Assessing angiogenesis factors as prognostic biomarkers in breast cancer patients and their association with clinicopathological factors.

INTRODUCTION: Angiogenesis is fundamental for tumor growth and metastasis across many solid malignancies. Considerable interest has focused on the molecular regulation of tumor angiogenesis as a means to predict disease outcomes and guide therapeutic decisions. METHODS: In the present study, we investigated the prognostic value of transforming growth factor beta (TGF-ß), epidermal growth factor (EGF), fibroblast growth factor (FGF), delta-like ligand 4 (DLL4), and vascular endothelial growth factor (VEGF) in the serum of 120 women diagnosed with breast cancer using ELISA as well as examined their associations with clinical parameters and the outcome of the disease. RESULTS: Our results demonstrated that the serum concentration of TGF-ß and EGF were remarkably higher in patients with higher tumor size, end stages of the disease, and positive lymph node involvement compared to patients with lower tumor size, early stages of the disease, and negative lymph node involvement. In addition, we found a significant correlation between the serum concentration of VEGF and the level of EGF, FGF, and DLL4 in patients with breast cancer. Furthermore, both univariate and multivariate analyses showed that TGF-ß and EGF can be used as end-stage predictors. DISCUSSION/CONCLUSION: Based on our findings, increasing the level of angiogenesis factors is significantly associated with higher tumor size and late stages of the disease in patients with breast cancer. Moreover, measuring the level of angiogenesis factors could lead to better prediction of disease outcomes and choosing the best treatments for patients.

T-Cell Immune Responses and Immunological Factors Associated with Coronavirus Disease 2019 Progression as Predictors for the Severity of the Disease in Hospitalized Patients.

INTRODUCTION: The prevalence of coronavirus disease 2019 (COVID-19) has rapidly increased worldwide. More investigation is needed to progress toward understanding the exact role of immune responses in the pathology of the disease, leading to improved anticipation and treatment options. METHODS: In the present study, we examined the relative expression of T-bet, GATA3, RORγt, and FoxP3 transcription factors as well as laboratory indicators in 79 hospitalized patients along with 20 healthy subjects as a control group. In order to make an exact comparison between various degrees of severity of disease, patients were divided into critical (n = 12) and severe (n = 67) groups. To evaluate the expression of genes of interest by performing real-time PCR, blood samples were obtained from each participant. RESULTS: We found a significant increase in the expression of T-bet, GATA3, and RORγt and a reduction in the expression of FoxP3 in the critically ill patients compared to the severe and control groups. Also, we noticed that the GATA3 and RORγt expressions were elevated in the severe group in comparison with healthy subjects. Additionally, the GATA3 and RORγt expressions showed a positive correlation with elevation in CRP and hepatic enzyme concentration. Moreover, we observed that the GATA3 and RORγt expressions were the independent risk factors for the severity and outcome of COVID-19. DISCUSSION: The present study showed that the overexpression of T-bet, GATA3, and RORγt, as well as a decrease in the FoxP3 expression was associated with the severity and fatal outcome of COVID-19.

Effect of clove mouthwash on the incidence of ventilator-associated pneumonia in intensive care unit patients: a comparative randomized triple-blind clinical trial.

OBJECTIVES: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in intensive care units (ICUs), and the use of mouthwash is the most widely used method to prevent its incidence. The aim of this study was to investigate effect of clove mouthwash on the incidence of VAP in the ICU. MATERIALS AND METHODS: This comparative, randomized, triple-blind, clinical trial was conducted on 168 eligible ICU patients at Kosar Hospital in Semnan, Iran, during 2021-2022, who were divided into intervention and control groups using random blocks. The intervention group received clove extract mouthwash at 6.66% concentration, and the control group received chlorhexidine 0.2% twice a day for 5 days (routine care). Data were collected using a demographic questionnaire, and disease severity was measured based on the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, oral health status was examined using the Beck Oral Assessment Scale (BOAS), and VAP diagnosis was made based on the Modified Clinical Pulmonary Infection Score (MCPIS). RESULTS: Before the intervention, there was no significant difference in disease severity (p = 0.412) and oral health status (p = 0.239) between the patients in the two groups. After the intervention, 20.2% of the patients in the intervention group and 41.7% of those in the control group acquired VAP. The risk of VAP was 2.06 times higher in the control group than in the intervention group (p = 0.005, 95% CI: 1.26-3.37, RR = 2.06), but the severity of VAP did not differ significantly between the patients in the two groups (p = 0.557). CONCLUSION: The findings showed that clove mouthwash reduces the incidence of VAP significantly. CLINICAL RELEVANCE: Clove mouthwash can be used as a simple and low-cost method to prevent VAP in ICU patients.

Immunomodulatory effects of probiotic supplementation in patients with asthma: a randomized, double-blind, placebo-controlled trial.

BACKGROUND: Asthma is considered to be a chronic inflammatory disorder of the airways. Probiotics are living microorganisms that are found in the human gut and have protective effects against a wide range of diseases such as allergies. The aim of this study was to investigate the improvement of clinical asthma symptoms and changes in the expression pattern of selective microRNAs in patients with asthma and the changes in IL-4 and IFN-γ plasma levels after receiving probiotics. MATERIALS AND METHODS: The present study was a randomized, double-blind, placebo-controlled trial that enrolled 40 asthmatic patients. They were treated with probiotics or placebo: 1 capsule/day for 8 weeks. Pulmonary function tests, IL-4 and IFN-γ levels, and expression of microRNAs were assessed at baseline and after treatment. RESULTS: The results showed that the expression of miR-16, miR146-a and IL-4 levels in patients with asthma after receiving probiotic supplementation was significantly reduced and miR-133b expression was increased. In addition, pulmonary function tests showed a significant improvement in Forced Expiratory Volume in 1 s and Forced Vital Capacity after receiving probiotics. CONCLUSION: In our study, 8-week treatment with probiotic supplementation led to reduced Th2 cells-associated IL-4 and improved Forced Expiratory Volume and Forced Vital Capacity. It appears probiotics can be used in addition to common asthma treatments.

Multistrain Probiotics Supplement Alleviates Asthma Symptoms via Increasing Treg Cells Population: A Randomized, Double-Blind, Placebo-Controlled Trial.

INTRODUCTION: The favorable effects of probiotics have been demonstrated in allergic disorders. However, the underlying immunological mechanisms are poorly understood. In the present study, we investigated the improvement of clinical symptoms and immunological balance after receiving probiotics in patients with asthma. METHODS: The present study was a randomized, double-blind, placebo-controlled trial in which 40 patients with asthma were enrolled. They were treated with probiotics or placebo: 1 capsule/day for 8 weeks. Pulmonary function test, percentage of CD4+ CD25+ FoxP3+ Tregs, and gene expression of T-bet, GATA-3, RORγt, and Foxp3 in PBMCs were assessed at baseline and after treatment. RESULTS: Our results showed a significant increase in the expression of FoxP3 and CD4+ CD25+ FoxP3+ Tregs population, while RORγt and GATA3 expression were reduced. In addition, pulmonary function tests showed a significant improvement in forced expiratory volume and forced vital capacity after receiving probiotics. DISCUSSION/CONCLUSION: Our findings demonstrate that 8-week treatment with probiotic supplementation can control T-helper 2-predominant and Th17 pro-inflammatory responses and improve forced vital and forced expiratory volume in asthmatic patients. It seems probiotics can be used besides common treatments for patients with asthma.

The impact of multistrains of probiotics on Th17-related cytokines in patients with asthma: a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: Asthma is known as one of the most common chronic inflammatory diseases characterized by recurrent obstruction and inflammation of the airways. Probiotics are defined as a group of beneficial living microorganisms that are beneficial in many disorders, including allergies. The aim of this study was to investigate the probiotic supplement effects on improvement of clinical asthma symptom and changes in the pattern of Th17-related inflammatory cytokines in asthmatic patients. METHODS: This was a randomized controlled clinical trial with parallel, double-blind groups. Forty patients with asthma were enrolled and received 1 capsule/day of a probiotic supplement for 8 weeks. Respiratory function tests; and the level of IL-6, IL-17, IL-21 and TGF-ß were evaluated at the baseline and end of intervention. RESULTS: The results showed that the level of IL-6 and IL-17 in patients after receiving probiotics was reduced and expression of TGF-ß was increased as compared to the baseline. Also, the expression of IL-17 and IL-21 in the probiotic group was significantly lower than the placebo group at the end of the intervention. In addition, an improvement in pulmonary function tests and clinical symptoms was observed after receiving probiotics. CONCLUSIONS: Eight-weeks treatment with a probiotic supplementation suggests that it may effect on Th17 cells-associated IL-6, IL-17 and TGF-ß; and Forced Expiratory Volume in 1 s and Forced Vital Capacity. Taken together, these results suggest that probiotics may have the ability to affect neutrophilic asthma and they can possibly be used besides common treatments for patients with neutrophilic asthma.

The Relationship Between Sleep Quality and Quality of Life Among Patients With Asthma.

Background and objective Asthma is a chronic recurring respiratory disease, and its prevalence is on the rise. A drop in the quality of life (QoL), as well as sleep problems, has been reported in asthmatic patients in the literature. This study was conducted to determine the relationship between QoL and sleep quality in asthmatic patients. Methods This cross-sectional study recruited 76 diagnosed asthmatic outpatients from our university clinic. The subjects completed the self-administered 36-Item Short-Form Health Survey QoL questionnaire (SF-36) and the Pittsburgh Sleep Quality Index (PSQI) assessment. Results The study results revealed poor sleep quality in 55 (72.4%) of the subjects. The total sleep quality scores significantly and negatively correlated with the physical and mental components of QoL (moderate, p=0.00). All QoL subscales were significantly higher in patients with good sleep quality (PSQI: <5, p<0.00). Logistic regression analysis showed that good sleep quality (modified) could predict a mental component score (MCS) of more than 64. Conclusion Poor sleep quality can bring down the scores of all QoL components in asthma patients and is the best predictor of their QoL. Therefore, sleep quality and QoL indicators could be applied as part of a better approach to classification, management, and control of asthma.

Evaluation of pulmonary function among detergent powder factory workers- a cross sectional study in Semnan, Iran.

Occupational respiratory diseases are the most prevalent occurring work-related diseases that contribute to global health concerns. The present study aimed to assess pulmonary function among detergent powder factory workers.In a cross-sectional study, 305 employees working at a detergent powder company in Semnan, Iran were enrolled. Demographic characteristics, health- and job-related information were recorded using a checklist. Subsequently, spirometer was used at baseline, before and after shift-working for recording respiratory ailments and pulmonary function tests (PFT).According to the results, the mean percentage of all spirometric indices significantly reduced after shift-work including forced vital capacity (FVC) (P < 0.01), forced expiratory volume in one second (FEV1) (P < 0.01), FEV1/FVC ratio (P = 0.038), peak expiratory flow (PEF) (P = 0.13) and forced expiratory flow at 25 and 75% of the pulmonary volume (FEF (25-75)) (P < 0.01). Although the mean percentage of FEV1 significantly improved upon wearing the protective mask (P = 0.014). Moreover, FVC and FEV1 indices were significantly less in smoking workers than in non-smoking participants (P = 0.005 and P = 0.003, respectively).This study revealed that using effective preventive measures should be tightly performed to promote health conditions. However, despite the occupational health programs for preventing and reducing work-related respiratory diseases, these can be considered as a serious threat for detergent powder factory workers that need to apply more control strategies and health assessment.

Effects of Chlorine Gas Exposure and Associated Factors on Spirometric Parameters in Detergent Industry Workers: a Four-Year Cross-Sectional Study.

BACKGROUND: This study aimed to determine the effects of chlorine gas exposure and the associated factors on spirometric parameters among detergent industry workers in Semnan, Iran. MATERIALS AND METHODS: This four-year cross-sectional study was concocted on 100 workers of two detergent factories in Semnan, Iran. Two questionnaires were used for data collection. The first questionnaire included demographic and occupational information, and the second questionnaire included spirometric parameters, such as forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), and PEF 25-75%. The spirometric parameters were measured over four consecutive years by a trained technician. Next, to determine the effects of chlorine gas exposure and its associated factors on spirometric parameters, a generalized estimating equation (GEE) model was used. The correlation structure of GEE was considered to be autoregressive 1 (AR-1). Analyses were performed in STATA version 14. RESULTS: All spirometric parameters showed a decreasing trend during 2012-2015. The GEE model showed a significant association between chlorine gas exposure and all spirometric parameters; the beta-coefficients for the effect of exposure (year) on FVC, FEV1, FEV1/FVC ratio, PEF, and PEF 25-75% were -4.51, -6.46, -4.27, -6.09, and -10.29, respectively. Also, this model demonstrated a significant association between smoking and FEV1, PEF, and PEF 25-75%; the beta-coefficients for the effect of smoking on these parameters were -5.64, -8.88, and -5.75, respectively. Additionally, the GGE model showed a significant association between the body mass index (BMI) and FVC and FEV1 (P<0.05); the beta-coefficients for the effect of BMI on these two parameters were - 0.59 and -0.48, respectively. CONCLUSION: The spirometric parameters showed a decreasing trend over time among detergent industry workers; this decline was more remarkable among individuals with a history of smoking. Therefore, it seems necessary to implement screening programs and periodic active examinations for these workers.

Improved solid phase extraction for selective and efficient quantification of sunset yellow in different food samples using a novel molecularly imprinted polymer reinforced by Fe3O4@UiO-66-NH2.

The overuse of synthetic dyes in food products has gradually increased in recent years, resulting food safety and human health has become a global issue. An innovative design of a magnetic molecularly imprinted polymer (Fe3O4@UiO-66-NH2@MIP) for efficient, fast, and selective determination of sunset yellow (SY) from different food products was described in this study. The absorption properties of Fe3O4@UiO-66-NH2@MIP were elucidated by adsorption kinetics, isotherms, reusability, and selectivity experiments. Because of the incorporation of porous Fe3O4@UiO-66-NH2nanocomposite into molecularly imprinted polymer an efficient nanosorbent with a short equilibrium time, a high adsorption capacity, and a good imprinting factor was finally obtained. The porous Fe3O4@UiO-66-NH2@MIP are also used for quantification of the SY. Under optimal conditions, good linearity (R2 0.9964) in the range of 1.0-120 mg L-1 and a low limit of detection (0.41 mg L-1) was observed with satisfactory recoveries (92.50-106.1%) and excellent reusability (RSD ≤ 6.6% after 12 cycles).

Prevalence of Sleep Apnea and its Associated Factors in Chronic Kidney Disease Patients.

BACKGROUND: This study aimed to determine the prevalence of sleep apnea and its associated factors in patients with chronic kidney disease (CKD). MATERIALS AND METHODS: This population-based cross-sectional study included 47 CKD patients, referred to the dialysis unit of Kosar Hospital in Semnan, Iran, in 2017. Two questionnaires were used for data collection. The first questionnaire included demographic and clinical variables, and the second questionnaire (STOP-BANG questionnaire) was used to measure sleep apnea in CKD patients. Also, the Apnea-Hypopnea Index (AHI) was calculated for all patients and was considered as the gold standard. To determine the factors associated with sleep apnea, univariate and multiple logistic regression models were used. Finally, the area under the receiver operating characteristic curve (ROC) was determined for assessing the discriminative ability of the model, as well as the accuracy of STOP-BANG questionnaire. STATA version 14 was used for data analysis. RESULTS: The prevalence of sleep apnea in CKD patients was 53.2%. Also, its prevalence in women and men was 52% and 48%, respectively. In the multiple logistic regression model, body mass index (BMI) (OR: 1.21, 95% CI: 1.04-1.31) and blood urea nitrogen (BUN) (OR: 0.94, 95% CI: 0.91-0.98) had significant associations with sleep apnea in CKD patients; the area under the ROC curve was 0.7982 for this model. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the ROC curve of STOP-BANG questionnaire for AHI≥15 were 71.43, 61.54, 60, 72.73, and 0.6932, respectively. CONCLUSION: This study showed that the prevalence of sleep apnea in CKD patients was high. Given the acceptable validity of STOP-BANG questionnaire, this scale can be used to screen sleep apnea in CKD patients.

Changes in spirometric parameters after protective interventions among workers at a chlorine production plant in Iran.

OBJECTIVES: This study was conducted to assess changes in spirometric parameters after protective interventions among workers at a chlorine production plant in Semnan, Iran during 2012-2016. METHODS: This quasi-experimental study included 100 workers at a chlorine production plant in Semnan during 2012-2016. Spirometric parameters (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1/FVC, peak expiratory flow [PEF], and PEF occurring in the middle 50% of the patient's exhaled volume [PEF 25-75%]) were measured in all workers before the initial intervention in 2012. Protective interventions were then implemented for 4 consecutive years and the parameters were measured annually. A multivariable linear regression model was used to assess the factors affecting spirometric parameters before and after the protective interventions in SPSS version 24. RESULTS: The mean values of all spirometric parameters significantly increased after the protective interventions (p<0.05). Multivariable linear regression showed that age (ß=-0.40), body mass index (BMI) (ß=0.71; 95% confidence interval [CI], 0.11 to 1.31), and type of mask (ß=-7.88; 95% CI, -15.96 to -0.46) had significant effects on the mean difference in FVC. Similarly, age (ß=-0.35; 95% CI, -0.70 to -0.01), BMI (ß=0.80; 95% CI, 0.20 to 1.41) and type of mask (ß=-8.88; 95% CI, -16.98 to -0.79) had significant associations with the mean difference in FEV1. The type of mask (ß=-12.81; 95% CI, -25.01 to -0.60) had a significant effect on the mean difference in PEF. CONCLUSIONS: All spirometric parameters significantly increased in workers after protective interventions were implemented. Therefore, protective interventions to prevent respiratory disorders in workers exposed to chlorine gas are suggested.

Adherence to Principles of Medical Ethics Among Physicians in Mazandaran Province, Iran.

BACKGROUND: Considering that medical ethics is an applied subject providing systematic solutions to help physicians with moral issues, this research aimed to evaluate adherence to the principles of medical ethics among physicians on the basis of attitude of physicians of Mazandaran province. METHODS: This cross-sectional study was conducted in Mazandaran province, Iran during 2015. A researcher-made questionnaire was used for data collection. The questionnaire was first completed by 40 physicians and its reliability was confirmed by obtaining a Cronbach's alpha coefficient equal to 0.818. Its validity was confirmed by medical ethics experts. Therefore, the questionnaire was reliable and valid. Analytical and descriptive analysis were performed. RESULTS: According to our findings, there is a significant correlation between some of variables of medical ethics principles. The results show that adherence to indicators of beneficence, non-maleficence and justice has been almost good; however, physicians' ethical behaviors which pertain towards the principle of autonomy have not been acceptable. There was not any significant difference in adherence to the principles of autonomy, beneficence and non-maleficence, and justice on the basis of sex, residency, education and occupation. CONCLUSION: According to the present study, more training is required to improve physicians' adherence to the principles of medical ethics .

Health-related quality of life of patients with asthma: a cross-sectional study in Semnan, Islamic Republic of Iran.

Asthma can profoundly affect the quality of life of individuals with the disease. There are limited data on the quality of life of people with asthma in the Islamic Republic of Iran. This cross-sectional study aimed to evaluate quality of life in adults with asthma in Semnan using the 36-item short form health survey (SF-36). The effect of sociodemographic characteristics on quality of life scores was examined. The study included a convenience sample of 385 outpatients with asthma attending a pulmonary clinic from June to December 2013. The mean physical and mental component scores were 58.8 (SD 18.3) and 57.3 (SD 17.0) respectively. The study sample had lower quality of life scores in all the fields than the reference population (P < 0.05). Patients with lower education, urban residents, widowed/divorced patients and manual workers had lower quality of life scores (P < 0.05). Efforts are needed to improve the quality of life of people with asthma in parallel with precise management plans.

Effects of hydrogen peroxide mouthwash on preventing ventilator-associated pneumonia in patients admitted to the intensive care unit

Abstract Aims The aim of the study was to determine the effect of hydrogen peroxide (HP) mouthwash on the incidence of ventilator associated pneumonia (VAP) in patients admitted to the intensive care unit (ICU). Methods This was a randomized clinical trial conducted on 68 patients. The intervention group used 3% HP as mouthwash and the control group used mouthwashes with 0.9% normal saline (NS) twice a day. Data were collected using a questionnaire and the Modified Clinical Pulmonary Infection Score (MCPIS). MCPIS includes five items, body temperature: white blood cell count, pulmonary secretions, the ratio of pressure of arterial oxygen (PaO2) to fraction of inspired oxygen (FiO2), and the chest X-ray. Each of these items scored 0–2. Scores ≥6 were considered as VAP signs. The SPSS-20 software was employed to analyze the data. Results In total, 14.7% patients of the HP group and 38.2% patients of the NS group contracted VAP. The risk of VAP in the NS group was 2.60 times greater than that in the HP group (RR = 2.60, 95% CI: 1.04–6.49, p = 0.0279). The mean ± SD MCPIS was calculated as 3.91 ± 1.35 in the HP group and 4.65 ± 1.55 in the NS group, a difference statistically significant (p = 0.042). There were no significant differences in the risk factors for VAP between the two groups. Conclusion HP mouthwash was found more effective than NS in reducing VAP. HP mouthwash can therefore be used in routine nursing care for reducing VAP.

Bronchiolitis obliterans organizing pneumonia associated with achalasia: A case report.

There is little mention in the literature about achalasia as an etiologic factor of Bronchiolitis obliterans organizing pneumonia (BOOP). In this study, a case of BOOP, which appeared to be secondary to achalasia is reported. A 35 years old man present with nonproductive cough, chills and fever from two month ago. Due to permanent consolidation in mid zone of right lung and unresponsive to antibiotics, transthoracic needle biopsy was done that showed BOOP. Due to esophageal dilatation in chest computerized tomography (CT) scan, endoscopy and esophagogram was done that showed achalasia. After surgery and a course of corticosteroid the patient condition became well. This report demonstrates that achalasia may be associated with BOOP.

Effects of hydrogen peroxide mouthwash on preventing ventilator-associated pneumonia in patients admitted to the intensive care unit.

AIMS: The aim of the study was to determine the effect of hydrogen peroxide (HP) mouthwash on the incidence of ventilator associated pneumonia (VAP) in patients admitted to the intensive care unit (ICU). METHODS: This was a randomized clinical trial conducted on 68 patients. The intervention group used 3% HP as mouthwash and the control group used mouthwashes with 0.9% normal saline (NS) twice a day. Data were collected using a questionnaire and the Modified Clinical Pulmonary Infection Score (MCPIS). MCPIS includes five items, body temperature: white blood cell count, pulmonary secretions, the ratio of pressure of arterial oxygen (PaO2) to fraction of inspired oxygen (FiO2), and the chest X-ray. Each of these items scored 0-2. Scores ≥6 were considered as VAP signs. The SPSS-20 software was employed to analyze the data. RESULTS: In total, 14.7% patients of the HP group and 38.2% patients of the NS group contracted VAP. The risk of VAP in the NS group was 2.60 times greater than that in the HP group (RR=2.60, 95% CI: 1.04-6.49, p=0.0279). The mean±SD MCPIS was calculated as 3.91±1.35 in the HP group and 4.65±1.55 in the NS group, a difference statistically significant (p=0.042). There were no significant differences in the risk factors for VAP between the two groups. CONCLUSION: HP mouthwash was found more effective than NS in reducing VAP. HP mouthwash can therefore be used in routine nursing care for reducing VAP.

Effects of cigarette smoking on morphological features of platelets in healthy men.

OBJECTIVES: To assess the effects of cigarette smoking on thrombocytopoiesis and some platelet morphological parameters in healthy male smokers. METHODS: In this cross-sectional study, 542 consecutive healthy men (aged 20 to 88 years), referred to the laboratory of Fatemieh Hospital, Semnan, Iran, between November 2011 and November 2012 for checking up were enrolled. The subjects were divided into 2 groups of smokers (n=258 with frequency of 10 or more cigarette per day with more than 12 months duration of smoking) and non-smokers (n=284). The blood samples were extracted to examine values of platelet indices using an ABX Micros 60 cell counter. RESULTS: Comparing platelet indices across smokers and non-smokers showed that the mean platelet count was statistically significantly higher in adult smokers than in nonsmokers (264.1 ± 81.2/µl versus 247.7 ± 83.9/µl, p=0.021), while the mean plateletcrit value was contrarily lower in the adult smokers (18.0 ± 12.0% versus 25.0 ± 10.0%, p less than 0.001). Other platelet indicators were not discrepant between the smokers and non-smokers. CONCLUSION: Cigarette smoking in healthy individuals results in significant and considerable effects on platelet morphological indices. The mean platelet count is significantly increased, and plateletcrit values are reduced, compared with non-smoking status.

Evaluation of noninvasive tests for diagnosis of Helicobacter pylori infection in hemodialysis patients.

BACKGROUND: Hemodialysis is the most common method of renal replacement therapy for treatment of acute and chronic kidney failure. Helicobacter pylori (H. pylori) plays a major role in development of peptic ulcer, gastric neoplasms, and lymphoma as well as increased risk of cardiovascular disorders in hemodialysis patients. OBJECTIVES: In this study the diagnostic values of noninvasive tests [i.e. urea breath test (UBT), helicobacter pylori stool antigen test (HPSA) and serology] in diagnosis of H. pylori infection in hemodialysis patients have been studied. PATIENTS AND METHODS: All patients undergoing hemodialysis in Fatemieh Hospital, Semnan, Iran, were enrolled in the study, and their H. pylori status were assessed by using non-invasive tests including UBT, HPSA and serology. Patients with at least two out of 3 positive tests were considered infected with H. pylori. RESULTS: The sensitivity, specificity, and positive and negative predictive values of the tests used in diagnosing H. pylori infection were 62.5%, 65.4%, 62.5% and 65.4% for UBT, 100%, 72.2%, 58.3% and 100% for serology, and 100%, 75%, 60.9% and 100% for fecal antigen test, respectively. CONCLUSIONS: This study showed that H. pylori serology and stool antigen tests have higher diagnostic values than UBT, and they are more reliable than UBT in diagnosis of H. pylori infection in hemodialysis patients.

Effect of different doses of folic acid on serum homocysteine level in patients on hemodialysis.

INTRODUCTION: Hyperhomocysteinemia is common in patients with end-stage renal disease. It is one of the risk factors for cardiovascular disease. We evaluated the effect of different doses of folic acid on serum homocysteine level in patients on hemodialysis. MATERIALS AND METHODS: Patients on maintenance hemodialysis were randomized into 4 groups to receive oral folic acid at doses of 2, 5, 10, and 15 mg/d, each for a period of 4 weeks. Serum homocysteine level was measured in all of the patients before and at the end of each week of therapy. Folic acid supplementation was discontinued during a washout period of 1 week between each of the four phases of the trial. RESULTS: Thirty-one hemodialysis patients completed the four phases of treatment with each dose of folic acid (17 women and 14 men). The mean age of patients was 57.6 ± 14.6 years. Serum homocysteine level was reduced significantly compared to its basal level after treatment with folic acid at different doses (P < .001). Different doses of folic acid were not significantly different in lowering serum homocysteine levels. CONCLUSIONS: Our study failed to show any difference between high-dose and low-dose folic acid therapy regarding their effect on serum homocysteine level. It seems folic acid, 2 mg/d, is an adequate dose, and there is no need to administer a higher dose of it.