Associations between specific antinuclear antibodies, detected by line immunoassay and clinical features of patients with systemic lupus erythematosus

Autoantibodies are an integral part of the process of classifying, detecting and at least in some cases, mediating autoimmune diseases. The antinuclear antibody is not just one antibody but, actually, many different antibodies associated with a variety of diseases and disease manifestations. Antinuclear antibodies [ANA], anti-Sm, or anti-dsDNA antibodies are part of the American College of Rheumatology criteria [ACR] for SLE. Specific reactivities are associated with distinct clinical features of SLE. To study associations between antinuclear antibodies [ANA] detected by Line Immunoassay and signs/symptoms in patients with Systemic Lupus Erythematosus [SLE]. A total of 38 unselected consecutive patients, diagnosed as having SLE and attending the rheumatology and nephrology units, King Saud Medical Complex Hospital, were included in this study. The patients met the American College of Rheumatology [ACR] revised criteria for classification of SLE. ANA profiles were determined by line immunoassay and by indirect immunofluorescence on Crithidia luciliae. An extensive list of signs/symptoms was evaluated. ANA were found by indirect immunofluorescence [IIF] in 36/38 [95%] patients. The frequencies of the specific reactivities were: Anti-dsDNA 60%, anti-SmB 35%, anti-SmD 25%, anti-RNP-C 25%, anti-Ro60 15%, anti-SSB 15%, anti-RNP-A 10%, antiRibosomal P 10%, anti-Ro52 5%, anti Cenp-B 5%, anti Scl-70 2.6% and anti-Histones 60%. Cutaneous manifestations were associated with anti-SSB, Ro52, Ribosomal P, anti-dsDNA and histones. Raynaud's phenomenon was associated with Ro52 and 60, histones and RNP-C. Xerostomia was associated with Ro52 and 60 as well as Cenp-B. Renal manifestations were associated with RNP-A, Ro52, Ro60 and dsDNA. By using a sensitive and specific multiparameter assay like LIA for identifying antinuclear reactivities, we could confirm some of the previously reported associations of antibodies with clinical symptoms of SLE. We also found several new associations meriting further study

KADIS-based diabetes management in United Arab Emirates

KADIS [Karlsburger Diabetes Management System] is a successfully tested software program that can be used in an interactive manner as a Disease Management Program [DMP] to optimize a person s daily diabetes treatment regimen. It is based on individual insulin/ glucose sensitivity characterization by applying data from a continuous glucose monitoring system. A single center, prospective, open-label study was performed in 18 insulin-dependent diabetic patients. Twelve of 18 subjects completed the pilot study. The primary outcomes were: HbAlc reduction by 1.2% [p<0.05] and mean blood glucose reduction by 1.9 mmol/l [p<0.05]. The secondary outcomes revealed a significant reduction of hypo- and hyperglycaemic episodes from 48% to 24% per day [50% reduction, p<0.05]. Reduction of insulin requirements was only significant in type 2 diabetes [-11.0 IU, p<0.05], whereas in type 1 a non significant slight increase in insulin requirements by 0.4 IU was observed. The overall reductions in insulin requirements by 1.4 IV per day, and of caloric intake by 1.2 BU per day were not significant. The reduction of HbAlc by 1.2% suggests the following: [i] study subjects benefited from the study; [ii] the KADIS[R] recommendations were reliable, and useful for physicians and acceptable to patients, and [in] the DCC[R]-model for diabetes care was applicable in the Arabian environment. The pilot study provides proof of concept for the DCC[R] model for the UAE. The DCC[R]-model was applicable and has a high potential to contribute substantially to improvement of diabetes care in the UAE

Knowledge and attitude of nursing students about elderly clients in Jordan

Nurses are responsible for providing quality health care for older clients. To do this, they must have an educational base in gerontological nursing. Baccalaureate schools of nursing prepare graduates to practice as generalists in gerontological nursing. Review of the literature reveals that the status of gerontological nursing content of curriculum, faculty preparation in gerontological nursing content of curriculum, faculty preparation in gerontological nursing, and clinical settings used for gerontological experience in baccalaureate schools of nursing have improved over the last 10 years. It is imperative to encourage the inclusion of gerontological nursing in the nursing curriculum in all baccalaureate nursing programs. Nurse educators in baccalaureate achools of nursing are resposible for ensuring the presence of gerontological nursing content throughout the curriculum. Ouging studies are necessary to monitor the progress toward incorporating gerontological nursing in baccalaureate achools of nursing. Improving the quality and quality of gerontological nursing teaching will directly affect the quality of nursing care for the elderly clients

Implementation and evaluation of an in-service education programme for nurses about care of the newborn

The study indicated the importance of the in-service education programme. This educational programme will increase the efficiency and correct deficiencies in the abilities of the learner. The result of the evaluation of the in-service education programme showed significant improvement in the knowledge of the learners. This was evident when comparing the result of the pre-test and post-test, where the majority failed in the pretest in most of the aspects. The programme also showed a direct effect on the nurses' performance. It was clear that most of the techniques taught were well mastered by nurses after the programme. The implemented programme showed significant results in most of the items taught. Clinical experience in the real situation showed improvement in the retained knowledge of the learner. Motivation for self-learning and reading was very effective in promoting the knowledge