Chemical defense of an Asian snake reflects local availability of toxic prey and hatchling diet

Species that sequester toxins from prey for their own defense against predators may exhibit population-level variation in their chemical arsenal that reflects the availability of chemically defended prey in their habitat. Rhabdophis tigrinus is an Asian snake that possesses defensive glands in the skin of its neck (‘nuchal glands’), which typically contain toxic bufadienolide steroids that the snakes sequester from consumed toads. In this study, we compared the chemistry of the nuchal gland fluid of R. tigrinus from toad-rich and toad-free islands in Japan and determined the effect of diet on the nuchal gland constituents. Our findings demonstrate that captive-hatched juveniles from toad-rich Ishima Island that had not been fed toads possess defensive bufadienolides in their nuchal glands, presumably due to maternal provisioning of these sequestered compounds. Wild-caught juveniles from Ishima possess large quantities of bufadienolides, which could result from a combination of maternal provisioning and sequestration of these defensive compounds from consumed toads. Interestingly, juvenile females from Ishima possess larger quantities of bufadienolides than do juvenile males, whereas a small sample of field-collected snakes suggests that adult males contain larger quantities of bufadienolides than do adult females. Captive-born hatchlings from Kinkasan Island lack bufadienolides in their nuchal glands, reflecting the absence of toads on that island, but they can sequester bufadienolides by feeding on toads (Bufo japonicus) in captivity. The presence of large quantities of bufadienolides in the nuchal glands of R. tigrinus from Ishima may reduce the risk of predation by providing an effective chemical defense, whereas snakes on Kinkasan may experience increased predation due to the lack of defensive compounds in their nuchal glands.

Vertebral subchondral bone

Vertebral subchondral bone, also known as bony or osseous endplate, is an important anatomical part of the spine, including cartilage endplate and intervertebral disk. Vertebral subchondral bone plays a critical role in spinal function and maintenance of intervertebral disk health. Recent data suggest that some vertebral subchondral bone changes, detected by MRI and described as Modic changes, may be specifically associated with degenerative disk disease and chronic low back pain, and that these changes may be related to local inflammation. Thus, Modic changes may be a useful imaging biomarker to identify particular sub-groups of patients with chronic low back pain for whom a link between pathoanatomy, namely vertebral subchondral bone alterations, and pain can be established. Such identification may give rise to develop more specific therapies targeting, for example, inflammatory changes involving vertebral subchondral bone in Modic change-associated non-specific chronic low back pain.

An analysis of Q fever patients 6 years after an outbreak in Newport, Wales, UK

BACKGROUND

A cohort of 211 factory workers was exposed to a point source of Q fever in 2002. A total of 38 cases and 14 controls took part in a follow-up study 6 years after the outbreak.

AIM

To compare Q fever serology, the presence of viable Coxiella burnetii, its DNA and fatigue between patients and controls.

DESIGN

Laboratory case study.

METHODS

Q fever serology was by microimmunofluroescence. Viable C. burnetii was detected by VERO cell culture and SCID mice inoculation with patient blood samples. Coxiella burnetii DNA was detected by qPCR (com1 gene) on patients' PBMC and on VERO cultures after 6 weeks incubation. Fatigue was measured by the Chalder Fatigue Scale.

RESULT

At 6 years after the outbreak, 7 of the 38 patients had become seronegative and 4 of the 14 of the controls had become seropositive for Q fever. None of the patient/control peripheral blood mononuclear cells (PBMC) contained viable C. burnetii by VERO cell culture or by SCID mouse inoculation (death or splenomegaly) and none contained C. burnetii DNA by qPCR.

CONCLUSION

Six years after acute Q fever, some patients had become seronegative but none contained viable C. burnetii or its DNA in their PBMC.

Responder and nonresponder patients exhibit different peripheral transcriptional signatures during major depressive episode

To date, it remains impossible to guarantee that short-term treatment given to a patient suffering from a major depressive episode (MDE) will improve long-term efficacy. Objective biological measurements and biomarkers that could help in predicting the clinical evolution of MDE are still warranted. To better understand the reason nearly half of MDE patients respond poorly to current antidepressive treatments, we examined the gene expression profile of peripheral blood samples collected from 16 severe MDE patients and 13 matched controls. Using a naturalistic and longitudinal design, we ascertained mRNA and microRNA (miRNA) expression at baseline, 2 and 8 weeks later. On a genome-wide scale, we detected transcripts with roles in various biological processes as significantly dysregulated between MDE patients and controls, notably those involved in nucleotide binding and chromatin assembly. We also established putative interactions between dysregulated mRNAs and miRNAs that may contribute to MDE physiopathology. We selected a set of mRNA candidates for quantitative reverse transcriptase PCR (RT-qPCR) to validate that the transcriptional signatures observed in responders is different from nonresponders. Furthermore, we identified a combination of four mRNAs (PPT1, TNF, IL1B and HIST1H1E) that could be predictive of treatment response. Altogether, these results highlight the importance of studies investigating the tight relationship between peripheral transcriptional changes and the dynamic clinical progression of MDE patients to provide biomarkers of MDE evolution and prognosis.

Intracellular calcium oscillations in articular chondrocytes induced by basic calcium phosphate crystals lead to cartilage degradation

OBJECTIVE

Basic calcium phosphate (BCP) crystals, including octacalcium phosphate (OCP), carbonated-apatite (CA) and hydroxyapatite (HA) crystals are associated with destructive forms of osteoarthritis. Mechanisms of BCP-induced cartilage breakdown remain incompletely understood. We assessed the ability of BCP to induce changes in intracellular calcium (iCa(2+)) content and oscillations and the role of iCa(2+) in BCP-induced cartilage degradation.

METHODS

Bovine articular chondrocytes (BACs) and bovine cartilage explants (BCEs) were stimulated with BCP or monosodium urate (MSU) crystals. iCa(2+) levels were determined by spectrofluorimetry and oscillations by confocal microscopy. mRNA expression of matrix metalloproteinase 3 (MMP-3), a disintegrin and metalloprotease with thrombospondin-like motifs 4 (ADAMTS-4) and ADAMTS-5 was assessed by quantitative real-time PCR. Glycosaminoglycan (GAG) release was measured in the supernatants of BCE cultures.

RESULTS

All three BCP crystals significantly increased iCa(2+) content. OCP also induced iCa(2+) oscillations. Rate of BACs displaying iCa(2+) oscillations increased over time, with a peak after 20 min of stimulation. OCP-induced iCa(2+) oscillations involved both extracellular Ca(2+) (eCa(2+)) influx and iCa(2+) stores. Indeed, OCP-induced iCa(2+) oscillations decreased rapidly in Ca(2+)-free medium. Both voltage- and non-voltage-dependent Ca(2+) channels were involved in eCa(2+) influx. BCP crystal-induced variation in iCa(2+) content was associated with BCP crystal-induced cartilage matrix degradation. However, iCa²(+) was not associated with OCP crystal-induced mRNA expression of MMP-3, ADAMTS-4 or ADAMTS-5.

CONCLUSION

BCP crystals can induce variation in iCa(2+) content and oscillations in articular chondrocytes. Furthermore, BCP crystal-induced changes in iCa(2+) content play a pivotal role in BCP catabolic effects on articular cartilage.

Safety and pharmacokinetics of aciclovir in women following release from a silicone elastomer vaginal ring

OBJECTIVES

Systemic aciclovir and its prodrug valaciclovir are effective in treating and reducing recurrences of genital herpes simplex virus (HSV) and reducing transmission. Local aciclovir delivery, if it can achieve and maintain comparable intracellular genital tract levels, may be equally effective in the treatment and suppression of genital HSV. Intravaginal ring (IVR) delivery of aciclovir may provide pre-exposure prophylaxis against HSV acquisition.

METHODS

Tolerability and pharmacokinetics were evaluated in six HIV-negative women with recurrent genital HSV who switched their daily oral valaciclovir suppression to an aciclovir IVR for 7 days (n = 3) or 14 days (n = 3). Blood and cervicovaginal lavage (CVL) were collected after oral and IVR dosing to measure aciclovir concentrations and genital swabs were obtained to quantify HSV shedding by PCR.

RESULTS

The rings were well tolerated. Median plasma aciclovir concentrations were 110.2 ng/mL (IQR, 85.9-233.5) 12-18 h after oral valaciclovir. Little or no drug was detected in plasma following IVR dosing. Median (IQR) CVL aciclovir levels were 127.3 ng/mL (21-660.8) 2 h after oral valaciclovir, 154.4 ng/mL (60.7-327.5) 12-18 h after oral valaciclovir and 438 ng/mL (178.5-618.5) after 7 days and 393 ng/mL (31.6-1615) after 14 days of aciclovir ring use. Median CVL aciclovir levels 2 h after oral dosing were similar to levels observed 7 (P = 0.99) and 14 (P = 0.75) days after ring use. HSV DNA was not detected in genital swabs and there was no significant change in inflammatory mediators.

CONCLUSIONS

This first-in-human study demonstrated that an IVR could safely deliver mucosal levels of aciclovir similar to oral valaciclovir without systemic absorption. More intensive site-specific pharmacokinetic studies are needed to determine whether higher local concentrations are needed to achieve optimal drug distribution within the genital tract.

α1 -Adrenergic receptor-induced cytoskeletal organization and cell motility in CCL39 fibroblasts requires phospholipase D1

The role of phospholipase D (PLD) in cytoskeletal reorganization, ERK activation, and migration is well established. Both isoforms of PLD (PLD1 and PLD2) can independently activate stress fiber formation and increase ERK phosphorylation. However, the isoform's specificity, upstream activators, and downstream targets of PLD that coordinate this process are less well understood. This study explores the role of α(1) -adrenergic receptor stimulation and its effect on PLD activity. We demonstrate that PLD1 activators, RhoA, and PKCα are critical for stress fiber formation and ERK activation, and enhance the production of phosphatidic acid (PA) upon phenylephrine addition. Ectopic expression of dominant negative PLD1 and not PLD2 blocks ERK activation, inhibits stress fiber formation, and reduces cell motility in CCL39 fibroblasts. Furthermore, we demonstrate the mechanism for PLD1 activation of ERK involves Ras. This work indicates that PLD1 plays a novel role mediating growth factor and cell motility events in α(1) -adrenergic receptor-activated cells.

Combined approach in bedside assessment of aspiration risk post stroke: PASS

BACKGROUND

Swallowing disorders are common and serious problems post stroke. Physical signs and ingestion test consist of main approaches of bedside screening of aspiration.

AIM

To assess the composability of these approaches.

DESIGN

A pilot study to develop a combined schema; secondly a validation study of this schema.

SETTING

Inpatient of Neurology Department and of Rehabilitation Department.

POPULATION

Forty-one patients post acute stroke included in the pilot study; 107 patients of subacute stroke for validation study.

METHODS

In pilot study, patients were assessed using Clinical Predicative Scale of Aspiration (CPSA) and 3-ounce Water swallow Test (3oz WT). Videofluoroscopic examination (VFSE) was performed as gold standard when the results of screening were discordant. In validation study, swallowing disorders were assessed systematically using CPSA, 3 oz WT and VFSE.

RESULTS

The combined screening schema, Practical Aspiration Screening Scheme (PASS), consisted of a 3oz WT to enhance results of the uncertain range of CPSA. Validation study showed that sensitivity and specificity of the 3oz WT were 87.3% and 42.3% respectively; those of CPSA were 50.1% and 50.0%, with a range of uncertainty in 42.6% of patients. The sensitivity of PASS was 89.1%, comparable to that of the 3oz WT, while the specificity of PASS was 80.8%, significantly higher than that of single tests. PASS also reduced systematic recourse to VFSE with a substantial agreement with it (kappa=0.7).

CONCLUSION

Physical signs and ingestion test are complementary in the screening of aspiration.

CLINICAL REHABILITATION IMPACT

Combined schema enhances the efficiency of bedside screening of aspiration.

Mimotopes of mutalysin-II from Lachesis muta snake venom induce hemorrhage inhibitory antibodies upon vaccination of rabbits

Mutalysin-II (mut-II) from Lachesis muta snake venom is an endopeptidase with hemorrhagic activity. A mAb against mutalysin-II that neutralized the hemorrhagic effect was produced previously. To identify the mAb epitopes, sets of 15-mer overlapping peptides covering the mut-II amino acid sequence were synthesized using the SPOT method and tested but failed to react with the mAb. Using a phage-display approach seventeen clones reactive with mAb were identified. Additional immunoassays with the peptides and mAb identified the QCTMDQGRLRCR, TCATDQGRLRCT, HCFHDQGRVRCA, HCTMDQGRLRCR and SCMLDQGRSRCR sequences as possible epitopes. Immunization of rabbits with these peptides induced antibodies that recognize mut-II and protected against the hemorrhagic effects of Lachesis venom.

Porous Organosilicates for On-Chip Dielectric Applications

Porous organosilicates useful for on-chip insulator applications can be prepared by templating the vitrification of low molecular weight silsesquioxanes (SSQs) using highly branched, thermally labile macromolecules which are subsequently removed in a thermal process to generate porosity. The process involves spin coating a mixture of the matrix material and the porogen (pore generator) followed by thermal curing to initiate vitrification and decomposition of the porogen. The morphology is fixed during the formation of the nanoscopic inorganicorganic hybrid and is maintained during foaming. This process generates controllable and stable morphologies where the void volume is determined by the porogen loading level. The porous materials are thermally robust and intrinsically hydrophobic without subsequent chemical treatment. Dielectric constants of < 2.2 are easily achieved for pore volumes of only 20%, and this porosity appears to be predominately closed cell in nature. These materials display a number of thermal mechanical and electric properties consistent with the requirements for on-chip insulator applications.

Existence of metastable kinetic modes

The nonlinear evolution of resonantly driven systems, such as suprathermal particle driven modes in magnetically confined plasmas, is shown to strongly depend on the existence and nature of an underlying damping mechanism. When background resonant damping is present, subcritical states can take place. In particular, purely nonlinear steady-state regimes are found, whose destabilization threshold and saturation levels are calculated and validated using numerical simulations. This nonlinear behavior can be of relevance for acoustic modes in magnetically confined plasmas.

Self- and clinician-rated Montgomery-Asberg Depression Rating Scale: evaluation in clinical practice

BACKGROUND

Time- and cost-effective self-rating scales of depressive symptoms are particularly valuable for frequent use in large-scale effectiveness trials. The aim of the present study was to examine the psychometric properties of the French version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-S) and determine whether it might complement the MADRS in monitoring depression severity and change over time in routine clinical practice.

METHODS

Sixty-three adult outpatients with a current depressive episode completed the MADRS-S and were interviewed with the MADRS on two occasions, within a 1-month interval.

RESULTS

All patients readily accepted the MADRS-S. It showed good to excellent internal consistency (Cronbach's alpha 0.85 at Time 1; 0.94 at Time 2). Its factor structure revealed that a single component explained a large proportion of variability (47.0% at Time 1; 68.8% at Time 2). Concurrent validity of the self- and clinician-rated versions was good (Pearson's correlation coefficients for total scores 0.81 at Time 1; 0.91 at Time 2). The MADRS-S was sensitive to change over the 4-week observation period (correlation of 0.71 between change scores on self- and clinician-rated instruments).

LIMITATIONS

Generalizability is restricted to outpatients with moderate to severe depression, and the MADRS-S ability to measure treatment effects needs to be examined.

CONCLUSIONS

The present study indicates that the MADRS-S displays favourable psychometric properties and suggests that it might be a valid complement to the MADRS, both in research settings and clinical practice.

Vasoactive intestinal peptide ameliorates intestinal barrier disruption associated with Citrobacter rodentium-induced colitis

Attaching and effacing bacterial pathogens attach to the apical surface of epithelial cells and disrupt epithelial barrier function, increasing permeability and allowing luminal contents access to the underlying milieu. Previous in vitro studies demonstrated that the neuropeptide vasoactive intestinal peptide (VIP) regulates epithelial paracellular permeability, and the high concentrations and close proximity of VIP-containing nerve fibers to intestinal epithelial cells would support such a function in vivo. The aim of this study was to examine whether VIP treatment modulated Citrobacter rodentium-induced disruption of intestinal barrier integrity and to identify potential mechanisms of action. Administration of VIP had no effect on bacterial attachment although histopathological scoring demonstrated a VIP-induced amelioration of colitis-induced epithelial damage compared with controls. VIP treatment prevented the infection-induced increase in mannitol flux a measure of paracellular permeability, resulting in levels similar to control mice, and immunohistochemical studies demonstrated that VIP prevented the translocation of tight junction proteins: zonula occludens-1, occludin, and claudin-3. Enteropathogenic Escherichia coli (EPEC) infection of Caco-2 monolayers confirmed a protective role for VIP on epithelial barrier function. VIP prevented EPEC-induced increase in long myosin light chain kinase (MLCK) expression and myosin light chain phosphorylation (p-MLC). Furthermore, MLCK inhibition significantly attenuated bacterial-induced epithelial damage both in vivo and in vitro. In conclusion, our results indicate that VIP protects the colonic epithelial barrier by minimizing bacterial-induced redistribution of tight junction proteins in part through actions on MLCK and MLC phosphorylation.

Coalescence and splitting of confined droplets at microfluidic junctions

The ability to merge two droplets is an important component of droplet-based lab-on-a-chip devices, yet flow-induced coalescence is difficult to achieve due to long film drainage times compared with relatively short residence times. We examine droplet collisions at a simple microfluidic T-junction and characterize the response for a wide range of droplet sizes and speeds. We find that three primary responses occur, where coalescence occurs easily at low collision speeds, smaller droplets traveling faster slip past one another without coalescing, and larger and faster droplets can break one another into multiple segments. The critical capillary number for coalescence agrees well with previously reported scaling for isolated droplet pairs when local curvature and speed are taken into account. The critical capillary number for splitting of droplets agrees well with a previously reported stability condition for individual droplets stretching in an extensional flow. Quantifying the necessary conditions for coalescence and non-coalescence behavior should enable the informed design of lab on chip devices based on discrete liquid segments.

Redistribution of suprathermal electrons due to fishbone frequency jumps

MHD instabilities driven by fast electrons identified as fishbonelike modes have been detected on Tore Supra during lower hybrid current drive discharges. Direct experimental evidence is reported of a novel feature: the regular redistribution of suprathermal electrons toward external tokamak regions which are correlated to periodic mode frequency jumps. Sharp drops of the electron temperature time trace are factually linked to the cyclical deterioration of the fast electron confinement.

Marijuana use in potential liver transplant candidates

Concern exists that liver transplant center substance abuse policies may have an inappropriate and disproportionate impact on marijuana users. Our hypothesis is that patients with chronic liver disease who were marijuana users will have inferior survival. This is a retrospective (1999-2007) cohort study. The primary outcome measure is time-dependent, adjusted patient survival from the time of liver transplant evaluation. The primary exposure variable is a positive cannabinoid toxicology screen during the liver transplant evaluation period. Overall, 155 patients qualified as marijuana users while 1334 patients were marijuana non-users. Marijuana users were significantly (p < 0.05) younger (48.3 vs. 52.1), more likely to be male (78.1% vs. 63.0%), have hepatitis C (63.9% vs. 40.6%) and were less likely to receive a transplant (21.8% vs. 14.8%). Marijuana users were more likely to use tobacco, narcotics, benzodiazepines, amphetamines, cocaine or barbiturates (p < 0.05). Unadjusted survival rates were similar between cohorts. Upon multivariate analysis, MELD score, hepatitis C and transplantation were significantly associated with survival, while marijuana use was not (HR 1.09, 95% CI 0.78-1.54). We conclude that patients who did and did not use marijuana had similar survival rates. Current substance abuse policies do not seen to systematically expose marijuana users to additional risk of mortality.

A qualitative assessment of non-carious cervical lesions in extracted human teeth

BACKGROUND

Opinions vary about the causes of non-carious cervical lesions (NCCLs). They have been attributed to toothbrush abrasion, acid corrosion (commonly termed dental erosion), and abfraction. The purpose of this study was to examine the microwear details of NCCLs in a collection of extracted human teeth using scanning election microscopy (SEM).

METHODS

Negative replicas of large NCCLs in 24 extracted human teeth were obtained in polyvinylsiloxane impression material (Light Body Imprint II, 3M ESPE) and viewed under SEM.

RESULTS

All NCCLs extended from the cemento-enamel junction to the root surface and they displayed a variety of wedge-shaped appearances. There was evidence of both abrasion and corrosion in 18 of the 24 teeth (75.0 per cent), abrasion only in one tooth (4.2 per cent) and corrosion only in five teeth (20.8 per cent). Horizontal furrows with smooth edges and minor scratch marks, characteristic of abrasion and corrosion, were noted in 13 teeth (54.2 per cent).

CONCLUSIONS

Based on microscopic assessment of a sample of extracted teeth, it appears that abrasion and corrosion are common associated aetiological factors in the formation of NCCLs.

Reactivity profile of anti-factor VIII antibodies with designed synthetic peptides mimicking epitopes of the C2 and a1 domains

Antibodies (Abs) that block factor VIII (FVIII) activity occur in hemophilia A patients treated with FVIII replacement therapy and severely impair treatment. In this work, we designed and synthesized ten peptides whose sequences are found in putative epitopes at the surface of a1 and C2 domains of the FVIII molecule. These peptides were screened for their ability to inhibit the binding of anti-FVIII Abs from plasmas of hemophilia A patients to FVIII. All peptides were efficient in inhibiting anti-FVIII Abs in plasma from patients with inhibitors, with however different efficiencies. It was found that each tested patient's plasma had a different profile of reactivity with peptides, consistent with an individual anti-FVIII Ab specificity. The profile of recognized peptides was also changing during the treatment of the patients. Three peptides were used in an affinity chromatography assay to attempt to remove anti-FVIII Abs from patients' plasma. Anti-FVIII IgGs were significantly captured by the peptide-Sepharose affinity matrixes as assessed by enzyme-linked immunosorbent assay. However, due to the low level of Abs in the plasma samples, other methods (Chromogenic and Bethesda assays) were not sensitive enough to properly detect the reduction of inhibitors.

Markers of exposure to spotted fever rickettsiae in patients with chronic illness, including fatigue, in two Australian populations

BACKGROUND

Some investigators believe that a proportion of chronically unwell patients, many with fatigue, have an underlying rickettsial disease.

AIM

To investigate the prevalence of markers of rickettsial infection in patients with chronic illnesses.

DESIGN

Observational study.

METHODS

A 526 patient cohort with chronic illnesses from Melbourne, Australia and 400 control patients from Newcastle, Australia were assessed using serology, culture and PCR for the detection of rickettsiae. Rickettsial serology was performed on another cohort of 581 chronically unwell patients (and 34 non-fatigued patients from the same practice) from Adelaide, Australia.

RESULTS

Of the Melbourne patient cohort, 14/526 (3%) were real-time PCR positive for rickettsial DNA compared to none of the 400 control patients (P < 0.001). Of these 14 patients, Rickettsia honei strain 'marmionii' was detected in 5 and isolated from 2. Rickettsaemia was seasonal, with more in winter (8/145; P < 0.03) and less in spring (0/143; P < 0.03). Positive rickettsial serology titres of >or=1:256 were seen in 206 (39%) patients. Of the Adelaide patient cohort, 238/581 (41%) had positive rickettsial antibodies titres. Of the 34 control sera, 5 (15%) were serologically positive (P < 0.002). Both Melbourne and Adelaide patient cohorts had significantly higher seropositivity than the Newcastle control cohort (3/399; P < 0.0001).

CONCLUSION

In patients with chronic illness, rickettsial DNA in peripheral blood and/or rickettsial seropositivity may represent exposure to rickettsiae or underlying rickettsial diseases. It is not known whether the presence of rickettsiae is causally related to the patients' chronic illnesses, or reactivation of a latent rickettsial infection.

Construction and validation of a patient-reported outcome dedicated to chronic venous disorders: SQOR-V (specific quality of life and outcome response - venous)

BACKGROUND

Chronic venous disorders (CVD) have an impact on quality of life (QoL), both physically and psychologically. As of now, several vein specific QoL scales exist, but no patient-reported outcome (PRO) is available which takes into account altogether symptoms, impairment of activities, appearance of the legs and concerns regarding health risk. Since clinical severity and disability are mostly evaluated in severe patients, where the main outcome - namely skin changes - is obvious but rare, the authors considered that a reproducible and clinically relevant survey that could account for specific patients' complaints was needed, particularly for CEAP C0s-C3 patients.

OBJECTIVES

The objective of this study was to build a specific autoquestionnaire and to establish its statistical validity and clinical relevance.

METHODS

A review of existing questionnaires and an analysis of relevant literature were carried out by a committee of experts. The committee then developed a questionnaire of 46 items, with special attention to relevance for venous disorders and patients' main complaints. After construction, the French version was field-tested and results statistically analyzed. In the specific QoL & Outcome Response - Venous (SQOR-V), each item is given a value by the patient and items are grouped in five dimensions. Each dimension is weighed to a maximum value of 20, yielding an overall maximum score of 100.

RESULTS

Two hundred and two questionnaires were analyzed for the initial evaluation and 152 at a second (test-retest). Determination of the Cronbach's alpha coefficient (0.96) and structural analysis demonstrated an excellent internal and structural coherence. Test-retest comparisons confirmed good reproducibility. Comparison with SF-12 and CED-D questionnaires and with CEAP classification groups verified both structural and clinical validity.

CONCLUSIONS

This study demonstrates QoL impairment in patients suffering from chronic venous disorders (CVD). It also verifies the statistical validity of the SQOR-V questionnaire. More studies are needed to demonstrate the improvement in specificity and accuracy this questionnaire provides compared to existing vein-specific QoL scales, and to determine its ability to assess efficacy of any kind of treatment at any stage of the disease. Provided adequate acknowledgment of its authors, the use of SQOR-V is free. An English version is available, currently pending validation.

Atopic Dermatitis: Impact on the Quality of Life of Patients and Their Partners

BACKGROUND

The impact of atopic dermatitis (AD) on the patient's quality of life is relatively well known. However, the influence on the patient's spouse has never been studied.

OBJECTIVE

To evaluate the impact of AD on the quality of life, sleeping and sexual life of patients and their partners.

METHODS

In this cross-sectional study, patients and their partners completed a number of questionnaires asking about their general health and their quality of life [Short Form 12, Epworth, Dermatology Life Quality Index (DLQI)] and completed an idiosyncratic measure asking about their sexual functioning. AD severity was clinician rated using Scoring atopic dermatitis (SCORAD).

RESULTS

A total of 266 patients were included. The mean DLQI score was 8.8. The physical and mental composite 12 scores were 50.7 and 39.5, respectively. These 3 scores were significantly related to SCORAD. A decrease in sexual desire due to AD was noted in 57.5% of patients. The quality of life of partners did not appear to be particularly impaired, but 36.5% reported that the appearance of eczema had an impact on their sex life.

CONCLUSION

The influence of AD on sex life is significant both for the patients and their partners.