Predictors of clinically significant quality of life impairment in Parkinson’s disease

COPPADIS Study Group.Quality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R 2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.Mir P. has received honoraria from AbbVie, Abbott, Allergan, Bial, Merz, UCB and Zambon and have received grants from the Spanish Ministry of Economy and Competitiveness [PI16/01575] co-founded by ISCIII (Subdirección General de Evaluación y Fomento de la Investigación) and by Fondo Europeo de Desarrollo Regional (FEDER), the Consejería de Economía, Innovación, Ciencia y Empleo de la Junta de Andalucía [CVI-02526, CTS-7685], the Consejería de Salud y Bienestar Social de la Junta de Andalucía [PI-0437-2012, PI-0471-2013], the Sociedad Andaluza de Neurología, the Jacques and Gloria Gossweiler Foundation, the Fundación Alicia Koplowitz, the Fundación Mutua Madrileña.Peer reviewe

Why there is such luxurious growth in the hypogean environments

Organisms building biofilms are of considerable interest in the context of degradation of cultural heritage. Particularly, hypogean environments exposed to artificial light are colonized by microbial communities, which damage walls and frescoes. In order to ascertain the mechanisms by which phototophic biofilms thrive under the particular conditions of hypogea, the organism composition and three-dimensional structure of biofilms from the Roman catacombs St. Callistus and Domitilla were studied. The main phototrophic organisms forming the biofilms were filamentous sheathed cyanobacteria and mosses. Biofilms were spatially very heterogeneous in thickness, density and organism composition but could be classified as regards their main organisms. There was a trend of decreasing diversity in the phototrophic composition of the biofilms under lower irradiances, the one at the lowest irradiance being uniquely built by erected filaments of Leptolyngbya sp. Except for this biofilm, the main organism composition was not clearly related with decreasing irradiance. However, biofilms from dim light samples were porous and the filamentous cyanobacteria in them were erected. Leptolyngbya sp., the most ubiquitous species, displayed a high number of phycobilisomes and its hormogonia a gliding movement that allowed colonization of substrata. Such mechanisms may have an important role for thriving under the low light conditions of the catacombs

Steam Explosion and Vibrating Membrane Filtration to Improve the Processing Cost of Microalgae Cell Disruption and Fractionation

The aim of this study is to explore an innovative downstream route for microalgae processing to reduce cost production. Experiments have been carried out on cell disruption and fractionation stages to recover lipids, sugars, and proteins. Steam explosion and dynamic membrane filtration were used as unit operations. The species tested were Nannochloropsis gaditana, Chlorella sorokiniana, and Dunaliella tertiolecta with different cell wall characteristics. Acid-catalysed steam explosion permitted cell disruption, as well as the hydrolysis of carbohydrates and partial hydrolysis of proteins. This permitted a better access to non-polar solvents for lipid extraction. Dynamic filtration was used to moderate the impact of fouling. Filtration enabled two streams: A permeate containing water and monosaccharides and a low-volume retentate containing the lipids and proteins. The necessary volume of solvent to extract the lipids is thus much lower. An estimation of operational costs of both steam explosion and membrane filtration was performed. The results show that the steam explosion operation cost varies between 0.005 $/kg and 0.014$/kg of microalgae dry sample, depending on the cost of fuel. Membrane filtration cost in fractionation was estimated at 0.12 $/kg of microalgae dry sample

Efficient harvesting of <i>Chaetoceros calcitrans</i> for biodiesel production

<div><p>Harvesting is one of the key challenges to determine the feasibility of producing biodiesel from algae. This paper presents experimental results for a cost-effective system to harvest <i>Chaetoceros calcitrans</i>, using natural sedimentation, flocculation, and inducing pH. No efficient sedimentation of microalgal cells was observed only by gravity. By alkalinity-induced flocculation, at a pH value of 9.51, 86% recovery of the cells was achieved with a sedimentation rate of 125 cm/h and a concentration factor (CF) of 4 (volume/volume (v/v)) in 10 min. The maximum photochemical quantum yield of photosystem II (<i>F</i>_<i>v</i>/<i>F</i>_m) of concentrated cells was almost the same as fresh culture (0.621). Commercial flocculants, aluminium sulphate and poly-aluminium chloride (PAC), were also successful in harvesting the studied algal cells. Optimum concentration of aluminium sulphate (AS) could be concluded as 10 ppm with 87.6% recovery and 7.10 CF (v/v) in 30 min for cost-efficient harvesting, whereas for PAC it was 20 ppm with 74% recovery and 6.6 CF (v/v). <i>F</i>_<i>v</i>/<i>F</i>_m yields of concentrated cells with AS and PAC showed a 1% reduction compared to fresh culture. Mg⁺² was the triggering ion for alkalinity-induced flocculation in the conditions studied. The rheology behaviour of the concentrated cells was Newtonian with values between 2.2 × 10⁻³ and 2.3 × 10⁻³ Pa s at 30°C.</p></div

Medication-related problems in older people in Catalonia : A real-world data study

Altres ajuts: Department of Health of the Catalan Government/SLT002/16/00058The aim of this study was to determine medication-related problems (MRPs) in primary care patients over 65 years of age. Cross-sectional study based on the electronic health records of patients (65-99 years of age) visited in 284 primary health care centers during 2012 in Catalonia. Variables: age, sex, sociodemographic variables, number of drugs, kidney and liver function and MRPs (duplicate therapy, drug-drug interactions, potentially inappropriate medications [PIMs] and drugs contraindicated in chronic kidney disease and in liver diseases). Unconditional logistic regression models were used to identify the factors associated with MRPs in patients with multimorbidity. 916 619 older people were included and 853 085 of them met the criteria for multimorbidity. Median age was 75 years and 57.7% of them were women. High percentages of MRPs were observed: PIMs (62.8%), contraindicated drugs in chronic kidney disease (12.1%), duplicate therapy (11.1%), contraindicated drugs in liver diseases (4.2%), and drug-drug interactions (1.0%). These numbers were higher in the subgroup of patients with ≥10 diseases. The most common PIMs were connected to drugs that increase the risk of fall (66.8%), antiulcer agents without criteria for gastroprotection (40.6%), and the combination of drugs with anticholinergic effects (39.7%). In the multivariate analysis, the variables associated with all MRPs among the patients with multimorbidity were the number of drugs and the number of visits. The coexistence of multimorbidity and polypharmacy is associated with an elevated risk of MRPs in older people. Medication safety for older patients constitutes a pressing concern for health services

Falso negativo en serología de VHC debido a interferencia por crioglobulinas

Las crioglobulinas (CG) son proteínas séricas que precipitan en frío in vitro. Se sabe que las CG causan interferencias analíticas en diversos tipos de análisis clínicos, lo que se traduce en resultados incorrectos. Presentamos el caso de una paciente diagnosticada erróneamente de crioglobulinemia esencial debido a la interferencia de las CG en la serología del virus de la hepatitis C (VHC)

False-seronegative HCV infection motivated by interference with cryoglobulins

Cryoglobulins (CGs) are serum proteins that undergo a reverse cold-induced precipitation in vitro. The CGs are a well-known cause of analytical interferences in several laboratory tests, leading to spurious results. With this in view, we present a case of a patient initially misdiagnosed due to CGs interference in Hepatitis C Virus (HCV) serology

Predictors of clinically significant quality of life impairment in Parkinson’s disease

Quality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R 2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients

Non-motor symptoms burden, mood, and gait problems are the most significant factors contributing to a poor quality of life in non-demented Parkinson's disease patients: Results from the COPPADIS Study Cohort

[Objective] To identify factors related to a poor health-related and global quality of life (QoL) in a cohort of non-demented Parkinson's disease (PD) patients and compare to a control group.[Methods] The data correspond to the baseline evaluation of the COPPADIS-2015 Study, an observational, 5-year follow-up, multicenter, evaluation study. Three instruments were used to assess QoL: (1) the 39-item Parkinson's disease Questionnaire (PDQ-39), (2) a subjective rating of global QoL (PQ-10), and (3) the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Multiple linear regression methods were used to evaluate the direct impact of different variables on these QoL measures.[Results] QoL was worse in PD patients (n = 692; 62.6 ± 8.9 years old, 60.3% males) than controls (n = 206; 61 ± 8.3 years old, 49.5% males): PDQ-39, 17.1 ± 13.5 vs 4.4 ± 6.3 (p < 0.0001); PQ-10, 7.3 ± 1.6 vs 8.1 ± 1.2 (p < 0.0001); EUROHIS-QOL8, 3.8 ± 0.6 vs 4.2 ± 0.5 (p < 0.0001). A high correlation was observed between PDQ-39 and Non-Motor Symptoms Scale (NMSS) (r = 0.72; p < 0.0001), and PDQ-39 and Beck Depression Inventory-II (BDI-II) (r = 0.65; p < 0.0001). For health-related QoL (PDQ-39), non-motor symptoms burden (NMSS), mood (BDI-II), and gait problems (Freezing Of Gait Questionnaire [FOGQ]) provided the highest contribution to the model (β = 0.32, 0.28, and 0.27, respectively; p < 0.0001); whereas mood and gait problems contributed the most to global QoL (PQ-10, β = -0.46 and −0.21, respectively; EUROHIS-QOL8, β = -0.44 and −0.23, respectively).[Conclusions] QoL is worse in PD patients than in controls. Mood, non-motor symptoms burden, and gait problems seem to be the most relevant factors affecting health-related and global perceived QoL in non-demented PD patients.Peer reviewe