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Endocrinology, Endocrinologie, Nutrition, obesity, metabolic disorders, Nutrition, obésité, maladies métaboliques, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Endocrinopathies, Pancréas endocrine. Cellules apud (pathologie), Endocrine pancreas. Apud cells (diseases), Diabète. Anomalie tolérance glucose, Diabetes. Impaired glucose tolerance, Maladies metaboliques, Metabolic diseases, Endocrinopathie, Endocrinopathy, Endocrinopatía, Hormone pancréatique, Pancreatic hormone, Hormona pancreática, Résistance tissu cible, Target tissue resistance, Resistencia tejido blanco, Amélioration, Improvement, Mejora, Endocrinologie, Endocrinology, Endocrinología, Essai clinique, Clinical trial, Ensayo clínico, Glycémie, Glycemia, Glucemia, Homme, Human, Hombre, Injection bolus, Bolus injection, Inyección bolo, Insuline, Insulin, Insulina, Insulinorésistance, Insulin resistance, Resistancia insulina, Malade, Patient, Enfermo, Maladie métabolique, Metabolic diseases, Metabolismo patología, Multiple, Múltiple, Nutrition, Nutrición, Quotidien, Daily, Cotidiano, Résultat, Result, Resultado, Traitement, Treatment, Tratamiento, Utilisation, Use, Uso, Contrôle glycémique, and Glycemic control

OBJECTIVE—Use of automated bolus advisors is associated with improved glycemic control in patients treated with insulin pump therapy. We conducted a study to assess the impact of using an insulin bolus advisor embedded in a blood glucose (BG) meter on glycemic control and treatment satisfaction in patients treated with multiple daily insulin injection (MDI) therapy. The study goal was to achieve >0.5% A1C reduction in most patients. RESEARCH DESIGN AND METHODS—This was a 26-week, prospective, randomized, controlled, multinational study that enrolled 218 MDI-treated patients with poorly controlled diabetes (202 with type 1 diabetes, 16 with type 2 diabetes) who were 18 years of age or older. Participants had mean baseline A1C of 8.9% (SD, 1.2 [74 mmol/mol]), mean age of 42.4 years (SD, 14.0), mean BMI of 26.5 kg/m2 (SD, 4.2), and mean diabetes duration of 17.7 years (SD, 11.1). Control group (CNL) patients used a standard BG meter and manual bolus calculation; intervention group (EXP) patients used the Accu-Chek Aviva Expert meter with an integrated bolus advisor to calculate insulin dosages. Glucose data were downloaded and used for therapy parameter adjustments in both groups. RESULTS—A total of 193 patients (CNL, n = 93; EXP, n = 100) completed the study. Significantly more EXP than CNL patients achieved >0.5% A1C reduction (56.0% vs. 34.4%; P < 0.01). Improvement in treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire scale) was significantly greater in EXP patients (11.4 [SD, 6.0] vs. 9.0 [SD, 6.3]; P < 0.01). Percentage of BG values <50 mg/dL was <2% in both groups during the study. CONCLUSIONS—Use of an automated bolus advisor resulted in improved glycemic control and treatment satisfaction without increasing severe hypoglycemia.

Hygiene and public health, epidemiology, occupational medicine, Hygiène et santé publique, épidémiologie, médecine du travail, Toxicology, Toxicologie, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Pneumologie, Pneumology, Bronchopneumopathie obstructive chronique, asthme, Chronic obstructive pulmonary disease, asthma, Bronchopneumopathie obstructive, Obstructive pulmonary disease, Enfermedad pulmonar obstructiva, Epidémiologie, Epidemiology, Epidemiología, Pathologie de l'appareil respiratoire, Respiratory disease, Aparato respiratorio patología, Pathologie des bronches, Bronchus disease, Bronquio patología, Pathologie des poumons, Lung disease, Pulmón patología, Asthme, Asthma, Asma, Etude cohorte, Cohort study, Estudio cohorte, Homme, Human, Hombre, Médecine catastrophe, Disaster medicine, Medicina catástrofe, Santé publique, Public health, Salud pública, Terrorisme, Terrorism, Terrorismo, Attentats 11 septembre 2001, NHIS, World Trade Center responders, and asthma

Background Studies have documented high rates of asthma symptoms among responders to the World Trade Center (WTC) disaster. However, whether there are increased rates of asthma among responders compared to the general population is unknown. Methods The study population consisted of a prospective cohort of 20,834 responders participating in the WTC Medical Monitoring and Treatment Program between July 2002 and December 2007. We calculated prevalence and standardized morbidity ratios (SMRs) of lifetime asthma and 12-month asthma (defined as ≥1 attacks in the prior 12 months) among WTC responders. The comparison population consisted of >200,000 adults who completed the National Health Interview Survey in 2000 (for pre-9/11 comparisons) and between 2002 and 2007 (for post-9/11 comparisons). Results WTC responders were on average 43 ± 9 years old, 86% male, 59% white, and 42% had an occupation in protective services. The lifetime prevalence of asthma in the general population was relatively constant at about 10% from 2000 to 2007. However, among WTC responders, lifetime prevalence increased from 3% in 2000, to 13% in 2002, and 19% in 2007. The age-adjusted overall SMR for lifetime asthma among WTC responders was 1.8 (95% CI: 1.8-1.9) for men and 2.0 (95% CI: 1.9―2.1) for women. Twelve-month asthma was also more frequent among WTC responders compared to the general population (SMR 2.4, 95% CI: 2.2-2.5) for men and 2.2 (95% CI: 2.0―2.5) for women. Conclusions WTC responders are at an increased risk of asthma as measured by lifetime prevalence or active disease.

Hygiene and public health, epidemiology, occupational medicine, Hygiène et santé publique, épidémiologie, médecine du travail, Toxicology, Toxicologie, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Sarcoidoses. Granulomatoses d'etiologie indeterminee. Maladies du tissu conjonctif. Maladies du tissu elastique. Vascularites, Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis, Maladie de système, Systemic disease, Enfermedad sistémica, Pathologie de l'appareil respiratoire, Respiratory disease, Aparato respiratorio patología, Capacité vitale forcée, Forced vital capacity, Capacidad vital forzada, Epidémiologie, Epidemiology, Epidemiología, Etiologie, Etiology, Etiología, Etude cas témoin, Case control study, Estudio caso control, Fonction respiratoire, Lung function, Función respiratoria, Granulomatose, Granulomatosis, Homme, Human, Hombre, Médecine catastrophe, Disaster medicine, Medicina catástrofe, Pathologie des poumons, Lung disease, Pulmón patología, Santé publique, Public health, Salud pública, Sarcoïdose, Sarcoidosis, Terrorisme, Terrorism, Terrorismo, Attentats 11 septembre 2001, World Trade Center (WTC), a case control etiologic study of sarcoidosis (ACCESS), forced vital capacity (FVC), granulomatous disease, and sarcoidosis

Background More than 20, 000 responders have been examined through the World Trade Center (WTC) Medical Monitoring and Treatment Program since September 11, 2001. Studies on WTCfirefighters have shown elevated rates of sarcoidosis. The main objective of this study was to report the incidence of sarcoid like granulomatous pulmonary disease in other WTC responders. Methods Cases of sarcoid like granulomatous pulmonary disease were identified by: patient self-report, physician report and ICD-9 codes. Each case was evaluated by three pulmonologists using the ACCESS criteria and only definite cases are reported. Results Thirty-eight patients were classified as definite cases. Six-year incidence was 192/100,000. The peak annual incidence of 54 per 100,000 person-years occurred between 9/11/2003 and 9/11/2004. Incidence in black responders was nearly double that of white responders. Low FVC was the most common spirometric abnormality. Conclusions Sarcoid like granulomatous pulmonary disease is present among the WTC responders. While the incidence is lower than that reported among firefighters, it is higher than expected.

General medicine general surgery, Médecine et chirurgie générales, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Generalites, General aspects, Sante publique. Hygiene-medecine du travail, Public health. Hygiene-occupational medicine, Santé publique. Hygiène, Public health. Hygiene, Divers, Miscellaneous, Médecine du travail, Occupational medicine, Association morbide, Concomitant disease, Asociación morbosa, Etude cohorte, Cohort study, Estudio cohorte, Homme, Human, Hombre, Médecine du travail, Occupational medicine, Medicina ocupacional, Persistance, Persistence, Persistencia, Polypathologie, Polypathology, Patología múltiple, Récupération, Recovery, Recuperación, Santé publique, Public health, Salud pública, Travailleur, Worker, Trabajador, and Attentats 11 septembre 2001

Background More than 50000 people participated in the rescue and recovery work that followed the Sept 11, 2001 (9/11) attacks on the World Trade Center (WTC). Multiple health problems in these workers were reported in the early years after the disaster. We report incidence and prevalence rates of physical and mental health disorders during the 9 years since the attacks, examine their associations with occupational exposures, and quantify physical and mental health comorbidities. Methods In this longitudinal study of a large cohort of WTC rescue and recovery workers, we gathered data from 27449 participants in the WTC Screening, Monitoring, and Treatment Program. The study population included police officers, firefighters, construction workers, and municipal workers. We used the Kaplan-Meier procedure to estimate cumulative and annual incidence of physical disorders (asthma, sinusitis, and gastro-oesophageal reflux disease), mental health disorders (depression, post-traumatic stress disorder [PTSD], and panic disorder), and spirometric abnormalities. Incidence rates were assessed also by level of exposure (days worked at the WTC site and exposure to the dust cloud). Findings 9-year cumulative incidence of asthma was 27·6% (number at risk: 7027), sinusitis 42·3% (5870), and gastro-oesophageal reflux disease 39·3% (5650). In police officers, cumulative incidence of depression was 7·0% (number at risk: 3648), PTSD 9·3% (3761), and panic disorder 8·4% (3780). In other rescue and recovery workers, cumulative incidence of depression was 27·5% (number at risk: 4200), PTSD 31·9% (4342), and panic disorder 21·2% (4953). 9-year cumulative incidence for spirometric abnormalities was 41·8% (number at risk: 5769); three-quarters of these abnormalities were low forced vital capacity. Incidence of most disorders was highest in workers with greatest WTC exposure. Extensive comorbidity was reported within and between physical and mental health disorders. Interpretation 9 years after the 9/11 WTC attacks, rescue and recovery workers continue to have a substantial burden of physical and mental health problems. These findings emphasise the need for continued monitoring and treatment of the WTC rescue and recovery population. Funding Centers for Disease Control and Prevention and National Institute for Occupational Safety and Health.

Environment, Environnement, Hygiene and public health, epidemiology, occupational medicine, Hygiène et santé publique, épidémiologie, médecine du travail, Toxicology, Toxicologie, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Otorhinolaryngologie. Stomatologie, Otorhinolaryngology. Stomatology, Voies aérodigestives supérieures, sinus de la face, glandes salivaires: maladies, sémiologie, Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology, Maladies non tumorales, Non tumoral diseases, Neurologie, Neurology, Système nerveux (sémiologie, syndromes), Nervous system (semeiology, syndromes), Système nerveux en général, Nervous system as a whole, Nerfs crâniens. Racines rachidiennes. Nerfs périphériques. Système nerveux autonome. Goût. Odorat, Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction, Pathologie ORL, ENT disease, ORL patología, Pathologie des sinus de la face, Paranasal sinus disease, Seno paranasal patología, Pathologie du nez, Nose disease, Nariz patología, Pathologie du système nerveux, Nervous system diseases, Sistema nervioso patología, Trouble neurologique, Neurological disorder, Trastorno neurológico, Anosmie, Anosmia, Appareil respiratoire, Respiratory system, Aparato respiratorio, Autoévaluation, Self evaluation, Autoevaluación, Exposition professionnelle, Occupational exposure, Exposición profesional, Homme, Human, Hombre, Identification, Identificación, Médecine du travail, Occupational medicine, Medicina ocupacional, Odeur, Odor, Olor, Olfaction, Olfación, Rhinite, Rhinitis, Rinitis, Santé publique, Public health, Salud pública, Sinusite, Sinusitis, Symptomatologie, Symptomatology, Sintomatología, Travailleur, Worker, Trabajador, Trouble de l'odorat, Olfactory disorder, Trastorno olfatorio, Attentats 11 septembre 2001, Hyposmia, Rhinology, Rhinosinusitis, SNOT-20, Smell, UPSIT, and World Trade Center

Following the World Trade Center (WTC) collapse on September 11, 2001, more than 40,000 people were exposed to a complex mixture of inhalable nanoparticles and toxic chemicals. While many developed chronic respiratory symptoms, to what degree olfaction was compromised is unclear. A previous WTC Medical Monitoring and Treatment Program study found that olfactory and nasal trigeminal thresholds were altered by the toxic exposure, but not scores on a 20-odor smell identification test. Objectives To employ a well-validated 40-item smell identification test to definitively establish whether the ability to identify odors is compromised in a cohort of WTC-exposed individuals and, if so, whether the degree of compromise is associated with self-reported severity of rhinitic symptoms. Methods The University of Pennsylvania Smell Identification Test (UPSIT) was administered to 99 WTC-exposed persons and 99 matched normal controls. The Sino-Nasal Outcomes Test (SNOT-20) was administered to the 99 WTC-exposed persons and compared to the UPSIT scores. Results The mean (SD) UPSIT scores were lower in the WTC-exposed group than in age-, sex-, and smoking history-matched controls [respective scores: 30.05 (5.08) vs 35.94 (3.76); p = 0.003], an effect present in a subgroup of 19 subjects additionally matched on occupation (p < 0.001). Fifteen percent of the exposed subjects had severe microsmia, but only 3% anosmia. SNOT-20 scores were unrelated to UPSIT scores (r = 0.20; p = 0.11). Conclusion Exposure to WTC air pollution was associated with a decrement in the ability to identify odors, implying that such exposure had a greater influence on smell function than previously realized.

Multidisciplinary, Multidisciplinaire, Sciences biologiques et medicales, Biological and medical sciences, Sciences biologiques fondamentales et appliquees. Psychologie, Fundamental and applied biological sciences. Psychology, Genetique des eucaryotes. Evolution biologique et moleculaire, Genetics of eukaryotes. Biological and molecular evolution, Génétique classique, génétique quantitative, hybrides, Classical genetics, quantitative genetics, hybrids, Homme, Human, Chromosome E16, Cromosoma E16, Dose génique, Gene dosage, Dosis génica, Duplication, Duplicación, Homme, Human, Hombre, Indice masse corporelle, Body mass index, Indice masa corporal, Locus, Phénotype, Phenotype, and Fenotipo

Both obesity and being underweight have been associated with increased mortality1,2. Underweight, defined as a body mass index (BMI) ≤ 18.5 kg per m2 in adults and ≤ -2 standard deviations from the mean in children, is the main sign of a series of heterogeneous clinical conditions including failure to thrive3-5, feeding and eating disorder and/or anorexia nervosa6,7. In contrast to obesity, few genetic variants underlying these clinical conditions have been reported8,9. We previously showed that hemizygosity of a ~600-kilobase (kb) region on the short arm of chromosome 16 causes a highly penetrant form of obesity that is often associated with hyperphagia and intellectual disabilities10. Here we show that the corresponding reciprocal duplication is associated with being underweight. We identified 138 duplication carriers (including 132 novel cases and 108 unrelated carriers) from individuals clinically referred for developmental or intellectual disabilities (DD/ID) or psychiatric disorders, or recruited from population-based cohorts. These carriers show significantly reduced postnatal weight and BMI. Half of the boys younger than five years are underweight with a probable diagnosis of failure to thrive, whereas adult duplication carriers have an 8.3-fold increased risk of being clinically underweight. We observe a trend towards increased severity in males, as well as a depletion of male carriers among non-medically ascertained cases. These features are associated with an unusually high frequency of selective and restrictive eating behaviours and a significant reduction in head circumference. Each of the observed phenotypes is the converse of one reported in carriers of deletions at this locus. The phenotypes correlate with changes in transcript levels for genes mapping within the duplication but not in flanking regions. The reciprocal impact of these 16p11.2 copy-number variants indicates that severe obesity and being underweight could have mirror aetiologies, possibly through contrasting effects on energy balance.

Nutrition, obesity, metabolic disorders, Nutrition, obésité, maladies métaboliques, Psychology, psychopathology, psychiatry, Psychologie, psychopathologie, psychiatrie, Sciences biologiques et medicales, Biological and medical sciences, Sciences biologiques fondamentales et appliquees. Psychologie, Fundamental and applied biological sciences. Psychology, Vertebres: anatomie et physiologie, organisme dans son ensemble ou etude de plusieurs organes ou systemes, Vertebrates: anatomy and physiology, studies on body, several organs or systems, Alimentation. Comportement alimentaire, Feeding. Feeding behavior, Psychologie. Psychophysiologie, Psychology. Psychophysiology, Sciences medicales, Medical sciences, Maladies metaboliques, Metabolic diseases, Psychologie. Psychanalyse. Psychiatrie, Psychology. Psychoanalysis. Psychiatry, Alimentation, Feeding, Alimentación, Homme, Human, Hombre, Adulte jeune, Young adult, Adulto joven, Affect affectivité, Affect affectivity, Afecto afectividad, Aliment, Food, Alimento, Comportement alimentaire, Feeding behavior, Conducta alimenticia, Femelle, Female, Hembra, Femme, Woman, Mujer, Humeur, Mood, Humor, Image corporelle, Body image, Imagen corporal, Nutrition, Nutrición, Perception sociale, Social perception, Percepción social, Psychologie, Psychology, Psicología, Psychométrie, Psychometrics, Psicometría, Psychopathologie, Psychopathology, Psicopatología, Régime alimentaire restrictif, Restricted diet, Régimen alimenticio restrictivo, Satisfaction, Satisfacción, Restriction alimentaire, Dietary restraint, Restricción alimenticio, Body image state, Body image states scale, Body satisfaction, Food perception, Profile of mood states, and Women

Body image can be influenced by day-to-day events, including food intake. The present study investigated the effects of foods typically perceived as healthy or unhealthy on state body image and mood. College-aged women were told the experiment was designed to assess the effects of food on cognition. Using a between-subjects design, participants consumed isocaloric amounts of foods perceived to be healthy (banana) or unhealthy (donut) or ate nothing. Next, participants completed three cognitive tasks. Prior to eating and following the cognitive tests, participants completed the BISS, POMS, the Figure Rating Scale, and the Restraint Scale. Body satisfaction decreased following intake of a donut, but was not altered in the other conditions. Depression scores significantly decreased after intake of either a donut or banana, but did not decrease in the no-food condition. Tension scores decreased significantly after consumption of a banana and in the no-food condition, but did not decrease following consumption of a donut. These results indicate that intake of a food that is perceived as unhealthy negatively affects state body image.

Alimentation, Feeding, Alimentación, Homme, Human, Hombre, Adulte jeune, Young adult, Adulto joven, Affect affectivité, Affect affectivity, Afecto afectividad, Aliment, Food, Alimento, Comportement alimentaire, Feeding behavior, Conducta alimenticia, Femelle, Female, Hembra, Femme, Woman, Mujer, Humeur, Mood, Humor, Image corporelle, Body image, Imagen corporal, Nutrition, Nutrición, Perception sociale, Social perception, Percepción social, Psychologie, Psychology, Psicología, Psychométrie, Psychometrics, Psicometría, Psychopathologie, Psychopathology, Psicopatología, Régime alimentaire restrictif, Restricted diet, Régimen alimenticio restrictivo, Satisfaction, Satisfacción, Restriction alimentaire, Dietary restraint, Restricción alimenticio, Body image state, Body image states scale, Body satisfaction, Food perception, Profile of mood states, Women, Sciences biologiques et medicales, Biological and medical sciences, Sciences biologiques fondamentales et appliquees. Psychologie, Fundamental and applied biological sciences. Psychology, Vertebres: anatomie et physiologie, organisme dans son ensemble ou etude de plusieurs organes ou systemes, Vertebrates: anatomy and physiology, studies on body, several organs or systems, Alimentation. Comportement alimentaire, Feeding. Feeding behavior, Psychologie. Psychophysiologie, Psychology. Psychophysiology, Sciences medicales, Medical sciences, Maladies metaboliques, Metabolic diseases, Psychologie. Psychanalyse. Psychiatrie, Psychology. Psychoanalysis. Psychiatry, Nutrition, obesity, metabolic disorders, Nutrition, obésité, maladies métaboliques, Psychology, psychopathology, psychiatry, and Psychologie, psychopathologie, psychiatrie

Body image can be influenced by day-to-day events, including food intake. The present study investigated the effects of foods typically perceived as healthy or unhealthy on state body image and mood. College-aged women were told the experiment was designed to assess the effects of food on cognition. Using a between-subjects design, participants consumed isocaloric amounts of foods perceived to be healthy (banana) or unhealthy (donut) or ate nothing. Next, participants completed three cognitive tasks. Prior to eating and following the cognitive tests, participants completed the BISS, POMS, the Figure Rating Scale, and the Restraint Scale. Body satisfaction decreased following intake of a donut, but was not altered in the other conditions. Depression scores significantly decreased after intake of either a donut or banana, but did not decrease in the no-food condition. Tension scores decreased significantly after consumption of a banana and in the no-food condition, but did not decrease following consumption of a donut. These results indicate that intake of a food that is perceived as unhealthy negatively affects state body image.

Hygiene and public health, epidemiology, occupational medicine, Hygiène et santé publique, épidémiologie, médecine du travail, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Sante publique. Hygiene-medecine du travail, Public health. Hygiene-occupational medicine, Santé publique. Hygiène, Public health. Hygiene, Généralités, General aspects, Epidémiologie, Epidemiology, Divers, Miscellaneous, Androgène, Androgen, Andrógeno, Hormone stéroïde sexuelle, Sex steroid hormone, Hormona esteroide sexual, Hormone testiculaire, Testicular hormone, Hormona testicular, Association, Asociación, Biologie clinique, Clinical biology, Biología clínica, Epidémiologie, Epidemiology, Epidemiología, Homme, Human, Hombre, Intervalle QT, QT interval, Intervalo QT, Santé publique, Public health, Salud pública, Sérum, Serum, Suero, Testostérone, Testosterone, Testosterona, QTc interval, RR interval, Serum testosterone, and Ventricular repolarization

It is assumed that testosterone is an important regulator of gender-related differences in ventricular repolarization. Therefore, our aim was to study whether serum levels of testosterone are associated with QTc, QT and RR interval variation. Setting: two independent population-based cohort studies. Participants: 445 male participants (>55 years) from the Rotterdam study cohort and 1,428 male participants from the study of health in Pomerania (SHIP) with an electrocardiogram who were randomly sampled for assessment of serum testosterone at baseline, after exclusion of participants with testosterone altering drugs, QTc prolonging drugs or dig(it)oxin, left ventricular hypertrophy and left and right bundle branch block. Endpoints: length of the QTc, QT and RR intervals. Analysis: linear regression model, adjusted for the two individual studies and a pooled analysis of both studies. The pooled analysis of the Rotterdam study and SHIP showed that the QTc interval gradually decreased among the tertiles (P value for trend 0.024). The third tertile of serum testosterone was associated with a lower QTc interval compared to the first tertile [—3.4 ms (-6.5; -0.3)]. However, the third tertile of serum testosterone was not associated with a lower QT interval compared to the first tertile [-0.7 ms (-3.1; 1.8)]. The RR interval gradually increased among the tertiles (P value for trend 0.002) and the third tertile of serum testosterone showed an increased RR interval compared to the first tertile [33.5 ms (12.2; 54.8)]. In the pooled analysis of two population-based studies, serum testosterone levels were not associated with the QT interval, which could be due to a lack of power. Lower QTc intervals in men with higher serum testosterone levels could be due to the association of serum testosterone with prolongation of the RR interval.

Environment, Environnement, Hygiene and public health, epidemiology, occupational medicine, Hygiène et santé publique, épidémiologie, médecine du travail, Toxicology, Toxicologie, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Pneumologie, Pneumology, Bronchopneumopathie obstructive chronique, asthme, Chronic obstructive pulmonary disease, asthma, Sante publique. Hygiene-medecine du travail, Public health. Hygiene-occupational medicine, Santé publique. Hygiène, Public health. Hygiene, Environnement. Conditions de vie, Environment. Living conditions, Pathologie des bronches, Bronchus disease, Bronquio patología, Bronchiolite, Bronchiolitis, Bronquiolitis, Etude cas, Case study, Estudio caso, Fumée, Fumes, Humo, Homme, Human, Hombre, Malade, Patient, Enfermo, Nanotube, Nanotubo, Pathologie de l'appareil respiratoire, Respiratory disease, Aparato respiratorio patología, Pathologie des poumons, Lung disease, Pulmón patología, Poumon, Lung, Pulmón, Poussière, Dust, Polvo, Santé et environnement, Health and environment, Salud y medio ambiente, Attentats 11 septembre 2001, Nanomatériau, WTC, bronchiolitis, carbon nanotubes, interstitial lung disease, and small airway disease

CONTEXT: After the collapse of the World Trade Center (WTC) on 11 September 2001, a dense cloud of dust containing high levels of airborne pollutants covered Manhattan and parts of Brooklyn, New York. Between 60,000 and 70,000 responders were exposed. Many reported adverse health effects. CASE PRESENTATION: In this report we describe clinical, pathologic, and mineralogic findings in seven previously healthy responders who were exposed to WTC dust on either 11 September or 12 September 2001, who developed severe respiratory impairment or unexplained radiologic findings and underwent video-assisted thoracoscopic surgical lung biopsy procedures at Mount Sinai Medical Center. WTC dust samples were also examined. We found that three of the seven responders had severe or moderate restrictive disease clinically. Histopathology showed interstitial lung disease consistent with small airways disease, bronchiolocentric parenchymal disease, and nonnecrotizing granulomatous condition. Tissue mineralogic analyses showed variable amounts of sheets of aluminum and magnesium silicates, chrysotile asbestos, calcium phosphate, and calcium sulfate. Small shards of glass containing mostly silica and magnesium were also found. Carbon nanotubes (CNT) of various sizes and lengths were noted. CNT were also identified in four of seven WTC dust samples. DISCUSSION: These findings confirm the previously reported association between WTC dust exposure and bronchiolar and interstitial lung disease. Long-term monitoring of responders will be needed to elucidate the full extent of this problem. The finding of CNT in both WTC dust and lung tissues is unexpected and requires further study.

Environment, Environnement, Hygiene and public health, epidemiology, occupational medicine, Hygiène et santé publique, épidémiologie, médecine du travail, Toxicology, Toxicologie, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Immunopathologie, Immunopathology, Immunodéficits. Immunoglobulinopathies, Immunodeficiencies. Immunoglobulinopathies, Immunoglobulinopathies, Hemopathies, Hematologic and hematopoietic diseases, Leucémies. Lymphomes malins. Réticuloses malignes. Hématodermies. Splénomégalie myéloïde, Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis, Cancer, Cáncer, Hémopathie maligne, Malignant hemopathy, Hemopatía maligna, Immunoglobulinopathie, Immunoglobulinopathy, Inmunoglobulinopatía, Immunopathologie, Immunopathology, Inmunopatología, Médecine du travail, Occupational medicine, Medicina ocupacional, Syndrome lymphoprolifératif, Lymphoproliferative syndrome, Linfoproliferativo síndrome, Exposition professionnelle, Occupational exposure, Exposición profesional, Homme, Human, Hombre, Industrie construction, Construction industry, Industria construcción, Myélome, Myeloma, Mieloma, Reconstruction, Reconstrucción, Secouriste, Rescuer, Socorrista, and Attentats 11 septembre 2001

Objectives: We report on cases of multiple myeloma (MM) observed in World Trade Center (WTC) responders registered in the WTC Medical Program. Methods: Possible cases of MM diagnosed between September 11, 2001, and September 10, 2007, in responders were confirmed if they met the World Health Organization and Mayo Clinic diagnostic criteria. Results: Among 28, 252 responders of known sex and age, eight cases of MM were observed (6.8 expected). Four of these cases were observed in responders younger than 45 years at the time of diagnosis (1.2 expected). A slight deficit of MM cases was observed in responders older than 45 years (4 observed, 5.6 expected). Conclusion: In this case series, we observe an unusual number of MM cases in WTC responders under 45 years. This finding underscores the importance of maintaining surveillance for cancer and other emerging diseases in this highly exposed population.

Genetics, Génétique, Sciences biologiques et medicales, Biological and medical sciences, Sciences biologiques fondamentales et appliquees. Psychologie, Fundamental and applied biological sciences. Psychology, Biologie moleculaire et cellulaire, Molecular and cellular biology, Genetique des eucaryotes. Evolution biologique et moleculaire, Genetics of eukaryotes. Biological and molecular evolution, Génétique classique, génétique quantitative, hybrides, Classical genetics, quantitative genetics, hybrids, Homme, Human, Sciences medicales, Medical sciences, Otorhinolaryngologie. Stomatologie, Otorhinolaryngology. Stomatology, Face, maxillaires, dents, parodonte: maladies, sémiologie, Facial bones, jaws, teeth, parodontium: diseases, semeiology, Maladies non tumorales, Non tumoral diseases, Genetique medicale, Medical genetics, Généralités. Conseil génétique, General aspects. Genetic counseling, Maladie congénitale, Congenital disease, Enfermedad congénita, Malformation, Malformación, Pathologie de la cavité buccale, Oral cavity disease, Cavidad bucal patología, Stomatologie, Stomatology, Estomatología, Bec de lièvre, Cleft lip, Labio leporino, Carte génétique, Genetic mapping, Mapa genético, Criblage, Screening, Cernido, Dépistage, Medical screening, Descubrimiento, Déterminisme génétique, Genetic determinism, Determinismo genético, Fente palatine, Cleft palate, Palato hendido, Fissure congénitale, Congenital cleft, Fisura congenital, Génome, Genome, Genoma, Génomique, Genomics, Genómica, Génétique, Genetics, Genética, Liaison génétique, Genetic linkage, Ligamiento genético, Pathogénie, Pathogenesis, Patogenia, GDF6, MYH9, SDC2, cleft lip and palate, and genome scan

Nonsyndromic cleft lip with or without cleft palate (NSCLP) is a common birth anomaly that requires prolonged multidisciplinary rehabilitation. Although variation in several genes has been identified as contributing to NSCLP, most of the genetic susceptibility loci have yet to be defined. To identify additional contributory genes, a high-throughput genomic scan was performed using the Illumina Linkage IVb Panel platform. We genotyped 6008 SNPs in nine non-Hispanic white NSCLP multiplex families and a single large African-American NSCLP multiplex family. Fourteen chromosomal regions were identified with LOD> 1.5, including six regions not previously reported. Analysis of the data from the African-American and non-Hispanic white families revealed two likely chromosomal regions: 8q21.3-24.12 and 22q12.2-12.3 with LOD scores of 2.98 and 2.66, respectively. On the basis of biological function, syndecan 2 (SDC2) and growth differentiation factor 6 (GDF6) in 8q21.3-24.12 and myosin heavy-chain 9, non-muscle (MYH9) in 22q12.2-12.3 were selected as candidate genes. Association analyses from these genes yielded marginally significant P-values for SNPs in SDC2 and GDF6 (0.01≤P<0.05). Evidence for an altered transmission was found for four MYH9 SNPs (P<0.01). SNP rs1002246 exhibited altered transmission by all analytic methods. However, analysis of two SNP MYH9 haplotypes did not identify a single high-risk haplotype. Our results confirm a previous report that 8q21.3-24.12 may harbor a clefting gene and identify 22q12.2-12.3 as a new candidate region that contains MYH9. Most importantly, we confirm the previous report of an association with MYH9.

Psychology, psychopathology, psychiatry, Psychologie, psychopathologie, psychiatrie, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Psychopathologie. Psychiatrie, Psychopathology. Psychiatry, Etude clinique de l'adulte et de l'adolescent, Adult and adolescent clinical studies, Divers, Miscellaneous, Psychologie. Psychanalyse. Psychiatrie, Psychology. Psychoanalysis. Psychiatry, PSYCHOPATHOLOGIE. PSYCHIATRIE, Langage, Language, Lenguaje, Analyse qualitative, Qualitative analysis, Análisis cualitativo, Effet psychologique, Psychological effect, Efecto psicológico, Environnement social, Social environment, Contexto social, Expérience personnelle, Personal experience, Experiencia personal, Homme, Human, Hombre, Narration, Narrative, Narración, Psychopathologie, Psychopathology, Psicopatología, Santé mentale, Mental health, Salud mental, Santé publique, Public health, Salud pública, Secouriste, Rescuer, Socorrista, Sinistre, Disaster, Siniestro, Symptomatologie, Symptomatology, Sintomatología, Traumatisme, Trauma, Traumatismo, Attentats 11 septembre 2001, 9/11, Disasters, Responders, and World Trade Center

A qualitative study of the experiences of rescue and recovery workers/volunteers at Ground Zero following the terrorist attacks of 9/11/01 is reported. Information was extracted from a semi-structured clinical evaluation of 416 responders who were the initial participants in a large scale medical and mental health screening and treatment program for 9/11 responders. Qualitative analysis revealed themes that spanned four categories― occupational roles, exposures, attitudes/experiences, and outcomes related to the experience of Ground Zero. Themes included details regarding Ground Zero roles, grotesque experiences such as smells, the sense of the surreal nature of responding, and a turning to rituals to cope after leaving Ground Zero. These findings personalize the symptom reports and diagnoses that have resulted from the 9/11 responders' exposure to Ground Zero, yielding richer information than would otherwise be available for addressing the psychological dimensions of disasters. This work shows that large scale qualitative surveillance of trauma-exposed populations is both relevant and feasible.

Langage, Language, Lenguaje, Analyse qualitative, Qualitative analysis, Análisis cualitativo, Effet psychologique, Psychological effect, Efecto psicológico, Environnement social, Social environment, Contexto social, Expérience personnelle, Personal experience, Experiencia personal, Homme, Human, Hombre, Narration, Narrative, Narración, Psychopathologie, Psychopathology, Psicopatología, Santé mentale, Mental health, Salud mental, Santé publique, Public health, Salud pública, Secouriste, Rescuer, Socorrista, Sinistre, Disaster, Siniestro, Symptomatologie, Symptomatology, Sintomatología, Traumatisme, Trauma, Traumatismo, Attentats 11 septembre 2001, 9/11, Disasters, Responders, World Trade Center, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Psychopathologie. Psychiatrie, Psychopathology. Psychiatry, Etude clinique de l'adulte et de l'adolescent, Adult and adolescent clinical studies, Divers, Miscellaneous, Psychologie. Psychanalyse. Psychiatrie, Psychology. Psychoanalysis. Psychiatry, PSYCHOPATHOLOGIE. PSYCHIATRIE, Psychology, psychopathology, psychiatry, and Psychologie, psychopathologie, psychiatrie

A qualitative study of the experiences of rescue and recovery workers/volunteers at Ground Zero following the terrorist attacks of 9/11/01 is reported. Information was extracted from a semi-structured clinical evaluation of 416 responders who were the initial participants in a large scale medical and mental health screening and treatment program for 9/11 responders. Qualitative analysis revealed themes that spanned four categories― occupational roles, exposures, attitudes/experiences, and outcomes related to the experience of Ground Zero. Themes included details regarding Ground Zero roles, grotesque experiences such as smells, the sense of the surreal nature of responding, and a turning to rituals to cope after leaving Ground Zero. These findings personalize the symptom reports and diagnoses that have resulted from the 9/11 responders' exposure to Ground Zero, yielding richer information than would otherwise be available for addressing the psychological dimensions of disasters. This work shows that large scale qualitative surveillance of trauma-exposed populations is both relevant and feasible.

Homme, Human, Hombre, Trouble développement, Developmental disorder, Trastorno desarrollo, Adulte, Adult, Adulto, Aptitude sociale, Social aptitude, Aptitud social, Autisme, Autism, Autismo, Enfant, Child, Niño, Etude cas, Case study, Estudio caso, Evaluation, Evaluación, Interaction sociale, Social interaction, Interacción social, Jouet, Toy, Juguete, Relation adulte enfant, Adult child relation, Relacíon adulto niño, Relation interpair, Peer relation, Relación interpar, Robot, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Psychopathologie. Psychiatrie, Psychopathology. Psychiatry, Etude clinique de l'enfant, Child clinical studies, Troubles du développement, Developmental disorders, Autisme infantile, Infantile autism, Psychologie. Psychanalyse. Psychiatrie, Psychology. Psychoanalysis. Psychiatry, PSYCHOPATHOLOGIE. PSYCHIATRIE, Pediatrics, Pédiatrie, Psychology, psychopathology, psychiatry, and Psychologie, psychopathologie, psychiatrie

Cet article rend compte d'un aspect d'une exploration plus large qui cherche à répondre à deux questions: comment et jusqu'à quel point un robot peut jouer le rôle d'un médiateur social, encourageant les enfants avec autisme à interagir entre eux, avec les adultes présents et avec le robot. L'article se concentre sur les potentiels bénéfices ajoutés que peut tirer un éducateur expérimenté qui utilise le robot comme un moyen pour parvenir à ces interactions triadiques. Il donne une évaluation monographique d'essais au cours desquels un robot médiatise des interactions directes et indirectes entre des enfants avec autisme, l'éducateur et d'autres enfants.

Biochemistry, molecular biology, biophysics, Biochimie, biologie moléculaire, biophysique, Pharmacology drugs, Pharmacologie, galénique, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Pharmacologie. Traitements medicamenteux, Pharmacology. Drug treatments, Anticancéreux, Antineoplastic agents, Généralités, General aspects, Mammalia, Rodentia, Vertebrata, Animal, Anticancéreux, Antineoplastic agent, Anticanceroso, Antimitotique, Antimitotic, Antimitótico, Antitubuline, Antitubulin, Antitubulina, Carcinome épidermoïde, Squamous cell carcinoma, Carcinoma epidermoide, Cellule tumorale, Tumor cell, Célula tumoral, Composé bicyclique, Bicyclic compound, Compuesto bicíclico, Cytotoxicité, Cytotoxicity, Citotoxicidad, Homme, Human, Hombre, Hétérocycle oxygène azote, Oxygen nitrogen heterocycle, Heterociclo oxígeno nitrógeno, Hétérocycle oxygène, Oxygen heterocycle, Heterociclo oxígeno, In vitro, In vivo, Lignée cellulaire, Cell line, Línea celular, Oxadiazole dérivé, Oxadiazole derivatives, Oxadiazol derivado, Pharmacocinétique, Pharmacokinetics, Farmacocinética, Pyridine dérivé, Pyridine derivatives, Piridina derivado, Relation structure activité, Structure activity relation, Relación estructura actividad, Souris, Mouse, Ratón, Synthèse chimique, Chemical synthesis, Síntesis química, Voie intrapéritonéale, Intraperitoneal administration, Vía intraperitoneal, Voie orale, Oral administration, Vía oral, 1,3,4-Oxadiazole(2-[(1,3-benzodioxol-5-yl)amino]-5-[(2-picolylamino)-3-pyridyl]), 1,3-Benzodioxole dérivé, Benzo[a]heptalène dérivé, Benzoheptalène, Lignée A431, 1,3,4-Oxadiazole, Antimitotic agent, Multiple-drug resistance, and Tubulin polymerization inhibitor

Oxadiazole derivatives were synthesized and evaluated for their ability to inhibit tubulin polymerization and to cause mitotic arrest in tumor cells. The most potent compounds inhibited tubulin polymerization at concentrations below 1 μM. Lead analogs caused mitotic arrest of A431 human epidermoid cells and cells derived from multi-drug resistant tumors (10, EC50 = 7.8 nM). Competition for the colchicine binding site and pharmacokinetic properties of selected potent compounds were also investigated and are reported herein, along with structure-activity relationships for this novel series of antimitotic agents.

Cardiology, blood circulation, phlebology, Cardiologie, appareil circulatoire, phlébologie, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Cardiologie. Appareil circulatoire, Cardiology. Vascular system, Vaisseaux sanguins et lymphatiques, Blood and lymphatic vessels, Hypertension artérielle. Hypotension artérielle, Arterial hypertension. Arterial hypotension, Pathologie expérimentale, Experimental diseases, Clinique. Epidémiologie. Exploration. Etiologie, Clinical manifestations. Epidemiology. Investigative techniques. Etiology, Enzyme, Enzima, Gestation pathologie, Pregnancy disorders, Gestación patología, Mammalia, Oxidoreductases, Rodentia, Toxémie gravidique, Pregnancy toxemia, Toxemia gravídica, Vertebrata, Vitamine, Vitamin, Vitamina, Acide ascorbique, Ascorbic acid, Acido ascórbico, Animal, Antioxydant, Antioxidant, Antioxidante, Artère mésentérique, Mesenteric artery, Arteria mesentérica, Azote monoxyde, Nitric oxide, Nitrógeno monóxido, Déficit, Deficiency, Déficiencia, Homme, Human, Hombre, Intercepteur radical, Radical scavenger, Interceptor radical, Nitric-oxide synthase, Pression sanguine, Blood pressure, Presión sanguínea, Prééclampsie, Preeclampsia, Radical libre, Free radical, Rat, Rata, antioxidants, preeclampsia, pregnancy, rats, and vessels

Plasma ascorbic acid is decreased in women with the pregnancy disorder preeclampsia. We used a mutant strain of rats (Osteogenic Disorder Shionogi), dependent on dietary sources of vitamin C, to investigate whether reduced intake of the vitamin would differentially affect vascular function in late-pregnant (day 19) and age-matched virgin rats. The animals were given either 1 mg/mL of ascorbic acid ad libitum in drinking water [fully supplemented (FS)] or 0.25 mg/mL [marginally supplemented (MS)]. Fetal weights were 21% lower in MS than FS rats, whereas mean maternal weights and pup numbers did not differ. Small mesenteric arteries (diameter, 268±7 μm) were mounted in a pressurized arteriograph. Myogenic reactivity (contractile response to step increases in intraluminal pressure) was increased in arteries from MS pregnant compared with FS pregnant rats to levels observed in virgin rats. Ascorbic acid intake did not affect myogenic responses of arteries from virgin rats. Hence, the normal pregnancy-induced reduction in myogenic reactivity was abrogated in MS pregnant animals. Inhibition of nitric oxide synthase had no effect on the myogenicity of arteries from virgin or MS pregnant rats but increased myogenicity of FS pregnant rats to the level of MS pregnant rats. Free radical scavengers reversed the accentuated myogenicity of MS pregnant rats without affecting FS pregnant or virgin rat arteries. These data indicate that moderate ascorbate deprivation increases mesenteric artery myogenic responsiveness during pregnancy. This increase may result from a decrease in nitric oxide-mediated modulation of the myogenic contractile response.

Biochemistry, molecular biology, biophysics, Biochimie, biologie moléculaire, biophysique, Pharmacology drugs, Pharmacologie, galénique, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Pharmacologie. Traitements medicamenteux, Pharmacology. Drug treatments, Anticancéreux, Antineoplastic agents, Généralités, General aspects, Angiogenèse, Angiogenesis, Angiogénesis, Antiangiogénique, Antiangiogenic agent, Antiangiogenico, Anticancéreux, Antineoplastic agent, Anticanceroso, Antimitotique, Antimitotic, Antimitótico, Antitubuline, Antitubulin, Antitubulina, Carcinome épidermoïde, Squamous cell carcinoma, Carcinoma epidermoide, Cellule tumorale, Tumor cell, Célula tumoral, Homme, Human, Hombre, Inhibiteur, Inhibitor, Inhibidor, Inhibition, Inhibición, Lignée cellulaire, Cell line, Línea celular, Néovascularisation, Neovascularization, Neovascularización, Pyridine dérivé, Pyridine derivatives, Piridina derivado, Relation structure activité, Structure activity relation, Relación estructura actividad, Site fixation, Binding site, Sitio fijación, Synthèse chimique, Chemical synthesis, Síntesis química, Triazole dérivé, Triazole derivatives, Triazol derivado, Vascularisation, Vascularization, Vascularización, 1,2,4-Triazole dérivé, 1,2,4-Triazole(2-[2-(3,5-diméthoxyanilino)-3-pyridyl]-5-[3-méthoxyanilino]), Benzo[a]heptalène dérivé, Benzoheptalène, Lignée A431, 1,2,4-triazole, Tubulin inhibitor, Tubulin polymerization, Tumor vasculature, and Vascular disrupting agent

A novel triazolc-containing chemical series was shown to inhibit tubulin polymerization and cause cell cycle arrest in A431 cancer cells with EC50 values in the single digit nanomolar range. Binding experiments demonstrated that representative active compounds of this class compete with colchicine for its binding site on tubulin. The syntheses and structure-activity relationship studies for the triazole derivatives are described herein.

Genetics, Génétique, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Endocrinopathies, Hypothalamus. Hypophyse. Epiphyse (pathologie), Hypothalamus. Hypophysis. Epiphysis (diseases), Pathologie non tumorale. Résistance tissu cible. Tumeurs bénignes, Non tumoral diseases. Target tissue resistance. Benign neoplasms, Genetique medicale, Medical genetics, Généralités. Conseil génétique, General aspects. Genetic counseling, Endocrinopathie, Endocrinopathy, Endocrinopatía, Hypophyse pathologie, Pituitary diseases, Hipófisis patología, Malformation, Malformación, Association, Asociación, Génétique, Genetics, Genética, Homme, Human, Hombre, Hypoplasie, Hypoplasia, Hipoplasia, Insuffisance hypophysaire, Hypophyseal insufficiency, and Insuficiencia hipofisaria

Duplications of Xq26-27 have been implicated in the etiology of X-linked hypopituitarism associated with mental retardation (MR). Additionally, an expansion of a polyalanine tract (by 11 alanines) within the transcription factor SOX3 (Xq27.1) has been reported in patients with growth hormone deficiency and variable learning difficulties. We report a submicroscopic duplication of Xq27.1, the smallest reported to date (685.6 kb), in two siblings with variable hypopituitarism, callosal abnormalities, anterior pituitary hypoplasia (APH), an ectopic posterior pituitary (EPP), and an absent infundibulum. This duplication contains SOX3 and sequences corresponding to two transcripts of unknown function; only Sox3 is expressed in the infundibulum in mice. Next, we identified a novel seven-alanine expansion within a polyalanine tract in SOX3 in a family with panhypopituitarism in three male siblings with an absent infundibulum, severe APH, and EPP. This mutation led to reduced transcriptional activity, with impaired nuclear localization of the mutant protein. We also identified a novel polymorphism (A43T) in SOX3 in another child with hypopituitarism. In contrast to findings in previous studies, there was no evidence of MR or learning difficulties in our patients. We conclude that both over- and underdosage of SOX3 are associated with similar phenotypes, consisting of infundibular hypoplasia and hypopituitarism but not necessarily MR.

Orthopedics traumatology, Orthopédie, traumatologie, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Radiotherapie. Traitement instrumental. Physiotherapie. Reeducation. Readaptation, orthophonie, crenotherapie. Traitement dietetique et traitements divers (generalites), Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects), Divers, Miscellaneous, A domicile, At home, A domicilio, Activation, Activación, Décharge, Discharge, Descarga, Etude cohorte, Cohort study, Estudio cohorte, Facteur prédictif, Predictive factor, Factor predictivo, Homme, Human, Hombre, Hôpital, Hospital, Identification, Identificación, Pronostic, Prognosis, Pronóstico, Réadaptation, Rehabilitation(human), Readaptación, Réhabilitation, Rehabilitation, Rehabilitación, Rééducation, Reeducation, Reeducación, Soin, Care, Cuidado, Sortie hôpital, Hospital discharge, Salida hospital, Symptomatologie, Symptomatology, Sintomatología, Traitement, Treatment, Tratamiento, Vie quotidienne, Daily living, Vida cotidiana, Vision, Visión, Patient discharge, and Treatment outcome

Objective: To determine which sociodemographic and clinical characteristics of patients admitted to a general activation service (GAS) are predictive of discharge to patients' discharge goal locations (DGLs). Design: Prospective cohort study. Setting: Rehabilitation and complex continuing care hospital in southern Ontario, Canada. Participants: Patients admitted from January 2000 to December 2002 (N=154). Intervention: The GAS. Main Outcome Measure: Patients indicated on their service applications where they wanted to be discharged. This is termed the DGL. Results: Fifty-three percent of the sample were discharged to their DGLs. Ninety-eight percent of these patients were discharged by 9 months. Eighty-seven percent who were discharged to their DGLs were discharged to their own home. Predictors of being discharged to the DGL were better activities of daily living scores, good vision, and having sufficient help at home. Expert clinician opinion of the likelihood of each patient being discharged to his/her DGL, based on initial assessment, was also predictive of each patient's eventual discharge to his/her DGL. Conclusions: The GAS has a 53% success rate in discharging patients to their DGLs. Variables have been identified that should be useful in predicting whether patients will be discharged to their DGLs. Our findings are meaningful and informative in determining future admission criteria for the service.