Hospitalized patients who meet specific criteria at discharge are referred to the transitional care clinic team consisting of a nurse practitioner and/or physician and a clinical pharmacist. In collaboration with the providers, the pharmacist reviews medications for appropriateness, assesses adherence, recommends medication changes and provides education. The purpose of this study was to measure the effect of an outpatient transitional care clinical pharmacist on 30-day re-admissions in an urban setting serving a population of low socioeconomic status. After receiving IRB approval, this single-center retrospective study analyzed records of 573 patient visits of which nearly 75% included a clinical pharmacist interaction. Rates of 30-day re-admissions were not statistically different among the two groups, however, it was found that each added co-morbidity significantly increased the patients' 30-day re-admission rate by 26%.

Chronic rhinosinusitis (CRS) is a common condition associated with inflammation and tissue remodeling of the nose and paranasal sinuses, frequently occurring with nasal polyps and allergies. Here we investigate inflammation and the protease profile in nasal tissues and plasma from control non-CRS patients and CRS patients. Gene expression for several cytokines, proteases, and antiproteases was quantified in nasal tissue from non-CRS and CRS subjects with nasal polyps. Elevated expression of S100A9, IL1A, MMP3, MMP7, MMP11, MMP25, MMP28, and CTSK was observed in tissue from CRS subjects with nasal polyps compared to control tissue. Tissue protein analysis confirmed elevated levels of these targets compared to controls, and increased MMP3 and MMP7 observed in CRS subjects with nasal polyps compared to CRS subjects without polyps. Plasma concentrations of MMP3 and MMP7 were elevated in the CRS groups compared to controls. The nasal cell line, CCL-30, was exposed to S100A9 protein, resulting in increased MMP3, MMP7, and CTSK gene expression and elevated proliferation. Silencing MMP3 significantly reduced S100A9-mediated cell proliferation. Therefore, the elevated expression of S100A9 and MMPs are observed in CRS nasal tissue and S100A9 stimulated MMP3 responses to contribute to elevated nasal cell proliferation.

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