Cardiovascular risk in lupus nephritis: Do renal disease-related and other traditional risk factors play a role?

This study was performed to evaluate the prevalence of thickened carotid intima media thickness (CIMT) in a Sri Lankan cohort of lupus nephritis (LN) patients and to identify associations between traditional cardiovascular disease (CVD) and LN-related risk factors with increased CIMT. Consecutive patients with biopsy-proven LN were evaluated for conventional CVD risk factors, renal parameters and extent of organ involvement in this cross-sectional study. Current disease activity and damage were assessed by the British Isles Lupus Activity Group (BILAG) score and the Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) damage index, respectively. CIMT was assessed by B Mode grey scale ultrasonography. Increased CIMT was defined as CIMT more than the 75th percentile based on cutoffs from the "Carotid Atherosclerosis Progression Study." Forty patients (98% female), with a mean age of 38 years (age range of 20-50) and of South Asian descent, were evaluated. The mean duration of disease of 6.15 years (SD = 4.66). The overall prevalence of cardiovascular events was low and included previous acute coronary syndromes in 7.5%, stable angina in 5%, cerebrovascular accidents in 7.5% and transient ischemic attacks in 2.5% of the patients; 72.5% had hypertension (HTN) [mean blood pressure (BP) 140/80 mm Hg]; 32.5% had dyslipidemias (mean serum cholesterol 5.9; SD = 5.6) and 25% had diabetes (mean blood sugar 103.7; SD = 15.6). Forty percent were obese and 20% were overweight (Asian cutoffs). Increased CIMT (57.5%) and atherosclerotic plaques (15.36%) indicated a high CVD risk in this cohort. Diabetes (P = 0.016), HTN (P = 0.002), dyslipidemia (P = 0.002) and obesity (P = 0.048) were associated with thickened CIMT. The only LN-related risk factor associated with thickened CIMT (P <0.05) was the SLICC/ACR damage index. The independent predictors of thickened CIMT determined by logistic regression analysis were HTN and dyslipidemia.

Prevalence of latex allergy among healthcare workers.

OBJECTIVES: The use of latex gloves has increased by several folds in the recent past due to concerns about blood-borne infections. Data from Asian countries with regard to latex allergy is scarce. The objective of this study was to determine the prevalence and risk factors of latex allergy among healthcare workers in a tertiary hospital in Sri Lanka. MATERIAL AND METHODS: A cross-sectional survey was carried out among different categories of employees in the hospital. A self-administered questionnaire was used to collect data related to latex allergy. RESULTS: A total of 524 employees was recruited and 62% responded to the questionnaire. Among them 49.2% wore gloves for more than 1 hour a day. Symptoms suggestive of latex allergy were reported by 53 (16.3%) subjects. A considerable proportion (11.4%) of workers had been suffering from latex allergy for more than 5 years. Nurses accounted for the highest prevalence for any job category, while the unit with the highest rate was the surgical ward. Duration in the service (OR = 1.006, P = 0.048) and wearing gloves for more than one hour a day (OR = 3.292, P = 0.004) were significant risk factors for latex allergy, but not atopy or family history of atopy. Seven employees noticed that they developed food allergy after assuming duties as healthcare personnel. CONCLUSIONS: Prevalence of latex allergy is high among healthcare workers in this study population. Environmental factors rather than genetic predisposition play the major role in the development of this condition.