House dust mite sublingual-swallow immunotherapy in perennial rhinitis: a double-blind, placebo-controlled Iranian study.

Sensitivity to house dust mite allergens in the development of allergic rhinitis has a key role. In this study, the clinical and immunological effects of high dose Dermatophagoides farinae sublingual immunotherapy (SLIT) versus placebo were compared. Forty poly-sensitized patients, ages 6-33 years, with allergic rhinitis and positive allergic reaction to the mites were enrolled in the study. Twenty-one patients were placed in the SLIT group and 19 in the placebo group. Expression levels of IL-10, TGF-ß, FOXP3 and IL-17 were measured by using real-time PCR before and after the administration of sublingual immunotherapy. Clinical efficacy was estimated by the reduction rate of symptom/medication scores in the SLIT group compared with placebo treatment. After 6 months of SLIT, TGF-ß expression levels were increased compared to pre-treatment (P less than 0.05). SLIT with D. Farinae extract is an effective treatment for poly-sensitized patients with allergic rhinitis. TGF-ß mediated T-cell suppression may be an important mechanism in the first 6 months of SLIT.

Concentrations of mercury, lead, chromium, cadmium, arsenic and aluminum in irrigation water wells and wastewaters used for agriculture in Mashhad, northeastern Iran.

BACKGROUND: Contamination of water by toxic chemicals has become commonly recognized as an environmental concern. Based on our clinical observation in Mashhad, northeastern Iran, many people might be at risk of exposure to high concentrations of toxic heavy metals in water. Because wastewater effluents as well as water wells have been commonly used for irrigation over the past decades, there has been some concern on the toxic metal exposure of crops and vegetables irrigated with the contaminated water. OBJECTIVE: To measure the concentrations of mercury, lead, chromium, cadmium, arsenic and aluminium in irrigation water wells and wastewaters used for agriculture in Mashhad, northeastern Iran. METHODS: 36 samples were taken from irrigation water wells and a wastewater refinery in North of Mashhad at four times--May 2008, March 2009, and June and July 2010. Atomic absorption spectrometry was used to measure the concentration of toxic metals. Graphite furnace was used for the measurement of lead, chromium, cadmium and aluminum. Mercury and arsenic concentrations were measured by mercury/hydride system. RESULTS: Chromium, cadmium, lead and arsenic concentrations in the samples were within the standard range. The mean±SD concentration of mercury in irrigation wells (1.02±0.40 µg/L) exceeded the FAO maximum permissible levels. The aluminum concentration in irrigation water varied significantly from month to month (p=0.03). All wastewater samples contained high mercury concentrations (6.64±2.53 µg/L). CONCLUSION: For high mercury and aluminum concentrations, the water sources studied should not be used for agricultural use. Regular monitoring of the level of heavy metals in water and employing the necessary environmental interventions in this area are strongly recommended.

Pseudoaneurysm of mitro-aortic intervalvular fibrosa during the course of mitral valve endocarditis with aorto-left ventricle outflow tract fistula.

The mitro-aortic intervalvular fibrosa (MAIVF) connects the anterior mitral leaflet to the posterior portion of the aortic annulus. The pseudoaneurysm of MAIVF is one of the uncommon but catastrophic complications of native or prosthetic aortic valve endocarditis or chest trauma. We report a case of infective endocarditis of mitral valve complicated by development of pseudoaneurysm of MAIVF, and fistulous formation causing massive shunt flow from the ascending aorta above the non-coronary cusp to the left ventricle outflow tract.

Plasma Brain Natriuretic Peptide (BNP) as an Indicator of Left Ventricular Function, Early Outcome and Mechanical Complications after Acute Myocardial Infarction.

AIMS: This study investigated the prognostic value of B type natriuretic peptide (BNP) in acute myocardial infarction (AMI) patients and its relation with left ventricular function and post-myocardial infarction complications. METHODS: In this cross-sectional study, plasma BNP level was measured for 42 consecutive patients (mean ± SD: 61.6 ± 10.85 years old) with acute ST elevation myocardial infarction (MI) and 42 healthy, age and gender matched subjects. RESULT: BNP level in AMI patients were significantly higher than control group (P < 0.001). Regarding to infarct location, the highest BNP level measured in inferoposterior MI (BNP = 4436.63 ± 6188.159 pg/ml) and the lowest one indicated in standalone inferior MI (BNP = 598.83 ± 309.867 pg/ml (P = 0.071). There was significant reverse relation between BNP and EF (P = 0.006, OR = -0.47) and a significant relationship between BNP and killip classification (P = 0.036). There was no significant relation between diastolic and right-ventricular function and BNP level (P = 0.61, P = 0.21). The highest BNP level was detected in LV septal rupture and false aneurysm (P = 0.02) and in ventricular tachycardia, but without significant relationship (P = 0.25). CONCLUSION: After the onset of AMI, BNP blood level can be used as an important predictor for left ventricular dysfunction, killip classification, early mechanical complications and cardiac death.

A pulse simulator for crystal identification validation of phoswich detectors used in positron emission tomography.

Crystal identification (CI) of phoswich detectors is a technique used in positron emission tomography (PET) for improving spatial resolution through depth-of-interaction determination or higher pixelization. Digital algorithms using advanced digital signal processing techniques currently provide the most powerful approaches for CI of phoswich detectors made of crystals with only slightly different scintillation decay times. Such methods can be implemented in the all-digital architecture of LabPET, a small animal PET scanner developed in Sherbrooke, for fast and accurate real-time CI. In order to validate the new CI algorithms and assess their performance for different front-end electronics, a pulse generator simulator was developed to generate PET signals and investigate the effects of factors such as electronic noise, photon statistics and pulse shaping filter. The pulse generator was validated with LabPET-like pulses and CI results were compared with experimental data. The pulse simulator enables CI algorithms to be validated together with detector performance such as energy and timing resolution at an early stage of scanner design.