BackgroundThe impact of COPD on patient’s quality of life is well established, but gender differences have received little attention.MethodsTo describe factors associated with the health-related quality of life by gender: A cross-sectional observational study (NCT01007734) was conducted in COPD patients followed by pulmonologists. The first patient included had to be a woman. Data concerning the patient, COPD and their management were collected by the physician. The patient had to fill in several questionnaires: Saint-George Hospital respiratory Questionnaire (SGRQ-C), and motivation to quit smoking.ResultsFour hundred and thirty patients were included: mean age 63.9 ± 11.3 years; 57.4% were women. Women were significantly younger than men (61.9 vs. 66.6) and their tobacco use was lower (37.1 vs. 40.4 PY). Cardiovascular comorbidities were more frequent in men while osteoporosis, anxiety and depression were frequent in women. The frequency of cough, sputum and the severity of dyspnea did not differ significantly between genders. Lung function impairment was less severe in women than in men (mean FEV1 52% predicted normal vs. 47. 8%). Anxiety score was higher (score 9.8 vs. 7.1) and quality of life (SGRQ-C) more impaired in women (scores 50.6 vs. 45.4; p < 0.02) than in men. Moreover, in multivariate analysis, chronic sputum was associated with higher SGRQ-C scores in women but not in men.ConclusionsThis study underlines that despite less airflow limitation, quality of life is more impacted by chronic sputum in women than in men.

No abstract

ABSTRACT:Purpose: To determine whether tear osmolarity contributes to the assessment of the ocular surface in soft contact lens (CL) wearers. Methods: Prospective, case-control series in 44 CL wearers (28 tolerant and 16 intolerant) and 34 healthy subjects. Every patient underwent a thorough ophthalmic examination with a tear osmolarity test (TearLab System), conjunctival impression cytology and meibomian lipid sampling. Symptoms, break-up time (BUT), tear osmolarity, conjunctival expression of HLA-DR and meibomian fatty acid composition were evaluated. Results: Tear osmolarity did not differ between controls and CL wearers (p = 0.23). Flow cytometry results expressed in antibody-binding capacity (ABC) units and percentage of positive cells revealed a significant difference between the intolerant CL wearer group and the control group (p < 0.0001). Comparisons between tolerant and intolerant CL wearers showed only a significant difference for mean fluorescence levels expressed in ABC units (p < 0.0001). The BUT was significantly shorter in intolerant and tolerant CL wearers subjects than in healthy subjects (p < 0.0001), whereas there was no significant difference in meibomian fatty acid composition (p = 0.99) between the two groups. Conclusion: Contact lens wear is responsible for ocular surface alterations whose patterns are very similar to those reported in early dry-eye syndrome. However, tear osmolarity was not modified in these selected CL wearers. The yield of tear osmolarity with TearLabÔ in assessing ocular surface disorders in CL wearers deserves further investigation.

No abstract

IntroductionLa psychoéducation du trouble bipolaire favorise l’adhésion thérapeutique et le maintien de l’euthymie à 2 ans [1]. Au terme d’un tel programme, les patients peuvent avoir besoin d’aide pour perpétuer la mise en place des apprentissages concernant l’observance thérapeutique, les routines de vie quotidienne, l’évitement des toxiques et le repérage des prodromes thymiques. Le Serious Game BIPOLIFE®, jeu centré sur un avatar souffrant de trouble bipolaire évoluant dans des situations de la vie courante, s’articule aussi autour de ces cibles. ObjectifsÉvaluer la qualité de l’observance thérapeutique par la Medication Adherence Rating Scale (MARS) [2], les indicateurs de routine de vie et de recours aux soins psychiatriques à 1 et 4 mois de la dernière séance de psychoéducation chez les patients utilisant BIPOLIFE® vs. suivi habituel.MéthodologieÉtude pilote multicentrique randomisée contrôlée à 2 bras (durée : 24 mois) incluant des sujets euthymiques (score de dépression MADRS ≤ 12 et de manie YMRS ≤ 8 depuis 3 mois), bénéficiant d’un programme de psychoéducation. Les patients du groupe « intervention » se connecteront au site BIPOLIFE®, de manière hebdomadaire, pendant un mois (durée de connexion libre). À l’inclusion (dernière séance de psychoéducation), 1 et 4 mois, seront évalués l’attitude vis-à-vis du traitement, la qualité du sommeil, l’indice de masse corporelle, le périmètre ombilical, la consommation de toxiques, le fonctionnement psychosocial et le recours aux soins psychiatriques.PerspectivesProposer BIPOLIFE® en add-on de la psychoéducation pour renforcer les compétences acquises lors du programme et le maintien de l’euthymie.