Adaptation et validation d'un questionnaire mesurant les représentations liées à l'incapacité au travail auprès d'adultes présentant un trouble musculosquelettique

La représentation de l'état de santé et du traitement est un facteur déterminant du retour au travail à la suite d'un trouble musculosquelettique (TMS). Or, il n'existe aucun outil de mesure des représentations qui soit adapté et validé pour une clientèle en incapacité prolongée au travail due à des TMS. Cette étude propose donc 3 objectifs pour combler cette lacune. Premièrement, l'adaptation d'un questionnaire évaluant la représentation de la maladie, le Revised 11/ness Perception Questionnaire (IPQ-R), a été effectuée grâce à un groupe de consensus formé d'experts dans le domaine de l'incapacité au travail. Deuxièmement, un prétest qualitatif du questionnaire adapté a été effectué auprès d'un échantillon de la population cible afin de vérifier la clarté des items. Troisièmement, le questionnaire adapté et 8 autres instruments de mesure validés documentant des composantes de la représentation ont été administrés à des travailleurs en situation d'incapacité prolongée du travail due à un TMS, afin de documenter la cohérence interne et la validité de construit du questionnaire adapté. Pour l'objectif 1, les résultats du groupe de consensus ont fait ressortir 8 items à retirer de la version originale. Le concept de « maladie » a été remplacé par « condition de santé actuelle » et 26 items ont été ajoutés, permettant maintenant une évaluation plus juste de la problématique de la clientèle cible. Pour l'objectif 2, les résultats du prétest qualitatif (n=9) ont confirmé la clarté des items. Les caractéristiques des participants étaient représentatives de la clientèle visée. Pour l'objectif 3, un échantillon composé de 23 femmes et 20 hommes, âgés en moyenne de 41 ans et absents du travail depuis en moyenne 8 mois a été constitué. La cohérence interne de chacune des dimensions est généralement satisfaisante (coefficients alpha de Cronbach entre 0,58 et 0,87). La validité de construit a été documentée par convergence à des instruments de mesure théoriquement en relation. Les modèles de régression effectués sur chacune des 9 dimensions du questionnaire adapté expliquent une proportion significative de la variance (r2 ajusté entre 0,33 et 0, 70) de chaque dimension, à l'exception de la dimension Durée cyclique. En résumé, les propriétés psychométriques évaluées sont considérées comme satisfaisantes. L'utilisation du questionnaire adapté, nommé Questionnaire des Représentations liées à !'Incapacité au Travail (QRIT), facilitera l'évaluation systématique des représentations liées à l'incapacité au travail, autant en recherche qu'en clinique.Abstract: Health, illness and treatment representations have been described as key factors for return to work. However, questionnaires assessing the individual's representations must be adapted and further validated prior to their use among a clientele in a work disability situation following a musculoskeletal disorder (MSD). This study proposes 3 objectives to fill this gap in the scientific literature. For the first objective, a self-administered questionnaire assessing illness representations, the Revised Illness Perception Questionnaire (IPQ-R), was adapted using a group consensus technique. The group was composed of experts in the work disability field. For the second objective, a qualitative pre-test was performed among a sample of workers from the target population, in order to assess item clarity. For the third objective, the adapted questionnaire and 8 selected instruments measuring separate components of the representation were administered to workers in a work disability situation following an MSD. For the first objective, results from the consensus group indicated 8 items to be removed from the original version. The concept of"illness" was modified for"current health condition" and 26 items were added in order to better assess representations related to work disability. For the second objective, results from the qualitative pre-test (n=9) confirmed item clarity. Participants' characteristics were representative of the target population. For the third objective, the sample consisted of 23 women and 20 men, with an average age of 41 and an average duration of work absence of 8 months. Internal consistency is generally satisfactory (with Cronbach's alphas from 0.58 to 0.87). Construct validity was assessed through multiple regression analyses performed with each of the questionnaire's 9 dimensions and significant independent variables. Final models explain a good proportion of the variance (adjusted r[superscript 2] from 0.33 to 0.70) for each dimension, except for the Cyclical timeline dimension. In summary, the psychometric properties of the adapted version of the Revised Illness Perception Questionnaire for Work Disability (IPQR-WD) are satisfactory. The use of the IPQR-WD in research and in clinic will facilitate a systematic evaluation of the worker's representations

La transmission : éléments bibliographiques

I. La transmission des textes Antiquité et Moyen Âge ADHEMAR, Jean, Influences antiques dans l’art du Moyen Âge français. Recherches sur les sources et les thèmes d’inspiration, Paris, Éditions du CTHS, 1996 (1ère éd. 1939). Badawi, Abdurrahman, La Transmission de la philosophie grecque au monde arabe, Paris, Vrin, 1968. Berthelot, Anne, Brusegan, Rosanna, buschinger, Danielle, et zironi, Alessandro (éd.), L’Antichità nella cultura europea del Medioevo. Ergebnisse der internationalen Tagung ..

La transmission : éléments bibliographiques

I. La transmission des textes Antiquité et Moyen Âge ADHEMAR, Jean, Influences antiques dans l’art du Moyen Âge français. Recherches sur les sources et les thèmes d’inspiration, Paris, Éditions du CTHS, 1996 (1ère éd. 1939). Badawi, Abdurrahman, La Transmission de la philosophie grecque au monde arabe, Paris, Vrin, 1968. Berthelot, Anne, Brusegan, Rosanna, buschinger, Danielle, et zironi, Alessandro (éd.), L’Antichità nella cultura europea del Medioevo. Ergebnisse der internationalen Tagung ..

Genital Schistosomiasis in European Women

Female genital schistosomiasis (FGS) is an isolated chronic form of schistosomiasis. Although most infections occur in residents of endemic areas, it has been clearly documented that brief freshwater exposure is sufficient to establish infection; thus, travellers may also be infected. The clinical manifestations of FGS are nonspecific, and lesions may mimic any neoplastic or infectious process in the female genital tract. It is important to take a careful history and physical examination, making sure to consider travel history in endemic areas. The diagnosis is confirmed by microscopy with egg identification or by serology. The standard of care for treatment is a single dose of oral praziquantel which avoids complications and substantial morbidity. Herein, we report a rare and original case of FGS in a European woman

Development and evaluation of a real-time PCR assay for detection and quantification of blastocystis parasites in human stool samples: prospective study of patients with hematological malignancies.

International audienceBlastocystis anaerobic parasites are widespread worldwide in the digestive tract of many animal species, including humans. Epidemiological Blastocystis studies are often limited by the poor sensitivity of standard parasitological assays for its detection. This report presents a highly sensitive real-time quantitative PCR (qPCR) assay developed to detect Blastocystis parasites in stool samples. The assay targets a partial sequence of the Blastocystis small ribosomal subunit (SSU) rRNA gene, allowing subtyping (ST) of Blastocystis isolates by direct sequencing of qPCR products. This qPCR method was assessed in a prospective study of 186 patients belonging to two cohorts--a group of 94 immunocompromised patients presenting hematological malignancies and a control group of 92 nonimmunocompromised patients. Direct-light microscopy and xenic in vitro stool culture analysis showed only 29% and 52% sensitivity, respectively, compared to our qPCR assay. Of the 27 (14.5%) Blastocystis-positive patients, 8 (4%) experienced digestive symptoms. No correlation was found between symptomatic patients and immune status, parasite load, or parasite subtypes, although subtyping of all isolates revealed a high (63.0%) prevalence of ST4. Two unexpected avian subtypes were found, i.e., ST6 and ST7, which are frequently isolated in Asia but rarely present in Western countries. In conclusion, this qPCR proved by far the most sensitive of the tested methods and allowed subtype determination by direct sequencing of qPCR products. New diagnostic tools such as the qPCR are essential for evaluating the clinical relevance of Blastocystis subtypes and their role in acute or chronic digestive disorders

Evaluation and management of leukolysis-mediated pseudohyperkalemia in paediatric leukemic samples

Leukolysis-related pseudohyperkalemia due to preanalytical procedures may lead to erroneous (or absence of) treatment based on an invalid lab test result. We aimed to obtain a leukocyte threshold above which leukolysis-related pseudohyperkalemia becomes clinical relevant. Secondly, temporal dynamics of treatment-induced leukocyte decrease were studied to allow tailored implementation of laboratory information system (LIS) decision rules based on the leukocyte threshold to avoid leukolysis-related pseudohyperkalemia. Potassium results of AU5811 routine chemistry (Beckman Coulter, Brea, California, USA) and iStat point of care (POC) (Abbott Diagnostics, Chicago, Illinois, USA) analysers were compared, the latter method being insensitive to leukolysis caused by pre-analytical procedures. Potassium results were combined with leukocyte counts obtained using a Cell-Dyn Sapphire haematology analyser (Abbott Diagnostics, Santa Clara, California, USA), resulting in 132 unique data triplets. Regression analysis was performed to establish a leukocyte threshold. The Reference Change Value (√2 x Z x √(CVa2 + CVi2)) was used to calculate maximum allowable difference between routine analyser and POC potassium results (deltamax + 0.58 mmol/L). Temporal analysis on the treatment-induced leukocyte decrease was performed by plotting leukocyte counts in time for all patients above the threshold leukocyte count (N = 41). Established leukocyte threshold was 63 x109/L. Temporal analysis showed leukocyte counts below the threshold within 8 days of treatment for all patients. Based on performed analyses we were able to implement LIS decision rules to reduce pseudohyperkalemia due to preanalytical procedures. This implementation can contribute to a reduction in erroneous (or absence of) treatments in the clinic

Near-infrared grating-assisted SPR optical fiber sensors : design rules for ultimate refractometric sensitivity

Plasmonic optical fiber sensors are continuously developed for (bio)chemical sensing purposes. Recently, surface plasmon resonance (SPR) generation was achieved in gold-coated tilted fiber Bragg gratings (TFBGs). These sensors probe the surrounding medium with near-infrared narrowband resonances, which enhances both the penetration depth of the evanescent field in the external medium and the wavelength resolution of the interrogation. They constitute a unique configuration to probe all the fiber cladding modes individually. We use them to analyze the modal distribution of gold-coated telecommunication-grade optical fibers immersed in aqueous solutions. Theoretical investigations with a finite-difference complex mode solver are confirmed by experimental data obtained on TFBGs. We show that the refractometric sensitivity varies with the mode order and that the global SPR envelope shift in response to surrounding refractive index (SRI) changes higher than 1e-2 RIU (refractive index unit) can be ~25% bigger than the local SPR mode shift arising from SRI changes limited to 1e-4 RIU. We bring clear evidence that the optimum gold thickness for SPR generation lies in the range between 50 and 70 nm while a cladding diameter decrease from 125 µm to 80 µm enhances the refractometric sensitivity by ~20%. Finally, we demonstrate that the ultimate refractometric sensitivity of cladding modes is ~550 nm/RIU when they are probed by gold-coated TFBGs

Decrease of a specific biomarker of collagen degradation in osteoarthritis, Coll2-1, by treatment with highly bioavailable curcumin during an exploratory clinical trial

BACKGROUND: The management of osteoarthritis (OA) remains a challenge. There is a need not only for safe and efficient treatments but also for accurate and reliable biomarkers that would help diagnosis and monitoring both disease activity and treatment efficacy. Curcumin is basically a spice that is known for its anti-inflammatory properties. In vitro studies suggest that curcumin could be beneficial for cartilage in OA. The aim of this exploratory, non-controlled clinical trial was to evaluate the effects of bio-optimized curcumin in knee OA patients on the serum levels of specific biomarkers of OA and on the evaluation of pain. METHODS: Twenty two patients with knee OA were asked to take 2x3 caps/day of bio-optimized curcumin (Flexofytol®) for 3 months. They were monitored after 7, 14, 28 and 84 days of treatment. Pain over the last 24 hours and global assessment of disease activity by the patient were evaluated using a visual analog scale (100 mm). The serum levels of Coll-2-1, Coll-2-1NO(2), Fib3-1, Fib3-2, CRP, CTX-II and MPO were determined before and after 14 and 84 days of treatment. RESULTS: The treatment with curcumin was globally well tolerated. It significantly reduced the serum level of Coll2-1 (p < 0.002) and tended to decrease CRP. No other significant difference was observed with the other biomarkers. In addition, curcumin significantly reduced the global assessment of disease activity by the patient. CONCLUSION: This study highlighted the potential effect of curcumin in knee OA patient. This effect was reflected by the variation of a cartilage specific biomarker, Coll2-1 that was rapidly affected by the treatment. These results are encouraging for the qualification of Coll2-1 as a biomarker for the evaluation of curcumin in OA treatment. TRIAL REGISTRATION: NCT01909037 at clinicaltrials.go