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BackgroundIdentification of serum proteins that track with disease course in sarcoidosis may have clinical and pathologic importance. We previously identified up-regulated transcripts for interferon-inducible chemokines CXCL9, and CXCL10, in blood of sarcoidosis patients compared to controls. The objective of this study was to determine whether proteins encoded by these transcripts were elevated in serum and identified patients with remitting vs. chronic progressive sarcoidosis longitudinally.MethodsSerum levels of CXCL9, CXCL10, and proteins associated with inflammation and/or disease activity (sIL2R, ACE, ESR and CRP) were measured in a prospective cohort of sarcoidosis subjects and controls. Comparisons were made between groups and clinical course using pulmonary function measures and a severity score developed by Wasfi et al.ResultsIn a cross-sectional analysis of 36 non-immunosuppressed sarcoidosis subjects, serum CXCL9, CXCL10, and sIL2R were significantly elevated compared to 46 controls (p < 0.0001). CXCL9 and CXCL10 were strongly inter-correlated (p = 0.0009). CXCL10 and CXCL9 were inversely correlated with FVC% predicted and DLCO% predicted, respectively. CXCL10 and CXCL9 significantly correlated with sarcoidosis severity score. sIL2R, ESR, CRP, and ACE serum levels did not correlate with pulmonary function measures or severity score. In the longitudinal analysis of 26 subjects, changes in serum CXCL10 level over time corresponded with progression versus remission of disease.ConclusionsInterferon-γ–inducible chemokines, CXCL9 and CXCL10, are elevated in sarcoidosis and inter-correlated with each other. Chemokine levels correlated with measures of disease severity. Serial measurements of CXCL10 corresponded to clinical course.

The STOP-D is a self-administered, self-report measure using two independent items that provide severity scores for depression and anxiety. The tool performs very well compared with other previously validated measures. Requiring no additional scoring and being free, STOP-D offers a simple and valid method for identifying hospitalized cardiac patients who are experiencing psychological distress. This crucial first step triggers initiation of appropriate monitoring and intervention, thus reducing the likelihood of the adverse cardiac outcomes associated with psychological distress.

We performed a literature review of composite metrics for describing the quality of glycemic control, as measured by continuous glucose monitors (CGMs). Nine composite metrics that describe CGM data were identified. They are described in detail along with their advantages and disadvantages. The primary benefit to using composite metrics in clinical practice is to be able to quickly evaluate a patient's glycemic control in the form of a single number that accounts for multiple dimensions of glycemic control. Very little data exist about (1) how to select the optimal components of composite metrics for CGM; (2) how to best score individual components of composite metrics; and (3) how to correlate composite metric scores with empiric outcomes. Nevertheless, composite metrics are an attractive type of scoring system to present clinicians with a single number that accounts for many dimensions of their patients' glycemia. If a busy health care professional is looking for a single-number summary statistic to describe glucose levels monitored by a CGM, then a composite metric has many attractive features.