The effect of Mediterranean diet on inflammatory biomarkers and components of metabolic syndrome in adolescent girls

BACKGROUND

The prevalence of obesity and metabolic syndrome (MetS) during childhood and adolescence is rising significantly worldwide. Previous studies have shown that following a healthy dietary pattern, like the Mediterranean diet (MD), might be an efficacious approach for the prevention and management of MetS during childhood. In the present study, we aimed to examine the effect of MD on inflammatory markers and components of MetS among adolescent girls with MetS.

METHODS

This randomized controlled clinical trial was conducted on 70 girl adolescents with metabolic syndrome. Patients in the intervention group followed a prescribed MD, while participants in the control group received dietary advice according to the food pyramid. The length of intervention was 12 weeks. Participants' dietary intakes were evaluated using three 1-day food records throughout the study. Anthropometric measures, inflammatory markers, systolic and diastolic blood pressure, and hematological factors were assessed at the baseline and end of the trial. An intention-to-treat approach was taken into account for the statistical analysis.

RESULTS

After 12 weeks, participants in the intervention group had lower weight (Ptime*group ≤ 0/001), body mass index (BMI) (Ptime*group ≤ 0/001), and waist circumference (WC) (Ptime*group ≤ 0/001) compared with those in the control group. In addition, MD resulted in a significantly reduced systolic blood pressure compared to the those in the control group (Ptime*group ≤ 0/001). In terms of metabolic variables, MD led to a significant decrease in fasting blood glucose (FBS) (Ptime*group ≤ 0/001), triglycerides (TG) (Ptime*group ≤ 0/001), low-density lipoprotein (LDL) (Ptime*group ≤ 0/001), homeostatic model assessment of insulin resistance (HOMA-IR) (Ptime*group = 0/02) and a meaningful increase in serum levels of high-density lipoprotein (HDL) (Ptime*group ≤ 0/001). In addition, adherence to the MD resulted in a significant reduction in serum levels of inflammatory markers including Interleukin 6 (IL-6) (Ptime*group = 0/02) and high-sensitivity C-reactive protein (hs-CRP) (Ptime*group = 0/02). However, no significant effect was seen on serum levels of tumor necrosis factor α (TNF-α) (Ptime*group = 0/43).

CONCLUSION

Overall, the findings of the present study revealed that consumption of MD for 12 weeks resulted in a favorable effect on anthropometric measures, components of MetS, as well as on some inflammatory biomarkers.

Does wearing a mask while exercising amid COVID-19 pandemic affect hemodynamic and hematologic function among healthy individuals? Implications of mask modality, sex, and exercise intensity

OBJECTIVES

We investigated how wearing a mask - and its modality (surgical vs. N95) - affect hemodynamic and hematologic function in males and females across two exercise intensities (submaximal (SUB) and maximal (MAX)).

METHODS

144 individuals participated in the present study and were randomly allocated to three mask groups of 48 (N95, SURGICAL, and NO MASK) with two exercise subgroups for each mask group (MAX, n = 24; SUB, n = 24) for both sexes. Participants in each experimental group (N95SUB, N95MAX; SURSUB, SURMAX; SUB, MAX) were assessed for their hemodynamic and hematologic function at baseline and during recovery after exercise.

RESULTS

No significant differences were noted for either hemodynamic or hematologic function at post-exercise as compared to baseline with regard to mask modality (P > 0.05). Heart rate (HR) for maximal intensity were significantly greater at 1 min post-exercise in N95 as compared to SURGICAL (P < 0.05). No differences were noted for hemodynamic and hematologic function with N95 and SURGICAL compared to NOMASK for either intensity (P > 0.05). Females showed significantly greater HR values at 1 min post-exercise in N95 as compared to NO MASK, but no significant differences were noted for hematological function between sexes (P > 0.05).

CONCLUSION

Our findings show that wearing a face mask (N95/surgical) while exercising has no detrimental effects on hemodynamic/hematologic function in both males and females, and suggest that wearing a mask, particularly a surgical mask, while exercising during the ongoing pandemic is safe and poses no risk to individual's health. Future studies examining physiological responses to chronic exercise with masks are warranted.

Molecular analysis of the bacille Calmette-Guérin vaccine strain currently being used in Iran

BACKGROUND

In developing countries, tuberculosis (TB) infection control remains a challenge. The bacille Calmette-Guérin (BCG) vaccine is the only effective vaccine available for TB control. Iran uses a local BCG vaccine strain with an unknown substrain.

OBJECTIVE

To investigate the molecular characteristics of the current BCG strain being used in Iran using comparative genomics of the evolutionarily late strains, including BCG vaccines Pasteur, BCG-Danish, BCG-Glaxo, BCG-Prague, BCG-Frappier, BCG-Connaught and BCG-Moreau.

METHODS

A total of 67 different vials of BCG vaccine were cultured. DNA was extracted using the modified cetrimonium bromide (CTAB) method, and multiplex polymerase chain reaction (PCR) was performed to determine four target genomic regions of difference (RD) 1, RD8, RD16 and SenX3-RegX3, and to see whether RD2 and RD14 were present.

RESULTS

Our results showed that all studied batches were Mycobacterium bovis; molecular analysis revealed that the Iranian vaccine strains possess RD8, RD16 and SenX3-RegX3 regions but not RD1, RD2 and RD14. All of the vaccine batches analysed were compatible with BCG-Pasteur 1173p2, the original strain.

CONCLUSION

All of the BCG strains studied were recognised as the BCG-Pasteur 1173p2 strain. No genetic diversity among stocks and ready-for-use vaccine vials were detected.

Risk assessment of gas oil and kerosene contamination on some properties of silty clay soil

Soil and ground water resource pollution by petroleum compounds and chemical solvents has multiple negative environmental impacts. The aim of this research was to investigate the impacts of kerosene and gas oil pollutants on some physical and chemical properties, breakthrough curve (BTC), and water retention curve (SWRC) of silty clay soil during a 3-month period. Therefore, some water-saturated soils were artificially contaminated in the pulse condition inside some glassy cylinders by applying half and one pore volume of these pollutants, and then parametric investigations of the SWRC were performed using RETC software for Van Genukhten and Brooks-Corey equations in the various suctions and the soil properties were determined before and after pollution during 3 months. The results showed that gas oil and kerosene had a slight effect on soil pH and caused the cumulative enhancement in the soil respiration, increase in the bulk density and organic matter, and reduction in the soil porosity and electrical and saturated hydraulic conductivity. Furthermore, gas oil retention was significantly more than kerosene (almost 40%) in the soil. The survey of SWRC indicated that the contaminated soil samples had a little higher amount of moisture retention (just under 15% in most cases) compared to the unpolluted ones during this 3-month period. The parametric analysis of SWRC demonstrated an increase in the saturated water content, Θ s, from nearly 49% in the control sample to just under 53% in the polluted ones. Contaminants not only decreased the residual water content, Θ r, but also reduced the SWRC gradient, n, and amount of α parameter. The evaluation of both equations revealed more accurate prediction of SWRC's parameters by Van Genukhten compared to those of Brooks and Corey.

The risk of contralateral breast cancer in daughters of women with and without breast cancer

We aimed to estimate the 15-year and lifetime risks of contralateral breast cancer in breast cancer patients according to the age of diagnosis of the first cancer and the history of breast cancer in the mother. The risks of contralateral breast cancer were estimated for all 78,775 breast cancer patients in the Swedish Family-Cancer Database (age at diagnosis of first breast cancer <70 years). The risk of experiencing a contralateral breast cancer within 15 years of diagnosis was 8.4% [95% confidence interval (CI): 8.1-8.7%] for women with an unaffected mother, was 12% (95%CI: 11-13%) for a woman with a mother with unilateral breast cancer and was 13% (95%CI: 9.5-17%) for women with a mother with bilateral breast cancer. In early-onset diagnosed women (<50 years) with an unaffected mother, the risk of contralateral breast cancer until age 80 was 23% (95%CI: 20-26%) and for late-onset (50-69 years) diagnosed women it was 17% (95%CI: 14-21%). In a woman with a mother with an early-onset unilateral breast cancer, risk of contralateral breast cancer by age 80 was 35% (95%CI: 25-46%). Women with a mother with early-onset bilateral breast cancer had 31% (95%CI: 12-67%) lifetime risk of contralateral breast cancer. The risk of contralateral breast cancer is higher for daughters of breast cancer patients than for daughters of women without breast cancer. Maternal cancer history and age at onset of first breast cancer in women should be taken into account when counseling breast cancer patients about their risk of contralateral breast cancer.

Metastatic sites and survival in lung cancer

OBJECTIVES

Population-based data on metastatic sites and survival in site-specific metastases are lacking for lung cancer and for any cancer because most cancer registries do not record metastases. This study uses a novel population-based approach to identify metastases from both death certificates and national inpatient data to describe metastatic pathways in lung cancer patients.

MATERIALS AND METHODS

17,431 deceased lung cancer patients diagnosed 2002-2010 were identified from the nationwide Swedish Cancer Registry, which is based on compulsory reports. The influence of age at diagnosis, sex, and histological subtype on metastatic spread was investigated. Survival in metastatic lung cancer was assessed by histology and metastatic site.

RESULTS

The most frequent metastatic sites were the nervous system, bone, liver, respiratory system, and adrenal gland. Liver (35%) and nervous system (47%) metastases were common in patients with metastases from small cell lung cancer, and bone (39%) and respiratory system (22%) metastases in adenocarcinoma. Women (43% vs. 35%) and younger patients had more metastases to the nervous system. Median survival after diagnosis was 13 months for non-metastatic and five months for metastatic lung cancer. In this novel data, liver metastases conferred the worst prognosis (three months), especially for large cell histology. Bone metastases also featured poor survival, whereas survival in respiratory and nervous system metastases was better.

CONCLUSION

Metastatic sites and survival in metastatic lung cancer is influenced by sex, histological subtype, and age at diagnosis. Liver and bone metastases signal poor survival, compared with nervous system metastases.

Hodgkin lymphoma after autoimmune diseases by age at diagnosis and histological subtype

BACKGROUND

Increased risk of Hodgkin lymphoma (HL) associated with personal history of several autoimmune diseases (ADs), such as rheumatoid arthritis, systemic lupus erythematosus, sarcoidosis, and immune thrombocytopenic purpura, are known. Whether there are other HL-related ADs and whether the increased risk of HL after ADs holds across sex, age, year of diagnosis, or HL histological subtype is unclear.

PATIENTS AND METHODS

We systematically analyzed the risk of HL in 878 161 Swedish patients diagnosed with 33 different ADs in 1964-2010. During ∼10-year follow-up of ADs patients, 371 incident HL cases were diagnosed.

RESULTS

Significantly increased overall standardized incidence ratio (SIR) for HL after ADs was 2.0 (95% confidence interval: 1.8-2.2); AD-specific SIRs: autoimmune hemolytic anemia 19.9 (7.2-43.6), sarcoidosis 10.3 (7.8-13.4), systemic lupus erythematosus 8.4 (5.2-12.9), immune thrombocytopenic purpura 7.0 (3.2-13.3), polyarteritis nodosa 6.6 (1.2-19.5), polymyositis/dermatomyositis 6.3 (2.0-14.9), Behcet's disease 5.6 (2.7-10.3), Sjögren's syndrome 5.0 (2.1-9.8), rheumatoid arthritis 3.2 (2.6-3.9), polymyalgia rheumatica 2.2 (1.4-3.5), and psoriasis 1.9 (1.3-2.6). Men with AD had slightly higher risk of HL (2.4, 2.0-2.7) compared with women (1.8, 1.5-2.0). Only 23% of ADs were diagnosed before age 35 years and the overall SIR for HL diagnosis before age 35 [1.4, (1.0-1.8)] was lower than that in older ages [35 ≤ age < 50: 2.1 (1.6-2.7); age ≥ 50: 2.2 (2.0-2.5)], except for sarcoidosis [age < 35: 19.3 (10.5-32.5); 35 ≤ age < 50: 10.4 (5.7-17.5); age ≥ 50: 8.4 (5.6-12.1)]. Risks of all classical HLs significantly increased after ADs: lymphocyte depletion 3.7 (1.5-7.6), lymphocyte-rich 3.7 (2.3-5.9), mixed cellularity 2.4 (1.8-3.2), and nodular sclerosis 1.7 (1.3-2.1).

CONCLUSION

Several, but not all ADs (11/33), had a positive association with all classical histological subtypes of HL. Higher risks of classical HL after polyarteritis nodosa, polymyositis/dermatomyositis, Behcet's disease, Sjögren's syndrome, polymyalgia rheumatica, and psoriasis were novel findings of this study.

Familial risk of early and late onset cancer: nationwide prospective cohort study

OBJECTIVE

To determine whether familial risk of cancer is limited to early onset cases.

DESIGN

Nationwide prospective cohort study.

SETTING

Nationwide Swedish Family-Cancer Database.

PARTICIPANTS

All Swedes born after 1931 and their biological parents, totalling >12.2 million individuals, including >1.1 million cases of first primary cancer.

MAIN OUTCOME MEASURES

Familial risks of the concordant cancers by age at diagnosis.

RESULTS

The highest familial risk was seen for offspring whose parents were diagnosed at an early age. Familial risks were significantly increased for colorectal, lung, breast, prostate, and urinary bladder cancer and melanoma, skin squamous cell carcinoma, and non-Hodgkin's lymphoma, even when parents were diagnosed at age 70-79 or 80-89. When parents were diagnosed at more advanced ages (≥ 90), the risk of concordant cancer in offspring was still significantly increased for skin squamous cell carcinoma (hazard ratio 1.9, 95% confidence interval 1.4 to 2.7), colorectal (1.6, 1.2 to 2.0), breast (1.3, 1.0 to 1.6), and prostate cancer (1.3, 1.1 to 1.6). For offspring with a cancer diagnosed at ages 60-76 whose parents were affected at age <50, familial risks were not significantly increased for nearly all cancers.

CONCLUSION

Though the highest familial risks of cancer are seen in offspring whose parents received a diagnosis of a concordant cancer at earlier ages, increased risks exist even in cancers of advanced ages. Familial cancers might not be early onset in people whose family members were affected at older ages and so familial cancers might have distinct early and late onset components.

A retrospective survey of human hydatidosis based on hospital records during the period of 10 years

Hydatid cyst is a parasitic infection that is widely seen endemically in the Middle East countries. We studied hydatid cyst pattern in hospitalized adult patients in our hospital from 2000 to 2010. In this study 89 patients, 50 females and 39 males who were diagnosed to have hydatid cyst were evaluated. The mean age of the patients was 37.3 and the mean hospital stay was 10.1 days. The main complaint was abdominal pain (66.2%). The most common localization of cysts was the liver and the most radiological method to diagnose the disease was ultrasonography followed by CT scan. Our recurrence rate was more than average. We had no mortality and did not find any serious postoperative complication. Safe surgery is a role for hydatid cysts.

Prevalence of Trichomonas vaginalis Infection in Hamadan City, Western Iran

BACKGROUND

Infection with Trichomonas vaginalis is one of the most common sexually transmitted diseases (STDs) in humans. The prevalence of infection in Iran has been reported between 2 to 8%, depending on deferent socio-cultural conditions. This study aimed to determine the prevalence of T. vaginalis in women referred to gynecologic clinics in Hamadan city, West of Iran.

METHODS

This descriptive cross-sectional study was conducted on 750 women who referred to Gynecologic clinics in Hamadan from November 2010 to July 2011. Vaginal samples were obtained from them and examined by wet mount and culture methods for the detection of T. vaginalis.

RESULTS

Sixteen out of 750 vaginal swab specimens (2.1%) were culture positive for T. vaginalis and 13 of these positive specimens (1.7%) were wet mount positive. Only 12 of 42 patients who were clinically diagnosed as having T. vaginalis infection, confirmed by culture method. Five hundred and fifty of the participants women (73.3%) had at least one of signs and symptoms of trichomoniasis. No statistical correlation was observed between clinical manifestations and parasitological results (p>0.05).

CONCLUSION

This study showed low prevalence of T. vaginalis infection in the study population. Since clinical signs of trichomonal vaginitis are the same of other STDs, a confirmatory laboratory diagnosis is necessary. Wet smear as well as culture are sensitive for detection of T. vaginalis.

Risk factor investigation for cardiovascular health through WHO STEPS approach in Ardabil, Iran

Objectives:

Reliable evidence is the keystone for any noncommunicable disease (NCD) prevention plan to be initiated. In this study we carried out a risk factor investigation based on the WHO Stepwise approach to Surveillance (STEPS).

Methods:

The study was conducted on 1000 adults between 15 and 64 years of age living in Ardabil province, north-west Iran during 2006, based on the WHO STEPS approach to surveillance of risk factors for NCD. At this stage only the first and second steps were carried out. Data were collected through standard questionnaires and methods analyzed using STATA version 8 statistical software package.

Results:

29.0% of men and 2.6% of women were current daily tobacco smokers. The mean number of manufactured cigarettes smoked per day was 18.9 among current daily smokers. Smoking was most prevalent among men of low-income families and those of lower education. The mean body mass index (BMI) was 26.6 kg/m², and was significantly correlated with systolic blood pressure. 58.9% were overweight or obese; 18.0% had raised blood pressure and 3.7% had isolated systolic hypertension. The mean number of servings of fruit consumed per day was 1.1; 33.1% had low levels of activity. Combined risk factor analysis showed that 4.1% of participants were in the low-risk group (up to 5.1% among men and 3.2% among women). Those in the high-risk group comprised 25.6% in the 25- to 44-year age group and 49.7% in the 45- to 64-year age group. Mean BMI increased by age in both sexes at least at the first three decades of adult life.

Conclusion:

Based on observed status of risk for cardiovascular health, burden of cardiovascular diseases is expected to increase if an effective prevention strategy is not undertaken.

Chromosome abnormality rate among Iranian patients with idiopathic mental retardation from consanguineous marriages

INTRODUCTION

Mental retardation (MR) has heterogeneous aetiology mostly with genetic causes. Chromosomal aberrations are one of the most common causes of MR. Reports on chromosome abnormality rate among consanguineous families are sparse. In order to identify the chromosome abnormality rate in idiopathic mental retardation from consanguineous marriages, a total of 322 Iranian families with positive family history for MR were investigated in the Genetics Research Center.

MATERIAL AND METHODS

In the majority of families (92%) at least two sibs were affected with MR and none had specific chromosomal syndromes such as Down syndrome. Standard cytogenetic techniques using high resolution GTG banding were carried out on all the patients.

RESULTS

The overall chromosome abnormality rate contributing to mental retardation was 1.24% (4 cases), which comprised 46,XY,der(18)t(4;18)(q31.1;q23)mat; 45,XY,-21,-22,+der(22)t(21;22)(q21.1;q13.33)mat; 46,XY,rec(2)dup(2p)inv(2)(p25.1q37.3)pat, and 46,XY,der(11)t(10;11)(q25.2;q25)pat.

CONCLUSIONS

Although the most likely genetic cause of mental retardation in patients with consanguineous parents is autosomal recessive, the fact that 1.24% of our patients had chromosomal abnormalities emphasizes the importance of cytogenetic investigation as the first laboratory genetic tests for all MR patients. To our knowledge, this is the first report on the rate of chromosome abnormality among patients with idiopathic mental retardation from consanguineous marriages.

Nervous system tumors in adult immigrants to Sweden by subsite and histology

BACKGROUND

The coding of histology of nervous system (NS) tumors with various degrees of malignancies differs between cancer registries, whereby the comparison of incidence rates from one registry to another seems difficult. No study has systematically defined whether the change in the risk of NS tumors upon immigration in adulthood varies by subsite or histology. Therefore, we aimed to address this issue amongst the first-generation immigrants to Sweden based on a large uniform cancer registry data (1958-2006).

METHODS

The nationwide Swedish Family-Cancer Database (2008 version; >11.8 million individuals; 1.8 million immigrants; histology code in force since 1958) was used to calculate standardized incidence ratios (SIRs). We analyzed 28,981 adult cases of NS tumors amongst Swedes and 2519 amongst immigrants (age ≥ 30).

RESULTS

Significantly decreased risks for brain glioma were amongst German (SIR = 0.64), Eastern European (0.62), some Asian (0.71), Chilean (0.34), and African immigrants (0.52). We found an increased risk for brain meningioma amongst Finns (1.15) and former Yugoslavians (1.33), whilst only Norwegians (0.71) and Latin Americans (0.21) had a decreased risk. The risk for spinal ependymoma and astrocytoma was increased in Germans (3.66) and former Yugoslavians (8.89). We found no significant difference for peripheral nerve tumors between immigrants and the native Swedes.

CONCLUSION

Significant differences between risk of NS tumors amongst immigrants and the native Swedes may suggest different risk factor profiles for glioma compared to meningioma indicating a higher etiological role of genetic background or childhood environmental risk factors rather than exposures after immigration.

Idiopathic generalized epilepsies: a follow-up study in a single-center

OBJECTIVE

To characterize adult patients with idiopathic generalized epilepsies (IGEs) with precise evaluation and to assess factors related to refractoriness.

MATERIALS AND METHODS

Hospital records of all our patients with IGEs (n = 128) were evaluated in 2005 and followed-up until 2008.

RESULTS

In 2005, 76% of patients were 1-year seizure-free. Seizure freedom increased to 82% during the 3-year follow-up. Seizure freedom was not significantly associated with age, age at diagnosis, epilepsy duration, exposure to inappropriate initial antiepileptic drug (AED), or delay time between starting initial AED and appropriate AED. Women constituted 78% of patients with merely provoked seizures. In 58% of women with recent seizure, one to two avoidable precipitating factors, such as lack of sleep, alcohol, and forgetting to take AED, were observed. In 2008, all patients with no medication, 91% of monotherapy patients, 60% of patients on two AED, and 14% of patients on three AED were seizure-free.

CONCLUSIONS

Most of patients with IGEs can be successfully treated with monotherapy. Refractory seizures in some patients may be because of avoidable factors, especially in young women.

CD 28 gene polymorphism and plasma concentration of soluble CD 28 in Iranian patients with visceral leishmaniasis

In visceral leishmaniasis (VL), the development of protective immunity is associated with expansion of leishmania-specific T-cell responses. Because of the essential role of CD28 in the effectiveness of T-cell activation, this study was carried out to investigate the CD28 gene polymorphism and plasma levels of soluble (s) CD28 molecule in Iranian patients with VL. Plasma concentrations of CD28 in 88 patients with VL, 132 individual with subclinical leishmaniasis, and 100 seronegative healthy controls were measured by enzyme-linked immunosorbent assay. Genotyping of CD28 gene polymorphism was performed by polymerase chain reaction based allotyping method using allele-specific primers for C or T at intron 3 position +17 in three groups. The frequency of CC genotype was significantly higher in subclinical VL patients (42.4%) than active VL group (27.3%) and healthy controls (16%) (P<0.001). Also, the frequency of allele C among subclinical VL group (57.6%) was significantly higher than active VL (40.9%) and control groups (34%) (p=0.003). No significant differences were observed between the plasma levels of sCD28 in three groups. Our findings suggest that the CD28 gene may have significant role in the protection of active VL in the Iranian population.

Gene polymorphism in transforming growth factor-beta codon 10 is associated with susceptibility to Giardiasis

Secretory immunoglobulin A (S-IgA) antibodies have a central role in anti-Giardial defence. It has been demonstrated that transforming growth factor-beta1 (TGF-beta1) stimulates B lymphocytes to produce and secrete S-IgA. We sought to determine the association between TGF-beta1 polymorphism (T+869C) with susceptibility to Giardiasis. The TGF-beta1 genotypes and levels of salivary (S-IgA) were analysed in individuals with Giardiasis (97 symptomatic and 57 asymptomatic) and controls (n = 92). Individuals with symptomatic Giardiasis had the lowest levels of S-IgA compared to individuals in asymptomatic Giardiasis and control groups (97%, 73% and 43%, <1 g L(-1), respectively, P = 0.002). The frequency of allele C and CC genotypes of TGF-beta1 polymorphism was significantly higher among symptomatic patients than asymptomatic and control groups. Logistic regression analysis demonstrated that the individuals homozygous for allele C of TGF-beta1 had a significantly higher risk for symptomatic Giardiasis with odds ratio of 2.76 (95% CI: 3.88, 1.71, P = 0.007). Among the participants with TT genotype per cent of individuals with S-IgA level of more than 1 g L(-1) was almost twice the percentage in CC genotype individuals (14% versus 7% respectively P = 0.01). Our data suggest that CC genotype of TGF-beta1 polymorphism at codon 10 is associated with occurrence of Giardiasis.

Retention rates of new antiepileptic drugs in localization-related epilepsy: a single-center study

OBJECTIVES

We evaluated long-term retention rates of newer antiepileptic drugs (AED) in adults with localization-related epilepsy retrospectively.

METHODS

We estimated retention rates by Kaplan-Meier method in all 222 patients (age > or = 16) with localization-related epilepsy exposed to new AED at the Tampere University Hospital.

RESULTS

There were 141 patients exposed to lamotrigine, 78 to levetiracetam, 97 to topiramate, 68 to gabapentin, and 69 to tiagabine. Three-year retention rate for lamotrigine was 73.5%, levetiracetam 65.4%, topiramate 64.2%, gabapentin 41.7%, and tiagabine 38.2%. The most common cause for withdrawal of these AED was lack of efficacy.

CONCLUSIONS

Our study suggests that there are clinically significant differences among gabapentin, lamotrigine, levetiracetam, tiagabine, and topiramate as treatment for focal epilepsy in everyday practice. Gabapentin and tiagabine seem to be less useful than the other three AED. Furthermore, our study supports the value of retention rate studies in assessing outcome of the drugs in clinical practice.

Clinical predictors in patients with refractory epilepsy exposed to levetiracetam: a single-center study

OBJECTIVES

This aim of the study was to ascertain the importance of clinical parameters on the response to treatment in refractory epilepsy patients on levetiracetam (LEV).

MATERIALS AND METHODS

We retrospectively evaluated medical records of 132 patients aged 17-78 years with refractory epilepsy (defined as a failure of at least two antiepileptic drugs due to the lack of efficacy) exposed to LEV. We analyzed the response (seizure freedom or continuing LEV) using logistic regression.

RESULTS

Of 132 patients exposed to LEV, 103 cases continued the drug. Of the discontinuations (29/132), 75% were for lack of efficacy and 25% for tolerability problems. Twenty-three percent of the previously refractory patients achieved seizure freedom for at least 1 year with LEV in combination therapy. The dose of LEV in 80% of seizure-free patients was 1000 mg/day or less. The duration of epilepsy, age and sex were not associated with response to LEV. Seizure freedom was associated with epileptic syndrome or etiology. If no specific syndrome was recognized, there was a significantly greater chance for response compared with temporal lobe epilepsy (OR 20.76; 95% CI 2.12-203.61).

CONCLUSIONS

Our study was based on the careful clinical evaluation of the patients with extensive use of video EEG (50%) and MRI scans (95%). These clinical predictors were evasive in previous studies. This study showed that they are worth pursuing but significantly larger groups of patients need to be investigated to reach significant findings.

Seroepidemiology of toxoplasmosis in primigravida women in Hamadan, Islamic Republic of Iran, 2004

We determined the prevalence of Toxoplasma antibodies in 576 primigravid women randomly selected from health houses in Hamadan. The relationship between positivity and some risk factors was assessed. Data were collected by questionnaire and blood samples examined for Toxoplasma antibodies by indirect fluorescent antibody test. Of the 576 women, 193 (33.5%) were positive for Toxoplasma antibodies (titre > or = 1:20). Age, consumption of fresh undercooked meat and frequent consumption of raw vegetables were statistically significantly associated with higher infection rates. Educational level, touching cats, handling raw meat, farming, method of washing vegetables and consumption of raw milk and eggs were not associated with infection.

A Study on the Prevalence of Cryptosporidium in HIV Positive Patients

BACKGROUND

AIDS is acquired by infection with HIV (human immuno-deficiency virus). It leaves the host susceptible to malignant and unusual infections especially opportunistic ones. Most of AIDS patients infected with opportunistic parasitic infections die because of chronic diarrhea and deaths due to Cryptosporidium diarrhea in AIDS patients are considerable in the recent two decades. The aim of this study is to find Cryptosporidium parasite in AIDS patients referring to the center of Diseases consultation in Kermanshah province and to determine the frequency of infection in those patients.

METHODS

In this study stool and blood samples were collected from 75 AIDS patients referring regularly to the Center of Diseases Consultation in Kermanshah and the gathered information were filled in the questionnaires together with their personal information regarding their names, sex and etc. Stool samples were tested using direct and formalin ether methods and then the smears that were dyed using modified acid fast staining were examined. Peripheral blood samples were used to determine the CD4 counts.

RESULTS

The results showed that the frequency of infection with Cryptosporidium in AIDS patients was 26.7% (20 cases).

CONCLUSION

According to the study, as the number of CD4 decreased in the patients, the probability of infection with opportunistic parasites increased and increase in the number CD4 that is normally accompanied with strengthening the body immune system resulted in the decrease in the frequency of infection with Cryptosporidium.