Identification of the period of stability in a balance test after stepping up using a simplified cumulative sum

Falls are a major cause of death in older people. One method used to predict falls is analysis of Centre of Pressure (CoP) displacement, which provides a measure of balance quality. The Balance Quality Tester (BQT) is a device based on a commercial bathroom scale that calculates instantaneous values of vertical ground reaction force (Fz) as well as the CoP in both anteroposterior (AP) and mediolateral (ML) directions. The entire testing process needs to take no longer than 12 s to ensure subject compliance, making it vital that calculations related to balance are only calculated for the period when the subject is static. In the present study, a method is presented to detect the stabilization period after a subject has stepped onto the BQT. Four different phases of the test are identified (stepping-on, stabilization, balancing, stepping-off), ensuring that subjects are static when parameters from the balancing phase are calculated. The method, based on a simplified cumulative sum (CUSUM) algorithm, could detect the change between unstable and stable stance. The time taken to stabilize significantly affected the static balance variables of surface area and trajectory velocity, and was also related to Timed-up-and-Go performance. Such a finding suggests that the time to stabilize could be a worthwhile parameter to explore as a potential indicator of balance problems and fall risk in older people

Etude de l'évolution de la schizophrénie sur un siècle : comparaison de deux cohortes randomisées et appariées de patients schizophrènes hospitalisée dans l'Aube

REIMS-BU Santé (514542104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Le sujet schizophrène vieillissant (données actuelles et mise en perspective)

REIMS-BU Santé (514542104) / SudocSudocFranceF

Force-plate technology used to develop a home-based device to evaluate equilibrium and fall risk in the elderly

International audienc

In-home physical frailty monitoring: relevance with respect to clinical tests

Abstract Background Frailty detection and remote monitoring are of major importance for slowing down, and/or even stopping the frailty process in home-dwelling older people. Taking the Fried’s criteria as a reference, this work aims to compare the results produced by a technological set (ARPEGE Pack) with those obtained by usual clinical tests, as well as to discuss the ability of the Pack to be used for long-run frailty remote monitoring. Methods 194 participants were given a number of geriatric tests and asked to make use of the ARPEGE technological tools as well as reference clinical tools to feed Fried’s indicators. Spearman or Pearson’s correlation coefficients were used to compare the ARPEGE results to the reference ones, depending on data statistical characteristics. Results Good correlations were obtained for measurements of weight (0.99), grip strength (0.89) and walking speed (0.79). Results are much less satisfactory for evaluation of physical activity and exhaustion (Spearman correlation coefficients 0.25 and 0.41, respectively). Conclusion Correlations regarding weight, grip strength and walking speed confirm the validity of the data produced by the ARPEGE Pack to feed Fried’s criteria. Assessing activity level and exhaustion from an abbreviated questionnaire is still questionable. However, for long-run monitoring other methods of evaluation can be explored. Beyond the quantitative results, the ARPEGE Pack has been proved to be acceptable and motivating in such a long-term frailty monitoring

Balance quality assessment as an early indicator of physical frailty in older people

Frailty is an increasingly common geriatric condition that results in an increased risk of adverse health outcomes such as falls. The most widely-used means of detecting frailty is the Fried phenotype, which includes several objective measures such as grip strength and gait velocity. One method of screening for falls is to measure balance, which can be done by a range of techniques including the assessment of the Centre of Pressure (CoP) during a balance assessment. The Balance Quality Tester (BQT) is a device based on a commercial bathroom scale that can evaluate balance quality. The BQT provides instantaneously the position of the CoP (stabilogram) in both anteroposterior (AP) and mediolateral (ML) directions and can estimate the vertical ground reaction force. The purpose of this study was to examine the relationship between balance quality assessment and physical frailty. Balance quality was compared to physical frailty in 186 older subjects. Rising rate (RR) was slower and trajectory velocity (TV) was higher in subjects classified as frail for both grip strength and gait velocity (p<;0.05). Balance assessment could be used in conjunction with functional tests of grip strength and gait velocity as a means of screening for frailty

Is there a relationship between frailty indices and balance assessment in older people?

Grip-strength, walking speed and weight-loss are key measurements in the evaluation of frailty. According to L. Fried, these quantities are compared with thresholds, leading to associated frailty indices that would afterwards be combined to establish an overall decision. One of the consequences of frailty is an increasing risk of falls, which are a major cause of death of older people. The purpose of this study is to examine the possible relationships that could exist between grip-strength, walking speed, weight-loss and other parameters extracted from balance quality assessment for older subjects. The study shows that a relationship does exist between the balance quality parameters and the frailty indices

Effects of maternal modafinil treatment on fetal development and neonatal growth parameters - a multicenter case series of the European Network of Teratology Information Services (ENTIS)

Objective: In recent years, safety concerns about modafinil exposure during pregnancy have emerged. In particular, increased risks for major congenital anomalies (MCA) and impaired fetal growth were reported, although study results were conflicting. Our investigation aims to examine previously reported safety signals. Method: Multicenter case series based on data from 18 Teratology Information Services from 12 countries. Modafinil exposed pregnancies with an estimated date of birth before August 2019 were included in this study. For prospectively ascertained pregnancies, cumulative incidences of pregnancy outcomes, rate of nonchromosomal MCA in first trimester exposed pregnancies and percentiles of neonatal/infant weight and head circumference (HC) were calculated. Potential dose-dependent effects on fetal growth were explored by linear regression models. Retrospectively ascertained cases were screened for pattern of MCA and other adverse events. Results: One hundred and seventy-five prospectively ascertained cases were included, of which 173 were exposed at least during the first trimester. Cumulative incidences for live birth, spontaneous abortion and elective termination of pregnancy were 76.9% (95% CI, 68.0%-84.8%), 9.3% (95% CI, 5.0%-16.9%), and 13.9% (95% CI, 8.1%-23.1%), respectively. Nonchromosomal MCA was present in 3/150 live births, corresponding to an MCA rate of 2.0% (95%CI, 0.6%-6.1%), none were reported in pregnancy losses. Compared to reference standards, birth weight (BW) tended to be lower and neonatal HC to be smaller in exposed newborns (data available for 144 and 73 of 153 live births, respectively). In nonadjusted linear regression models, each 100 mg increase of average dosage per pregnancy day was associated with a decrease in standard deviation score (SDS) of -0.28 SDS (95% CI, -0.45 to -0.10) for BW and of -0.28 SDS (95% CI, -0.56 to 0.01) for HC. Screening of 22 retrospectively reported cases did not reveal any specific pattern of MCA or other adverse outcomes. Conclusion: The results do not indicate an increased risk of MCA after in utero exposure to modafinil, but a tendency toward lower BW and reduced neonatal HC. However, these findings should be regarded as preliminary. Until further studies allow for a definite conclusion, modafinil should not be used during pregnancy.The Berlin Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy is financially supported by the German Federal Institute for Drugs and Medical Devices (BfArM); included German study cases were obtained from the Embryotox cohort. The UK Teratology Information Service is funded by the UK Health Security Agency. The Dutch Teratology Information Service is funded by the Ministerie van Volksgezondheid, Welzijnen Sport Research Unit on Congenital Anomalies-UIAC & Spanish Teratology Information Services SITTE and SITE are financially supported by Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, of Spain.S

Effets indésirables « graves » du tramadol : bilan 2010-2011 de pharmacovigilance en France

Objectif. Le tramadol est un opioïde de palier 2 indiqué en France dans les douleurs modérées à sévères. Une enquête nationale de pharmacovigilance a été mise en place après le retrait du dextropropoxyphène. Méthodes. Nous avons analysé les notifications françaises d’effets indésirables « graves » (EIG) imputées au tramadol et parvenues aux Centres régionaux de pharmacovigilance (CRPV) ou aux firmes pharmaceutiques entre le 1er août 2010 et le 31 juillet 2011. Résultats. Durant la période d’enquête, 296 cas d’EIG ont été notifiés aux CRPV et 59 aux firmes. Outre les EI opioïdes, nous avons identifié plusieurs EI sérotoninergiques, dont des convulsions et des syndromes sérotoninergiques. Nous avons aussi mis en évidence des EI « inattendus », certains méconnus des professionnels de santé (hypoglycémie, hyponatrémie), d’autres n’ayant jamais fait l’objet de publications (œdèmes des membres inférieurs, pancréatites). Conclusion. Ce suivi montre qu’à côté des EI opioïdes ou sérotoninergiques bien décrits, le tramadol peut aussi déterminer 2 autres EI relativement peu connus : hypoglycémie et hyponatrémie