Antibodies contained in "M" component of some patients with multiple myeloma are directed to food antigens?

Multiple myeloma is malignant disease that is characterized in most patients, by the presence in the serum of monoclonal gamma globulins, which in agarose gel after electrophoresis appear as protein band of restricted mobility, “M” component.

The aim of this study was to determine are the antibodies contained in M-component directed to some antigen chronically present in the organism, to some of food antigens.

Seventeen patients with secretory plasmacytoma were included in the study: eight of them had IgG(kappa), three had IgG(lambda), and one had biclonal IgG(kappa) and IgA(kappa), while two had IgA(kappa), the other two IgA(lambda) and one IgM(lambda) as paraproteins. M-proteins were detected analyzing patients’ sera by agarose gel electrophoresis in 0.09 M barbital buffer. The each M-protein was confirmed by immunotyping (immunofixation) with corresponding antihuman antibodies directed to heavy or light chains of immunoglobulins. After the patients serum separation on agarose gel by electrophoresis, fresh 0.4% solution of crude gliadin (Sigma) in 1% SDS was put over the slides for immunoprecipitation.

Preliminary results showed the interaction of gliadin with patient's serum proteins present in the protein fraction of the same mobility as it was the mobility of the M-component, in 6 from 17 investigated sera.

These results are the first reporting that in sera of some patients with multiple myeloma antibodies from M-component could be directed to some of gliadin antigens.

As the serum antigliadin immunoreactivity is present in patients with gluten intolerance, celiac disease, it could be of importance to elucidate is the multiple myeloma more severe form of gluten intolerance than celiac disease.     

Influence of local inflammation of the peritoneal membrane on diuresis and residual renal function in patients treated with peritoneal dialysis

The aim of this study was to investigate the connection between local inflammation of the peritoneal membrane and diuresis, as well as the residual renal function (RRF) in patients treated with continuous ambulatory peritoneal dialysis (CAPD). Twenty patients treated with CAPD participated in this cross-sectional study. To determine the influence of local inflammation of the peritoneal membrane, effluent interleukin-6 (IL-6) and soluble interleukin-6 receptor (sIL-6R) levels were measured. The level of IL-6, in the group as a whole, was significantly higher in effluent (7.87 pg/mL) than in serum (1.29 pg/mL). There was a significant correlation between effluent and serum IL-6 (r = 0.608; P = 0.002). There was also a significant relationship between effluent and serum IL-6 and duration of CAPD treatment, respectively (r = 0.577; P = 0.004; r = 0.528; P = 0.008). Further, there was a significant negative correlation between effluent IL-6 and daily diuresis (r = −0.533; P = 0.008), but there was no significant correlation between effluent IL-6 and RRF (r = −0.339, P = 0.072). On the other hand, the concentrations of effluent IL-6 were significantly higher in patients with RRF <2 mL/min than in those with RRF ≥2 mL/min (P = 0.039). In conclusion, local inflammation has a significant impact on the amount of diuresis and probably on RRF in patients on CAPD.     

Serum platelet-activating factor acetylhydrolase and paraoxonase-1 activity in horses infected with Leptospira spp

Chagas disease is a tropical parasitic disease endemic to Latin America which affects more than 10 million people, and kills more than 15,000 people each year. This condition, caused by the protozoan parasite Trypanosoma cruzi, is principally transmitted by kissing bugs (Triatominae). In Bolivia, recent reports by the Departmental Health Service showed the presence of Panstrongylus rufotuberculatus in dwellings located in the Charazani Valley (La Paz). A study was then carried out in the area to evaluate the degree of domiciliation of this species, and its possible role in the transmission of Chagas disease. In seven communities, 108 dwellings were visited to actively search for the bugs and 217 people participated in a serological study to determine the prevalence of Chagas disease in the population. Nymphs and adults belonging to two species: Panstrongylus geniculatus (5 insects, 1.5%) and P. rufotuberculatus (344 insects, 98.5%) were collected. One P. rufotuberculatus was captured in a bed, while all the other specimens of this species were found in kitchens in which guinea pigs were being reared. A large bug colony has been encountered in a kitchen environment, with more than 300 specimens of all stages. None of the 201 analyzed bugs was positive for T. cruzi. The seroprevalence of Chagas disease in the human population was low (1.3%); no evidence of a local vectorial transmission was found. In conclusion, for the time being there is no evidence of vectorial transmission of Chagas disease in the region. The possible association between reared guinea pigs and the bugs is discussed. The presence of infected people, the migratory movement of the human population and the relatively high colonization process demonstrate that the region needs to be regularly controlled to prevent the area from becoming a local source of Chagas transmission.     

Internet health-information seekers in Croatia--who, what, and why?

The aim of this study is to investigate the characteristics of the Internet users in Croatia related to seeking health information, which information they seek, the reasons, and the outcomes of that information on them. We surveyed the users of the Internet health portal 'Cybermed', in spring 2003 and autumn 2004. Responses were collected from a pop-up questionnaire, which appeared at every website visit. There were 369 respondents in 2003 and 580 respondents in 2004. Most respondents were women (82% in 2003 and 80% in 2004). While more than half of the respondents (55%) in 2003 had a college or university degree, this changed in 2004, when only 40% of respondents had a college or university degree (P < 0.001). Also, we recorded a significant age-related change, suggesting that the average age of the respondents increased in 2004 (P < 0.001). The leading motivation for seeking medical information was 'unanswered questions after visiting a physician'. Most respondents (90% in 2003, 87% in 2004) went online to seek information on a specific illness or condition. Women sought information for friends and colleagues more often than men (42% vs. 28%, P = 0.031) in 2003, while these differences were diluted in 2004. Approximately half of all respondents discussed the information they found online with their physicians. Patients who feel they were given insufficient information, or simply seek more information than the physician provided, turn to using online health information, which no longer seems to be reserved to those with the highest education degrees. Health-care providers should consider creating health-related Internet portals, supplementing the information they provide.     

Interprofessional pharmacotherapy workshop: intervention to improve health professionals’ and students’ attitudes towards collaboration between physicians and pharmacists

ABSTRACT

Collaboration between physicians and pharmacists is recognized as an important factor for reducing medication errors and improving patient outcomes. Therefore, two pharmacotherapy workshops were delivered in Croatia - one for pre-registration medical (n=42, 4th-6th year) and pharmacy (n=38, 4th-5th year) students, and the other one for physicians (n=18) and pharmacists (n=23). The purpose of this study was to determine whether participation in common pharmacotherapy workshop could improve attitudes among participants towards interprofessional collaboration between pharmacists and physicians. Attitudes were measured by validated questionnaire “Scale of Attitudes Towards Collaboration Between Pharmacists and Physicians” at the beginning and at the end of the workshops. Three complex clinical scenarios were presented during the workshops. Participants were given general information about cases (all participants) and 2 groups of specific information (only for medical students/physicians and only for pharmacy students/pharmacists). For the first scenario, medical and pharmacy students/professionals were not allowed to exchange their specific information. However, participants collaborated for the 2nd and 3rd scenarios in order to achieve the hypothesized therapeutic goals. Before the workshops, pharmacists and pharmacy students showed more positive attitudes than physicians and medical students. However, the workshop contributed in closing the gap by equating health care professionals’ attitudes. Additionally, students’ attitudes were more positive after the workshop with an increase of 10% for medical and 2.2% for pharmacy students. This study indicates that interprofessional pharmacotherapy workshops could significantly improve attitudes toward collaboration between physicians and pharmacists for both students and practicing professionals.