Coronary Artery Calcium Score and Bone Metabolism: A Pilot Study in Postmenopausal Women

BACKGROUND: Since 1991 many studies evaluated the link between cardiovascular diseases and osteoporosis, two age-related conditions, but the main common pathologic pathway has not been determined yet. The histological similarity between arterial calcified plaque and bone matrix and involvement of similar cells and mediators provide a special field of research. Therefore in the present study, we aimed to evaluate the relationship between coronary artery calcium score (CACS) as a surrogate marker of atherosclerosis and bone mediators and parameters in postmenopausal women. METHODS: Eleven postmenopausal women who had CACS higher than 80 were enrolled into the study and underwent bone densitometry. In addition, their serum and urine samples were taken for measuring osteoprotegerin, osteocalcin, and β cross laps. Patients' 10-year probability of fracture was calculated by the World Health Organization fracture-risk assessment tool (FRAX). RESULTS: The regression analysis of our results showed the association between CACS and OC (std β=0.66, 95% confidence interval [CI] 5.47-72.27, P=0.027), femoral bone density (std β=−0.6, 95% CI -6864.34-14.27, P=0.05) and T-score (std β=−0.6, 95% CI −773.08-1.28, P=0.05) which remained significant after adjustment for age, weight, years since menopause and body mass index. No association was found between CACS and osteoprotegerin, spinal bone density and FRAX score. CONCLUSIONS: In conclusion, this pilot study with small sample size showed the potential association between CACS and osteocalcin, femoral bone density and T-score. However, the relationship between CACS and osteoprotegerin, receptor activator of nuclear factor-kappa B ligand, FRAX score and other bone parameters remain to be clarified in larger sample size studies.

[Association of school children's overweight and obesity with maternal overweight and obesity in the rural areas]

Background and Aim: Childhood obesity is one of the most important health problems in developed and developing countries that may result from the parents' overweight. This study aimed to compare the status of obesity and overweight in the children of overweight or obese mothers with the children whose mothers were not overweight or obese

Material and Methods: In this cross-sectional study, 249 elementary-school children from Bijar, Kordestan, Iran were selected using simple random sampling. Children's food intake and physical activities and mothers' and children's anthropometric [weight and height] indices were measured by standard method. The relationship between overweight or obesity of the mothers with overweight or obesity of the children was assessed and analyzed by logistic regression

Results: Body mass index [P value < 0.01] and maternal age [P value<0.01] were significantly higher in the children of overweight or obese mothers compared to children whose mothers were not overweight or obese. No significant differences were found between the two groups of children in regard to energy intake, physical activity, and consumption of the main food groups. Overweight or obesity of the mothers significantly increased the risk of overweight or obesity in the children after adjustment for age, sex, physical activity, energy intake, and maternal age. [Odds ratio: 3.00, P value = 0.04]

Conclusion: According to the results of this study, overweight or obesity of the mother can be associated with the likelihood of overweight and obesity in the school age children in rural areas and this relationship is independent of energy intake, physical activity, and consumption of different food groups

Epidemiological profile of hepatitis B virus infection in Iran in the past 25 years; a systematic review and meta-analysis of general population studies

Background: Chronic hepatitis B virus [HBV] infection is one of the most important health problems worldwide with a high rate of morbidity and mortality. It is a major risk factor for cirrhosis and liver cancer. Currently, Iran is located in the intermediate HBV zone; however, recent studies have provided some evidence indicating an epidemiological change in the country. The aim of this study was to estimate the prevalence of HBV in Iran

Methods: A systematic review was conducted to evaluate the studies performed in the past 25 years that have reported the prevalence of HBV infection and its associated factors in the Iranian general population [1990-2014]. Any study assessing and reporting serum Hbs Ag levels was included in this review

Results: After excluding all impertinent studies, 19 eligible studies were included in the analysis. The overall prevalence of HBV was 3% [95% CI 2% to 3%]. Its distribution showed that the prevalence of HBV varies in different provinces from 0.87% to 8.86%. The HBV rate was highest in the Golestan [8.86%] and lowest in the Kurdistan [0.87%] provinces

Conclusion: This study provides some evidence about the prevalence of HBV in Iran. However, the collected data was very heterogenic, even within a single province, which made it hard to estimate a single-point prevalence. High quality studies are needed to find reliable information about HBV prevalence and to decrease the heterogeneity of results in the country

Evaluation of some plasma coagulation factors in women with spontaneous miscarriage

It has been reported that 15-20% of parous female have experienced at least one miscarriage, while 3% of them have experienced two miscarriages. The goal of this study was to evaluate the plasma level of coagulation factors in women with a his-tory of spontaneous abortions. In this case-control study, 82 women with a history of two or more abortions referred to the six private gynecologic clinics in Gorgan city without any structural abnormality were recruited during 201 1-2012. Plasma levels of antithrom-bin III [ATIII] using colorimetric assay, protein C, protein S, factor V Leiden and lupus anticoagulant [LAC] using coagulation method were measured. The control group was women with a history of normal delivery and no abortions. Those under anti-coagulant therapy were excluded from the study. Data were entered into the computer using the Statistical Package for the Social Sciences [SPSS, SPSS Inc., Chicago, IL, USA] version 16 and analyzed by Chi-square, t test and non-parametric tests. At least one abnormality was reported in 35 cases [42.7%]. Among them, protein C deficiency was the most prevalent [30.5%]. ATIII was abnormal in 17.1% and lupus anti-coagulant was abnormal in 8.5%. Factor V Leiden was normal in all cases and protein S deficiency was only seen in one case. We suggest to perform these tests in regards to the thrombophilia in cases with spontaneous abortions in order to find an early cure for this treatable disorder

impact of alendronate on bone mineral density of osteoporotic patients

The present study assessed the real life therapeutic effects of weekly doses of alendronate in treating a group of osteoporotic patients in Iran. The present historical cohort was conducted on patients who had undergone two or more bone mineral densitometry within an interval of 1.5-2 years in Shariati Hospital bone mineral density department between 2002 and 2010. Patients were asked by phone about consumption of alendronate. The mean increase in the BMD values at different sites was calculated. There was a significant increase in the body mass index [BMI] values of both the individuals taking alendronate and the control group [P<0.001]. Taking the weekly dosage of the drug was associated with a 7.67% increase in the BMD values at the femoral neck, 8.68% at the total hip, and 3.17% at the lumbar spine. Moreover, our results showed a significant difference between the height decline in the two groups [alendronate taking: 0.7 +/- 2.4 vs. control: -0.7 +/- 2.6, P<0.001]. Comparing the results of the present study with that of previous ones revealed the drug is beneficial in improving bone mineral density in Iranians; as well alendronate is more effective in Iranian postmenopausal women when compared with the Americans

Goiter Frequency Is More Strongly Associated with Gastric Adenocarcinoma than Urine Iodine Level

PURPOSE: We designed our study to evaluate the hypothesis that gastric cancer is correlated with iodine deficiency or thyroid dysfunction. MATERIALS AND METHODS: We investigated the total body iodine reserve, thyroid function status and autoimmune disorder in 40 recently diagnosed gastric adenocarcinoma cases versus 80 healthy controls. The participants came from a region with high gastric cancer rate but sufficient iodine supply due to salt iodination. The investigation included urine iodine level, thyroid gland clinical and ultrasonographic examination, and thyroid function tests. RESULTS: Goiter was detected more frequently in the case group (P=0.001); such a finding, however, was not true for lower than normal urine iodine levels. The free T3 mean level was significantly lower in the case group compared to the control group (P=0.005). CONCLUSIONS: The higher prevalence of goiter rather than low levels of urinary iodine in gastric adenocarcinoma cases suggests that goiter, perhaps due to protracted but currently adjusted iodine deficiency, is more likely to be associated with gastric adenocarcinoma compared to the existing iodine deficiency itself.

Cancer incidence in golestan province: report of an ongoing population-based cancer registry in Iran between 2004 and 2008

Golestan Province, at the western end of the Asian esophageal cancer [EC] belt in northeastern Iran, was reported to have one of the highest worldwide rates of EC in the 1970s. We have previously shown a declining incidence of EC in Golestan during the last decades. This study reports additional new results from the Golestan Population-based Cancer Registry [GPCR]. The GPCR collected data from newly diagnosed [incident] cancer cases from all 68 public and private diagnostic and therapeutic centers in Golestan Province. CanReg-4 software was used for data entry and analysis based on the guidelines of the International Agency for Research on Cancer [IARC]. Age-standardized incidence rates [ASR] of cancers were calculated using the 2000 world standard population. From 2004 through 2008, 9007 new cancer cases were reported to the GPCR. The mean [SD] age was 55.5 [18.6] years, and 54% were diagnosed in men. The ASRs of all cancers were 175.3 and 141.1 per 100,000 person-years for males and females, respectively. Cancers of the stomach [ASR:30.7], esophagus [24.3], and lung [15.4] were the most common cancers in males. In females, breast cancer [ASR:26.9] was followed by malignancies of the esophagus [19.1] and stomach [12.4]. The diagnosis of cancer was based on histopatho-logical reports in 71% and on death certificate only in 9% of cases. The EC incidence rate continues to decline in Golestan, while the incidence rates of stomach, colorectal, and breast cancers continue to increase

role of IL-6 for predicting neonatal sepsis: a systematic review and meta-analysis

Neonatal sepsis [NS] is a common and life-threatening disorder in infants. Previous studies showed that interleukin-6 [IL-6] may be a valid non-invasive and rapid method for diagnosis of NS. We conducted this review to assess the validity of IL-6 for predicting NS. This was a systematic review with meta-analysis. Embase, Medline and Web of Science databases were searched between January 1990 and December 2009. The search terms used were [cytokine], [neonate], [sepsis] and [interleukin-6]. We used standard methods recommended for meta analyses of diagnostic test evaluations. The analysis was based on a summary ROC [SROC] curve. Meta-regression analysis was used to assess the effects of some confounding factors on the results of meta-analysis. Potential presence of publication bias was tested using funnel plots and the Egger test. Meta-analysis was performed on 13 publications including 353 infants with sepsis and 691 control infants. The pooled sensitivity and specificity of IL-6 was 0.79 and 0.84, respectively. The maximum joint sensitivity and specificity [i.e., the Q value] in SROC curve was 0.82 and the area under curve [AUC] was 0.89 [95% CI: 0.84-0.94]. Meta-regression analysis showed that the diagnostic accuracy of IL-6 was not affected by confounding variables. The evaluation of publication bias showed that the Egger test was not significant [P=0.07]. IL-6 seems to be a valid marker for predicting NS. It may be considered for early diagnosis of sepsis in neonatal care units

Effects of vitamin E and zinc supplementation on antioxidants in beta thalassemia major patients

In beta thalassemic patients, tissue damage occurs due to oxidative stress and it happens because of the accumulation of iron in the body. This study was conducted to determine the effect of zinc and vitamin E supplementation on antioxidant status in beta-thalassemic major patients. This double blind randomized clinical trial was carried out on 120 beta thalassemic patients older than 18 years. Patients were randomly categorized in four groups. Zinc [50mg/day] and vitamin E [400mg/day] supplements were administered for former and latter group, respectively. In the third group both supplements were administered in similar doses. The fourth [control] group received no supplement. The effect of supplementations on serum zinc and vitamin E, superoxide dismutase [SOD], glutathione peroxidase [GPX], total antioxidant capacity [TAC] and body mass index [BMI] were measured at the beginning and the end of the study. Serum zinc levels in group 1 and 3 were significantly increased [P<0.007 and P<0.005, respectively]. Serum vitamin E levels in group 2 and 3 were also increased significantly [P<0.001]. Mean GPX activity in group1, 2 and 3 decreased significantly [P<0.015, P<0.032 and P<0.029, respectively]. Mean SOD activity and TAC did not show significant change after supplementation. BMI had significant increase in all treated groups [P<0.001]. Our results suggest that beta thalassemic patients have enhanced oxidative stress and administration of selective antioxidants may preclude oxidative damage

Adverse reactions following immunization with MMR vaccine in children at selected provinces of Iran

Several adverse events following immunization [AEFI] have been attributed to immunization with live attenuated measles, mumps, and rubella [MMR] vaccines. The MMR vaccine was introduced into the routine infant immunization schedule in 2003, followed by a second dose of vaccine at school-entry for children 4 to 6 years of age. The objective of this study was to characterize adverse reactions following MMR vaccination in Iran. Children who received the MMR vaccine and resided in five selected provinces of Iran were examined weekly for four weeks to detect well-known AEFIs that included: parotitis, fever and convulsions, convulsions without fever, encephalopathy, and anaphylactic reactions. Incidence of AEFIs were calculated and compared among recipients in both age groups. During the follow-up period, trained providers reported 792 AEFIs. Parotitis was the most frequent event occurring in 1.8% of recipients. Of 14, 109 children vaccinated at 12 months of age the following AEFIs occurred: parotitis [147], fever and convulsions [8], convulsions [7], encephalopathy [1], and anaphylactic reactions [1]. Of 29,338 children vaccinated to 4 to 6 years of age, parotitis, fever and convulsions, encephalopathy, and anaphylaxis occurred in 626, 5, 1, and 1 child, respectively; no convulsions without fever were reported in this age groups. Parotitis is the most frequent AEFI among MMR vaccine recipients in Iran. Incidence rates of AEFIs following MMR vaccination in Iran are similar to rates of AEFIs reported in other studies

Incidence of childhood cancers in Golestan province of Iran

This paper presents the incidence rates of childhood cancers using the data obtained from Golestan population based cancer registry [GPCR] between 2004 and 2006. GPCR registers only primary cancers based on standard protocols of the international association of cancer registries [IACR]. We collect data on newly diagnosed [incident] cancer cases from all public and private diagnostic and therapeutic centers of the whole province. CanReg-4 software was used for data entry and analysis. Totally 5076 cancer cases [all ages] were diagnosed in GPCR between 2004 and 2006. Of these, 139 [2.74%] were children [aged 0-14 years] with mean [ +/- SD] age of 8.06 [ +/- 4.48] years. The age standardized incidence rates for childhood cancer were 119.8 and 78.3 per 1000000 person-years in male and female children, respectively. Leukemia was the most common childhood cancer in Golestan province of Iran. Lymphomas and central nervous system tumors were the second and third ones, respectively. The incidence rates of childhood cancers were relatively high in Golestan province of Iran. So, controlling of childhood cancers should be mentioned as an important issue in health policy making in this area

Maternal folate and vitamin biz status and neural tube defects in northern Iran: a case control study

This study was conducted to determine the serum level in neural tube defects pregnancies [NTD] and healthy controls in Northern Iran. This case-control study was performed on women with neural tube defects pregnancies and controls with unaffected pregnancies in Northern Iran during 2006. Twenty three pregnant women whose pregnancies were diagnosed as NTD by a second-trimester ultrasonographic examination were recruited as cases. The control group [n=23] consisted of women who were selected among socio-economic status [SES] matched women who had a normal targeted ultrasound during the second trimester with documented normal fet al outcome. Fetal NTD was suspected with targeted second-trimester ultrasound during the 16[th] week of gestation and confirmed with high maternal serum a-fetoprotein levels. Folate, vitamin 812, homocysteine and alpha fetoprotein were evaluated after target ultrasonography. Serum alpha fetoprotein level [mean +/- SD] in cases and controls was 120.2 +/- 64.1 and[tm]50 +/- 33.5 iu /ml, respectively [P<0.05]. The mean +/- SD folate in cases and controls was 8.4 +/- 4.2 versus 9.3 +/- 4.2 ng/ml, respectively. This difference was not significant. Folate deficiency was found in 30.4% of the cases and 13% of the controls [OR = 2.9, 95%: 0.54-19.8]. Vitamin B12 deficiency was found in 13% of cases and 17.7% of the controls [OR=0.7, 95%: 0.1-4.9]. This study showed that the probability of having a newborn with NTDs in maternal folate deficiency is three times higher than with normal folate in Northern Iran

Seroprevalence of hepatitis B virus and its co-infection with hepatitis D virus and hepatitis C virus in Iranian adult population.

CONTEXT: Hepatitis B virus (HBV) infection is one of the most prevalent public health problems worldwide (especially in developing countries). AIMS: This study was carried out to determine the seroprevalence of HBV and its co-infection with hepatitis D (HDV) and C (HCV) viruses in the northeastern part of Iran. SETTING AND DESIGN: A population-based cross-sectional study in Iran. MATERIALS AND METHODS: As many as 1,850 subjects were explored for HBsAg. Anti-HDV and anti-HCV antibodies were assessed in HBsAg-positive cases. STATISTICAL ANALYSIS USED: Proportions were compared by Chi-square and Fisher's exact tests. RESULTS: The mean age of subjects was 43.86 +/- 11.2 years. The age- and sex-standardized prevalence for HBsAg positivity was 9.7%. It was higher in males than in females (OR: 1.28; 95% CI: 0.9-1.7). The risk of infection in singles was significantly higher than in married cases (OR: 2.13). Eight (5.8%) of HBsAg-positive cases were infected with HDV and 17 (12.3%) were positive for anti-HCV antibody. CONCLUSION: This study demonstrates that the prevalence of HBsAg seropositivity in Golestan province of Iran is higher than the levels reported by WHO and previous studies from Iran. It is very important, especially for health providers and policy makers, to recognize the risk factors of HBV infection and its co-infection with HDV and HCV in this area and design effective preventive programs.

[Relationship between occurrence of guillan-barre syndrome and mass campaign of measles and rubella immunization in Iranian 5-14 years old children]

Several case reports and epidemiologic studies have reported a relation between different vaccines including measles, rubella, and mumps and Guillain-Barre syndrome [GBS]. In this study we investigated relation between receiving measles and/or rubella vaccines and occurrence of Guillain-Barre syndrome after national immunization campaign in 2003 in Iran. In this study we used National Surveillance system for acute flaccid paralysis data from the beginning of 2002 to the end of 2004. We studied 5-14 year-old children. Three-year time span of the study was divided into fifteen 10 weeks periods, and number of reported and approved cases of Guillain-Barre syndrome in each time period has been analyzed supposing their distribution was according to Poisson distribution. One of time periods has been chosen in a manner that its first 4 weeks included embedded National Immunization and following 6 weeks were designated for covering incubation period of Guillin-Barre syndrome. Of total 553 reported flaccid paralysis cases in 5-15 year-old children 370 were approved to be Guillain-Barre [67%]. Estimated average incidence of Guillain-Barre syndrome in<15 year-olds is 1/100,000/year [95% CI: 0.88-13], and in 5-15 year-old children is 0.6/100,000/year [95% CI: 0.58-083]. Thus, number of expected cases in 25 cases each 10 weeks time period was 23.8 of GBS that were reported in the time period which coincided with immunization campaign. Probability of occurring>/=25 cases of GBS in that time period according to Poison distribution with expected case numbers of 23.8 is equal to 0.43 [P=0.43]. Yearly incidence rate of GBS in this study was similar to other studies. According to our results, there was no increase in GBS incidence in the 4 weeks national Immunization Campaign and 6 weeks after it in comparison to other 10 weeks periods before or after this time period