Our results suggest that autofeedback from US assessment provides quick improvement in palpation skills for identifying joint swelling in patients with RA.

MicroRNAs (miRNAs, miRs) are small non-coding RNAs that mainly function in the post-transcriptional regulation of genes. miRNA that is secreted outside of cells, and which circulates in the peripheral blood, is called circulating microRNA. Systemic lupus erythematosus (SLE) is a typical autoimmune connective tissue disease and is mainly treated with immunosuppressive drugs. Therapeutic apheresis is often used to eliminate autoantibodies and cytokines. We have previously shown that circulating miRNAs in the blood of patients with SLE can be separated and removed from the blood using a plasma separation membrane. In the present study, we further separated circulating miRNA from three SLE patient's blood plasma by passing it through a plasma adsorption membrane, and then measured changes in miRNA levels using miRNAs microarray chip. Although the levels of many miRNAs were unaffected after passage through the plasma adsorption membrane, expression of some miRNAs, including miR-1246, miR-4732-5p, and miR-6088 are declined.

BACKGROUND:Bacteremia and its complications are important causes of morbidity and mortality in hospitalized patients. However, the yield of blood cultures is relatively low, with many false‐positive results from bacterial contamination.METHODS:We investigated the relationship between patient food consumption and the presence of bacteremia. This was an observational analysis of a cohort of 1179 patients who underwent blood culture analysis between January 2005 and December 2009. Patients with anorexia‐inducing conditions, such as gastrointestinal illness and malignant disease treated with chemotherapy, were excluded. Food consumption was rated by nurses as the percentage of food consumed during the meal preceding the blood culture. Groupings were as follows: low consumption (<50%), moderate (>50% to <80%), and high (>80%).RESULTS:Low consumption was observed in 39.8% of patients, moderate in 17.8%, and high in 41.6%. The average body temperature was 38.1 ± 1.1°C. Bacteremia was present in 18.5%, 3.9%, and 1.4% of patients in the low, moderate, and high food consumption groups, respectively. The negative predictive value was 98.3%, suggesting that bacteremia is very unlikely in the setting of good food intake.CONCLUSION:Bacteremia is an unlikely occurrence in hospitalized patients who maintain adequate food consumption at the time of blood culture. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine

MicroRNAs (miRNAs), which are important inhibitors of mRNA translation, participate in differentiation, migration, cell proliferation, and cell death. The pathology of miRNAs results in alterations in protein expression. Recently, miRNAs circulating in peripheral blood have been shown to control the synthesis and translation of proteins at distal sites after intake into local cells. A number of studies are currently being conducted to investigate how to use miRNAs in disease treatment, but no studies have attempted to alleviate disease by directly eliminating miRNAs from blood. Therefore, we examined whether the removal or reduction of circulating miRNAs with apheresis improved pathologies caused by miRNAs. After approval of the study by our medical school's ethics committee, we collected blood and separated plasma samples from three patients with systemic lupus erythematosus who were undergoing plasmapheresis at our hospital. Peripheral blood was collected before and after it was passed through a primary membrane, centrifuged, and used to extract circulating miRNAs. A comprehensive expression analysis was then performed with a miRNA array chip. The levels of expression of a large number of circulating miRNAs were measured in the plasma samples separated by the primary membranes from all 3 patients with systemic lupus erythematosus. We present the first report that circulating miRNAs in peripheral blood can be separated and possibly directly removed using membrane separation apheresis.