[Comparison of adenosine deaminase level in HIV positive patients co-infected with hepatitis B and C and healthy subjects]

Measurement of adenosine deaminase and its isoenzymes in serum has been used for diagnosis and differentiation of intracellular infections and malignancies of immune cells. The aim of this study was to compare ADA levels and its isoenzymes in HIV positive patients and HIV positive patients co-infected with hepatitis B and C and healthy individuals, as a quick and low-cost diagnostic biochemical marker. This historical cohort study included 97 HIV positive IDU patients. After obtaining blood samples, serum was separated and examined for hepatitis B and C. We used Guisti method for measurment of ADA activity and EHNA inhibitor for the activity of its isoenzymes. Data analysis was performed by SPSS 16 [SPSS Inc., Chicago]. Our results showed that there was a high prevalence of HBV and HCV in HIV positive IV drug users. We found that total ADA activity in the patients groups was significantly higher than control group. Also HIV-HCV group showed a higher activity of this enzyme in comparison to HIV positive groups. Significant differences were found in regard to ADA2 isoenzymes among the four groups [P<0.05]. But ADA1 activity showed no significant difference. CD4+ counts were lower in HIV-HCV and HIV-HBV patients than HIV positive patients. ADA activity was considerably increased in HIV positive patients co-infected with either HBV or HCV. According to the results of this study and because of its low cost and simplicity to perform, in addition to other markers, measurement of ADA activity in serum is a sensitive biological marker for assessment of intracellular infections, particularly hepatitis in HIV positive patients

[Survival analysis of the patients with acute myocardial infarction by use of penalized splines]

Cardiovascular diseases are one of the most common causes of death and also major health problems in the world. The classical methods such as Cox regression are used in most medical studies on survival distribution, while this model assumes a linear relationship between log hazard ratio and risk factors which is not useful in many cases. The present study was performed to use the method of penalized splines to analyze the survival rate of the patients who had acute myocardial infraction. This research was a prospective descriptive-analytical study of longitudinal type which included 650 patients with acute myocardial infarction. Patients were followed for one year from the moment of diagnosis of MI, for survival analysis. The collected data were recorded in a check-list for every patient. Two different multivariate methods, proportional hazard regression and Cox model with penalized splines were used. Data analysis was carried out using R version 2.12 software and significant levels were considered 0.05. The mortality rate of the patients in a period of one year was 10.3% [67patients]. History of smoking, hypertension, diabetes, hyperlipidemia, arrhythmia and heart block were detected in 48%, 33.4%, 17.7%, 15.3%, 30% and 10.3% of the patient respectively. Based on Cox model with penalized splines the factors affecting survival rate were age, ejection fraction and use of streptokinase. Knowledge of the survival rate and factors affecting survival in the patients with acute MI can be used to provide the patients with valuable services, and to take measures to control and reduce mortality rate which can lead to increased life expectancy of these patients