Low vitamin D level is not associated with increased incidence of rheumatoid arthritis

To evaluate the association of vitamin D level with incident rheumatoid arthritis (RA) in a patient population using electronic health records (EHR). Case–control study with data extracted from EHR from 1/1/2001 to 12/31/2012 in the Geisinger Health System (GHS). Incident RA was defined as International Classification of Disease-9 code 714.0 twice by a GHS rheumatologist. Patients were identified at time of RA diagnoses and were matched 1:5 for age and gender with non-RA controls. Vitamin D levels were identified and extracted prior to RA diagnosis. The subjects were followed retrospectively with regard to their vitamin D levels; the most recent value of vitamin D prior to the RA diagnosis was used in the analysis. Vitamin D levels were treated both as continuous and categorical with two different cutoff values, 30 and 20 ng/ml. The association between vitamin D and RA was presented as the odds ratios with 95 % confidence intervals (OR, 95 % CI) from a conditional logistic regression model adjusting for obesity and smoking status. A total of 270 patients with incident RA and 1,341 matched controls were identified. The RA patients were 83.3 % female with median age at RA diagnosis of 62 years. The adjusted OR (95 % CI) for the association of vitamin D levels with incident RA compared with controls was 1.00 (0.99, 1.01), 0.98 (0.75, 1.29) and 1.12 (0.80, 1.57) for continuous, <30 and <20 ng/ml vitamin D levels, respectively. Subgroup analysis according to gender or rheumatoid factor positivity yielded similar results. In this patient population, vitamin D levels were not associated with the development of RA.     

Effect of Moderate Wine Consumption on Oxidative Stress Markers in Coronary Heart Disease Patients

Evidence from research studies reports that wine consumption is associated with lower cardiovascular disease risk, partly through the amelioration of oxidative stress. The aim of the present study was to examine the effect of regular light to moderate wine consumption from coronary heart disease (CHD) patients compared to the effect induced by alcohol intake without the presence of wine microconstituents, on oxidation-induced macromolecular damage as well as on endogenous antioxidant enzyme activity. A randomized, single-blind, controlled, three-arm parallel intervention was carried out, in which 64 CHD patients were allocated to three intervention groups. Group A consumed no alcohol, and Group B (wine) and Group C (ethanol) consumed 27 g of alcohol/day for 8 weeks. Blood and urine samples were collected at baseline and at 4 and 8 weeks. Urine oxidized guanine species levels, protein carbonyls, thiobarbituric acid substances (TBARS) levels, as well as superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities, were measured. Oxidized guanine species and protein carbonyl levels were significantly increased in the ethanol group during the intervention and were significantly decreased in the wine group. These results support the idea that wine’s bioactive compounds may exert antioxidant actions that counteract the macromolecular oxidative damage induced by alcohol in CHD patients.     

3例肝移植术后罕见高热患者的护理

对3例肝移植术后高热患者进行生命体征监测,并结合实验室检查结果分析,认为肝移植术后高热除了排斥反应和感染等原因外,可能存在疟原虫感染.细致的护理对查找高热原因和促进患者康复具有重要的意义.     

Endogenous sex hormones and endometrial cancer risk in women in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Epidemiological data show that reproductive and hormonal factors are involved in the etiology of endometrial cancer, but there is little data on the association with endogenous sex hormone levels. We analyzed the association between prediagnostic serum concentrations of sex steroids and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition using a nested case-control design of 247 incident endometrial cancer cases and 481 controls, matched on center, menopausal status, age, variables relating to blood collection, and, for premenopausal women, phase of menstrual cycle. Using conditional regression analysis, endometrial cancer risk among postmenopausal women was positively associated with increasing levels of total testosterone, free testosterone, estrone, total estradiol, and free estradiol. The odds ratios (ORs) for the highest versus lowest tertile were 2.66 (95% confidence interval (CI) 1.50-4.72; P=0.002 for a continuous linear trend) for estrone, 2.07 (95% CI 1.20-3.60; P=0.001) for estradiol, and 1.66 (95% CI 0.98-2.82; P=0.001) for free estradiol. For total and free testosterone, ORs for the highest versus lowest tertile were 1.44 (95% CI 0.88-2.36; P=0.05) and 2.05 (95% CI 1.23-3.42; P=0.005) respectively. Androstenedione and dehydroepiandrosterone sulfate were not associated with risk. Sex hormone-binding globulin was significantly inversely associated with risk (OR for the highest versus lowest tertile was 0.57, 95% CI 0.34-0.95; P=0.004). In premenopausal women, serum sex hormone concentrations were not clearly associated with endometrial cancer risk, but numbers were too small to draw firm conclusions. In conclusion, relatively high blood concentrations of estrogens and free testosterone are associated with an increased endometrial cancer risk in postmenopausal women.     

Depression, anxiety and pain in children with juvenile idiopathic arthritis (JIA).

The aim of this study was to assess relations among depression, anxiety and pain in children with juvenile idiopathic arthritis (JIA). Pain was measured with the visual analogue scale (VAS), and depression and anxiety with depression and anxiety subscales from the Trauma Symptom Checklist for Children (TSC-C). Pain perception was significantly correlated with depression scores.     

Computer assisted evaluation of wound healing in chronic ulcers

The aim of this work was to present an efficient and objective method of wound healing assessment based on serial measurements of ulcer dimensions and calculation of wound margin advancement towards the center of the lesion. The method is implemented via computer software, which permits clinicians to perform necessary computations. The proposed method of wound assessment integrates pieces of work that have been published in the past into a user-friendly environment. The high accuracy of computations may help clinicians to make objective decisions in the management of difficult to heal ulcers.     

Evaluation of the Olympus AU 400 clinical chemistry analyzer

The performance of the Olympus AU 400 clinical chemistry analyzer was evaluated according to the guidelines of the European Committee for Clinical Laboratory Standards. The following analytes were tested: glucose, urea, creatinine, calcium, AST, ALT, CK, LDH, ALP and amylase. The Olympus AU 400 was compared with the Olympus AU 800. Coefficients of correlation showed high correlation between the compared analyzers. Other performances (intra- and inter-assay variation, carry-over and interferences) of the analyzer were satisfactory.