Linguistic validation and cognitive assessment of the French version of the Acute Cystitis Symptom Score questionnaire.

INTRODUCTION: The Acute Cystitis Symptom Score (ACSS) questionnaire first developed in Russian and Uzbek languages and now available in many other languages can be used for clinical diagnostics and patient-reported outcome (PRO) in female patients with acute uncomplicated cystitis (AUC). The aim of the current study was the linguistic validation and cognitive assessment of the French version of the ACSS questionnaire according to internationally accepted guidelines. METHODS: After two forward translations from Russian into the French language and backward translation into Russian and Uzbek, the two original languages, the scientific committee (SC) performed a slightly adapted French version, which finally was cognitively assessed by female subjects with different ages and educational levels and medical professionals, such as nurses, physicians, and pharmacists. RESULTS: All comments of the female subjects and professionals were discussed within the SC and after slight, but necessary adaptations, the SC agreed on the final study version of the French ACSS. CONCLUSION: Now, the linguistically validated and cognitively assessed French version of the ACSS can be used for clinical studies and practice.

Evolution of psychosocial factors at work in a French region.

BACKGROUND: Psychosocial factors at work (PFW) can be defined as all non-physicochemical occupational risks. Several epidemiological models have been proposed to measure PFW, but one of the most widely used is Karasek's model. AIMS: To determine whether psychosocial factors, evaluated by Karasek's questionnaire, had increased in a cohort of workers. METHODS: A random sample of workers in the Pays de la Loire region of France, who could be considered representative of the region's population of salaried workers, filled in a self-administered questionnaire, including Karasek's self-administered questionnaire, in 2002-05 and 2007-09. Karasek's questionnaire can be used to study three psychosocial dimensions (psychological demand, decision latitude and social support in the workplace) in workers in order to define two high-risk situations for their health: 'Job Strain' and 'Iso Strain'. Changes in job strain and iso strain among workers were studied according to the workers' sociodemographic characteristics and their working conditions. RESULTS: In this sample of 2049 workers, the proportion with iso strain increased between the two periods from 12 to 16%, P < 0.001, mainly among manual workers. Deterioration of Karasek indicators was mainly explained by an increase of the 'low social support' dimension (38 versus 49%, P < 0.001). Working conditions such as temporary employment of colleagues and high perceived physical exertion were associated with higher PFW. CONCLUSIONS: This study, based on a quantitative and collective model, showed deterioration of working team environments and increased risk for individual mental health in this cohort of French workers in recent years.

Updated clinical diagnostic criteria for sporadic Creutzfeldt-Jakob disease.

Several molecular subtypes of sporadic Creutzfeldt-Jakob disease have been identified and electroencephalogram and cerebrospinal fluid biomarkers have been reported to support clinical diagnosis but with variable utility according to subtype. In recent years, a series of publications have demonstrated a potentially important role for magnetic resonance imaging in the pre-mortem diagnosis of sporadic Creutzfeldt-Jakob disease. Magnetic resonance imaging signal alterations correlate with distinct sporadic Creutzfeldt-Jakob disease molecular subtypes and thus might contribute to the earlier identification of the whole spectrum of sporadic Creutzfeldt-Jakob disease cases. This multi-centre international study aimed to provide a rationale for the amendment of the clinical diagnostic criteria for sporadic Creutzfeldt-Jakob disease. Patients with sporadic Creutzfeldt-Jakob disease and fluid attenuated inversion recovery or diffusion-weight imaging were recruited from 12 countries. Patients referred as 'suspected sporadic Creutzfeldt-Jakob disease' but with an alternative diagnosis after thorough follow up, were analysed as controls. All magnetic resonance imaging scans were assessed for signal changes according to a standard protocol encompassing seven cortical regions, basal ganglia, thalamus and cerebellum. Magnetic resonance imaging scans were evaluated in 436 sporadic Creutzfeldt-Jakob disease patients and 141 controls. The pattern of high signal intensity with the best sensitivity and specificity in the differential diagnosis of sporadic Creutzfeldt-Jakob disease was identified. The optimum diagnostic accuracy in the differential diagnosis of rapid progressive dementia was obtained when either at least two cortical regions (temporal, parietal or occipital) or both caudate nucleus and putamen displayed a high signal in fluid attenuated inversion recovery or diffusion-weight imaging magnetic resonance imaging. Based on our analyses, magnetic resonance imaging was positive in 83% of cases. In all definite cases, the amended criteria would cover the vast majority of suspected cases, being positive in 98%. Cerebral cortical signal increase and high signal in caudate nucleus and putamen on fluid attenuated inversion recovery or diffusion-weight imaging magnetic resonance imaging are useful in the diagnosis of sporadic Creutzfeldt-Jakob disease. We propose an amendment to the clinical diagnostic criteria for sporadic Creutzfeldt-Jakob disease to include findings from magnetic resonance imaging scans.

Muscle assessment in healthy teenagers, Comparison with teenagers with low back pain.

OBJECTIVES: To describe muscle parameters in healthy teenagers and compare them to teenagers with chronic low back pain. METHODS: A comparative study of 276 control teenagers and 51 teenagers with chronic low back pain (CLBP), benefiting from a specific treatment, 14.5 years average age. The control group is made up of teenagers without back pain and teenagers who reported some back pain when we asked them, but without specific treatment. The results to four static tests assessing trunk flexors, trunk extensors, hip extensors and quadriceps endurance are statistically compared. In the control group, associations between different clinical measures and possible back pain are looked for. RESULTS: The two groups are homogeneous, concerning age, weight, standing height, sitting height and BMI (p>0,05). Low back pain is more common in girls, either in the control group (n=48; 69% of girls) or in the group with CLBP (n=51; 78%). CLBP is associated with a poor endurance strength of the trunk extensors (median: 2 min 31 s in the control group to 1 min 45 s in the CLBP), with hip extensors weakness (median: 2 min 20s in the control group to 1 min 24s in the CLBP), and with quadriceps weakness (median: 2 min 39 s in the control group to 1 min 20s in the CLBP), (p=0.000). No significant difference was found between trunk flexors endurance in the two groups (median: 2 min 11s in the control group to 2 min 13s in the CLBP). In the control group, 48 teenagers reported back pain "often", "very often" or "all the time"; no links were found between pain and muscle flexibility, measured with finger-floor distance, heel-cheek distance, and popliteal angle. Only the sitting height was found statistically higher (p=0.003) in the control teenagers who reported back pain (87 cm) related to the ones who have no pain (85 cm). Sport influences global strength in lower limbs and changes the ratio of quadriceps to hip extensors, in favour of quadriceps. Neither pain nor the ratio of trunk flexors to trunk extensors are modified by sport. There is a linear relation between Shirado's and Sorensen's logarithmic values: it is consequently possible to predict the Shirado value when we have the Sorensen one. Trunk extensors, hip extensors and quadriceps endurance is lower in the CLBP group, 14.5 years of age.

IL-1 receptor antagonist in saliva; characterization in normal saliva and reduced concentration in Sjögren's syndrome (SS).

The characterization of a salivary factor cross-reacting with IL-1 receptor antagonist (IL-1Ra) is described. The apparent molecular weights of two species were 23 kD, consistent with the secreted peptide (sIL-1Ra), and 20 kD, consistent with the intracellular peptide (icIL-1Ra). It had an inhibitory activity on IL-1-stimulated fibroblasts, which is characteristic of IL-1Ra. Its source was the oral mucosa and not the salivary glands. Saliva from patients with SS contained significantly less IL-1Ra than saliva from controls. The decrease was marked in patients with early dental loss but whose xerostomia was still partial. In SS, the salivary IL-1/IL-1Ra imbalance may promote inflammatory lesions in the mouth and impede mucosal cell differentiation.