Increased serum levels of adhesion molecules ICAM-1 and VCAM-1 in systemic sclerosis are not specific for pulmonary manifestations

Studies suggest elevated serum intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) levels may be markers of pulmonary arterial hypertension in systemic sclerosis (SSc-PAH). We sought to evaluate whether ICAM-1 and VCAM-1 levels are useful screening biomarkers for incident SSc-PAH. In this cross-sectional study, four groups were selected from the Australian Scleroderma Cohort Study: group 1 (n?=?15) had definite PAH; group 2 (n?=?19) had interstitial lung disease (ILD); group 3 (n?=?30) were SSc-controls; and group 4 (n?=?34) were healthy controls. Serum ICAM-1 and VCAM-1 levels were measured using the Millipore Milliplex MAP Human 2-Plex Panel. There were no differences in ICAM-1 levels in the PAH versus ILD group (263.0?±?85.4 vs 380.4?±?168.3 ng/mL, p?=?0.136), SSc-controls (263.0?±?85.4 vs 253.1?±?98.0 ng/mL, p?=?1.00), or healthy controls (263.0?±?85.4 vs 201.8?±?57.2 ng/mL, p?=?0.093). Similarly, there were no differences in VCAM-1 level in PAH versus ILD groups (1476.2?±?434.9 vs 1424.8?±?527.6 ng/mL, p?=?1.00) and SSc-controls (1476.2?±?434.9 vs 1409.5?±?341.1 ng/mL, p?=?1.00). SSc subjects had significantly higher levels of ICAM-1 (297.4?±?134.0 vs 201.8?±?57.2 ng/mL, p?<?0.0001) and VCAM-1 compared to healthy controls (1432.7?±?427.4 vs 1125.6?±?273.4 ng/mL, p?<?0.0001). Neither ICAM-1 nor VCAM-1 is a specific screening biomarker of SSc-PAH. Instead, increased levels of these adhesion molecules in SSc, irrespective of pulmonary complications, suggest that they may play a role in SSc pathogenesis.     

Effect of health on knowledge,self‐efficacy and health behaviours of women with urinary tract infection

Urinary tract infection (UTI) is one of the most common bacterial infections affecting about 40% of women in some points in their lives. UTI can cause serious potential consequences such as life‐threatening sepsis, if it is not treated by primary health care providers. Health behaviours play an important role in causing UTI. Self‐efficacy, as an important moderator of the relationship between knowledge and behaviour, is an important prerequisite for behaviour change. The aim of this study is to investigate the effect of health education on knowledge, self‐efficacy and health behaviours of women with UTI. This is a quasi‐experimental study of the intervention and comparison groups, with pre‐test and post‐test design, conducted with 170 married women with UTI; referred to selected hospital laboratories in Tehran. The data collection tool was a self‐made questionnaire which was answered by both groups, prior to the intervention and 12 weeks thereafter. The intervention was performed on the intervention group samples. On the basis of the study results, after the intervention the average score of the knowledge (p = 0·002), self‐efficacy (p < 0·001) and health behaviours (p < 0·001) of the intervention group had significantly increased compared to the comparison group. The findings showed that health education was effective in promotion of the knowledge, self‐efficacy and health behaviours of women with UTI.     

Colonoscopic evaluation of minimal rectal bleeding in average-risk patients for colorectal cancer

AIM： To assess the prevalence of clinically significant lesions in patients with minimal bright red bleeding per rectum （BRBPR）. METHODS： Consecutive outpatients prospectively underwent colonoscopy at Loghman Hakim Hospital, Tehran. Minimal BRBPR was defined as small amounts of red blood after wiping or in the toilet bowl. Patients with the following alarm signs were excluded： Positive personal history of colorectal neoplasms or inflammatory bowel disease （IBD）, positive first degree family history of colorectal neoplasms, history of altered bowel habits, recent significant weight loss, and presence of iron deficiency anemia. Neoplastic polyps, colorectal carcinoma, and IBD were defined as significant lesions. RESULTS： A total of 402 patients （183 female and 219 male, aged 43.6 ± 15.7 years） were studied. Hemorrhoids （54.2%）, anal fissures （14.2%） and ul- cerative colitis （14.2%） were the most common lesions and colonoscopy was normal in 8.0%. Significant lesions were found in 121 （30.1%） patients, including 26 patients （6.5%） with adenocarcinoma and 30 （7.5%） with adenomatous polyps. Almost all patients with significant lesions had at least one lesion in the distal colon; an adenocarcinoma and an adenomatous polyp in the proximal colon were found in 2 patients with hemorrhoids. CONCLUSION： Flexible sigmoidoscopy appears to be sufficient for the evaluation of average risk patients with minimal BRBPR. Rigid sigmoidoscopy may be used as an alternative in patients less than 40 years of age in settings where the former is not available. Thechoice of colonoscopy over flexible sigmoidoscopy in patients aged over 50 years should be individualized.     

Frequency and determinants of flare and persistently active disease in systemic lupus erythematosus

Objective

Selection of flare as the primary outcome variable in systemic lupus erythematosus (SLE) clinical trials fails to capture patients with persistently active disease (PAD). We sought to elucidate the frequency and determinants of flare and PAD.

Methods

Prospectively collected data from the Toronto Lupus Cohort were used to determine the incidence of flare and PAD in 2004 and 2005. Flare was defined as an increase in SLE Disease Activity Index 2000 update (SLEDAI‐2K) score of ≥4 from the previous visit. PAD was defined as a SLEDAI‐2K score of ≥4, excluding serology alone, on ≥2 consecutive visits. Data from 1, 2, and 3 years prior were used to model flare and PAD in 2004. Model properties were tested for prediction of flare and PAD in 2005.

Results

One‐third of the patients had ≥1 flare, whereas nearly half experienced PAD in a given year. Nearly 60% of the patients had episodes of flare or PAD per year. At least 25% of patients had PAD without achieving the definition of flare. In the best‐fitting model, predictors of PAD in 2004 were SLEDAI‐2K score at the start of the outcome interval and prior cutaneous or musculoskeletal disease activity. This model gave 79% correct prediction of PAD in 2005. In contrast, flare prediction models performed poorly.

Conclusion

Persistent activity is a common disease state in SLE and should be an outcome variable in SLE clinical trials. Our PAD prediction model may aid prognostication and selection of patients for inclusion in clinical trials.     

Influence of Lifestyle Factors on Inflammation in Men and Women with Type 2 Diabetes: Results from the National Health and Nutrition Examination Survey, 1999–2004

Background

Type 2 diabetes is associated with low-grade systemic inflammation, increasing the risk for various adverse health outcomes.

Purpose

Our objective was to investigate the association between C-reactive protein (CRP), a marker for systemic inflammation, and lifestyle factors in a national sample of people with type 2 diabetes.

Methods

This study analyzed data from 1,086 men and women with diabetes, who completed the 1999?C2004 NHANES. Lifestyle factors included diet quality, body mass index (BMI), smoking, and physical activity.

Results

Stratified logistic regression showed that for both men and women, BMI was a strong predictor of elevated CRP after adjusting for age, energy intake, race/ethnicity, medications, diabetes duration, and glycosylated hemoglobin. However, among men, but not among women, the likelihood of elevated CRP increased with lower diet quality and physical inactivity.

Conclusions

Among people with type 2 diabetes, higher levels of CRP were associated with lower diet quality and physical inactivity among men, and with obesity among both men and women.     

Altered expression of LINC-ROR in cancer cell lines and tissues

Tumor Biology - According to GLOBOCAN 2012, the worldwide burden of cancer increased and is expected to worsen within the next decades. Therefore, universal combat against cancer will not succeed...