Risk factors associated with pulmonary arterial hypertension in Colombian patients with systemic sclerosis: review of the literature

OBJECTIVE: Considering the significant morbidity and mortality of pulmonary arterial hypertension (PAH) in patients with systemic sclerosis (SSc) and the lack of precise information on disease in Latin America, we investigated the clinical and laboratory characteristics associated with PAH in Colombian patients with SSc and review the literature. METHODS: This multicenter study included patients followed at 5 rheumatology units that were systematically assessed using a pretested questionnaire on clinical and immunological variables, focusing on PAH. Conditional logistic regression was employed to assess association between PAH and specific clinical characteristics. A systematic review of the literature was performed through electronic databases. RESULTS: Of a total of 349 patients with SSc, 61 (17%) met the criteria for PAH. Pulmonary fibrosis [adjusted odds ratio (AOR) 7.37, 95% CI 3.67-14.81, p < 0.0001], microstomia (AOR 3.3, 95% CI 1.70-6.28, p < 0.0001), gastroesophageal reflux (AOR 2.41, 95% CI 1.31-4.43, p = 0.005), dysphagia (AOR 2.7, 95% CI 1.49-4.77, p = 0.001), hyperpigmentation (AOR 2.15, 95% CI 1.11-4.16, p = 0.02), and hypopigmentation (AOR 2.4, 95% CI 1.26-4.64, p = 0.008) were the most prevalent clinical characteristics associated with PAH, while anemia (AOR 5.4, 95% CI 1.98-14.93, p = 0.001) was observed as the unique laboratory risk factor. Association between subtypes of SSc and PAH was not observed. Significant differences in both clinical and laboratory data were observed among different series. CONCLUSION: PAH may be a frequent complication of SSc in the Colombian population regardless of disease subtype. The identified clinical and laboratory risk factors might assist earlier diagnosis and guide decisions on therapeutic interventions on this critical complication of SSc. The reasons underlying the reported divergences among patients from different ethnicities are not fully understood, but it is most likely that both genetic and environmental factors are responsible for them.     

A Human Endogenous Retrovirus K dUTPase Triggers a TH1, TH17 Cytokine Response: Does It Have a Role in Psoriasis?

Psoriasis is a chronic inflammatory immune disease of the skin characterized by a complex interplay between multiple risk genes and their interactions with environmental factors. Recent haplotype analyses have suggested that deoxyuridine triphosphate nucleotidohydrolase (dUTPase) encoded by a human endogenous retrovirus K (HERV-K) may be a candidate gene for the psoriasis susceptibility 1 locus. However, no functional studies have been conducted to determine the role of HERV-K dUTPase in psoriasis. For this purpose, we constructed an HERV-K dUTPase wild-type sequence, as well as specific mutations reflecting the genotype characteristic of high- and low-risk haplotypes, purified the recombinant proteins, and evaluated whether they could modulate innate and/or adaptive immune responses. In this study, we demonstrate that wild-type and mutant HERV-K dUTPase proteins induce the activation of NF-κB through Toll-like receptor 2, independent of enzymatic activity. Proteome array studies revealed that treatment of human primary cells with wild-type and mutant HERV-K dUTPase proteins triggered the secretion of T(H)1 and T(H)17 cytokines involved in the formation of psoriatic plaques, including IL-12p40, IL-23, IL-17, tumor necrosis factor-α, IL-8, and CCL20, in dendritic/Langerhans-like cells and to a lesser extent in keratinocytes. These data support HERV-K dUTPase as a potential contributor to psoriasis pathophysiology.     

Measurement properties of the Community Wellbeing Index in older adults

Purpose  

The international wellbeing index (IWI) consists of two scales, the personal (PWI) and national (NWI) wellbeing indices. The community wellbeing index (CWI) is a new measure of the individual’s level of satisfaction with the local place of residence. The main goal of this paper is to validate the CWI in a sample of older adults.     

Lectin-mediated microfluidic capture and release of leukemic lymphocytes from whole blood

Lectins are a group of proteins that bind specifically and reversibly to mono- and oligosaccharide carbohydrate structures that are present on the surfaces of mammalian cells. The use of lectins as capture agents in microfluidic channels was examined with a focus on cells associated with T and B lymphocytic leukemia. In addition to examining the adhesion of Jurkat T and Raji B lymphocytes to a broad panel of lectins, this work also examined the capture of these cells from whole blood. Captured T and B lymphocytes were eluted from the microfluidic devices with a solution of the lectin’s inhibiting sugar. The capture and release steps were accomplished in under 1 h. The significance of this work lies within the realm of low-cost capture of abundant target cells with non-stimulatory elution capability.     

Impact of a drug-drug interaction intervention on pharmacy and medical students' knowledge and attitudes: A 1-year follow-up

BackgroundThere have been many interventions aimed at improving retention of drug-drug interaction (DDI) knowledge of health care professionals. Much less is known about their retention of such knowledge for extended periods of time after an educational intervention.ObjectivesTo evaluate pharmacy and medical students’ knowledge retention and attitudes 1 year after participating in an educational session on DDIs.MethodsThis study used a pre-post design with an assessment of DDI knowledge and attitude by pharmacy and medical students before and after the final didactic year of their professional education. The intervention was a 1-hour program.ResultsA total of 74 of 193 students (38%) completed the pre, post, and final questionnaire. The median numbers of correctly identified DDIs before the program were 8 and 7 for pharmacy and medical students, respectively, out of a possible score of 15. One year after, the median identification knowledge scores were 12 and 8, respectively, for pharmacy and medical students. The median difference scores of correctly managed DDIs on this evaluation 1 year after the program were ?4 and ?8 for pharmacy and medical students, respectively (P < .05).ConclusionThis study found that the ability to identify important DDIs is poor among both pharmacy and medical students 1 year after being exposed to the educational session.