Impact of treatment with inhaled corticosteroids on bone mineral density of patients with asthma: related with age

The effect of inhaled corticosteroid on bone mineral density (BMD) was investigated in 44 asthmatic patients after median treatment duration of 6.5 years. Compared with controls, BMD decreased only in patients aged <50 years in both the spine (11.3 %, p = 0.013) and hip (8.8 %, p = 0.044), whereas in patients ≥50 years BMD did not decrease significantly.

INTRODUCTION

The results of studies which addressed the impact of inhaled corticosteroid (ICS) therapy on BMD of patients with asthma are conflicting. This case-control study aimed to compare BMD status in ICS user with asthma with healthy controls according to age.

METHODS

BMD at the lumbar spine (LS), femoral neck (FN) was measured by dual energy X-ray absorptiometry (DEXA). Patients and controls were compared according to BMD gr/cm(2), BMD T-score, BMD Z-score, frequency of osteoporosis (defined as BMD T-score ≤-2.5), and frequency of patients with BMD Z-score <-1 at LS and FN with regard to age <50 and ≥50 years old.

RESULTS

Forty-four ICS user patients (females 63.6 %) with median treatment duration of 6.5 years and 50 controls (females, 69.4 %) with respective mean age of 49.2 ± 9.5 and 47.4 ± 10.5 years (p = 0.38 and p = 0.35) entered the study. Overall LS-BMD and FN-BMD gr/cm2 in total patients were lower than in controls by 6 % (p = 0.065) and 5.9 % (p = 0.09), respectively. In patients <50 years, mean LS-BMD gr/cm(2) was lower than controls by 11.3 % (p = 0.013) and FN-BMD by 8.8 % (p = 0.044). Mean BMD T-score and BMD Z-score in both measurement sites were also lower than controls (p = 0.013 and 0.01, respectively. Frequency of osteoporosis did not differ but frequency of patients with BMD Z-score <-1 was significantly higher in patients (odds ratio (OR) = 6.57 95 % CI, 1.8-23.9, p = 0.004). In age group ≥50 years old, reduction of BMD in both measurement sites did not reach to a significant level.

CONCLUSION

This study indicates that BMD reduction in ICS user with asthma is dependent on age and appears that younger patients are at greater risk of BMD loss. These findings suggest preventive measures particularly in patients <50 years.

High crash areas resulting in injuries and deaths in Tehran traffic areas from november 2011 through february 2012: a geographic information system analysis

BACKGROUND

Evaluation of intra-city roads in terms of environmental factors of motor vehicle injuries can help us to better identify these factors and the share of each of the factors in injuries. Therefore, this study was conducted to determine the high injury areas and the risk factors of motor vehicle crashes resulting in injury and death in Tehran, the capital city of Iran, from November 2011 through February 2012.

METHODS

In this cross sectional study, the locations of the motor vehicle injuries resulting in injuries and deaths were obtained from police stations in Tehran. The coordinates of the injuries locations were extracted and entered into the Arc-GIS software to overlay the different layers of geographical data and extract the risk map.

RESULTS

A total of 4257 motor vehicle injuries were evaluated in this study. Forty-two injuries (1%) resulted in death and 4215 injuries (99%) resulted in injury. The traffic districts 5 and 21 had the highest frequency of injuries resulting in death. The type of the motor vehicle resulting in injury or death was motorcycle in 2330 injuries (54.73%).

CONCLUSION

The frequency of traffic injuries is more in the west and northwest areas of Tehran, and it is caused more by motorcycles in terms of traffic and motor injuries resulting in injury and death. It is useful to conduct more studies to better identify these factors considering their importance in traffic injuries.

Boceprevir and telaprevir-based triple therapy for chronic hepatitis C: virological efficacy and impact on kidney function and model for end-stage liver disease score

Triple therapy using telaprevir or boceprevir [hepatitis C virus (HCV)-NS3/NS4A protease inhibitors (PI)] in association with PEG-IFN/ribavirin has recently become the new standard of care (SOC) for treatment of HCV genotype 1 patients. Our objective was to assess the efficacy and tolerance of triple therapy in routine clinical practice. A total of 186 consecutive HCV patients initiating triple therapy were enrolled in a single centre study. Clinical, biological and virological data were collected at baseline and during follow-up as well as tolerance and side effect details. Among 186 HCV patients initiating triple therapy, 69% received telaprevir and 31% boceprevir. Sixty-one per cent of patients had cirrhosis. The overall extended rapid virological response (eRVR) rate and sustained virological response (SVR) rate were 57.0% and 59.7%, respectively. IL28B CC phenotype was associated with increased probability of achieving eRVR and SVR, whereas previous non-response was associated with low eRVR and SVR rates. The SVR rate increased from 30.8% in previously non-responders to 59.1% in partial non-responders and 75% in relapsers. SVR rate in naive patients was 62.5%. Glomerular filtration rate assessed by MDRD after 12 weeks of therapy was significantly reduced for both PI (P < 0.001). The model for end-stage liver disease (MELD) score was significantly increased at W12 for telaprevir (P = 0.008) and at W24 for boceprevir (P = 0.027). PI-based triple therapy leads to high rates of virological response even in previously non-responder patients. Renal function after triple therapy is impaired as well as MELD score in all patients. Cautious clinical monitoring should focus not only on haematological and dermatological side effects but also on renal function.

Regulation of luteinizing hormone receptor in hippocampal neurons following different long-lasting treatments of castrated adult rats

The aim of this study was to investigate the effects of different Luteinizing hormone (LH) and steroid hormones levels on LH receptor (LHR) expression in the hippocampal cells. Rats (24 males and 24 females) were assigned to four groups: one control and three experimental [gonadectomy (GDX), gonadectomy + gonadotropin releasing hormone analogue (GDX+GnRHa) and GDX+GnRHa+estradiol (E2) or testosterone (T)] independently for each gender. All experimental rats were gonadectomized; then GnRHa was administrated to GDX+GnRHa group, and GnRHa plus steroid hormone to GDX+GnRHa+E2 or T group in both genders for four-month. LHR mRNA expression and its protein level in hippocampal cells were measured using QRT-PCR and Western blotting. Quantification of mRNA revealed a decrease in LHR transcripts level in GDX+GnRHa group of females. A significant change was observed between GDX groups and GDX+GnRHa+E2 or T versus GDX+GnRHa group in females. High levels of LH decreased significantly the immature isoform of LHR in GDX group compared to control group in both genders, but low LH concentrations in GDX+GnRHa group induced immature LHR isoform production only in females. Therefore increased LH concentration induces production of incomplete LHR transcripts in hippocampal cells and decreases immature LHR at the protein level. This implies that LH decreases the efficiency of translation through either producing non-functional LHR molecules or preventing their translation.

Incidence and risk factors of sternal wound infection at site of incision after open-heart surgery

OBJECTIVE

To identify the incidence of sternal wound infection and the risk factors before, during and after open-heart surgery in an Iranian critical care unit.

METHOD

A descriptive, analytic study investigating all open-heart surgery patients from March 2010 to March 2011, in terms of the incidence of sternal wound infection and the risk factors before, during, and after surgery. Patients were examined for signs of infection at the site of surgical incision on presentation to the ward, daily during their stay, and on discharge. The same investigator reviewed all wounds, every day.

RESULTS

The incidence of sternal wound infection was found to be 10%. Multivariate regression analysis identified the following risk factors: diabetes (OR: 0.439; 95%CI: 0.21-0.95; p=0.04), age (OR: 1.033; 95%CI: 1.003-1.064; p=0.03), hyperlipidaemia (OR: 1.008; 95%CI: 1.005-1.011; p<0.001), history of respiratory disorders ([COPD] OR: 2.952; 95%CI: 1.3-6.4; p=0.007), female gender (OR: 2.06; 95%CI: 1.40-3.03; p<0.008), and history of addiction to opiates (OR: 2.33; 95%CI: 1.56-3.49; p<0.006).

CONCLUSION

This study found a high rate of surgical sternal wound infection in open-heart surgery patients in an Iranian critical care unit, suggesting that the medical and care-giving team in the cardiac intensive care unit need further education.

DECLARATION OF INTEREST

There were no external sources of funding for this study. The authors have no conflicts of interest to declare.

Mental health promotion of Iranian university students: the effect of self-esteem and health locus of control

The purpose of this study was to investigate the effect of self-esteem and health control belief on promoting students' mental health. In so doing, 144 students from two medical universities in the north-east of Iran were recruited into study. They were pair-matched and randomly assigned to case and control groups. The data were collected through Goldberg's General Health Questionnaire-28, Multidimensional Health Locus of Control and Rosenberg's Self-Esteem Scales. The results showed that there were significant differences between the groups before and after the intervention. The external components of health locus of control (chance and powerful others) showed a significant decrease but the internal health locus of control and self-esteem revealed a significant increase after the intervention (P < 0.0001). Moreover, the students' mental health had a significant increase after 3 months of intervention (P < 0.0001). The findings emphasize that the programme can improve the health locus of control beliefs, self-esteem and mental health promotion of the students. This will require additional monitoring and uninterrupted attempts to be effective.

Treatment outcome, mortality and their predictors among HIV-associated tuberculosis patients

The risk of death is significantly higher in HIV-infected patients with tuberculosis (TB). This study aims to evaluate the impact of demographic, clinical and laboratory characteristics on the treatment outcome and mortality of TB/HIV co-infected patients in a tertiary TB centre in Iran. In total, 111 patients were recruited from 2004 to 2007. Mycobacteriological studies and demographic, clinical, and laboratory data from all patients were analysed and predictors of unsuccessful outcomes as well as mortality were determined. The mean age for all 111 TB-HIV patients was 38 ± 9 years (range 22-70) and 107 (96.3%) were men; 104 (93.7%) had a history of drug abuse and 96 (86.4%) had a history of imprisonment. The method of HIV transmission was intravenous drug use in 88 (79.3%). Twenty-three (20.7%) had a history of Category 1 (CAT I) TB treatment and six (5.4%) Category 2 (CAT II) treatment. Combination antiretroviral therapy (cART) was given to 48 (43.2%). No significant associations were found between treatment outcomes or mortality and gender, smoking, drug and alcohol abuse, imprisonment, method of transmission, history of CAT I and CAT II treatments, CD4 counts or adverse effects (P > 0.05). Administration of cART led to significantly better outcomes (P < 0.001). Lower serum albumin levels and low body weight were significantly associated with mortality.

The effect of egg yolk oil in the healing of third degree burn wound in rats

BACKGROUND

Burn injury is a major cause of death and disability worldwide. A domestic medication in wound healing, preventing infection and reduction of scar tissue as well as availability is still an important challenge. This study aims to evaluate the efficacy of yolk egg oil in treatment of burn wounds in rats.

METHODS

A standard 3rd degree burn wound was produced and the animals were divided into three groups according to topical treatment including yolk oil, 1% silver sulfadiazine (SSD) and control. In days 7, 14 and 30,animal's weight, wound size, as well as histopathological findings of skin were evaluated in different groups.

RESULTS

Average size of wound after 7 days was 3.4, 5.3, and 6.7 cm in yolk oil, SSD and control groups. There were significant differences between yolk oil and the other groups in this aspect. The wound size of yolk egg group was also significantly smaller than other groups in 14th and 30th days. Results of the histological studies indicated significant differences between yolk oil, SSD and control groups on day 30, with mean score of 3.75, 3.5 and 2.8 respectively. The difference between yolk oil and the other groups was significant.

CONCLUSION

Yolk oil-treated burned animals showed abundant re-epithelialization without tissue scar in comparison with SSD group. Although the egg yolk has many vital nutrients, but its exact mechanism in healing process is unknown. Therefore, further studies evaluating the influence of individual components on burn-healing process is advised.

On the thermodynamic entropy of fatigue fracture

Entropy production during the fatigue process can serve as a measure of degradation. We postulate that the thermodynamic entropy of metals undergoing repeated cyclic load reaching the point of fracture is a constant, independent of geometry, load and frequency. That is, the necessary and sufficient condition for the final fracture of a metal undergoing fatigue load corresponds to a constant irreversible entropy gain. To examine validity, we present the results of an extensive set of both experimental tests and analytical predictions that involve bending, torsion and tension-compression of aluminium 6061-T6 and stainless steel 304 specimens. The concept of tallying up the entropy generation has application in determining the fatigue life of components undergoing cyclic bending, torsion and tension-compression.

Radiochemical studies relevant to the no-carrier-added production of 61,64Cu at a cyclotron

Copper-64 (t ½ = 12.7 h) is a promising cancer treatment radiotherapy agent and combines positron emission tomography (PET). It was produced utilizing the 64Ni(p,n) 64Cu nuclear reaction channel. Natural nickel was electroplated successfully, 48 μm thick, onto a gold-coated copper backing slab. Bombardment of nickel plated target was performed with 16 MeV protons at a current of 200 μA. Copper-64 together with copper-61 was separated from Ni and other non-isotopic impurities by ion exchange chromatography. The method of separation of radiocopper has been improved.

Seroepidemiological study for toxocariasis among children in Zanjan-northwest of Iran

Determination of seroepidemiological survey of Toxocara infection in 810 sera from children inhabitants in rural and urban area of Zanjan (North-West of Iran) was adjusted for specific antibody level against of second stage larvae of Toxocara for excretory and secretory antigens based on ELISA technique. In contrast of the other studies, the overall seroprevalence was quite low, reaching to 2.7% out of 810 samples was positive to anti Toxocara species antibodies. Neither age nor gender seemed to be significant factor to positive serology. Seroprevalence of anti Toxocara antibody were detected in 8 out of 494 (1.6%) children from urban area, whereas 316 sample (4.4%) were the positive in the rural area. Positive children who had contact or ownership of cats and dog were 6.9 and 3.9%, respectively. Albeit, concerning to this study, seroprevalence of toxocariosis is lower than other countries and other studies in Iran. But protections of toxocariosis in children must be taking into account in public health program. Suggest that increase of hygiene education would be a crucial affective on population to reduce infection risk factor and zoonotic disease.