Differences between Luxembourg and Portugal in the Life Satisfaction of Stroke Survivors, two years post-event: The influence of an unequal quality of life.

Two years post-event, we described the survivors’ life satisfaction (LS) and Quality of Life (QoL), the LS and QoL of their caregivers, and their socio-demographic and health characteristics. We analysed the survivors’ LS and its associations with the above-mentioned determinants from a national (mainly urban society) survey in Luxembourg (LU) and a Bragança district (mainly rural) survey in the Northeast of Portugal (PT). Methods. Over 18 months, survivors (≥18 years) of a stroke, living at home and having given their informed consent were contacted. The Inspection Générale de la Sécurité Sociale of LU and the District Health Centre in PT had previously confirmed all diagnoses and listed the potential participants. Survivors identified their caregivers and both were interviewed, at home, using questionnaires measuring LS (scale 1-10) and two internationally validated QoL’ scales: the survivors’ Newcastle Quality of Life (Newsqol) and the Whoqol-Bref for the caregivers. Results. The participation rate was 26.5% LU and 38% PT: 94 LU (65.5 years) and 50 PT (70.1 years) survivors; 62 LU (59.3 years) and 46 PT (60.7 years) caregivers. The LU survivors and their caregivers had higher QoL scores than the PT samples. In contrast, the PT survivors were more affected by stroke-related impacts, with significant differences in Newsqol ‘mobility’ (i.e. walking, managing stairs, bending down, standing), ‘self-care’ (i.e. preparing food, shopping, using transport, getting washed, getting dressed, and showed), feelings regarding the current situation (i.e. less independence, feelings about oneself, life changes acceptance, depressive mood, feelings of useless, loss of control over their life), and their emotional status (i.e. more emotional, sometimes crying, short-tempered, less tolerant and nervous). Only the PT survivors’ LS was linked to the ‘current neurological impairment’ domains. The LU survivors’ LS was associated with all Newsqol dimensions; stronger links (p<0.001) were found in ‘feelings’ and ‘sleep’, but no relation existed with the caregivers’ Whoqol-bref domains. Difference estimates were obtained between the survivors’ LS and the Newsqol ‘self-care’ dimension (regression coefficient (rc) -0.28 for PT), their caregivers’ LS (rc -0.63 for PT) and Whoqol-bref psychological (rc -0.67 for PT), environmental (rc -0.73 for PT), and social relationship (rc -0.91 for PT) domains. Discussion. Two years post-event, the survivors' multi-dimensional QoL was a more relevant predictor of their LS, than that of their caregivers. LU-PT differences recalled the hypothesis of the cumulative effect throughout life of social inequalities in health and highlighted the distinct impact in survivors’ LS of living in an urban society, turned towards community supports or in a rural society based on a domestic care. In home-based care settings, the survivors’ LS and Newsqol are useful patient-centred markers for individual and community interventions

ANÁLISE DA DEPRESSÃO EM IDOSOS DE SÃO CAETANO DO SUL E OS FATORES ASSOCIADOS AVALIADOS PELA GDS-15

Depression is the most common psychiatric disorder in all age groups, being, in elderly, associated with more unusual signs and symptoms than in other ages, such as irritability, reduced functionality and slowed thinking. Questionnaires and scales can be used to screen symptoms in elderly, such as the Reduced Geriatric Depression Scale-15 (GDS-15), by Yesavage. This is an observational, cross-sectional, study, carried out using the GDS-15 scale and applied to elderly residents in São Caetano do Sul-SP, Brazil, and registered at UBS Amélia Locatelli and at the University Ambulatorial Center of the University of São Caetano do Sul. The objective is to analyze the prevalence of depression in elderly people from that city and its associated factors, according to the GDS-15. The conclusion was that 41 (73.21%) of 56 participants had a normal psychological condition, 13 had mild depression and 2 had severe depression. The total prevalence of depression was 26.78%, being higher in elderly women than in men (Ratio=1,34). The most selected question (29 times) was “Have you dropped many of your interests and activities?”, followed by “Would you rather stay home than go out and do new things?”, selected 25 times. Thus, isolation and loneliness, indirectly assessed in questions 2 and 9, are factors that influence depression, selected in 12 of the 15 scales applied with positive results for depressive conditions, reinforcing the correlation between quarantine, imposed by the COVID-19, and the rise of depression in the elderly population, as suggested by other studies.La depresión es el trastorno psiquiátrico más frecuente entre todas las edades, asociándose, en el caso de los ancianos, a señales y síntomas inusuales en otras edades, como la irritabilidad y lentitud del pensamiento. La Geriatric Depression Scale-15 (GDS-15), de Yesavage es una escala para detectar estos síntomas en ancianos. Se trata de un estudio observacional, transversal, realizada mediante la Escala GDS-15, aplicada a ancianos residentes en São Caetano do Sul-SP, Brasil, (UBS Amélia Locatelli y Centro Universitario Ambulatorio de la Universidad de São Caetano do Sul). Buscamos analizar la prevalencia de depresión en ancianos de São Caetano do Sul y los factores asociados, evaluados por la GDS-15. Como resultado, 41 de los 56 participantes tenían un cuadro psicológico normal, 13 tenían depresión leve y 2 depresión severa. La prevalencia total de depresión fue del 26,78%, siendo mayor en mujeres ancianas que en hombres (R=1,34). La pregunta con la puntuación más alta ("¿Ha abandonado muchos de sus intereses y actividades?") fue seleccionada 29 veces, seguida de "¿Preferiría quedarse en casa que salir y hacer cosas nuevas?" puntuada 25 veces. Por lo tanto, fue posible concluir que el aislamiento y la soledad, evaluados indirectamente en las preguntas 2 y 9, son factores que influyen en la depresión, seleccionados en 12 de las 15 escalas aplicadas con resultados positivos para estados depresivos, reforzando la relación entre la cuarentena del COVID-19 y el aumento de la depresión en la población, como sugieren otros estudios.A depressão é o distúrbio psiquiátrico mais comum em todas as faixas etárias, sendo, no idoso, associada a sinais e sintomas mais incomuns que em outras idades, como irritabilidade, perda da funcionalidade e lentificação do raciocínio. Questionários e escalas podem ser utilizados para rastreio dos sintomas em idosos, como a Escala de Depressão Geriátrica reduzida (GDS-15), de Yesavage. Trata-se de uma pesquisa observacional, de caráter transversal, realizada através da Escala GDS-15 e aplicada em idosos residentes em São Caetano do Sul-SP, Brasil, e cadastrados na UBS Amélia Locatelli e no Centro Ambulatorial Universitário da Universidade de São Caetano do Sul. Buscou-se analisar a prevalência de depressão nesses idosos e os fatores associados, avaliados pela GDS-15. Como resultado, 41 (73,21%) dos 56 participantes apresentaram quadro psicológico normal, 13, quadro depressivo leve e 2, depressão severa. A prevalência total de depressão foi 26,78%, sendo maior nas idosas que nos homens (Relação=1,34). A pergunta mais pontuada (“Você deixou de lado muitos de seus interesses e atividades?”) foi selecionada 31 vezes, seguida de “Você prefere ficar em casa a sair e fazer coisas novas?”, pontuada 25 vezes. Concluiu-se que o isolamento e a solidão, indiretamente avaliados nas perguntas 2 e 9, são fatores que influenciam a depressão, selecionados em 12 das 15 escalas aplicadas com resultados positivos para quadros depressivos, reforçando a relação entre a quarentena, imposta pela pandemia da COVID-19, e o aumento da depressão na população idosa, como sugerido em outros estudos.A depressão é o distúrbio psiquiátrico mais comum em todas as faixas etárias, sendo, no idoso, associada a sinais e sintomas mais incomuns que em outras idades, como irritabilidade, perda da funcionalidade e lentificação do raciocínio. Questionários e escalas podem ser utilizados para rastreio dos sintomas em idosos, como a Escala de Depressão Geriátrica reduzida (GDS-15), de Yesavage. Trata-se de uma pesquisa observacional, de caráter transversal, realizada através da Escala GDS-15 e aplicada em idosos residentes em São Caetano do Sul-SP, Brasil, e cadastrados na UBS Amélia Locatelli e no Centro Ambulatorial Universitário da Universidade de São Caetano do Sul. Buscou-se analisar a prevalência de depressão nesses idosos e os fatores associados, avaliados pela GDS-15. Como resultado, 41 (73,21%) dos 56 participantes apresentaram quadro psicológico normal, 13, quadro depressivo leve e 2, depressão severa. A prevalência total de depressão foi 26,78%, sendo maior nas idosas que nos homens (Relação=1,34). A pergunta mais pontuada (“Você deixou de lado muitos de seus interesses e atividades?”) foi selecionada 31 vezes, seguida de “Você prefere ficar em casa a sair e fazer coisas novas?”, pontuada 25 vezes. Concluiu-se que o isolamento e a solidão, indiretamente avaliados nas perguntas 2 e 9, são fatores que influenciam a depressão, selecionados em 12 das 15 escalas aplicadas com resultados positivos para quadros depressivos, reforçando a relação entre a quarentena, imposta pela pandemia da COVID-19, e o aumento da depressão na população idosa, como sugerido em outros estudos

In Vivo, Multimodal Imaging of B Cell Distribution and Response to Antibody Immunotherapy in Mice

BACKGROUND: B cell depletion immunotherapy has been successfully employed to treat non-Hodgkin's lymphoma. In recent years, increasing attention has been directed towards also using B-cell depletion therapy as a treatment option in autoimmune disorders. However, it appears that the further development of these approaches will depend on a methodology to determine the relation of B-cell depletion to clinical response and how individual patients should be dosed. Thus far, patients have generally been followed by quantification of peripheral blood B cells, but it is not apparent that this measurement accurately reflects systemic B cell dynamics. METHODOLOGY/PRINCIPAL FINDINGS: Cellular imaging of the targeted population in vivo may provide significant insight towards effective therapy and a greater understanding of underlying disease mechanics. Superparamagnetic iron oxide (SPIO) nanoparticles in concert with near infrared (NIR) fluorescent dyes were used to label and track primary C57BL/6 B cells. Following antibody mediated B cell depletion (anti-CD79), NIR-only labeled cells were expeditiously cleared from the circulation and spleen. Interestingly, B cells labeled with both SPIO and NIR were not depleted in the spleen. CONCLUSIONS/SIGNIFICANCE: Whole body fluorescent tracking of B cells enabled noninvasive, longitudinal imaging of both the distribution and subsequent depletion of B lymphocytes in the spleen. Quantification of depletion revealed a greater than 40% decrease in splenic fluorescent signal-to-background ratio in antibody treated versus control mice. These data suggest that in vivo imaging can be used to follow B cell dynamics, but that the labeling method will need to be carefully chosen. SPIO labeling for tracking purposes, generally thought to be benign, appears to interfere with B cell functions and requires further examination

Fast Retinal Vessel Detection and Measurement Using Wavelets and Edge Location Refinement

The relationship between changes in retinal vessel morphology and the onset and progression of diseases such as diabetes, hypertension and retinopathy of prematurity (ROP) has been the subject of several large scale clinical studies. However, the difficulty of quantifying changes in retinal vessels in a sufficiently fast, accurate and repeatable manner has restricted the application of the insights gleaned from these studies to clinical practice. This paper presents a novel algorithm for the efficient detection and measurement of retinal vessels, which is general enough that it can be applied to both low and high resolution fundus photographs and fluorescein angiograms upon the adjustment of only a few intuitive parameters. Firstly, we describe the simple vessel segmentation strategy, formulated in the language of wavelets, that is used for fast vessel detection. When validated using a publicly available database of retinal images, this segmentation achieves a true positive rate of 70.27%, false positive rate of 2.83%, and accuracy score of 0.9371. Vessel edges are then more precisely localised using image profiles computed perpendicularly across a spline fit of each detected vessel centreline, so that both local and global changes in vessel diameter can be readily quantified. Using a second image database, we show that the diameters output by our algorithm display good agreement with the manual measurements made by three independent observers. We conclude that the improved speed and generality offered by our algorithm are achieved without sacrificing accuracy. The algorithm is implemented in MATLAB along with a graphical user interface, and we have made the source code freely available