Validation of the Saint George's Respiratory Questionnaire in patients with chronic obstructive pulmonary disease in Brazil

Introduction: The term quality of life has gained increasing importance in the scientific context. This study describes the adaptation of a disease-specific questionnaire developed by Paul Jones et al. in 1991, the St. George's Respiratory Questionnaire (SGRQ), to the Brazilian language and culture. This questionnaire evaluates the quality of life in patients with chronic obstructive pulmonary disease (COPD) and contains three domains (symptoms, activity, and impacts) divided in 76 items. The questionnaire is self-administrated, but it may be read to illiterate persons. Goal: To verify if the St. George's Respiratory Questionnaire is a valid tool to measure quality of life in patients with chronic obstructive pulmonary disease in Brazil. Methods: In order to validate the questionnaire in Brazil, it was initially translated into Portuguese and afterwards a back-translation into English, that was compared to the original version. A final Portuguese version was then written. This final version was, then, answered by 30 clinically stable COPD patients, according to the spirometry and oximetry values. Patients answered the questionnaire twice, within a 15 day interval. The length of time the patients took to answer the questionnaire and their doubts were noted. Wilcoxon test was used for the calculation of r probability between every single question between the two days; interclass correlation ratio was calculated to test the trustworthiness and reliability of the questionnaire. Results: Among the 30 participant patients, 10 were female and 20 were male. Mean age was 65.9 years. Most of the patients were found to be in stage 2 (56.7 %) of COPD, according to the American Thoracic Society classification. The interclass correlation ratio for the total score of the questionnaire was a = 0.79 and Wilcoxon p = 0.2110 (not statistically significant). The mean answering time for the two days of interview was, respectively, 11 minutes and 50 seconds and 10 minutes and 31 seconds. As concerns the doubts about the questions, the patients reported difficulties in answering Sections 4 and 5, each one of these questions written in a negative form. Conclusion: It can be concluded that the Brazilian version of the St. George's Respiratory Questionnaire is a valid and reliable tool to measure quality of life in patients with COPD in Brazil.Introdução: O termo qualidade de vida tem adquirido cada vez mais importância no contexto científico. O presente estudo descreve a adaptação para as língua e cultura brasileiras de um questionário doença-específico desenvolvido por Paul Jones et al. em 1991(1): o Questionário do Hospital Saint George na Doença Respiratória (SGRQ), para a avaliação de qualidade de vida em pacientes portadores de doença pulmonar obstrutiva crônica (DPOC). Esse questionário contém três componentes (sintomas, atividade e impactos) divididos em 76 itens. É auto-administrado e pode ser lido para pacientes analfabetos. Objetivo: Verificar se o SGRQ é um instrumento válido para medir qualidade de vida em pacientes portadores de DPOC no Brasil. Métodos: Para a validação deste questionário no Brasil, realizou-se, inicialmente, uma versão da língua inglesa para o português; em seguida, foi realizada a tradução retrógrada (back translation), do português para o inglês, e uma versão final foi aplicada em 30 pacientes com diagnóstico de DPOC, estáveis clinicamente e baseado em critérios de espirometria e oximetria. Os pacientes responderam ao questionário por duas vezes, num intervalo de 15 dias. O tempo de resposta foi cronometrado e as dúvidas apontadas pelos pacientes, anotadas. Foi utilizado o teste estatístico de Wilcoxon para cálculo de probabilidade de r e calculado o coeficiente de correlação intraclasse para testar a fidedignidade e a confiabilidade do questionário. Resultados: Dos 30 pacientes que participaram do estudo, 10 eram do sexo feminino e 20 do masculino. A média de idade foi de 65,9 anos. A maioria dos pacientes encontrava-se no estádio 2 (56,7%) da DPOC, segundo a classificação da American Thoracic Society. O coeficiente de correlação intraclasse para a pontuação total do questionário foi a = 0,79 e o resultado do teste de Wilcoxon p = 0,2110 (não significante estatisticamente). O tempo médio de resposta dos dois dias de entrevista foi, respectivamente, 11 minutos e 50 segundos e 10 minutos e 31 segundos. Em relação às dúvidas, as questões mais freqüentemente referidas foram as das seções 4 e 5, que contêm uma frase cada na forma negativa. Conclusão: Pode-se concluir que a versão brasileira do Questionário do Hospital Saint George na Doença Respiratória (SGRQ) é um instrumento válido e fidedigno para medir qualidade de vida em pacientes portadores de DPOC no Brasil.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaCentro Universitário de UberlândiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Centro de Reabilitação PulmonarUniversity of LondonUNIFESP, EPM, Centro de Reabilitação PulmonarSciEL

Brazilian version of airways questionnaire 20: a reproducibility study and correlations in patients with COPD

This study describes the correlations and reproducibility of AQ20, a simple health status questionnaire with 20 questions, which was designed to be useful especially in time sparing situations. A format language validation process was done, in order to validate the AQ20 before studying its reproducibility. Thirty stable COPD patients answered the final version twice within 15 days. To test the reproducibility of AQ20, the interclass correlation coefficient and Bland Altman display were used. Results were correlated with FEV1, SpO(2), BMI, Mahler BDI, and the Saint George Respiratory Questionnaire (SGRQ). Twenty-five patients (83.3%) were male, with a mean age of 68.6 years. the mean predicted FEV1 (%) was 56.8%. the interclass correlation ratio for the total score was alpha = 0.90 for the intraobserver variability and alpha = 0.93 for the interobserver variability. the correlation with total SGRQ score was 0.76, with P < 0.001. the mean application time for AQ20 was 4min and 6s, and the score calculation time, was 8s. It can be concluded that AQ20 is reproducible, with an excellent correlation with SGRQ total score, and also having the advantage of taking just a few minutes to be applied and to have its score calculated. (c) 2004 Elsevier B.V. All rights reserved.Universidade Federal de São Paulo, Div Resp, Rehabil Ctr, BR-04023062 São Paulo, BrazilUniv London St Georges Hosp, Sch Med, London SW17 0RE, EnglandUniversidade Federal de São Paulo, Div Resp, Rehabil Ctr, BR-04023062 São Paulo, BrazilWeb of Scienc

Prescribing patterns in premenstrual syndrome

BACKGROUND: Over 300 therapies have been proposed for premenstrual syndrome. To date there has been only one survey conducted in the UK of PMS treatments prescribed by GPs, a questionnaire-based study by the National Association of Premenstrual Syndrome in 1989. Since then, selective serotonin re-uptake inhibitors have been licensed for severe PMS/PMDD, and governmental recommendations to reduce the dosage of vitamin B6 (the first choice over-the-counter treatment for many women with PMS) have been made. This study investigates the annual rates of diagnoses and prescribing patterns for premenstrual syndrome (1993–1998) within a computerised general practitioner database. METHODS: Retrospective survey of prescribing data for premenstrual syndrome between 1993–1998 using the General Practice Research Database for the West Midlands Region which contains information on 282,600 female patients RESULTS: Overall the proportion of women with a prescription-linked diagnosis of premenstrual syndrome has halved over the five years. Progestogens including progesterone were the most commonly recorded treatment for premenstrual syndrome during the whole study period accounting for over 40% of all prescriptions. Selective serotonin-reuptake inhibitors accounted for only 2% of the prescriptions in 1993 but rose to over 16% by 1998, becoming the second most commonly recorded treatment. Vitamin B6 accounted for 22% of the prescriptions in 1993 but dropped markedly between 1997 and 1998 to 11%. CONCLUSIONS: This study shows a yearly decrease in the number of prescriptions linked to diagnoses for premenstrual syndrome. Progestogens including progesterone, is the most widely prescribed treatment for premenstrual syndrome despite the lack of evidence demonstrating their efficacy

Crop Updates 1999 - Oilseeds

This article contains eighteen papers INTRODUCTION, Paul Carmody, Agriculture Western Australia PLENARY SESSION Transgenic canola in Western Australia: Outlook and challenges, Phil Salisbury, University of Melbourne Farming system issues for herbicide tolerant canola, Rick Madin, Rick Madin and Associates, David Bowran, Agriculture Western Australia Beating blackleg in 1999, Martin Barbetti, Ravjit Khangura, Paul Carmody, Graham Walton, Agriculture Western Australia The Mustard Industry in Australia – Opportunities for a new oilseed, Phil Parker, NSW Agriculture Management of blackleg with fungicides, Ravjit Khangura and Martin Barbetti, Agriculture Western Australia Effect of aphid feeding damage on canola yields in 1998, Francoise Berlandier and Linnet Cartwright, Agriculture Western Australia Post-anthesis duration and rainfall affect oil content of canola, Ping Si, University of West Australia, Graham Walton, Agriculture Western Australia, Nick Galwey and David Turner, University of West Australia Canola responded to high rates of fertiliser in 1998, Wayne Pluske, CSBP Impact of agronomic practices on canola quality, Graham Walton, Agriculture Western Australia Survey reveals widespread infection with two virus diseases in Western Australian canola crops, Roger Jones and Brenda Coutts, Agriculture Western Australia Calculating canola yields and oil contents as a function of soil and fertiliser nitrogen supply, Bill Bowden and Isabel Arevalo-Vigne, Agriculture Western Australia Canola benchmarks 1997/98 – Central Eastern District, Jeff Russell, Agriculture Western Australia Seeding rate affects the yield and some architectural features of canola, Syed H. Zaheer, Nick W. Galwey and David Turner, University of Western Australia Foliar applied fungicides for blackleg, Andrew Simon and Art Diggle, Agriculture Western Australia Farm based demonstration 1998 canola N – Wheel evaluation, Jeff Russell, Agriculture Western Australia Effect of sowing date on seed yield of canola, Dave Eksteen, Agriculture Western Australia Investigating water use of summer crops on the South Coast of Western Australia, Arjen Ryder, Agriculture Western Australia, Bill Crabtree, Western Australia No Till Farming Association, Serena Wyatt, Catchment Landcare Coordinator, Wellstead, Jim Baily, Subasio Downs, Wellstead INTRODUCTION, Paul Carmody, Agriculture Western Australia PLENARY SESSION Transgenic canola in Western Australia: Outlook and challenges, Phil Salisbury, University of Melbourne Farming system issues for herbicide tolerant canola, Rick Madin, Rick Madin and Associates, David Bowran, Agriculture Western Australia Beating blackleg in 1999, Martin Barbetti, Ravjit Khangura, Paul Carmody, Graham Walton, Agriculture Western Australia The Mustard Industry in Australia – Opportunities for a new oilseed, Phil Parker, NSW Agriculture Management of blackleg with fungicides, Ravjit Khangura and Martin Barbetti, Agriculture Western Australia Effect of aphid feeding damage on canola yields in 1998, Francoise Berlandier and Linnet Cartwright, Agriculture Western Australia Post-anthesis duration and rainfall affect oil content of canola, Ping Si, University of West Australia, Graham Walton, Agriculture Western Australia, Nick Galwey and David Turner, University of West Australia Canola responded to high rates of fertiliser in 1998, Wayne Pluske, CSBP Impact of agronomic practices on canola quality, Graham Walton, Agriculture Western Australia Survey reveals widespread infection with two virus diseases in Western Australian canola crops, Roger Jones and Brenda Coutts, Agriculture Western Australia Calculating canola yields and oil contents as a function of soil and fertiliser nitrogen supply, Bill Bowden and Isabel Arevalo-Vigne, Agriculture Western Australia Canola benchmarks 1997/98 – Central Eastern District, Jeff Russell, Agriculture Western Australi

Phosphorylation-Independent Regulation of the Diguanylate Cyclase WspR

Environmental signals that trigger bacterial pathogenesis and biofilm formation are mediated by changes in the level of cyclic dimeric guanosine monophosphate (c-di-GMP), a unique eubacterial second messenger. Tight regulation of cellular c-di-GMP concentration is governed by diguanylate cyclases and phosphodiesterases, which are responsible for its production and degradation, respectively. Here, we present the crystal structure of the diguanylate cyclase WspR, a conserved GGDEF domain-containing response regulator in Gram-negative bacteria, bound to c-di-GMP at an inhibitory site. Biochemical analyses revealed that feedback regulation involves the formation of at least three distinct oligomeric states. By switching from an active to a product-inhibited dimer via a tetrameric assembly, WspR utilizes a novel mechanism for modulation of its activity through oligomerization. Moreover, our data suggest that these enzymes can be activated by phosphodiesterases. Thus, in addition to the canonical pathways via phosphorylation of the regulatory domains, both product and enzyme concentration contribute to the coordination of c-di-GMP signaling. A structural comparison reveals resemblance of the oligomeric states to assemblies of GAF domains, widely used regulatory domains in signaling molecules conserved from archaea to mammals, suggesting a similar mechanism of regulation

Investigation of type 1 diabetes and coeliac disease susceptibility loci for association with juvenile idiopathic arthritis

BACKGROUND: There is strong evidence suggesting that juvenile idiopathic arthritis (JIA) shares many susceptibility loci with other autoimmune diseases. OBJECTIVE: To investigate variants robustly associated with type 1 diabetes (T1D) or coeliac disease (CD) for association with JIA. METHODS: Sixteen single-nucleotide polymorphisms (SNPs) already identified as susceptibility loci for T1D/CD were selected for genotyping in patients with JIA (n=1054) and healthy controls (n=3129). Genotype and allele frequencies were compared using the Cochrane-Armitage trend test implemented in PLINK. RESULTS: One SNP in the LPP gene, rs1464510, showed significant association with JIA (p(trend)=0.002, OR=1.18, 95% CI 1.06 to 1.30). A second SNP, rs653178 in ATXN2, also showed nominal evidence for association with JIA (p(trend)=0.02, OR=1.13, 95% CI 1.02 to 1.25). The SNP, rs17810546, in IL12A showed subtype-specific association with enthesitis-related arthritis (ERA) subtype (p(trend)=0.005, OR=1.88, 95% CI 1.2 to 2.94). CONCLUSIONS: Evidence for a novel JIA susceptibility locus, LPP, is presented. Association at the SH2B3/ATXN2 locus, previously reported to be associated with JIA in a US series, also supports this region as contributing to JIA susceptibility. In addition, a subtype-specific association of IL12A with ERA is identified. All findings will require validation in independent JIA cohorts

Investigation of rheumatoid arthritis susceptibility loci in juvenile idiopathic arthritis confirms high degree of overlap

&lt;p&gt;Objectives: Rheumatoid arthritis (RA) shares some similar clinical and pathological features with juvenile idiopathic arthritis (JIA); indeed, the strategy of investigating whether RA susceptibility loci also confer susceptibility to JIA has already proved highly successful in identifying novel JIA loci. A plethora of newly validated RA loci has been reported in the past year. Therefore, the aim of this study was to investigate these single nucleotide polymorphisms (SNP) to determine if they were also associated with JIA.&lt;/p&gt; &lt;p&gt;Methods: Thirty-four SNP that showed validated association with RA and had not been investigated previously in the UK JIA cohort were genotyped in JIA cases (n=1242), healthy controls (n=4281), and data were extracted for approximately 5380 UK Caucasian controls from the Wellcome Trust Case–Control Consortium 2. Genotype and allele frequencies were compared between cases with JIA and controls using PLINK. A replication cohort of 813 JIA cases and 3058 controls from the USA was available for validation of any significant findings.&lt;/p&gt; &lt;p&gt;Results: Thirteen SNP showed significant association (p&#60;0.05) with JIA and for all but one the direction of association was the same as in RA. Of the eight loci that were tested, three showed significant association in the US cohort.&lt;/p&gt; &lt;p&gt;Conclusions: A novel JIA susceptibility locus was identified, CD247, which represents another JIA susceptibility gene whose protein product is important in T-cell activation and signalling. The authors have also confirmed association of the PTPN2 and IL2RA genes with JIA, both reaching genome-wide significance in the combined analysis.&lt;/p&gt

Macaque models of human infectious disease.

Macaques have served as models for more than 70 human infectious diseases of diverse etiologies, including a multitude of agents-bacteria, viruses, fungi, parasites, prions. The remarkable diversity of human infectious diseases that have been modeled in the macaque includes global, childhood, and tropical diseases as well as newly emergent, sexually transmitted, oncogenic, degenerative neurologic, potential bioterrorism, and miscellaneous other diseases. Historically, macaques played a major role in establishing the etiology of yellow fever, polio, and prion diseases. With rare exceptions (Chagas disease, bartonellosis), all of the infectious diseases in this review are of Old World origin. Perhaps most surprising is the large number of tropical (16), newly emergent (7), and bioterrorism diseases (9) that have been modeled in macaques. Many of these human diseases (e.g., AIDS, hepatitis E, bartonellosis) are a consequence of zoonotic infection. However, infectious agents of certain diseases, including measles and tuberculosis, can sometimes go both ways, and thus several human pathogens are threats to nonhuman primates including macaques. Through experimental studies in macaques, researchers have gained insight into pathogenic mechanisms and novel treatment and vaccine approaches for many human infectious diseases, most notably acquired immunodeficiency syndrome (AIDS), which is caused by infection with human immunodeficiency virus (HIV). Other infectious agents for which macaques have been a uniquely valuable resource for biomedical research, and particularly vaccinology, include influenza virus, paramyxoviruses, flaviviruses, arenaviruses, hepatitis E virus, papillomavirus, smallpox virus, Mycobacteria, Bacillus anthracis, Helicobacter pylori, Yersinia pestis, and Plasmodium species. This review summarizes the extensive past and present research on macaque models of human infectious disease

Bose-Einstein Correlations of Three Charged Pions in Hadronic Z^0 Decays

Bose-Einstein Correlations (BEC) of three identical charged pions were studied in 4 x 10^6 hadronic Z^0 decays recorded with the OPAL detector at LEP. The genuine three-pion correlations, corrected for the Coulomb effect, were separated from the known two-pion correlations by a new subtraction procedure. A significant genuine three-pion BEC enhancement near threshold was observed having an emitter source radius of r_3 = 0.580 +/- 0.004 (stat.) +/- 0.029 (syst.) fm and a strength of \lambda_3 = 0.504 +/- 0.010 (stat.) +/- 0.041 (syst.). The Coulomb correction was found to increase the \lambda_3 value by \~9% and to reduce r_3 by ~6%. The measured \lambda_3 corresponds to a value of 0.707 +/- 0.014 (stat.) +/- 0.078 (syst.) when one takes into account the three-pion sample purity. A relation between the two-pion and the three-pion source parameters is discussed.Comment: 19 pages, LaTeX, 5 eps figures included, accepted by Eur. Phys. J.