Rationale & ObjectivePeople with idiopathic pulmonary fibrosis (IPF) have been shown to be at an increased risk of cardiovascular disease but reasons for this are unknown. The aim of this study was to compare the prevalence of common cardiovascular risk factors in people with IPF and the general population and establish the incidence of ischaemic heart disease (IHD) and stroke after the diagnosis of IPF, controlling for these risk factors. MethodsWe used data from a large United Kingdom primary care database to identify incident cases of IPF and matched general population controls. We compared the prevalence of risk factors for cardiovascular disease and prescription of cardiovascular medications in people with IPF (before diagnosis) with general population controls, and assessed the incidence of IHD and stroke in people with IPF (after diagnosis) compared to controls. ResultsWe identified 3,211 cases of IPF and 12,307 controls. Cases with IPF were more likely to have a record of hypertension (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.19 -1.44), and diabetes (OR 1.20, 95% CI 1.07 -1.34) compared with controls; they were also more likely to have been prescribed several cardiovascular drugs. The rate of first time IHD events was more than twice as high in cases compared to controls (rate ratio [RR] 2.32, 95% CI 1.85-2.93; p<0.001) but the incidence of stroke was only marginally higher (p=0.09). Rate ratios for IHD and stroke were not altered substantially after adjusting for cardiovascular risk factors. 2 ConclusionSeveral cardiovascular risk factors were more prevalent in people with IPF; however this did not account for the increased rate of IHD in this group of patients. Abstract word count 257

BackgroundPeer teaching is now used in medical education with its value increasingly being recognised. It is not yet established whether students differ in their satisfaction with teaching by peer-teachers compared to those taught by academic or clinical staff. This study aimed to establish satisfaction with communication skills teaching between these three teaching groups.MethodsStudents participated in a role-play practical facilitated either by clinicians, peer-teachers or non-clinical staff. A questionnaire was administered to first-year medical students after participating in a communication skills role-play session asking students to evaluate their satisfaction with the session. Data were analysed in SPSS 20.ResultsOne hundred and ninety eight students out of 239 (83%) responded. Students were highly satisfied with the teaching session with no difference in satisfaction scores found between those sessions taught by peers, clinical and non-clinical staff members. 158 (80%) considered the session useful and 139 (69%) strongly agreed tutors facilitated their development. There was no significant difference in satisfaction scores based on tutor background.ConclusionsSatisfaction is as high when tutored by peer-teachers compared to clinicians or non-clinical staff. Constructive feedback is welcomed from a range of personnel. Final-year students could play an increasing role in the teaching of pre-clinical medical students.

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Dendritic cells (DCs) are part of the innate immune system with a key role in initiating and modulating T cell mediated immune responses. Coeliac disease is caused by inappropriate activation of such a response leading to small intestinal inflammation when gluten is ingested. Tissue transglutaminase, an extracellular matrix (ECM) protein, has an established role in coeliac disease; however, little work to date has examined its impact on DCs. The aim of this study was to investigate the effect of small intestinal ECM proteins, fibronectin (FN) and tissue transglutaminase 2 (TG-2), on human DCs by including these proteins in DC cultures.The study used flow cytometry and scanning electron microscopy to determine the effect of FN and TG-2 on phenotype, endocytic ability and and morphology of DCs. Furthermore, DCs treated with FN and TG-2 were cultured with T cells and subsequent T cell proliferation and cytokine profile was determined.The data indicate that transglutaminase affected DCs in a concentration-dependent manner. High concentrations were associated with a more mature phenotype and increased ability to stimulate T cells, while lower concentrations led to maintenance of an immature phenotype.These data provide support for an additional role for transglutaminase in coeliac disease and demonstrate the potential of in vitro modelling of coeliac disease pathogenesis.