B-cell-attracting chemokine-1 (BCA-1/CXCL13) in systemic lupus erythematosus, its correlation to disease activity and renal involvement.

Systemic lupus erythematosus (SLE) is a prototype of systemic autoimmune disease in which cytokines such as B lymphocyte chemoattractant (BLC or CXCL13) may play important roles in pathogenesis. The aim of our study was to investigate the implications of CXCL13 in SLE diagnosis and its correlation with disease activity and renal involvement. The study included 50 adult female patients with SLE and 30 age-matched female healthy individuals serving as a control group. Patients' Group was further subdivided according to disease activity calculated by SLE Disease Activity Index (SLEDAI). All studied individuals were subjected to assessment of serum CXCL13 by ELISA. A highly significant stepwise progressive increase in CXCL 13 level was recorded through controls, inactive SLE and active disease (P < 0.01). Moreover, it correlated positively with SLEDAI and proteinuria (P < 0.01). At a cut- off level 80 pg/mL, CXCL13 could discriminate active SLE from inactive (AUC = 0.989, sensitivity 100% & specificity 96%). In conclusion, an increased level of CXCL13 is a distinctive feature in SLE. CXCL13 correlates with disease activity and renal involvement.

Nursing considerations of bevacizumab use in multiple tumor types.

PURPOSE/OBJECTIVES: To update information concerning the antiangiogenic agent bevacizumab, discuss side effects, and provide information on nursing management of the side effects. DATA SOURCES: Published articles, abstracts, and research data. DATA SYNTHESIS: In clinical trials, the addition of bevacizumab to standard chemotherapy increased survival in patients with metastatic colorectal cancer and advanced non-small cell lung cancer and increased progression-free survival in patients with metastatic breast cancer. Bevacizumab also is being evaluated in combination with other targeted agents in various tumor types. Commonly reported side effects associated with bevacizumab include hypertension, proteinuria, and minor bleeding. CONCLUSIONS: The value of bevacizumab in treating metastatic colorectal cancer has long been established. Clinical trial data have demonstrated the benefit of using bevacizumab in combination with standard chemotherapy in the treatment of non-small cell lung cancer and metastatic breast cancer. Because of bevacizumab's expanding role in cancer treatment, nurses need to know how to use it, be aware of possible side effects, and anticipate interventions. IMPLICATIONS FOR NURSING: Nurses play an important role in the identification and management of adverse events associated with bevacizumab.

Advanced practice nursing in pediatric nephrology.

This article provides the nurse practitioner with a concise and accurate reference for the evaluation of children with hematuria, proteinuria, and hypertension. Although the incidence of these disorders in children is lower than in adults, they are not uncommon. The nurse practitioner must be able to accurately assess the results of a urinalysis and measure and interpret blood pressure readings in children. A discussion of when to refer children with signs and symptoms of serious disease; and how to educate patients and families in order to promote children's health is also provided.

Prevalencia del síndrome hipertensivo del embarazo en mujeres con factores de riesgo asociado a proteinuria / Prevalence of hypertensive syndrome of pregnancy in women with risk factors associated to proteinuria

El embarazo es una de las etapas más importantes en la vida de una mujer, sin embargo, se asocian a él diversas patologías de riesgo para el binomio madre-hijo, como es el Síndrome Hipertensivo del Embarazo (SHE). Mediante este estudio quisimos ver si a través de la aplicación del enfoque de riesgo se podrían encontrar los grupos más afectados canalizando los recursos hacia ellos. Nuestro estudio fue de tipo descriptivo y transversal. El universo correpondió a 1247 mujeres que controlaron su embarazo en el CEDIUC y que atendieron su parto en el Hospital Clínico de la Universidad Católica entre los meses de Julio y Diciembre de 1996. De este universo se obtuvo una muestra aleatoria de 249 fichas clínicas y la unidad de análisis fue de 222 fichas clínicas. A través de una plantilla de doble entrada se recolectaron los datos para su posterior análisis. Se pudo concluir que del total de la muestra el 8,12 por ciento desarrolló preeclapsia, siendo un porcentaje menor en relación a resultados arrojados en otros estudios en Chile, lo que problamente se deba a subregistros. El 11 por ciento de las mujeres que desarrollaron SHE eran gestantes en edades extremas, el 55 por ciento eran primigestas y según su estado nutritivo el 55 por ciento de ellas se clasificó en la categoría C o D. Estos datos se encuentran aumentados en comparación con aquellos obtenidos en la muestra y además son factores de riesgo para desarrollar SHE. En relación a los resultados obtenidos acerca del hallazgo de proteinuria (de 222 mujeres a 150 se les aplicó este test), el 8,5 por ciento presentó proteinuria, de las cuales el 50 por ciento desarrolló SHE. El 81, 9 por ciento de los hallazgos de proteinuria se pesquisaron en una edad gestacional mayor a 32 semanas, no encontrándose casos antes de las 24 semanas de gestación, con esto se puede concluir que la proteinuria es un test de aparición tardía en relación a otros predictores de SHE, como son el aumento de peso y la alteración de la curva de presión arterial caracterítica de la mujer embarazada. Cabe destacar que el 100 por ciento de las mujeres que presentaron hallazgo de proteinuria poseían factores de riesgo para desarrollar SHE