Mucosal Immune Defence Gene Polymorphisms as Relevant Players in the Pathogenesis of IgA Vasculitis?

ITGAM–ITGAX (rs11150612, rs11574637), VAV3 rs17019602, CARD9 rs4077515, DEFA (rs2738048, rs10086568), and HORMAD2 rs2412971 are mucosal immune defence polymorphisms, that have an impact on IgA production, described as risk loci for IgA nephropathy (IgAN). Since IgAN and Immunoglobulin-A vasculitis (IgAV) share molecular mechanisms, with the aberrant deposit of IgA1 being the main pathophysiologic feature of both entities, we assessed the potential influence of the seven abovementioned polymorphisms on IgAV pathogenesis. These seven variants were genotyped in 381 Caucasian IgAV patients and 997 matched healthy controls. No statistically significant differences were observed in the genotype and allele frequencies of these seven polymorphisms when the whole cohort of IgAV patients and those with nephritis were compared to controls. Similar genotype and allele frequencies of all polymorphisms were disclosed when IgAV patients were stratified according to the age at disease onset or the presence/absence of gastrointestinal or renal manifestations. Likewise, no ITGAM–ITGAX and DEFA haplotype differences were observed when the whole cohort of IgAV patients, along with those with nephritis and controls, as well as IgAV patients, stratified according to the abovementioned clinical characteristics, were compared. Our results suggest that mucosal immune defence polymorphisms do not represent novel genetic risk factors for IgAV pathogenesis

Implementation Plan of the Clinical Practice Guideline for the Early Detection, Diagnosis and Treatment of Patients With Alcohol Abuse or Dependence in a Colombian Hospital

Objective: Implement a Clinical Practice Guideline for the early detection, diagnosis and treatment of the acute phase of intoxication of patients with alcohol abuse or dependence in the priority consultation services and outpatient consultation of the E.S.E Cari Neurosciences Hospital of the city of Barranquilla. Introduction: Alcoholism is the first drug addiction in many countries of the world. It affects all ages, both sexes and in almost all social groups. Alcohol is estimated to cause nearly 4% of deaths worldwide and is one of the top 20 causes of disability-adjusted life years (DALYs), either due to associated neurological and / or psychiatric conditions (38%), accidental injury (28%) or intentional injury (12%). In Colombia, alcohol consumption is widely accepted and promoted. The life prevalence of psychoactive substance use disorders is 10.6%, and alcohol abuse is the most prevalent disorder. Materials and Methods: An implementation plan for a management CPG for the early detection, diagnosis and treatment of an acute phase of intoxication of patients with alcohol abuse or dependence will be developed, according to the manual methodology of implementation of guidelines Clinical practice based on evidence from the Colombian Ministry of Health. Conclusions: The CPGs contain recommendations with the best clinical evidence available. Therefore, it is necessary that they be adopted by users, for which it is necessary to follow the dissemination, dissemination and implementation plan, address the intrinsic and extrinsic obstacles and facilitators of the CPGs and monitor the indicators described to measure the process of implementing CPGs in clinical practice

Screening of Anxiety and Depression in Patients With Fibromyalgia From 18 to 65 Years Old and Its Relationship With the Severity of Fibromyalgia and Quality of Life

Objective: To identify the relationship between anxiety and depression with the severity of fibromyalgia and quality of life in patients aged 18 to 65 years, clinic of rheumatology of Barranquilla. Methods: Observational, descriptive, comparative cross-sectional study. Patients with fibromyalgia who attend the external consultation of rheumatology will be surveyed. The questionnaires to be applied are the Fibromyalgia Impact Questionnaire Revised (Spanish version), Health Questionnaire SF-36, Patient Health Questionnaire and a Scale of 7 questions for generalized anxiety disorder. The data collected in this descriptive study will be analyzed by means of frequency and association measures. The analysis of association between sociodemographic factors and clinical characteristics will be carried out with bivariate analysis and the comparison of qualitative or categorical variables will be done through the analysis of variance, to compare variables of ordinal type and variables of type ratio. Results: 34.2% of the patients did not present anxiety whereas 83.6% of the patients had some degree of depression. 50% of the patients had moderate, severe and extreme degrees of depression. An association was found between severity of fibromyalgia with anxiety, depression and quality of life (p <0.05). Conclusion: A directly proportional relationship was found between the severity of depression and anxiety and the severity of FM. An elevated score in the FIQR, lower weighted scores for quality of life in the participants, in addition to greater severity in the scales GAD - 7 and PHQ - 9, all score to lower quality of life