Impact du statut nutritionnel sur la qualité de vie des patients atteints de carcinomes épidermoïdes de la tête et du cou

Mise en contexte: Les cancers de la tête et du cou, ainsi que les effets secondaires reliés à leurs traitements, prédisposent les patients à la malnutrition. Celle-ci représente une cause importante de morbidité et mortalité. Cependant, des incertitudes persistent quant à son impact sur la qualité de vie. Objectif: L’objectif de cette étude est d’évaluer le statut nutritionnel des patients traités pour un carcinome épidermoïde de la tête et du cou ainsi que leur impact sur la qualité de vie à quatre mois et un an après leur diagnostic. Méthodes: Les données de statut nutritionnel, tel que mesurées par l’IMC, la perte de poids, l’albumine et la pré-albumine, ont été collectées avant le début des traitements. La qualité de vie a été évaluée prospectivement à l’aide du questionnaire University of Washington Quality of Life Questionnaire, à trois occasions : avant le début du traitement, quatre mois plus tard et à un an. Un total de 155 patients traités pour un carcinome épidermoïde de la tête et du cou ont été examinés à partir de cette banque de données prospectives. Une régression linéaire multiple a été utilisée pour l’analyse statistique. Résultats: Avec ajustement pour l’âge, le sexe, le stade de cancer, le type de traitement, les comorbidités et la qualité de vie prétraitement, un plus faible IMC est associé avec une moins bonne qualité de vie globale à un an après le diagnostic (p=0,03). Aucune association n’a été démontrée entre les marqueurs nutritionnels et la qualité de vie à quatre mois après le diagnostic. Conclusion: L’évaluation du statut nutritionnel est une composante essentielle des soins des patients atteints de cancers de la tête et du cou, puisque la malnutrition est corrélée à une moins bonne qualité de vie à long terme.Background: Head and neck cancer and the side effects related to its treatment predispose patients to malnutrition, which is an important cause of morbidity and mortality. However, uncertainties persist as to its impact on quality of life. Objective: The objective of this study is to evaluate the nutritional status of patients treated for head and neck squamous cell carcinoma and its impact on their quality of life at four months and one year after diagnosis. Methods: Data regarding nutritional status, as measured with BMI, weight loss, albumin and prealbumin, was collected before the beginning of treatment. Quality of life was evaluated prospectively, using the University of Washington Quality of Life Questionnaire, on three occasions: before the beginning of treatment, four months after diagnosis and one year later. A total of 155 patients treated for head and neck squamous cell carcinoma were reviewed from this prospective databank. Multiple linear regression was used for statistical analysis. Results: With adjustment for age, sex, cancer stage, type of treatment, comorbidities and pretreatment quality of life, a lower BMI is associated with a poorer overall quality of life at one year post-diagnosis (p=0,03). No association was demonstrated between the nutritional markers and quality of life at four months after diagnostic. Conclusion: Evaluation of nutritional status is an essential component in the care of head and neck cancer patients, as malnutrition is correlated with poorer long-term quality of life

French translation, cultural adaptation and validation of the BDDQ-AS for rhinoplasty patients

The Body Dysmorphic Disorder Questionnaire-Aesthetic Surgery (BDDQ-AS) is a validated questionnaire that is used as a screening tool for body dysmorphic disorder (BDD) in aesthetic rhinoplasty patients. The BDDQ-AS questionnaire was translated from English to French according to international guidelines. Ten French-speaking rhinoplasty patients were interviewed in order to evaluate the understandability and acceptability of the translation and produce a final version. It was then administered to 165 consecutive patients. Psychometric properties were evaluated using item-reponse theory (IRT). Internal consistency was high, with Cronbach's alpha of 0.90 (95% lower CL 0.88). While the discrimination abilities of all the items were good (over 2.0), their difficulty parameters were shifted towards greater severity of symptoms. That shift could also be observed in information function graph for the entire scale. In other words, the BDDQ-AS performed better in patients with more severe body dysmorphic symptoms. In conclusion, the BDDQ-AS was translated, adapted, and psychometrically validated for use in a French-speaking population

A global perspective of advanced practice nursing research:a review of systematic reviews protocol

INTRODUCTION: In 2020, the World Health Organization called for the expansion and greater recognition of all nursing roles, including advanced practice nurses (APNs), to better meet patient care needs. As defined by the International Council of Nurses (ICN), the two most common APN roles include nurse practitioners (NPs) and clinical nurse specialists (CNSs). They help ensure care to communities as well as patients and families with acute, chronic or complex conditions. Moreover, APNs support providers to deliver high quality care and improve access to services. Currently, there is much variability in the use of advanced practice nursing roles globally. A clearer understanding of the roles that are in place across the globe, and how they are being used will support greater role harmonization, and inform global priorities for advanced practice nursing education, research, and policy reform. OBJECTIVE: To identify current gaps in advanced practice nursing research globally. MATERIALS AND METHODS: This review of systematic reviews will provide a description of the current state of the research, including gaps, on advanced practice nursing globally. We will include reviews that examine APNs, NPs or CNSs using recognized role definitions. We will search the CINAHL, EMBASE, Global Health, HealthStar, PubMed, Medline, Cochrane Library Database of Systematic Reviews and Controlled Trials Register, Database of Abstracts of Reviews of Effects, Joanna Briggs Institute, and Web of Science electronic databases for reviews published from January 2011 onwards, with no restrictions on jurisdiction or language. We will search the grey literature and hand search the reference lists of all relevant reviews to identify additional studies. We will extract country, patient, provider, health system, educational, and policy/scope of practice data. We will assess the quality of each included review using the CASP criteria, and summarize their findings. This review of systematic reviews protocol was developed following the PRISMA-P recommendations. PROSPERO REGISTRATION NUMBER: CRD42021278532

Ceacam1 separates graft-versus-host-disease from graft-versus-tumor activity after experimental allogeneic bone marrow transplantation.

BACKGROUND: Allogeneic bone marrow transplantation (allo-BMT) is a potentially curative therapy for a variety of hematologic diseases, but benefits, including graft-versus-tumor (GVT) activity are limited by graft-versus-host-disease (GVHD). Carcinoembryonic antigen related cell adhesion molecule 1 (Ceacam1) is a transmembrane glycoprotein found on epithelium, T cells, and many tumors. It regulates a variety of physiologic and pathological processes such as tumor biology, leukocyte activation, and energy homeostasis. Previous studies suggest that Ceacam1 negatively regulates inflammation in inflammatory bowel disease models. METHODS: We studied Ceacam1 as a regulator of GVHD and GVT after allogeneic bone marrow transplantation (allo-BMT) in mouse models. In vivo, Ceacam1(-/-) T cells caused increased GVHD mortality and GVHD of the colon, and greater numbers of donor T cells were positive for activation markers (CD25(hi), CD62L(lo)). Additionally, Ceacam1(-/-) CD8 T cells had greater expression of the gut-trafficking integrin α(4)β(7), though both CD4 and CD8 T cells were found increased numbers in the gut post-transplant. Ceacam1(-/-) recipients also experienced increased GVHD mortality and GVHD of the colon, and alloreactive T cells displayed increased activation. Additionally, Ceacam1(-/-) mice had increased mortality and decreased numbers of regenerating small intestinal crypts upon radiation exposure. Conversely, Ceacam1-overexpressing T cells caused attenuated target-organ and systemic GVHD, which correlated with decreased donor T cell numbers in target tissues, and mortality. Finally, graft-versus-tumor survival in a Ceacam1(+) lymphoma model was improved in animals receiving Ceacam1(-/-) vs. control T cells. CONCLUSIONS: We conclude that Ceacam1 regulates T cell activation, GVHD target organ damage, and numbers of donor T cells in lymphoid organs and GVHD target tissues. In recipients of allo-BMT, Ceacam1 may also regulate tissue radiosensitivity. Because of its expression on both the donor graft and host tissues, this suggests that targeting Ceacam1 may represent a potent strategy for the regulation of GVHD and GVT after allogeneic transplantation

CEACAM1, an inhibitory co-receptor in T lymphocytes

A number of reports examining the role of CEACAM1 (Carcinoembryonic Antigen-related Cell Adhesion Molecule 1) in T lymphocytes have defined for it both stimulatory or inhibitory co-receptor functions. Using our unique Ceacaml1-/- mouse model, we previously observed that CEACAM1 is not involved in the development nor in the migration of T cells, but that it exerts a co-inhibitory effect on their activation and proliferation. Here, we report that its loss does not affect the ratios of naive and memory helper or cytotoxic T cells. Moreover, cytotoxic T cells from OT-1:Ceacam1-/- mice, resulting from breeding OT-1 TCR transgenic mice with Ceacam1-/- mice, are hyperproliferative and secrete more interleukin-2 and interferon-7 than their OT-1 counterparts. Finally, studies involving CD2-CCl-L transgenic mice whose T cells overexpress CEACAM1 did not consistently yield the hypoproliferative behaviour expected. Together, these findings suggest that CEACAM1 is an inhibitory co-receptor in T cells

Translation, cultural adaptation and validation of the SCHNOS in French

Abstract Background The Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) is a validated questionnaire that assesses functional and aesthetic outcomes of rhinoplasty patients. There are 274 million French speakers worldwide, and this questionnaire is currently not available in French. The purpose of this study was to translate, adapt, and validate a French version of the SCHNOS questionnaire. Methods The SCHNOS questionnaire was translated from English to French according to international guidelines. Ten French-speaking rhinoplasty patients were interviewed in order to evaluate the understandability and acceptability of the translation and produce a final version. The final version was administered prospectively to 25 rhinoplasty patients and 25 controls at two-week intervals. It was then administered to 165 consecutive patients. Psychometric properties were evaluated using the Item Reponse Theory (IRT) and confirmatory factor analysis (CFA). Results Three items from the original SCHNOS were modified to produce the French-SCHNOS (F-SCHNOS). Discrimination abilities of F-SCHNOS-O and F-SCHNOS-C were perfect, with values of 2.18(p < 0.001, 95% CI 1.74 to 2.62) for SCHNOS-O and 2.62(p < 0.001, 95% CI 2.03 to 3.21). Internal consistency was high, with Cronbach’s alpha of 0.93 for F-SCHNOS-O and 0.95 for F-SCHNOS-C. IRT showed good psychometric properties with almost each step up or down across the scale associating with meaningful differences in outcome severity. All four SCHNOS-O items were equally “important” in defining the total score. The F-SCHNOS-C total score was defined by mostly four out of six items. Conclusions The SCHNOS was translated, adapted, and psychometrically validated for use in a French-speaking population

French translation, cultural adaptation and validation of the BDDQ-AS for rhinoplasty patients

Abstract The Body Dysmorphic Disorder Questionnaire-Aesthetic Surgery (BDDQ-AS) is a validated questionnaire that is used as a screening tool for body dysmorphic disorder (BDD) in aesthetic rhinoplasty patients. The BDDQ-AS questionnaire was translated from English to French according to international guidelines. Ten French-speaking rhinoplasty patients were interviewed in order to evaluate the understandability and acceptability of the translation and produce a final version. It was then administered to 165 consecutive patients. Psychometric properties were evaluated using item-reponse theory (IRT). Internal consistency was high, with Cronbach’s alpha of 0.90 (95% lower CL 0.88). While the discrimination abilities of all the items were good (over 2.0), their difficulty parameters were shifted towards greater severity of symptoms. That shift could also be observed in information function graph for the entire scale. In other words, the BDDQ-AS performed better in patients with more severe body dysmorphic symptoms. In conclusion, the BDDQ-AS was translated, adapted, and psychometrically validated for use in a French-speaking population

A global perspective of advanced practice nursing research: A review of systematic reviews protocol.

IntroductionIn 2020, the World Health Organization called for the expansion and greater recognition of all nursing roles, including advanced practice nurses (APNs), to better meet patient care needs. As defined by the International Council of Nurses (ICN), the two most common APN roles include nurse practitioners (NPs) and clinical nurse specialists (CNSs). They help ensure care to communities as well as patients and families with acute, chronic or complex conditions. Moreover, APNs support providers to deliver high quality care and improve access to services. Currently, there is much variability in the use of advanced practice nursing roles globally. A clearer understanding of the roles that are in place across the globe, and how they are being used will support greater role harmonization, and inform global priorities for advanced practice nursing education, research, and policy reform.ObjectiveTo identify current gaps in advanced practice nursing research globally.Materials and methodsThis review of systematic reviews will provide a description of the current state of the research, including gaps, on advanced practice nursing globally. We will include reviews that examine APNs, NPs or CNSs using recognized role definitions. We will search the CINAHL, EMBASE, Global Health, HealthStar, PubMed, Medline, Cochrane Library Database of Systematic Reviews and Controlled Trials Register, Database of Abstracts of Reviews of Effects, Joanna Briggs Institute, and Web of Science electronic databases for reviews published from January 2011 onwards, with no restrictions on jurisdiction or language. We will search the grey literature and hand search the reference lists of all relevant reviews to identify additional studies. We will extract country, patient, provider, health system, educational, and policy/scope of practice data. We will assess the quality of each included review using the CASP criteria, and summarize their findings. This review of systematic reviews protocol was developed following the PRISMA-P recommendations.Prospero registration numberCRD42021278532