[Effects of oral sodium nitrate administration on cell blood count in obese type 2 diabetic male rats]

Introduction: Type 2 diabetes is one of the most common metabolic diseases. Nitrate has been introduced as a new therapeutic agent for type 2 diabetes. Considering that both diabetes and nitrate have some effects on blood cell count and 30% of diabetic patients have anemia, the aim of this study was to determine the effect of sodium nitrate on blood cell count in obese type 2 diabetic rats

Materials and Methods: Forty-eight male Wistar rats were divided into four groups: Control, Control + nitrate, Diabetes and Diabetes + nitrate. The groups that received nitrate [Control + nitrate, Diabetes + nitrate] again were divided into two subgroups, which received sodium nitrate [100 and 250 mg/L in drinking water] for two months: control+nitrate100 [CN100], control+nitrate 250 [CN250], diabetes+nitrate100 [DN100], and diabetes+nitrate250 [DN250]. Diabetes was induced using a high-fat diet for 14 days and injection of streptozotocin. Blood cell count was performed at the end of the study

Results: In diabetic rats, nitrate administration reduced body weight, blood glucose, hematocrits, and neutrophils [all p<0.05] but increased total number of white blood cells and lymphocytes [p<0.05]. Nitrate administration had no effect on the number of red blood cells, hemoglobin concentration, MCV, MCH, MCHC, or platelet numbers

Conclusion: Administration of sodium nitrate, which is considered as a therapeutic agent in type 2 diabetes, decreased blood glucose in the type 2 diabetic rats but had no major harmful effects on blood parameters; in addition, it may also have anti-inflammatory effects by decreasing the number of neutrophils

[Prevalence and incidence of thyroid dysfunction in individuals aged over 55 years [Tehran thyroid study]]

Introduction: Considering the remarkable increase in life expectancy among older people and lack of data on thyroid diseases in elderly Iranians, this study was designed to determine thyroid dysfunction in people, aged over 55 years

Materials and Method: This study was conducted on 819 Tehranian participants, aged over 55 years from the Tehran Thyroid Study, who were assessed every 3 years for serum free T4 [FT4] and TSH levels and were followed for 10.6 years. Data were analyzed by t test' chi-square test, sig test and cox regression analysis

Results: Mean age of participants was 62.5+/-5.5 years. Of these 712 [86.9%] were euthyroid, 41[5%] had subclinical hypothyroidism [SCH], 19[2.4%] had overt hypothyroidism [OH], 34[4.1%] had subclinical hyperthyroidism and 13[1.5%] overt hyperthyroidism. Overall 13% of participants had thyroid dysfunction. The annual incidence rate of SCH and OH were 8.8 and 7.1 cases per 1000 people respectively. Multivariate regression analysis showed the risk of hypothyroidism in euthyroid people to be affected by TPO positivity [HR=1.9 [CI 95% 1.04-3.5]] and TSH>1.88 mlu/l [HR=8.1 [CI 95% 3.4-19]]

Conclusion: More than one-tenth of aged people have thyroid dysfunction. High TSH and TPO positivity are the most important risk factors of hypothyroidism in elderly people

[Mimetical signs and symptoms of thyroid disorders in healthy pregnant women, a population based study]

Introduction: Although for thyroid disorders are the second most prevalent endocrine abnormalities among reproductive aged women, the signs and symptoms of thyroid disease can often be masked by the physiologic changes of pregnancy. The aim of this study was to identify physiological signs and symptoms common to both pregnancy and thyroid disorders among a community based sample of pregnant women without thyroid dysfunction

Materials and Methods: This population-based cross-sectional study was conducted on 1600 pregnant women. A comprehensive questionnaire including questions regarding the signs and symptoms of thyroid disease was completed for subjects and relevant clinical examinations were conducted. Blood samples were taken and serum thyroxine [T4], T-uptake, thyrotropin [TSH] and thyroid peroxidase antibodies [TPO-Ab] were measured

Results: Of study participants, 63.5% had normal thyroid function. The prevalence of overt hypothyroidism and hyperthyroidism were 3.8%, and 0.8%, respectively and 29.8% of patients had subclinical hypothyroidism. Of pregnant women without thyroid dysfunction, 64.8% had one or more of the signs and symptoms of thyroid disorders. Most common symptoms were fatigue [30.3%], followed by lethargy and drowsiness [20.3%]

Conclusion: Normal physiological changes of pregnancy can mimic some of the signs and symptoms of thyroid disorders. The results indicated that over half of the healthy pregnant women experienced one or more of the signs and symptoms of thyroid disorders during pregnancy. Correct interpretation of signs and symptoms of thyroid dysfunction during normal pregnancy is critical to discriminate between physiologic and pathological changes

Study on the correlation between serum androgens and sexual function in post-menopausal women

Sexual dysfunction could be influenced by menopause and related hormonal changes. The purpose of this study is to examine the correlation between serum levels of androgens and sexual function in post-menopausal women. This is a community-based, descriptive-analytical study involving 405 post-menopausal women, aged 40 to 65 years, who had reached menopause during the three years prior to the study. A multi-stage, randomized sampling was conducted. Data was collected using the Female Sexual Function Index [FSFI] questionnaire, a researcher-made questionnaire, and blood samples were obtained to assess serum levels of androgens [testosterone, DHEAS], SHBG and estradiol. Among subjects, 61% had female sexual dysfunction [FSD]. Total testosterone levels had a negative correlation with scores in the domain of desire [r=-0.108, P=0.029], DHEAS levels were positively correlated with scores in the domain of pain [r=0.113, P=0.022] and the free estradiol index [FEI] was also positively correlated with scores in the domain of pain [r=0.115, P=0.020]. Satisfaction with marital relationship had a significant positive correlation with total testosterone levels [r=0.131, P=0.008] and the free androgen index [FAI] [r=0.100, P=0.044]. Examining the correlation between FSFI scores and hormone levels, multiple regression analysis showed that serum levels of total testosterone and FAI were predicting factors, in the domains of lubrication [P=0.042] and satisfaction [P=0.021] respectively. Androgenic hormones can affect certain aspects of sexual function in post-menopausal women, subject, which, however, requires further investigation

incidence of thyroid dysfunctions in patients with type 2 diabetes: a twelve-year follow-up of the Tehran lipid and glucose study

Undiagnosed thyroid dysfunction may impair metabolic control in patients with diabetes. Due to the lack of adequate studies on the incidence of thyroid dysfunction in patients with type 2 diabetes mellitus there is no consensus regarding optimal thyroid screening strategies in routine diabetes care. The aim of this study was to determine the incidence of thyroid dysfunction in patients with type 2 diabetes. In this study, patients aged >/=30 years, participants of in the prospective Tehran Lipid and Glucose Study, who had complete thyroid assessments were divided into two groups of 428 diabetic and 2847 nondiabetic controls and followed for 12 years. The incidence of thyroid dysfunction in these two groups was compared and the relative risk of type 2 diabetes for thyroid dysfunction was calculated. Compared to those without diabetes the disorders patients with diabetes were less likely to develop thyroid dysfunction [incidence rate 12.56 vs. 16.50 cases per 1000 person-years, Relative risk 0.74, 95% Cl, 0.534-1.026, P=0.071]. The incidence of thyroid dysfunction in type 2 diabetic patients is not higher than in non-diabetic individuals, indicating that routine screening of thyroid dysfunctions is not recommended in type 2 diabetic subjects

[Determination of technical efficiency of intensive care units in hospitals afilliated to Kerman University of Medical Sciences by stochastic frontier analysis in 2008]

Background and Aims: Hospitals are the most important centers that provide health services in the country. They have to use scientific and efficient management at all levels for promoting health. Intensive care units [ICU] are one of the most sensitive parts of the hospitals; therefore, paying attention to its efficiency is of particular importance. The purpose of this paper was to estimate the technical efficiency of intensive care units in teaching hospitals in Kerman, Iran

Methods: This descriptive-analytic study was done in 2009 in Kerman teaching hospitals. Input variables included the number of staff [physicians, nurses and other staff], number of equipments, number of beds and output variables include the percentage of bed occupancy. Data were collected by checklists and forms built by the researchers and were analyzed by applying stochastic frontier analysis [SFA] by the Frontier 4.1 software

Results: The results of stochastic frontier analysis in intensive care unit showed that the capacity to improve efficiency of intensive care units in these hospitals could increase to 21% [compared with the most efficient hospitals in the studied population]. The ICU No. 3 of Bahonar Hospital had the lowest technical efficiency [0.414] in April and maximum technical efficiency was of Afzalipour Hospital intensive care unit in January [0.951]; Moreover, given minor elasticity coefficients indicated that their sum was more than one, and as a result, it showed a rising in productivity scale

Conclusion: Results of analysis of surplus and an additional use of inputs produced in intensive care units suggested that efficiency achieved in August was more than the other months; it is noteworthy that the average of technical efficiency in these sectors has not have a stable process

[Comparison of glucose tolerance in patients with graves disease treated with methimazole with those who have received radioiodine]

One of the major concern of the administration of radioiodine is its complications. Pancras has sodium iodine symporter and may concentrate radioiodine. This study compared glucose tolerance in Graves disease patients on continuous treatment with antithyroid drugs, with those who received radioiodine. Materials and In this study, 132 patients with Graves' disease who relapsed after drug therapy were randomly selected on by the patient preference for long-term treatment with either methimazole or radioactive iodine. In each group, fasting blood sugar, glucose tolerance test, and lipid profiles, TSH, insulin, HOMA-IR and HOMA-B were measured. The two groups showed no significant difference in age sex, BMI and BP. Median FBS and HOMA-IR in the radioactive iodine group were higher than in the methimazole group [94 mg/dl vs. 90 mg/dl, P=0.019] and 1.5[1.2-2.3] vs. 1.3[0.8-2.1, P=0.045, respectively, but after adjustment there was no difference between the two groups; no significant difference was seen in HOMA-B, median two-hour blood glucose and serum insulin levels, between the two groups. Results indicate no relationship between radioactive iodine treatment and glucose intolerance

[Effect of long-term continuous methimazole treatment of thyrotoxicosis: comparison with radioiodine]

The major complication of radioiodine therapy for thyrotoxicosis is hypothyroidism, the long-term management of which is often problematic. In this study, the long-term effects of continuous methimazole [MMI] therapy are investigated. One hundred and thirty-two patients, aged between 36-66 years, with Graves recurrence, were semi randomly randomized in 2 groups for continuous antithyroid and radioiodine treatment. The number of thyroid dysfunctions in each patient were recorded and serum TSH, FT4, Anti TPO, TRAb, FBS, HOMA IR, and lipid profiles were measured. Bone mineral density and echocardiography were performed. There was no significant differences in age, duration of symptoms and thyroid function between the 2 groups. No serious complications occurred in the MMI group and no difference in any of parameters was seen between groups 1 and 2. Goiter rate and anti TPO concentration were higher in group 1 than in group 2. Serum triglycerides and cholesterol were increased in group 2 as compared to group 1. Bone mineral density was more reduced in group 2, especially in the spine. Echocardiography showed diastolic dysfunction in group 2 as compared to group 1. Some parameters in neuro-pschyciatric evaluation were significantly better in the MMI group, as compared to the radioiodine one. Considering it is a safe treatment and has fewer complications, methimazole is another option for patients with recurrent Graves', who do not wish to use radioiodine

[ incidence of subclinical thyroid dysfunction and it's natural course in the Tehranian adults]

The aim of this study was to determine the incidence of thyroid dysfunction and the natural course of subclinical thyroid disorders in the Tehranian community. All individual >/= 20 years, who participated during the first to third phases [6 years, 7 months], of the [Tehran Lipid and Glucose Study] and provided the relevant data were included in this study. Both Tpo-Ab and TSH were measured. In 808 TPO-Ab negative individuals who were not taking any thyroid and anti-thyroid drugs and without a history of thyroid disease, thyroid surgery, goiter and thyroid nodules, mean, median, 2.5, 5, 95, 97.5 percentile TSH were determined. On the basis of 2.5 and 97.5 percentile, normal reference range for TSH was 0.4- 5.8 micro u/mL. In those, whose TSH fell outside the reference range, T3, T4 and T3 uptake were measured and FTI was calculated. In the first stage, 1065 women and 693 men had normal thyroid tests. After 6.7 years the incidence of clinical hypothyroidism was 0.28 in 1000 women and 0.21 in 1000 men, subclinical hypothyroidism was 11.59 in 1000 women and 4.69 in 1000 men, clinical hyperthyroidism was 1.4 in 1000 women and 0.21 in 1000 men, subclinical hyperthyroidism was 5.72 in 1000 women and 3.62 in 1000 men. In this period, increasing positivity of TPO-Ab from 15.9 to 17.7% in women was significant. [P=0.06] In the first stage 8 women had subclinical hypothyroidism, 5 still did on follow-up, one was normal, and one was diagnosed with clinical hypothyroidism. The remaining one was hyperthyroid on levothyroxin. Two women with subclinical hyperthyroidism in the first stage were normal in follow-up, without any treatment. In the first stage 2 men had subclinical hypothyroidism, and in follow-up, one was same, while the other was diagnosed with clinical hypothyroidism. Normal range of TSH was 0.4-5.8 micro u/mL in the Tehranian community. There was significant increase of the frequency of subclinical thyroid disorders in both genders and frequency of clinical hyperthyroidism and TPO-Ab positive in women. Compared to clinical thyroid disorders, the incidence of subclinical thyroid disorders, was more significant

[Prevalence of osteoporosis in rural men of Fars based on both local and WHO reference data]

Recently osteoporosis [OP] has emerged as a basic public health problem. It is characterized by low bone mass with micro architectural destruction of bone, resulting in increased bone fractures, morbidity and mortality. To evaluate the prevalence of OP using the local reference data of rural males of Fars and to compare it with WHO criteria, a total of 263 male adults, aged between 2-94 yrs, participated in this cross-sectional study. Bone Mineral Density [BMD] was measured by DXA. We utilized a fit curve method to determine the best age range over which to calculate Peak Bone Mass [PBM] and we used regression analysis for association of OP with age and Body mass index [BMI]. PBM was observed at the age range of 20-24 years, at the various sites. The prevalence of OP increased with age. It was negatively correlated with BMI and varied dramatically based on local versus WHO criteria. Based on local criteria, prevalence of OP in the lumbar spine, femoral neck and total femur were 3.8%, 24.8% and 14.8%, respectively, and based on WHO criteria, they were 10%, 6.1% and 24%, respectively. Using local or WHO reference values for evaluation of OP may yield different prevalences. Therefore prospective fracture studies in correlation with the two above reference values are recommended

Effects of maternal postpartum thyroiditis on thyroid function, intelligence quotient and cognitive development of their offspring

The effect of thyroid hormones on all stages of the development of central nervous system has been documented in different studies. Postpartum thyroiditis [PPT] is associated with high titers of TPO-Ab during pregnancy. Thyroid autoimmunity in pregnancy results in reduction of serum free thyroxin level, even in the presence of normal thyroid function. This study was conducted to evaluate the effect of PPT on the thyroid function and cognitive development of the offspring. Materials and Methods: In this prospective cohort study, conducted between December 2007 and March 2008, children born to mothers who had developed postpartum thyroiditis after delivery and those mothers who had not, were included in this study. Blood and urine samples were obtained from all children and blood samples were drawn from their mothers. All children underwent 7 cognitive tests in a clinical psychology laboratory. Results: We enrolled 124 children for the study, 55 cases [children of mothers with PPT] and 69 controls [children of mothers without PPT]. Average age of cases was 9.5 +/- 1.4 and in controls was 9.4 +/- 0.1 [P=0.2]. No difference was noted between the two groups for baseline characteristics which might have affected their neurodevelopment. Mean scores for total IQ, performance IQ, and verbal IQ in cases and controls were as follows: 115 +/- 10 vs. 116 +/- 12, 113 +/- 11 vs. 116 +/- 12, and 113 +/- 12 vs. 113 +/- 13, respectively [P=0.5]. There was no difference between the results of the other tests [CPT, WCST, PRM Test, SWM Test, MFVP Test, SOC] in the two groups. No difference was noted between the thyroid function of the two groups. Conclusion: Prevalence of goiter, thyroid function, cognitive development, and intelligence quotient of children born to mothers who later develop postpartum thyroiditis are similar to those of normal children. Postpartum thyroiditis in mother is not a threat for the newborn

[Relationship between maternal hypothyroidism during pregnancy and intellectual development of offspring]

Children who were born from untreated hypothyroid mothers, have lower intelligence quotient [IQ] levels in school age in comparison with same age group. Nonetheless, the effect of hypothyroidism, especially subclinical form on fetal neuronal cell growth and subsequent imprints on intelligence and learning are unclear. This study was designed to evaluate intellectual development of children of mothers who had hypothyroidism, especially subclinical type during their pregnancies. In this historical cohort study, out of 441 hypothyroid women, 90 patients with 106 pregnancies were reviewed. 44 children were enrolled in this study. They were divided to case [N=25] and control groups [N=19] according to the maternal TSH level during pregnancy. For all children serum TSH and free T4 were measured by radioimmunoassay and urine Iodine concentration was assayed by acid digestion method. IQ level and cognitive performance of all children were also evaluated. The basic characteristics of children except maternal TSH and 14 were the same between two groups. The age range of children was 4-14.5 years. All laboratory parameters [TSH, free T4 and urinary iodine] were similar in two groups. There was no significant difference in IQ level and cognitive performance between two groups. Using Pearson correlation test, except mother education level and neonatal weight there were no relationship between variables and IQ level. This study showed that IQ level and cognitive performance in children who were born from sub clinical hypothyroid mothers are similar to control group

Improvement in prediction of incident type 2 diabetes using the 2003 criteria of impaired fasting glucose: results from a population-based 6.5-year follow-up study in Iran

To investigate whether using the 2003 criteria for impaired fasting glucose [IFG] improves the prediction of Type 2 diabetes mellitus [T2DM] in comparison to the 1997 criteria. A total of 5794 non-diabetic subjects, aged 42 +/- 13 years, were followed for 6.5 years. T2DM was defined based on the WHO 1999 criteria. Cox regression analysis was used to calculate the relative- risk [RR] of developing T2DM. Model discrimination was assessed by calculating the area under the receiver operating characteristic curve [AUC]. During the follow-up, there were 351 new cases of T2DM. In univariate analysis, the RR of the 1997 and 2003 criteria were 9.6 [7.5-12.3] and 8.4 [6.4-10.0] respectively. After adjustment for a full range of diabetes risk factors, the RR of the 2003 criteria was higher compared to that of the 1997 definition [RR [95%CI]: 3.3 [2.6-4.2] vs. 2.4 [1.8-3.2] respectively]. Inclusion of the 2003 criteria in the multivariate model significantly improved discrimination in comparison to the 1997 definition [AUC [95%CI]: 0.78 [0.74-0.83] vs. 0.74 [0.70-0.79], P<0.01]. When fasting glucose is used in community screening for pre-diabetes state, the 2003 IDF criteria yield significantly better results than the original criteria for prediction of future T2DM

[Role of C - reactive protein in prediction of type 2 diabetes: Tehran lipid and glucose study]

Several studies suggest that CRP plays a role in the pathogenesis of diabetes in adults. We tested the hypothesis that elevated levels of CRP at baseline can predict later onset of type 2 diabetes mellitus. In a nested case-control study, serum level of CRP was measured from stored samples of 73 control and 80 cases from among participants of the Tehran Lipid Glucose Study, who had been followed for 3.6 years. In age adjusted model, levels of CRP were associated with an increased risk of type2 diabetes, OR 3/6 [95% Cl: 1.5 - 8.2] for tertile 3 versus 1, p.001. However in multivariate analysis the association between CRP and type 2 diabetes was significantly decreased after adjustment for fasting plasma glucose, body mass index, family history of diabetes, HOMA-IR, OR .8 [95% Cl: 0.2 - 2.8] for tertile 3 versus 1, p 0.7. Elevated levels of CRP were associated with an increased risk of type 2 diabetes; however, the association was not independent of other diabetes risk factors, including fasting plasma glucose, body mass index, HOMA-IR and family history of diabetes

[Prevalence of obesity in subjects aged 50 years and over in Tehran]

Overweight and obesity are major health problems affecting communities worldwide and the prevalence is rapidly rising. Although the prevalence of obesity in Iran has been reported, there are no data available on the prevalence of these factors in individuals aged over 50 years, individuals who are naturally more prone to cardiovascular diseases and death. This study aims at determining the prevalence of overweight and obesity in this high risk age group. In this investigation, data for 3391 individuals aged >/= 50 y, participants of the Tehran Lipid and Glucose study, was collected and assessed. Overall 1566 men [46.2%] and 1825 women [53.8%] were studied. The mean age for women was 59.8 +/- 7.2y and that for men was 62 +/- 7.9y. Average weight for males was 73 +/- 11.9 kg. and for females was 68.6 +/- 11.8 kg. On the whole prevalence of abnormal BMI [>/= 25 kg/mg2] was 73.3% [CI 95%, 71.8-74.8%]; of these 44.1% [CI 95%, 42.4-45.8%] were overweight and 29.2% [CI 95%, 27.7-30.8%] were obese. Percentages for overweight were 82% and 63.2% for women and men respectively. To conclude the prevalence of obesity and overweight in those aged over 50 years are rapidly rising. It is highly recommended that interventions for lifestyle changes be implemented in this high risk age group

[Population attribtable risk for diabetes associated to obesity in Iranian adults]

Excess weight is a well known risk factor for Type 2 diabetes mellitus. Several studies have estimated the population attributable risk of diabetes associated with overweight and obesity in developed countries. However, little evidence exists regarding the contribution of excess weight to diabetes in the Middle East countries. This study aimed at quantification of the impact of overweight and obesity on a population level in Iran. Using data of a population-based short-term cohort study in Iran, which began in 1998 with 3.6-year follow-up, we calculated the adjusted odds ratios [OR] and population attributable risks [PAR] of developing diabetes, i.e. the proportion of diabetes that would have been avoided had overweight and/or obesity not been present in the population. Results: Of the 4728 subjects studied, during the 3.6- year follow-up period, 3.5% [n=164] developed diabetes. This proportion was 1.3%, 3.2%, and 7.0% for the normal, overweight, and obese subjects, respectively. When compared to normal BMI, the adjusted ORs for incident diabetes were 1.78 [95% confidence interval [CI] 1.05 to 3.02] for overweight and 3.61 [95% CI 2.13-6.10] for obesity. The adjusted-PAR was 23.8% for overweight and 37.6% for obesity. Relatively feasible lifestyle changes of preventing overweight and obesity could substantially lower population diabetes incidence

[Association of apolipoprotein E gene polymorphism and obesity in an Iranian population: Tehran Lipid and Glucose study]

The Apo E is one of the genes, which play a role in the regulation of lipid metabolism, especially in obesity. In other studies a common Apo E polymorphism has been shown to be associated with obesity, and in the present study our aim is to determine this association in an Iranian population. Subjects were randomly selected from the Tehran Lipid and Glucose Study and classified into 3 in three groups according to their body mass index: BMI<25, 25.BMI<30, BMI.30 and finally 429[150 in men and 179 in women]. We measured FBS, HDL-C, triglyceride, cholesterol levels and blood pressure for all individuals. A segment of the mentioned gene with PCR was amplified and the polymorphism with RFLP [HhaI] revealed. The allele frequency of Apo E polymorphism was in the Hardy Weinberg equilibrium and the allele frequency was e2 [0.065], e3 [0.851] and e4 [0.083]; there was no relation between BMI and the frequency of this allele. These results show that there is no relation between Apo E polymorphism and BMI in this study

[C-Reactive protein in risk prediction of cardiovascular outcomes:Tehran lipid and glucose study]

The main aim of this study was to evaluate the utility of C-reactive protein [CRP] in risk prediction of cardiovascular outcomes. In a nested case-control study, 207 cardiovascular events among participants over 30 years of the Tehran Lipid and Glucose Study [TLGS] were documented during 3 years of follow up. Cases that were free of cardiovascular disease at baseline [126 subjects] were matched to 259 normal controls for age and sex. High sensitivity CRP and traditional cardiovascular risk factors were measured at baseline. Modest correlation was found between CRP and body mass index [r=0.34], waist-to-hip ratio [r=0.22], total cholesterol [r=0.24] and calculated 10-year Framingham coronary risk score [FRS] [r=0.27] [all P values <0.001]. The age and sex adjusted relative risk of cardiovascular events for subjects in the highest quartile of the population distribution of CRP when compared with the lowest quartile was 2.6 [95% CI=1.4-5.1, P=0.006]. After additional adjustment for traditional cardiovascular risk factors the odds ratio decreased to non-significant levels [0.8,95% CI=0.3-1.9]. Addition of CRP did not improve the area under receiver operating characteristic curve of risk functions that was based on traditional cardiovascular risk factors or FRS. It is concluded that for short-term prediction of cardiovascular outcomes in the Iranian population, when traditional cardiovascular risk factors are known measurement of CRP has no additional value

[Carcinoid tumor of trachea: a case report]

Carcinoid Tumor in trachea is rare, and in 25% are asymptomatic. Cough is the most common symptom and some times have similar symptoms such as chronic obstructive pulmonary disease. The best method of treatment is surgical resection and recurrency after resection is rare. In this study we report a 47 year's old man with chronic cough and dyspnea that treated with bronchodilator as COPD but without recovery. In evaluation with chest X. Ray, CT scan and bronchoscopy carcinoid tumor was diagnosed and surgical resection performed.There was no recurrency or complication in 5 years follow-up

[Anticardiolipin antibody in type I diabetic patients]

Type 1 diabetes mellitus is an autoimmune disorder which is associated with different organ specific autontibodies including anticardiolipin antibody [ACLA]. The association of ACLA with diabetes has not been widely reported. The aim of this study was to determine the prevalence of ACLA IgG and IgM and evaluation of their possible association with other auto-antibodies, duration of disease and status of control of blood glucose in type 1 diabetes patients. In a cross sectional study, 48 patients with type 1 diabetes in Bandar Abbas were compared with 41 age and sex matched healthy persons for the presence of ACLA [IgG and IgM], Rheumatoid Factor [RF] and Anti Nuclear Antibody. The mean age of diabetic patients was 20/5 +/- 10 years. High titers of ACLA [IgG and/or IgM] were more common in type 1 diabetic patients than in healthy controls [18% vs. 0%, p<0.01] with no significant difference between males and females [4 and 12% respectively]. Unlike ACLA IgG, the mean value of serum ACLA IgM was significantly higher in type 1 diabetic patients than in controls [6.8 +/- 2.8 vs. 4.5 +/- 2.4 GPLU/ml]. Among type 1 diabetic patients, those with high titers of ACLA [ACLA+] were older and had higher age of onset of diabetes than those with normal titers, but there were no difference in duration of diabetes or level of HbA1c between them. No significant difference was observed in the prevalence of ACLA+or the mean values of ACLA IgG and IgM between recently [<1 years] and previously [>1 years] diagnosed diabetic patients. ACLA+patients were also more likely to show positive RF than the ACLA-group[25 vs. 0%]. The relatively high prevalence of ACLA [+] in type 1 diabetic patients and its association with other autoantibodies may reflect an abnormal immunologic response in some stages of type 1 diabetes. ACLA might be added to the list of autoantibodies that should be measured in type 1 diabetes patients