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D Jolly

Publications and source records attributed to D Jolly.

99 records · Page 6Linked to original sources
PubMedDate not supplied

Evaluation of the quality of life in dementia with a generic quality of life questionnaire: the Duke Health Profile.

OBJECTIVE: The study was designed to determine the acceptability, feasibility and validity of measuring quality of life in a representative sample of dementia patients with a generic instrument, the Duke Health Profile. METHOD: The French version of the Duke Health Profile was administered to 148 subjects with a mental disorder according to the DSM-III-R diagnostic criteria. The feasibility and acceptability of employing the instrument were determined by the refusal rate, the type of administration, and the percentage and distribution of missing data. Reliability was determined with Cronbach's alpha coefficient. Instrument reproducibility was assessed with the intraclass correlation coefficient for test-retest values. Internal construct validity was determined by factor analysis. Discriminant capacity was determined by comparing the average scores on each measure among patients with and without an additional chronic pathology. The measurements obtained were compared by source of information (patient, family proxy and care provider proxy). RESULTS: The feasibility and acceptability of the instrument was good. Only 2% of the patients refused to complete the questionnaire. Help from the interviewer was necessary in 79% of the cases. The average completion time was 10.6 min. Missing data exist in only 3.5% of the cases on average, except among patients with severe dementia (Mini Mental State Examination <10). For reliability, internal consistency was acceptable (Cronbach's coefficient alpha = 0.5--0.7) when the self-esteem (0.23) and social health (0.26) concepts were eliminated. Reproducibility as measured by test-retest scores was moderate to good (intraclass correlation coefficient r = 0.53--0.80), except for anxiety (0.48) and perceived health (0.45). Severity of dementia mainly affected the feasibility, acceptability and reproducibility of the instrument. The family proxy seemed to agree more with the patient than did the care provider proxy. CONCLUSION: Quality of life can be measured in patients with dementia, but special tools need to be developed for severe dementia.

Aged↗
PubMedDate not supplied

[Lipoprotein (a) and diabetes: relationship based on 224 cases].

Recent studies have suggested that Lp(a) is implicated in the high incidence of coronary heart disease in diabetic subjects, but data are still controversial. We therefore studied the distribution of plasma Lp(a), assayed by radial immunodiffusion, in a group of 224 diabetics and compared them to 92 non diabetic controls. Besides plasma Lp(a), TG and glucose were evaluated in 16 insulin-requiring diabetic patients before and after 10 days of normoglycaemia. The distribution of plasma Lp(a), as usually skewed to the left, was not different either between diabetic subjects and controls or between Type 1 and Type 2 diabetic subjects. No significant correlation was observed between Lp(a) and glycaemic control expressed by HbA1c. The sequence of normoglycaemia did not affect plasma Lp(a), no significant correlation between the variations of glycaemia and Lp(a) levels and the variations of triglyceridaemia and Lp(a) levels were found. Thus our group of diabetic subjects has a similar distribution of Lp(a) to controls. Lp(a) concentrations do not seem to be affected by chronic hyperglycaemia or rapid normalisation of glycaemic levels. However there is a strong need of standardization of Lp(a) assay before any definitive conclusion. As we have so far no efficient treatment for lowering Lp(a) in daily clinical practice, the energetic care of other associated vascular risk factors is needed.

Adult↗
PubMedDate not supplied

Eradication of melanoma pulmonary metastases by immunotherapy with tumor cells engineered to secrete interleukin-2 or gamma interferon.

This study was undertaken to investigate the effectiveness of interleukin-2 (IL-2) and gamma interferon (gammaIFN)-modified B16 melanoma cells in the immunotherapy of established melanoma pulmonary metastases. The genes for IL-2 and gammaIFN were introduced retrovirally into B16 melanoma cells. Transduction with the gammaIFN, but not the IL-2, gene caused significant increases in the expression of major histocompatibility complex (MHC) antigens on B16-gammaIFN cells. The in vivo tumor-forming capacity of both IL-2- and gammaIFN-transduced B16 cells was drastically reduced when the cells were inoculated subcutaneously (SC) in syngeneic C57BL/6 mice. After intravenous (IV) inoculation, most of the B16-gammaIFN cells were rejected, but B16-IL-2 cells were relatively tumorigenic and formed pulmonary metastases. C57BL/6 mice bearing 4-day established parental B16 lung metastases were treated with B16 parental (B16P) unmodified cells, IL-2- or gammaIFN-modified B16 cells, or a combination of both transduced cells. Treatment consisted of a weekly intraperitoneal (IP) injection of one million irradiated (10,000 rad) tumor cells alone or in combination with exogenous IL-2 for a total of three to four injections. Immunotherapy with B16 parental or B16-IL-2 secreting cells caused a moderate reduction in the number of lung metastases. However, mice treated with gammaIFN-secreting B16 cells showed a significant reduction or complete elimination of lung metastases. There was no additive effect for combining both IL-2- and gammaIFN-modified tumor cells in the immunotherapy. Exogenous IL-2 (50,000-100,000 U/day for 3 days) caused a significant enhancement of the immunotherapeutic benefit of the vaccines. Moreover, mice treated with gammaIFN-modified B16 cells survived longer than the other groups. Twenty-five percent of these mice were tumor free and remained alive for an observation period of 4 months. The in vitro cytolytic activity of splenocytes in chromium release assays did not correlate in every case with the in vivo antitumor effect of the treatment. Our findings have implications for the use of cytokine-modified cells for immunotherapy and for evaluating the therapeutic benefit of this novel treatment.

Animals↗