Construction and feasibility study of the SOFMER Activity Score (SAS), a new assessment of physical and cognitive activity.

OBJECTIVES: For hospitalizations in rehabilitation centers (RCs) in France, the quantification of healthcare givers' activity is based on the dependency of the patients, defined as a total or partial inability to perform activities required for daily living without help. The tools currently used to quantify dependency are not sufficiently precise. Here we describe the construction of a new tool, the SOFMER Activity Score (SAS scoring), which allows for a good description of the level of activity of patients hospitalized in RCs, and a feasibility study of the tool. METHODS: After a study group proposed the first version of the SAS, the validity of its content was studied by the Delphi consensus method: 26 physicians or healthcare professionals known for their expertise in PMR responded to the first round. The feasibility study was prospective and involved multi-site professionals. Data related to the SAS determined by a multidisciplinary team were collected and compared to the Activité de la Vie Quotidienne (AVQ) scale, which is administered to all patients and included in medical and administrative data. RESULTS: We included 81 patients in the feasibility study. The mean (SD) time to obtain the SAS was 4.5 (3.3) min. For 97.5% of scorings, the participating professionals judged that the SAS was compatible or fairly compatible with clinical practice. The internal structure of the SAS scale seemed better than that of the AVQ scale, for which the present study confirmed a floor effect for all items. CONCLUSIONS: The SAS allows for measuring the level of physical and cognitive activity of a patient hospitalized in an RC. If validation studies for the SAS, exploring its reliability, construct validity or criterion validity, confirm the tool's good metrological qualities, the SAS will allow for a good quantification of the burden of care.

Do cancer patients change their diet in the e-health information era? A review of the literature and a survey as a proposal for the Italian population.

In recent years, there has been an explosion in the amount of available information on cancer in parallel with an ever-increasing number of cancer survivors. Cancer patients and long-term survivors are known to be more sensitive to health-related information and dietary changes could represent a potential consequence of this huge availability of messages. In our review about dietary changes after cancer diagnosis, we found that this topic is particularly investigated among the breast cancer population. The literature examined show that breast cancer patients modify their eating habits after diagnosis in a percentage that varies between approximately 30% and 60%. The most reported changes were an increased consumption of fruit and vegetables, a decrease in the consumption of red meat, fats and sugary foods. Patients who reported changes were more likely to be younger, with higher educational levels and with a longer period of time since their diagnosis of cancer. It also emerged that cancer patients are often more likely to use supplements. This topic has not been investigated in cancer patients in Italy, therefore, we propose an approach to explore it with a structured questionnaire: The "ECHO SURVEY - Eating habits CHanges in Oncologic patients".

Silybin, a new iron-chelating agent.

Silybin, a natural occurring flavolignan isolated from the fruits of Silibum marianum, has been reported to exert antioxidant and free radical scavenging abilities. It was suggested to act also as an iron chelator. The complexation and protonation equilibria of the ferric complex of this compound have been studied by potentiometric, spectrophotometric and electrochemical techniques. The formation of the complex silybin-Ga(III) in anhydrous DMSO-d6 has been studied by 1H NMR spectroscopy. Mass spectrometry and infrared spectroscopy on silybin-Fe(III) complex confirm all data obtained by 1H NMR spectroscopy. The experimental results show that silybin binds Fe(III) even at acidic pH. Different ternary complexes were observed at increasing methoxide ion concentration and their stability constants have been calculated. The results show the possible role of silybin in relation to the chelation therapy of chronic iron overload, as occurs in the treatment of Cooley's anemia.