Recent studies indicate its possible involvement in the remodeling process of human systemic rheumatic diseases such as rheumatoid arthritis and ankylosing spondylitis. DKK-1 may also play a role in osteoarthritis, metabolic bone disease (osteoporosis and Paget’s disease), as well as multiple myeloma-associated bone disease and prostate cancer bone metastases.

Conclusions:

DKK-1 is a regulator of bone mass and joint remodeling. It may be a promising therapeutic target in osteoporosis; monoclonal antibody-based inhibition of Dkk-1 is already under development for osteoporosis treatment. Its role as a regulator of joint remodeling in animal models requires ALK inhibitor clinical trial further exploration in humans. (C) 2011 Elsevier Inc. All rights reserved. Semin Arthritis Rheum 41:170-177″
“BackgroundHematopoietic stem cell transplantation (HSCT) recipients colonized with vancomycin-resistant

Enterococcus (VRE) may have an increased risk of developing VRE bacteremia. Identification of risk factors for the development of subsequent VRE bacteremia among colonized HSCT recipients is necessary to predict which patients may benefit the most from receiving anti-VRE antibiotic therapy as part of an initial antimicrobial regimen when gram-positive bacteremia is suspected.

MethodsThis study was a retrospective chart review conducted from May 2008 to May 2011. Adult Selleck ATR inhibitor HSCT patients admitted to the hospital found to have positive VRE surveillance cultures were included. A multivariate analysis was completed to identify risk factors for the development of VRE bacteremia in the study population.

ResultsOf 152 patients, 19 (13%) patients developed subsequent VRE bacteremia. Risk factors identified for patients with current VRE colonization for VRE bacteremia were the utilization of vancomycin subsequent to VRE surveillance culture positivity (P=0.017), prolonged 3-MA order duration of neutropenia (P=0.001), immunosuppression (P<0.001), and timing of first VRE surveillance screen positivity at week 1 (P=0.005). A history of VRE colonization on a prior admission was not an independent risk factor for bacteremia in HSCT patients (P=1.0). HSCT patients with VRE bacteremia had a 30-day all-cause

inpatient mortality rate of 29% (P=0.001).

ConclusionHSCT patients receiving immunosuppressive therapy, who have been exposed to vancomycin subsequent to surveillance culture positivity, have had prolonged neutropenia of >30days, or first surveillance culture positive at week 1 of admission are potential candidates for early implementation of anti-VRE therapy when a gram-positive bacteremia is suspected.”
“Prospective studies of the effects of long-standing haemodialysis (HD) on quality of life (QOL) show conflicting results. We investigated how QOL progresses over time in HD patients and what factors are associated with this evolution.

We included chronic HD patients over the age of 18 from a single unit, who had never had transplants and survived the first 3 months of treatment.