The assessment of quality of Life (QOL) in chronic vascular diseases II : The evaluation of a new self-completed questionnaire for QOL (QUIK)

われわれが考案した自己記入式質問表（QUIK）の再現性と安定性を検討するために，再調査のできた242名の循環器疾患患者（男96，女146，69±11歳）を対象にQUIKを実施し，前回の結果と比較した。再テスト法による信頼性はr=0.74であった。QUIK総得点は11.5±8.9で，前回の総得点結果と今回の結果との間には有意の関連(r=0.66, P<0.01)があった。また，両者の総得点の平均および6段階評価の分布に差異はなかった。区分点を9/10点とすると，対象患者群と非患者群との比較では，感度は0.47，特異度は0.81，判別率は0.55，オッズ比は3.9となる。各尺度の平均得点は身体機能5.0±3.6，情緒適応2.2±2.3，対人関係1.8±2.0，生活目標2.6±2.0を示し，前回の結果とほぼ同様であり，また，各尺度間には有意の関連が見られた。On evaluating the stability and the repeatability of a new self completed QOL questionnaire(QUIK), we examined the QUIK of another two hundred forty five patients with chronic vascular diseases (male:96, female:146, mean 69±11 y.o.) and compared the results in this study with those in the former studies. The average total score was 11.5±8.9. Comparison of the first and second studies showed a statistically significant correlation between total score (P<0.01). According to a six tiered rating scale, the total score showed an approximately normal distribution curve, which was similar to that in the first study. If the cut-off point was set between scores of 9 and 10, the sensitivity was 0.47, the specificity was 0.81, the overall diagnostic power was 0.55 and the odds ratio was 3.9 in a comparison of subjects and healthy controls. The mean and standard deviation of each domain were 5.0±3.6 for physical functioning, 2.2±2.3 for emotional adjustment. 1.8±2.0 for interpersonal relationships and 2.6±2.0 for attitudes toward life. These results showed no significant difference compared with those in the first study. There existed a close correlation among the four domains, similar to that seen in the first study. The mean and the standard deviation of the total scores for each patients group were 18.7±8.6 for in-patients, 16.9±9.8 for house-bound patients and 9.0±7.1 for out-patients. The mean and the standard deviation of the total scores for each diseases were 14.8±8.9 for apoplexy, 9.0±6.0 for ischemic heart disease and 7.5±7.3 for hypertension. These figures are concordant with those in the former study

The assessment of Quality of Life (QOL) in chronic vascular diseases Ⅰ : The evaluation of a new self-completed questionnaire for QOL (QUIK)

われわれが考案した身体機能，情緒適応，対人関係，生活目標の4つの尺度（計50問）からなる自己記入式質問表（QUIK）を用いて，212名の循環器疾患患者（高血圧症，脳血管障害，虚血性心疾患）のQOLを検討した。患者群と非患者群のQUIKの結果をみると，総得点およびいずれの尺度においても対象群における得点が高く，疾病により，機能障害から能力低下を引き起こし，さらに社会的不利（QOLの劣悪化）へと至ることが示唆された。また，患者群の内， 70歳以上の高齢患者ではそれ以下の年齢の者に比べ，QUIKはより不良であり，特に生活目標面でより劣悪であった。QUIKの総得点は，年齢では高齢者ほど，受診形態では在宅往診，疾患としては脳血管障害において高かった。In order to investigate the Quality of Life (QOL) in elderly patients, a new QOL questionnaire (QUIK) was given to in-, or out-patients with chronic vascular diseases. We selected 212 patients with cerebral disease (67 patients). ischemic heart disease (38 patients) or hypertension (107 patients) aged over 40 years (mean 68±13 years). As a control group, 69 healthy volunteers aged over 40 years (mean 62±11 years) were selected. QUIK, which we developed in 1991, is a self-completed and close-ended questionnaire, which covers four domains including physical functioning (20 questions). emotional adjustment (10), interpersonal relationships (10), and attitudes toward life (10), totaling 50 questions from the perspective of holistic system theory. Our data were statistically analyzed using the t-test, Welch\u27s test, chi-square test, Fischer\u27s exact test and regression analysis. QUIK scores in the patient group were notably worse in terms of total score (11.0±8.1 vs 5.0±4.4), for physical functioning (5.2±3.6 vs 2.5±2.2), for emotional adjustment (2.1±2.1 vs 1.1±1.3), interpersonal relationships (1.6±1.7 vs 0.7±1.2) and attitudes toward life (2.2±2.5 vs 1.1±1.3) as compared with the healthy group (p<0.05). QUIK scores in patients aged over 70 years were significanthy worse than those in the yonger patients, particularly for attitudes toward life (3.1±2.8 vs 1.2±1.8, p<0.01)

新しい介護負担評価尺度(ABC-16)の妥当性

目的：本研究の目的は、新たに作成された自己記入式介護負担評価尺度(ABC-16) の妥当性を検討することである方法：対象者は、第1群では51名（平均年齢63±11歳）、第2群では31名（平均年齢58±14歳）の家族介護者である。結果：第1群におけるABC-16総計の平均点は14.98±7.52であった。第1群では高い妥当性（内的整合性、α=0.821) を示し、かつ4つの領域間に有意の相関が得られた(P<0.05)。重回帰分析によりABC-16と介護者のQOL (P=0.034) および夜間介護(P=0.001) とにおいて強い関連が見られた。第2群は第1群の結果とほぽ同様の結果が得られ、ABC-16の交差妥当性のあることが示唆された。結論： ABC-16は高い妥当性を有する大変優れた介護負担評価尺度であることが示された。Aims: The aim of this study is to evaluate the validation of a newly developed self-administered assessment of the burden on caregivers (ABC-16). Methods: The subjects were 51 family caregivers (mean age 63 ± 11 years) for the first trial and 31 family caregivers (mean age 58 ± 14 years) for the second trial. The ABC-16 consists of 16 items and is designed to cover 4 dimensions (the care receiver\u27s burden, burden on social life, financial burden, and burden on health). Results: In the first trial, the mean and standard deviation of the total score of the ABC-16 was 14.98 ± 7.52. The first trial showed high reliability; the internal consistency was α=0.821 and significant correlations among the four dimensions were found (P<0.05). A multiple regression analysis showed strong correlations between the ABC-16 and the QOL of the caregivers (P=0.034), and the caregiving during the night (P=0.001). The second trial showed findings similar to those in the first trial, which suggested the good cross validation of the ABC-16. Conclusions: It is suggested that the ABC-16 is an excellent tool for assessing the care burden with high validity

DOCK2 is involved in the host genetics and biology of severe COVID-19

「コロナ制圧タスクフォース」COVID-19疾患感受性遺伝子DOCK2の重症化機序を解明 --アジア最大のバイオレポジトリーでCOVID-19の治療標的を発見--. 京都大学プレスリリース. 2022-08-10.Identifying the host genetic factors underlying severe COVID-19 is an emerging challenge. Here we conducted a genome-wide association study (GWAS) involving 2, 393 cases of COVID-19 in a cohort of Japanese individuals collected during the initial waves of the pandemic, with 3, 289 unaffected controls. We identified a variant on chromosome 5 at 5q35 (rs60200309-A), close to the dedicator of cytokinesis 2 gene (DOCK2), which was associated with severe COVID-19 in patients less than 65 years of age. This risk allele was prevalent in East Asian individuals but rare in Europeans, highlighting the value of genome-wide association studies in non-European populations. RNA-sequencing analysis of 473 bulk peripheral blood samples identified decreased expression of DOCK2 associated with the risk allele in these younger patients. DOCK2 expression was suppressed in patients with severe cases of COVID-19. Single-cell RNA-sequencing analysis (n = 61 individuals) identified cell-type-specific downregulation of DOCK2 and a COVID-19-specific decreasing effect of the risk allele on DOCK2 expression in non-classical monocytes. Immunohistochemistry of lung specimens from patients with severe COVID-19 pneumonia showed suppressed DOCK2 expression. Moreover, inhibition of DOCK2 function with CPYPP increased the severity of pneumonia in a Syrian hamster model of SARS-CoV-2 infection, characterized by weight loss, lung oedema, enhanced viral loads, impaired macrophage recruitment and dysregulated type I interferon responses. We conclude that DOCK2 has an important role in the host immune response to SARS-CoV-2 infection and the development of severe COVID-19, and could be further explored as a potential biomarker and/or therapeutic target