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Afin d'évaluer l'adhésion des patients souffrant de rhumatismes inflammatoires chroniques (RIC) à leurs traitements, de nombreux auto-questionnaires existent dont celui dédié et validé par la British Society of Rheumatology, le Compliance Questionnaire for Rheumatology (CQR) à 19 questions. Dans un souci de facilité et de rapidité d'utilisation en pratique clinique, a été développée et validée une version à 5 items (CQR-5) permettant de définir soit un profil hautement adhérent soit faiblement adhérent. L'objectif de cette étude a été de traduire et valider la traduction française du CQR-5 en suivant les recommandations internationales [1]. Une étude observationnelle et monocentrique a été menée chez des patients atteints de RIC ayant eu une consultation médicale en rhumatologie entre mai 2019 et avril 2020. Les patients inclus étaient traités par un biomédicament sous forme sous-cutanée depuis au moins 3 mois. Les patients ont été invités à compléter en ligne deux fois le questionnaire CQR-5 ainsi que le questionnaire Routine Assessment of Patient Index Data 3 (RAPID3) à sept jours d'intervalle pour s'assurer de la stabilité de la maladie. L'adhésion des patients a été aussi évaluée grâce au Medication Possession Ratio (MPR) sur une période de 6 mois (juillet 2020 à janvier 2021) par un appel au pharmacien d'officine déclaré préalablement par le patient. La validité du CQR-5 a été évaluée par le coefficient α de Cronbach, par la méthode du test-retest à 7 jours et par la comparaison au MPR en utilisant le coefficient de corrélation de Mathews. Au total, 92 patients ont été inclus (moyenne d'âge : 47,5 ± 13,6 ans et 56,5 % de femmes). Les patients étaient atteints de spondyloarthrite (75 %), de polyarthrite rhumatoïde (23,9 %) ou d'arthrite juvénile (1,1 %). Parmi les biomédicaments, les anticorps monoclonaux anti TNF-α étaient prescrits chez 78,3 % des patients. Selon le CQR-5 français, 81,5 % (n = 75) des patients étaient hautement adhérents. Selon le MPR, 79 % des patients étaient hautement adhérents. Selon le MPR, la sensibilité et la spécificité du CQR-5 étaient respectivement de 85 % et 32 % (corrélation : 0,17). La consistance interne du CQR-5 français est fiable (α Cronbach : 0,74 ; IC95 % :0,66-0,83), a une seule dimension (les 5 items explorent bien un seul concept : l'adhésion) et est reproductible (Kappa : 0,82 (95 %CI 0,51-0,96)). La faible spécificité de la version française par rapport au MPR peut être expliquée par la période de recueil de données (la pandémie COVID19 ayant entraîné des suspensions de biomédicament) et par l'espacement médicalement autorisé des injections par les patients, ce qui a contribué à sous-estimer le MPR. La traduction française du CQR-5 est un outil pratique, rapide et reproductible en pratique clinique comme outil d'évaluation de l'adhésion aux biomédicaments chez les patients atteints de RIC. [ABSTRACT FROM AUTHOR]

Background: Cardiopulmonary-bypass (CPB) induces hyperglycemia. There is growing evidence that perioperative maintenance of blood glucose within the physiological range improves patients' outcome. Nevertheless, perioperative normoglycemia is often difficult to achieve during surgery with CPB and the response to insulin infusion is characterized by a considerable variability. The aim of this study was to determine to what extent the presence of pre-operative metabolic syndrome (MS) influences the blood glucose and insulin response during cardiac surgery. Methods: Forty-five patients scheduled for elective cardiac surgery were screened for the presence of MS according to the International Diabetes Federation definition. Patients were then assigned to two groups: those with metabolic syndrome (MSP) and those without (control). During surgery, blood glucose levels were measured in all patients and hyperglycemia was treated with a standard protocol of continuous insulin infusion. Results: The mean blood glucose levels during CPB increased only in the MSP group ( P<0.001). Mean blood glucose in control patients did not increase during CPB ( P=0.4). Patients with MS received 13.3±8.4 IU of insulin during CPB, while the control group did not require insulin treatment ( P<0.001). Forty percent of patients in the control group and 100% of those in the MSP group developed post-operative insulin resistance. C-reactive protein was higher in the MSP group before, during and at 48 h after surgery. Conclusions: The mean blood glucose levels during CPB increased only in patients with MS, while they remained unchanged in patients in the control group. [ABSTRACT FROM AUTHOR]

Reciprocal chromosome painting between mouse and rat using complete chromosome probe sets of both species permitted us to assign the chromosomal homology between these rodents. The comparative gene mapping data and chromosome painting have a better than 90% correspondence. The reciprocal painting results graphically show that mouse and rat have strikingly different karyotypes. At least 14 translocations have occurred in the 10–20 million years of evolution that separates these two species. The evolutionary rate of chromosome translocations between these two rodents appears to be up to 10 times greater than that found between humans and cats, or between humans and chimpanzees, where over the last 5–6 million years just one translocation has occurred. Outgroup comparison shows that the mouse genome has incorporated at least three times the amount of interchromosomal rearrangements compared to the rat genome. The utility of chromosome painting was also illustrated by the assignment of two new chromosome homologies between rat and mouse unsuspected by gene mapping: between mouse 11 and rat 20 and between mouse 17 and rat 6. We conclude that reciprocal chromosome painting is a powerful method, which can be used with confidence to chart the genome and predict the chromosome location of genes. Reciprocal painting combined with gene mapping data will allow the construction of large-scale comparative chromosome maps between placental mammals and perhaps other animals. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is widely identified as the most common cause of sporadic dementia. Its aetiology is still debated, as despite several hypotheses, different factors seem to play a role in its establishment and development. Recent studies have proposed a possible preventing role of nutrition. The weight loss typical of earlier phase of disease and the finding of malnutrition as a common trait between patients leads to hypothesize that a supplementation of specific nutrients seems to be useful and effective in terms of improvement of cognitive functions. Malnourished patients show also altered parameters when investigating inflammation markers: for example, hyperhomocysteinemia is a typical finding in elderly affected by dementia, and it can be prevented and corrected by using a proper nutrients supplementation. Pro-inflammatory state can be reduced with supplementation of polyunsaturated fatty acids, vitamins of the group B and phosphatidylserine, that can act reducing IL-1β (pro-inflammatory cytokine) and improving IL-10 (anti-inflammatory cytokine) synthesis. While investigating the role of nutrition, it seems to be deeply linked with genetic; a genetic onset AD-related could be latent and can be influenced by nutritional attitude. AD can be considered a sort of latent clinical condition that would disclose or not, depending also on micro-environment and nutritional parameters. The genetic expression can be influenced by assumptions or not of specific nutrients, with the promotion of different pro- or anti-inflammatory settings. The specific role of each micronutrient (in particular vitamins) and trace elements still needs to be punctuated, as they are involved in a pool of different reactions. Also genes acts not independently but in an interconnected pattern, in which the role of a single gene needs to be cleared, depending on others. This complex system of predisposing conditions and a possible role of nutrition as modulator of the inflammatory state is the object of this review. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To assess the effects of rocking motion on labour pain and before epidural catheter insertion. Study design: Clinical prospective observational study. Patients and methods: Pain scores (numerical scale: 0–10) were recorded in 50 laboring women in three consecutive positions: lying down, sitting and then rocking back and forth while seated. The overall satisfaction (0–10) and any comment related to the rocking procedure were also recorded. Results: One woman refused to rock during the procedure and five alternated moving and still periods. Pain scores were similar in the lying (8.1 ± 1.8) and sitting position (8.0 ± 1.8), whereas they significantly decreased while rocking (6.6 ± 1.7; p < 0.001 versus both lying and sitting still positions). Satisfaction associated with rocking chair motion was high (8.9 ± 1.4). Discussion: Within the limits of an observational and preliminary study, we observed that rocking motion during the procedure was associated with a significant decrease in labour pain and that patient satisfaction was high. Several hypotheses are proposed to explain these effects, i.e. patient''s involvement in an action that focuses attention, loss of parturient''s landmarks and stimulation of the vestibular system which might lead to a change in the cognitive perception of the body. [Copyright &y& Elsevier]