Activation toll-like receptor7 [TLR7] responsiveness associated with mitogen- activated protein kinase [MAPK] activation in HIOEC cell line of oral squamous cell carcinoma

Statement of the Problem: Oral squamous cell carcinoma is the most common oral malignancy. Toll-like receptor [TLR] activation led to alterations in the levels of mRNA encoding the TLR accountable for recognizing the inducing agonist and cross-regulation of other TLR

Purpose: The purpose of this study is determination of mitogen-associated protein kinase [MAPK] activation in human immortalized oral epithelial cell [HIOEC] line via up regulating of TLR7

Materials and Method: expression of TLR7 was measured in HIOEC and normal cells by quantitative real-time polymerase chain reaction [qRT-PCR] and samples were calibrated by Beta-actin

Results: Western blot analysis discovered high expression of TLR7 and MAPK in HIOEC cell lines. TLR7 was over-expressed in HIOEC cell line. Imiquimod-induced expression of interleukin [IL]-6, IL-8, and vascular endothelial growth factor [VEGF] was inhibited by TLR7 siRNA in HIOEC cells as determined by reverse transcription polymerase chain reaction [RT-PCR]. Mean fluorescence intensity of nuclear p38 expression was determined in HIOEC cell lines [p< 0.05]. RT-PCR analysis of IL-6, IL-8, and VEGF mRNA expression in HIOEC cells stimulated with imiquimod [1 Mug/ml] for indicated time points

Conclusion: TLR7 is functionally over-expressed in HIOEC cell line of oral squamous cell carcinoma and development of resistance to cisplatin in human oral squamous cell carcinoma might occur through the mechanism involving activation of TLR7 and its dependent signaling pathway

Clinical features and antimicrobial resistance of bacterial agents of ventilator-associated tracheobronchitis in Hamedan, Iran

Objectives: Ventilator-associated tracheobronchitis [VAT] is a common cause of mortality and morbidity in patients admitted to intensive care units [ICUs]. This study was conducted to evaluate the clinical course, etiology, and antimicrobial resistance of bacterial agents of VAT in ICUs in Hamedan, Iran

Methods: During a 12-month period, all patients with VAT in a medical and a surgical ICU were included. The criteria for the diagnosis of VAT were fever, mucus production, a positive culture of tracheal secretions, and the absence of lung infiltration. Clinical course, including changes in temperature and tracheal secretions, and outcomes were followed. The endotracheal aspirates were cultured on blood agar and chocolate agar, and antimicrobial susceptibility testing of isolates were performed using the disk diffusion method

Results: Of the 1 070 ICU patients, 69 [6.4%] were diagnosed with VAT. The mean interval between the patient's intubation and the onset of symptoms was 4.7+/-8.5 days. The mean duration of response to treatment was 4.9+/-4.7 days. A total of 23 patients [33.3%] progressed to ventilator-associated pneumonia [VAP], and 38 patients [55.0%] died. The most prevalent bacterial isolates included Acinetobacter baumannii [24.6%], Pseudomonas aeruginosa [20.2%], and Enterobacter [13.0%]. P. aeruginosa and Enterobacter were the most prevalent bacteria in surgical ICU, and A. baumannii and K. pneumoniae were the most common in the medical ICU. All A. baumannii and Citrobacter species were multidrug-resistant [MDR]. MDR pathogens were more prevalent in medical ICU compared to surgical ICU [p < 0.001]

Conclusions: VAT increases the rates of progression to VAP, the need for tracheostomy, and the incidence of mortality in ICUs. Most bacterial agents of VAT are MDR. Preventive policies for VAP, including the use of ventilator care bundle, and appropriate empirical antibiotic therapy for VAT may reduce the incidence of VAP

Disposition of lead [Pb] in brain of rats following oral exposure to lipstick

Information about the health risks that might be associated with lipstick consumption effects is scarce in the literature. The present work investigated the bioaccumulation of lead [Pb] in brain of rats originated from lipstick sample. First, Lead contents were determined in 12 different brands of lipsticks. Lead was detected in all the studied samples. The average lead content in 14 lipsticks samples was 12.2 PPM wet wt. Then, one brand was selected for feeding to the rats and amount of oral exposing in the three doses was calculated. Sixty rats were used for the experiment. Animals were divided into 4 groups of 15 animals each. While 1group served as control group, the remaining 3 groups were exposed to lipstick through oral gavage for 12 weeks. Results show that, exposure to the lipstick cause significantly disposition of lead in the brain of rats

Seroprevalence of Bordetella pertussis antibody in pregnant women in Iran

The increasing incidence of pertussis among adolescents and adults in recent years is an alarming factor in transmission of the infection to non-immune infants and children. Vaccination of pregnant women, immediately after delivery and before being discharged from the hospital may help to protect mothers and their newborns against the disease. Decision making process, regarding maternal immunization, requires credible information and knowledge about seroepidemiology of the infection in pregnant women. The aim of this study was to determine the seroprevalence of Bordetella pertussis antibody among admitted pregnant women in Hamadan, western Iran. In this cross-sectional study, 288 pregnant women admitted to the Fatemiyeh Hospital, Hamadan, western Iran, were enrolled into the study. After obtaining consent from every patient, serum samples were taken from patients and were kept frozen until testing. Serum level of B. pertussis antibody was measured using ELISA. Level of antibody higher than 24 U/ml was considered positive. The obtained data were analyzed using the statistical software SPSS. From 288 pregnant women, 126 [43.8%] were in their second trimester. Serological results in 103 patients [35.8%] were positive. The mean age of mothers with positive serology was 27.5 +/- 6 years old. Thirty-five percent of patients had a valid immunization record, and 1.57% of those with no vaccination record had a positive serology. The level of immunity against B. pertussis in pregnant women was low. Immunization before or during pregnancy can stimulate newborn's immune response and gives them required protection against pertussis infection

prevalence of antibiotic resistance of Enterobacteriaceae strains isolated in community- and hospital-acquired infections in teaching hospitals of Hamadan, west of Iran

The prevalence of antimicrobial resistance among Enterobacteriaceae is increasing worldwide. Identification of pathogens and their resistance to antimicrobials is mandatory for successful empiric antibiotic treatment. The aim of this study was to investigate the prevalence of antimicrobial resistance of Enterobacteriaceae isolated from hospital-acquired and community-acquired infections. In a descriptive-comparative study, during 2010, all clinical isolates of Enterobacteriaceae and their antibiograms from laboratories of Sina and Bessat Hospitals, Hamadan, west of Iran were included. Hospital-acquired infections were identified by records from infection-control units. A questionnaire containing information about demographic characteristics, source of specimen, kind of En-terobacteriaceae and their antimicrobial resistance was filled for each patient. Data were analysed using SPSS. A total of 574 samples were collected, out of which the most prevalent pathogens were Escherichia coli and Klebsiella pneumoniae. Almost all isolates of Enterobacteriaceae were resistant to ampicillin [98.8%], and the least resistance was to piperacillin [3.7%]. In addition, most isolates were resistant to cefazolin, cefixime, and co-trimoxazole. Among third generation cephalosporins, the highest resistance to ceftriaxone and the least resistance to ceftizoxime were observed. 19.3% of isolates were resistant to imipenem. In terms of fluroquinolones, nosocomial infections and community acquired infections were resisitant to ciprofloxacin 33% and 4.1% respectively. The rate of resistance in nosocomial infections was higher than that of community-acquired infections. The prevalence of multidrug resistant Enterobacteriaceae is increasing both in community-acquired and hospital-acquired infections. Because of propable increasing resistance to fluoro-quinolones and newer betalactams, reassessment of resistance of Enterobacteriaceae must continue in future years

Prevalence and antibiotic resistance patterns of diarrheagenic Escherichia coli isolated from adolescents and adults in Hamedan, Western Iran

Pathogenic strains of Escherichia coli are a common cause of acute infectious diarrhea. The aim of this study was to investigate the frequency, virulence markers and antibiotic resistance patterns of diarrheagenic E. coli [DEC] isolated from adolescents and adults in Hamadan, west of Iran. A total of 187 stool samples were collected from adults with acute diarrhea. Stool culture was performed by conventional methods for enteropathogenic bacteria. Virulence factor genes for DEC were detected by polymerase chain reaction. Antimicrobial susceptibility was tested using the disk diffusion method. Among the 187 patients, 40 [21.4%] were positive for DEC. The most frequently identified DEC was enteropathogenic E. coli [47.5%], followed by enteroaggregative [20%], enterotoxigenic [17.5%] and shiga-toxin producing E. coli [15%]. No isolates of enteroinvasive E. coli were detected. All STEC strains were stx[+] / eaeA[-]. Out of the seven ETEC strains, five [71.4%] produced ST, one [14.3%] produced only LT and one [14.3%] of the isolates produced both ST and LT encoded by est and elt genes, respectively. Among the 40 DEC strains 27[67.5%] were multidrug resistant. DEC contribute to the burden of diarrhea in adults in Hamadan. Enteropathogenic E. coli was the most commonly identified DEC strain in the region studied

Evaluation of fibronectin and c-reactive protein levels in patients with sepsis: a case-control study

Sepsis is a significant health problem with an estimated 750,000 new cases in the USA annually. It is also the third leading cause of death in developed countries, equaling the number of fatalities from acute myocardial infarction. The high sepsis-related mortalities mean there is an urgent need to improve the diagnosis and management of sepsis patients. The aim of this study was the evaluation of fibronectin and C-reactive protein [CRP] plasma levels in patients with sepsis and other infectious diseases without sepsis. In a case-control study, 90 patients with sepsis and 90 patients with other infectious diseases without sepsis were studied. Serum levels of fibronectin and CRP were measured. The data were analyzed by SPSS version 15. The mean levels of fibronectin in the cases and controls were 288.97 +/- 89.10 mg/l and 341.24 +/- 110.53 mg/l respectively [P=0.001]. The mean levels of CRP in the cases and controls were 89.42 +/- 54.05 micro g/ml and 27.42 +/- 25.89 micro g/ml respectively [P<0.001]. Concerning the source of infection, the mean CRP levels were significantly higher in septic patients with urinary tract infection, pneumonia, and soft tissue infection [P<0.001]. Decreased levels of fibronectin and increased levels of CRP may be considered as reliable diagnostic markers for sepsis. Also, CRP could be a better predictive factor for sepsis than fibronectin

Effect of vitamin C administration on leukocyte vitamin C level and severity of bronchial asthma

Oxidative stress mediated by reactive oxygen species is known to contribute to the inflammatory process of bronchial asthma. Reactive oxygen species are released into the bronchial tree by activated inflammatory cells. In this study, we aimed to determine the effect of vitamin C administration on leukocyte vitamin C level as well as severity of asthma. In this double blind clinical trial study we evaluated 60 patients with chronic stable asthma. The patients were divided into two groups [A and B] including 30 patients in each group. Patients in these groups were matched according to their age, weight, height, gender, BMI and drug consumption. In addition to standard asthma treatment [according to stepwise therapy in 4[th] step of bronchial asthma] in which the patients were controlled appropriately, group A received 1000 mg vitamin C daily and group B received placebo. At the baseline and after one month treatment, non-fasting blood samples were drawn for laboratory evaluations. Asthmatic patient's clinical condition was evaluated through standard pulmonary function test [PFT]. The mean [ +/- SD] leukocyte vitamin C level in group A at the baseline and after one month treatment with 1000 mg/day vitamin C, were 0.0903 [ +/- 0.0787] microg/10[8] leukocytes and 0.1400 [ +/- 0.0953] microg/10[8] leukocytes respectively [P<0.05]. The mean [ +/- SD] leukocyte vitamin C level in group B at the baseline and after one month administration of placebo, were 0.0867 [ +/- 0.0629] microg/10[8] leukocytes and 0.0805[ +/- 0.0736] microg/10[8] leukocytes respectively. The leukocyte vitamin C level in group A was higher than those of group B after one month treatment with vitamin C and placebo and the difference was statistically significant [P<0.05]. Comparing PFT [FEV[1], FVC and FEV1/FVC] in group B during the study period showed a significant increase in FEV[1] [P<0.05], while the other two parameters remained unchanged. In group A, who received 1000 mg/day vitamin C, none of the spirometry parameters changed after one month treatment, indicating no effect of vitamin C treatment in the spirometry parameters

Relationship between Helicobacter pylori infection and chronic obstructive pulmonary disease

There is some evidence indicating the role of Helicobacter pylori infection in pathogenesis of extragastrointestinal diseases including skin, vascular, and autoimmune disorders, as well as some respiratory diseases. The aim of this study was to investigate the association between H. pylori and chronic obstructive pulmonary disease [COPD]. In a case-control study, 90 patients with COPD and 90 age-and sex-matched control subjects were included. Serum samples were tested for anti-H. pylori and anti-CagA IgG by ELISA. A physician completed a questionnaire including demographic characteristics, habitual history, and spirometric findings for each patient. Of 90 patients with COPD 66 [51%] had mild, 31 [34.4%] moderate, and 13 [14.4%] sever disease. There was no significant association between H. pylori IgG seropositivity and COPD. Serum levels of anti-CagA IgG were significantly higher in patients with COPD than in the control subjects [P<0.001]. No association was observed between H. pylori infection and severity of COPD. The results suggest that there is an association between CagA-positive H. pylori infections and COPD. Further studies should be planned to investigate the potential pathogenic mechanisms that might underlie these associations

Nosocomial bacterial infections and their antimicrobial resistance paterns in university hospitals of Hamedan, Iran

Nosocomial infections constitute a global health problem, leading to a high rate of morbidity and mortality. The aim of this study was to determine the frequency and antimicrobial resistance patterns of nosocomial infections in educational hospitals of Hamadan, western, Iran. During a 1-year period from April 2006 to March 2007, all patients with culture-proven nosocomial infections from educational hospitals in Hamedan, western Iran were included. Nosocomial infections were defined as a culture-proven infection, which occurred more than 48h after admission in the hospital. Antimicrobial susceptibility testing of isolated bacteria was performed by disc diffusion method. A total of 170 cases of culture-proven nosocomial infections were diagnosed. Most cases were in intensive care units [ICUs] [57.4%]. The common sites of infection were lower respiratory tract [51.8%] and urinary tract [31.9%]. Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli, were the most prevalent pathogens [32.7%, 22.9%, and 14.8% respectively]. Most enterobacteriacea isolates were resistant to third generation cephalosporins. The resistant rates to ceftriaxone were 75.5% for K. pneumoniae, and 76% for E. coli. Among P. aeruginosa isolates, 26.5% were resistant to ceftazidim, and 36% to ciprofloxacin. Among S. aureus isolates, 80% were methicillin-resistant. The patients in the ICUs are at a higher risk of nosocomial infections. The high prevalence of antimicrobial resistance in the hospitals highlights the need of further infection control activities and surveillance programs

Screening for tuberculosis among patients with chronic psychiatric disorders in Hamedan

Tubercle bacilli most often are transmitted from one person by the airborne route. The aim of the present study was to determine the frequency of latent tuberculosis infection and active pulmonary tuberculosis among patients with chronic psychiatric disorders in Hamedan. In a cross sectional study, 215 patients with chronic psychiatric disorders were investigated for tuberculin skin test. Those with an induration of >/= 10 mm were introduced for further evaluation, including a chest-x-ray and examination of the sputum for acid-fast bacilli for those with radiographic abnormalities. Of 215 patients, 62 [28.8%] had positive tuberculin skin test reaction. Age and duration of psychiatric disorders were significantly associated with test positivity. Of 62 tuberculin-positive patients, 25 [40.3%] had radiographic evidences of inactive pulmonary tuberculosis. None of them had positive sputum smear for tuberculosis. Chronic psychiatric patients are more susceptible to tuberculosis infection. Screening tests should be applied for these patients

E-selectin S128R polymorphism leads to severe asthma

The E-selectin mediates the interaction of activated endothelial cells with leukocytes and plays a fundamental role in the pathogenesis of asthma. It has been suggested that an S/R [Serine128 Arginine] polymorphism of E-selectin alters ligand binding function. Our purpose in this study was to determine whether this Serine128 Arginine polymorphism influences the risk of asthma and also to analyze the possible correlation of disease severity in Iranian patients with polymorphism of E-selectin. We studied human E-selectin gene polymorphism in 172 asthmatic patients and 173 healthy volunteers by polymerase chain reaction-restriction fragment length polymorphism [PCR-RFLP]. To determine the severity of the asthma's situation, a questionnaire was prepared requesting the following information: age, sex, clinical signs and symptoms and past medical history. After the participants filled in the questionnaire, all active or ex-smoker patients were excluded. A trained observer assessed airway reversibility, peak flowmetry and spirometry in asthmatic patients. We found increased serum levels of soluble E-selectin [sE-selectin] in asthmatic patients compared with healthy subjects [P <0.0001]. Frequencies of the SS, SR, and RR genotypes were found as 66.3%, 31.4%, and 2.3% in the patients and 91.9%, 8.1%, and 0.0% in control subjects, respectively. The 128 Arg allele was more prevalent in patients than controls [OR 5.78; 95% CI, 3.07-10.86, P<0.0001]. However, in this study the polymorphism was not associated with circulating sE-selectin levels. We found a direct correlation between the level of sE-selectin and the severity of asthma [P=0.001]. On the other hand, there was a close relation between 128 Arginine carriage and disease severity [P<0.0001]. These results suggest that the Ser 128 Arg polymorphism of the E-selectin gene is a genetic factor that may be associated with the severity of asthma

epidemiology of burn wound infections in patients hospitalized in burn center of Hamedan, Western Iran

A total of 465 burned patients with wound infections who admitted to referral burns center of Hamedan Imam Khomeiny hospital from July 1998 to June 2001 were retrospectively studied. The required data including age, sex, season, causes of burns, burn size of wounds and types of organisms isolated from patients [wounds and blood], was recorded in a questionnaire. The susceptibility of the isolates to eight routine antibiotics was tested by disc diffusion method.The data was analyzed by SPSS and EP16 software package. Out of 465 burn wound infections 73.1% of isolates were Gram-negative bacilli and 26.9% were Gram-positive cocci. Pseudomonas aeruginosa [32.7%], Klebsiella pneumoniae [21.8%] and Staphylococcus aureus [21.2%] were the most common isolates. In 28.7% of patients, blood culture became positive, Klebsiella pneumoniae [30.4%], Pseudomonas aeruginosa [26.9%], were predominant isolates. 57.3% of patients were males and the most frequency of burn patients belonged to age group 0-9 years old [28.6%], most of the burns occurred during summer. Boiled water, fuel oil flames and firewood flames were the commonest causative agent for burns, respectively. The most effective antibiotics against isolates were ciprofloxacin, ceftizoxime, amikacin and gentamicin, while most of isolates showed high resistance to ampicillin, tetracycline and carbenicillin. Present results indicated that Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus were predominant isolates with high resistance to tested antibiotics. These data can be used to evaluate the effects of changes in burn treatment and antimicrobial resistance development in relation to antibiotic usage