Global epidemiology of HBV infection among hemodialysis patients: A systematic review and meta-analysis

BACKGROUND & AIMS

Hemodialysis (HD) is a life-saving procedure that purifies the blood in patients with end-stage renal disease (ESRD). Among all major complications, blood-borne diseases like hepatitis B virus (HBV) may be exposed as serious side effects of hemodialysis. A comprehensive review of the global burden of HBV among HD patients has not been written so far. The aim of the current systematic review and meta-analysis was to determine the globally epidemiology of HBV infection among HD patients.

METHODS

Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, articles that investigated the prevalence of HBV among HD patients were searched from the major databases such as EMBASE, PubMed, Web of Science collection, and Scopus. Pooled prevalence with 95% CI and identification of heterogeneity were obtained using the random effects model and Cochran's Q-test, respectively, and quantification was evaluated using the I2 statistics. All statistical analyses were performed by STATA 14.1 statistical software.

RESULTS

among 322 datasets (795,623 cases) that included in this study, the pooled prevalence of HBV infection among HD patients was 7.32% (95% CI: 6.53-8.15%; I2 = 97.91%), including 7.57% (95% CI: 6.69-8.48%) for HBsAg and 6.09% (95% CI: 4.05-8.49%) for DNA, respectively. In addition, based on geographic area, the prevalence was 7.44% (95% CI: 6.35-8.61%) in Asia, 4.32% (95% CI: 2.21-7.04%) in North America, 7.07% (95% CI: 6.35-8.61%) in Europe, 5.52% (95% CI: 3.60-7.78%) in Africa, 8.45% (95% CI: 5.81-11.78%) in Oceania, and 9.73% (95% CI: 7.11-12.70%) in South America.

CONCLUSIONS

Our analysis indicates a relatively high prevalence of HBV infection in HD patients, even in some developed countries. Considering that ESRD patients are not able to properly respond to the vaccination strategies in order to develop an acceptable immunity, vaccination of healthy individuals is highly recommended to arm their bodies for possible immunocompromise conditions in the future. Moreover, donated blood in blood transfusion centers should be checked for possible hepatitis B virus infection using sensitive molecular tests.

First seroepidemiological investigation of human enterovirus 71 in Iran

Background and Objectives:

Human Enterovirus 71 (EV-A71) is the causative agent for many dermal to neurological diseases especially polio-like paralysis outbreaks around the world. This study, the first of this kind in Iran, aimed to find neutralizing antibodies against EV-A71 in serum of healthy individuals in different age groups based on neutralization test (NT).

Materials and Methods:

In this cross-sectional study, 547 serum samples were collected from healthy individuals who were referring for routine checkup tests (aged from under 6 months to over 31 years old) to Imam-Khomeini Hospital in Tehran during January-December 2015. Serum samples were examined by NT in cell culture to detect neutralizing antibodies against EV-A71. In the next step, some of the positive samples were subjected to complete titration to determine the exact titer of anti-EV-A71 antibodies.

Results:

Of 547 samples, 310 (56.7%) were positive for EV-A71 neutralizing antibody. The presence of the antibody increased with age (p<0.001), and there was a significant statistical relationship between sex and the presence of antibody (p=0.009).

Conclusion:

Our results demonstrated an apparent but limited circulation of EV-A71 in our society. After the worldwide eradication of poliovirus, EV-A71 which can cause polio-likes syndrome, might be the new challenge for our health care system as regard more in depth research is however needed.

The association between risk perception and knowledge with the behavior of using respiratory protection devices in the four National Oil Products Distribution Company

Introduction: Having a clear understanding of the relationship between risk perception, knowledge, and protective behaviors could play a significant role in occupational risk management. This study aimed to survey the relationship between risk perception and knowledge on the behavior of using respiratory protection equipment in the four National Oil Products Distribution Company. Materials and Methods: In this descriptive cross-sectional study conducted in 2018, 52 workers from the loading and quality control departments of 4 national companies distributing petroleum products in Sabzevar, Bojnourd, Torbat Heydariyeh, and Shahroud participated. Data were collected through a researcher-made questionnaire whose validity and reliability were assessed (CVI: 0.9 and CVR: 0.92 and Cronbach's alpha coefficient was determined to be 0.73), and data were analyzed using SPSS19 software, and descriptive statistics and linear regression were analyzed. Results: More than half of the participants, who were exposed to the chemicals, use RPDs (Respiratory Protective Devices) all the time and when they are exposed to chemicals. While 75% of them reported using RPDs (Respiratory Protective Devices), reduces the quality of their work. In this study, there was not any significant relationship between RPDs behavior with knowledge and risk perception (P > 0.05). However, the association between work experience and RPDs was negatively significant (p= 0.009).  Conclusion: The results of this study suggested that only education and knowledge could not promote individual risk perception, improving protective behavior, therefore other barriers such as uncomfortably of RPDs, or their interference with the worker should be considered. To achieve this goal, the safety and health officials of the companies must pay attention to its quality in addition to the correct choice of these devices.

Cost analysis and safety comparison of Cisatracurium and Atracurium in patients undergoing general anesthesia

BACKGROUND

Non-depolarizing neuromuscular blocking agents (NMB) differ in pharmacokinetic and pharmacodynamic parameters. An anesthesiologist according to these similarities and differences is able to choose the least costly one if the same safety profile and same clinical benefit achieved with the different alternatives.

AIM

The main objective of this study is to evaluate the economic and adverse drug reactions prevalence and differences between cisatracurium and atracurium the two non-depolarizing NMB drugs, which are widely used in adult patients undergoing surgery with general anesthesia in a teaching Hospital in Iran.

MATERIALS AND METHODS

A cost analysis and adverse drug reactions (ADR) monitoring were performed. Only direct costs were considered and data were collected through a prospective randomized study. Regardless of the type of surgery, 100 patients were randomly divided into two equal groups to receive either cisatracurium or atracurium by anesthesiologists. ADRs prevalence and cost differences between patients receiving one of the two non-depolarizing NMB agents were evaluated by independent sample t-test and Chi-square test respectively.

RESULTS

No significant difference was observed between the two groups of patients in demographic data. There was no statistical difference in the ADR prevalence in both groups. The numbers of ADR within atracurium group was higher than cisatracurium group, but this distinction was not statistically significant (p > 0.05). It was significant difference in cost between the two neuromuscular blocking drugs (p < 0.05).

CONCLUSIONS

According to our study it seems that atracurium and cisatracurium had similar safety profile and atracurium had a cost benefit relative to cisatracurium in initial loading doses. In patients with instability in hemodynamic parameters the cisatracurium was the appropriate choice.  

Body composition and heat expenditure in broiler chickens fed diets with or without trans fatty acids

The effect of a diet containing trans fatty acids (TFA) on the fatty acid composition and fat accumulation was investigated in broiler chickens. Female broilers were fed a control or a TFA-containing diet. The difference between the diets was that a part of cis 18:1 in the control diet was replaced by the TFA. Body composition, energy balance and the fatty acid composition were examined. Over the time-period studied (15 days), the body fat content and the protein content did not differ significantly between the TFA-fed group and the control. In energy balance studies, total energy intake, energy loss in excreta, energy expenditure and energy storage did not differ between the treatments. Compared to the control diet, the TFA diet resulted in significantly higher amounts of 14:0 and 18:1n-7 and lower amounts of 18:1n-9 and 20:4n-6 in the body. In conclusion, the data suggest that feeding TFA for 15 days to female broilers had no effect on energy retention, energy expenditure and energy loss in excreta or in body composition in terms of fat and protein. Only the fatty acid composition in the body was affected by the treatment with TFA. In addition, 50% of ingested TFA was incorporated into the body fat. This may have a negative effect on the dietetic value of chicken meat.

Body composition and selected blood parameters in mice fed a combination of fibre and conjugated linoleic acid

Feeding mice conjugated linoleic acid (CLA) reduces body fat. Soluble fibre decreases apparent lipid digestibility. The objective of the present study was to examine whether a combination of dietary CLA and soluble fibre would further decrease the proportion of body fat than a diet with CLA alone. Therefore, we fed mice diets with CLA and different amounts of Nutrim, containing 10% soluble fibre. CLA was added to the control diet at the expense of high oleic acid sunflower oil (HOSF) component and Nutrim was added at the expense of an isoenergetic combination of starch, dextrose and cellulose. The diets were fed for 28 days. Weight gain after 28 days was less in CLA-fed animals than in HOSF-fed animals. Both CLA and Nutrim increased the body water content. CLA reduced total body fat and epidydymal fat but Nutrim did not. No interaction of CLA and fibre was detected. We, therefore, must conclude that under the present experimental conditions dietary CLA and fibre do not interact to reduce body fat deposition.

The effect of six different C18 fatty acids on body fat and energy metabolism in mice

We studied the effects of five high-fat semi-purified diets varying at a 4 % (w/w) level in either stearic, oleic, linoleic, α-linolenic, or γ-linolenic acid on body fat and energy metabolism in BALB/c mice. A diet containing caprylic, capric, lauric, and myristic acid was used as a reference diet and a diet with 4 % conjugated linoleic acid (CLA) was used as a positive control as it is known to effectively lower body fat in mice. The diets were fed for 35 d. Body fat was significantly lower in the CLA group than in the other groups but was not significantly different among the non-CLA groups. Among the non-CLA groups, the linoleic acid group tended to have the highest and the α-linolenic acid group the lowest proportion of body fat. In energy-balance studies, the percentage of energy intake that was stored in the body was significantly lower in the CLA group compared with the other dietary groups. The percentage of energy intake eliminated in excreta was highest in the stearic acid group followed by the γ-linolenic acid group. These results were reflected in apparent fat digestibility, which was lowest in the stearic acid group. The percentage of energy intake expended as heat was highest in the CLA-fed mice. The results of the present study suggest that body fat and energy accretion in mice fed diets containing different C18 fatty acids is by far the lowest with CLA and that linoleic acid produced the highest fat intake and energy accretion.

The influence of dietary linoleic and alpha-linolenic acid on body composition and the activities of key enzymes of hepatic lipogenesis and fatty acid oxidation in mice

We have recently suggested that feeding the C18 polyunsaturated fatty acid, alpha-linolenic acid (ALA), instead of linoleic acid (LA) reduced body fat in mice. However, the difference in body fat did not reach statistical significance, which prompted us to carry out this study using more animals and diets with higher contents of ALA and LA so that the contrast would be greater. The diets contained either 12% (w/w) LA and 3% ALA or 12% ALA and 4% LA. A low-fat diet was used as control. The diets were fed for 35 days. The proportion of body fat was not influenced by the type of dietary fatty acid. Plasma total cholesterol and phospholipids were significantly lower in ALA-fed mice than in mice fed LA. Activities of enzymes in the fatty acid oxidation pathway were significantly raised by these two diets when compared with the control diet. alpha-Linolenic acid vs. LA did not affect fatty acid oxidation enzymes. In mice fed the diet with LA activities of enzymes of de novo fatty acid synthesis were significantly decreased when compared with mice fed the control diet. alpha-Linolenic acid vs. LA feeding did not influence lipogenic enzymes. It is concluded that feeding mice for 35 days with diets either rich in LA or ALA did not significantly influence body composition.

Dietary conjugated linoleic acids as free fatty acids and triacylglycerols similarly affect body composition and energy balance in mice

The objective of this study was to compare the effects of conjugated linoleic acid (CLA) as triacylglycerols (TAG) or free fatty acids (FFA) on body composition and energy balance in mice. We fed four groups of 5-wk-old Balb-C mice (n = 9) semipurified diets containing either CLA (0.5 g CLA/100 g of diet) or high oleic sunflower oil (HOSF) in the form of FFA or TAG for 42 d. Body composition was determined and the energy in the carcasses, excreta and food was measured in a bomb calorimeter. The amount of body fat was 4.72 +/- 0.95 g (17.9 +/- 2.8%) in the HOSF-FFA group, 2.36 +/- 0.29 g (9.4 +/- 1.0%) in the CLA-FFA mice (mean +/- SD, P < 0.05), 4.76 +/- 0.74 g (18.2 +/- 2.2%) in the HOSF-TAG group and 2.32 +/- 0.38 g (9.3 +/- 1.1%) in the CLA-TAG mice (P < 0.05). The percentage of energy intake that was stored in the body was 3.5 +/- 1.2% in the HOSF-FFA group, 0.6 +/- 0.3% in the CLA-FFA group (P < 0.05), 3.5 +/- 1.1% in the HOSF-TAG group and 0.5 +/- 0.4 in the CLA-TAG mice (P < 0.05). Conversely, the percentage of energy intake that was expended as heat was 89.4 +/- 1.2% in the HOSF-FFA group, 92.4 +/- 0.8% in the CLA-FFA mice (P < 0.05), 89.47 +/- 1.23% in the HOSF-TAG group and 92.2 +/- 0.4% in the CLA-TAG group (P < 0.05). Thus, CLA in the form of FFA or TAG had similar effects on body composition and energy balance.

The fruit essential oil of Pimpinella anisum exerts anticonvulsant effects in mice

This study investigates anticonvulsant effects of an essential oil of the fruits of Pimpinella anisum (Umbelliferae), a folkloric remedy in the Iranian traditional medicine, against seizures induced by pentylenetetrazole (PTZ) or maximal electroshock (MES) in male mice. The essential oil suppressed tonic convulsions induced by PTZ or MES. It also elevated the threshold of PTZ-induced clonic convulsions in mice. The essential oil produced motor impairment. However, this effect was not observed at the doses and time courses needed for anticonvulsant activity.

Evaluation of the anticonvulsant activity of the essential oil of Eugenia caryophyllata in male mice

In this study, the effect of an essential oil of Eugenia caryophyllata (Myrtaceae), an antiepileptic remedy in Iranian folk medicine, against seizures induced by maximal electroshock (MES) or pentylenetetrazole (PTZ) in male mice was studied. The essential oil exhibited anticonvulsant activity against tonic seizures induced by MES. Although it was not effective against clonic convulsions induced by intraperitoneal administration of PTZ, the seizure threshold which was determined by an increase in the dose of intravenously infused PTZ required to induce clonus, was elevated by the essential oil. In addition, at some anticonvulsant doses, the essential oil produced motor impairment on the rotarod.