Aims: To describe and compare physical growth, current health status, functional limitations and neurodevelopmental impairments (defined as low IQ, school problems or psychiatric disorder) at 11 y of age in a populati...Aims: To describe and compare physical growth, current health status, functional limitations and neurodevelopmental impairments (defined as low IQ, school problems or psychiatric disorder) at 11 y of age in a population of non-handicapped low-birthweight (LBW) children with that of normal-birthweight (NBW) children. Methods: A population-based sample of 130 LBW children (weighing less than 2000 g at birth) without major handicaps, and a random sample of 131 NBW children born at term. Somatic and mental health and cognitive abilities were assessed through questionnaires to parents, a physical examination, standardized tests of cognitive function (WISC-R) and a semi-structured interview (Children Assessment Schedule). Results: General somatic health status was similar for the LBW and NBW children. The LBW children were shorter (mean difference -2.5 cm; 95% CI -0.9 to -4.2) and had a smaller head circumference (mean difference -0.8 cm; 95% CI -0.4 to -1.1) but similar weights and body mass indices. Differences and similarities in anthropometric measures were the same at 5 and 11 y of age. The LBW children had higher systolic (mean difference 3.2 mmHg; 95% CI -0.6 to -0.3) but similar diastolic blood pressure. A higher proportion of LBW children had decreased visual acuity and hearing impairment. Forty per cent of LBW children had neurodevelopmental impairments, compared to 20% of NBW children (OR 2.6; 95% CI 1.5 to 4.5). Conclusion: At 11 y of age, survivors of moderately low birthweight without major handicaps may have generally good health, but are at risk of neurodevelopmental impairments.展开更多
Introduction. Pemphigus is a frequent chronic bullous dermatosis in Morocco that predominantly affects young women. It requires serious therapeutic management and often repeated hospitalizations. The purpose of this s...Introduction. Pemphigus is a frequent chronic bullous dermatosis in Morocco that predominantly affects young women. It requires serious therapeutic management and often repeated hospitalizations. The purpose of this study was to assess the particular impact of pemphigus on quality of life by comparing the quality of life in patients suffering from pemphigus with that of the general population using a generic instrument of measure of health related quality of life: the SF- 36, in association with a questionnaire exploring the impact of the disease on self perception, social relationship and behaviour. Participants and methods. A French version of the SF- 36 underwent 2 translations from French to Moroccan dialect, then two retrograde translations. After a pre- test, the questionnaire survey was administered by the same investigator to 30 patients who suffered from pemphigus, followed- up in the Ibn Rochd UHC in Casablanca and to 60 healthy adults. The two samples were paired according to age and sex. Results. In the pemphigus group, there was a significant decrease of mean scores of all the SF- 36 dimensions, except for physical pain and alteration in general status of health. The greatest alteration concerned the impact on physical and emotional status (P < 0.00001) and the smallest alteration concerned the perception of general health(P=0.02). The factors influencing this impact were: profession, face involvement and extent of lesions. Other results concerning the psychosocial impact of pemphigus are presented. Conclusion. Our study confirmed that pemphigus is responsible for great alterations in health related quality of life. Therefore, the management of this disease must take into account its impact on various fields of life of the patients.展开更多
Purpose To investigate the emotional status of children un-dergoing active treatment for ambly opia.Design Postal survey,in the context of a prospecti ve,multicenter,ran-domized controlled trial.Particip ants Parents ...Purpose To investigate the emotional status of children un-dergoing active treatment for ambly opia.Design Postal survey,in the context of a prospecti ve,multicenter,ran-domized controlled trial.Particip ants Parents of 177chil-dren with a unilateral visual impair ment referred from preschool vision screening.The chi ldren had been re-cruited to a randomized controlled t rial of treatment for u-nilateral visual impairment and ran domly assigned to re-ceive either glasses with or without patches,glasses alone,or treatment deferred for 1year.Methods A self-completion questionnaire,including a psychom etric behavioral scale,was sent to the parents of all childre n recruited to the trial at age 4years,to 66whose deferred tr eatment began at age5years,and finally to 151remaining in the trial at the end of follow-up.Main outcome measures Mean scores per treatment group on the Revised Rutte r Parent Scale for Preschool Children.Comparison of p arent responses to questions assessing the child’s general well-being and dif-ficulties associated with treatmen t.Results Completed questionnaires were returned for 144of 177(81%)chil-dren at a mean age(standard deviation)of 48months(5.0),for 45of 66(68%)at a mean age of 61months(5.8),and for 78of 151(52%)at a mean age of 67 months(5.0).Most parents reported having diffi culty with patching their child regardless of a ge(77%at age 4years and 73%at age 5years),with fewer reporting difficulties with glasses alone(42%and 53%,respectively).Chil-dren were significantly more upset b y patching than by glasses only(chi-square test,P=0.03for age 4years and P=0.01for age 5years),as were the parents of4-year-olds(chi-square test,P=0.01).Most parents thought their children were happy,c ooperative,and good tempered,and behavioral scores did not differ between treatment groups.Conclusions Treatment for unilateral vi-sual impairment is not easy to implem ent and is commonly associated with some degree of distr ess.Despite this,no impact on the childs global well-being or behavior was seen either during or after the treatment period.展开更多
Purpose: To investigate the impact of stereopsis on vision-related quality of life and general health status of the elderly. Methods: A quota of 200 subjects aged 65 years or older and had their households registered ...Purpose: To investigate the impact of stereopsis on vision-related quality of life and general health status of the elderly. Methods: A quota of 200 subjects aged 65 years or older and had their households registered in Guando district was recruited for a general physical examination including ophthalmic evaluation. A structured questionnaire consisting of seven vision-specific items as well as 36-item short-form survey of the Medical Outcomes Study (SF-36) was administered. Stereoscopic level was divided into three groups: no stereopsis, gross stereopsis, and fine stereopsis. Fisher’s exact test was used to detect any difference in subjective visual functioning andMann-Whitney U test was used for analyses of SF-36 scores. Results: A total of 187 volunteers were recruited and 150 were analysed for stereoscopic levels. There was no significant difference in vision-specific difficulty among the threestereoscopic groups. For SF-36, having no stereopsis scored significantly less than having gross (P=0.005) and fine (P < 0.0001) stereopsis in the vitality/energy dimension. General health perception dimension fared significantly lower in the group with no stereopsis compared to the fine stereoscopic group (P=0.01). In multivariate analysis, having fine stereopsis scored significantly higher in the energy/vitality dimension than having no stereopsis (P=0.02). On the other hand, visual impairment imposed significant adverse effect on five vision-specific items and had no significant relationship with the eight dimensions of SF-36. Conclusions: Defective stereopsis in the elderly imposes no significant adverse effect on vision-related quality of life. However, subjects may feel more exhausted in accomplishing their usual tasks.展开更多
Background: Chronic neuropathic pain occurs in 10-15%of patients with neuroborreliosis and is difficult to treat. Objective: We evaluated the effect of gabapentin monotherapy on residual pain in patients with neurobor...Background: Chronic neuropathic pain occurs in 10-15%of patients with neuroborreliosis and is difficult to treat. Objective: We evaluated the effect of gabapentin monotherapy on residual pain in patients with neuroborreliosis after intravenous ceftriaxone treatment. Methods: Ten patients with neuroborreliosis and a long-lasting history of neurologic symptoms were treated with gabapentin, starting with 300 mg/day. Doses were raised over a period of 4-12 weeks to the individually effective and tolerated maximum dose (500-1,200 mg). Treatment was maintained until pain disappeared and then gradually reduced in dose over weeks. If symptoms recurred, the doses were raised again. Therapy was maintained over an average of 1-2 years. Results: Pain quality and pain quantity were evaluated using the McGill pain questionnaire and a visual analogue scale. There was an improvement of ‘crawling’and ‘burning’pain sensations, neck and radiating lumbar pain in 9/10 (90%) patients as well as a positive effect on mood, general feeling of health and quality of sleep in 5/10 (50%) patients. The average dose leading to a clear-cut pain reduction was 700 mg. Conclusions: In an open pilot study (10 patients), gabapentin monotherapy which has to our knowledge not been published as treatment of chronic neuropathic pain in patients with late Lyme borreliosis is efficacious in treating pain associated with neuroborreliosis and can thus improve quality of life in these patients.展开更多
文摘Aims: To describe and compare physical growth, current health status, functional limitations and neurodevelopmental impairments (defined as low IQ, school problems or psychiatric disorder) at 11 y of age in a population of non-handicapped low-birthweight (LBW) children with that of normal-birthweight (NBW) children. Methods: A population-based sample of 130 LBW children (weighing less than 2000 g at birth) without major handicaps, and a random sample of 131 NBW children born at term. Somatic and mental health and cognitive abilities were assessed through questionnaires to parents, a physical examination, standardized tests of cognitive function (WISC-R) and a semi-structured interview (Children Assessment Schedule). Results: General somatic health status was similar for the LBW and NBW children. The LBW children were shorter (mean difference -2.5 cm; 95% CI -0.9 to -4.2) and had a smaller head circumference (mean difference -0.8 cm; 95% CI -0.4 to -1.1) but similar weights and body mass indices. Differences and similarities in anthropometric measures were the same at 5 and 11 y of age. The LBW children had higher systolic (mean difference 3.2 mmHg; 95% CI -0.6 to -0.3) but similar diastolic blood pressure. A higher proportion of LBW children had decreased visual acuity and hearing impairment. Forty per cent of LBW children had neurodevelopmental impairments, compared to 20% of NBW children (OR 2.6; 95% CI 1.5 to 4.5). Conclusion: At 11 y of age, survivors of moderately low birthweight without major handicaps may have generally good health, but are at risk of neurodevelopmental impairments.
文摘Introduction. Pemphigus is a frequent chronic bullous dermatosis in Morocco that predominantly affects young women. It requires serious therapeutic management and often repeated hospitalizations. The purpose of this study was to assess the particular impact of pemphigus on quality of life by comparing the quality of life in patients suffering from pemphigus with that of the general population using a generic instrument of measure of health related quality of life: the SF- 36, in association with a questionnaire exploring the impact of the disease on self perception, social relationship and behaviour. Participants and methods. A French version of the SF- 36 underwent 2 translations from French to Moroccan dialect, then two retrograde translations. After a pre- test, the questionnaire survey was administered by the same investigator to 30 patients who suffered from pemphigus, followed- up in the Ibn Rochd UHC in Casablanca and to 60 healthy adults. The two samples were paired according to age and sex. Results. In the pemphigus group, there was a significant decrease of mean scores of all the SF- 36 dimensions, except for physical pain and alteration in general status of health. The greatest alteration concerned the impact on physical and emotional status (P < 0.00001) and the smallest alteration concerned the perception of general health(P=0.02). The factors influencing this impact were: profession, face involvement and extent of lesions. Other results concerning the psychosocial impact of pemphigus are presented. Conclusion. Our study confirmed that pemphigus is responsible for great alterations in health related quality of life. Therefore, the management of this disease must take into account its impact on various fields of life of the patients.
文摘Purpose To investigate the emotional status of children un-dergoing active treatment for ambly opia.Design Postal survey,in the context of a prospecti ve,multicenter,ran-domized controlled trial.Particip ants Parents of 177chil-dren with a unilateral visual impair ment referred from preschool vision screening.The chi ldren had been re-cruited to a randomized controlled t rial of treatment for u-nilateral visual impairment and ran domly assigned to re-ceive either glasses with or without patches,glasses alone,or treatment deferred for 1year.Methods A self-completion questionnaire,including a psychom etric behavioral scale,was sent to the parents of all childre n recruited to the trial at age 4years,to 66whose deferred tr eatment began at age5years,and finally to 151remaining in the trial at the end of follow-up.Main outcome measures Mean scores per treatment group on the Revised Rutte r Parent Scale for Preschool Children.Comparison of p arent responses to questions assessing the child’s general well-being and dif-ficulties associated with treatmen t.Results Completed questionnaires were returned for 144of 177(81%)chil-dren at a mean age(standard deviation)of 48months(5.0),for 45of 66(68%)at a mean age of 61months(5.8),and for 78of 151(52%)at a mean age of 67 months(5.0).Most parents reported having diffi culty with patching their child regardless of a ge(77%at age 4years and 73%at age 5years),with fewer reporting difficulties with glasses alone(42%and 53%,respectively).Chil-dren were significantly more upset b y patching than by glasses only(chi-square test,P=0.03for age 4years and P=0.01for age 5years),as were the parents of4-year-olds(chi-square test,P=0.01).Most parents thought their children were happy,c ooperative,and good tempered,and behavioral scores did not differ between treatment groups.Conclusions Treatment for unilateral vi-sual impairment is not easy to implem ent and is commonly associated with some degree of distr ess.Despite this,no impact on the childs global well-being or behavior was seen either during or after the treatment period.
文摘Purpose: To investigate the impact of stereopsis on vision-related quality of life and general health status of the elderly. Methods: A quota of 200 subjects aged 65 years or older and had their households registered in Guando district was recruited for a general physical examination including ophthalmic evaluation. A structured questionnaire consisting of seven vision-specific items as well as 36-item short-form survey of the Medical Outcomes Study (SF-36) was administered. Stereoscopic level was divided into three groups: no stereopsis, gross stereopsis, and fine stereopsis. Fisher’s exact test was used to detect any difference in subjective visual functioning andMann-Whitney U test was used for analyses of SF-36 scores. Results: A total of 187 volunteers were recruited and 150 were analysed for stereoscopic levels. There was no significant difference in vision-specific difficulty among the threestereoscopic groups. For SF-36, having no stereopsis scored significantly less than having gross (P=0.005) and fine (P < 0.0001) stereopsis in the vitality/energy dimension. General health perception dimension fared significantly lower in the group with no stereopsis compared to the fine stereoscopic group (P=0.01). In multivariate analysis, having fine stereopsis scored significantly higher in the energy/vitality dimension than having no stereopsis (P=0.02). On the other hand, visual impairment imposed significant adverse effect on five vision-specific items and had no significant relationship with the eight dimensions of SF-36. Conclusions: Defective stereopsis in the elderly imposes no significant adverse effect on vision-related quality of life. However, subjects may feel more exhausted in accomplishing their usual tasks.
文摘Background: Chronic neuropathic pain occurs in 10-15%of patients with neuroborreliosis and is difficult to treat. Objective: We evaluated the effect of gabapentin monotherapy on residual pain in patients with neuroborreliosis after intravenous ceftriaxone treatment. Methods: Ten patients with neuroborreliosis and a long-lasting history of neurologic symptoms were treated with gabapentin, starting with 300 mg/day. Doses were raised over a period of 4-12 weeks to the individually effective and tolerated maximum dose (500-1,200 mg). Treatment was maintained until pain disappeared and then gradually reduced in dose over weeks. If symptoms recurred, the doses were raised again. Therapy was maintained over an average of 1-2 years. Results: Pain quality and pain quantity were evaluated using the McGill pain questionnaire and a visual analogue scale. There was an improvement of ‘crawling’and ‘burning’pain sensations, neck and radiating lumbar pain in 9/10 (90%) patients as well as a positive effect on mood, general feeling of health and quality of sleep in 5/10 (50%) patients. The average dose leading to a clear-cut pain reduction was 700 mg. Conclusions: In an open pilot study (10 patients), gabapentin monotherapy which has to our knowledge not been published as treatment of chronic neuropathic pain in patients with late Lyme borreliosis is efficacious in treating pain associated with neuroborreliosis and can thus improve quality of life in these patients.
