppress immune responses in patients with autoimmune or inflammatory conditions. Infliximab, a therapeutic anti-tumor necrosis factor alpha (TNFα) antibody, has also been shown to activate macrophages to produce IL-10 in response to inflammatory stimuli. IVIg and other antibody-based biologics can be tested to determine their effects on macrophage activation. This paper describes methods for derivation, stimulation, and assessment of murine bone marrow macrophages activated by antibodies in vitro and murine peritoneal macrophages activated with antibodies in vivo. Finally, we demonstrate the use of western blotting to determine the contribution of specific cell signaling pathways to anti-inflammatory macrophage activity. These protocols can be used with genetically modified mice, to determine the effect of a specific protein(s) on anti-inflammatory macrophage activation. These techniques can also be used to assess whether specific biologics may act by changing macrophages to an IL-10-producing anti-inflammatory activation state that reduces inflammatory responses in vivo. This can provide information on the role of macrophage activation in the efficacy of biologics during disease models in mice, and provide insight into a potential new mechanism of action in people. Conversely, this may caution

  20. Distribution pattern of MRI abnormalities within the knee and wrist of juvenile idiopathic arthritis patients: signature of disease activity

    NARCIS (Netherlands)

    Nusman, Charlotte M.; Hemke, Robert; Schonenberg, Dieneke; Dolman, Koert M.; van Rossum, Marion A. J.; van den Berg, J. Merlijn; Kuijpers, Taco W.; Maas, Mario

    2014-01-01

    The aim of this study in clinically active juvenile idiopathic arthritis (JIA) was to assess the frequency and distribution pattern of synovitis as hallmark of disease and additional soft-tissue and bony abnormalities on MRI in the knee and wrist as two target joints. MRI datasets of 153 clinically

  1. Development and assessment of users' satisfaction with the systemic lupus erythematosus disease activity index 2000 responder index-50 website.

    Science.gov (United States)

    Touma, Zahi; Gladman, Dafna D; MacKinnon, Anne; Carette, Simon; Abu-Shakra, Mahmoud; Askanase, Anca; Nived, Ola; Hanly, John G; Landolt-Marticorena, Carolina; Tam, Lai-Shan; Toloza, Sergio; Nikpour, Mandana; Riddell, Claire; Steiman, Amanda; Eder, Lihi; Haddad, Amir; Barber, Claire; Urowitz, Murray B

    2013-01-01

    To describe the development of the Systemic Lupus Erythematosus Disease Activity Index 2000 Responder Index-50 (S2K RI-50) Website (www.s2k-ri-50.com) and to assess satisfaction with its training and examination modules among rheumatologists and rheumatology fellows. The development of the Website occurred in 3 phases. The first was a deployment phase that consisted of preparing the site map along with its content. The content included the S2K RI-50 training manual, the tests and corresponding question bank, and the online adaptive training module, along with the extensive site testing. The second phase included the participation of rheumatologists and trainees who completed the Website modules. The third was a quality assurance phase in which an online survey was developed to determine the satisfaction level of its users. Further modifications were implemented per participants' recommendations. The site has been online since it was registered in September 2010. Fourteen rheumatologists and rheumatology trainees from different centers reviewed and completed the material contained in the Website. The survey revealed acceptance among rheumatologists for the Website's content, design, and presentation. The Website was rated as user-friendly and useful in familiarizing investigators with the S2K RI-50. After completion of the training and examination modules, participants reported a suitable level of preparation to implement the S2K RI-50 in clinical trials and research settings in a timely manner. The Website includes training and examination modules that familiarize rheumatologists with the S2K RI-50 and assesses their competence to use the index. This prepares them for the use of the S2K RI-50 in clinical trials and research settings.

  2. Early chronic obstructive pulmonary disease: definition, assessment, and prevention.

    Science.gov (United States)

    Rennard, Stephen I; Drummond, M Bradley

    2015-05-02

    Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. COPD, however, is a heterogeneous collection of diseases with differing causes, pathogenic mechanisms, and physiological effects. Therefore a comprehensive approach to COPD prevention will need to address the complexity of COPD. Advances in the understanding of the natural history of COPD and the development of strategies to assess COPD in its early stages make prevention a reasonable, if ambitious, goal. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Measures of Patient Activation and Social Support in a Peer-Led Support Network for Women With Cardiovascular Disease.

    Science.gov (United States)

    Witt, Dawn; Benson, Gretchen; Campbell, Susan; Sillah, Arthur; Berra, Kathy

    Social support has been associated with beneficial effects on many disease states and overall health and well-being. However, there is limited research exploring the impact of peer-led support models among women living with coronary heart disease. This study describes the structure of peer-led support groups offered by WomenHeart (WH): The National Coalition for Women Living with Heart Disease, and assesses WH participants' quality of life and social, emotional, and physical health. Participants were recruited from 50 WH groups. A 70-item online survey was administered, and the main analytic sample included 157 women. Multivariate logistic regression was used to examine the association between patient activation levels (lower activation levels: 1, 2 vs higher activation levels: 3, 4) and social support scores (range: lowest 8 to highest 34), adjusting for age. High levels of social support, patient activation, physical activity, and low levels of stress, anxiety, and depression were reported. Those who were at or above the median for the social support measures (indicating high levels of social support) had greater odds of high levels of patient activation (level 3 or 4) than individuals reporting low levels of social support (OR = 2.23; 95% CI, 1.04-4.76; P = .012). Women who regularly attended a support group by a trained peer leader were highly engaged in their health care and had low levels of stress, anxiety, and depression. These findings lend credibility to the value of the peer support model and could potentially be replicated in other disease states to enhance patient care.

  4. [Nutritional Assessment and Management for Patients with Chronic Liver Disease].

    Science.gov (United States)

    Lee, Tae Hee

    2018-04-25

    When liver disease is severe, the prognosis can be worse if the patient is malnourished. Adequate nutritional support for patients with liver diseases can improve the patient's condition and prognosis. In the case of liver cirrhosis, malnutrition can occur due to a variety of causes, including poor oral intake, maldigestion, malabsorption, associated renal disease, and metabolic abnormalities. For a nutritional assessment, it is important to check the dietary intake, change in body composition, including anthropometry, and a functional assessment of muscle. Counselling and oral or enteral nutrition is preferred over parenteral nutrition as in other diseases. If esophageal varices are present, care should be taken when installing a feeding tube, but if there are ascites, percutaneous endoscopic gastrostomy is contraindicated because of the risk of complications. Calories of 30-35 kcal/kg/day and protein from 1.2 to 1.5 g/kg/day are appropriate. Protein restriction is unnecessary unless the hepatic encephalopathy is severe. A late evening snack and branched chain amino acids can be helpful. In the case of cholestasis, the supply of manganese and copper should be restricted. Sarcopenia in patients with liver cirrhosis is also prevalent and associated with the prognosis.

  5. Parthenium dermatitis severity score to assess clinical severity of disease

    Directory of Open Access Journals (Sweden)

    Kaushal K Verma

    2017-01-01

    Full Text Available Background: Parthenium dermatitis is the most common type of airborne contact dermatitis in India. It is a chronic disease of a remitting and relapsing course with significant morbidity and distress, but there is no scoring system to assess its severity. Aim: To design a scoring system for the assessment of clinical severity of disease in Parthenium dermatitis and to use this scoring system in various studies to determine its sensitivity, specificity, and reproducibility. Methods and Results: In our first few studies on Parthenium dermatitis, we designed and used a basic clinical severity scoring system based on itching, morphology of the lesions, and areas involved. However, in subsequent studies, we modified it to the present scoring system as Parthenium dermatitis severity score (PDSS. Our studies showed the high sensitivity of PDSS in characterization of the disease severity at the given point of time, as well as to determine the efficacy of a prescribed treatment modality which was reliable and reproducible. Conclusion: Thus, PDSS may be used by clinicians for appropriate scoring of the clinical severity of Parthenium dermatitis and in monitoring the disease response to therapy.

  6. Differing Relationship of Psycho-Social Variables with Active Ulcerative Colitis or Crohn's Disease.

    Science.gov (United States)

    Sarid, Orly; Slonim-Nevo, Vered; Schwartz, Doron; Friger, Michael; Sergienko, Ruslan; Pereg, Avihu; Vardi, Hillel; Chernin, Elena; Singer, Terri; Greenberg, Dan; Odes, Shmuel

    2018-03-09

    How psycho-social variables affect the degree of disease activity in patients with ulcerative colitis (UC) or Crohn's disease (CD) is incompletely understood. Therefore, we measured and compared the impact of psycho-social variables on the active disease state in UC and CD. One hundred and twenty-two UC and 305 CD patients with active disease completed questionnaires detailing their psychological symptoms, threatening experiences, disease-coping strategies, satisfaction with life, quality of life, and demographics. UC and CD patients were aged (mean, SD) 38.6 ± 14.0 and 45.2 ± 15.1 years, respectively. The psychological symptom index (median, IQR) was greater in UC 1.24 (0.8) than CD 0.9 (0.8), p psycho-social variables on the active disease state differs between UC and CD, thus indicating a need for specifically tailored psychotherapies.

  7. Electromagnetic fields: risk assessment and occupational diseases in Italy

    Energy Technology Data Exchange (ETDEWEB)

    Filosa, L.; Frusteri, L. [Risk Assessment and Prevention, Technical Advisory Dept., Italian Workers Compensation Authority, Rome (Italy)

    2006-07-01

    Every year about 8000 occupational diseases are accepted in Italy by I.N.A.I.L., the Italian Workers' Compensation Authority. The occupational diseases are caused by different agents (chemical, biological, physical) but only a very little percentage resulted to be caused by non ionizing radiations. In this paper the Authors report an analysis of occupational diseases caused by non ionising radiations denounced to I.N.A.I.L. and compensated. It is discussed the Italian situation in light of the controversial studies related to the link between exposure and health effects. Because of the uncertainty about an E.M.F. - health link, the main effort is to determine the probability and seriousness of E.M.F. hazard and to realize an accurate risk assessment at workplace, which is one of the main objectives pursued by I.N.A.I.L. Technical Advisory Department for Risk Assessment and Prevention. Moreover, in this paper it is also reported the state of advancement of Italian legislation on health protection against non ionizing radiations at workplace in view of the new European Directive (2004/40/C.E.). (authors)

  8. Electromagnetic fields: risk assessment and occupational diseases in Italy

    International Nuclear Information System (INIS)

    Filosa, L.; Frusteri, L.

    2006-01-01

    Every year about 8000 occupational diseases are accepted in Italy by I.N.A.I.L., the Italian Workers' Compensation Authority. The occupational diseases are caused by different agents (chemical, biological, physical) but only a very little percentage resulted to be caused by non ionizing radiations. In this paper the Authors report an analysis of occupational diseases caused by non ionising radiations denounced to I.N.A.I.L. and compensated. It is discussed the Italian situation in light of the controversial studies related to the link between exposure and health effects. Because of the uncertainty about an E.M.F. - health link, the main effort is to determine the probability and seriousness of E.M.F. hazard and to realize an accurate risk assessment at workplace, which is one of the main objectives pursued by I.N.A.I.L. Technical Advisory Department for Risk Assessment and Prevention. Moreover, in this paper it is also reported the state of advancement of Italian legislation on health protection against non ionizing radiations at workplace in view of the new European Directive (2004/40/C.E.). (authors)

  9. Developing an Assessment Method of Active Aging: University of Jyvaskyla Active Aging Scale.

    Science.gov (United States)

    Rantanen, Taina; Portegijs, Erja; Kokko, Katja; Rantakokko, Merja; Törmäkangas, Timo; Saajanaho, Milla

    2018-01-01

    To develop an assessment method of active aging for research on older people. A multiphase process that included drafting by an expert panel, a pilot study for item analysis and scale validity, a feedback study with focus groups and questionnaire respondents, and a test-retest study. Altogether 235 people aged 60 to 94 years provided responses and/or feedback. We developed a 17-item University of Jyvaskyla Active Aging Scale with four aspects in each item (goals, ability, opportunity, and activity; range 0-272). The psychometric and item properties are good and the scale assesses a unidimensional latent construct of active aging. Our scale assesses older people's striving for well-being through activities pertaining to their goals, abilities, and opportunities. The University of Jyvaskyla Active Aging Scale provides a quantifiable measure of active aging that may be used in postal questionnaires or interviews in research and practice.

  10. Effect of Dexmedetomidine and Propofol on Basal Ganglia Activity in Parkinson Disease: A Controlled Clinical Trial.

    Science.gov (United States)

    Martinez-Simon, Antonio; Alegre, Manuel; Honorato-Cia, Cristina; Nuñez-Cordoba, Jorge M; Cacho-Asenjo, Elena; Trocóniz, Iñaki F; Carmona-Abellán, Mar; Valencia, Miguel; Guridi, Jorge

    2017-06-01

    Deep brain stimulation electrodes can record oscillatory activity from deep brain structures, known as local field potentials. The authors' objective was to evaluate and quantify the effects of dexmedetomidine (0.2 μg·kg·h) on local field potentials in patients with Parkinson disease undergoing deep brain stimulation surgery compared with control recording (primary outcome), as well as the effect of propofol at different estimated peak effect site concentrations (0.5, 1.0, 1.5, 2.0, and 2.5 μg/ml) from control recording. A nonrandomized, nonblinded controlled clinical trial was carried out to assess the change in local field potentials activity over time in 10 patients with Parkinson disease who underwent deep brain stimulation placement surgery (18 subthalamic nuclei). The relationship was assessed between the activity in nuclei in the same patient at a given time and repeated measures from the same nucleus over time. No significant difference was observed between the relative beta power of local field potentials in dexmedetomidine and control recordings (-7.7; 95% CI, -18.9 to 7.6). By contrast, there was a significant decline of 12.7% (95% CI, -21.3 to -4.7) in the relative beta power of the local field potentials for each increment in the estimated peak propofol concentrations at the effect site relative to the control recordings. Dexmedetomidine (0.2 μg·kg·h) did not show effect on local field potentials compared with control recording. A significant deep brain activity decline from control recording was observed with incremental doses of propofol.

  11. Validation of reported physical activity for cholesterol control using two different physical activity instruments

    Directory of Open Access Journals (Sweden)

    Amy Z Fan

    2009-08-01

    Full Text Available Amy Z Fan1, Sandra A Ham2, Shravani Reddy Muppidi3, Ali H Mokdad41Behavioral Surveillance Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion; 2Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; 3College of Public Health, University of Georgia, Athens, GA, USA; 4Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USAAbstract: The National Cholesterol Education Program recommends increasing physical activity to improve cholesterol levels and overall cardiovascular health. We examined whether US adults who reported increasing their physical activity to control or lower blood cholesterol following physician’s advice or on their own efforts had higher levels of physical activity than those who reported that they did not. We used data from the National Health and Nutrition Examination Survey 2003–2004, which implemented two physical activity assessment instruments. The physical activity questionnaire (PAQ assessed self-reported frequency, intensity, and duration of leisure-time, household, and transportation-related physical activity in the past month. Physical movement was objectively monitored using a waist accelerometer that assessed minute-by-minute intensity (counts of movement/minute during waking time over a 7-day period. We adjusted our analysis for age, gender, race/ethnicity, educational attainment, and body mass index. Participants who reported increasing physical activity to control blood cholesterol had more PAQ-assessed physical activity and more accelerometer-assessed active days per week compared to those who did not. However, there were no significant differences in cholesterol levels between comparison groups. These findings suggest that self-report of exercising

  12. Comparison of simultaneous [sup 99m]Tc-HMPAO and [sup 111]In oxine labelled white cell scans in the assessment of inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Allan, R.A.; Bassingham, S.; Lazarus, C.; Clarke, S.E.M.; Fogelman, I. (Guy' s Hospital, London (United Kingdom). Dept. of Nuclear Medicine); Sladen, G.E. (Guy' s Hospital, London (United Kingdom). Dept. of Gastroenterology)

    1993-03-01

    Forty-seven patients, 29 with chronic inflammatory bowel disease (IBD) and 18 with presumed irritable bowel syndrome, including one with uncomplicated diverticular disease, were studied with simultaneous technetium-99m hexamethylpropylene amine oxime and indium-III oxine labelled leucocyte scans performed at 1, 3 and 24 h. Twenty-seven patients with IBD had active disease as judged by clinical and laboratory criteria and all of these had positive scans with both agents. No false positive studies were obtained. The 1-h [sup 99m]Tc-HMPAO WBC scans showed the same distribution to disease as the 3-h [sup 111]-In WBC scans, with no difference in intensity (P<0.92); they showed more extensive disease (P<0.02) and more intense uptake (P<0.001) than did the 1-h [sup 111]-In scans. The 3-h [sup 99m]Tc-HMPAO WBC scans showed more extensive disease (P<0.002), with greater intensity (P<0.0005), than did the 3-h [sup 111]In WBC scans. Physiological bowel activity on 3-h [sup 99m]Tc-HMPAO WBC scans was present in 12 patients but was faint and did not interfere with assessment of disease extent and activity. It is concluded that in terms of isotope availability, radiation dosimetry and image quality, [sup 99m]Tc-HMPAO is the agent of choice in detecting active IBD, with localization of disease possible at 1-h after re-injection and optimal resolution and definition of disease extent at 3 h. A negative scan reliably excludes active disease. (orig.).

  13. Systematic review: questionnaires for assessment of gastroesophageal reflux disease

    NARCIS (Netherlands)

    Bolier, E. A.; Kessing, B. F.; Smout, A. J.; Bredenoord, A. J.

    2015-01-01

    Numerous questionnaires with a wide variety of characteristics have been developed for the assessment of gastroesophageal reflux disease (GERD). Four well-defined dimensions are noticeable in these GERD questionnaires, which are symptoms, response to treatment, diagnosis, and burden on the quality

  14. An integrated risk assessment tool for team-based periodontal disease management.

    Science.gov (United States)

    Thyvalikakath, Thankam P; Padman, Rema; Gupta, Sugandh

    2013-01-01

    Mounting evidence suggests a potential association of periodontal disease with systemic diseases such as diabetes, cardiovascular disease, cancer and stroke. The objective of this study is to develop an integrated risk assessment tool that displays a patients' risk for periodontal disease in the context of their systemic disease, social habits and oral health. Such a tool will be used by not just dental professionals but also by care providers who participate in the team-based care for chronic disease management. Displaying relationships between risk factors and its influence on the patient's general health could be a powerful educational and disease management tool for patients and clinicians. It may also improve the coordination of care provided by the provider-members of a chronic care team.

  15. Disease activity of idiopathic pulmonary fibrosis -value of high resolution CT-

    International Nuclear Information System (INIS)

    Lee, Jin Seong; Im, Jung Gi; Han, Man Chung; Kim, Chu Wan; Suh, Jin Suk

    1991-01-01

    Idiopathic pulmonary fibrosis (IPF) has characteristic clinical and pathologic features. In patients with uniform intra-alveolar cellularity, the process is often referred to as desquamative interstitial pneumonia. When alveolar septal fibrosis predominate, the process is known as usual interstitial pneumonia. Recently most investigators believe that desquamative interstitial pneumonia is the early stage and usual interstitial pneumonia is the late stage of the same disease process. The lone-term survival and the best response to treatment with corticosteroids is found in patients with marked disease activity and little fibrosis. Since disease activity is reflected by interstitial and intraalveolar cellularity, activity of idiopathic pulmonary fibrosis might result in opacification of air spaces on CT scans. There was no significant difference in estimating the visual HRCT scores of active area between two observers (p>0.05). Activity score of HRCT scan correlated significantly with improvement of DLCO/VA after corticosteroids treatment

  16. Disease activity of idiopathic pulmonary fibrosis -value of high resolution CT-

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jin Seong; Im, Jung Gi; Han, Man Chung; Kim, Chu Wan; Suh, Jin Suk [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1991-01-15

    Idiopathic pulmonary fibrosis (IPF) has characteristic clinical and pathologic features. In patients with uniform intra-alveolar cellularity, the process is often referred to as desquamative interstitial pneumonia. When alveolar septal fibrosis predominate, the process is known as usual interstitial pneumonia. Recently most investigators believe that desquamative interstitial pneumonia is the early stage and usual interstitial pneumonia is the late stage of the same disease process. The lone-term survival and the best response to treatment with corticosteroids is found in patients with marked disease activity and little fibrosis. Since disease activity is reflected by interstitial and intraalveolar cellularity, activity of idiopathic pulmonary fibrosis might result in opacification of air spaces on CT scans. There was no significant difference in estimating the visual HRCT scores of active area between two observers (p>0.05). Activity score of HRCT scan correlated significantly with improvement of DLCO/VA after corticosteroids treatment.

  17. Indium-111 granulocyte scintigraphy in inflammatory bowel disease

    International Nuclear Information System (INIS)

    Devillers, A.; Moisan, A.; Heresbach, D.; Darnault, P.; Bretagne, J.F.

    1996-01-01

    The present paper reports our experience since 1963 concerning 111-indium labeled autologous granulocytes scanning in the assessment of inflammatory bowel diseases and in the assessment of activity in Crohn's disease and ulcerative colitis. (authors). 94 refs., 3 figs

  18. Costs in Relation to Disability, Disease Activity, and Health-related Quality of Life in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Wallman, Johan K; Eriksson, Jonas K; Nilsson, Jan-Åke

    2016-01-01

    between-patient associations) and by generalized estimating equations (GEE), using all observations to also account for within-patient associations of HAQ/DAS28/EQ-5D to costs. RESULTS: Regardless of the methodology (linear or GEE regression), HAQ was most closely related to both cost types, while work......OBJECTIVE: To compare how costs relate to disability, disease activity, and health-related quality of life (HRQOL) in rheumatoid arthritis (RA). METHODS: Antitumor necrosis factor (anti-TNF)-treated patients with RA in southern Sweden (n = 2341) were monitored 2005-2010. Health Assessment...... Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), and EQ-5D scores were linked to register-derived costs of antirheumatic drugs (excluding anti-TNF agents), patient care, and work loss from 30 days before to 30 days after each visit (n = 13,289). Associations of HAQ/DAS28/EQ-5D to healthcare...

  19. Assessment of logistic outsourcing of the innovatively-active enterprise

    OpenAIRE

    E.A. Belovodskaya; D.A. Latunova

    2013-01-01

    Assessment of logistic outsourcing of the innovatively-active enterpriseThe aim of the article. The object of this article is a comparative analysis, systematization of assessment methods and methodological approach development to assess the logistics outsourcing assessment of the innovatively active enterprise. The results of the analysis. Due to our research, five approaches for outsourcing assessment were identified.The first approach suggests such way of outsourcing efficiency assessment:...

  20. Gastric emptying and disease activity in inflammatory bowel disease

    DEFF Research Database (Denmark)

    Keller, Jutta; Binnewies, Ulrich; Rösch, Marie

    2015-01-01

    BACKGROUND: Gastric emptying (GE) is delayed in a subset of patients with inflammatory bowel disease (IBD). We have shown before that altered release of gastrointestinal hormones may contribute to GE disturbances, but overall effects of disease activity remain unclear. Thus, we aimed to evaluate GE...... test (baseline test). Plasma glucose, cholecystokinin (CCK), peptide YY (PYY) and glucagon-like peptide-1 (GLP-1) were measured periodically throughout the test. A total of 16 patients underwent a second GE test after 3-4 months of therapy. RESULTS: At baseline, nine patients with IBD had...... pathologically delayed GE half-time (T½ > 150 min) (P = 0·028 vs. HC). Moreover, T½ was significantly longer in the total group of patients with IBD than in HC (129 ± 12 min vs. 96 ± 7, P = 0·030). Postprandial GLP-1 responses were elevated in IBD (P = 0·002 vs. HC) and correlated with T½ (P = 0·05). Following...

  1. Physical Activity and Telomere Biology: Exploring the Link with Aging-Related Disease Prevention

    Directory of Open Access Journals (Sweden)

    Andrew T. Ludlow

    2011-01-01

    Full Text Available Physical activity is associated with reduced risk of several age-related diseases as well as with increased longevity in both rodents and humans. Though these associations are well established, evidence of the molecular and cellular factors associated with reduced disease risk and increased longevity resulting from physical activity is sparse. A long-standing hypothesis of aging is the telomere hypothesis: as a cell divides, telomeres shorten resulting eventually in replicative senescence and an aged phenotype. Several reports have recently associated telomeres and telomere-related proteins to diseases associated with physical inactivity and aging including cardiovascular disease, insulin resistance, and hypertension. Interestingly several reports have also shown that longer telomeres are associated with higher physical activity levels, indicating a potential mechanistic link between physical activity, reduced age-related disease risk, and longevity. The primary purpose of this review is to discuss the potential importance of physical activity in telomere biology in the context of inactivity- and age-related diseases. A secondary purpose is to explore potential mechanisms and important avenues for future research in the field of telomeres and diseases associated with physical inactivity and aging.

  2. Bioimpedance Harmonic Analysis as a Diagnostic Tool to Assess Regional Circulation and Neural Activity

    International Nuclear Information System (INIS)

    Mudraya, I S; Revenko, S V; Khodyreva, L A; Markosyan, T G; Dudareva, A A; Ibragimov, A R; Romich, V V; Kirpatovsky, V I

    2013-01-01

    The novel technique based on harmonic analysis of bioimpedance microvariations with original hard- and software complex incorporating a high-resolution impedance converter was used to assess the neural activity and circulation in human urinary bladder and penis in patients with pelvic pain, erectile dysfunction, and overactive bladder. The therapeutic effects of shock wave therapy and Botulinum toxin detrusor injections were evaluated quantitatively according to the spectral peaks at low 0.1 Hz frequency (M for Mayer wave), respiratory (R) and cardiac (C) rhythms with their harmonics. Enhanced baseline regional neural activity identified according to M and R peaks was found to be presumably sympathetic in pelvic pain patients, and parasympathetic – in patients with overactive bladder. Total pulsatile activity and pulsatile resonances found in the bladder as well as in the penile spectrum characterised regional circulation and vascular tone. The abnormal spectral parameters characteristic of the patients with genitourinary diseases shifted to the norm in the cases of efficient therapy. Bioimpedance harmonic analysis seems to be a potent tool to assess regional peculiarities of circulatory and autonomic nervous activity in the course of patient treatment.

  3. Bioimpedance Harmonic Analysis as a Diagnostic Tool to Assess Regional Circulation and Neural Activity

    Science.gov (United States)

    Mudraya, I. S.; Revenko, S. V.; Khodyreva, L. A.; Markosyan, T. G.; Dudareva, A. A.; Ibragimov, A. R.; Romich, V. V.; Kirpatovsky, V. I.

    2013-04-01

    The novel technique based on harmonic analysis of bioimpedance microvariations with original hard- and software complex incorporating a high-resolution impedance converter was used to assess the neural activity and circulation in human urinary bladder and penis in patients with pelvic pain, erectile dysfunction, and overactive bladder. The therapeutic effects of shock wave therapy and Botulinum toxin detrusor injections were evaluated quantitatively according to the spectral peaks at low 0.1 Hz frequency (M for Mayer wave), respiratory (R) and cardiac (C) rhythms with their harmonics. Enhanced baseline regional neural activity identified according to M and R peaks was found to be presumably sympathetic in pelvic pain patients, and parasympathetic - in patients with overactive bladder. Total pulsatile activity and pulsatile resonances found in the bladder as well as in the penile spectrum characterised regional circulation and vascular tone. The abnormal spectral parameters characteristic of the patients with genitourinary diseases shifted to the norm in the cases of efficient therapy. Bioimpedance harmonic analysis seems to be a potent tool to assess regional peculiarities of circulatory and autonomic nervous activity in the course of patient treatment.

  4. 78 FR 15894 - Draft Qualitative Risk Assessment of Risk of Activity/Food Combinations for Activities (Outside...

    Science.gov (United States)

    2013-03-13

    .... FDA-2012-N-1258] Draft Qualitative Risk Assessment of Risk of Activity/Food Combinations for... comment period for a document entitled ``Draft Qualitative Risk Assessment of Risk of Activity/ [[Page... ``Draft Qualitative Risk Assessment of Risk of Activity/Food Combinations for Activities (Outside the Farm...

  5. Combined influence of healthy diet and active lifestyle on cardiovascular disease risk factors in adolescents.

    Science.gov (United States)

    Cuenca-García, M; Ortega, F B; Ruiz, J R; González-Gross, M; Labayen, I; Jago, R; Martínez-Gómez, D; Dallongeville, J; Bel-Serrat, S; Marcos, A; Manios, Y; Breidenassel, C; Widhalm, K; Gottrand, F; Ferrari, M; Kafatos, A; Molnár, D; Moreno, L A; De Henauw, S; Castillo, M J; Sjöström, M

    2014-06-01

    To investigate the combined influence of diet quality and physical activity on cardiovascular disease (CVD) risk factors in adolescents, adolescents (n = 1513; 12.5-17.5 years) participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence study were studied. Dietary intake was registered using a 24-h recall and a diet quality index was calculated. Physical activity was assessed by accelerometry. Lifestyle groups were computed as: healthy diet and active, unhealthy diet but active, healthy diet but inactive, and unhealthy diet and inactive. CVD risk factor measurements included cardiorespiratory fitness, adiposity indicators, blood lipid profile, blood pressure, and insulin resistance. A CVD risk score was computed. The healthy diet and active group had a healthier cardiorespiratory profile, fat mass index (FMI), triglycerides, and high-density lipoprotein cholesterol (HDL-C) levels and total cholesterol (TC)/HDL-C ratio (all P ≤ 0.05). Overall, active adolescents showed higher cardiorespiratory fitness, lower FMI, TC/HDL-C ratio, and homeostasis model assessment index and healthier blood pressure than their inactive peers with either healthy or unhealthy diet (all P ≤ 0.05). Healthy diet and active group had healthier CVD risk score compared with the inactive groups (all P ≤ 0.02). Thus, a combination of healthy diet and active lifestyle is associated with decreased CVD risk in adolescents. Moreover, an active lifestyle may reduce the adverse consequences of an unhealthy diet. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. The value of [18F]FDG-PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease

    International Nuclear Information System (INIS)

    Walter, Martin A.; Mueller-Brand, Jan; Nitzsche, Egbert U.; Melzer, Ralph A.; Tyndall, Alan; Schindler, Christian

    2005-01-01

    This study was performed to investigate the value of 18 F-fluorodeoxyglucose positron emission tomography ([ 18 F]FDG-PET) in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease. Twenty-six consecutive patients (21 females, 5 males; median age - years, range 17-86 years) with giant cell arteritis or Takayasu's arteritis were examined with [ 18 F]FDG-PET. Follow-up scans were performed in four patients. Twenty-six age- and gender-matched controls (21 females, 5 males; median age 71 years, range 17-86 years) were included. The severity of large-vessel [ 18 F]FDG uptake was visually graded using a four-point scale. C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) were measured and correlated with [ 18 F]FDG-PET results by logistic regression. [ 18 F]FDG-PET revealed pathological findings in 18 of 26 patients. Three scans were categorised as grade I, 12 as grade II and 3 as grade III arteritis. Visual grade was significantly correlated with both CRP and ESR levels (p=0.002 and 0.007 respectively; grade I: CRP 4.0 mg/l, ESR 6 mm/h; grade II: CRP 37 mg/l, ESR 46 mm/h; grade III: CRP 172 mg/l, ESR 90 mm/h). Overall sensitivity was 60% (95% CI 40.6-77.3%), specificity 99.8% (95% CI 89.1-100%), positive predictive value 99.7% (95% CI 77-100%), negative predictive value 67.9% (95% CI 49.8-80.9%) and accuracy 78.6% (95% CI 65.6-88.4%). In patients presenting with a CRP 18 F]FDG-PET is highly effective in assessing the activity and the extent of large-vessel vasculitis. Visual grading was validated as representing the severity of inflammation. Its use is simple and provides high specificity, while high sensitivity is achieved by scanning in the state of active inflammation. (orig.)

  7. Disease activity decrease is associated with improvement in work productivity over 1 year in early axial spondyloarthritis (SPondyloArthritis Caught Early cohort).

    Science.gov (United States)

    van Lunteren, Miranda; Ez-Zaitouni, Zineb; Fongen, Camilla; Landewé, Robert; Ramonda, Roberta; van der Heijde, Désirée; van Gaalen, Floris A

    2017-12-01

    To assess if a change in disease activity is associated with a change in work productivity loss (WPL) over 1 year in early axial SpA (axSpA) patients. Baseline and 1 year data of axSpA patients in the SPondyloArthritis Caught Early cohort were analysed. Linear regression models were built explaining the change in the Ankylosing Spondylitis Disease Activity Score (ASDAS) over time by the change in absenteeism, presenteeism, WPL and activity impairment over time. Effect modification and confounding were tested for age, gender, arm of Assessment of SpondyloArthritis international Society classification criteria, HLA-B27, duration of chronic back pain, profession and medication. At baseline, in 105 axSpA patients (48% female, mean age 30.8 years, mean symptom duration 13.6 months, 92% HLA-B27 positive, 24% radiographic sacroiliitis), the mean ASDAS was 2.4 (s.d. 1.0), absenteeism 9% (s.d. 23), presenteeism 33% (s.d. 28), WPL 36% (s.d. 30) and activity impairment 37% (s.d. 25). After 1 year, the mean ASDAS decreased to 2.0 (s.d. 0.8) and absenteeism, presenteeism, WPL and activity impairment improved to 6% (s.d. 22), 26% (s.d. 26), 27% (s.d. 29) and 27% (s.d. 26), respectively. Models showed that if ASDAS decreased 1 unit, absenteeism, presenteeism, WPL and activity impairment improved by 5, 17, 16 and 18%, respectively. The impact of disease activity on work productivity was higher in patients with shorter symptom duration and the impact on absenteeism was higher in patients starting pharmacological treatment. In early axSpA patients, work productivity and daily activities are seriously impacted at baseline and 1 year. However, decreasing disease activity is associated with marked improvements in work productivity and daily activities. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  8. Biosynthesis of silver nanoparticles from Catharanthus roseus leaf extract and assessing their antioxidant, antimicrobial, and wound-healing activities.

    Science.gov (United States)

    Al-Shmgani, Hanady S A; Mohammed, Wasnaa H; Sulaiman, Ghassan M; Saadoon, Ali H

    2017-09-01

    Biosynthesis of silver nanoparticles (AgNPs) from Catharanthus roseus leaf extract was carried out, and their characterization, as well as antioxidant, antimicrobial, and wound-healing activities were evaluated. Color change, UV-vis spectrum, XRD, FTIR, and AFM assessments supported the biosynthesis and characterization of AgNPs. The synthesized AgNPs showed strong in vitro antioxidant and antimicrobial activities against various pathogens. The in vivo assessment of wound healing in AgNPs-treated mice revealed their effectiveness in closuring and reducing size of wounds. Such potent bioactivity may justify their biomedical use as antioxidant and antimicrobial agents for controlling various health-related diseases, particularly in wound healing.

  9. The internal consistency and validity of the Self-assessment Parkinson's Disease Disability Scale.

    NARCIS (Netherlands)

    Biemans, M.A.J.E.; Dekker, J.; Woude, L.H.V. van der

    2001-01-01

    OBJECTIVE: To test the consistency and validity of the Self-assessment Parkinson's Disease Disability Scale in patients with Parkinson's disease living at home. DESIGN: Patients with Parkinson's disease responded to a set of questionnaires. In addition, an observation of the performance of daily

  10. Internal consistency and validity of the self-assessment Parkinson's Disease disability scale. Abstract.

    NARCIS (Netherlands)

    Dekker, J.; Biemans, M.A.J.E.; Woude, L.H.V. van der

    2000-01-01

    OBJECTIVE: To test the consistency and validity of the Self-assessment Parkinson's Disease Disability Scale in patients with Parkinson's disease living at home. DESIGN: Patients with Parkinson's disease responded to a set of questionnaires. In addition, an observation of the performance of daily

  11. Does expert opinion match the operational definition of the Lupus Low Disease Activity State (LLDAS)? A case-based construct validity study.

    Science.gov (United States)

    Golder, Vera; Huq, Molla; Franklyn, Kate; Calderone, Alicia; Lateef, Aisha; Lau, Chak Sing; Lee, Alfred Lok Hang; Navarra, Sandra Teresa V; Godfrey, Timothy; Oon, Shereen; Hoi, Alberta Yik Bun; Morand, Eric Francis; Nikpour, Mandana

    2017-06-01

    To evaluate the construct validity of the Lupus Low Disease Activity State (LLDAS), a treatment target in systemic lupus erythematosus (SLE). Fifty SLE case summaries based on real patients were prepared and assessed independently for meeting the operational definition of LLDAS. Fifty international rheumatologists with expertise in SLE, but with no prior involvement in the LLDAS project, responded to a survey in which they were asked to categorize the disease activity state of each case as remission, low, moderate, or high. Agreement between expert opinion and LLDAS was assessed using Cohen's kappa. Overall agreement between expert opinion and the operational definition of LLDAS was 77.96% (95% CI: 76.34-79.58%), with a Cohen's kappa of 0.57 (95% CI: 0.55-0.61). Of the cases (22 of 50) that fulfilled the operational definition of LLDAS, only 5.34% (59 of 22 × 50) of responses classified the cases as moderate/high activity. Of the cases that did not fulfill the operational definition of LLDAS (28 of 50), 35.14% (492 of 28 × 50) of responses classified the cases as remission/low activity. Common reasons for discordance were assignment to remission/low activity of cases with higher corticosteroid doses than defined in LLDAS (prednisolone ≤ 7.5mg) or with SLEDAI-2K >4 due to serological activity (high anti-dsDNA antibody and/or low complement). LLDAS has good construct validity with high overall agreement between the operational definition of LLDAS and expert opinion. Discordance of results suggests that the operational definition of LLDAS is more stringent than expert opinion at defining a low disease activity state. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Active and Passive Smoking, Chronic Disease and Poverty in China ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Active and Passive Smoking, Chronic Disease and Poverty in China. The globalization ... The impending burden of tobacco-related chronic disease will be significant in a population of 1.3 billion. ... Center for Health Statistics and Information.

  13. Mast cell inflammasome activity in the meninges regulates EAE disease severity.

    Science.gov (United States)

    Russi, Abigail E; Walker-Caulfield, Margaret E; Brown, Melissa A

    2018-04-01

    Inflammasomes are multiprotein complexes that assemble in response to microbial and other danger signals and regulate the secretion of biologically active IL-1β and IL-18. Although they are important in protective immunity against bacterial, viral and parasitic infections, aberrant inflammasome activity promotes chronic inflammation associated with autoimmune disease. Inflammasomes have been described in many immune cells, but the majority of studies have focused on their activity in macrophages. Here we discuss an important role for mast cell-inflammasome activity in EAE, the rodent model of multiple sclerosis, a CNS demyelinating disease. We review our evidence that mast cells in the meninges, tissues that surround the brain and spinal cord, interact with infiltrating myelin-specific T cells in early disease. This interaction elicits IL-1β expression by mast cells, which in turn, promotes GM-CSF expression by T cells. In view of the essential role that GM-CSF plays in T cell encephalitogenicity, we propose this mast cell-T cell crosstalk in the meninges is critical for EAE disease development. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Assessing Health Status in Inflammatory Bowel Disease using a Novel Single-Item Numeric Rating Scale

    Science.gov (United States)

    Surti, Bijal; Spiegel, Brennan; Ippoliti, Andrew; Vasiliauskas, Eric; Simpson, Peter; Shih, David; Targan, Stephan; McGovern, Dermot; Melmed, Gil Y.

    2014-01-01

    Background Current instruments used to measure disease activity and health-related quality of life (HRQOL) in patients with Crohn’s disease (CD) and ulcerative colitis (UC) are often cumbersome, time-consuming, and expensive; although used in clinical trials, they are not convenient for clinical practice. A numeric rating scale (NRS) is a quick, inexpensive, and convenient patient-reported outcome (PRO) that can capture the patient’s overall perception of health. Aims To assess the validity, reliability, and responsiveness of an NRS and evaluate its use in clinical practice in patients with CD and UC. Methods We prospectively evaluated patient-reported NRS scores and measured correlations between NRS and a range of severity measures, including physician-reported NRS, Crohn’s disease activity index (CDAI), Harvey-Bradshaw index (HBI), inflammatory bowel disease questionnaire (IBDQ), and C-reactive protein (CRP) in patients with CD. Subsequently, we evaluated the correlation between the NRS and standard measures of health status (HBI or simple colitis clinical activity index [SCCAI]) and laboratory tests (sedimentation rate [ESR], CRP, and fecal calprotectin) in patients with CD and UC. Results The patient-reported NRS showed excellent correlation with CDAI (R2=0.59, p<0.0001), IBDQ (R2=0.66, p<0.0001), and HBI (R2=0.32, p<0.0001) in patients with CD. The NRS showed poor, but statistically significant correlation with SCCAI (R2=0.25, p<0.0001) in patients with UC. The NRS did not correlate with CRP, ESR, or calprotectin. The NRS was reliable and responsive to change. Conclusions The NRS is a valid, reliable, and responsive measure that may be useful to evaluate patients with CD and possibly UC. PMID:23250673

  15. Serum thymidine kinase activity of various cancer and HBV positive liver diseases

    Energy Technology Data Exchange (ETDEWEB)

    Torizumi, Kazutami; Aibata, Hirofumi; Kiji, Shigeyuki; Ohta, Kiichiro; Okamoto, Yukiharu; Ohshiro, Iwao; Hirose, Tetsuhito

    1987-03-01

    Clinical utility of determination of serum deoxythymidine kinase (TK) activity is described. It is well known that elevated TK level is observed in leukemia and other malignant diseases, or some viral infectious diseases. The TK activity was assayed on normal subjects, hepatitis B virus (HBV) positive liver diseases and various cancer by a newly developed high sensitive method, radioenzyme assay (REA) utilizing /sup 125/I-iododeoxyuridine as the substrate. Measurement of TK activity by the REA is revealed to be useful for ''the marker of DNA metabolism anomaly'' in leukemia, etc.

  16. A new integrative model of cerebral activation, deactivation and default mode function in Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Wermke, Marc [Technische Universitaet, Department of Nuclear Medicine, Munich (Germany); Technische Universitaet Muenchen, Nuklearmedizinische Klinik u. Poliklinik, Klinikum rechts der Isar, Muenchen (Germany); Sorg, Christian [Technische Universitaet, Department of Psychiatry and Psychotherapy, Munich (Germany); Wohlschlaeger, Afra M. [Technische Universitaet, Departments of Neuroradiology and Neurology, Munich (Germany); Drzezga, Alexander [Technische Universitaet, Department of Nuclear Medicine, Munich (Germany)

    2008-03-15

    Functional imaging methods such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) allow in vivo assessment of cerebral metabolism at rest and cerebral responses to cognitive stimuli. Activation studies with different cognitive tasks have deepened the understanding of underlying pathology leading to Alzheimer disease (AD) and how the brain reacts to and potentially compensates the imposed damage inflicted by this disease. The aim of this manuscript study was to summarize current findings of activation studies in healthy people at risk for AD, in people with mild cognitive impairment (MCI) as a possible progenitor of AD and finally in patients with manifest AD, adding recent results about impaired deactivation abilities and default mode function in AD. A new comprehensive model will be introduced integrating these heterogeneous findings and explaining their impact on cognitive performance. (orig.)

  17. Increased CSF-BACE1 activity associated with decreased hippocampus volume in Alzheimer's disease.

    LENUS (Irish Health Repository)

    Ewers, Michael

    2012-02-01

    The enzyme beta-secretase (BACE1) is essentially involved in the production of cerebral amyloidogenic pathology in Alzheimer\\'s disease (AD). The measurement of BACE1 activity in cerebrospinal fluid (CSF) has been reported, which may render CSF measurement of BACE1 a potential biomarker candidate of AD. In order to investigate whether BACE1 protein activity is correlated with regional brain atrophy in AD, we investigated the association between CSF levels of BACE1 and MRI-assessed hippocampus volume in patients with AD (n = 30). An increase in CSF-BACE1 activity was associated with decreased left and right hippocampus volume corrected for global head volume in the AD patients. Boot-strapped regression analysis showed that increased CSF levels of BACE1 activity were associated with increased CSF concentration of total tau but not amyloid-beta1-42 in AD. White matter hyperintensities did not influence the results. BACE1 activity and protein levels were significantly increased in AD compared to 19 elderly healthy controls. Thus, the CSF biomarker candidate of BACE1 activity was associated with hippocampus atrophy in AD in a robust manner and may reflect neurotoxic amyloid-beta-related processes.

  18. Evaluation of methods to assess physical activity

    Science.gov (United States)

    Leenders, Nicole Y. J. M.

    Epidemiological evidence has accumulated that demonstrates that the amount of physical activity-related energy expenditure during a week reduces the incidence of cardiovascular disease, diabetes, obesity, and all-cause mortality. To further understand the amount of daily physical activity and related energy expenditure that are necessary to maintain or improve the functional health status and quality of life, instruments that estimate total (TDEE) and physical activity-related energy expenditure (PAEE) under free-living conditions should be determined to be valid and reliable. Without evaluation of the various methods that estimate TDEE and PAEE with the doubly labeled water (DLW) method in females there will be eventual significant limitations on assessing the efficacy of physical activity interventions on health status in this population. A triaxial accelerometer (Tritrac-R3D, (TT)), an uniaxial (Computer Science and Applications Inc., (CSA)) activity monitor, a Yamax-Digiwalker-500sp°ler , (YX-stepcounter), by measuring heart rate responses (HR method) and a 7-d Physical Activity Recall questionnaire (7-d PAR) were compared with the "criterion method" of DLW during a 7-d period in female adults. The DLW-TDEE was underestimated on average 9, 11 and 15% using 7-d PAR, HR method and TT. The underestimation of DLW-PAEE by 7-d PAR was 21% compared to 47% and 67% for TT and YX-stepcounter. Approximately 56% of the variance in DLW-PAEE*kgsp{-1} is explained by the registration of body movement with accelerometry. A larger proportion of the variance in DLW-PAEE*kgsp{-1} was explained by jointly incorporating information from the vertical and horizontal movement measured with the CSA and Tritrac-R3D (rsp2 = 0.87). Although only a small amount of variance in DLW-PAEE*kgsp{-1} is explained by the number of steps taken per day, because of its low cost and ease of use, the Yamax-stepcounter is useful in studies promoting daily walking. Thus, studies involving the

  19. Mental health status can reflect disease activity in rheumatoid arthritis.

    Science.gov (United States)

    Sokolovic, Sekib; Dervisevic, Vedina; Fisekovic, Saida

    2014-06-01

    A significant number of patients with rheumatoid arthritis (RA) link the start of illness with psychological trauma or severe stress. Impaired mental health (IMH), defined as depression and anxiety with psychoneuroimmunological factors, can play a significant role in RA. The main objective of this research was to investigate the mutual correlation of IMH and RA activity, estimated by the laboratory and clinical parameters in RA patients. An open clinical prospective study that lasted for 6 months was designed. There were 72 patients included, 58 women and 14 men, aged 34 to 80 years and screened for mental health status. The study population was randomized following the Brief Symptoms Inventory (BSI) scale, comprised of 53 questions with a range from 0 (no symptoms) to 4 (severe). This mental test was done only once during the study. Following the results from the BSI scale, RA patients were divided into mentally stable and mentally unstable patients to investigate the influence of RA activity on mental health. The following laboratory and clinical parameters were analyzed: sex, age, erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), anti-cyclic citrullinated peptide (anti-CCP) antibody, and disease activity score (DAS28). All RA patients did not express extra-articular manifestations or Sjögren's syndrome. The chi-square test, ANOVA, Pearson's coefficient, and IBM Statistics - SPSS v19 were used. From a total of 72 RA patients, there were 44 mentally stable and 28 mentally unstable patients. All patients had either moderate or severe active disease. The only significant correlation of IMH and activity of RA was found in CRP and DAS28, but no significance was observed in ESR, RF, and anti-CCP. The DAS28 showed high disease activity with an average of 5.3 and CRP of 20.9 mg/L in patients with unstable mental health compared to stable mental health patients, where RA was associated with a moderate DAS average value of 4.35 and

  20. Technologies Assessing Limb Bradykinesia in Parkinson's Disease.

    Science.gov (United States)

    Hasan, Hasan; Athauda, Dilan S; Foltynie, Thomas; Noyce, Alastair J

    2017-01-01

    The MDS-UPDRS (Movement Disorders Society - Unified Parkinson's Disease Rating Scale) is the most widely used scale for rating impairment in PD. Subscores measuring bradykinesia have low reliability that can be subject to rater variability. Novel technological tools can be used to overcome such issues. To systematically explore and describe the available technologies for measuring limb bradykinesia in PD that were published between 2006 and 2016. A systematic literature search using PubMed (MEDLINE), IEEE Xplore, Web of Science, Scopus and Engineering Village (Compendex and Inspec) databases was performed to identify relevant technologies published until 18 October 2016. 47 technologies assessing bradykinesia in PD were identified, 17 of which offered home and clinic-based assessment whilst 30 provided clinic-based assessment only. Of the eligible studies, 7 were validated in a PD patient population only, whilst 40 were tested in both PD and healthy control groups. 19 of the 47 technologies assessed bradykinesia only, whereas 28 assessed other parkinsonian features as well. 33 technologies have been described in additional PD-related studies, whereas 14 are not known to have been tested beyond the pilot phase. Technology based tools offer advantages including objective motor assessment and home monitoring of symptoms, and can be used to assess response to intervention in clinical trials or routine care. This review provides an up-to-date repository and synthesis of the current literature regarding technology used for assessing limb bradykinesia in PD. The review also discusses the current trends with regards to technology and discusses future directions in development.

  1. Assessing dietary and lifestyle risk factors and their associations with disease comorbidities among patients with schizophrenia: A case-control study from Bahrain.

    Science.gov (United States)

    Jahrami, Haitham Ali; Faris, Mo'ez Al-Islam Ezzat; Saif, Zahraa Qassim; Hammad, Laila Habib

    2017-08-01

    Acquired dietary habits and lifestyle behaviors of patients with schizophrenia may affect their life expectancy, disease complications and prognosis. The objectives of the current study were to assess the dietary habits and other lifestyle behaviors for Bahraini patients with schizophrenia, and to determine their associations with different medical comorbidities. A case-control study was conducted during the period of March to December 2016. A sample of 120 cases were recruited from the Psychiatric Hospital, Bahrain and age-sex-matched with 120 controls. Controls were recruited from primary health centres, and were free from serious mental illness. Dietary habits and lifestyle behaviors including smoking, alcohol intake and physical activity were assessed using a questionnaire. All medical records were reviewed retrospectively. Logistic regression analysis was used to identify dietary and lifestyle risk factors that are associated with one or more disease comorbidities. Cases had higher prevalence of smoking and alcohol intake, excessive dietary intake, and decreased physical activity (all Prisk for developing chronic medical conditions such as obesity, type 2 diabetes, hypertension, cardiovascular disease, and musculoskeletal disorders. Cases were three times more likely to have up to three or more medical comorbidities compared with controls. Excessive dietary intake and decreased physical activity were identified as the main risk factors. Excessive caloric intake and decreased physical activity represent the main dietary and lifestyle risk factors associated with comorbidities among patients with schizophrenia in Bahrain. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Prevalence and risk factors of Clostridium difficile infection in patients hospitalized for flare of inflammatory bowel disease: a retrospective assessment.

    Science.gov (United States)

    Regnault, Helene; Bourrier, Anne; Lalande, Valerie; Nion-Larmurier, Isabelle; Sokol, Harry; Seksik, Philippe; Barbut, Frederic; Cosnes, Jacques; Beaugerie, Laurent

    2014-12-01

    Recent studies have identified a high frequency of Clostridium difficile infections in patients with active inflammatory bowel disease. To retrospectively assess the determinants and results of Clostridium difficile testing upon the admission of patients hospitalized with active inflammatory bowel disease in a tertiary care centre and to determine the predicting factors of Clostridium difficile infections. We reviewed all admissions from January 2008 and December 2010 for inflammatory bowel disease flare-ups. A toxigenic culture and a stool cytotoxicity assay were performed for all patients tested for Clostridium difficile. Out of 813 consecutive stays, Clostridium difficile diagnostic assays have been performed in 59% of inpatients. The independent predictive factors for the testing were IBD (ulcerative colitis: OR 2.0, 95% CI 1.5-2.9; pClostridium difficile infection was present in 7.0% of the inpatients who underwent testing. In a multivariate analysis, the only independent predictor was the intake of nonsteroidal anti-inflammatory drugs within the two months before admission (OR 3.8, 95% CI 1.2-12.3; p=0.02). Clostridium difficile infection is frequently associated with active inflammatory bowel disease. Our study suggests that a recent intake of nonsteroidal anti-inflammatory drugs is a risk factor for inflammatory bowel disease -associated Clostridium difficile infection. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  3. Sulfur amino acids in Cushing's disease: insight in homocysteine and taurine levels in patients with active and cured disease.

    Science.gov (United States)

    Faggiano, Antongiulio; Melis, Daniela; Alfieri, Raffaele; De Martino, MariaCristina; Filippella, Mariagiovanna; Milone, Francesco; Lombardi, Gaetano; Colao, Annamaria; Pivonello, Rosario

    2005-12-01

    Cushing's syndrome is associated with an increased cardiovascular risk. Although a series of cardiovascular risk factors have been identified, sulfur amino acids (SAAs), recently indicated as independent cardiovascular risk factors, have been poorly investigated in patients with Cushing's syndrome. The aim of this cross-sectional controlled study was to evaluate serum and urinary levels and urinary excretion rate (ER) of SAAs in patients with Cushing's disease (CD) during the active disease and after long-term disease remission. Forty patients with CD (20 with active disease and 20 with cured disease for at least 5 yr) and 40 controls entered the study. Serum and urinary concentrations and urinary ER of SAAs, namely methionine, cystine, homocysteine, and taurine, were measured by means of cationic exchange HPLC. Serum folic acid and vitamin B12 levels were also evaluated in patients and controls and correlated to SAA levels. CD patients with active disease had higher serum and urinary concentrations of cystine and homocysteine, and lower serum and higher urinary concentrations and ER of taurine than cured patients and controls. Vitamin B12 levels were significantly decreased in patients with active disease compared with cured patients and controls, whereas folic acid levels were slightly decreased in patients than in controls. In patients with active CD, urinary cortisol concentrations were significantly and inversely correlated to serum taurine and directly correlated to taurine urinary ER, and fasting serum glucose levels were significantly correlated to taurine urinary ER. At the multiple regression analysis, urinary cortisol concentrations were the best predictors of taurine ER. CD is associated with hyperhomocysteinemia and hypotaurinemia. Glucocorticoid excess, acting directly or indirectly, seems to be the most responsible for this imbalance in SAA levels. The long-term disease remission is accompanied by normalization of SAA levels. Hyperhomocysteinemia and

  4. Physiological assessment of sensitivity of noninvasive testing for coronary artery disease

    International Nuclear Information System (INIS)

    Simonetti, I.; Rezai, K.; Rossen, J.D.; Winniford, M.D.; Talman, C.L.; Hollenberg, M.; Kirchner, P.T.; Marcus, M.L.

    1991-01-01

    The sensitivity of three noninvasive tests for coronary artery disease was assessed by means of quantitative indexes of disease severity in three different groups of patients. The overall population consisted of 110 subjects with limited coronary artery disease and no myocardial infarction. Planar dipyridamole- 201 Tl scintigraphy was evaluated in 31 patients, computer-assisted exercise treadmill in 28, and high-dose dipyridamole echocardiography testing in 51. Sensitivity was assessed by rigorous gold standards to define disease severity, such as measurement of minimum cross-sectional area and percent area of stenosis, by quantitative computerized coronary angiography (Brown/Dodge method). On the basis of the results of previous studies, the presence of physiologically significant coronary artery disease was indicated by a stenotic minimum cross-sectional area (MCSA) of less than 2.0 mm 2 or a greater than 75% area of stenosis. With MCSA as the gold standard, dipyridamole- 201 Tl scintigraphy, computerized exercise treadmill, and dipyridamole echocardiography testing showed sensitivities of 52%, 54%, and 61%, respectively, in the three different patient cohorts enrolled. With percent area of stenosis as the gold standard, the sensitivity figures obtained for dipyridamole- 201 Tl, computerized exercise treadmill, and dipyridamole echocardiography testing were 64%, 54%, and 69%, respectively. For each of the three tests, sensitivity increased with increasing lesion severity. Sensitivity was also better in patients with left anterior descending coronary (LAD) disease when compared with patients with left circumflex or right coronary artery disease. Results of these studies demonstrate that in patients with limited coronary artery disease none of the tests evaluated is definitely superior in sensitivity

  5. APACHE II SCORING SYSTEM AND ITS MODIFICATION FOR THE ASSESSMENT OF DISEASE SEVERITY IN CHILDREN WHO UNDERWENT POLYCHEMOTHERAPY

    Directory of Open Access Journals (Sweden)

    А. V. Sotnikov

    2014-01-01

    Full Text Available Short-term disease prognosis should be considered for the appropriate treatment policy based on the assessment of disease severity in patients with acute disease. The adequate assessment of disease severity and prognosis allows the indications for transferring patients to the resuscitation and intensive care department to be defined more precisely. Disease severity of patients who underwent polychemotherapy was assessed using APACHE II scoring system.

  6. Evaluation of high density lipoprotein as a circulating biomarker of Gaucher disease activity

    Science.gov (United States)

    Stein, Philip; Yang, Ruhua; Liu, Jun; Pastores, Gregory M.; Mistry, Pramod K.

    2011-01-01

    Circulating biomarkers are important surrogates for monitoring disease activity in type I Gaucher disease (GD1). We and others have reported low high-density lipoprotein (HDL) in GD1. We assessed HDL cholesterol as a biomarker of GD1, with respect to its correlation with indicators of disease severity and its response to imiglucerase enzyme replacement therapy (ERT). In 278 consecutively evaluated GD1 patients, we correlated HDL cholesterol, chitotriosidase, and angiotensin-converting enzyme (ACE) with indicators of disease severity. Additionally, we measured the response of these biomarkers to ERT. HDL cholesterol was negatively correlated with spleen volume, liver volume, and GD severity score index; the magnitude of this association of disease severity with HDL cholesterol was similar to that for ACE and for chitotriosidase. Within individual patients monitored over many years, there was a strikingly strong correlation of HDL with liver and spleen volumes; there was a similarly strong correlation of chitotriosidase and ACE with disease severity in individual patients monitored serially over many years (chitotriosidase r=0.96 to 0.98, ACE r =0.88 to 0.94, and HDL r=−0.84 to −0.94, p<0.001). ERT for 3 years resulted in a striking increase of HDL while serum levels of chitotriosidase and ACE decreased. Our results reveal markedly low HDL cholesterol in untreated GD1, a correlation with indicators of disease severity in GD1, and a rise towards normal after ERT. These findings suggest HDL cholesterol merits inclusion within the “biomarker basket” for monitoring of patients with GD1. PMID:21290183

  7. Behavioural intervention to increase physical activity in adults with coronary heart disease in Jordan.

    Science.gov (United States)

    Alsaleh, Eman; Windle, Richard; Blake, Holly

    2016-07-26

    Patients with coronary heart disease often do not follow prescribed physical activity recommendations. The aim of this study was to assess the efficacy of a behavioural intervention to increase physical activity in patients with coronary heart disease not attending structured cardiac rehabilitation programmes. Parallel randomised controlled trial comparing 6-month multi-component behavioural change intervention (n = 71) with usual care (n = 85) was conducted in two hospitals in Jordan, Middle East. Intervention included one face-to-face individualised consultation, 6 telephone support calls (for goal-setting, feedback and self-monitoring) and 18 reminder text messages. Patients were randomly allocated to the two groups by opening opaque sealed sequence envelopes. The patients and the researcher who provided the intervention and assessed the outcomes were not blinded. Outcomes were assessed at baseline and 6 months. Primary outcome was physical activity level, secondary outcomes were blood pressure, body mass index, exercise self-efficacy for exercise and health-related quality of life. Intervention and control groups were comparable at baseline. Moderate physical activity significantly increased in the intervention group compared with control group (mean change (SD) of frequency: 0.23 (0.87) days/week versus -.06 (0.40); duration: 15.53 (90.15) minutes/week versus -3.67 (22.60) minutes/week; intensity: 31.05 (105.98) Metabolic equivalents (METs) versus 14.68 (90.40) METs). Effect size was 0.03 for moderate PA frequency, 0.02 for moderate PA duration and 0.01 for moderate PA intensity. Walking significantly increased in the intervention group compared with control group (mean change (SD) of frequency: 3.15 (2.75) days/week versus 0.37 (1.83) days/week; duration: 150.90 (124.47) minutes/week versus 24.05 (195.93) minutes/week; intensity: 495.12 (413.74) METs versus14.62 (265.06) METs). Effect size was 0.36 for walking frequency, 0.05 for walking duration, 0

  8. Behavioural intervention to increase physical activity in adults with coronary heart disease in Jordan

    Directory of Open Access Journals (Sweden)

    Eman Alsaleh

    2016-07-01

    Full Text Available Abstract Background Patients with coronary heart disease often do not follow prescribed physical activity recommendations. The aim of this study was to assess the efficacy of a behavioural intervention to increase physical activity in patients with coronary heart disease not attending structured cardiac rehabilitation programmes. Methods Parallel randomised controlled trial comparing 6-month multi-component behavioural change intervention (n = 71 with usual care (n = 85 was conducted in two hospitals in Jordan, Middle East. Intervention included one face-to-face individualised consultation, 6 telephone support calls (for goal-setting, feedback and self-monitoring and 18 reminder text messages. Patients were randomly allocated to the two groups by opening opaque sealed sequence envelopes. The patients and the researcher who provided the intervention and assessed the outcomes were not blinded. Outcomes were assessed at baseline and 6 months. Primary outcome was physical activity level, secondary outcomes were blood pressure, body mass index, exercise self-efficacy for exercise and health-related quality of life. Results Intervention and control groups were comparable at baseline. Moderate physical activity significantly increased in the intervention group compared with control group (mean change (SD of frequency: 0.23 (0.87 days/week versus -.06 (0.40; duration: 15.53 (90.15 minutes/week versus −3.67 (22.60 minutes/week; intensity: 31.05 (105.98 Metabolic equivalents (METs versus 14.68 (90.40 METs. Effect size was 0.03 for moderate PA frequency, 0.02 for moderate PA duration and 0.01 for moderate PA intensity. Walking significantly increased in the intervention group compared with control group (mean change (SD of frequency: 3.15 (2.75 days/week versus 0.37 (1.83 days/week; duration: 150.90 (124.47 minutes/week versus 24.05 (195.93 minutes/week; intensity: 495.12 (413.74 METs versus14.62 (265.06 METs. Effect size was 0.36 for walking

  9. Bone loss in rheumatoid arthritis. Influence of disease activity, duration of the disease, functional capacity, and corticosteroid treatment

    DEFF Research Database (Denmark)

    Hansen, M; Florescu, A; Stoltenberg, M

    1996-01-01

    Axial and appendicular bone mass were studied in 95 patients with rheumatoid arthritis. The aims were to quantify bone mineral density (BMD) and to evaluate the importance of disease activity, duration of disease, functional capacity, and corticosteroid treatment for bone loss in patients...... after the start of the disease. The overall functional capacity in terms of physical activity increased BMD in the axial skeleton. The local functional capacity in terms of grip strength was positively related to BMD in the appendicular skeleton. Patients with severe functional impairment had the lowest...

  10. Treatment with radioiodine of Graves' disease. Calculated activity; fixed activity or ablation. Were are we going?

    International Nuclear Information System (INIS)

    Degrossi, O.

    2006-01-01

    The new tendencies of radioiodine ( 131 I) treatment of Graves'disease are presented . One group have the objective of administrate an activity of radioiodine to bring back the patient to euthyroidism , using individual activities to each patient. Others propose a fixed dose, with high activity to cure the disease and anticipating the hypothyroidism of the patient. The third group propose directly the ablation of the thyroids with a calculated activity to deliver 300 Gy .This calculi demand the investigation of the maximum uptake of radioiodine, the biological half life, and the thyroid weight with adequate method (US, TC, MR) Finally, the dose to not thyroid tissues are discussed and the risk of these procedures are presented. (author)

  11. The Association between Dry Eye Disease and Physical Activity as well as Sedentary Behavior: Results from the Osaka Study.

    Science.gov (United States)

    Kawashima, Motoko; Uchino, Miki; Yokoi, Norihiko; Uchino, Yuichi; Dogru, Murat; Komuro, Aoi; Sonomura, Yukiko; Kato, Hiroaki; Nishiwaki, Yuji; Kinoshita, Shigeru; Tsubota, Kazuo

    2014-01-01

    Purpose. To assess the association of dry eye disease (DED) with physical activity and sedentary behavior. Methods. The cross-sectional survey conducted included Japanese office workers who use visual display terminals (n = 672). DED was assessed according to the Japanese Dry Eye Diagnostic Criteria, and participants were categorized into "definite DED," "probable DED," or "non-DED" groups based on the results of DED examinations. Physical activity and sedentary behavior of participants were assessed using the International Physical Activity Questionnaire (IPAQ), and physical activity level was calculated in metabolic equivalent units per week (MET, min/week). Participants were classified as having a high, moderate, or low level of physical activity. Results. Participants with abnormal tear break-up time (BUT) (≤5 s) were involved in sedentary behavior for significantly longer duration than those with normal BUT (P = 0.035). Non-DED participants (14.5%) tended to have higher levels of physical activity than definite DED participants (2.5%). Participants with definite DED had significantly lower MET scores than those with non-DED (P = 0.025). Conclusions. Our findings suggest that a lower level of physical activity and sedentary behavior are associated with DED; however, longitudinal/intervention studies with large groups of participants are needed to validate these findings.

  12. An ethical assessment model for digital disease detection technologies.

    Science.gov (United States)

    Denecke, Kerstin

    2017-09-20

    Digital epidemiology, also referred to as digital disease detection (DDD), successfully provided methods and strategies for using information technology to support infectious disease monitoring and surveillance or understand attitudes and concerns about infectious diseases. However, Internet-based research and social media usage in epidemiology and healthcare pose new technical, functional and formal challenges. The focus of this paper is on the ethical issues to be considered when integrating digital epidemiology with existing practices. Taking existing ethical guidelines and the results from the EU project M-Eco and SORMAS as starting point, we develop an ethical assessment model aiming at providing support in identifying relevant ethical concerns in future DDD projects. The assessment model has four dimensions: user, application area, data source and methodology. The model supports in becoming aware, identifying and describing the ethical dimensions of DDD technology or use case and in identifying the ethical issues on the technology use from different perspectives. It can be applied in an interdisciplinary meeting to collect different viewpoints on a DDD system even before the implementation starts and aims at triggering discussions and finding solutions for risks that might not be acceptable even in the development phase. From the answers, ethical issues concerning confidence, privacy, data and patient security or justice may be judged and weighted.

  13. Effects of physical activity on life expectancy with cardiovascular disease

    NARCIS (Netherlands)

    O.H. Franco (Oscar); C.E.D. de Laet (Chris); A. Peeters (Andrea); J. Jonker (Joost); J.P. Mackenbach (Johan); W.J. Nusselder (Wilma)

    2005-01-01

    textabstractBackground: Physical inactivity is a modifiable risk factor for cardiovascular disease. However, little is known about the effects of physical activity on life expectancy with and without cardiovascular disease. Our objective was to calculate the consequences of different physical

  14. ASSESSMENT OF HUMAN RESOURCES FOR REGIONAL INNOVATION ACTIVITY

    Directory of Open Access Journals (Sweden)

    R. R. Lukyanova

    2010-03-01

    Full Text Available The paper deals with the issues of human resource development regarding an innovation activity. Concepts of labor and human resources have been surveyed. An integral index for assessment of human resources for regional innovation activity has been developed and assessment of the Russian regions has been made on the basis of it. Development tendencies of modern human resources for innovation activity in Russia have been revealed.

  15. Could occupational physical activity mitigate the link between moderate kidney dysfunction and coronary heart disease?

    Science.gov (United States)

    Esquirol, Yolande; Tully, Mark; Ruidavets, Jean-Bernard; Fogarty, Damian; Ferrieres, Jean; Quinn, Michael; Hughes, Maria; Kee, Frank

    2014-12-20

    Chronic kidney disease is now regarded as a risk factor for cardiovascular disease. The impact of occupational or non-occupational physical activity (PA) on moderate decreases of renal function is uncertain. We aimed to identify the potential association of PA (occupational and leisure-time) on early decline of estimated glomerular filtration rate (eGFR) and to determine the potential mediating effect of PA on the relationship between eGFR and heart disease. From the PRIME study analyses were conducted in 1058 employed men. Energy expended during leisure, work and commuting was calculated. Linear regression analyses were used to determine the link between types of PA and moderate decrements of eGFR determined with the KDIGO guideline at the baseline assessment. Cox proportional hazards analyses were used to explore the potential effect of PA on the relationship between eGFR and heart disease, ascertained during follow-up over 10 years. For these employed men, and after adjustment for known confounders of GFR change, more time spent sitting at work was associated with increased risk of moderate decline in kidney function, while carrying objects or being active at work was associated with decreased risk. In contrast, no significant link with leisure PA was apparent. No potential mediating effect of occupational PA was found for the relationship between eGFR and coronary heart disease. Occupational PA (potential modifiable factors) could provide a dual role on early impairment of renal function, without influence on the relationship between early decrease of e-GFR and CHD risk. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Physical activity, health status and risk of hospitalization in patients with severe chronic obstructive pulmonary disease.

    Science.gov (United States)

    Benzo, Roberto P; Chang, Chung-Chou H; Farrell, Max H; Kaplan, Robert; Ries, Andrew; Martinez, Fernando J; Wise, Robert; Make, Barry; Sciurba, Frank

    2010-01-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of death and 70% of the cost of COPD is due to hospitalizations. Self-reported daily physical activity and health status have been reported as predictors of a hospitalization in COPD but are not routinely assessed. We tested the hypothesis that self-reported daily physical activity and health status assessed by a simple question were predictors of a hospitalization in a well-characterized cohort of patients with severe emphysema. Investigators gathered daily physical activity and health status data assessed by a simple question in 597 patients with severe emphysema and tested the association of those patient-reported outcomes to the occurrence of a hospitalization in the following year. Multiple logistic regression analyses were used to determine predictors of hospitalization during the first 12 months after randomization. The two variables tested in the hypothesis were significant predictors of a hospitalization after adjusting for all univariable significant predictors: >2 h of physical activity per week had a protective effect [odds ratio (OR) 0.60; 95% confidence interval (95% CI) 0.41-0.88] and self-reported health status as fair or poor had a deleterious effect (OR 1.57; 95% CI 1.10-2.23). In addition, two other variables became significant in the multivariate model: total lung capacity (every 10% increase) had a protective effect (OR 0.88; 95% CI 0.78-0.99) and self-reported anxiety had a deleterious effect (OR 1.75; 95% CI 1.13-2.70). Self-reported daily physical activity and health status are independently associated with COPD hospitalizations. Our findings, assessed by simple questions, suggest the value of patient-reported outcomes in developing risk assessment tools that are easy to use.

  17. Border Patrol Gone Awry: Lung NKT Cell Activation by Francisella tularensis Exacerbates Tularemia-Like Disease.

    Science.gov (United States)

    Hill, Timothy M; Gilchuk, Pavlo; Cicek, Basak B; Osina, Maria A; Boyd, Kelli L; Durrant, Douglas M; Metzger, Dennis W; Khanna, Kamal M; Joyce, Sebastian

    2015-06-01

    The respiratory mucosa is a major site for pathogen invasion and, hence, a site requiring constant immune surveillance. The type I, semi-invariant natural killer T (NKT) cells are enriched within the lung vasculature. Despite optimal positioning, the role of NKT cells in respiratory infectious diseases remains poorly understood. Hence, we assessed their function in a murine model of pulmonary tularemia--because tularemia is a sepsis-like proinflammatory disease and NKT cells are known to control the cellular and humoral responses underlying sepsis. Here we show for the first time that respiratory infection with Francisella tularensis live vaccine strain resulted in rapid accumulation of NKT cells within the lung interstitium. Activated NKT cells produced interferon-γ and promoted both local and systemic proinflammatory responses. Consistent with these results, NKT cell-deficient mice showed reduced inflammatory cytokine and chemokine response yet they survived the infection better than their wild type counterparts. Strikingly, NKT cell-deficient mice had increased lymphocytic infiltration in the lungs that organized into tertiary lymphoid structures resembling induced bronchus-associated lymphoid tissue (iBALT) at the peak of infection. Thus, NKT cell activation by F. tularensis infection hampers iBALT formation and promotes a systemic proinflammatory response, which exacerbates severe pulmonary tularemia-like disease in mice.

  18. Assessment of physical activity of the human body considering the thermodynamic system.

    Science.gov (United States)

    Hochstein, Stefan; Rauschenberger, Philipp; Weigand, Bernhard; Siebert, Tobias; Schmitt, Syn; Schlicht, Wolfgang; Převorovská, Světlana; Maršík, František

    2016-01-01

    Correctly dosed physical activity is the basis of a vital and healthy life, but the measurement of physical activity is certainly rather empirical resulting in limited individual and custom activity recommendations. Certainly, very accurate three-dimensional models of the cardiovascular system exist, however, requiring the numeric solution of the Navier-Stokes equations of the flow in blood vessels. These models are suitable for the research of cardiac diseases, but computationally very expensive. Direct measurements are expensive and often not applicable outside laboratories. This paper offers a new approach to assess physical activity using thermodynamical systems and its leading quantity of entropy production which is a compromise between computation time and precise prediction of pressure, volume, and flow variables in blood vessels. Based on a simplified (one-dimensional) model of the cardiovascular system of the human body, we develop and evaluate a setup calculating entropy production of the heart to determine the intensity of human physical activity in a more precise way than previous parameters, e.g. frequently used energy considerations. The knowledge resulting from the precise real-time physical activity provides the basis for an intelligent human-technology interaction allowing to steadily adjust the degree of physical activity according to the actual individual performance level and thus to improve training and activity recommendations.

  19. Circulating angiotensin-converting enzyme 2 activity in patients with chronic kidney disease without previous history of cardiovascular disease.

    Science.gov (United States)

    Anguiano, Lidia; Riera, Marta; Pascual, Julio; Valdivielso, José Manuel; Barrios, Clara; Betriu, Angels; Mojal, Sergi; Fernández, Elvira; Soler, María José

    2015-07-01

    Patients with cardiovascular (CV) disease have an increased circulating angiotensin-converting enzyme 2 (ACE2) activity, but there is little information about changes in ACE2 in chronic kidney disease (CKD) patients without history of CV disease. We examined circulating ACE2 activity in CKD patients at stages 3-5 (CKD3-5) and in dialysis (CKD5D) without any history of CV disease. Circulating ACE2 activity was measured in human ethylenediamine-tetraacetic acid (EDTA)-plasma samples from the NEFRONA study (n = 2572): control group (CONT) (n = 568), CKD3-5 (n = 1458) and CKD5D (n = 546). Different clinical and analytical variables such as gender; age; history of diabetes mellitus (DM), dyslipidemia and hypertension; glycaemic, renal, lipid and anaemia profiles; vitamin D analogues treatment and antihypertensive treatments (angiotensin-converting enzyme inhibitor and angiotensin receptor blockade) were analysed. Circulating ACE2 and ACE activities were measured using modified fluorimetric assay for EDTA-plasma samples, where zinc chloride was added to recover enzymatic activity. In CKD3-5 and CKD5D, significant decrease in circulating ACE2 activity was observed when compared with CONT, but no differences were found between CKD3-5 and CKD5 when performing paired case-control studies. By multivariate linear regression analysis, male gender and advanced age were identified as independent predictors of ACE2 activity in all groups. Diabetes was identified as independent predictor of ACE2 activity in CKD3-5. Significant increase in the activity of circulating ACE was found in CKD3-5 and CKD5D when compared with CONT and in CKD5D when compared with CKD3-5. By multiple regression analysis, female gender and younger age were identified as independent predictors of ACE activity in CONT and CKD3-5. Diabetes was also identified as an independent predictor of ACE activity in CKD3-5 patients. Circulating ACE2 and ACE activities can be measured in human EDTA-plasma samples with zinc

  20. Endogenous and recombinant type I interferons and disease activity in multiple sclerosis

    DEFF Research Database (Denmark)

    Sellebjerg, Finn; Krakauer, Martin; Limborg, Signe

    2012-01-01

    the percentage of CD4+ T cells expressing CD71 and HLA-DR (activated T cells), and this was associated with an increased risk of clinical disease activity. In contrast, induction of CD71 and HLA-DR was not observed in untreated MS patients with evidence of endogenous type IFN I activity. In conclusion......Although treatment of multiple sclerosis (MS) with the type I interferon (IFN) IFN-ß lowers disease activity, the role of endogenous type I IFN in MS remains controversial. We studied CD4+ T cells and CD4+ T cell subsets, monocytes and dendritic cells by flow cytometry and analysed the relationship...... with endogenous type I IFN-like activity, the effect of IFN-ß therapy, and clinical and magnetic resonance imaging (MRI) disease activity in MS patients. Endogenous type I IFN activity was associated with decreased expression of the integrin subunit CD49d (VLA-4) on CD4+CD26(high) T cells (Th1 helper cells...

  1. A longitudinal assessment of periodontal disease in 52 Miniature Schnauzers.

    Science.gov (United States)

    Marshall, Mark D; Wallis, Corrin V; Milella, Lisa; Colyer, Alison; Tweedie, Andrew D; Harris, Stephen

    2014-09-01

    Periodontal disease (PD) is the most widespread oral disease in dogs and has been associated with serious systemic diseases. The disease is more prevalent in small breeds compared to large breeds and incidence increases with advancing age. In prevalence studies 84% of Beagles over the age of 3 and 100% of Poodles over the age of 4 were diagnosed with PD. Current knowledge of the rate of progression of PD is limited. The objective of this study was to determine the rate of PD progression in Miniature Schnauzers, an at risk small breed of dog. Dogs (n = 52, age 1.3-6.9 years) who had received a regular oral care regime prior to this study were assessed for levels of gingivitis and periodontitis around the whole gingival margin in every tooth under general anaesthetic. Assessments were conducted approximately every six weeks for up to 60 weeks following the cessation of the oral care regime. All of the 2155 teeth assessed entered the study with some level of gingivitis. 23 teeth entered the study with periodontitis, observed across 12 dogs aged between 1.3 and 6.9 years. 35 dogs had at least 12 teeth progress to periodontitis within 60 weeks. Of the teeth that progressed to periodontitis, 54% were incisors. The lingual aspect of the incisors was significantly more likely to be affected (p periodontitis-affected teeth was variable with 24% of the aspects affected having very mild gingivitis, 36% mild gingivitis and 40% moderate gingivitis. Periodontitis progression rate was significantly faster in older dogs. Only one dog (age 3.5) did not have any teeth progress to periodontitis after 60 weeks. This is the first study to have assessed the progression rate of periodontitis in Miniature Schnauzers and highlights that with no oral care regime, the early stages of periodontitis develop rapidly in this breed. An oral care regime and twice yearly veterinary dental health checks should be provided from an early age for this breed and other breeds with similar

  2. Evaluation of a daily practice composite score for the assessment of Crohn's disease: the treatment impact of certolizumab pegol.

    Science.gov (United States)

    Feagan, B G; Hanauer, S B; Coteur, G; Schreiber, S

    2011-05-01

    Successful treatment of systemic inflammatory symptoms is essential for improving health-related quality of life in patients with active Crohn's disease. Patient-reported outcomes provide unique perspectives on the impact of chronic disease. It is unknown whether a combination of different instruments might improve sensitivity to clinically relevant changes in health status. To develop a composite score based upon Crohn's Disease Activity Index (CDAI) and Inflammatory Bowel Disease Questionnaire (IBDQ) items. Patients from the PRECiSE 2 trial who responded at week 6 to certolizumab pegol (CZP) were randomised to receive treatment with CZP 400 mg or placebo for up to 26 weeks. IBDQ and CDAI scores were assessed at weeks 0, 6, 16 and 26. A 'daily practice' composite score (DP-6) containing two items from the CDAI and four items from IBDQ was constructed. Correlation coefficients between the CDAI score and IBDQ total score at baseline and at week 26 were -0.344 and -0.603, respectively (Pimpact of different treatments on patient-reported outcomes, and to determine if the use of the DP-6 improves the care of patients in clinical practice. © 2011 Blackwell Publishing Ltd.

  3. Parkinson's disease: acid-glucocerebrosidase activity and alpha-synuclein clearance.

    Science.gov (United States)

    Blanz, Judith; Saftig, Paul

    2016-10-01

    The role of mutations in the gene GBA1 encoding the lysosomal hydrolase β-glucocerebrosidase for the development of synucleinopathies, such as Parkinson's disease and dementia with Lewy bodies, was only very recently uncovered. The knowledge obtained from the study of carriers or patients suffering from Gaucher disease (a common lysosomal storage disorder because of GBA1 mutations) is of particular importance for understanding the role of the enzyme and its catabolic pathway in the development of synucleinopathies. Decreased activity of β-glucocerebrosidase leads to lysosomal dysfunction and the accumulation of its substrate glucosylceramide and related lipid derivatives. Glucosylceramide is suggested to stabilize toxic oligomeric forms of α-synuclein that negatively influence the activity of β-glucocerebrosidase and to partially block export of newly synthesized β-glucocerebrosidase from the endoplasmic reticulum to late endocytic compartments, amplifying the pathological effects of α-synuclein and ultimately resulting in neuronal cell death. This pathogenic molecular feedback loop and most likely other factors (such as impaired endoplasmic reticulum-associated degradation, activation of the unfolded protein response and dysregulation of calcium homeostasis induced by misfolded GC mutants) are involved in shifting the cellular homeostasis from monomeric α-synuclein towards oligomeric neurotoxic and aggregated forms, which contribute to Parkinson's disease progression. From a therapeutic point of view, strategies aiming to increase either the expression, stability or delivery of the β-glucocerebrosidase to lysosomes are likely to decrease the α-synuclein burden and may be useful for an in depth evaluation at the organismal level. Lysosomes are critical for protein and lipid homeostasis. Recent research revealed that dysfunction of this organelle contributes to the development of neurodegenerative diseases such as Parkinson's disease (PD). Mutations in the

  4. Variable activation of immune response by quinoa (Chenopodium quinoa Willd.) prolamins in celiac disease.

    Science.gov (United States)

    Zevallos, Victor F; Ellis, H Julia; Suligoj, Tanja; Herencia, L Irene; Ciclitira, Paul J

    2012-08-01

    Celiac disease is an enteropathy triggered by dietary gluten found in wheat, barley, and rye. The current treatment is a strict gluten-free diet. Quinoa is a highly nutritive plant from the Andes, with low concentrations of prolamins, that has been recommended as part of a gluten-free diet; however, few experimental data support this recommendation. We aimed to determine the amount of celiac-toxic prolamin epitopes in quinoa cultivars from different regions of the Andes and the ability of these epitopes to activate immune responses in patients with celiac disease. The concentration of celiac-toxic epitopes was measured by using murine monoclonal antibodies against gliadin and high-molecular-weight glutenin subunits. Immune response was assessed by proliferation assays of celiac small intestinal T cells/interferon-γ (IFN-γ) and production of IFN-γ/IL-15 after organ culture of celiac duodenal biopsy samples. Fifteen quinoa cultivars were tested: 4 cultivars had quantifiable concentrations of celiac-toxic epitopes, but they were below the maximum permitted for a gluten-free food. Cultivars Ayacuchana and Pasankalla stimulated T cell lines at levels similar to those for gliadin and caused secretion of cytokines from cultured biopsy samples at levels comparable with those for gliadin. Most quinoa cultivars do not possess quantifiable amounts of celiac-toxic epitopes. However, 2 cultivars had celiac-toxic epitopes that could activate the adaptive and innate immune responses in some patients with celiac disease. These findings require further investigation in the form of in vivo studies, because quinoa is an important source of nutrients for patients with celiac disease.

  5. Autologous mesenchymal stem cell treatment increased T regulatory cells with no effect on disease activity in two systemic lupus erythematosus patients.

    Science.gov (United States)

    Carrion, F; Nova, E; Ruiz, C; Diaz, F; Inostroza, C; Rojo, D; Mönckeberg, G; Figueroa, F E

    2010-03-01

    Mesenchymal stem cells (MSCs) exert suppressive effects in several disease models including lupus prone mice. However, autologous MSC therapy has not been tested in human systemic lupus erythematosus (SLE). We evaluate the safety and efficacy of bone marrow (BM)-derived MSCs in two SLE patients; the suppressor effect of these cells in-vitro and the change in CD4+CD25+FoxP3+ T regulatory (Treg) cells in response to treatment. Two females (JQ and SA) of 19 and 25 years of age, fulfilling the 1997 American College of Rheumatology (ACR) criteria for SLE were infused with autologous BM-derived MSCs. Disease activity indexes and immunological parameters were assessed at baseline, 1, 2, 7 and 14 weeks. Peripheral blood lymphocyte (PBL) subsets and Treg cells were quantitated by flow cytometry, and MSCs tested for in-vitro suppression of activation and proliferation of normal PBLs. No adverse effects or change in disease activity indexes were noted during 14 weeks of follow-up, although circulating Treg cells increased markedly. Patient MSCs effectively suppressed in-vitro PBL function. However, JQ developed overt renal disease 4 months after infusion. MSC infusion was without adverse effects, but did not modify initial disease activity in spite of increasing CD4+CD25+FoxP3+ cell counts. One patient subsequently had a renal flare. We speculate that the suppressive effects of MSC-induced Treg cells might be dependent on a more inflammatory milieu, becoming clinically evident in patients with higher degrees of disease activity.

  6. Correlation of Gastroesophageal reflux disease Assessment Symptom Questionnaire to impedance-pH measurements in children

    OpenAIRE

    Prachuapthunyachart, Sittichoke; Jarasvaraparn, Chaowapong; Gremse, David A

    2017-01-01

    Background: Esophageal multichannel intraluminal impedance-pH monitoring has become one of the preferred tests to correlate observed reflux-like behaviors with esophageal reflux events. The Gastroesophageal reflux disease Assessment Symptom Questionnaire is a validated tool used to distinguish infants with gastroesophageal reflux disease from healthy children. The aim of this study was to determine whether the Gastroesophageal reflux disease Assessment Symptom Questionnaire composite symptom ...

  7. Assessing Physical Activity and its Relationship to Cardiovascular Risk Factors: NHANES 2003-2006

    Directory of Open Access Journals (Sweden)

    Cao Guichan

    2011-05-01

    Full Text Available Abstract Background Levels of physical activity (PA in the general population are difficult to characterize. Historically measurement has been based on self-report, which can be subject to bias. PA monitor use has created opportunities to improve surveillance and analytic research on activity and health. The aims of the current study were to investigate the associations between objectively measured PA and cardiovascular disease risk factors and obesity. Methods Data on PA from accelerometers, demographics, blood pressure, plasma glucose and lipids, self-reported hypertension and diabetes were obtained for adults, ages 20-65, in the NHANES surveys, 2003-2006. Outcomes were assessed as levels of moderate and vigorous activity, percentage of participants meeting recommended guidelines, and the correlations between activity and cardiovascular risk factors. Accelerometry data were available on 3,370 adults. Based on standard algorithms, activity levels were extremely low in all age-gender-race/ethnic groups, with an average of only 1 bout of vigorous activity lasting longer than 1 minute/day. Results Men spent 35 minutes in moderate activity/day, women 21 minutes; >75% of this activity was accumulated in 1-minute bouts. Levels of activity declined sharply after age 50 in all groups. Negative associations were observed between minutes of combined moderate and vigorous activity and systolic blood pressure, blood glucose, diabetes, hypertension, body mass index and obesity, and a positive association was seen with HDL-cholesterol (all P ≤ 0.03, suggesting valid rank ordering of participants by activity level. Conclusion The magnitude of the gap between self-report and accelerometry activity must be a result of either a vast social acceptability bias in reporting or inaccurate measurement with accelerometry. Therefore, due to the low validity of self reported PA data for epidemiologic research, it is pertinent to encourage the use of valid, objective

  8. Nailfold capillaroscopy in children and adolescents with rheumatic diseases.

    Science.gov (United States)

    Piotto, Daniela Gerent Petry; Len, Cláudio Arnaldo; Hilário, Maria Odete Esteves; Terreri, Maria Teresa Ramos Ascensão

    2012-10-01

    To assess nailfold capillaroscopy in children and adolescents with autoimmune rheumatic diseases (juvenile idiopathic arthritis, systemic lupus erythematosus, juvenile dermatomyositis, scleroderma and mixed connective tissue disease) and relate it to clinical and laboratory findings and disease activity. Cross-sectional study assessing 147 patients by use of nailfold capillaroscopy as follows: 60 with juvenile idiopathic arthritis; 30 with systemic lupus erythematosus; 30 with juvenile dermatomyositis; 20 with localized scleroderma; four with systemic sclerosis; and three with mixed connective tissue disease. Clinical and laboratory tests and nailfold capillaroscopy were performed in all patients. The nailfold capillaroscopy was performed with an optical microscope (at 10- and 16-time magnifications) by the same observer. Most patients (76.2%) had normal nailfold capillaroscopy. The major changes in nailfold capillaroscopy, characterizing the scleroderma pattern, were observed in patients with juvenile dermatomyositis, systemic scleroderma and mixed connective tissue disease. There was no association between nailfold capillaroscopy and disease activity in patients with juvenile idiopathic arthritis, systemic lupus erythematosus and localized scleroderma. Disease activity and capillaroscopy were associated in patients with juvenile dermatomyositis. Nailfold capillaroscopy is a useful method to diagnose autoimmune rheumatic diseases and monitor disease activity.

  9. Diagnosis and activity assessment of immunoglobulin A nephropathy: current perspectives on noninvasive testing with aberrantly glycosylated immunoglobulin A-related biomarkers

    Directory of Open Access Journals (Sweden)

    Suzuki Y

    2014-10-01

    Full Text Available Yusuke Suzuki,1 Hitoshi Suzuki,1 Yuko Makita,1 Akiko Takahata,1 Keiko Takahashi,1 Masahiro Muto,1 Yohei Sasaki,1 Atikemu Kelimu,1 Keiichi Matsuzaki,2 Hiroyuki Yanagawa,1 Keiko Okazaki,1 Yasuhiko Tomino1 1Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, 2Kyoto University Health Service, Kyoto, Japan Abstract: Immunoglobulin (Ig A nephropathy (IgAN is the most common form of glomerular disease worldwide and is associated with a poor prognosis. Thus, development of a curative treatment and strategies for early diagnosis and treatment are urgently needed. Pathological analysis of renal biopsy is the gold standard for the diagnosis and assessment of disease activity; however, immediate and frequent assessment based on biopsy specimens is difficult. Therefore, a simple and safe alternative is desirable. On the other hand, it is now widely accepted that multi-hit steps, including production of aberrantly glycosylated serum IgA1 (first hit, and IgG or IgA autoantibodies that recognize glycan containing epitopes on glycosylated serum IgA1 (second hit and their subsequent immune complex formation (third hit and glomerular deposition (fourth hit, are required for continued progression of IgAN. Although the prognostic and predictive values of several markers have been discussed elsewhere, we recently developed a highly sensitive and specific diagnostic method by measuring serum levels of glycosylated serum IgA1 and related IgA immune complex. In addition, we confirmed a significant correlation between serum levels of these essential effector molecules and disease activity after treatment, suggesting that each can be considered as a practical surrogate marker of therapeutic effects in this slowly progressive disease. Such a noninvasive diagnostic and activity assessment method using these disease-oriented specific biomarkers may be useful in the early diagnosis of and intervention in IgAN, with

  10. Quantitative analysis of contrast-enhanced ultrasonography of the bowel wall can predict disease activity in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Romanini, Laura, E-mail: laura.romanini@libero.it [Department of Radiology, Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia (Italy); Passamonti, Matteo, E-mail: matteopassamonti@gmail.com [Department of Radiology-AO Provincia di Lodi, Via Fissiraga, 15, 26900 Lodi (Italy); Navarria, Mario, E-mail: navarria.mario@tiscali.it [Department of Radiology-ASL Vallecamonica-Sebino, Via Manzoni 142, 25040 Esine, BS (Italy); Lanzarotto, Francesco, E-mail: francesco.lanzarotto@spedalicivili.brescia.it [Department of Gastroenterology, Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia (Italy); Villanacci, Vincenzo, E-mail: villanac@alice.it [Department of Pathology, Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia (Italy); Grazioli, Luigi, E-mail: radiologia1@spedalicivili.brescia.it [Department of Radiology, Spedali Civili di Brescia, P.le Spedali Civili, 1, 25123 Brescia (Italy); Calliada, Fabrizio, E-mail: fabrizio.calliada@gmail.com [Department of Radiology, University of Pavia, Viale Camillo Golgi 19, 27100 Pavia (Italy); Maroldi, Roberto, E-mail: rmaroldi@gmail.com [Department of Radiology, University of Brescia, P.le Spedali Civili, 1, 25123 Brescia (Italy)

    2014-08-15

    Purpose: To evaluate the accuracy of quantitative analysis of bowel wall enhancement in inflammatory bowel disease (IBD) with contrast enhanced ultrasound (CEUS) by comparing the results with vascular density in a biopsy sample from the same area of the intestinal tract, and to determine the usefulness of this analysis for the prediction of disease activity. Materials and methods: This prospective study was approved by our institute's ethics committee and all patients gave written informed consent. We enrolled 33 consecutive adult patients undergoing colonoscopy and biopsy for IBD. All patients underwent CEUS and the results were quantitatively analyzed. Vessel count per high-power field on biopsy specimens was compared with colonoscopy, baseline ultrasonography, and CEUS findings, and with analysis of peak intensity, time to peak, regional blood volume, mean transit time, and regional blood flow. Results in patients with high and low vascular density were compared using Fisher's test, t-test, Pearson's correlation test, and receiver operating characteristic curve (ROC) analysis. Cutoff values were determined using ROC analysis, and sensitivity and specificity were calculated. Results: High vascular density (>265 vessels per field) on histological examination was significantly correlated with active disease on colonoscopy, baseline ultrasonography, and CEUS (p < .0001). Quantitative analysis showed a higher enhancement peak, a shorter time to peak enhancement, a higher regional blood flow and regional blood volume in patients with high vascular density than in those with low vascular density. Cutoff values to distinguish between active and inactive disease were identified for peak enhancement (>40.5%), and regional blood flow (>54.8 ml/min). Conclusion: Quantitative analysis of CEUS data correlates with disease activity as determined by vascular density. Quantitative parameters of CEUS can be used to predict active disease with high sensitivity and

  11. Quantitative analysis of contrast-enhanced ultrasonography of the bowel wall can predict disease activity in inflammatory bowel disease

    International Nuclear Information System (INIS)

    Romanini, Laura; Passamonti, Matteo; Navarria, Mario; Lanzarotto, Francesco; Villanacci, Vincenzo; Grazioli, Luigi; Calliada, Fabrizio; Maroldi, Roberto

    2014-01-01

    Purpose: To evaluate the accuracy of quantitative analysis of bowel wall enhancement in inflammatory bowel disease (IBD) with contrast enhanced ultrasound (CEUS) by comparing the results with vascular density in a biopsy sample from the same area of the intestinal tract, and to determine the usefulness of this analysis for the prediction of disease activity. Materials and methods: This prospective study was approved by our institute's ethics committee and all patients gave written informed consent. We enrolled 33 consecutive adult patients undergoing colonoscopy and biopsy for IBD. All patients underwent CEUS and the results were quantitatively analyzed. Vessel count per high-power field on biopsy specimens was compared with colonoscopy, baseline ultrasonography, and CEUS findings, and with analysis of peak intensity, time to peak, regional blood volume, mean transit time, and regional blood flow. Results in patients with high and low vascular density were compared using Fisher's test, t-test, Pearson's correlation test, and receiver operating characteristic curve (ROC) analysis. Cutoff values were determined using ROC analysis, and sensitivity and specificity were calculated. Results: High vascular density (>265 vessels per field) on histological examination was significantly correlated with active disease on colonoscopy, baseline ultrasonography, and CEUS (p < .0001). Quantitative analysis showed a higher enhancement peak, a shorter time to peak enhancement, a higher regional blood flow and regional blood volume in patients with high vascular density than in those with low vascular density. Cutoff values to distinguish between active and inactive disease were identified for peak enhancement (>40.5%), and regional blood flow (>54.8 ml/min). Conclusion: Quantitative analysis of CEUS data correlates with disease activity as determined by vascular density. Quantitative parameters of CEUS can be used to predict active disease with high sensitivity and

  12. How to assess treatment efficacy in Sjogren's syndrome?

    NARCIS (Netherlands)

    Vissink, Arjan; Bootsma, Hendrika; Kroese, Frans G. M.; Kallenberg, Cees G. M.

    Purpose of review This article critically reviews the current views and discusses the future challenges with regard to assessing disease progression and disease activity in Sjogren's syndrome, as a decrease of disease progression and activity is what an effective Sjogren's syndrome therapy aims for.

  13. Mannose-binding lectin gene polymorphisms are associated with disease activity and physical disability in untreated, anti-cyclic citrullinated peptide-positive patients with early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Garred, Peter; Madsen, Hans Ole

    2009-01-01

    OBJECTIVE: To study the association between polymorphisms in the mannose-binding lectin gene (MBL2) and disease activity, physical disability, and joint erosions in patients with newly diagnosed rheumatoid arthritis (RA). METHODS: Patients with early RA (n=158) not previously treated with disease...... modifying antirheumatic drugs, participating in a treatment trial (CIMESTRA study) were examined at inclusion for MBL2 pooled structural genotypes (O/O, A/O, A/A), regulatory MBL2 promoter polymorphism in position -221 (XX, XY, YY), anti-cyclic citrullinated peptide 2 antibodies (anti-CCP2), disease...... activity by Disease Activity Score-28 (DAS28 score), physical disability by Health Assessment Questionnaire (HAQ) score, and erosive changes in hands and feet (Sharp-van der Heijde score). RESULTS: Eight patients were homozygous MBL2 defective (O/O), 101 belonged to an intermediate group, and 49 were MBL2...

  14. Low Sensitivity of the Mini-Mental State Examination for Cognitive Assessment of Brazilian Patients With Parkinson Disease.

    Science.gov (United States)

    Breder, Raphael; Leite, Marco Antonio Araujo; Pinto, Jony Arrais; Cavalcante, Igor Pinto; Pessoa, Bruno Lima; Neves, Marco Antônio Orsini

    2017-11-01

    Recent publications have highlighted the low sensitivity of the Mini-Mental State Examination (MMSE) for the cognitive assessment of patients with Parkinson disease (PD). The Montreal Cognitive Assessment (MoCA), otherwise, has shown greater sensitivity when compared to the MMSE. Based on this, we have searched for the cognitive impairment measurable by the MoCA and the functional performance on activities of daily living in a sample of Brazilian patients with PD and normal MMSE. We hypothesized that the low sensitivity of the MMSE, already shown by other authors, could be replicated in a low-income country. To describe the performance on the MoCA and the dependence on third parties for activities of daily living in a sample of Brazilian patients with PD and normal MMSE. We evaluated 43 volunteers with PD and normal MMSE considering the Brazilian cutoffs. Cognitive performance was assessed through the MoCA and functional performance through a modified version of the Disability Assessment for Dementia Scale. Despite normal score on the MMSE, considering the Brazilian cutoffs, 62.7% of the volunteers performed below the literature cutoff for the MoCA (26 points). Furthermore, 30.2% had dependence on third party for activities of daily living. By using a strict cutoff for the MMSE (26 points), 56.7% performed below the MoCA cutoff and 24.3% had dependence for activities of daily living. Our findings confirm the limitations of the MMSE for the cognitive screening of patients with PD in a low-income country.

  15. Influence of Education on Disease Activity and Damage in Systemic Lupus Erythematosus: Data From the 1000 Canadian Faces of Lupus.

    Science.gov (United States)

    George, Angela; Wong-Pak, Andrew; Peschken, Christine A; Silverman, Earl; Pineau, Christian; Smith, C Douglas; Arbillaga, Hector; Zummer, Michel; Bernatsky, Sasha; Hudson, Marie; Hitchon, Carol; Fortin, Paul R; Nevskaya, Tatiana; Pope, Janet E

    2017-01-01

    To determine whether socioeconomic status assessed by education is associated with disease activity and the risk of organ damage in systemic lupus erythematosus (SLE). Data from the 1000 Canadian Faces of Lupus, a multicenter database of adult SLE patients, was used to compare education as either low (did not complete high school) or high (completed high school or further) for disease activity and damage. Education was also studied as a continuous variable. The relationships between education and SLE outcomes (any organ damage defined as a Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index [SDI] score ≥1, serious organ damage [SDI score ≥3], and end-stage renal disease) were evaluated using logistic regression analyses adjusted for age, sex, race/ethnicity, and disease duration. A total of 562 SLE patients met inclusion criteria (mean age 47 years, 91% female, and mean disease duration of 10 years); 81% had high education. The low education group was twice as likely to be work disabled (30%; P education was significantly associated with higher disease activity at enrollment into the 1000 Canadian Faces of Lupus database, after adjustment for age (at entry and at diagnosis), race/ethnicity, and sex (B 1.255 + 0.507 [SE], β = 0.115, P = 0.014). In our adjusted logistic regression models we were unable to demonstrate significant associations between education and SLE damage. Results did not change when varying the education variable. In this cohort, low education was associated cross-sectionally with higher disease activity and work disability, but not damage. © 2016, American College of Rheumatology.

  16. Microbial enrichment to enhance the disease suppressive activity of compost

    NARCIS (Netherlands)

    Postma, J.; Montenari, M.; Boogert, van den P.H.J.F.

    2003-01-01

    Compost amended soil has been found to be suppressive against plant diseases in various cropping systems. The level and reproducibility of disease suppressive properties of compost might be increased by the addition of antagonists. In the present study, the establishment and suppressive activity of

  17. Primary care nursing activities with patients affected by physical chronic disease and common mental disorders: a qualitative descriptive study.

    Science.gov (United States)

    Girard, Ariane; Hudon, Catherine; Poitras, Marie-Eve; Roberge, Pasquale; Chouinard, Maud-Christine

    2017-05-01

    To describe nursing activities in primary care with patients affected by physical chronic disease and common mental disorders. Patients in primary care who are affected by physical chronic disease and common mental disorders such as anxiety and depression require care and follow-up based on their physical and mental health condition. Primary care nurses are increasingly expected to contribute to the care and follow-up of this growing clientele. However, little is known about the actual activities carried out by primary care nurses in providing this service in the Province of Quebec (Canada). A qualitative descriptive study was conducted. Data were obtained through semistructured individual interviews with 13 nurses practising among patients with physical chronic disease in seven Family Medicine Groups in Quebec (Canada). Participants described five activity domains: assessment of physical and mental health condition, care planning, interprofessional collaboration, therapeutic relationship and health promotion. The full potential of primary care nurses is not always exploited, and some activities could be improved. Evidence for including nurses in collaborative care for patients affected by physical chronic disease and common mental disorders has been shown but is not fully implemented in Family Medicine Groups. Future research should emphasise collaboration among mental health professionals, primary care nurses and family physicians in the care of patients with physical chronic disease and common mental disorders. Primary care nurses would benefit from gaining more knowledge about common mental disorders and from identifying the resources they need to contribute to managing them in an interdisciplinary team. © 2016 John Wiley & Sons Ltd.

  18. Technetium-99m-HMPAO labeled leukocyte single photon emission computerized tomography (SPECT) for assessing Crohn's disease extent and intestinal infiltration.

    Science.gov (United States)

    Biancone, L; Schillaci, O; Capoccetti, F; Bozzi, R M; Fina, D; Petruzziello, C; Geremia, A; Simonetti, G; Pallone, F

    2005-02-01

    Scintigraphy using radiolabeled leukocytes is a useful technique for assessing intestinal infiltration in Crohn's disease (CD). However, limits of planar images include overlapping activity in other organs and low specificity. To investigate the usefulness of (99m)Tc-HMPAO (hexametyl propylene amine oxime) labeled leukocyte single photon emission computerized tomography (SPECT) for assessing CD lesions, in comparison with planar images. Twenty-two inflammatory bowel disease patients (19 CD; 2 ulcerative colitis, UC; 1 ileal pouch) assessed by conventional endoscopy or radiology were enrolled. Leukocytes were labeled with (99m)Tc-HMPAO. SPECT images were acquired at 2 h and planar images at 30 min and 2 h. Bowel uptake was quantitated in nine regions (score 0-3). Both SPECT and planar images detected a negative scintigraphy (score 0) in the UC patient with no pouchitis and a positive scintigraphy (score 1-3) in the 21 patients showing active inflammation by conventional techniques. SPECT showed a higher global score than planar images (0.71 +/- 0.09 vs 0.30 +/- 0.05; p < 0.001), and in particular in the right iliac fossa (p= 0.003), right and left flank (p < 0.001; p= 0.02), hypogastrium (p= 0.002), and mesogastrium (p < 0.001). SPECT provided a better visualization and a higher uptake than planar images in patients with ileal and ileocolonic CD (6.45 +/- 0.82 vs 2.8 +/- 0.55, p < 0.001; 5.5 +/- 1.6 vs 2.6 +/- 0.7, p= 0.03), and with perianal CD (6.6 +/- 1.6 vs 3.4 +/- 1.2; p= 0.03). (99m)Tc-HMPAO labeled leukocyte SPECT provides a more detailed visualization of CD lesions than planar images. This technique may better discriminate between intestinal and bone marrow uptake, thus being useful for assessing CD lesions within the pelvis, including perianal disease.

  19. An assessment of psychiatric disturbances in graves disease in a ...

    African Journals Online (AJOL)

    An assessment of psychiatric disturbances in graves disease in a medical college in eastern India. ... standard error of difference, the chi-square test, and paired Student's T-test. ... The common symptoms were insomnia, irritability, and anxiety.

  20. Comparative assessment of the prevalence of periodontal disease in subjects with and without systemic autoimmune diseases: A case-control study.

    Science.gov (United States)

    Ramesh Kumar, S G; Aswath Narayanan, M B; Jayanthi, D

    2016-01-01

    Immune mechanism shares a common pathway both for systemic autoimmune diseases and periodontal diseases. Scientific exploration of literature revealed limited studies on the association between systemic autoimmune diseases and periodontal diseases in India. The aim of the study is to find whether the presence of systemic autoimmune diseases in an individual is a risk factor for the development of periodontal disease. This was a hospital-based case-control study. A sample of 253 patients with systemic autoimmune diseases, attending the Rheumatology Department of Government General Hospital, Chennai-3, and 262 patients without systemic autoimmune diseases, attending the outpatient department of the Tamil Nadu Government Dental College and Hospital, Chennai-3, constituted the case and control groups, respectively. Age, gender, and oral hygiene status matching was done. Oral hygiene status was assessed using oral hygiene index (OHI) and periodontal status was assessed using community periodontal index (CPI) and loss of attachment (LOA) index. Statistical analysis was done using SPSS version 15 (SPSS Inc, 2006, Chicago). Results showed 99.2% and 73.9% prevalence of gingivitis and periodontitis, respectively, in the case group as compared to 85.5% and 14.9%, respectively, in the control group. There is no linear relationship between OHI scores and prevalence of periodontitis (CPI and LOA scores) in the case group. Patients suffering from systemic autoimmune diseases showed more prevalence of periodontal diseases irrespective of oral hygiene scores. It is postulated that the presence of systemic autoimmune diseases may pose a risk for the development of periodontal diseases.

  1. 78 FR 64428 - Draft Qualitative Risk Assessment of Risk of Activity/Animal Food Combinations for Activities...

    Science.gov (United States)

    2013-10-29

    .... FDA-2013-N-1043] Draft Qualitative Risk Assessment of Risk of Activity/Animal Food Combinations for... entitled ``Draft Qualitative Risk Assessment of Risk of Activity/Animal Food Combinations for Activities...(n) of the FD&C Act. II. Qualitative Risk Assessment As explained in the draft RA, we conducted the...

  2. [Vitamin D levels in ankylosing spondylitis: does deficiency correspond to disease activity?].

    Science.gov (United States)

    Pokhai, Gabriel G; Bandagi, Sabiha; Abrudescu, Adriana

    2014-01-01

    Ankylosing spondylitis (AS) is an inflammatory disorder that presents with arthritis of the axial skeleton, including sacroiliac joints. Vitamin D is a secosteroid hormone with a long-established role in calcium and phosphate homeostasis, and in the regulation of bone formation and resorption. It is now known that vitamin D plays an immunosuppressive role in the body, and there is interest of late in the role of vitamin D in autoimmune diseases. Inflammation may be responsible for some of the loss of bone mineral density seen in AS. We reviewed the literature for studies assessing vitamin D level as a marker of AS disease activity and those examining vitamin D levels in AS in comparison to healthy controls. Four of 7 studies found a significant negative correlation between vitamin D levels and Bath Ankylosing Spondylitis Index (BASDAI), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). In a review of 8 case-control studies, the mean level of 25-hydroxyvitamin D3 was 22.8 ± 14.1 ng/mL in 555 AS patients versus 26.6 ± 12.5 ng/mL in 557 healthy controls. When compared with a 2-sample t test, vitamin D levels were significantly higher in healthy controls (p < 0.01). We conclude that patients with AS appear to have lower vitamin D levels versus healthy controls; however, the cause is unclear. Existing studies do not demonstrate a consistent link between vitamin D levels and disease activity in AS. Further studies are in need to determine if a causative link exists between vitamin D deficiency and AS. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

  3. Correlation between the Modified Systemic Lupus Erythematosus Disease Activity Index 2000 and the European Consensus Lupus Activity Measurement in juvenile systemic lupus erythematosus.

    Science.gov (United States)

    Sato, J O; Corrente, J E; Saad-Magalhães, C

    2016-11-01

    Objective The objective of this study was to assess Modified Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and European Consensus Lupus Activity Measurement (ECLAM) disease activity correlation in addition to their respective correlation to Pediatric Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (Ped-SDI), in juvenile systemic lupus erythematosus (JSLE). Methods The activity indices were scored retrospectively and summarized by adjusted means during follow-up. The Ped-SDI was scored during the last visit for those with more than six months follow-up. Pearson correlation between the Modified SLEDAI-2K and ECLAM, as well as Spearman correlations between the Modified SLEDAI-2K, ECLAM, and Ped-SDI were calculated. The receiver operating characteristic (ROC) curve was calculated for both activity indices discriminating damage measured by Ped-SDI. Results Thirty-seven patients with mean age at diagnosis 11 ± 2.9 years and mean follow-up time 3.2 ± 2.4 years were studied. The Modified SLEDAI-2K and ECLAM adjusted means were highly correlated ( r = 0.78, p  0.7, p < 0.001), but Modified SLEDAI-2K and ECLAM correlation with Ped-SDI was only moderate. ROC analysis discriminant performance for both activity indices resulted in area under curve (AUC) of 0.74 and 0.73 for Modified SLEDAI-2K and ECLAM, respectively. Conclusion The high correlation found between the Modified SLEDAI-2K and ECLAM adjusted means indicated that both tools can be equally useful for longitudinal estimates of JSLE activity.

  4. Ezetimibe decreased nonalcoholic fatty liver disease activity score but not hepatic steatosis.

    Science.gov (United States)

    Lee, Hyo Young; Jun, Dae Won; Kim, Hyun Jung; Oh, Hyunwoo; Saeed, Waqar Khalid; Ahn, Hyeongsik; Cheung, Ramsey C; Nguyen, Mindie H

    2018-03-20

    A number of clinical trials reported varying effects of cholesterol lowering agents in nonalcoholic fatty liver disease (NAFLD) patients. We, therefore, assessed the changes in hepatic steatosis and NAFLD activity score (NAS) after treatment with cholesterol lowering agents in NAFLD patients by metaanalysis. The Cochrane Library, the MEDLINE, and the Embase databases were searched until May 2015, without any language restrictions, for randomized controlled trials (RCTs) and nonrandomized studies (NRSs). Additional references were obtained from review of bibliography of relevant articles. The quality of evidence was assessed using the grading of recommendations assessment, development and evaluation guidelines. Three RCTs (n = 98) and two NRSs (n = 101) met our study inclusion criteria (adult, NAFLD, liver biopsy). Liver biopsy was performed in all five studies, but only the three studies reported NAS. Ezetimibe significantly decreased NAS (standardized mean difference [SMD], -0.30; 95% confidence interval [CI], -0.57 to -0.03) but not hepatic steatosis in RCT (SMD, -0.1; 95% CI, -0.53 to 0.32), while the effect was significant for both NAS and intrahepatic content in NRSs (SMD, -3.0; 95% CI, -6.9 to 0.91). Ezetimibe decreased NAS without improving hepatic steatosis.

  5. Determining transition readiness in congenital heart disease: Assessing the utility of the Transition Readiness Questionnaire

    Science.gov (United States)

    The Transition Readiness Assessment Questionnaire (TRAQ) is a tool commonly used to assess transition readiness in adolescents with chronic diseases. It was previously validated in youth with special health care needs (YSHCN), but no patients with congenital heart disease (CHD) were included in the ...

  6. Assessing peridomestic entomological factors as predictors for Lyme disease

    Science.gov (United States)

    Connally, N.P.; Ginsberg, H.S.; Mather, T.N.

    2006-01-01

    The roles of entomologic risk factors, including density of nymphal blacklegged ticks (Ixodes scapularis), prevalence of nymphal infection with the etiologic agent (Borrelia burgdorferi), and density of infected nymphs, in determining the risk of human Lyme disease were assessed at residences in the endemic community of South Kingstown, RI. Nymphs were sampled between May and July from the wooded edge around 51 and 47 residential properties in 2002 and 2003, respectively. Nymphs were collected from all residences sampled. Tick densities, infection rates, and densities of infected nymphs were all significantly higher around homes reporting Lyme disease histories in 2003, while only infection rates were significantly higher in 2002. However, densities of infected nymphs did not significantly predict the probability of Lyme disease at a residence (by logistic regression) in either year. There were no significant differences in entomologic risk factors between homes with state-confirmed Lyme disease histories and homes with self-reported cases (not reported to the state health department). Therefore, although entomologic risk factors tended to be higher at residences with cases of Lyme disease, entomological indices, in the absence of human behavior measures, were not useful predictors of Lyme disease at the scale of individual residences in a tick-endemic community.

  7. Assessment of the (/sup 14/C) aminopyrine breath test in liver disease

    Energy Technology Data Exchange (ETDEWEB)

    Galizzi, J; Long, R G; Billing, B H; Sherlock, S [Royal Free Hospital, London (UK)

    1978-01-01

    Different methods of performing the (/sup 14/C) aminopyrine breath test have been assessed. A tracer dose of 2 ..mu..Ci without a loading dose and with a single breath collection at two hours was the method selected, since it gave the best discrimination between patients with hepatocellular diseases and normal subjects (5.2 +- 0.2%, mean - SEM). Reduced values occurred in patients with chronic active hepatitis (with and without cirrhosis) (1.5 +- 0.2%), alcoholic cirrhosis (1.7 +- 0.4%) and hepatitis (2.5 +- 0.3%), and late primary biliary cirrhosis suggesting defective microsomal function with respect to demethylation. Normal results were common in early primary biliary cirrhosis. Two weeks of prednisolone therapy caused some improvement in the breath test in nine of ten patients with chronic active hepatitis. It is concluded that the (/sup 14/C) aminopyrine breath test is a simple test for detecting hepatocellular dysfunction, but has no obvious diagnostic advantage over the determination of serum aspartate transaminase and two hour post-prandial bile-acids.

  8. Assessment report on research and development activities. Activity: 'Advanced science research' (Interim report)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-11-15

    Japan Atomic Energy Agency (hereinafter referred to as 'JAEA') consulted an assessment committee, 'Evaluation Committee of Research Activities for Advanced Science Research' (hereinafter referred to as 'Committee') for interim assessment of 'Advanced Science Research,' in accordance with 'General Guideline for the Evaluation of Government Research and Development (R and D) Activities' by Cabinet Office, Government of Japan, 'Guideline for Evaluation of R and D in Ministry of Education, Culture, Sports, Science and Technology' and 'Regulation on Conduct for Evaluation of R and D Activities' by JAEA. In response to the JAEA's request, the Committee assessed the research programs and activities of the Advanced Science Research Center (hereinafter referred to as 'ASRC') for the period of two years from April 2010. The Committee evaluated the management and the research programs of the ASRC based on the explanatory documents prepared by the ASRC and the oral presentations with questions-and-answers by the Director and the research group leaders. This report summarizes the result of the assessment by the Committee with the Committee report attached from page 7. (author)

  9. Health impact assessment of increasing public transport and cycling use in Barcelona: a morbidity and burden of disease approach.

    Science.gov (United States)

    Rojas-Rueda, D; de Nazelle, A; Teixidó, O; Nieuwenhuijsen, M J

    2013-11-01

    Quantify the health impacts on morbidity of reduced car trips and increased public transport and cycling trips. A health impact assessment study of morbidity outcomes related to replacing car trips in Barcelona metropolitan (3,231,458 inhabitants). Through 8 different transport scenarios, the number of cases of disease or injuries related to physical activity, particulate matter air pollution public transport and cycling trips resulted in annual reductions of 127 cases of diabetes, 44 of cardiovascular diseases, 30 of dementia, 16 minor injuries, 0.14 major injuries, 11 of breast cancer and 3 of colon-cancer, amounting to a total reduction of 302 Disability Adjusted Life Years per year in travelers. The reduction in PM2.5 exposure in the general population resulted in annual reductions of 7 cases of low birth weight, 6 of preterm birth, 1 of cardiovascular disease and 1 of lower respiratory tract infection. Transport policies to reduce car trips could produce important health benefits in terms of reduced morbidity, particularly for those who take up active transportation. © 2013.

  10. Psychological Assessment of Patients With Biotin-Thiamine-Responsive Basal Ganglia Disease.

    Science.gov (United States)

    Alfadhel, Majid; Al-Bluwi, Amal

    2017-01-01

    Biotin-thiamine-responsive basal ganglia disease is a devastating autosomal recessive inherited neurological disorder. We conducted a retrospective chart review of all patients with biotin-thiamine-responsive basal ganglia disease who underwent a formal psychological assessment. Six females and 3 males were included. Five patients (56%) had an average IQ, two patients (22%) had mild delay, and two (22%) had severe delay. A normal outcome was directly related to the time of diagnosis and initiation of treatment. Early diagnosis and immediate commencement of treatment were associated with a favorable outcome and vice versa. The most affected domain was visual motor integration, while understanding and mathematical problem-solving were the least affected. In summary, this is the first study discussing the psychological assessment of patients with biotin-thiamine-responsive basal ganglia disease. The results of this study alert clinicians to consider prompt initiation of biotin and thiamine in any patient presenting with neuroregression and a basal ganglia lesion on a brain magnetic resonance imaging.

  11. The value of power Doppler ultrasound in patients with rheumatoid arthritis in clinical remission: Reclassifying disease activity?

    Science.gov (United States)

    Vergara, Facundo; Ruta, Santiago; Rosa, Javier; Marín, Josefina; García-Mónaco, Ricardo; Soriano, Enrique R

    2017-03-18

    The aim of the present study was to describe the ultrasound (US) findings in patients with rheumatoid arthritis (RA) in clinical remission, and to evaluate the ability of power Doppler (PD) US to reclassify disease activity in these patients. We included consecutive patients with RA according to 2010 American College of Rheumatology/European League Against Rheumatism criteria, who were in clinical remission by the Disease Activity Score (DAS28<2.6). Twenty joints of both hands were assessed by US. PD signal was evaluated on a semi-quantitative scale from 0 to 3. Three different US-modified DAS28 (US-DAS28) were constructed, replacing the clinical swollen joint count by the PD US joint count using PD score ≥1, ≥2 or ≥3, respectively. Eighty-six patients were included. Twenty-three (26.7%) patients had at least one joint with abnormal US-positive PD signal. Thirteen percent of patients were reclassified to low disease activity by applying the US-DAS28 when joints were considered active with a PD signal ≥1; 12%, when a PD signal ≥2 was considered, and 2% of the patients were reclassified when a PD score of 3 was considered. No patients were reclassified to a level of moderate or high activity applying US-DAS28. Although around a quarter of patients with RA in clinical remission showed PD US features indicating residual activity, only a small percentage were reclassified to a state of low activity and none to a level of moderate or high activity, applying the proposed US-DAS28. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  12. Nutrition and Physical Activity in Nonalcoholic Fatty Liver Disease

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    Claudia P. Oliveira

    2016-01-01

    Full Text Available Nonalcoholic fatty liver disease (NAFLD is the most common liver disease worldwide and it is associated with other medical conditions such as diabetes mellitus, metabolic syndrome, and obesity. The mechanisms of the underlying disease development and progression are not completely established and there is no consensus concerning the pharmacological treatment. In the gold standard treatment for NAFLD weight loss, dietary therapy, and physical activity are included. However, little scientific evidence is available on diet and/or physical activity and NAFLD specifically. Many dietary approaches such as Mediterranean and DASH diet are used for treatment of other cardiometabolic risk factors such as insulin resistance and type-2 diabetes mellitus (T2DM, but on the basis of its components their role in NAFLD has been discussed. In this review, the implications of current dietary and exercise approaches, including Brazilian and other guidelines, are discussed, with a focus on determining the optimal nonpharmacological treatment to prescribe for NAFLD.

  13. Clinical Applications of Natriuretic Peptides in Assessment of Valvular Heart Disease

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    Abhishek Sharma

    2015-01-01

    Full Text Available Biomarkers such as natriuretic peptides (NPs have evolving clinical utility beyond the scope of heart failure. The role of NPs in the management of valvular heart disease is a growing area of investigation. NPs have much potential in the assessment of asymptomatic patients with hemodynamically significant valvular lesions who have traditionally been excluded from consideration of surgical intervention. NPs also have a role in the risk stratification of these patients as well as in routine surveillance and monitoring. Together with echocardiographic data and functional status, NPs are being incorporated into the management of valvular heart disease. In this review we examine the evidence for the role of natriuretic peptides in assessment of VHD.

  14. Clinical Applications of Natriuretic Peptides in Assessment of Valvular Heart Disease

    Science.gov (United States)

    Ahmed, Vaseem; Garg, Aakash; Aggarwal, Chirag

    2015-01-01

    Biomarkers such as natriuretic peptides (NPs) have evolving clinical utility beyond the scope of heart failure. The role of NPs in the management of valvular heart disease is a growing area of investigation. NPs have much potential in the assessment of asymptomatic patients with hemodynamically significant valvular lesions who have traditionally been excluded from consideration of surgical intervention. NPs also have a role in the risk stratification of these patients as well as in routine surveillance and monitoring. Together with echocardiographic data and functional status, NPs are being incorporated into the management of valvular heart disease. In this review we examine the evidence for the role of natriuretic peptides in assessment of VHD. PMID:26265794

  15. Risk assessment and level of physical activity of students in Poland

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    Jolanta Grażyna Zuzda

    2017-08-01

    Full Text Available Aim . The aim of the study was to determine the risks of activity by using Physical Activity Readiness Questionnaire (PAR-Q and describe the PA profile using the short-version of the International Physical Activity Questionnaire (IPAQ-SF among selected groups of sport science students. Material and methods The study covered 99 students - 61 females aged 21.08 ± 1.43 and 38 males aged 21.24 ± 1.22 y. In order to asses and stratify the risk of PA the Polish short version of the IPAQ-SF was used. Results. The total level of physical activity of the male students was 3460.039±2502.207 MET- min/week and was higher than in the case of female students (3388,107±2204,290 MET- min/week. The dominant type physical activity of female and male students was intensive effort. Among 22 men and 39 women, risk factors for cardiac events, pulmonary and musculoskeletal injuries were reported. The relationship between PAR-Q results and the on the IPAQ-SF results was no statistically significant. Conclusions This study demonstrates that students achieve the level of physical activity recommended by experts for the prevention of chronic diseases. This research allows sports science students to understand their own health issues through self-assessments of personal risk factors for cardiac events, pulmonary and musculoskeletal injury.

  16. Activities, Participation and Quality of Life Concepts in Children and Adolescents with Celiac Disease: A Scoping Review

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    Sonya Meyer

    2017-08-01

    Full Text Available Celiac disease (CD is a food-related chronic condition and adherence to a strict gluten-free diet is the only available treatment. Adherence to the restrictive diet is challenging among children, especially adolescents. The aim was to describe existing knowledge about food-related activities, participation, and quality of life in daily life among children and adolescents with CD and to illuminate gaps in knowledge. The scoping review methodology was applied and literature searches were conducted in electronic databases. Twenty-three articles met the inclusion criteria. Food-related activities were identified, classified, and coded under the International Classification of Functioning, Disability, and Health adapted for children and youth (ICF-CY concepts of activities and participation. A wide variety of study populations, objectives, methods, and tools involving 55 different food-related activities were found. Incorporation of the ICF-CY concepts and quality of life captures new insights into everyday challenges. Reviewing the CD literature using this different lens reveals areas yet to receive sufficient attention. Further research can deepen the understanding of daily functioning of children with CD and the underlying skills required to participate in daily food-related activities while adhering to the diet. This can lead to the development of standardized disease-specific assessment tools and suitable intervention programs.

  17. Evaluating peer teaching about chronic disease.

    Science.gov (United States)

    Guenther, Sylvia; Shadbolt, Narelle; Roberts, Chris; Clark, Tyler

    2014-12-01

    The primary care areas of priority (PCAP) activity was developed to engage medical students in learning about chronic disease management in a clinical context from their peers. It is one of several summative assessment tasks that occur during a primary care community term rotation in a graduate-entry medical programme. We evaluated the acceptability and effectiveness of the PCAP activity as a combined teaching, learning and assessment innovation. Evaluation and assessment data from students who rotated through the four community term blocks during the 2011-2012 academic year was analysed using both qualitative and quantitative methods. PCAP peer teaching activity is an effective format for teaching about the management of chronic conditions in the community Analysis indicated that 89 per cent (n = 148/166) of responding students rated the PCAP as satisfactory, good or excellent. The marking rubric contained 11 assessable components, including teaching skills, mastery of clinical knowledge, developing a management plan, disease prevention and health promotion opportunities, identifying patient safety issues, the impact of the clinical presentation on the patient and family, and consideration of health equity factors. Analysis of the assessment scores indicated that the majority of students achieved the specified learning outcomes. The PCAP peer teaching activity was an acceptable and effective format for teaching about the management of chronic conditions in the community, and is adaptable to other teaching contexts. Students enjoyed teaching and being taught by their peers, and assessment results indicated that they developed their clinical knowledge as well as their teaching ability regarding chronic disease management. © 2014 John Wiley & Sons Ltd.

  18. Minimal Disease Activity as a Treatment Target in Psoriatic Arthritis

    DEFF Research Database (Denmark)

    Gossec, Laure; McGonagle, Dennis; Korotaeva, Tatiana

    2018-01-01

    As in other inflammatory rheumatic diseases, the objective of psoriatic arthritis (PsA) treatment is the achievement of a defined target. Recent recommendations propose aiming for remission or low disease activity; however, a consensual definition of remission is lacking. A state of minimal disease....... Since its development, MDA has been used increasingly in studies and clinical trials. In this article, the potential use of MDA as a treatment target in PsA is reviewed. The frequencies of MDA achievement with biologic disease-modifying antirheumatic drugs are summarized based on data from registries...

  19. Correlation of Gastroesophageal reflux disease Assessment Symptom Questionnaire to impedance-pH measurements in children.

    Science.gov (United States)

    Prachuapthunyachart, Sittichoke; Jarasvaraparn, Chaowapong; Gremse, David A

    2017-01-01

    Esophageal multichannel intraluminal impedance-pH monitoring has become one of the preferred tests to correlate observed reflux-like behaviors with esophageal reflux events. The Gastroesophageal reflux disease Assessment Symptom Questionnaire is a validated tool used to distinguish infants with gastroesophageal reflux disease from healthy children. The aim of this study was to determine whether the Gastroesophageal reflux disease Assessment Symptom Questionnaire composite symptom scores and individual symptom scores correlate with outcomes in esophageal multichannel intraluminal impedance-pH monitoring. A total of 26 patients with gastroesophageal reflux disease-associated symptoms, aged 0-2 years, for whom both esophageal multichannel intraluminal impedance-pH monitoring and Gastroesophageal reflux disease Assessment Symptom Questionnaire survey results were available were included in the study. Gastroesophageal reflux disease Assessment Symptom Questionnaire score data were collected from a 7-day recall of parent's responses about the frequency and severity of gastroesophageal reflux disease symptoms, which determined the individual symptom scores. The composite symptom scores is the sum of all individual symptom scores. Multichannel intraluminal impedance-pH study results were compared to Gastroesophageal reflux disease Assessment Symptom Questionnaire data using Pearson correlation. Among 26 patients, a total number of 2817 (1700 acid and 1117 non-acid) reflux episodes and 845 clinical reflux behaviors were recorded. There were significant correlations between the reflux index and the individual symptom scores for coughing/gagging/choking (r 2 = 0.2842, p = 0.005), the impedance score and individual symptom scores for coughing/gagging/choking (r 2 = 0.2482, p = 0.009), the reflux symptom index for acid reflux-related coughing/gagging/choking and the individual symptom scores for coughing/gagging/choking (r 2 = 0.1900, p = 0.026), the impedance score and

  20. Awareness of chronic disease related health benefits of physical activity among residents of a rural South Indian region: a cross-sectional study.

    Science.gov (United States)

    Veluswamy, Sundar Kumar; Maiya, Arun G; Nair, Suma; Guddattu, Vasudeva; Nair, Narayanapillai Sreekumaran; Vidyasagar, Sudha

    2014-02-27

    Physical activity trends for a lower-middle income country like India suggest a gradual decline in work related physical activity and no concomitant increase in leisure time physical activity. Perceived health benefits of physical activity and intention to increase physical activity have been established as independent correlates of physical activity status. In India, not much is known about peoples' perceptions of health benefits of physical activity and their intention to increase physical activity levels. This study was performed to understand peoples' perceptions and awareness about health benefits of physical activity in a rural South Indian region. This cross-sectional study was conducted using a multistage cluster sampling design. A content validated, field tested questionnaire was administered in person by a trained interviewer in the participants' native language. The questionnaire assessed the participants' perceptions about their lifestyle (active or sedentary), health benefits of physical activity and need for increasing their physical activity. In addition, the participant's physical activity was assessed using version 2 of global physical activity questionnaire. Frequencies and percentages were used to summarise perceived health benefits of physical activity and other categorical variables. Age and body mass index were summarised using mean ± SD, whereas physical activity (MET.min.wk -1) was summarised using median and interquartile range. Four hundred fifty members from 125 randomly selected households were included in the study, of which 409 members participated. 89% (364) of participants felt they lead an active lifestyle and 83.1% (340) of participants did not feel a need to increase their physical activity level. 86.1%, (352) of the participants were physically active. Though 92.4% (378) of participants felt there were health benefits of physical activity, majority of them (75.1%) did not report any benefit related to chronic diseases. None

  1. Automatic and Objective Assessment of Alternating Tapping Performance in Parkinson’s Disease

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    Mevludin Memedi

    2013-12-01

    Full Text Available This paper presents the development and evaluation of a method for enabling quantitative and automatic scoring of alternating tapping performance of patients with Parkinson’s disease (PD. Ten healthy elderly subjects and 95 patients in different clinical stages of PD have utilized a touch-pad handheld computer to perform alternate tapping tests in their home environments. First, a neurologist used a web-based system to visually assess impairments in four tapping dimensions (‘speed’, ‘accuracy’, ‘fatigue’ and ‘arrhythmia’ and a global tapping severity (GTS. Second, tapping signals were processed with time series analysis and statistical methods to derive 24 quantitative parameters. Third, principal component analysis was used to reduce the dimensions of these parameters and to obtain scores for the four dimensions. Finally, a logistic regression classifier was trained using a 10-fold stratified cross-validation to map the reduced parameters to the corresponding visually assessed GTS scores. Results showed that the computed scores correlated well to visually assessed scores and were significantly different across Unified Parkinson’s Disease Rating Scale scores of upper limb motor performance. In addition, they had good internal consistency, had good ability to discriminate between healthy elderly and patients in different disease stages, had good sensitivity to treatment interventions and could reflect the natural disease progression over time. In conclusion, the automatic method can be useful to objectively assess the tapping performance of PD patients and can be included in telemedicine tools for remote monitoring of tapping.

  2. Achieving simplified disease activity index remission in patients with active rheumatoid arthritis is associated with subsequent good functional and structural outcomes in a real-world clinical setting under a treat-to-target strategy.

    Science.gov (United States)

    Hirano, Fumio; Yokoyama, Waka; Yamazaki, Hayato; Amano, Koichi; Kawakami, Atsushi; Hayashi, Taichi; Tamura, Naoto; Yasuda, Shinsuke; Dobashi, Hiroaki; Fujii, Takao; Ito, Satoshi; Kaneko, Yuko; Matsui, Toshihiro; Okuda, Yasuaki; Saito, Kazuyoshi; Suzuki, Fumihito; Yoshimi, Ryusuke; Sakai, Ryoko; Koike, Ryuji; Kohsaka, Hitoshi; Miyasaka, Nobuyuki; Harigai, Masayoshi

    2017-09-01

    To verify predictive validity of simplified disease activity index (SDAI) remission for subsequent functional and structural outcomes in real-world clinical settings under a treat-to-target strategy (T2T). In this multicenter, prospective cohort study, T2T was implemented in rheumatoid arthritis (RA) patients with moderate-to-high disease activity. SDAI or clinical disease activity index (CDAI) was assessed every 12 weeks, and treatment was adjusted to achieve clinical remission or low disease activity (LDA). Multivariate logistic regression models were used to examine the associations of SDAI remission (≤3.3) at week 24 with the health assessment questionnaire-disability index (HAQ-DI) ≤ 0.5 or with the delta van der Heijde-modified total Sharp score (ΔvdH-mTSS) 

  3. The retirement impact in people with Parkinson disease during active age

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    Angela Maria Alvarez

    2017-11-01

    Full Text Available Our objective was to comprehend the retirement impact in individuals with Parkinson disease during active age. We conducted a qualitative study using as Methodological Reference the Theory Grounded on Data. We interviewed 30 people with Parkinson disease, from those six were retired during active age. The data collection was in September 2013 to April 2014 and analyzed through open coding, axial and selective techniques. From the analysis, four categories emerged: retirement and identity in Parkinson disease; the incompatibility between the desire and the capacity to work; disconnecting and facing reality; the unexpected from retirement. The results indicated that people face difficulties in the disability retirement process, and we identified the need for emotional accompaniment and preparation for this transition moment in a way to stimulate a productive living, even with Parkinson disease.

  4. Neuropsychological correlates of cognitive, emotional-affective and auto-activation apathy in Alzheimer's disease.

    Science.gov (United States)

    Perri, Roberta; Turchetta, Chiara Stella; Caruso, Giulia; Fadda, Lucia; Caltagirone, Carlo; Carlesimo, Augusto Giovanni

    2018-01-31

    Apathy symptoms include different dimensions: cognitive (C), emotional-affective (E-Aff) and auto-activation; they have been related to dysfunctions of the dorsolateral, orbito-basal prefrontal cortex and the subcortical frontal connections to the basal ganglia, respectively. In Alzheimer's disease (AD), an association has been found between apathy severity and both executive deficits and atrophy of the dorso-lateral prefrontal cortex; however, it is not clear whether these associations concern only the cognitive aspects of apathy. Furthermore, whether there is an association in AD between E-aff apathy and theory of mind (ToM),the cognitive functions subsumed by the orbito-basal prefrontal cortex, has not been investigated. Aim of the study was to investigate the relationship between C, E-Aff and auto-activation apathy and performance on tasks investigating executive and ToM cognitive functions in AD. For this purpose, 20 AD patients with apathy and 20 matched controls were submitted to an executive and ToM neuropsychological assessment. Apathy was assessed with a weekly diary (ApD) created specifically to assist caregivers in quantifying the C, E-Aff and auto-activation symptomatology of apathy. Correlational analyses showed that AD patients' scores on the Modified Card Sorting Test (MCST) and Emotion Attribution tasks were correlated with most ApD scores. However, regression analyses showed that C diary scores were predicted by MCST performance, E-Aff diary scores by performance on the E-Attribution task and ApD scores measuring auto-activation apathy were predicted by both the MCST and the Emotion Attribution scores. These results confirm the co-occurrence of apathy and executive-function deficits in AD and suggest a specific association between AD patients' executive deficits and the cognitive component of apathy. Furthermore, they document, for the first time, an association between poor performance on tests assessing ToM abilities and the emotional

  5. Fruit consumption and physical activity in relation to all-cause and cardiovascular mortality among 70,000 Chinese adults with pre-existing vascular disease.

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    Xiaocao Tian

    Full Text Available To assess the associations of fresh fruit consumption and total physical activity with all-cause and cardiovascular mortality among Chinese adults who have been diagnosed with cardiovascular disease (CVD or hypertension.During 2004-08, the China Kadoorie Biobank study recruited 70,047 adults, aged 30-79 years, with physician-diagnosed stroke or transient ischaemic attack, ischemic heart disease, or hypertension. Information on diet and physical activity was collected using an interviewer-administered electronic questionnaire. Cox regression was used to yield hazard ratios (HRs for the independent and joint associations of fresh fruit consumption and total physical activity with mortality.At baseline, 32.9% of participants consumed fresh fruit regularly (i.e. >3 days/week and the mean total physical activity were 15.8 (SD = 11.8 MET-hr/day. During ~7-years follow-up, 6569 deaths occurred with 3563 from CVD. Compared to participants with 16.53 MET-hr/day was associated with about 40% lower mortality.Among Chinese adults with pre-existing vascular disease, higher physical activity and fruit consumption were both independently and jointly associated with lower mortality.

  6. The Association between Dry Eye Disease and Physical Activity as well as Sedentary Behavior: Results from the Osaka Study

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    Motoko Kawashima

    2014-01-01

    Full Text Available Purpose. To assess the association of dry eye disease (DED with physical activity and sedentary behavior. Methods. The cross-sectional survey conducted included Japanese office workers who use visual display terminals (n=672. DED was assessed according to the Japanese Dry Eye Diagnostic Criteria, and participants were categorized into “definite DED,” “probable DED,” or “non-DED” groups based on the results of DED examinations. Physical activity and sedentary behavior of participants were assessed using the International Physical Activity Questionnaire (IPAQ, and physical activity level was calculated in metabolic equivalent units per week (MET, min/week. Participants were classified as having a high, moderate, or low level of physical activity. Results. Participants with abnormal tear break-up time (BUT (≤5 s were involved in sedentary behavior for significantly longer duration than those with normal BUT (P=0.035. Non-DED participants (14.5% tended to have higher levels of physical activity than definite DED participants (2.5%. Participants with definite DED had significantly lower MET scores than those with non-DED (P=0.025. Conclusions. Our findings suggest that a lower level of physical activity and sedentary behavior are associated with DED; however, longitudinal/intervention studies with large groups of participants are needed to validate these findings.

  7. Strengthening Chronic Disease Prevention Programming: the Toward Evidence-Informed Practice (TEIP) Program Assessment Tool

    Science.gov (United States)

    Albert, Dayna; Fortin, Rebecca; Lessio, Anne; Herrera, Christine; Hanning, Rhona; Rush, Brian

    2013-01-01

    Best practices identified solely on the strength of research evidence may not be entirely relevant or practical for use in community-based public health and the practice of chronic disease prevention. Aiming to bridge the gap between best practices literature and local knowledge and expertise, the Ontario Public Health Association, through the Toward Evidence-Informed Practice initiative, developed a set of resources to strengthen evidence-informed decision making in chronic disease prevention programs. A Program Assessment Tool, described in this article, emphasizes better processes by incorporating review criteria into the program planning and implementation process. In a companion paper, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool,” we describe another tool, which emphasizes better evidence by providing guidelines and worksheets to identify, synthesize, and incorporate evidence from a range of sources (eg, peer-reviewed literature, gray literature, local expertise) to strengthen local programs. The Program Assessment Tool uses 19 criteria derived from literature on best and promising practices to assess and strengthen program planning and implementation. We describe the benefits, strengths, and challenges in implementing the tool in 22 community-based chronic disease prevention projects in Ontario, Canada. The Program Assessment Tool helps put best processes into operation to complement adoption and adaptation of evidence-informed practices for chronic disease prevention. PMID:23721789

  8. MDCT abnormalities of small- and medium-sized bronchus in active tuberculosis: a new angle on an old disease

    International Nuclear Information System (INIS)

    Oh, Jin Kyoung; Ahn, Myeong Im; Jung, Jung Im; Han, Dae Hee; Kim, Young Kyoon; Oh, Eun-Jee; Park, Yeon-Joon

    2011-01-01

    Background: The incidence and findings of tuberculous invasion of the peripheral bronchus have not been fully investigated with MDCT. Purpose: To evaluate the prevalence and findings of MDCT abnormalities of small- and medium-sized bronchus (SMB) in active pulmonary tuberculosis (TB). Material and Methods: Using multiplanar reformation, 35 consecutive MDCT scans (follow-up exams available in 14 patients with a mean interval of 8.1 months) were assessed for following abnormalities of SMB: bronchial impaction (BI), wall thickening, dilatation, peribronchial cuff of soft tissue, and bronchocavitary fistula. It was also assessed whether tree-in-buds (TIB) have a tendency to distribute in the territories of diseased SMB, and whether SMB abnormalities are present in patients with relatively mild disease. Results: SMB abnormalities were observed in 23 (65.7%) patients with active TB. The most frequent finding was wall thickening (n=18, 51.4%), followed by BI (n=13, 37.1%; zigzag-shaped in four), dilatation (n =11, 31.4%), amputated appearance of air column (n=11, 31.4%), peribronchial cuff of soft tissue (n=10, 28.6%), and bronchocavitary fistula (n=8, 22.9%). TIB (n=29; absent in two patients with SMB) was mainly within (n=14) or close to (n=4) the territory of diseased SMB. Follow-up CT frequently showed improvement of wall thickening (11/12) and persistence of bronchial dilatation (11/13). SMB abnormality was present in all of six patients with mild disease. Conclusion: MDCT shows that tuberculous invasion of the peripheral bronchus may be more frequent than previously thought, of which findings include wall thickening, BI, dilatation, amputated appearance of air column, peribronchial cuff of soft tissue and bronchocavitary fistula

  9. MDCT abnormalities of small- and medium-sized bronchus in active tuberculosis: a new angle on an old disease

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jin Kyoung; Ahn, Myeong Im; Jung, Jung Im; Han, Dae Hee (Dept. of Radiology, Seoul St Mary' s Hospital, The Catholic Univ. of Korea, Seoul (Korea, Republic of)), email: lepolder@gmail.com; Kim, Young Kyoon (Dept. of Internal Medicine, Seoul St Mary' s Hospital, The Catholic Univ. of Korea, Seoul (Korea, Republic of)); Oh, Eun-Jee; Park, Yeon-Joon (Dept. of Laboratory Medicine, Seoul St Mary' s Hospital, The Catholic Univ. of Korea, Seoul (Korea, Republic of))

    2011-02-15

    Background: The incidence and findings of tuberculous invasion of the peripheral bronchus have not been fully investigated with MDCT. Purpose: To evaluate the prevalence and findings of MDCT abnormalities of small- and medium-sized bronchus (SMB) in active pulmonary tuberculosis (TB). Material and Methods: Using multiplanar reformation, 35 consecutive MDCT scans (follow-up exams available in 14 patients with a mean interval of 8.1 months) were assessed for following abnormalities of SMB: bronchial impaction (BI), wall thickening, dilatation, peribronchial cuff of soft tissue, and bronchocavitary fistula. It was also assessed whether tree-in-buds (TIB) have a tendency to distribute in the territories of diseased SMB, and whether SMB abnormalities are present in patients with relatively mild disease. Results: SMB abnormalities were observed in 23 (65.7%) patients with active TB. The most frequent finding was wall thickening (n=18, 51.4%), followed by BI (n=13, 37.1%; zigzag-shaped in four), dilatation (n =11, 31.4%), amputated appearance of air column (n=11, 31.4%), peribronchial cuff of soft tissue (n=10, 28.6%), and bronchocavitary fistula (n=8, 22.9%). TIB (n=29; absent in two patients with SMB) was mainly within (n=14) or close to (n=4) the territory of diseased SMB. Follow-up CT frequently showed improvement of wall thickening (11/12) and persistence of bronchial dilatation (11/13). SMB abnormality was present in all of six patients with mild disease. Conclusion: MDCT shows that tuberculous invasion of the peripheral bronchus may be more frequent than previously thought, of which findings include wall thickening, BI, dilatation, amputated appearance of air column, peribronchial cuff of soft tissue and bronchocavitary fistula

  10. Cardiovascular magnetic resonance imaging to assess myocardial fibrosis in valvular heart disease.

    Science.gov (United States)

    Podlesnikar, Tomaz; Delgado, Victoria; Bax, Jeroen J

    2018-01-01

    The left ventricular (LV) remodeling process associated with significant valvular heart disease (VHD) is characterized by an increase of myocardial interstitial space with deposition of collagen and loss of myofibers. These changes occur before LV systolic function deteriorates or the patient develops symptoms. Cardiovascular magnetic resonance (CMR) permits assessment of reactive fibrosis, with the use of T1 mapping techniques, and replacement fibrosis, with the use of late gadolinium contrast enhancement. In addition, functional consequences of these structural changes can be evaluated with myocardial tagging and feature tracking CMR, which assess the active deformation (strain) of the LV myocardium. Several studies have demonstrated that CMR techniques may be more sensitive than the conventional measures (LV ejection fraction or LV dimensions) to detect these structural and functional changes in patients with severe left-sided VHD and have shown that myocardial fibrosis may not be reversible after valve surgery. More important, the presence of myocardial fibrosis has been associated with lesser improvement in clinical symptoms and recovery of LV systolic function. Whether assessment of myocardial fibrosis may better select the patients with severe left-sided VHD who may benefit from surgery in terms of LV function and clinical symptoms improvement needs to be demonstrated in prospective studies. The present review article summarizes the current status of CMR techniques to assess myocardial fibrosis and appraises the current evidence on the use of these techniques for risk stratification of patients with severe aortic stenosis or regurgitation and mitral regurgitation.

  11. PoCos: Population Covering Locus Sets for Risk Assessment in Complex Diseases.

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    Marzieh Ayati

    2016-11-01

    Full Text Available Susceptibility loci identified by GWAS generally account for a limited fraction of heritability. Predictive models based on identified loci also have modest success in risk assessment and therefore are of limited practical use. Many methods have been developed to overcome these limitations by incorporating prior biological knowledge. However, most of the information utilized by these methods is at the level of genes, limiting analyses to variants that are in or proximate to coding regions. We propose a new method that integrates protein protein interaction (PPI as well as expression quantitative trait loci (eQTL data to identify sets of functionally related loci that are collectively associated with a trait of interest. We call such sets of loci "population covering locus sets" (PoCos. The contributions of the proposed approach are three-fold: 1 We consider all possible genotype models for each locus, thereby enabling identification of combinatorial relationships between multiple loci. 2 We develop a framework for the integration of PPI and eQTL into a heterogenous network model, enabling efficient identification of functionally related variants that are associated with the disease. 3 We develop a novel method to integrate the genotypes of multiple loci in a PoCo into a representative genotype to be used in risk assessment. We test the proposed framework in the context of risk assessment for seven complex diseases, type 1 diabetes (T1D, type 2 diabetes (T2D, psoriasis (PS, bipolar disorder (BD, coronary artery disease (CAD, hypertension (HT, and multiple sclerosis (MS. Our results show that the proposed method significantly outperforms individual variant based risk assessment models as well as the state-of-the-art polygenic score. We also show that incorporation of eQTL data improves the performance of identified POCOs in risk assessment. We also assess the biological relevance of PoCos for three diseases that have similar biological mechanisms

  12. 3D-based visual physical activity assessment of children

    Directory of Open Access Journals (Sweden)

    Maile S.

    2015-09-01

    Full Text Available In the last decades, an alarming rise in prevalence of childhood overweight and obesity has been observed which is partly attributed to a lack in physical activity and has started to become a public health concern. Therefore, the necessity for accurate physical activity assessment has become more and more apparent. Physical activity can be assessed objectively using accelerometers or combined devices. The application of such devices is sometimes complex and wearing the device may influence the behaviour of the test person. Therefore, assessment without any worn device would be an advantage.

  13. Physical activity in adults with congenital heart disease and associations with functional outcomes.

    Science.gov (United States)

    Müller, Jan; Amberger, Tamara; Berg, Anika; Goeder, Daniel; Remmele, Julia; Oberhoffer, Renate; Ewert, Peter; Hager, Alfred

    2017-07-01

    Improved survival has yielded to growing importance of functional outcome measures in patients with congenital heart disease (CHD). This study applied the International Physical Activity Questionnaire (IPAQ) to assess self-reported physical activity (PA) in patients with CHD and their association with exercise capacity and health-related quality of life (HrQoL). Prior to cardiopulmonary exercise testing (CPET), 786 consecutive patients (335 female, 31.1±11.6 years) with CHD filled in the short form of the IPAQ and the HrQoL questionnaire 36-Item Short Form. In total, 393 (50.0%) patients reported health-enhancing physical activity (HEPA), 237 (30.2%) minimal activity and 156 (19.8%) inactivity. In comparison with the HEPA group, the inactive group had significant lower peak oxygen uptake (74.2%±20.7% vs 86.8%±22.3%; pphysical (91.0%±16.9% vs 97.4%±13.6%; pphysical (OR: 0.46, 95% CI: 0.23 to 0.92; p=0.027) HrQoL and exercise capacity (OR: 0.36, 95% CI: 0.22 to 0.59; p<0.001). Categorisation of patientswith CHD with the IPAQ quickly provides clinical information as HEPA patients have a less probability for impaired HrQoL and diminished exercise capacity. Nevertheless, the IPAQ cannot substitute an accelerometer-based assessment for PA, nor a CPET for exercise capacity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Biomarkers of disease activity in vitiligo: A systematic review.

    Science.gov (United States)

    Speeckaert, R; Speeckaert, M; De Schepper, S; van Geel, N

    2017-09-01

    The pathophysiology of vitiligo is complex although recent research has discovered several markers which are linked to vitiligo and associated with disease activity. Besides providing insights into the driving mechanisms of vitiligo, these findings could reveal potential biomarkers. Activity markers can be used to monitor disease activity in clinical trials and may also be useful in daily practice. The aim of this systematic review was to document which factors have been associated with vitiligo activity in skin and blood. A second goal was to determine how well these factors are validated in terms of sensitivity and specificity as biomarkers to determine vitiligo activity. Both in skin (n=43) as in blood (n=66) an adequate number of studies fulfilled the predefined inclusion criteria. These studies used diverse methods and investigated a broad range of plausible biomarkers. Unfortunately, sensitivity and specificity analyses were scarce. In skin, simple histopathology with or without supplemental CD4 and CD8 stainings can still be considered as the gold standard, although more recently chemokine (C-X-C motif) ligand (CXCL) 9 and NLRP1 have demonstrated a good and possibly even better association with progressive disease. Regarding circulating biomarkers, cytokines (IL-1β, IL-17, IFN-γ, TGF-β), autoantibodies, oxidative stress markers, immune cells (Tregs), soluble CDs (sCD25, sCD27) and chemokines (CXCL9, CXCL10) are still competing. However, the two latter may be preferable as both chemokines and soluble CDs are easy to measure and the available studies display promising results. A large multicenter study could make more definitive statements regarding their sensitivity and specificity. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Development of Transcriptional Fusions to Assess Leptospira interrogans Promoter Activity

    Science.gov (United States)

    Cerqueira, Gustavo M.; Souza, Natalie M.; Araújo, Eduardo R.; Barros, Aline T.; Morais, Zenaide M.; Vasconcellos, Sílvio A.; Nascimento, Ana L. T. O.

    2011-01-01

    Background Leptospirosis is a zoonotic infectious disease that affects both humans and animals. The existing genetic tools for Leptospira spp. have improved our understanding of the biology of this spirochete as well as the interaction of pathogenic leptospires with the mammalian host. However, new tools are necessary to provide novel and useful information to the field. Methodology and Principal Findings A series of promoter-probe vectors carrying a reporter gene encoding green fluorescent protein (GFP) were constructed for use in L. biflexa. They were tested by constructing transcriptional fusions between the lipL41, Leptospiral Immunoglobulin-like A (ligA) and Sphingomielynase 2 (sph2) promoters from L. interrogans and the reporter gene. ligA and sph2 promoters were the most active, in comparison to the lipL41 promoter and the non-induced controls. The results obtained are in agreement with LigA expression from the L. interrogans Fiocruz L1-130 strain. Conclusions The novel vectors facilitated the in vitro evaluation of L. interrogans promoter activity under defined growth conditions which simulate the mammalian host environment. The fluorescence and rt-PCR data obtained closely reflected transcriptional regulation of the promoters, thus demonstrating the suitability of these vectors for assessing promoter activity in L. biflexa. PMID:21445252

  16. Development of transcriptional fusions to assess Leptospira interrogans promoter activity.

    Directory of Open Access Journals (Sweden)

    Gustavo M Cerqueira

    Full Text Available BACKGROUND: Leptospirosis is a zoonotic infectious disease that affects both humans and animals. The existing genetic tools for Leptospira spp. have improved our understanding of the biology of this spirochete as well as the interaction of pathogenic leptospires with the mammalian host. However, new tools are necessary to provide novel and useful information to the field. METHODOLOGY AND PRINCIPAL FINDINGS: A series of promoter-probe vectors carrying a reporter gene encoding green fluorescent protein (GFP were constructed for use in L. biflexa. They were tested by constructing transcriptional fusions between the lipL41, Leptospiral Immunoglobulin-like A (ligA and Sphingomyelinase 2 (sph2 promoters from L. interrogans and the reporter gene. ligA and sph2 promoters were the most active, in comparison to the lipL41 promoter and the non-induced controls. The results obtained are in agreement with LigA expression from the L. interrogans Fiocruz L1-130 strain. CONCLUSIONS: The novel vectors facilitated the in vitro evaluation of L. interrogans promoter activity under defined growth conditions which simulate the mammalian host environment. The fluorescence and rt-PCR data obtained closely reflected transcriptional regulation of the promoters, thus demonstrating the suitability of these vectors for assessing promoter activity in L. biflexa.

  17. Assessing the quality of activities in a smart environment.

    Science.gov (United States)

    Cook, Diane J; Schmitter-Edgecombe, M

    2009-01-01

    Pervasive computing technology can provide valuable health monitoring and assistance technology to help individuals live independent lives in their own homes. As a critical part of this technology, our objective is to design software algorithms that recognize and assess the consistency of activities of daily living that individuals perform in their own homes. We have designed algorithms that automatically learn Markov models for each class of activity. These models are used to recognize activities that are performed in a smart home and to identify errors and inconsistencies in the performed activity. We validate our approach using data collected from 60 volunteers who performed a series of activities in our smart apartment testbed. The results indicate that the algorithms correctly label the activities and successfully assess the completeness and consistency of the performed task. Our results indicate that activity recognition and assessment can be automated using machine learning algorithms and smart home technology. These algorithms will be useful for automating remote health monitoring and interventions.

  18. Increased Kappa/Lambda Hybrid Antibody in Serum Is a Novel Biomarker Related to Disease Activity and Inflammation in Rheumatoid Arthritis.

    Science.gov (United States)

    Yi, Lang; Hao, Mingju; Lu, Tian; Lin, Guigao; Chen, Lida; Gao, Ming; Fan, Gaowei; Zhang, Dong; Wang, Guojing; Yang, Xin; Li, Yulong; Zhang, Kuo; Zhang, Rui; Han, Yanxi; Wang, Lunan; Li, Jinming

    2016-01-01

    The κ/λ hybrid antibodies in normal human serum were reported recently, but their clinical relevance has not yet been explored. Rheumatoid arthritis (RA) is one of the major joint diseases, and the early diagnosis and treatment of RA remain a challenge. Here, we developed a double-sandwich enzyme-linked immunosorbent assay system to quantify relative serum κ/λ hybrid antibody levels in RA patients, osteoarthritis (OA) patients, and healthy controls (HC) in order to assess their potential use as a serological biomarker of early disease and clinical activity and to preliminarily investigate their immunomodulatory roles in RA. Surprisingly, we found that κ/λ hybrid antibody was markedly increased in both early and established RA. Serum κ/λ hybrid antibody levels were significantly correlated with clinical indexes and inflammatory markers in RA. Further analysis showed a positive correlation between κ/λ hybrid antibody levels and the 28-joint disease activity score (DAS28). In conclusion, serum κ/λ hybrid antibodies in RA were identified for the first time. High levels of κ/λ hybrid antibody may be a useful tool in distinguishing early RA from OA and HC. We suggest κ/λ hybrid antibody as a marker for disease activity. The increased κ/λ hybrid antibodies were associated with inflammatory conditions in RA.

  19. Clinical outcomes assessment in clinical trials to assess treatment of femoroacetabular impingement

    DEFF Research Database (Denmark)

    Harris-Hayes, Marcie; McDonough, Christine M; Leunig, Michael

    2013-01-01

    Patient-reported outcome measures are an important component of outcomes assessment in clinical trials to assess the treatment of femoroacetabular impingement (FAI). This review of disease-specific measures and instruments used to assess the generic quality of life and physical activity levels...... developed recently and have not been established in the literature. Although currently used generic and activity-level measures have limitations, as well, they should be considered, depending on the specific goals of the study. Additional research is needed to assess the properties of these measures fully...

  20. Myeloperoxidase as an Active Disease Biomarker: Recent Biochemical and Pathological Perspectives.

    Science.gov (United States)

    Khan, Amjad A; Alsahli, Mohammed A; Rahmani, Arshad H

    2018-04-18

    Myeloperoxidase (MPO) belongs to the family of heme-containing peroxidases, produced mostly from polymorphonuclear neutrophils. The active enzyme (150 kDa) is the product of the MPO gene located on long arm of chromosome 17. The primary gene product undergoes several modifications, such as the removal of introns and signal peptides, and leads to the formation of enzymatically inactive glycosylated apoproMPO which complexes with chaperons, producing inactive proMPO by the insertion of a heme moiety. The active enzyme is a homodimer of heavy and light chain protomers. This enzyme is released into the extracellular fluid after oxidative stress and different inflammatory responses. Myeloperoxidase is the only type of peroxidase that uses H₂O₂ to oxidize several halides and pseudohalides to form different hypohalous acids. So, the antibacterial activities of MPO involve the production of reactive oxygen and reactive nitrogen species. Controlled MPO release at the site of infection is of prime importance for its efficient activities. Any uncontrolled degranulation exaggerates the inflammation and can also lead to tissue damage even in absence of inflammation. Several types of tissue injuries and the pathogenesis of several other major chronic diseases such as rheumatoid arthritis, cardiovascular diseases, liver diseases, diabetes, and cancer have been reported to be linked with MPO-derived oxidants. Thus, the enhanced level of MPO activity is one of the best diagnostic tools of inflammatory and oxidative stress biomarkers among these commonly-occurring diseases.

  1. Myeloperoxidase as an Active Disease Biomarker: Recent Biochemical and Pathological Perspectives

    Directory of Open Access Journals (Sweden)

    Amjad A. Khan

    2018-04-01

    Full Text Available Myeloperoxidase (MPO belongs to the family of heme-containing peroxidases, produced mostly from polymorphonuclear neutrophils. The active enzyme (150 kDa is the product of the MPO gene located on long arm of chromosome 17. The primary gene product undergoes several modifications, such as the removal of introns and signal peptides, and leads to the formation of enzymatically inactive glycosylated apoproMPO which complexes with chaperons, producing inactive proMPO by the insertion of a heme moiety. The active enzyme is a homodimer of heavy and light chain protomers. This enzyme is released into the extracellular fluid after oxidative stress and different inflammatory responses. Myeloperoxidase is the only type of peroxidase that uses H2O2 to oxidize several halides and pseudohalides to form different hypohalous acids. So, the antibacterial activities of MPO involve the production of reactive oxygen and reactive nitrogen species. Controlled MPO release at the site of infection is of prime importance for its efficient activities. Any uncontrolled degranulation exaggerates the inflammation and can also lead to tissue damage even in absence of inflammation. Several types of tissue injuries and the pathogenesis of several other major chronic diseases such as rheumatoid arthritis, cardiovascular diseases, liver diseases, diabetes, and cancer have been reported to be linked with MPO-derived oxidants. Thus, the enhanced level of MPO activity is one of the best diagnostic tools of inflammatory and oxidative stress biomarkers among these commonly-occurring diseases.

  2. CRED REA Coral Health and Disease Assessment at Guam, Marianas Archipelago in 2007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Coral health and disease assessments were conducted along 2 consecutively placed 25-m transects, as part of Rapid Ecological Assessments conducted at 10 sites at...

  3. Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA

    DEFF Research Database (Denmark)

    Sørensen, Jan; Primdahl, J; Horn, Hc

    2014-01-01

    per quality-adjusted life year (QALY) threshold, shared care and nurse care were cost-effective with more than 90% probability. Nurse care was cost-effective in comparison with shared care with 75% probability. Conclusions: Shared care and nurse care seem to cost less but provide broadly similar......Objectives: To compare the cost-effectiveness of three types of follow-up for outpatients with stable low-activity rheumatoid arthritis (RA). Method: In total, 287 patients were randomized to either planned rheumatologist consultations, shared care without planned consultations, or planned nurse...... consultations. Effectiveness measures included disease activity (Disease Activity Score based on 28 joint counts and C-reactive protein, DAS28-CRP), functional status (Health Assessment Questionnaire, HAQ), and health-related quality of life (EuroQol EQ-5D). Cost measures included activities in outpatient...

  4. Prognostic factors in pulmonary arterial hypertension: assessing the course of the disease

    Directory of Open Access Journals (Sweden)

    L.S. Howard

    2011-12-01

    Full Text Available The practical management of pulmonary arterial hypertension (PAH requires an accurate assessment of disease severity and prognosis. A number of prognostic indicators are known to be associated with patient outcome, and recent treatment guidelines advocate using such parameters to guide management decisions. Although PAH is characterised by the presence of pulmonary vasculopathy, it is the response of the right ventricle to an increased afterload that is the greatest determinant of a patient's symptoms and survival; thus, measurements that capture right ventricular function provide the best potential to assess PAH severity. One challenge is to understand how the tests we use in everyday clinical practice relate to right heart function in PAH patients, and how current measures can be improved and developed to optimise assessment of disease status and progress. Future research in the field of PAH should focus on how best to assess right heart function, and which measures or combination of measures provide the most relevant information for the individual patient.

  5. Prevalence of chronic diseases and use of medicines among elders who practice supervised physical activity

    Directory of Open Access Journals (Sweden)

    Francisco Tiago Ricarte Gonçalves

    2014-05-01

    Full Text Available Objective: To assess the prevalence of chronic diseases and use of medicines among elders who practice supervised physical activity. Methods: The study was conducted from September to October 2011 with 148 individuals, aged over 60 years, women (N =109 and men (N = 39 who practiced supervised physical activity, divided into Group 1– water aerobics, Group 2 - weight training, and Group 3 - gymnastics / walking. It was used a questionnaire with general questions (gender, age, type of exercise and closedended questions about health problems and use of medicines. Descriptive statistics (mean and standard deviation, absolute and relative frequency, and Chi-Square test were used for data analysis with a significance level of p <0.05. Results: There was a high prevalence of diseases of the metabolic, endocrine, cardiovascular and musculoskeletal systems among women in the three groups. There was a higher prevalence of musculoskeletal disorders among men in the three groups. Regarding the use of medicines, all groups presented a higher prevalence of antihypertensive medication use by both genders. Conclusion: There was no significant difference (for both genders in the prevalence of self-reported chronic diseases affecting organ systems among the groups of elders who practiced physical exercise. There was a high prevalence of elders affected by disorders relating to the musculoskeletalsystem and use of antihypertensive medication. doi:10.5020/18061230.2013.p372

  6. Mycobacterium tuberculosis: Active disease and latent infection in a renal transplant cohort.

    Science.gov (United States)

    Rafiei, Nastaran; Williams, Jackie; Mulley, William R; Trauer, James M; Jenkin, Grant A; Rogers, Benjamin A

    2018-04-16

    Tuberculosis (TB) is a serious opportunistic infection in renal transplant recipients associated with high mortality. Screening and treatment of latent Mycobacterium tuberculosis infection (LTBI) offers an opportunity to prevent subsequent active disease. We retrospectively reviewed the records of all adult patients who underwent renal transplantation at our centre from 2005 to 2014 to assess current screening practices, the risks for and burden of active TB. A total of 660 individuals underwent renal transplantation during this period, totalling 3647 person years of follow up. Three patients were diagnosed with active TB after renal transplant, resulting in an incidence of 82 per 100,000 person-years. Of 656 transplant recipients, 102 (15.5%) were born in high TB incidence countries and 89 (13.5%) had an interferon gamma release assay (IGRA) at any point. Individuals born in high TB risk countries had a much higher incidence of active TB (530 per 100,000 person-years). Ten individuals had positive IGRA tests, of whom two were treated for active TB, two received chemoprophylaxis and six were not treated. In the absence of formal guidelines, IGRA-based screening for LTBI was infrequently performed. Our data suggests that screening and treatment of renal transplant recipients born in high incidence countries is an important preventive measure. This article is protected by copyright. All rights reserved.

  7. [Quality assessment program of the Spanish Society of Infectious Diseases and Clinical Microbiology. Analysis of results. 2005].

    Science.gov (United States)

    Orta Mira, Nieves; Guna Serrano, M del Remedio; Pérez, José L; Gimeno Cardona, Concepción

    2006-10-01

    Quality assurance of the analytical processes performed at the clinical microbiology laboratory is mandatory and should be carried out by using external and internal quality control activities. External quality assessment programs allow intercomparison within laboratories, detection of errors, and evaluation of the suitability of some reagents or diagnostic kits for the purpose for which they were designed; these activities are also useful for continuous education. The program launched 15 years ago by the Spanish Society of Infectious Diseases and Clinical Microbiology is based on sending typified materials along with a clinical and microbiological case related to these control materials. The spectrum of the samples is broad, including bacteriology (monthly and three-monthly), serology, mycology, parasitology, mycobacteria, virology, and molecular microbiology. After receiving the results from the participants, the program organization delivers an individual certificate comparing the results with those of a reference laboratory. Additionally, a report is generated by analyzing all the results sent by the participants; laboratories are also sent review articles on the subject of each assessment as a tool for continuous education in clinical microbiology. In this article, the most relevant conclusions and lessons from the 2005 assessments are presented.

  8. Analysis of correlations between selected endothelial cell activation markers, disease activity, and nailfold capillaroscopy microvascular changes in systemic lupus erythematosus patients.

    Science.gov (United States)

    Ciołkiewicz, Mariusz; Kuryliszyn-Moskal, Anna; Klimiuk, Piotr Adrian

    2010-02-01

    The aim of the study was to evaluate the correlation between selected serum endothelial cell activation markers such as vascular endothelial growth factor (VEGF), endothelin-1 (ET-1), soluble thrombomodulin (sTM), soluble E-selectin (sE-selectin), disease activity, and microvascular changes determined by nailfold capillaroscopy in patients with systemic lupus erythematosus (SLE). Serum levels of VEGF, ET-1, sTM, and sE-selectin were determined by an enzyme-linked immunosorbent assay in 80 SLE patients. The disease activity was measured with Systemic Lupus Erythematosus Disease Activity Index score. Nailfold capillaroscopy was performed in all patients. Positive correlation was found between VEGF and both ET-1 (r = 0.294, p nailfold capillaroscopy (r = 0.458, p nailfold capillaroscopy. The relationship between changes in nailfold capillaroscopy, endothelial cell activation markers, and the clinical activity of SLE points to an important role of microvascular abnormalities in the clinical manifestation of the disease.

  9. A Critical Assessment of Research on Neurotransmitters in Alzheimer’s Disease

    Science.gov (United States)

    Reddy, P. Hemachandra

    2018-01-01

    The purpose of this mini-forum, “Neurotransmitters and Alzheimer’s Disease”, is to critically assess the current status of neurotransmitters in Alzheimer’s disease. Neurotransmitters are essential neurochemicals that maintain synaptic and cognitive functions in mammals, including humans, by sending signals across pre- to post-synaptic neurons. Authorities in the fields of synapses and neurotransmitters of Alzheimer’s disease summarize the current status of basic biology of synapses and neurotransmitters, and also update the current status of clinical trials of neurotransmitters in Alzheimer’s disease. This article discusses the prevalence, economic impact, and stages of Alzheimer’s dementia in humans. PMID:28409748

  10. Active ingredients of ginger as potential candidates in the prevention and treatment of diseases via modulation of biological activities

    Science.gov (United States)

    Rahmani, Arshad H; shabrmi, Fahad M Al; Aly, Salah M

    2014-01-01

    The current mode of treatment based on synthetic drugs is expensive and also causes genetic and metabolic alterations. However, safe and sound mode of treatment is needed to control the diseases development and progression. In this regards, medicinal plant and its constituents play an important role in diseases management via modulation of biological activities. Ginger, the rhizome of the Zingiber officinale, has shown therapeutic role in the health management since ancient time and considered as potential chemopreventive agent. Numerous studies based on clinical trials and animal model has shown that ginger and its constituents shows significant role in the prevention of diseases via modulation of genetic and metabolic activities. In this review, we focused on the therapeutics effects of ginger and its constituents in the diseases management, and its impact on genetic and metabolic activities. PMID:25057339

  11. Imaging movement-related activity in medicated Parkin-associated and sporadic Parkinson's disease

    DEFF Research Database (Denmark)

    van Eimeren, Thilo; Binkofski, Ferdinand; Buhmann, Carsten

    2010-01-01

    Treatment-related motor complications such as dyskinesias are a major problem in the long-term management of Parkinson's disease (PD). In sporadic PD, a relatively early onset of the disease is known to be associated with an early development of dyskinesias. Although linked with early onset...... selected movements. Patients with Parkin-associated and sporadic PD showed no difference in movement-related activation patterns. Moreover, the covariates 'age' and 'disease duration' similarly influenced brain activation in both patient groups. The present finding suggests that a stable long-term motor...

  12. Does Cueing Training Improve Physical Activity in Patients With Parkinson's Disease?

    NARCIS (Netherlands)

    Lim-de Vries, L.I.I.K.; van Wegen, E.E.H.; Jones, D.; Rochester, L.; Nieuwboer, A.; Willems, A.M.; Baker, K.; Hetherington, V.; Kwakkel, G.

    2010-01-01

    Background. Patients with Parkinson's disease (PD) are encouraged to stay active to maintain their mobility. Ambulatory activity monitoring (AM) provides an objective way to determine type and amount of gait-related daily activities. Objective. To investigate the effects of a home cueing training

  13. Exploring Formative Assessment Using Cultural Historical Activity Theory

    Directory of Open Access Journals (Sweden)

    Mandy Asghar

    2013-02-01

    Full Text Available Formative assessment is a pedagogic practice that has been the subject of much research and debate, as to how it can be used most effectively to deliver enhanced student learning in the higher education setting. Often described as a complex concept it embraces activities that range from facilitating students understanding of assessment standards, to providing formative feedback on their work; from very informal opportunities of engaging in conversations, to the very formal process of submitting drafts of work. This study aims to show how cultural historical activity theory can be used as a qualitative analysis framework to explore the complexities of formative assessment as it is used in higher education. The original data for the research was collected in 2008 by semi structured interviews and analysed using a hermeneutic phenomenological approach. For this present paper three selected transcripts were re-examined, using a case study approach that sought to understand and compare the perceptions of five academic staff, from three distinct subject areas taught within a UK university. It is proposed that using activity theory can provide insight into the complexity of such experiences, about what teachers do and why, and the influence of the community in which they are situated. Individually the cases from each subject area were analysed using activity theory exploring how the mediating artefacts of formative assessment were used; the often implicit rules that governed their use and the roles of teachers and students within the local subject community. The analysis also considered the influence each aspect of the unit of activity had on the other in understanding formative assessment practice. Subsequently the three subject cases were compared and contrasted. The findings illuminate a variety of practices, including how students and staff engage together in formative assessment activities and for some, how dialogue is used as one of the key tools

  14. Parent knowledge of disease management in cystic fibrosis: Assessing behavioral treatment management.

    Science.gov (United States)

    Nicolais, Christina J; Bernstein, Ruth; Riekert, Kristin A; Quittner, Alexandra L

    2018-02-01

    Cystic fibrosis (CF) is a life-shortening, burdensome disease requiring complex knowledge to manage the disease. Significant gaps in knowledge have been documented for parents, which may lead to unintentionally poor adherence and insufficient transfer of treatment responsibility from parents to adolescents. There are no current, validated measures of parent knowledge for this population and there are no measures that assess the knowledge required for day-to-day behavioral management of CF. We assessed the psychometric properties of the parent version of the Knowledge of Disease Management-Cystic Fibrosis measure (KDM-CF-P) using data from iCARE (I Change Adherence and Raise Expectations), a randomized control adherence intervention trial. A total of 196 parents in the iCARE standard care/control arm completed 35 items assessing their knowledge of disease management at their 12-month study visit, prior to beginning the intervention. Items were eliminated from the measure if they met the threshold for ceiling effects, were deemed clinically irrelevant, or did not correlate well with their intended scale. Item-to-total correlations, confirmatory factor analysis, discriminant function, reliability, and convergent validity were calculated. The KDM-CF-P (19 items) demonstrated internal consistency of KR20 = 0.60 on each scale and a two-scale structure. Convergent validity for knowledge scores was found with maternal education, family income, and type of medical insurance. Parents correctly answered approximately 85% of items on the KDM-CF-P. The KDM-CF-P psychometrics support a two-scale measure with clinical utility. It is useful for assessing gaps in knowledge that can be remediated through individualized, tailored interventions. © 2017 Wiley Periodicals, Inc.

  15. Validation and clinical significance of the Childhood Myositis Assessment Scale for assessment of muscle function in the juvenile idiopathic inflammatory myopathies.

    Science.gov (United States)

    Huber, Adam M; Feldman, Brian M; Rennebohm, Robert M; Hicks, Jeanne E; Lindsley, Carol B; Perez, Maria D; Zemel, Lawrence S; Wallace, Carol A; Ballinger, Susan H; Passo, Murray H; Reed, Ann M; Summers, Ronald M; White, Patience H; Katona, Ildy M; Miller, Frederick W; Lachenbruch, Peter A; Rider, Lisa G

    2004-05-01

    To examine the measurement characteristics of the Childhood Myositis Assessment Scale (CMAS) in children with juvenile idiopathic inflammatory myopathy (juvenile IIM), and to obtain preliminary data on the clinical significance of CMAS scores. One hundred eight children with juvenile IIM were evaluated on 2 occasions, 7-9 months apart, using various measures of physical function, strength, and disease activity. Interrater reliability, construct validity, and responsiveness of the CMAS were examined. The minimum clinically important difference (MID) and CMAS scores corresponding to various degrees of physical disability were estimated. The intraclass correlation coefficient for 26 patients assessed by 2 examiners was 0.89, indicating very good interrater reliability. The CMAS score correlated highly with the Childhood Health Assessment Questionnaire (C-HAQ) score and with findings on manual muscle testing (MMT) (r(s) = -0.73 and 0.73, respectively) and moderately with physician-assessed global disease activity and skin activity, parent-assessed global disease severity, and muscle magnetic resonance imaging (r(s) = -0.44 to -0.61), thereby demonstrating good construct validity. The standardized response mean was 0.81 (95% confidence interval 0.53, 1.09) in patients with at least 0.8 cm improvement on a 10-cm visual analog scale for physician-assessed global disease activity, indicating strong responsiveness. In bivariate regression models predicting physician-assessed global disease activity, MMT remained significant in models containing the CMAS (P = 0.03) while the C-HAQ did not (P = 0.4). Estimates of the MID ranged from 1.5 to 3.0 points on a 0-52-point scale. CMAS scores corresponding to no, mild, mild-to-moderate, and moderate physical disability, respectively, were 48, 45, 39, and 30. The CMAS exhibits good reliability, construct validity, and responsiveness, and is therefore a valid instrument for the assessment of physical function, muscle strength, and

  16. Non-perforating small bowel Crohn's disease assessed by MRI enterography: Derivation and histopathological validation of an MR-based activity index

    International Nuclear Information System (INIS)

    Steward, Michael J.; Punwani, Shonit; Proctor, Ian; Adjei-Gyamfi, Yvette; Chatterjee, Fiona; Bloom, Stuart; Novelli, Marco; Halligan, Steve; Rodriguez-Justo, Manuel

    2012-01-01

    Objectives: To develop and validate a qualitative scoring system for enteric Crohn's disease activity using MR enterography (MRE). Methods: MRE was performed in 16 patients (mean age 33, 8 male) undergoing small bowel resection. Mural thickness, T2 signal, contrast enhancement, and perimural oedema were scored qualitatively (0–3) at 44 locations. Transmural histopathological scoring of acute inflammation (AIS) was performed at all locations (score 0–13). MRI parameters best predicting AIS were derived using multivariate analysis. The MRI activity index was applied to 26 Crohn's patients (mean age 32, range 13–69 years, 15 male) and correlated to terminal ileal biopsy scores of acute inflammation (“eAIS” score 1–6). Receiver operator characteristic curves were calculated. Results: Mural thickness (coefficient 1.34 (95% CI 0.36, 2.32)], p = 0.007) and T2 signal (coefficient 0.90 (95% CI −0.24, 2.04) p = 0.06) best predicted AIS (AIS = 1.79 + 1.34*mural thickness + 0.94*mural T2 score [R-squared 0.52]). There was a significant correlation between the MRI index and eAIS (Kendall's tau = 0.40, 95% CI 0.11–0.64, p = 0.02). The model achieved a sensitivity of 0.81 (95% CI 0.54–0.96), specificity of 0.70 (0.35–0.93) and AUC 0.77 for predicting acute inflammation (eAIS ≥2). Conclusions: A simple qualitative MRI Crohn's disease activity score appears predictive against a histopathological standard of reference

  17. Mechanisms of physical activity limitation in chronic lung diseases.

    Science.gov (United States)

    Vogiatzis, Ioannis; Zakynthinos, George; Andrianopoulos, Vasileios

    2012-01-01

    In chronic lung diseases physical activity limitation is multifactorial involving respiratory, hemodynamic, and peripheral muscle abnormalities. The mechanisms of limitation discussed in this paper relate to (i) the imbalance between ventilatory capacity and demand, (ii) the imbalance between energy demand and supply to working respiratory and peripheral muscles, and (iii) the factors that induce peripheral muscle dysfunction. In practice, intolerable exertional symptoms (i.e., dyspnea) and/or leg discomfort are the main symptoms that limit physical performance in patients with chronic lung diseases. Furthermore, the reduced capacity for physical work and the adoption of a sedentary lifestyle, in an attempt to avoid breathlessness upon physical exertion, cause profound muscle deconditioning which in turn leads to disability and loss of functional independence. Accordingly, physical inactivity is an important component of worsening the patients' quality of life and contributes importantly to poor prognosis. Identifying the factors which prevent a patient with lung disease to easily carry out activities of daily living provides a unique as well as important perspective for the choice of the appropriate therapeutic strategy.

  18. Mechanisms of Physical Activity Limitation in Chronic Lung Diseases

    Directory of Open Access Journals (Sweden)

    Ioannis Vogiatzis

    2012-01-01

    Full Text Available In chronic lung diseases physical activity limitation is multifactorial involving respiratory, hemodynamic, and peripheral muscle abnormalities. The mechanisms of limitation discussed in this paper relate to (i the imbalance between ventilatory capacity and demand, (ii the imbalance between energy demand and supply to working respiratory and peripheral muscles, and (iii the factors that induce peripheral muscle dysfunction. In practice, intolerable exertional symptoms (i.e., dyspnea and/or leg discomfort are the main symptoms that limit physical performance in patients with chronic lung diseases. Furthermore, the reduced capacity for physical work and the adoption of a sedentary lifestyle, in an attempt to avoid breathlessness upon physical exertion, cause profound muscle deconditioning which in turn leads to disability and loss of functional independence. Accordingly, physical inactivity is an important component of worsening the patients’ quality of life and contributes importantly to poor prognosis. Identifying the factors which prevent a patient with lung disease to easily carry out activities of daily living provides a unique as well as important perspective for the choice of the appropriate therapeutic strategy.

  19. Subclinical atherosclerosis in young patients with rheumatoid arthritis and low disease activity

    Directory of Open Access Journals (Sweden)

    F. Ragni Alunni

    2011-09-01

    Full Text Available Background: There is an increasing body of evidence suggesting that subjects with rheumatoid arthritis (RA are characterized by acceleration of atherosclerotic process of arterial wall. However, all investigations performed so far to evaluate subclinical atherosclerosis in RA included subjects without selection for age and degree of disease activity that may represent confounding factors in such an evaluation. Objectives: To verify signs of accelerated subclinical atherosclerosis in young subject suffering from RA but with low disease activity. Methods: Thirty-two patients with RA and 28 age- and sex-matched control subjects with non-inflammatory rheumatic diseases were enrolled. Inclusion criteria were age less than 60 and low disease activity with score £3.2 according to DAS28, while subjects with traditional risk factors for and/or overt cardiovascular disease were ruled out from the study. Both patients and controls underwent evaluation of carotid and femoral artery intima-media thickness by ultrasounds. Results: Patients had higher intima-media thickness than controls of all the sites evaluated at carodit artery level, whereas there were no differences at the comparison of the superficial and common femoral artery wall. At the univariate analysis, a positive correlation between LDL cholesterol levels and intima-media thickness at the carotid bifurcation was found. Conclusions: Young patients with RA and low disease activity have acceleration of atherosclerosis development as shown by increased intima-media thickness of carotid artery with respect to subjects without inflammatory rheumatic disease. It is conceivable that the organic damage of arterial wall could be the result of persistent endothelial dysfunction induced by chronic inflammation and immune dysregulation which characterize RA.

  20. Natalizumab stabilizes physical, cognitive, MRI, and OCT markers of disease activity: A prospective, non-randomized pilot study.

    Directory of Open Access Journals (Sweden)

    Garrick D Talmage

    Full Text Available Natalizumab is an effective therapy for multiple sclerosis (MS. Its effectiveness has been demonstrated in several clinical and imaging studies. The objective of this study was to further demonstrate the efficacy of natalizumab using a comprehensive battery of clinical and imaging markers in the same cohort of patients followed longitudinally, hence capturing the multi-faceted nature of the MS disease process. A prospective, open-label, pilot study of 20 MS patients treated with natalizumab was conducted. High resolution MRI, Symbol-Digit Modalities Test (SDMT, and Optical Coherence Tomography (OCT scans were obtained at baseline, 48, and 96 weeks. 15 patients completed the study. Natalizumab treatment decreased Expanded Disability Status Scale score (EDSS and no change in SDMT, Brain Parenchymal Fraction (BPF, or any of the OCT markers of retinal degeneration was observed. Thalamic and whole brain volume as assessed by Percentage Brain Volume Change (PBVC showed continuous deterioration. Higher baseline T2 lesion load correlated with increased rate of PBVC at 96-weeks (r = 0.566, R2 = 0.320, p = 0.035 and thalamic volume loss (r = -0.586, R2 = 0.344, p = 0.027. Most patients, 93%, achieved no evidence of disease activity (NEDA at 2 years, likely due to early disease duration and lower initial baseline lesion load. This study further demonstrates stabilization of clinical and imaging markers of disease activity during natalizumab treatment.