Recombinant human growth hormone (rhGH) can increase the growth rate in growth hormone deficient children (GHD). In this randomized clinical trial, we compared the efficacy and side effects of an Iranian brand; Samtropin with Norditropin.
The GHD children were randomly treated either with standard dose of Samtropin or Norditropin rhGH for one year. Upstanding height, height standard deviation score (HSDS), growth velocity (GV), serum levels of insulin like growth factor-1 (IGF-1), and bone age (BA) were determined before and during one year treatment concomitant side effects of treatment.
We evaluated 22 subjects; 12 on Samtropin and, 10 on Norditropin. In each group, mean age was 12 yr and 50% of them were male. The mean differences in height, HSDS, IGF-1 and BA by Norditropin before and after 12 months were 8.8 cm, 0.5, 49 ng/ml and 2.8 yr, respectively. These measures by Samtropin were 9.1 cm, 0.6, 133 ng/ml, and 1.7 yr, respectively without any significant difference. The mean of GV by Samtropin was 9.1 vs. 8.8 cm by Norditropin without significant difference. Since the efficacy of Samtropin was found to be similar to Norditropin after 12 months; we switched to use only Samtropin for the next 12 months. The mean differences in height, HSDS, GV and BA in 20 children between months 12 and 24 were 7.0 cm, 1.6, 2.1 cm/yr and 1.0 yr, respectively (P < 0.001). We also found a non-significant decrease in IGF-1 levels. No side effects were observed.
We need to conduct a post marketing surveillance with a large sample size in order to confirm our findings.
Registration code number in the Iranian Registry of Clinical Trials (IRCT): IRCT1138901181414N11.
Growth hormone deficiency; Recombinant human growth hormone; Insulin like growth factor-1; Children
Obesity is one of the most important underlying risk factors for chronic disease. Dramatically increasing and following complication of obesity should be alerted to health politicians and practitioners to prevent associated health risks. This review aimed to give a better insight into the prevalence of obesity and overweight in different areas of Iran.
All published internal (SID, Irandoc, Iranmedex), and international (Web of Knowledge, Pubmed, Scopus) source studies, reported the prevalence of overweight/obesity among normal population samples, during Jan 2005 through Jan 2014, were assessed in this review. Paper selection processes were done by two researchers separately. Studies which met the eligible criteria were included in this review.
One hundred ninety three eligible studies enter into our review. Of 193 final selected studies, 86 (15 national, 71 sub national) of them were reported the prevalence of obesity/overweight in adult, and 107 studies (11 national, 96 sub national) in under-18 by individual. The range of overweight and obesity prevalence in national studies in adult, was 27.0-38.5 (95% CI: 26.8-27.1, 37.2-39.8), and 12.6-25.9 (95% CI: 12.2-13.0, 24.9-26.8), separately. In under-18 the range of overweight and obesity prevalence in national studies were 5.0-13.5 (95% CI: 4.5-5.5, 13.4-13.6), and 3.2-11.9 (95% CI: 3.0-3.4, 11.3-12.4).
Obesity as an important public health problem has been discussed in recent few decades worldwide. Although the national reported prevalence of obesity in Iran was not considerably diverse, but remarkable differences were seen in the sub national prevalence which must be noticed more in political health programs especially among women and children.
Electronic supplementary material
The online version of this article (doi:10.1186/s40200-014-0121-2) contains supplementary material, which is available to authorized users.
Obesity; Overweight; Prevalence; Iran; Metabolic syndrome
Background: Dual-energy X-ray Absorptiometry (DXA) is considered the gold standard for non-invasive measurement of bone mass. T-scores and Z-scores are used to present the results of bone mass. The present study was designed to evaluate the discordance between T-scores and Z-scores calculated at a same level and its relation with age, gender and body mass index (BMI) in a representative sample of normal population.
Methods: This cross-sectional study was conducted as a part of a comprehensive survey, Iranian Multicenter Osteoporosis Study (IMOS), designed to assess bone health among healthy adults. Each individual underwent both L1–L4 antero-posterior lumbar spine and hip DXA scan. The difference between the T- and Z-scores measured at each of the four skeletal sites was then calculated.
Results: A -1.21 to 1.21 point difference was noted in the Z- and T- scores measured at each site. While the difference between the T-and Z-scores was less than 0.5 SD in most of the cases, the difference was higher than 1 SD in about 5% of the subjects.
Conclusion: Standardization of Z-score definition and calculation techniques as well as developing an ethnicity-matched reference population is needed to improve the reliability of DXA-generated Z-scores.
Osteoporosis; Bone Mineral Density; T-scores; Z-scores; Iran
The Childhood and Adolescence Surveillance and PreventIon of Adult Non-communicable disease (CASPIAN) study is implemented in the Islamic Republic of Iran from 2003. The aim of this national school- based surveillance program was to provide accurate data of regular surveys of this program to be reviewing methodology, protocols, data collection and questionnaires of these surveys. Information was obtained from articles and books were published from CASPIAN studies. The CASPIAN studies were repeated every two years, with blood sampling for biochemical factors every four years. Methods and questionnaires of all surveys were similar at their core level and some optional factors added in different surveys. The results of CASPIAN studies represent the public health of Iranian children and adolescents that are useful for policy makers and based on them, intervention programs can set in national and sub-national level.
Prevention; School- based survey; Non-communicable diseases; Children; Adolescents
The aim of this study was to assess knowledge, attitude and practice of urban and rural households toward principles of nutrition in Iran.
The study population was Iranian households who live in rural and urban areas in all provinces of the country. The sampling method at households’ level in each province was single stage cluster sampling with equal size clusters. The incumbent data was collected by a structured questionnaire and through the interview with the eligible subject in each household.
A total of 14,136 Iranian households were selected as total sample size, 9,149 urban households, and 4,987 rural households. Around 57.2% of urban and 49.5% of rural households was aware of food groups. Respectively in urban and rural households, about 35.1% and 39.7% had correct knowledge toward roles of food groups. Approximately 41.5% and 39.9% of households had accurate knowledge about reason of food eating in urban and rural areas, respectively. The results showed that 79.6% of them had favorable attitudes.
The most of the households consumed red meat and poultry weekly whereas fish was eaten rarely. Fruits, vegetables and dairy were consumed daily in the most of households. Sugar intake was daily in the most of households and cream and butter intake was weekly.
The most of households had moderate knowledge and good attitudes. Practice of families about food consumption was good. The results of this study can be used for proper intervention for improving of health society.
Knowledge; Attitude; Practice; Nutrition; Urban; Rural
The present study is designed to evaluate the validity of the measurement of capillary blood hemoglobin A1c levels in comparison with venous blood hemoglobin A1c.
The data of this cross-sectional study are collected from a sample of 45 Iranian diabetic patients referred to one particular laboratory for the assessment of HbA1c level during a period from April to December 2013. Venous and simultaneous capillary blood samples were obtained from each subject for measurement of hemoglobin A1c levels. Both samples were tested using two different NGSP certified systems: CERA STAT 2000 (Ceragem Medisys Inc) and NycoCard Reader II (Axis-Shield).
The mean hemoglobin A1c in venous and capillary blood samples measured using CERA STAT 2000 assays were 6.30 ± 1.68% and 6.34 ± 1.65% respectively (p = 0.590). However, when NycoCard Reader II assay was employed, the mean hemoglobin A1c in venous and capillary blood samples were 6.73 ± 1.35% and 6.92 ± 1.50% (p = 0.007). Moreover, a strong correlation was observed between venous and capillary hemoglobin A1c levels with Pearson’s concordance correlation coefficients of 0.96 and 0.94 with the use of NycoCard Reader II and CERA STAT 2000 assays respectively. Application of CERA STAT 2000 demonstrated to be of a considerably higher value using the ROC curve analysis assay (AUC = 0.991). Also, similar analysis by using NycoCard Reader II assay demonstrated that capillary hemoglobin A1c measurement had high value for differentiation of uncontrolled from controlled blood glucose level (AUC = 0.935).
It was demonstrated that capillary hemoglobin A1c measurement had a considerably high value for differentiating between poorly-controlled and well-controlled blood glucose levels.
The present study is designed to assess the incidence rate of osteoporotic fracture and its risk factors, particularly those used to predict the 10-year risk of osteoporotic fracture in FRAX based on the data gathered through a follow up cohort initiated in 2000.
The present retrospective cohort was conducted on men and women from 40 to 90 years of age enrolled in the IROSTEOPs study. A phone survey was conducted during 2013 and beginning of 2014 to assess the fractures (traumatic/osteoporotic) occurring at the time of inclusion until the date of the telephone survey, its type and mechanism, and the patient’s age at the time of accident. Survival analysis using Kaplan-Meier product-limit method was performed with the time of fracture as the study outcome.
Final study population consisted of 1233 individuals, translated in to 9133 person years. The incidence rate of osteoporotic fracture was reported to be 359.1 cases in every 10,000 person years. The 10-year Kaplan-Meier estimate of any kind of major osteoporotic fractures for all the subcohort population was 10.75%. Osteoporosis (HR = 0.75), Discordance between femoral neck and spine (HR = 1.45), Diabetes (HR = 1.81), IBD (HR = 1.84), immobility more than 90 days (HR = 2.19), and personal history of fracture (HR = 7.75) had a considerable effect on the 10-year risk of major osteoporotic fractures.
Adding new clinical risk factors to FRAX® may help improve fracture prediction in the Iranian population.
Fracture; FRAX; Major osteoporotic fracture
Palpable thyroid nodules are present in 4-7% of general population and Fine Needle Aspiration (FNA) is now accepted by endocrinologists and thyroid surgeons as a safe, simple and cost effective procedure for evaluating a thyroid nodule. The obtained sample can be spread directly on slides, processed as cell block preparations or prepared as liquid base smears. Liquid base method has been recently accepted due to its shorter preparation time and better preservation of nuclear details.
The aim of this study is to compare the diagnostic results of two commonly used methods: Liquid Base Preparation and Cell Block Preparation in evaluation of thyroid nodules.
The samples were taken from 100 patients with a solitary nodule or a prominent nodule on a multinodular goiter background (excluding hot nodules). The obtained samples were used to prepare conventional smears (CS), Cell Block Preparations (CBP) and Liquid Base Preparations (LBP). The slides were studied by two pathologists, considering the following parameters: Cellularity, Colloid, Lymphocytes/Plasma cells and Macrophages.
87% of cases revealed informative results in LBP method while in the same group of patients only 69% of samples were informative after processing by CBP method. Sensitivity and specificity of both methods compared with the conventional smears and with each other and it is concluded that LBP is a reliable method for evaluating of a thyroid nodule. Other studies also show the same results.
The liquid base method should be trusted due to its easier procedure, cleaner slide background, its higher specificity and higher diagnostic yields. It can be used instead of CBP and in association with CS to increase the accuracy of evaluation of thyroid nodules.
Thyroid fine needle aspiration; Conventional smears; Cell block preparation; Liquid base preparation
Men, much like women, are faced with age-related menopause-like symptoms as they age. In recent years, increasing attention has been drawn to clinical research into elderly men and their health-related quality of life. The Aging Male Scales (AMS) questionnaire is an international tool for assessing the health-related quality of life in elderly men. Hence far this questionnaire has not been subjected to psychometric assessment in Iran. This study aims to evaluate the validity and reliability of the Persian version of the AMS questionnaire specific to the health of elderly men in Iran.
To validate this instrument, a cross-sectional study was conducted on 521 healthy Iranian men aged 40-65 years old, who attended the blood transfusion center clinic between February 2011 and June 2012. The English version of the AMS questionnaire was translated to Persian and then back-translated. To determine the reliability of the AMS questionnaire, internal consistency was evaluated and test-retest was done. The questionnaire was validated using convergent and structural validity methods. To assess the factor structure of the questionnaire, a correlation matrix of questions and domains was used.
Cronbach's alpha was higher than 0.7 (0.73-0.88) in all domains. A Pearson's correlation coefficient of 0.87 between pretest and posttest indicated a high correlation and an acceptable reliability. The convergent validity of the questionnaire was found acceptable by calculating the correlation between the domains and items-total correlation ranging 0.40-0.85, except for question 14 that had a 0.28 correlation with the whole test. The criterion-related validity of the questionnaire in the psychological domain was confirmed with the “two-item Patient Health Questionnaire” (r = 0.63, P < 0.001).
According to the results, the Persian version of the AMS questionnaire has high validity and reliability and may be used to assess the health-related quality of life of men between 40 and 65 years old.
Aging male scales; andropause; psychometrics; quality of life; reliability; validity
The present study was designed to investigate from which tissues the decrease in retinol‐binding protein 4 (RBP4) expression could contribute to the improvement of serum RBP4 and insulin resistance (IR) after endurance training.
Materials and Methods
Male 7‐week‐old Wistar rats were randomly assigned into four groups including control (C), trained (T), diabetic control (DC) and trained diabetic (TD). At 8 weeks‐of‐age, diabetes was induced by a high‐fat diet and intraperitoneal injection of low‐dose streptozotocin (STZ; 35 mg/kg). Rats in the T and TD groups carried out a 7‐week exercise program on a motorized treadmill (15–20 m/min for 20 min/day for 5 weeks), whereas the C and DC remained sedentary in their cages. Tissues gene expression and protein levels of RBP4 were assessed by using real‐time polymerase chain reaction and western blot, respectively, while serum RBP4 was measured using an enzyme‐linked immunosorbent assay kit.
Exercise significantly improved IR and reduced serum concentration of RBP4 in the TD group. This reduction of serum RBP4 was accompanied by decreased RBP4 protein expression in visceral fat tissue. In contrast, exercise had no significant effect on RBP4 expression in liver and subcutaneous fat tissue in the TD group. Exercise also significantly decreased RBP4 gene expression in visceral fat tissue and muscle, whereas the effect of exercise on liver RBP4 messenger ribonucleic acid expression was not significant.
The present study showed that the mechanism for RBP4 reducing the effect of endurance training could involve decreased RBP4 messenger ribonucleic acid expression and its protein level in adipose tissue in STZ‐induced diabetic rats.
Endurance training; Insulin resistance; Retinol‐binding protein 4 gene and protein expression
There has been no data on population based dietary patterns during the Ramadan fasting month.
The purpose of this study was to detect Ramadan major dietary patterns among those who fast in Tehran.
Materials and Methods:
This cross-sectional study included 600 subjects, aged 18-65 with body mass index (BMI) of 18.5-40, who had decided to fast during Ramadan. Anthropometric measurements, usual physical activity level and educational status were collected two weeks before Ramadan. Information on Ramadan dietary intakes was obtained using a food frequency questionnaire and factor analysis was used to identify major dietary patterns.
We identified four major dietary patterns: 1) Western-like pattern; high in fast foods, salty snacks, nuts, potato, fish, poultry, chocolates, juices; 2) high cholesterol and high sweet junk food pattern; high in pickles, sweets and condiments, butter and cream, canned fish, visceral meats and eggs; 3) Mediterranean-like pattern; high in vegetables, olive oil, dates, dairy, dried fruits, fruits, red meats, tea and coffee and 4) Ramadan-style pattern; large consumption of Halim, soups, porridges, legumes and whole grains, soft drinks, Zoolbia and Bamieh. Age was positively and inversely associated with Mediterranean-like (P = 0.003; r = 0.17) and Ramadan style (P = 0.1; r = -0.13) dietary pattern, respectively. Pre-Ramadan physical activity level was associated with a Mediterranean-like dietary pattern (P < 0.0001; r = 0.20).
This study showed a Ramadan-specific dietary pattern has unique characteristics, which has not yet been identified as a model of dietary pattern. Also, among identified dietary patterns, Mediterranean-like was the healthiest.
Ramadan; Fasting; Diet
Atherogenic effects of ELF-MF exposure have not been studied well so far. Therefore we have hypothesized that ELF-MF exposure might have atherogenic effect by impairing antioxidant function and increasing lipid peroxidation. This study was therefore undertaken to examine the effects of ELF-MF on paraoxonase (PON) activity, antioxidant capacity and lipid peroxidation metabolites. Effects of time on remodeling of antioxidant system were also investigated in this study.
Seventy five Wistar rats were randomly allocated into five groups as follows: 1) Sham exposure, 2) Single exposure to 60 Hz, sacrificed immediately after exposure, 3) Single exposure to 60 Hz, sacrificed 72 hours after exposure, 4) Fourteen days of exposure to 60 Hz, sacrificed immediately after exposure, and 5) Fourteen days of exposure to 60 Hz, sacrificed 72 hours after exposure. Blood samples were collected and analyzed. The results were compared using ANOVA and post hoc Tukey HSD for multiple caparisons.
Single ELF-MF exposure significantly increased lipid peroxidation (CD and MDA) and increased antioxidant serum activity (HDL, paraoxonase activity, and serum total antioxidant capacity). Chronic ELF-MF exposure increased lipid peroxidation and affected antioxidant system. Free fatty acids levels were significantly increased after both single and two weeks exposure. Chronic exposure led to irreversible changes while acute exposure tended to reversible alterations on above mentioned parameters.
According to the results of this study, ELF-MF exposure could impair oxidant-antioxidant function and might increase oxidative stress and lipid peroxidation. Antioxidant capability was dependent on the duration and continuity of ELF-MF exposure.
Paraoxonase; Lipid peroxidation; Electromagnetic radiation; Magnetic fields; Free fatty acids
Many studies suggested mesenchymal stem cells (MSCs) transplantation as a new approach to control hyperglycemia in type 1 diabetes mellitus through differentiation mechanism. In contrary others believed that therapeutic properties of MSCs is depends on paracrine mechanisms even if they were not engrafted. This study aimed to compare these two approaches in control of hyperglycemia in STZ-induced diabetic rats.
Animals were divided into five groups: normal; diabetic control; diabetic received MSCs; diabetic received supernatant of MSCs; diabetic received co-administration of MSCs with supernatant. Blood glucose, insulin levels and body weight of animals were monitored during experiment. Immunohistochemical and immunofluorescence analysis were performed to monitor functionality and migration of labeled-MSCs to pancreas.
First administration of MSCs within the first 3 weeks could not reduce blood glucose, but second administration significantly reduced blood glucose after week four compared to diabetic controls. Daily injection of supernatant could not reduce blood glucose as efficient as MSCs. Interestingly; Co-administration of MSCs with supernatant significantly reduced blood glucose more than other treated groups. Insulin levels and body weight were significantly increased in MSCs + supernatant-treated animals compared to other groups. Immunohistological analysis showed an increase in number and size of islets per section respectively in supernatant, MSCs and MSCs + supernatant-treated groups.
Present study exhibited that repeated-injection of MSCs reduced blood glucose and increased serum insulin levels in recipient rats. Injection of supernatant could not reverse hyperglycemia as efficient as MSCs. Interestingly; co-administration of MSCs with supernatant could reverse hyperglycemia more than either group alone.
Hyperglycemia; Mesenchymal stem cells; Diabetes mellitus
Medical ethics is a realm where four important subjects of philosophy, medicine, theology and law are covered. Physicians and philosophers cooperation in this area will have great efficiency in the respective ethical rules formation. In addition to respect the autonomy of the patient, physician’s obligation is to ensure that the medical intervention has benefit for the patient and the harm is minimal. There is an obvious conflict between duty of confidentiality and duty of mandatory reporting.
Professional confidentiality is one of the basic components in building a constant physician-patient relationship which nowadays, beside the novelty, it is the subject of discussion. Legal obligation of confidentiality is not absolute. In physician-patient relationship, keeping patient’s secrets and maintaining confidentiality is a legal and ethical duty, and disclosure of such secrets is mainly through specific statutes. Thus, there are a number of situations where breach of confidentiality is permitted in different legal systems. One of the situations where breaching confidentiality is permitted is the medical mandatory reporting to the relevant authority which is in accordance with many countries’ legal systems. Some situations are considered in many countries legal systems’ such as notification of births and deaths, infectious diseases, child abuse, sport and relevant events, medical errors, drug side effects and dangerous pregnancies.
In this paper, we will examine and discuss medical mandatory reporting and its ethical and legal aspects in the judicial and legal system of Iran and few other countries. Finally we will suggest making Medical Mandatory Reporting Law in Iran.
mandatory reporting; medical reporting; confidentiality; patient’s rights; public interest
Some variability for dietary pattern analysis due to subjective procedures (e.g. arbitrary food categorization and number of factors extraction) was reported. The aim of this study was to present or design a new approach to challenge the conventional dietary pattern analysis through new classification of dietary patterns according to the possibility of the high adherence to more than one dietary pattern and calorie adjusted factor extracting.
This cross-sectional study conducted on 734 type2 diabetic patients. Factor analysis defined three major dietary patterns (Western like, Asian like and Traditional like) and the associations of each pattern were assessed with glycemic control and lipid profiles among tertiles of each pattern. In order to compare variables in highest tertile of three defined dietary patterns, eight new different groups were classified according to the high adherence to one or more patterns and ANOVA and ANCOVA were used to compare them. Also, calorie adjusted factor extracting were done to find out if the same factor loadings would be extract.
Among three major dietary patterns, only Western like showed a significant association with fasting blood sugar (p = 0.03, 12.49 ± 5.99), serum total cholesterol (p = 0.02, 8.71 ± 3.81) and LDL cholesterol (p = 0.04, 5.04 ± 2.40). While comparison of new classified patterns, showed no significant differences, except a high blood glucose in Western like- Asian like versus traditional like dietary pattern (p = 0.04). Also, calorie adjusted factor extracting showed different factor loadings.
Results showed that the conventional dietary pattern analysis method may have substantial limitations in interpreting the results and may lead to inappropriate conclusions.
Factor analysis; Diabetes mellitus; Type 2
The aim of this study was to evaluate whether global levels of DNA methylation status were associated with albuminuria and progression of diabetic nephropathy in a case-control study of 123 patients with type 2 diabetes- 53 patients with albuminuria and 70 patients without albuminuria.
The 5-methyl cytosine content was assessed by reverse phase high pressure liquid chromatography (RP-HPLC) of peripheral blood mononuclear cells to determine individual global DNA methylation status in two groups.
Global DNA methylation levels were significantly higher in patients with albuminuria compared with those in normal range of albuminuria (p = 0.01). There were significant differences in global levels of DNA methylation in relation to albuminuria (p = 0.028) and an interesting pattern of increasing global levels of DNA methylation in terms of albuminuria severity.
In patients with micro- and macro albuminuria, we found no significant correlations between global DNA methylation levels and duration of diabetes (p > 0.05). In both sub groups, there were not significant differences between global DNA methylation levels with good and poor glycaemic control (p > 0.05). In addition, in patients with albuminuria, no differences in DNA methylation levels were observed between patients with and without other risk factors including age, gender, hypertension, dyslipidaemia and obesity.
These data may be helpful in further studies to develop novel biomarkers and new strategies for clinical care of patients at risk of diabetic nephropathy.
Type 2 diabetes; Diabetic nephropathy; Albuminuria; Global DNA methylation; Epigenetic
Type 1 diabetes is recognized as an autoimmune inflammatory disease and low grade inflammation is also observed in type 2 diabetic patients. Interleukin 17 (IL-17) is a new player in inflammation. Th17 cells, as the main source of IL-17, require transforming growth factor β (TGF-β) and interleukin 23 (IL-23). The aim of this study was to investigate serum IL-17, IL-23 and TGF-β levels in diabetic patients and controls. In this case-control study, serum levels of IL-17, IL-23, and TGF-β were measured in 24 type 1 diabetic patients and 30 healthy controls using the ELISA method. Simultaneously, the same methodology was used to compare serum concentration of these three cytokines in 38 type 2 diabetic patients and 40 healthy controls. There was no significant difference between serum levels of IL-17 and IL-23 cytokines between cases and controls. However, TGF-β was significantly lower in type 1 diabetic patients (P < 0.001). Serum IL-17 and IL-23 levels demonstrate no association with type 1 and type 2 diabetes, but, in line with previous studies, TGF-β levels were lower in type 1 diabetic patients.
Revealing data on the role of vitamin D and calcium supplementation in bone health has led some to suggest that vitamin D and calcium treatment could also play a role in protecting bone against microgravity-induced mineral loss.
The aim of the present study was to investigate the effects of vitamin D and calcium administration on microscopic and densitometric changes of rat femur in a Microgravity Simulator Model.
Materials and Methods:
After designing a Microgravity Simulator Model, 14 rats were placed in the cages as follows: seven rats as osteoporosis group and seven rats received oral supplement of calcium/vitamin D as the treatment group. Animals were sacrificed after eight weeks and then both femurs were removed. Bone mineral density was measured for one femur from each animal, and morphologic studies were evaluated for the contralateral femur.
Bone mineral density of the whole femur in the treatment group was significantly higher than the osteoporosis group (0.168 ± 0.005 vs. 0.153 ± 0.006, P = 0.003). Also, bone mineral content of the whole femur was significantly higher in treatment group (0.415 ± 0.016 vs. 0.372 ± 0.019, P = 0.003). However, resorption eroded surface percentage was higher in the osteoporosis group (18.86 ± 3.71% vs. 9.71 ± 1.61%, P = 0.002).
According to the results of this study, vitamin D and calcium administration might have protective effects against microgravity-induced mineral loss in a Rat Microgravity Simulator Model.
Weightlessness; Bone Density; Osteoporosis; Dietary Supplements; Calcium; Vitamin D
Valproic acid (VPA) has been identified as a histone deacetylase inhibitor, inducing differentiation in transformed cells. However, no study has shown the effect of VPA in the redifferentiation induction and stemness of anaplastic thyroid. The main objective of this study was to evaluate the efficacy of VPA as a differentiation therapy agent in human thyroid cancer based on its effect on stemness and differentiation process. Indications for differentiation of 8305C and B-CPAP cell lines following VPA treatment were obtained by analyzing cell proliferation rate, morphological changes, adherent-dependent colony formation, and Hoechst 33342 staining. The expressions of stemness, differentiation, and aggressiveness specific marker genes were measured by quantitative RT-PCR. VPA treatment effectively showed growth inhibition in both cell lines. The high nuclear-cytoplasmic (N : C) ratio of 8305C cells markedly decreased and treated cells became more epithelial-like. Treated cells showed stronger Hoechst 33342 fluorescence compared with control cells. The hTERT and OCT-4 reduction was paralleled with adherent-dependent colony formation decrement in both cell lines. VPA effectively induced NIS and TTF-1 in anaplastic cells, it whereas showed no clear pattern in papillary cell line. VPA treatment also resulted in the reduction of MMP-2 and MMP-9. These finding suggest that VPA could redifferentiate the anaplastic thyroid cancer cells.
The aim of this study was assessment of predictive factors of diabetic retinopathy.
A cross-sectional study was designed by recruiting 1228 type 2 diabetic patients from a diabetes referral clinic over a six-month period (from July to December, 2012). Diabetes risk factors, complications, laboratory results have been recorded.
Of the 1228 diabetic patients (54% women, mean age 58.48 ± 9.94 years), prevalence of diabetes retinopathy was 26.6%. There were significant associations between retinopathy and family history of diabetes (p = 0.04), hypertension (p = 0.0001), diabetic duration (p = 0.0001), poor glycemic control (p = 0.0001) and age of onset of diabetes (p = 0.0001). However, no significant associations were found between retinopathy with dyslipidemia and obesity. In logistic regression model, poor glycemic control (p = 0.014), hypertension (p = 0.0001), duration of diabetes (p = 0.0001) and family history of diabetes (p = 0.012) independently predicted retinopathy after adjustment for age and sex.
Diabetic complications are resulting from an interaction from genes and environmental factors. A family history of diabetes is pointing toward a possible genetic and epigenetic basis for diabetic retinopathy. Our findings suggest the role of epigenetic modifications and metabolic memory in diabetic retinopathy in subjects with family history of diabetes.
Diabetic retinopathy; Epigenetic; Family history of diabetes
Nowadays, scientific findings in the field of regeneration of nervous system have revealed the possibility of stem cell based therapies for damaged brain tissue related disorders like stroke. Furthermore, to achieve desirable outcomes from cellular therapies, one needs to monitor the migration, engraftment, viability, and also functional fate of transplanted stem cells. Magnetic resonance imaging is an extremely versatile technique for this purpose, which has been broadly used to study stroke and assessment of therapeutic role of stem cells. In this review we searched in PubMed search engine by using following keywords; “Stem Cells”, “Cell Tracking”, “Stroke”, “Stem Cell Transplantation”, “Nanoparticles”, and “Magnetic Resonance Imaging” as entry terms and based on the mentioned key words, the search period was set from 1976 to 2012. The main purpose of this article is describing various advantages of molecular and magnetic resonance imaging of stem cells, with focus on translation of stem cell research to clinical research.
Cell fate; cell tracking; magnetic resonance imaging; nanoparticle; stem cells; stroke; tracking
Growth factors are generally believed to have a perpetuating role in the development of diabetic complications, However there is ample of evidence of a protective or therapeutic potential for some of them. IGF-I, according to some reports, may contribute to complication development, although a protective role for IGF-I has been claimed for all late diabetic complications, making it an exception among growth factors. Transforming growth factor (TGF)-β1 as a pleiotropic cytokine is a key player in immunoregulation. Dysregulation of TGF-β1 in diabetes has been addressed as a leading event of kidney pathologies, while there is no similar pivotal role for TGF-β1 in diabetic retinopathy or neuropathy. An association study was conducted to evaluate the distinctive roles of TGF-β1 and IGF-I in T1DM microvascular complications by gene variation-based regulatory mechanisms that are operational in modulation of both in situ and systemic levels of the gene product.
Two polymorphisms of the IGF-I gene at positions −383*C/T and −1089*C/T and two functional TGF-β1 gene polymorphisms, including codons 10 (+869*C/T) and 25 (+915*G/C) were examined in 248 British Caucasian T1DM patients and 113 healthy controls.
The distribution of IGF-1 gene polymorphisms did not reflect any significant association with different endpoints among the cases or different subgroups (complication triad) and controls. For TGF-β1 gene codon 25 polymorphism the low producer variant (allele C) were more frequent in cases than controls, which is compatible with the anti-inflammatory role of TGF-β1 and for codon 10 polymorphism the frequency of allele C was highest in retinopaths and, on the contrary and expectedly, nephropathy was more frequently accompanied by allele T (high producer). The frequency of allele G (high producer) of codon 25 polymorphism was slightly higher in the complication free group than in other subgroups.
Although there were some differences in distribution of allele and genotype frequencies of TGF-β1 gene polymorphism in diabetes microvascular complications the differences were not statistically significant. Regarding IGF-1 our result firstly questions the functionality of the employed polymorphic marker and secondly may entail that the main regulator of IGF-I functionality resides elsewhere rather than the IGF-I gene itself, such as post-transcriptional regulation.
T1DM; IGF-I; TGF-β1; Polymorphism
TNF-α has accelerating role in development of type 1 diabetes. Although an immunosupressor function and leading protecting role in T1DM also has been claimed for this pro-inflammatory cytokine. Over-expression of pro-inflammatory and type 1 cytokines (Th1, like IFN-γ) drive insulitis toward the destructive form that leads to type 1 diabetes (T1DM). Among type 1 cytokines only IFN-γ has been detectable in the islet β cells. In deletion studies IFN-γ was also the only Th1 cytokine for which its ablation or blockade caused delayed or decreased incidence of T1DM.
Functional polymorphisms of TNF-α at position -308*G/A and at position +874*T/A of IFN-γ gene were employed as markers and the comparative distribution of derived genotypes/alleles were assessed in 248 British Caucasian T1DM patients and 118 healthy controls.
There was no significant association between IFN-γ gene polymorphism and T1DM or the diabetic complication triad. There was a marginal association between TNF-α –308*G/A polymorphism in nephropaths (vs healthy controls) (p = 0.06), which its insignificancy may be due to survivor factor. No significant association was evident between the genotype/allele of the applied marker and T1DM or diabetic complication triad.
Our results are in contrast with previous reports suggesting that these polymorphisms are not related to T1DM. This study also underlines the importance of replication of association studies to confirm the previous interpretation.
More than 80% cardiovascular disease (CVD) is preventable despite the fact that it is currently the ultimate cause of disability in the world. Assessment of the nationwide prevalence of dyslipidemia as a major CVD risk factor is essential to efficiently conduct prevention programs. We extracted data according to the cut-off points of dyslipidemia used in each study. All published papers on this topic in Iranian and international journals with affiliation of “Iran” were reviewed using standard keywords up to September 2011. We included all available population-based studies and national surveys conducted in individuals aged ≥ 15 years. We excluded studies with < 300 individuals, non-population-based studies, or duplicated citations. We analyzed by random effect method due to between-study heterogeneity. The estimated prevalence and 95% confidence intervals in 29 eligible articles and one un-published data for hypercholesterolemia (≥200 mg/dl), hypertriglyceridemia (≥150 mg/dl), high levels of low density lipoprotein cholesterol ([LDL-C] [≥ 130 mg/dl]) and low levels of high density lipoprotein cholesterol ([HDL-C] <40 mg/dl in males, <50 mg/dl in females), in Iranian people were 41.6% (36.1-47.0), 46.0% (43.3-48.7), 35.5% (24.0-47.1) and 43.9% (33.4-54.4), respectively among both sexes and in both rural and urban areas. Hypercholesterolemia, high LDL-C and low HDL-C were more prevalent in women, whereas hypertriglyceridemia was more prevalent in men. All types of lipid component abnormalities were more prevalent in urban residents. Prevalence of dyslipidemia is considerable in Iran. It is necessary to enforce current measures of dyslipidemia control in the Iranian people to reduce CVD burden.
Cardiovascular disease; dyslipidemia; Iran
In Western literatures, “conflict” is a general term that refers to discord between two or more entities. In Islamic jurisprudence, however, in addition to the term “conflict” (Taāruz), there is another term which is called tazāhum. The two terms, however, have different definitions. Conflict between two concepts, for instance, indicates that one is right and the other is wrong, while tazāhum does not necessarily have to be between right and wrong, and may appear between two equally right concepts. Moreover, conflict exists on a legislative level, while tazāhum is a matter of obedience and adherence, meaning that in practice, both sides cannot continue to coexist. Conflict of interest is a known term in Western literatures, and according to D.F. Thompson, it refers to a situation where professional judgment regarding a primary interest is improperly and unjustifiably influenced by a secondary interest. Taking into account Thompson’s definition and the distinction between “conflict” (Taāruz) and “tazāhum”, the English term “conflict of interest” translates to “tazāhum of interest” in Islamic jurisprudence as it refers to a person’s action without reflecting right or wrong, and simply concerns priority of one interest over another. The resolution to tazāhum in Islamic jurisprudence lies in two principles: the principle of significance and the principle of choice. For instance, in case of conflict (the Western term) or tazāhum (the Islamic term) between the interests of patient and physician, the patient’s interest should be the main concern based on the principle of significance. Although Western literatures propose methods such as disclosure or prohibition in order to resolve conflict of interest, the foundation for these solutions seems to have been the principle of significance.
conflict; conflict of interest; Taāruz; Tazāhum