Delonix regia Leaf Extract (DRLE): A Potential Therapeutic Agent for Cardioprotection.

Delonix regia (Boj. Ex. Hook) is a flowering plant in the pea family found in tropical areas and its leaves are used informally to treat diseases in folk medicine. However, the cardioprotective effects in this plant are still unclear. In this study, we found that the Delonix regia leaf extract (DRLE) (400 mg/kg/d) can reduce the mortality rate in an isoproterenol (ISO)-induced heart injury and hypertrophy mouse model. Decreased serum levels of creatine phosphokinase, LDH, GOT, TNF-alpha and increased nitric oxide levels were found in DRLE-treated ISO-injured mice. In the in vitro study, the porcine coronary artery exhibited vasodilation effect induced by DRLE in a dose-dependent manner. In the DRLE toxic test, overdose of DRLE showed the high safety in normal mice and may have the ability to remove the metabolic wastes in blood. In conclusion, we demonstrated for the first time that DRLE has the cardioprotective effects by activating the vasodilation through NO pathway and preventing the myocyte injury via inhibition of TNF-alpha pathway. We suggest that DRLE may act as a promising novel herbal medicine for cardioprotection.

Development and validation of a new performance-based measurement of instrumental activities of daily living in Taiwan.

BACKGROUND: The performance-based instrumental activities of daily living (IADL) measurement is thought to improve the validity and reliability of conventional tools that rely on proxy reports. The aims of this study were to develop and validate a performance-based measurement of IADL for use in elderly patients with cognitive impairment in Taiwan and other Chinese-speaking communities. METHODS: Referring to current versions of performance-based IADL, we developed the new Taiwan Performance-Based IADL (TPIADL) measurement to minimize literacy dependency and render it compatible with local culture. Participants performed tasks, including finding a telephone number, calculating the correct amount of change, reading the ingredients on a tin of food, finding food items on a shelf, and reading instructions on a medicine container. The internal consistency and convergent and criteria validity of the TPIADL were examined. RESULTS: Altogether, 117 elderly subjects were invited to participate in this study, including 39 patients with dementia due to Alzheimer's disease, 29 with amnestic mild cognitive impairment, and 49 without cognitive impairment. The internal consistency of the TPIADL was 0.82. The TPIADL scores were significantly correlated with the Lawton Instrumental Activities of Daily Living Scale (r = 0.76, P < 0.001). The area under the relative operating characteristic curve was 0.90 (95% confidence interval = 0.84-0.97) to differentiate dementia due to Alzheimer's disease and others. The optimal cut-off point for the TPIADL was 6/7, which gives a sensitivity of 84.6% and a specificity of 75.6%. CONCLUSIONS: The TPIADL is a validated instrument for the measurement of IADL in elderly subjects. It might replace conventional assessment as a valid and easily administered measurement.

Cognitive profile difference between Allen Cognitive Levels 4 and 5 in schizophrenia.

OBJECTIVE: We compared the pattern of cognitive deficits exhibited by people with schizophrenia at Allen Cognitive Level (ACL) 4 with that of people at Level 5. METHOD: Participants were classified into two groups on the basis of their ACL Screen scores: ACL 4 (n = 35) and ACL 5 (n = 41). We assessed cognitive functions and psychotic symptoms in all participants. RESULTS: Multivariate analysis of covariance controlling for gender and negative symptoms revealed that people at ACL 4 performed significantly worse than those at ACL 5 on processing speed, verbal memory, and working memory. The discriminant analysis with all cognitive variables produced a classification accuracy of 78% in differentiation of cognitive levels. CONCLUSION: We verified the validity of the hierarchy of cognitive disability for ACLs 4 and 5 in people with schizophrenia.

Psychometric properties of the Loewenstein Occupational Therapy Cognitive Assessment-Second Edition in Taiwanese persons with schizophrenia.

OBJECTIVE: This study sought to determine the psychometric properties for the Loewenstein Occupational Therapy Cognitive Assessment-Second Edition (LOTCA-II) in a population of persons with schizophrenia. METHOD: Sixty-four participants with schizophrenia were administered the LOTCA-II at baseline, and 43 of these were randomly selected to undertake four more standardized measures of cognitive and instrumental activities of daily living (IADL) functions to test convergent validity. One week later, 48 randomly selected participants from the total sample were readministered the LOTCA-II to determine test-retest reliability. RESULTS: Substantial ceiling effects existed in 96% of LOTCA-II items. Cronbach's alpha for all six sub-tests ranged from .20 to .91; the alpha for the global scale was .90. Intraclass correlation coefficients ranged from .49 to .89 for the subtests and .95 for the full LOTCA-II. Low to moderate correlations were found between LOTCA-II total score and scores on cognitive and IADL measures. No overall significant differences in subtest scores were found across participants differing in employment status. CONCLUSION: LOTCA-II performance is best interpreted in the context of total score. Further revision of the test items is recommended for a more reliable and valid use of the LOTCA-II in persons with schizophrenia.

Development and validation of a muscular dystrophy-specific functional rating scale.

OBJECTIVE: To develop a reliable and valid new rating scale for measuring the functional impact of muscular dystrophy. DESIGN: Prospective and longitudinal investigation. SETTING: Three academic medical centres in Taiwan and the Muscular Dystrophy Association of Taiwan. MEASURES: The Brooke Scale, the Vignos Scale, the Barthel Index, muscular strength, contracture severity, and predicted forced vital capacity (FVC%). METHODS: Scale development was in three stages. In stage I, a preliminary pool of 53 items was generated from patient interviews (n = 25), literature review, existing functional rating scales and expert opinion. In stage II, these items were administered to 85 patients with muscular dystrophy. The resulting data were analysed to construct a rating scale (the Muscular Dystrophy Functional Rating Scale, MDFRS) that encompassed four unidimensional constructs: mobility, basic activities of daily living, arm function and impairment. In stage III, the measurement properties of this rating scale were assessed in 121 muscular dystrophy patients different from those examined with the preliminary instrument. RESULTS: Internal consistency reliability was excellent for all domains of the final 33-item scale, with values of Cronbach's alpha ranging from 0.84 to 0.97. Intraclass correlation coefficients for test-retest and inter-rater reliability were 0.99 for all domains of the MDFRS. The MDFRS showed moderate to high correlations with a range of functional rating scales measuring similar aspects and impairment parameters (Spearman's rho = 0.65-0.91; P < 0.001, each). Confirmatory factor analysis supported a unitary construct of the four-dimensional MDFRS. The MDFRS had small floor and ceiling effects in the study samples. Sensitivity to change was confirmed by large standardized response means for the MDFRS total score. CONCLUSIONS: The MDFRS is a reliable and valid disease-specific measure of functional status for patients with muscular dystrophy.