Predictors of peripheral arterial disease in SLE change with patient’s age

OBJECTIVE: To analyse the differential influence of risk factors of peripheral artery disease (PAD) according to age in patients with SLE. METHODS: 216 patients from the Lupus-Cruces cohort were divided in three age groups: ≤34 years, 35-49 years and ≥50 years. A low ankle-brachial index defined PAD. Significant variables were identified by univariant and multivariant analysis in each age group. RESULTS: Different factors were identified in different age groups: antiphospholipid antibodies/antiphospholipid syndrome and glucocorticoids in patients ≤34 years; in patients 35-49 years old, hypertension was the only statistically significant predictor, although a trend was observed for fibrinogen levels; a trend was observed for hypercholesterolaemia in those ≥50 years. CONCLUSIONS: Age may modulate the influence of risk factors for PAD in patients with SLE

Predictors of major infections in systemic lupus erythematosus

Introduction Infections commonly complicate the course of systemic lupus erythematosus (SLE). Our aim is to investigate the clinical predictors of major infections in patients with SLE. Methods A nested case-control study design was used within the prospective Lupus-Cruces cohort. The endpoints of the study were major infections. Cases were defined as patients with a major infection. Two controls (SLE patients without major infections), matched for time of follow-up until the event and age at diagnosis, were selected for each case. Univariate analysis and logistic regression models were used for the analysis of data. Results Two hundred and forty-nine patients (83 cases, 166 controls) were selected. Eighty-three episodes of major infections were analyzed; E. coli, S. aureus, M. tuberculosis and S. pneumoniae being the most frequent isolates. Univariate analysis identified several variables related with infection: lung and renal involvement, at or previous to the study point; leukopenia at the study point; antiphospholipid antibody-positivity and treatment with prednisone within 3 months previous to the study point, and the dose of prednisone received. Treatment with antimalarials, on the other hand, showed a strong inverse association with major infections. Logistic regression models identified treatment with antimalarials (odds ratio (OR) = 0.06, 95% confidence interval (CI) = 0.02 to 0.18), prednisone dose (OR = 1.12, 95% CI = 1.04 to 1.19) and lung involvement (OR = 4.41, 95% CI = 1.06 to 18.36) as significant and independent predictors of major infections. No significant interactions among these three variables were found. Further adjustment for potential confounders related with antimalarial treatment did not change the results. Conclusions The risk of major infections in patients with SLE is mostly influenced by treatment. Prednisone treatment, even at moderate doses, increases the risk, whilst antimalarials have a protective effect

Desarrollo y validación de una versión preliminar de la escala de competencia emocional en el deporte (ECE_D)

El importante papel que juegan las emociones en los contextos deportivos ha sido ampliamente defendido en la literatura sobre psicología del deporte. El objetivo de este estudio es desarrollar y validar un instrumento para evaluar la competencia emocional de los deportistas. La muestra la componen 367 deportistas de ambos géneros pertenecientes a diferentes disciplinas deportivas. Se analizaron los antecedentes y las características psicométricas de la Escala de Desarrollo Emocional (Schutte, Malouff, Hall, Haggerty, Cooper, Golden y Dornhein, 1998). Los resultados obtenidos confirmaron en términos generales el modelo de cuatro factores propuesto por los autores originales y además, plantea la posibilidad de incluir mejoras sustanciales del cuestionario para futuras versiones relacionadas con su aplicabilidad.The relevant role of emotions in competitive contexts has been widely supported in the sport psychology literature. The aim of this study was to create a valid measure of emotional development in sports. The sample is composed by 367 sportsmen/women belonging to different sporting disciplines. Analyses were performed about the antecedents and the psychometric properties of the Emotional Development Scale (Schutte, Malouff, Hall, Haggerty, Cooper, Golden & Dornhein, 1998). Results showed that, in general terms, the initially proposed four factor model was supported. Implications for considering the improvement of the applicability questionnaire are advance

New insights into the genetic component of non-infectious uveitis through an Immunochip strategy

Background: Large-scale genetic studies have reported several loci associated with specific disorders involving uveitis. Our aim was to identify genetic risk factors that might predispose to uveitis per se, independent of the clinical diagnosis, by performing a dense genotyping of immune-related loci. Methods: 613 cases and 3693 unaffected controls from three European case/control sets were genotyped using the Immunochip array. Only patients with non-infectious non-anterior uveitis and without systemic features were selected. To perform a more comprehensive analysis of the human leucocyte antigen (HLA) region, SNPs, classical alleles and polymorphic amino acid variants were obtained via imputation. A meta-analysis combining the three case/control sets was conducted by the inverse variance method. Results: The highest peak belonged to the HLA region. A more detailed analysis of this signal evidenced a strong association between the classical allele HLA-A*2902 and birdshot chorioretinopathy (p=3.21E-35, OR=50.95). An omnibus test yielded HLA-A 62 and 63 as relevant amino acid positions for this disease. In patients with intermediate and posterior uveitis, the strongest associations belonged to the rs7197 polymorphism, within HLA-DRA (p=2.07E-11, OR=1.99), and the HLA-DR15 haplotype (DRB1*1501: p=1.16E-10, OR=2.08; DQA1*0102: p=4.37E-09, OR=1.77; DQB1*0602: p=7.26E-10, OR=2.02). Outside the HLA region, the MAP4K4/IL1R2 locus reached statistical significance (rs7608679: p=8.38E-07, OR=1.42). Suggestive associations were found at five other loci. Conclusions: We have further interrogated the association between the HLA region and non-infectious non-anterior uveitis. In addition, we have identified a new non-HLA susceptibility factor and proposed additional risk loci with putative roles in this complex condition

The influence of the physical education teacher on intrinsic motivation, self-confidence, anxiety, and pre-and post-competition mood states

One of the fundamental problems facing teachers of physical education (PE) is how to increase pupils' motivation. From the point of view of goal achievement, guidelines need to be established so that information may be used to greater effect in classes. This study examined the relationship between the motivational climate created by the PE teacher and the intrinsic motivation of the preparatory sessions together with self-confidence and anxiety prior to competition and pre- and post-competition mood states. The sample was made up of school children (M age = 11.7) from a state school (N = 115), who, after an introduction to an athletics course of 12 sessions, took part in a sports competition. During this time, a teacher (trained to this effect) manipulated the motivational climate, adapting the strategies of TARGET (11, 12, 26, 28). The mastery climate was linked to enjoyment, perceived ability, and effort in the PE classes, as well as to pre-competition somatic anxiety and post-competition vigor. On the other hand, the performance climate was associated with self-confidence, pre-competition vigor, and post-competition stress. The results are discussed in relation to achievement goal theory and motivational climate manipulation

Glucocorticoids—All-Rounders Tackling the Versatile Players of the Immune System

Glucocorticoids regulate fundamental processes of the human body and control cellular functions such as cell metabolism, growth, differentiation, and apoptosis. Moreover, endogenous glucocorticoids link the endocrine and immune system and ensure the correct function of inflammatory events during tissue repair, regeneration, and pathogen elimination via genomic and rapid non-genomic pathways. Due to their strong immunosuppressive, anti-inflammatory and anti-allergic effects on immune cells, tissues and organs, glucocorticoids significantly improve the quality of life of many patients suffering from diseases caused by a dysregulated immune system. Despite the multitude and seriousness of glucocorticoid-related adverse events including diabetes mellitus, osteoporosis and infections, these agents remain indispensable, representing the most powerful, and cost-effective drugs in the treatment of a wide range of rheumatic diseases. These include rheumatoid arthritis, vasculitis, and connective tissue diseases, as well as many other pathological conditions of the immune system. Depending on the therapeutically affected cell type, glucocorticoid actions strongly vary among different diseases. While immune responses always represent complex reactions involving different cells and cellular processes, specific immune cell populations with key responsibilities driving the pathological mechanisms can be identified for certain autoimmune diseases. In this review, we will focus on the mechanisms of action of glucocorticoids on various leukocyte populations, exemplarily portraying different autoimmune diseases as heterogeneous targets of glucocorticoid actions: (i) Abnormalities in the innate immune response play a crucial role in the initiation and perpetuation of giant cell arteritis (GCA). (ii) Specific types of CD4+ T helper (Th) lymphocytes, namely Th1 and Th17 cells, represent important players in the establishment and course of rheumatoid arthritis (RA), whereas (iii) B cells have emerged as central players in systemic lupus erythematosus (SLE). (iv) Allergic reactions are mainly triggered by several different cytokines released by activated Th2 lymphocytes. Using these examples, we aim to illustrate the versatile modulating effects of glucocorticoids on the immune system. In contrast, in the treatment of lymphoproliferative disorders the pro-apoptotic action of glucocorticoids prevails, but their mechanisms differ depending on the type of cancer. Therefore, we will also give a brief insight into the current knowledge of the mode of glucocorticoid action in oncological treatment focusing on leukemia

Evaluation of phosphatidylserine-dependent antiprothrombin antibody testing for the diagnosis of antiphospholipid syndrome: results of an international multicentre study.

OBJECTIVE: A task force of scientists at the International Congress on Antiphospholipid Antibodies recognized that phosphatidylserine-dependent antiprothrombin antibodies (aPS/PT) might contribute to a better identification of antiphospholipid syndrome (APS). Accordingly, initial and replication retrospective, cross-sectional multicentre studies were conducted to ascertain the value of aPS/PT for APS diagnosis. METHODS: In the initial study (eight centres, seven countries), clinical/laboratory data were retrospectively collected. Serum/plasma samples were tested for IgG aPS/PT at Inova Diagnostics (Inova) using two ELISA kits. A replication study (five centres, five countries) was carried out afterwards. RESULTS: In the initial study (n = 247), a moderate agreement between the IgG aPS/PT Inova and MBL ELISA kits was observed (k = 0.598). IgG aPS/PT were more prevalent in APS patients (51%) than in those without (9%), OR 10.8, 95% CI (4.0-29.3), p < 0.0001. Sensitivity, specificity, positive (LR+) and negative (LR-) likelihood ratio of IgG aPS/PT for APS diagnosis were 51%, 91%, 5.9 and 0.5, respectively. In the replication study (n = 214), a moderate/substantial agreement between the IgG aPS/PT results obtained with both ELISA kits was observed (k = 0.630). IgG aPS/PT were more prevalent in APS patients (47%) than in those without (12%), OR 6.4, 95% CI (2.6-16), p < 0.0001. Sensitivity, specificity, LR + and LR- for APS diagnosis were 47%, 88%, 3.9 and 0.6, respectively. CONCLUSIONS: IgG aPS/PT detection is an easily performed laboratory parameter that might contribute to a better and more complete identification of patients with APS.info:eu-repo/semantics/publishedVersio

Aula de innovación educativa

Se presenta la experiencia llevada a cabo en el colectivo educativo Zangoza Ikastola, con alumnos de primaria. Se pretende mostrar a los niños la situación de carencia en que viven muchas personas y fomentar en ellos la sensibilidad y la solidaridad hacia estas realidades. Para ello, se planifican actividades que sirvan para colaborar con el proyecto Amantaní, de Perú. Una de esas actividades es la organización de un mercadillo. En cuanto a la sensibilización del alumnado se intenta mostrarles la vida de un niño como ellos para concienciarles de la desigualdad social. Asimismo, presenciaron una exposición relacionada con el tema y participaron en la recogida de material para el mercadillo.CataluñaES