The impact of and subsequent chronic pain on patients' daily lives

Aim: The aim of our study was to carry out a literature review and develop a model illustrating the domains of patients' lives that are impacted by herpes zoster (HZ) and subsequent chronic pain. Subjects and methods: Biomedical databases and online congress archives were searched using keywords related to HZ or post-herpetic neuralgia (PHN) and social, psychological or physical impact. A total of 733 abstracts were reviewed, and 29 publications containing concepts reported by patients were retained for the model. Wilson and Cleary’s model was used to organise the findings. Links between concepts were documented on three levels: hypothesis, observation and evidence. The final model illustrates the concepts impacted by HZ and PHN, relationships between these concepts and the level of evidence identified. Results: The concepts identified from the articles were grouped into the following categories: biological/ physiological, symptom status, functional status, health perceptions, characteristics of the individual, health-related quality of life (HRQOL), treatment and characteristics of the environment. Evidence exists showing that HZ-related pain directly impacts functional status, health perceptions and HRQOL. Conclusion: Patients report that all major domains of life are impaired by HZ or subsequent chronic pain. HZ and its painful and debilitating complications can have a substantial impact on physical, psychological, social and role functioning, HRQOL and activities of daily living. The impact on elderly patients needs to be further assessed with appropriately designed and validated instruments, with specific attention paid to dependence

Impact of respiratory viruses in intensive care unit patient with community-acquired pneumonia : a one-year retrospective single-centre study.

International audienc

ARCHES: A Randomized, Phase III Study of Androgen Deprivation Therapy With Enzalutamide or Placebo in Men With Metastatic Hormone-Sensitive Prostate Cancer

PURPOSE: Enzalutamide, a potent androgen-receptor inhibitor, has demonstrated significant benefits in metastatic and nonmetastatic castration-resistant prostate cancer. We evaluated the efficacy and safety of enzalutamide in metastatic hormone-sensitive prostate cancer (mHSPC). METHODS: ARCHES (ClinicalTrials.gov identifier: NCT02677896) is a multinational, double-blind, phase III trial, wherein 1,150 men with mHSPC were randomly assigned 1:1 to enzalutamide (160 mg/day) or placebo, plus androgen deprivation therapy (ADT), stratified by disease volume and prior docetaxel chemotherapy. The primary end point was radiographic progression-free survival. RESULTS: As of October 14, 2018, the risk of radiographic progression or death was significantly reduced with enzalutamide plus ADT versus placebo plus ADT (hazard ratio, 0.39; 95% CI, 0.30 to 0.50; P < .001; median not reached v 19.0 months). Similar significant improvements in radiographic progression-free survival were reported in prespecified subgroups on the basis of disease volume and prior docetaxel therapy. Enzalutamide plus ADT significantly reduced the risk of prostate-specific antigen progression, initiation of new antineoplastic therapy, first symptomatic skeletal event, castration resistance, and reduced risk of pain progression. More men achieved an undetectable prostate-specific antigen level and/or an objective response with enzalutamide plus ADT (P < .001). Patients in both treatment groups reported a high baseline level of quality of life, which was maintained over time. Grade 3 or greater adverse events were reported in 24.3% of patients who received enzalutamide plus ADT versus 25.6% of patients who received placebo plus ADT, with no unexpected adverse events. CONCLUSION: Enzalutamide with ADT significantly reduced the risk of metastatic progression or death over time versus placebo plus ADT in men with mHSPC, including those with low-volume disease and/or prior docetaxel, with a safety analysis that seems consistent with the safety profile of enzalutamide in previous clinical trials in castration-resistant prostate cancer

Parental transfer of the antimicrobial protein LBP/BPI protects Biomphalaria glabrata eggs against oomycete infections

Copyright: © 2013 Baron et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This work was funded by ANR (ANR-07-BLAN-0214 and ANR-12-EMMA-00O7-01), CNRS and INRA. PvW was financially supported by the BBSRC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

The Precipitation Inferred from Soil Moisture (PrISM) Near Real-Time Rainfall Product: Evaluation and Comparison

Near real-time precipitation is essential to many applications. In Africa, the lack of dense rain-gauge networks and ground weather radars makes the use of satellite precipitation products unavoidable. Despite major progresses in estimating precipitation rate from remote sensing measurements over the past decades, satellite precipitation products still suffer from quantitative uncertainties and biases compared to ground data. Consequently, almost all precipitation products are provided in two modes: a real-time mode (also called early-run or raw product) and a corrected mode (also called final-run, adjusted or post-processed product) in which ground precipitation measurements are integrated in algorithms to correct for bias, generally at a monthly timescale. This paper describes a new methodology to provide a near-real-time precipitation product based on satellite precipitation and soil moisture measurements. Recent studies have shown that soil moisture intrinsically contains information on past precipitation and can be used to correct precipitation uncertainties. The PrISM (Precipitation inferred from Soil Moisture) methodology is presented and its performance is assessed for five in situ rainfall measurement networks located in Africa in semi-arid to wet areas: Niger, Benin, Burkina Faso, Central Africa, and East Africa. Results show that the use of SMOS (Soil Moisture and Ocean Salinity) satellite soil moisture measurements in the PrISM algorithm most often improves the real-time satellite precipitation products, and provides results comparable to existing adjusted products, such as TRMM (Tropical Rainfall Measuring Mission), GPCC (Global Precipitation Climatology Centre) and IMERG (Integrated Multi-satellitE Retrievals for GPM), which are available a few weeks or months after their detection

Pharmacodynamics of bisphosphonates in arthritis.

Inflammatory arthritis is a group of autoimmune diseases characterized by chronic inflammation of the joints. Rheumatoid arthritis, the most common form of arthritis, is associated with local joint destruction and systemic bone loss. Osteoclasts, the only cells of the body able to resorbe bone, are key players in these two types of bone loss. Bisphosphonates are analogs of pyrophosphate that inhibit osteoclast action and bone resorption. They are indicated in pathology associated with excess resorption. Besides their effect on bone they also exhibit extra-osseous properties, acting on tumor cells, inflammation and angiogenesis. As a result, they have been trialed in the context of arthritis. It is now clear that they do not have any significant direct effect on disease activity or pain. If their indication in the prevention of glucocorticoid-induced osteoporosis is clear, any beneficial effects on bone erosions are still controversial but interesting preliminary results warrant further investigations

Catching Element Formation In The Act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions.Comment: 14 pages including 3 figure