[Histological and biochemical characteristics of arteries and veins in patients candidate for coronary bypass surgery]

The occlusion of the artery and vein grafts are currently a major problem in coronary bypass surgery. Degradation of collagen and elastin, the most abundant extracellular matrix proteins in the vessel wall by matrix metalloproteinase [MMPs], leads to a rearrangement of the extracellular matrix and vascular wall structure. The present study aimed to compare the histological and biochemical characteristics of arteries and veins which could have a role in the failure of the graft. This study was a cross-sectional study of 80 patients conducted at Heart Hospitals in Isfahan, Iran, between July 2012 and November 2013. Samples were collected from the remains of vessels used in bypass surgery of 11 male nondiabetic patients. The histologic, collagen elastin ratio and MMPs levels of the vessels were investigated. MMPs were determined using the Gelatin Zymography method. For elastin and collagen content measurement, the sample was digested by cyanogen bromide and hydrochloric acid and then hydroxyproline was measured with a spectrophotometer. The amount of active and inactive MMP-2 and MMP-9 of the left internal mammary artery [Lima] was similar to aorta, but the amount of MMP-2 and MMP-9 in the radial artery and saphenous vein were significantly higher than aorta. Elastin to collagen ratio in Lima [1.92 +/- 1.15] was similar to the aorta [3.4+1.66], but this proportion in saphenous vein [1.07+0.47] and radial artery [1.14+0.39] was significantly lower in the aorta [P<0.05]. Most patients had atherosclerotic plaque in radial while there was atherosclerotic plaque in Lima of only one case. The presence of atherosclerotic plaques in radial and thickening of the intimal layer of the saphenous vein in the majority of patients and decrease of collagen to elastin ratio and the high level of matrix metalloproteinase enzymes in the radial and saphenous vein can induce early pathological conditions, and remodeling of the vessels involved. So the results of this study confirm that Left Internal Mammary Artery [LIMA] is the most suitable candidate for bypass surgery

effects of Adiantum capillus-veneris on wound healing: an experimental in vitro evaluation

A lot of remedies, mostly plant based, were mentioned in the Persian old pharmacopoeias for promoting of burn and wound healing and tissue repairing. The efficacy of most of these old remedies is unexplored till now. Adiantum capillus-veneris from Adiantaceae family is one of them that was used to treating of some kinds of chronic wounds. Methanol extract was fractionated to four different partitions that is, hexane, ethyl acetate, n-butanol, and aqueous. The potential of A. capillus-veneris fractions in wound healing or prevention of chronic wounds were evaluated through angiogenesis and fibroblast proliferation, in addition to in vitrotests for protection against damage to fibroblasts by oxygen free radicals. The aqueous part of A. capillus-veneris promoted significant angiogenesis [P < 0.05] through both capillary-like tubular formations and proliferation of endothelial cells in vitro. In addition, in the tests for protection against damage to fibroblasts by oxygen free radicals, aqueous and butanol fractions showed significant protective effects in the concentrations 50, and 500 microg/ml [P < 0.05] in comparison with a control group. In the toxicity testing, it showed weak irritation in the Hen's egg test chorioallantoic membrane [CAM] bioassay at the vascular level on the CAM of the chicken and no significant cytotoxicity in the MTT assays on normal human dermal fibroblasts. Angiogenic effects and protective effects against oxygen free radicals suggested aqueous partition of A. capillus-veneris local application for prevention of late-radiation-induced injuries after radiation therapy and healing of external wounds similar to bedsores and burns

Preventive effects of a three-month yoga intervention on endothelial function in patients with migraine

Migraine is a neurovascular disorder and any interventions improving endothelial function may contribute to its treatment and prevention of vascular complications like ischemic stroke. Yoga has been shown to have several beneficial effects on cardiovascular systems. However, no randomized controlled studies to date have investigated its effects on endothelial function of migraineurs. A total of 42 women patients with migraine were enrolled and randomized into either a Yoga exercise group or a control group. The control group received only medication for 12 weeks and the Yoga group was placed in yoga training program in addition to the same medical treatment. Blood test was given from all patients in order to measure plasma levels intercellular adhesion molecule [ICAM] and vascular cell adhesion molecule [VCAM] after yoga training program. Totally 32 patients were participated in the final analyses [yoga: n - 18, control: n - 14]. By analyzing data between yoga and control groups after the treatment period, there was a significant decreased in plasma level of VCAM in yoga group compare with the control group [15.29 +/- 2.1 ng/ml vs. 21.70 +/- 3.0 ng/ml, P < 0.05], whereas there was no significant difference in ICAM level between groups [19.1 +/- 1.8 ng/ml vs. 20.97 +/- 1.9 ng/ml P>0.05]. It seems that yoga exercises, as a complementary treatment beside pharmacological treatments, can be potentially an effective way of improving vascular functions in migraineurs

Genetic Diversity of Echinococcus granulosus in Center of Iran

Hydatid cyst caused by Echinococcus granulosus is one of the most important parasitic diseases around the world and many countries in Asia, including Iran, are involved with this infection. This disease can cause high mortality in humans as well as economic losses in livestock. To date, several molecular methods have been used to determine the genetic diversity of E. granulosus. So far, identification of E. granulosus using real-time PCR fluorescence-based quantitative assays has not been studied worldwide, also in Iran. Therefore, the aim of this study was to investigate the genetic diversity of E. granulosus from center of Iran using real-time PCR method. A total of 71 hydatid cysts were collected from infected sheep, goat, and cattle slaughtered in Isfahan, Iran during 2013. DNA was extracted from protoscolices and/or germinal layers from each individual cyst and used as template to amplify the mitochondrial cytochrome c oxidase subunit 1 gene (cox1) (420 bp). Five cattle isolates out of 71 isolates were sterile and excluded from further investigation. Overall, of 66 isolates, partial sequences of the cox1 gene of E. granulosus indicated the presence of genotypes G1 in 49 isolates (74.2%), G3 in 15 isolates (22.7%), and G6 in 2 isolates (3.0%) in infected intermediate hosts. Sixteen sequences of G1 genotype had microgenetic variants, and they were compared to the original sequence of cox1. However, isolates identified as G3 and G6 genotypes were completely consistent with original sequences. G1 genotype in livestock was the dominant genotype in Isfahan region, Iran.

G395R mutation of the sodium/iodide symporter [NIS] gene in patients with dyshormonogenetic congenital hypothyroidism

Considering the high prevalence of congenital hypothyroidism [CH] in Isfahan and its different etiologies in comparison with other countries, the high rate of parental consanguinity, and the role of NIS gene in permanent CH due to dyshormonogenesis, the aim of this study was to investigate the G395R mutation of the NIS gene in patients with permanent CH due to dyshormonogenesis. In this case-control study, patients diagnosed with permanent CH due to dyshormonogenesis during CH screening program were selected. Venous blood sample was obtained to determine the G395R mutations of NIS gene using polymerase chain reaction [PCR] sequencing method. In this study, 35 CH patients with permanent CH due to dyshormonogenesis and 35 neonates with normal screening results as a control group were studied. We did not find any changes of the mentioned mutation of NIS gene in the patients' group. Considering the findings of the current study, it seems that further studies with larger sample size and with consideration of other gene mutations such as pendrin and thyroglobulin are needed for more accurate conclusion

Efficacy of enalapril in migraine prophylaxis: a randomized, double-blind, placebo-controlled trial

Some angiotensin converting enzyme [ACE] inhibitors have previously been shown to be effective in migraine prophylaxis. The aim of this study was to evaluate whether Enalapril is effective in migraine prophylaxis. In this randomized, double-blind, placebo-controlled clinical trial, the effects of 10 mg Enalapril given daily were compared with those of matched placebo in 40 migraineurs for 2 months. Response to treatment was assessed at 0, 1, and 2 months after the start of intervention according to headache parameters like frequency, severity, and duration. This trial is registered with Iranian Registry of Clinical Trials [IRCT], number IRCT138711011570N1. A significant effect on reducing migraine attack more than 50% at first and second months [P=0.016] occurred in Enalapril group. Indeed, at the first and second months of treatment, the severities [P=0.000 and P=0.000] and duration [P=0.037 and 0.003] in the Enalapril treated group were significantly lower than in the placebo group. Enalapril may be effective in migraine prophylaxis according to its effect in decreasing the frequency, severity, and duration of headaches. The results support the previous suggestions on usage of ACE inhibitors in migraine prophylaxis

Chronic kidney disease stages 3-5 in Iranian children: need for a school-based screening strategy: the CASPIAN-III study

There is scarce epidemiological data on early and asymptomatic stages of chronic kidney disease [CKD] in children, especially from developing countries. In this study, we investigated the frequency of CKD stages 3-5 among general students of Isfahan [a large province of Iran], and compared the findings with those derived from the main pediatric nephrology referral center of province. This study was performed among 712 Isfahani school students [377 boys] aged 7-18 years, as part of the baseline survey of a national surveillance system. Blood samples were analyzed for blood urea nitrogen, creatinine, and cystatin C. Glomerular filtration rate [GFR] was calculated based on two 2009 Schwartz equations [the "updated" and the "new" equations]. CKD was defined as GFR <60 ml/min/1.73 m2. Additionally, a retrospective analysis of clinical records of children with stages 3-5 CKD referred to main referral center of province from November 2001 to December 2011 was made. The mean age of students was 12.2 +/- 2.4 years. In students' screening, the frequency of CKD was 1.3% and 1.7% based on the updated Schwartz and the new Schwartz equation, respectively. The referral center survey revealed an annual incidence of 14.5 per million age-related population [pmarp], and a prevalence of 118.8 pmarp in our province. The prevalence of asymptomatic and undetected low GFR in Iranian children is higher than what is reflected from the reports of referral centers. Simple screening programs like annual urinalysis among high-risk school students should be considered

Left atrial appendage occlusion

Left atrial appendage [LAA] occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy [PTMC], it can be done during closed and open mitral valve commissurotomy [CMVC, OMVC] and mitral valve replacement [MVR] too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis [MS] and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC

Skew-symmetric random effect models with application to a preventive cohort study: improving outcomes in low back pain patients

To investigate the respective contribution of various biologic and psychosocial factors, especially Health Related Quality of Life [HRQOL] as a main outcome, in the natural history of acute low back pain [LBP] and to evaluate the impact of this condition on HRQOL. In a prospective cohort study For 24 weeks, 150 patients were assessed at an outpatient clinic in Korea consulting for low back and confirmed disc herniation duration at inclusion and treated with treatment package comprised of herbal medicines, acupuncture, bee venom acupuncture, and a Korean version of spinal manipulation [Chuna]. Study participants were evaluated at baseline and every 4 weeks for 24 weeks. Low back intensity levels were measured on a visual analog scale [0-10], back function was evaluated with the Oswestry Disability Index [0-100], disability assessed by HRQOL assessed by the short form 36 health survey [0-100 in 8 different sub-categories]. Out of 150 patients, 128 completed the 24 weeks of traditional therapy. Patients reported improvements SF-36 outcome measures. At the completion of the study, low back pain scores improved by a mean of 3.3 [95% CI = 2.8 to 3.8]. According to the results of our modeling, low back intensity level, back function and BMI measures had significant effects on quality of life during study. Interpreting the coefficients of modeling, the impact of the decreasing acute LBP episode on HRQOL by VAS and ODI outcomes, was high and important. This study highlights the large contribution of integrative package therapy as an effective preventive method for improving LBP patient's HRQOL

effect of pioglitazone on the Alzheimer's disease-induced apoptosis in human umbilical vein endothelial cells

Alzheimer's disease [AD] is a progressive neurodegenerative disease and nowadays the role of endothelial cell [EC] injury has been proposed in pathological process in AD. Peroxisome proliferator-activated receptor- gamma [PPAR- gamma] agonist has anti-inflammatory properties through activation in glial cells and improves vascular function and prevent atherosclerotic disease progression. The aim of this study is evaluation of pioglitazone effects as a drug of PPAR- gamma agonist on endothelial apoptosis induced by sera from AD patients. Human umbilical vein endothelial cells [HUVECs] were treated with sera from AD patients [n = 10] and sera from controls [n = 10]. Apoptosis was identified by annexin V-propidium iodide staining and cell death detection kit. Apoptosis was evaluated after and before adding of 10 micro M pioglitazone on EC. Nitrite [NO[2]] levels were determined in the culture supernatants. Induced apoptosis by the serum of patients was inhibited markedly when pioglitazone used before treating HUVECs with the sera of AD. Also, the measurement of nitrite concentration showed significantly greater levels of dissolved NO[2]/NO[3] metabolite in the culture media of HUVECs treated by sera of AD patients [P < 0.05], while the rate of nitric oxide significantly decreased when pioglitazone exists in culture media. Further studies are justified to investigate the novel role of the PPARs in the prevention of the neuronal and endothelial damage in neurological disorder and present a new therapeutic approach for Alzheimer's patients

role of maternal thyroid stimulating hormone receptor blocking antibodies in the etiology of congenital hypothyroidism in Isfahan, Iran

Considering the role of maternal thyroid stimulating hormone [TSH] receptor blocking antibody [TRAb] in the etiology of congenital hypothyroidism [CH], this study aimed to determine TRAb among patients with CH in Isfahan, Iran. In this case-control study, patients with CH and their mothers were compared with a group of healthy neonates and their mothers. Venous blood samples were obtained for measurement of TRAb using enzyme-linked immunosorbent assay [ELISA] method among mothers and their neonates. TSH of mothers was also determined. The case group consisted of 65 patients with CH and their mothers; controls were 148 healthy neonates and their mothers. The prevalence of positive TRAb in patients with CH and their mothers was higher than in the control group [81.5% vs. 1.3% in mothers and 80% vs. 0% in neonates, respectively, P<0.05]. The relationship between the TRAb and occurrence of CH was significant [P<0.05], whereas the corresponding figure was not significant for TRAb and the level of maternal and neonatal TSH in case and control groups [P>0.05]. It seems that autoimmunity has an important role in the etiology of CH. Further studies are necessary to determine other autoantibodies in CH patients