Impact of cancer occurrence on health-related quality of life: A longitudinal pre-post assessment

BACKGROUND: Investigations focusing and implementing on the impact of cancer on health-related quality of life (HRQoL) by the way of a mean comparison between cancer patients and subjects from the general population, are scarce and usually cross-sectional. Longitudinal application of HRQoL instruments to a general, initially healthy population allows for change to be assessed as an event occurs, rather than afterwards. The objective of the present study was to investigate the impact of new cancer on HRQoL. METHODS: The 36-item Short Form (SF-36) and 12-item General Health Questionnaire (GHQ-12) were applied to the French SU.VI.MAX cohort in 1996 and 1998. A controlled longitudinal study was used to determine the impact on HRQoL of newly diagnosed cancer: 84 patients with cancer that occurred between the 2 HRQoL measures were compared with 420 age- and sex-matched cancer-free controls. RESULTS: Initial HRQoL level was similar in the two groups. A new cancer had a particularly marked effect on the SF-36 Physical functioning, Role-physical and General health dimensions (more than 6.6-point difference in change in HRQoL evolution on a 0–100 scale). The Bodily pain and Vitality dimensions were less severely affected (difference in change varying from 4.4 to 6.3 points), and there was no effect on either the GHQ-12 score or the SF-36 Mental health, Role-emotional and Social functioning dimensions. CONCLUSIONS: The negative impact of cancer on the lives of patients was assessed in terms of HRQoL. The aspects most likely to be affected were those with a physical component, and general health perceptions. These results can thus help quantify the impact of a new cancer on HRQoL evolution and potentially facilitate early intervention by identifying the most affected HRQoL domains

Health-related quality of life in French adolescents and adults: norms for the DUKE Health Profile

<p>Abstract</p> <p>Background</p> <p>The continual monitoring of population health-related quality of life (HRQoL) with validated instruments helps public health agencies assess, protect, and promote population health. This study aimed to determine norms for the French adolescent and adult general population for the Duke Health Profile (DUKE) questionnaire in a large representative community sample.</p> <p>Methods</p> <p>We randomly selected 17,733 French people aged 12 to 75 years old in 2 steps, by households and individuals, from the National Health Barometer 2005, a periodic population study by the French National Institute for Prevention and Health Education. Quality of life and other data were collected by computer-assisted telephone interview.</p> <p>Results</p> <p>Normative data for the French population were analyzed by age, gender and self-reported chronic disease. Globally, function scores (best HRQoL=100) for physical, mental, social, and general health, as well as perceived health and self-esteem, were 72.3 (SEM 0.2), 74.6 (0.2), 66.8 (0.1), 71.3 (0.1), 71.3 (0.3), 76.5 (0.1), respectively. Dysfunction scores (worst HRQoL=100) for anxiety, depression, pain and disability domains were 30.9 (0.1), 27.6 (0.2), 34.3 (0.3), 3.1 (0.1), respectively.</p> <p>Conclusion</p> <p>The French norms for adolescents and adults for the DUKE could be used as a reference for other studies assessing HRQoL, for specific illnesses, in France and for international comparisons.</p

Processing-induced-transformations (PITs) during direct compression: Impact of tablet composition and compression load on phase transition of caffeine

International audienceIn the pharmaceutical field, solid-state transitions that may occur during manufacturing of pharmaceuticals are of great importance. The phase transition of a model API, caffeine Form I (CFI), was studied during direct compression process by analysing the impacts of the operating conditions (process and formulation). This work is focused on two formulation parameters: nature of the diluent and impact of the caffeine dilution, and one process parameter: the compression pressure that may impact the phase transition of CFI. Tablets were made from pure CFI and from binary mixture of CFI/diluent (microcrystalline cellulose or anhydrous dicalcium phosphate). A kinetic study performed during six months helped to highlight the influence of these parameters on the CFI transition degree. Results showed a triggering effect of the direct compression process, transformation was higher in tablets than in uncompressed powders. Whatever the pressure applied, CFI transition degree was almost constant and uniformly occurring throughout the tablet volume. Nevertheless, several differences on the evolution of the CFI transition degree were observed between binary mixtures of CFI/diluent. An analysis of the transition mechanism with a stretched exponential law of the Johnson-Mehl-Avrami model shows that tableting accelerates the polymorphic transition without modifying its mechanism controlled by nucleation only

Hot homogenization process optimization for fragrance encapsulation in solid lipid nanoparticles: Fragrance encapsulation in SLN by hot homogenization process

International audienceSolid lipid nanoparticles (SLNs) loaded with perfume were prepared using a hot homogenization process coupled with ultrasounds. The objective was to develop a simple process adjustable to several kinds of lipids. The process comprised two steps: a pre‐emulsion of the melted lipids in water followed by a size reduction by sonication, before cooling. The study of several formulation parameters showed that the size distribution of SLNs depended essentially on the sonication step, and especially on the ultrasounds power and time. Five types of SLNs loaded with perfume were produced, based on petrolatum, candelilla, shea butter, C10‐18 triglycerides, and cetyl palmitate. The size distribution was below 200 nm with a narrow size distribution. Moreover, high encapsulation efficiency was obtained, at least 66.5% (±0.5) for petrolatum SLNs and 94.9% (±0.5) for cetyl palmitate SLNs and the loading % was comprised between 4.9% (±0.5) (petrolatum) and 7.0% (±0.5) (cetyl palmitate). A correlation between the partition coefficient of the molecules and the encapsulation efficiency was established for all lipids except cetyl palmitate. Cetyl palmitate, candelilla and petrolatum SLNs were stable for at least one month at 4 °C and 25 °C

Confocal Raman microspectroscopy of the skin

International audienceConfocal Raman spectroscopy is a technique with considerable potential for the non-invasive study of biological tissues and skin samples in vitro or in vivo. It can be used to study skin physiology and possible pathological conditions and to obtain data about molecular composition and the structure of skin, for example, water content, moisturization and changes in the skin barrier function can all be observed. In-depth measurements also allow biopharmaceutical studies, such as analyzing the rate of penetration of a drug and the biochemical changes that may be induced by an applied formulation. Confocal Raman microspectroscopy is now at such a stage of refinement that it opens up new vistas. The big leap forward in its ease of use enables this technology to be used as an analytical method by more and more non-specialist laboratories. This review gives an overview of the state of the art of this technology by presenting an update on the principles of Raman spectroscopy and then by looking at examples of new developments in in vivo and in vitro applications

Comparaison de deux enquêtes nationales sur la qualité de vie des patients atteints d’insuffisance rénale chronique terminale entre 2005–2007 et 2011 : des indicateurs sensiblement en baisse

International audienceBACKGROUND:The Epidemiology Network and Nephrology Information provides since 2001 the epidemiological monitoring of end stage renal disease (ESRD) in France. Two cross-sectional studies to estimate the level of quality of life in ESRD patients were performed in 2005 and 2007 and repeated in 2011. The main objective is to analyze the evolution of the quality of life of ESRD between these two surveys.METHODS:The studies were conducted on a representative sample of subjects aged 18 and over, prevalent dialysis or holders of a functioning kidney transplant last year, followed in center dialysis and/or transplantation in one of the eight French regions selected. The quality of life was measured by a generic questionnaire, and two specifics questionnaires.RESULTS:The evolution of the quality of life deteriorated slightly between 2005-2007 and 2011. There is however few dimensions affected. The variation in scores is not meaningful in general, with maximum decreases less than 4 points according to the statistical methods used. This diminution is not clinically significant.DISCUSSION:The quality of life in dialysis patients or transplant did not evolve between 2005-2007 and 2011. Currently, it is difficult to assess the benefits of the national plan for improving the quality of life of people with chronic diseases because the last data are too close to the end of the plan.IntroductionLe réseau épidémiologie et information en néphrologie (REIN) assure depuis 2001 le suivi épidémiologique et la prise en charge de l’insuffisance rénale chronique terminale (IRCT) en France. La connaissance d’indicateurs de qualité de vie (QDV) relative à la santé est capitale afin de mieux comprendre les domaines touchés par la maladie et ainsi proposer des actions appropriées visant à mieux vivre avec sa pathologie. Dans ce contexte, deux études transversales visant à estimer le niveau de QDV liée à la santé des patients en IRCT ont été mises en place en 2005 (enquête dialyse) et 2007 (enquête greffe) sur un échantillon de patients français, puis reconduites en 2011. L’objectif de cet article est de comparer ces deux enquêtes et d’analyser l’évolution de la qualité de vie des patients atteints d’IRCT entre ces deux enquêtes.MéthodesLes études ont été réalisées sur un échantillon représentatif de sujets âgés de 18 ans et plus, prévalents dialysés (quelles que soient les modalités de dialyse) ou porteurs d’un greffon rénal fonctionnel depuis un an, suivis dans un centre de dialyse et/ou de transplantation dans l’une des huit régions françaises sélectionnées. Le recueil des données a été réalisé par auto-questionnaire adressé par voie postale au domicile des patients. La qualité de vie (QDV) a été mesurée par un questionnaire générique, le MOS SF-36 et deux questionnaires spécifiques : le Kidney Disease Quality of Life (KDQOL) version courte pour les dialysés et le ReTransQol V2 (RTQ V2) pour les patients greffés. L’évolution des scores a été réalisée par des analyses multivariées, le calcul d’un score de propension et de pondération afin de prendre en compte les différences de profil des patients entre les périodes d’enquêtes.RésultatsLa QDV s’est légèrement dégradée entre 2005–2007 et 2011, et ce, quel que soit le questionnaire utilisé (générique ou spécifique). Il n’y a cependant que peu de dimensions affectées, avec 2 ou 3 domaines par outils de mesure. Pour le SF-36, ce sont les dimensions « santé générale », « douleurs physiques » ainsi que « vie et relation avec les autres » qui diminuent de manière significative (−3,2, −3,7 et −3,8 points). Pour les questionnaires spécifiques, la dimension « traitement » du RTQ V2 est la plus affectée (−2,5 points), ainsi que la dimension « symptôme/problèmes » du KDQOL (−2,4 points). La variation des scores de QDV est peu signifiante dans l’ensemble, allant de −1,6 point à −3,8 points pour la plus forte baisse, selon les méthodes statistiques utilisées. Cette diminution reste toujours inférieure au seuil des 5 points considérés comme cliniquement signifiant.DiscussionLa qualité de vie chez les patients dialysés ou greffés s’est légèrement dégradée entre 2005–2007 et 2011. Le recueil des dernières données de notre étude ayant été réalisé dès la fin du plan pour l’amélioration de la qualité de vie des personnes atteintes de maladies chroniques 2005–2011, le bénéfice du plan paraît donc difficile à évaluer dans sa globalité

Predialysis therapeutic care and health-related quality of life at dialysis onset (The pharmacoepidemiologic AVENIR study).

International audienceBACKGROUND: To determine the impact of the quality of pre-dialysis nephrological care on health-related quality of life (HRQoL) at dialysis onset, which has not been well evaluated. METHODS: All adults who began a dialysis treatment in the administrative region of Lorraine (France) in 2005 or 2006, were enrolled in this prospective observational study. HRQoL was measured using the Kidney Disease Quality of Life V36 questionnaire, which enables calculation of two generic (physical and mental) and three specific dimensions (Symptoms/problems, Effects and Burden of kidney disease). The specific dimensions were scored from 0 to 100 (worst to best possible functioning). Pre-dialysis nephrological care was measured using three indicators: quality of therapeutic practices (evaluated across five main aspects: hypertension/proteinuria, anemia, bone disease, metabolic acidosis and dyslipidemia), time since referral to a nephrologist and number of nephrology consultations in the year preceding dialysis treatment. RESULTS: Two thousand and eighty-three (67.4%) patients were referred to a nephrologist more than 1 month before dialysis initiation and completed the HRQoL questionnaire. Quality of therapeutic practices was significantly associated with the Mental component. Time since referral to a nephrologist was associated with Symptoms/problems and the Effects of kidney disease dimensions, but no relationship was found between the number of nephrology consultations and HRQoL. CONCLUSIONS: HRQoL at dialysis onset is significantly influenced by the quality of pre-dialysis nephrological care. Therefore, disease management should be emphasized

Ingredients Tracking of Cosmetic Formulations in the Skin: A Confocal Raman Microscopy Investigation

International audienceConfocal Raman microspectroscopy (CRM) was used to follow the absorption of retinol into the skin and to track the absorption of ingredients in topically applied formulations. Three surfactants, PEG20C12, PEG20C18:1 (hydrophilic) and PEG6C18:1 (lipophilic), were used in preparing three o/w emulsions and three surfactant solutions all containing retinol. Quantitative retinol penetration studies for 24 h were carried out using Franz diffusion cells. CRM was used to follow the skin penetration of retinol, oil and water and also to study a possible modification of the lipid skin barrier in the stratum corneum (SC) using the ratio of I(2880)/I(2850). The oily surfactant solution containing PEG6C18:1 and dodecane showed the highest retinol penetration rate. This appears to be related both to the short polar head group of the surfactant and to the effect of dodecane on skin lipids. All the surfactant solutions showed a higher penetration rate compared with the corresponding emulsions. CRM measurements showed that the ratios of I(2880)/I(2850) were significantly modified using surfactant solutions. Penetration behavior appeared to be dependent on the surfactant used in the formulation. CRM associated to the Franz cell method gives new insights on permeation of drug related to vehicle or ingredient

Experimental study of tensile strength of pharmaceutical tablets: effect of the diluent nature and compression pressure

In the pharmaceutical field, tablets are the most common dosage form for oral administration in the world. Among different manufacturing processes, direct compression is widely used because of its economics interest and it is a process which avoids the steps of wet granulation and drying processes. Tablets are composed of at least two ingredients: an active pharmaceutical ingredient (API) which is mixed with a diluent. The nature of the powders and the processing conditions are crucial for the properties of the blend and, consequently, strongly influence the mechanical characteristics of tablets. Moreover, tablets have to present a suitable mechanical strength to avoid crumbling or breaking when handling, while ensuring an appropriate disintegration after administration. Accordingly, this mechanical property is an essential parameter to consider. Experimental results showed that proportion of the diluent, fragmentary (DCPA) or plastic (MCC), had a large influence on the tensile strength evolution with API content as well as the compression load applied during tableting process. From these results a model was developed in order to predict the tensile strength of binary tablets by knowing the compression pressure. The validity of this model was demonstrated for the two studied systems and a comparison was made with two existing models