Exploring Clinical Subgroups of Participants with Major Depressive Disorder that may Benefit from Adjunctive Minocycline Treatment

Objective@#To explore illness-related factors in patients with major depressive disorder (MDD) recipients of adjunctive minocycline (200 mg/day) treatment. The analysis included participants experiencing MDD from a 12-week, double blind, placebo-controlled, randomized clinical trial (RCT). @*Methods@#This is a sub-analysis of a RCT of all 71 participants who took part in the trial. The impact of illness chronicity (illness duration and number of depressive episodes), systemic illness (endocrine, cardiovascular and obesity), adverse effects and minocycline were evaluated as change from baseline to endpoint (12-week) using ANCOVA. @*Results@#There was a consistent but statistically non-significant trend on all outcomes in favour of the use of adjunctive minocycline for participants without systemic illness, less illness chronicity, and fewer adverse effects. @*Conclusion@#Understanding the relationship between MDD and illness chronicity, comorbid systemic illness, and adverse effects, can potentially better characterise those individuals who are more likely to respond to adjunctive anti-inflammatory medications.

Does Post-traumatic Stress Disorder Impact Treatment Outcomes within a Randomised Controlled Trial of Mitochondrial Agents for Bipolar Depression?

Objective@#Bipolar disorder often co-occurs with post-traumatic stress disorder, yet few studies have investigated the impact of post-traumatic stress disorder in bipolar disorder on treatment outcomes. The aim of this sub-analysis was to explore symptoms and functioning outcomes between those with bipolar disorder alone and those with comorbid bipolar disorder and post-traumatic stress disorder. @*Methods@#Participants (n = 148) with bipolar depression were randomised to: (i) N-acetylcysteine alone; (ii) a combination of nutraceuticals; (iii) or placebo (in addition to treatment as usual) for 16 weeks (＋4 weeks discontinuation).Differences between bipolar disorder and comorbid bipolar disorder and post-traumatic stress disorder on symptoms and functioning at five timepoints, as well as on the rate of change from baseline to week 16 and baseline to week 20, were examined. @*Results@#There were no baseline differences between bipolar disorder alone and comorbid bipolar disorder and post-traumatic stress disorder apart from the bipolar disorder alone group being significantly more likely to be married (p = 0.01). There were also no significant differences between bipolar disorder alone and comorbid bipolar disorder and post-traumatic stress disorder on symptoms and functioning. @*Conclusion@#There were no differences in clinical outcomes over time within the context of an adjunctive randomised controlled trial between those with bipolar disorder alone compared to those with comorbid bipolar disorder and post-traumatic stress disorder. However, differences in psychosocial factors may provide targets for areas of specific support for people with comorbid bipolar disorder and post-traumatic stress disorder.

The Impact of N-acetylcysteine on Major Depression: Qualitative Observation and Mixed Methods Analysis of Participant Change during a 12-week Randomised Controlled Trial

Objective@#N -acetylcysteine (NAC) is a novel therapeutic agent with multiple mechanisms of action in the central nervous system and a favourable side effect profile. Clinical evidence indicates that adjunctive NAC may reduce the severity of depressive symptoms in individuals with major depressive disorder (MDD). @*Methods@#A 12-week randomised controlled trial of 2,000 mg/day adjunctive NAC for MDD found no significant improvement at the primary endpoint (week 12) but did see improvements at the post-discontinuation interview (week 16). Within the context of patient-centered treatment, mixed-methods qualitative analysis was also included to explore factors that may determine individual responses to adjunctive NAC treatment. These data were drawn, under blinded conditions, from clinician notes recorded in the case report form. Using the DSM-5 symptom profile for MDD as the initial framework, themes were developed and explored. Frequencies were compared between placebo and NAC groups. @*Results@#Per protocol analysis of individual themes across the six interviews revealed group differences in favour of NAC for overall depressive affect, optimism, relationships and reduced functional impairment. @*Conclusion@#This study provides further evidence for the utility of the mixed methods approach complimenting the primary findings using traditional quantitative analyses, as well as being able to capture additional, often more subtle, evidence of individual symptom-level change that reflects improvement in functional abilities in response to NAC supplementation. The use of mixed methods to explore outcomes from psychiatric studies should be considered in future to work towards improved patient-centred care and both confirm quantitative findings and generate novel hypotheses.

Lived Experience of Iranian Family Caregivers of Person with Tuberculosis: A Qualitative Study / Experiencia vivida de los cuidadores familiares de personas con tuberculosis: Un estudio cualitativo / Experiência vivida de cuidadores familiares de pessoas com tuberculose: um estudo qualitativo

Objective. To investigate the lived experience of family caregivers of persons with tuberculosis. Methods.In this study, the method of hermeneutic phenomenology. Data were collected through online in-depth semi-structured interviews with nine family caregivers of TB patients. The obtained data were thematically analyzed to explain the concept of home care for TB patients through van Manen's 6-step methodology. Results. After the thematic analysis, three main themes of caregivers' mental distresses, quality care stasis, and facilitated care were obtained from 944 primary codes and 11 categories. Conclusion.Family caregivers of these patients suffer from mental distress. This issue affects the quality and ease of caregiving for these patients. Therefore, policymakers of this area should pay attention to the family caregivers of these patients and attempt to provide support; they should try to improve their quality of life.

Objetivo. Investigar la experiencia vivida por los cuidadores familiares de personas con tuberculosos. Métodos. En este estudio se utilizó el método de la fenomenología hermenéutica. Los datos se recogieron mediante entrevistas semiestructuradas en línea con nueve cuidadores familiares de pacientes con tuberculosis. Los datos obtenidos se analizaron temáticamente para explicar el concepto de atención domiciliaria a los pacientes con TB mediante la metodología de 6 pasos de van Manen. Resultados. Tras el análisis temático, se obtuvieron tres temas principales: angustia mental de los cuidadores, estancamiento de la atención de calidad y facilitación de la atención, a partir de 944 códigos primarios y 11 categorías. Conclusión.Los cuidadores familiares de estos pacientes sufren de distrés sicológico. Este problema afecta la calidad y la facilidad con que se brinda el cuidado. Por lo tanto, los responsables de la política en salud deben prestar atención a los cuidadores familiares de estos pacientes para proporcionarles más apoyo, lo que redundará en una mejoría de su calidad de vida.

Objetivo.Investigar a experiência vivida por cuidadores familiares de pessoas com tuberculose.Métodos.Neste estudo foi utilizado o método da fenomenologia hermenêutica. Os dados foram coletados por meio de entrevistas semiestruturadas online com nove cuidadores familiares de pacientes com tuberculose. Os dados obtidos foram analisados tematicamente para explicar o conceito de atenção domiciliar aos pacientes com TB utilizando a metodologia de 6 etapas de van Manen. Resultado S. Após a análise temática, três temas principais ­ sofrimento mental dos cuidadores, estagnação do cuidado de qualidade e facilitação do cuidado ­ foram derivados de 944 códigos primários e 11 categorias. Conclusão. Os cuidadores familiares desses pacientes sofrem de sofrimento psíquico. Essa questão afeta a qualidade e a facilidade com que os cuidados são prestados a esses pacientes. Portanto, os responsáveis pela política de saúde devem estar atentos aos cuidadores familiares desses pacientes para dar-lhes mais suporte, o que resultará em uma melhora em sua qualidade de vida.

Personality disorder and functioning in major depressive disorder: a nested study within a randomized controlled trial

Objective: This study aimed to determine if personality disorder (PD) predicted functional outcomes in patients with major depressive disorder (MDD). Methods: Data (n=71) from a double-blind, randomized, placebo-controlled 12-week trial assessing the efficacy of 200 mg/day adjunctive minocycline for MDD were examined. PD was measured using the Standardized Assessment of Personality Abbreviated Scale. Outcome measures included Clinical Global Impression - Improvement (CGI-I), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Social and Occupational Functioning Scale (SOFAS), and Range of Impaired Functioning (RIFT). Analysis of covariance was used to examine the impact of PD (dichotomized factor [≥ 3] or continuous measure) on the outcome measures-treatment group correlation. Results: PD was identified in 69% of the sample. After adjusting for age, sex, and baseline scores for each of the outcome measures, there was no significant difference between participants with and without PD on week 12 scores for any of the outcome measures (all p > 0.14). Conclusion: In this secondary analysis of a primary efficacy study, PD was a common comorbidity among those with MDD, but was not a significant predictor of functional outcomes. This study adds to the limited literature on PD in randomized controlled trials for MDD. Clinical trial registration: ACTRN12612000283875.

Double Whammy: Concomitant Acute Type B Aortic Dissection and Acute Pulmonary Embolism

The concomitant occurrence of acute type B aortic dissection (TBAD) and acute pulmonary embolism (PE) is a rare but challenging condition. Although anticoagulation therapy is essential in the treatment of PE, it may increase the risk of aortic rupture and bleeding complications. We herein describe a patient with acute TBAD complicated by PE, which was successfully treated with early thoracic endovascular aortic repair (TEVAR) followed by anticoagulation. The present case report demonstrates that early TEVAR not only treats the aortic pathology but also allows the safe initiation of anticoagulation therapy.

State of Mental Health and Associated Factors in Nursing Students from Southeastern Iran

Objective. To evaluate the state of mental health and its relation with associated factors among nursing students. Methods. A cross-sectional study was conducted with 130 students from the Nursing and Midwifery College affiliated to the University of Medical Sciences of Shiraz (Iran). Data was collected through a document that included information on the demographic characteristics, the mean grades of the practical assignments and of the total (practical and theoretical assignments), and the Goldberg Health Questionnaire (GHQ-28) that measures symptoms grouped into four dimensions (somatic symptoms, anxiety and insomnia, social dysfunction, and depression). Results. Most of the participants (65.1%) were women; 5.3% were between 21 and 22 years of age, 84.5% were single, and 33.3% were in the sixth semester; 68.5% of the students had problems with mental health. By dimensions of the GHQ-28, it was found that 7.7% had somatic symptoms, 13.8% symptoms of anxiety and sleep disorders, 52.3% social dysfunction, and 6.2% depression. Males had a higher score of depression than females, and being single was related with higher scores of physical symptoms, anxiety and insomnia, and depression, compared with those who were married. An inverse relationship was found between the GHQ-28 average score and the semester, the grade in practical assignments, and the total grade for physical symptoms and anxiety and insomnia. Conclusion. There is a high proportion of nursing students with suspected mental health disorder. Some demographic and academic factors are related with the mental health of students and must be kept in mind by the institutions training future nurses.

Objetivo. Evaluar el estado de salud mental y su relación con factores asociados entre los estudiantes de enfermería. Métodos. Se realizó un estudio de corte transversal con 130 estudiantes del Colegio de Enfermería y Partería afiliado a la Universidad de Ciencias Médicas de Shiraz (Irán). Para la toma de los datos se empleó un formulario que incluía información sobre las características demográficas, los promedios de calificación de las asignaturas prácticas y del total (asignaturas prácticas más teóricas), y el Cuestionario de Salud Goldberg (GHQ-28) que mide síntomas agrupados en cuatro dimensiones (síntomas somáticos, ansiedad e insomnio, disfunción social, y depresión). Resultados. La mayoría de los participantes (65.1%) fueron mujeres; el 5.3% tenía entre 21 y 22 años; solteros, el 84.5% y el 33.3% estudiaba en el sexto semestre. El 68.5% de los estudiantes tenía problemas con la salud mental. Por dimensiones del GHQ-28, se encontró que el 7.7% tenía síntomas somáticos; 13.8%, síntomas de ansiedad y trastornos del sueño; 52.3%, disfunción social y 6.2% depresión. El sexo masculino tuvo mayor puntaje de depresión que las mujeres, y el estado civil soltero se relacionó con mayores puntajes de síntomas físicos, ansiedad e insomnio y depresión, comparado con los casados. Se encontró una relación inversa entre el promedio del puntaje del GHQ-28 y el semestre, la calificación en las asignaturas prácticas y la calificación total para síntomas físicos y ansiedad e insomnio. Conclusión. Es alta la proporción de estudiantes de enfermería con sospecha de trastorno de la salud mental. Algunos factores demográficos y académicos están relacionados con su salud mental y deben ser tenidos en cuenta por las instituciones formadoras de los futuros enfermeros.

Objetivo. Avaliar o estado de saúde mental e sua relação com fatores associados entre os estudantes de enfermagem. Métodos. Se realizou um estudo de corte transversal com 130 estudantes do Colégio de Enfermagem e Parteira afiliada à Universidade de Ciências Médicas de Shiraz (Irã). Para a toma dos dados se empregou um formulário que incluía informação sobre as características demográficas, as médias de qualificação das matérias práticas e do total (matérias práticas mais teóricas), e o Questionário de Saúde Goldberg (GHQ-28) que mede sintomas agrupados em quatro dimensões (sintomas somáticos, ansiedade e insônia, disfunção social, e depressão). Resultados. A maioria dos participantes (65.1%) eram mulheres; 5.3% tinham entre 21 e 22 anos, eram solteiros (84.5%) e o 33.3% estudavam no sexto semestre. 68.5% dos estudantes tinham problemas com a saúde mental. Por dimensões de GHQ-28, se encontrou que 7.7% tinham sintomas somáticos, 13.8% sintomas de ansiedade e transtornos do sono, 52.3% disfunção social e 6.2% depressão. O sexo masculino teve maior pontuação de depressão que as mulheres, e o estado civil solteiro se relacionou com maiores pontuações de sintomas físicos, ansiedade e insônia e depressão, comparado com os casados. Se encontrou uma relação inversa entre a média da pontuação de GHQ-28 e o semestre, a qualificação nas matérias práticas e a qualificação total para sintomas físicos e ansiedade e insônia. Conclusão. É alta a proporção de estudantes de enfermagem com suspeita de transtorno da saúde mental. Alguns fatores demográficos e acadêmicos estão relacionados com a saúde mental dos estudantes e devem ser tidos em conta pelas instituições formadoras dos futuros enfermeiros.

Experience Lived by Iranian Patients with Irritable Bowel Syndrome: Transitory Crisis and Liberation

Objective. Research on the nature of living with Irritable Bowel Syndrome. Methods. Qualitative study of the hermeneutical phenomenology, which conducted in-depth semi-structured interviews with people trained on the irritable bowel syndrome. The sampling was intentional type and open questions were used to collect data. The Thematic Analysis Method by Van Manen was used. Results. Two principal themes and five subthemes emerged in this research to determine the meaning of living with the irritable bowel syndrome: Storm in corporality (body with pain and affliction, tension and sequence of symptoms, and: distress during moments of life) and Relief (sense of liberation of the body symptoms, and moments with pleasure). Conclusion. The experience lived by patients with irritable bowel syndrome is of a transitory crisis and liberation.

Objetivo. Conocer la experiencia de vivir con el Síndrome del Intestino Irritable. Métodos. Estudio cualitativo de la fenomenología hermenéutica en el que se realizaron entrevistas semiestructuradas en profundidad a personas con diagnóstico de síndrome del intestino irritable. El muestreo fue de tipo intencional y se utilizaron preguntas abiertas para recopilar los datos. Se empleó el método de análisis temático de Van Mennen. Resultados. Dos temas principales y cinco subtemas emergieron en la presente investigación para determinar el significado de vivir con este síndrome: Tormenta en la corporalidad (cuerpo con dolor y aflicción, tensión y secuencia de síntomas, y: angustia en los momentos de la vida) y Alivio (sensación de liberación de los síntomas corporales, y momentos con placer). Conclusión. La experiencia vivida de pacientes con síndrome del intestino irritable es de una crisis transitoria y de liberación.

Objetivo. Investigar a natureza de viver com a Síndrome do Intestino Irritável. Métodos. Estudo qualitativo da fenomenologia hermenêutica na qual se realizaram entrevistas semiestruturadas em profundidade a pessoas com diagnóstico de síndrome do intestino irritável. A amostragem foi de tipo intencional e se utilizaram perguntas abertas para recopilar os dados. Se empregou o método de análises temático de Van Mennen. Resultados. Dois temas principais e cinco subtemas emergiram na presente investigação para determinar o significado de viver com a Síndrome do Intestino Irritável: Tormenta na corporalidade (corpo com dor e aflição, tensão e sequência de sintomas, e: angustia nos momentos da vida) e Alívio (sensação de liberação dos sintomas corporais, e momentos com prazer). Conclusão. A experiência vivida de pacientes com síndrome do intestino irritável é de uma crises transitórias e liberação.

The Effect of Aerobic Exercise on Occupational Stress of Female Nurses: A Controlled Clinical Trial

Abstract Objective. This work sought to determine the effectiveness of an aerobic exercise program on the occupational stress of nurses. Methods. Prevention-type controlled clinical trial carried out with the participation of 60 nurses working in hospitals affiliated to Shahrekord University of Medical Sciences in Iran. Randomly, the nurses were assigned to the experimental group or to the control group. The intervention consisted in an aerobic exercise program lasting three months with three weekly sessions one hour each. The Health and Safety Executive (HSE) questionnaire measured occupational stress with 35 questions, each with five Likert-type response options, which can have a maximum score of 175 points; higher scores meant lower levels of occupational stress. The HSE was evaluated during three moments: upon registering, after finishing the exercise program (week 8), and two months after terminating the intervention (week 16). Results. The level of occupational stress was the same in the experimental and control groups during registration (86.2 vs. 86.3). Upon finishing the aerobic exercise program(week 8), the experimental group showed a higher score than the control group (119.7 vs. 86.2, p<0.01), with this score diminishing after two months of having ended the intervention (91.4 vs. 85.8, p=0.061). Conclusion. The aerobic exercise program was associated to decreased work stress of nurses in the experimental group compared to the control group at eight weeks, but this difference did not persist when the experimental group did not continue with the program.

Resumen Objetivo. Determinar la efectividad de un programa de ejercicio aeróbico en el estrés ocupacional de las enfermeras. Métodos. Ensayo clínico controlado de tipo preventivo que se llevó a cabo con la participación de 60 enfermeras que trabajaban en hospitales afiliados a Shahrekord University of Medical Sciences en Irán. Las enfermeras se asignaron aleatoriamente al grupo experimental o al grupo control. La intervención consistió en un programa de ejercicio aeróbico realizado durante dos meses con tres sesiones semanales de una hora de duración. El estrés ocupacional se midió con el cuestionario Health and Safety Executive (HSE) de 35 preguntas, con opciones de respuesta tipo Likert que van de 1 a 5; puede llegar a puntuar en 175 como máximo: a mayor puntaje, menor el nivel de estrés ocupacional. Se evaluó el HSE en tres momentos: en la inscripción, después de finalizar el programa de ejercicio (semana 8) y también dos meses después de terminada la intervención (semana 16). Resultados. Fue igual el nivel de estrés ocupacional en los grupos de intervención y de control en la inscripción (86.2 vs. 86.3), pero al finalizar el programa de ejercicios aeróbicos (semana 8) el grupo experimental mostró un puntaje mayor que el del grupo control (119.7 vs. 86.2, p<0.01), para luego disminuir este puntaje a los dos meses de haber finalizado la intervención, (91.4 vs. 85.8, p=0.061). Conclusión. El programa de ejercicio aeróbico se asoció a la disminución del estrés laboral de las enfermeras en el grupo de intervención en comparación con el grupo control a las ocho semanas, pero esta diferencia no se mantuvo cuando el grupo experimental no continuó con el programa.

Resumo Objetivo. Determinar a efetividade de um programa de exercício aeróbico sobre o estresse ocupacional das enfermeiras. Métodos. Ensaio clínico controlado de tipo preventivo que se levou a cabo com a participação de 60 enfermeiras que trabalhavam em hospitais afiliados a Shahrekord University of Medical Sciences no Irã. Em forma aleatorizada, as enfermeiras foram designadas ao grupo experimental ou ao grupo controle. A intervenção consistiu num programa de exercício aeróbico realizado durante dois meses com três sessões semanais de uma hora de duração. O estresse ocupacional se mediu com o questionário Health and Safety Executive (HSE) de 35 perguntas, que tem opções de resposta tipo Likert que vão de 1 a 5, pode chegar a pontuação de 175 como máximo; a maior pontuação, é menor o nível de estresse ocupacional. Se avaliou o HSE em três momentos: a inscrição, depois de finalizar o programa de exercício (semana 8) e também dois meses depois de terminada a intervenção (semana 16). Resultados. Foi igual o nível de estresse ocupacional nos grupos de intervenção e de controle na inscrição (86.2 vs. 86.3), mas ao finalizar o programa de exercícios aeróbicos (semana 8) o grupo experimental mostrou uma pontuação maior que o do grupo controle (119.7 vs. 86.2, p<0.01), para depois diminuir esta pontuação aos dois meses de haver finalizado a intervenção, (91.4 vs. 85.8, p=0.061). Conclusão. O programa de exercício aeróbico se associou à diminuição do estresse profissional das enfermeiras no grupo de intervenção em comparação com o grupo de controle às oito semanas, mas esta diferença não se manteve quando o grupo experimental não continuou com o programa.

Primary cardiac osteosarcoma: A rare cause of chest pain in a young man

Although primary cardiac osteosarcoma is uncommon, cardiac neoplasms should be in the differential diagnosis of cardiac complaints. We present a case of a 35 year old man with recurrent episodes of exertional chest pain and who was diagnosed with primary cardiac osteosarcoma. Cardiac osteosarcomas are rare but must be suspected.

Healing effects of Pergularia tomentosa L., a native medicinal plant in Bushehr province, Iran on burn, in animal model

Burn injury is one of the most destructive events in the world. The Pergularia tomentosa L. is a medicinal plant that traditionally, applies for treatment of burning, in Bushehr province, Iran. Various bioactive compounds such as steroid glycosides, tannins, various vitamins, saponins, cardenolides and anthraquinones were identified into extract of the plant, which can be effective in burn wound healing. Twenty-one rats weighting every one 200+/-5 grams were divided equally into three groups. The second-degree burning induced on all groups. One of groups did not receive any treatment [The control group] and was treated locally with saline and eucerin. The Second group received the P. tomentosa L. as a topical ointment, and the third group received locally, a thin layer of silver sulfadiazine ointment 3% after washing the wound with saline. Afterward treatment period, the microscopic slides from histological sections were prepared. At that point, amounts of the fibroblast cells, blood vessels, wound area, necrotic tissues, and diameter of epidermis rate of wound healing were determined. Also the exterior status of wound in different days was considered. Results obtained from current study have revealed that the extract of P. tomentosa L. can significantly, cause qualitative and quantitative acceleration in healing of second degree burn wounds, due to their bioactive and vasoactive properties. In conclusion the P. tomentosa L. can is used as an overborne medicine with lower cost and side effect than the similar chemical medicines. Although, the further studies are needed on these plants, due to their some toxic effects

Acetylcholinesterase inhibitory activity of a neurosteroidal alkaloid from the upside-down jellyfish Cassiopea andromeda venom

Abstract Natural compounds from marine organisms have been rarely studied for their acetylcholinesterase inhibitory activities. The aim of this study was to isolate novel compounds with antiAChE activity from the venom of upside-down jellyfish Cassiopea andromeda Forskål, 1775. The compounds of the fractionated venom on gel filtration chromatography were identified by analyzing gas chromatography-mass spectroscopy data. The structure of the isolated compound that showed the most potent antiAChE activity in a docking study was elucidated by different spectral data, including 1H NMR and 13C NMR. Three compounds, including a neurosteroidal alkaloid androtoxin B, were identified from two venom fractions. This neurosteroidal alkaloid showed strong acetylcholinesterase inhibitory activity (IC50 2.24 ± 0.1 µM) compared with the reference standard, galantamine. The results obtained by a docking study demonstrated that Androtoxin B had close contact with two of the three amino acid residues of the catalytic triad of acetylcholinesterase gorge and was accommodated within a peripheral hydrophobic pocket composed of numerous aromatic site chains. In conclusion, the isolated neurosteroidal alkaloid from Cassiopea andromeda was a potent antiAChE agent with strong binding to both the catalytic and peripheral sites of acetylcholinesterase that correlated well with the experimental data. Further studies are required to determine whether androtoxin B could be a potential treatment for Alzheimer's disease.

Characterization of the "a" determinant region of the hepatitis B virus genome in Iranian patients at different clinical phases of chronic infection

Aim: To determine the distribution of important mutations of the "a" determinant region in the HBV genome among patients in different clinical phases of HBV infection

Background: Variations in Hepatitis B infection not only change the outcome of the disease but also the symptoms from which the chronic HBV patients are suffering

Methods: We have meticulously selected a total of 40 chronic HBV patients from four different subclasses of chronic HBV clinical phases including immune tolerant [IT], immune active [IA], inactive carrier [1C] and hepatitis B e antigen [HBeAg]-negative [ENEG]; 10 samples per each phase. Mutations of the [a] determinant region were identified using PCR-Direct sequencing method

Results: 17 amino-acid substitutions at 12 positions inside the [a] determinant were identified in all forty samples; 3 mutations in the IT group, 6 mutations in the IA phase, 3 mutations in the 1C patients and 5 mutations in the ENEG phase. Different substitutions were observed in all four clinical phases. The IA phase was the most variant group with the highest number of amino-acid substitutions

Conclusion: These results did not reveal a strong pattern to distinguish different clinical phases of Chronic HBV infection, but there are some obvious differences regarding the number and position of mutations between these four clinical phases

Detection of Parvovirus 4 in Iranian patients with HBV, HCV, HIV mono-infection, HIV and HCV co-infection

Aim: In this study, we investigated the prevalence of PARV4 virus among the healthy population and four other groups of HBV infected, HCV infected, HIV infected and HIV/HCV co-infected individuals in Iran

Background: Parvovirus 4 [PARV4] was first discovered in 2005, in a hepatitis B virus-infected injecting drug user [IDU]. To date, the best evidence about PARV4 transmission is parenteral roots which comes from IDU individuals. It seems that the prevalence of the virus in the normal population is very low

Methods: A total of 613 patients, including chronic HCV [n=103], HBV [n=193], HIV [n=180] infected individuals, HIV/HCV [n=34] co-infected patients and 103 healthy controls, were studied by using nested-PCR and also real-time PCR techniques

Results: Of those 180 samples were positive for HIV RNA, co-infection of PARV4 was detected in 3 cases [1.66%]. All these three patients were male with the age of 28, 32 and 36 years [mean: 32]. No statistical differences were found between HIV positive group and the healthy individuals. [P>0.05] The result of PARV4 PCR was negative in all other samples and healthy controls as well

Conclusion: This study is the first to investigate the occurrence of PARV4 among these groups in Iran. The results show, that the virus is not significant in Iranian population, even in patients with blood born infections such as HCV, HBV or even HIV patients. Further studies in other areas and various groups are required

Genetic analysis of Iranian patients with familial hypercholesterolemia

Background: Familial hypercholesterolemia [FH] is a frequent autosomal dominant disorder of lipoprotein metabolism. This disorder is generally caused by mutations in low-density lipoprotein receptor [LDLR], apolipoprotein B 100 [APOB], and proprotein convertase subtilisin/kexin type 9 [PCSK9] genes. In the present study, we aimed at identifying the common LDLR and APOB gene mutations in an Iranian population

Methods: Eighty unrelated Iranian patients with FH entered the study, based on Simon Broome diagnostic criteria. All samples were screened for two common APOB gene mutations, including R3500Q and R3500W, by the means of ARMS-PCR and PCR- RFLP assays, respectively. In addition, exons 3, 4, 9, and 10 of LDLR gene were sequenced in all patients

Results: A novel mutation in exon 3 [C95W] and a previously described mutation in exon 4 [D139H] of LDLR gene were found. Three previously reported polymorphisms in LDLR gene as well as three novel polymorphisms were detected in the patients. However, in the studied population, no common mutations were observed in APOB gene

Conclusion: The results of our study imply that the genetic basis of FH in Iranian patients is different from other populations

ODF4, MAGEA3, and MAGEB4: potential biomarkers in patients with transitional cell carcinoma

Background: This study aimed to evaluate the diagnostic value of outer dense fiber 4 [ODF4], melanoma associated antigen A3 [MAGEA3], and MAGEAB4 mRNAs in transitional cell carcinoma [TCC], using a small amount of cell reverse transcriptase-polymerase chain reaction [RT-PCR] on urinary exfoliated cells

Methods: We recruited a total of 105 suspected TCC patients and 54 sex- and age-matched non-TCC controls. The candidates' genetic expression patterns were investigated with RT-PCR, while reverse transcription quantitative PCR was applied to quantify and compare each mRNA level between cases and control groups

Results: The sensitivity of ODF4, MAGEA3, and MAGEAB4 RT-PCR was 54.8%, 63%, and 53.4%, whereas the specificity was 73.7%, 86%, and 94.7%, respectively. Combining ODF4, MAGEA3, and MAGEAB4 RT-PCR offered a relatively higher sensitivity [83.6%]

Conclusion: RT-PCR with ODF4, MAGEA3, and MAGEAB4 on urinary exfoliated cells could provide clinicians with a promising method to improve TCC diagnosis, especially in the case of gross hematuria and catheterization. The method used here is non-invasive, simple and convenient, and unlike cytology, it does not rely directly on expert professional opinions. These features can be of particular importance to the management of TCC patients in whom regular and lifelong surveillance is required

Systematic review of priority setting studies in health research in the Islamic Republic of Iran

Background: Several research priority-setting studies have been conducted in different countries, including the Islamic Republic of Iran.

Aims: We conducted a systematic review and evaluated the quality of the priority-setting reports about health research in the Islamic Republic of Iran.

Methods: English and Farsi databases were searched from January to July 2016 to extract reports [up to December 2015] about priority setting in health research in the Islamic Republic of Iran. We constructed a checklist to extract data from the identified studies. Articles were studied in detail and content analysis was carried out. Relevant items were scored and analysed using Microsoft Excel.

Results: We identified 36 articles. Eight articles involved all the main stakeholders. About half the articles used valid criteria for ranking. Transparency was fulfilled in 13 articles. Upstream rules and regulations were ignored in 26 articles. An implementation plan was considered in 9 articles and context analysis was demonstrated in only 3.

Conclusions: Developing standard packages for priority setting, training of researchers and improving the capacity of organizations may improve the quality of priority-setting studies in the future.

Genetic association between a single nucleotide polymorphism in Interleukin-16 [rs4072111] and susceptibility to chronic HCV infection in an Iranian population

Aim: Our goal was to identify the putative association of rs4072111 variant in IL-16 gene and HCV susceptibility in an Iranian population

Background: Interleukin 16 [IL-16], a multifunctional cytokine, plays a vital role in modulation of immune system

Methods: In present case control and cross sectional study, IL-16 gene variant in 300 patients with hepatitis C [HCV] infection and 300 healthy individuals were analyzed. To evaluate this possible association, genomic DNA from venous blood was extracted and genotypes of IL-16 rs4072111 variant were determined by polymerase chain reaction- Fragments Length Polymorphism Technique [PCR-RFLP]. Then, rs4072111 C/T genotypes frequency and allelic distribution were evaluated in each group

Results: The results of genotyping showed 82% CC, 17.3% CT, 0.7% TT in the control group and 78% CC, 20% CT and 2% TT in the case group. The distribution of rs4072111 C allele was 90.7% in controls and 88% in case group respectively. However, no correlation between IL-16 rs4072111 C/T variants and susceptibility to chronic HCV infection was found in the present study

Conclusion: We concluded the rs4072111 C/T cannot be considered as a proper biomarker to identify susceptibility to chronic hepatitis C virus infection

[ effect of high intensity interval training on the serum levels of irisin and fibroblastic growth factor-21 [FGF-21], and insulin resistance in obese male rats]

Introduction: the purpose of this study was to investigate the effects of high intensity interval training [HIIT] and moderate intensity continuous training [MICT] on irisin, FGF-21 and insulin resistance in obese male rats

Material and Methods: forty male rats were divided into two groups: high-fat diet [n=32] and standard diet [n=8], for 10 weeks. After inducing obesity, eight rats from the high-fat diet group [O] and eight from the standard dietary group [C] were sacrificed, and the other obese rats were randomly divided into three groups: obesity control [OC], moderate intensity continuous training [MICT] and high intensity interval training [HIIT]. The HIIT protocol, including 10 bouts of 4-minute activity with equivalent intensity of 85-90% vo2max and 2 minute active rest periods, and the MICT protocol with equivalent intensity of 65-70% VO2max, with covered distance matched to that of the HIIT protocol, were performed for 12 weeks and 5 sessions per week. Serum samples were collected in two steps [after completion of diet and training protocols] to measure serum levels of irisin, FGF-21, insulin and glucose by ELISA

Results: in the comparison of the HIIT group to the OC group, serum levels of irisin [6.43 +/- 0.93 ng/ml vs. 4.61 +/- 0.61 ng/ml, p=0.003] and FGF-21 [1658 +/- 206.5 ng/l vs. 1093 +/- 125.97 ng/l, P=0.007] significantly increased, while MICT had no significant effect on these two hormones [P=0.29, P=1.00 respectively]. Also, when comparing both the HIIT and MICT groups to the OC group, serum levels of glucose [HIIT: 111.16 +/- 4.07 mg/dl, MICT: 117.5 +/- 1.37 mg/dl vs. 154.66 +/- 13.21 mg/dl, P=0.001, P=0.001 respectively] and insulin resistance index [HIIT: 1.96 +/- 0.20, MICT: 2.53 +/- 0.46 vs. 3.89 +/- 0.54, P=0.001, P=0.01 respectively] significantly decreased; although, serum insulin reduction [1.49 +/- 0.15 ng/ml vs. 2.14 +/- 0.43 ng/ml, P=0.018] was only significant in the HIIT group [P=0.018]

Conclusion: it seems that both HIIT and MICT training protocols lead to improved insulin resistance in obese rats. However the increase in serum irisin and FGF-21 was significant only in the HIIT group, suggesting that exercise intensity plays an important role in regulating the secretion of these hormones

The sphenoid sinus, foramen rotundum and vidian canal: a radiological study of anatomical relationships / Seio esfenoidal, forame redondo e canal pterigoideo: estudo radiológico das relações anatômicas

Abstract Introduction: The sphenoid sinus is an important structure in ventral skull base surgeries that is surrounded by several vital anatomical structures including the internal carotid arteries, optic nerve and cranial nerves inside the cavernous sinus. In addition, the foramen rotundum is a small canal deeply situated in the base of the skull, which represents the way for exit of the maxillary nerve. Understanding of the sphenoid bone anatomical relationships is central to the expanded endonasal approaches to the skull base. Objective: To record and analyze the measurement indexes of the sphenoid sinus and foramen rotundum in the coronal plane of normal computer tomography scans. Methods: Patients underwent paranasal sinuses computer tomography scan from June 2014 to November 2015 were retrospectively entered this cross-sectional study. We obtained several morphometric measurements from both the right and left sides using computer software. We also classified foramen rotundum and vidian canal types and determined position of the foramen rotundum regarding to base of lateral pterygoid plate. Results: One-hundred patients with the mean age of 38.56 ± 18.51 years entered this study. Mean bilateral FR distances were 38.48 ± 3.87 mm. Average right and left FRs distances to midline were 19.00 ± 2.07 and 19.34 ± 2.17 mm, respectively (p = 0.03). Twenty-eight cases (28%) had type I vidian canal, 48% and 24% had type II and III vidian canals, respectively. Four patients (4%) had type I rotundum foramen, 28% and 44% had type IIa and IIb, respectively and 24% had type III rotundum foramen. The position of foramen rotundums regarding to the base of lateral pterygoid plate was online in 50% of cases, medially placed in 47% and laterally placed in 3% of cases. Conclusion: The results of this study can be used to provide a better anatomical understanding of the area, which is necessary for endoscopic skull base surgeons.

Resumo Introdução: O seio esfenoidal (SE) é uma estrutura importante em cirurgias da base do crânio, que está cercada por várias estruturas anatômicas vitais, como as artérias carótidas internas, o nervo óptico e os nervos cranianos no interior do seio cavernoso. Além disso, o forame redondo (FR) é um pequeno canal profundamente situado na base do crânio, que representa a forma de saída do nervo maxilar. Compreender as relações anatômicas do osso esfenoidal é fundamental para as abordagens endonasais expandidas da base do crânio. Objetivo: Registrar e analisar os índices de medição do SE e FR no plano coronal de exames normais de tomografia computadorizada (TC). Método: Os pacientes que foram submetidos a TC dos seios paranasais (SPN) de junho de 2014 a novembro 2015 foram retrospectivamente incluídos neste estudo transversal. Obtivemos várias medidas morfométricas de ambos os lados, direito e esquerdo, com o uso do software de computador. Também classificamos os tipos de FR e canal pterigoideo (CP) e determinamos a posição do FR em relação à base da placa pterigoide lateral. Resultados: Cem pacientes com a média de 38,56 ± 18,51 anos foram incluídos neste estudo. As distâncias médias bilaterais de FR foram de 38,48 ± 3,87 mm. As distâncias médias direita e esquerda dos FR até a linha média foram de 19,00 ± 2,07 e 19,34 ± 2,17 mm, respectivamente (p = 0,03). Vinte e oito casos (28%) tinham canal pterigoideo do tipo I, 48% e 24% canais pterigoideos de tipo II e III, respectivamente. Quatro pacientes (4%) tinham forame redondo do tipo I, 28% e 44% do tipo II-a e II-b, respectivamente, e 24% forame redondo do tipo III. A posição dos FR em relação à base da placa pterigoide lateral era em linha em 50% dos casos, medialmente posicionados em 47% e lateralmente posicionados em 3% dos casos. Conclusão: Os resultados deste estudo podem ser usados para promover uma melhor compreensão anatômica da área, necessária para cirurgias endoscópicas da base do crânio.