The effect of fresh frozen plasma in severe closed head injury

OBJECTIVE: Traumatic brain injury (TBI) is one of the most common causes of morbidity and mortality. Coagulopathy, commonly occurring after severe TBI, is associated with poor outcome and secondary complications, especially delayed traumatic intracerebral hematoma (DTICH). In this study we evaluated the effect of fresh frozen plasma (FFP) on the reduction in the incidence of DTICH in severe closed head injury victims. METHODS: This study was carried out as a double-blind randomized clinical trial. Ninety patients were entered in two parallel groups taking either FFP or normal saline (N/S). Patients' selection criteria for both groups were: severe closed head injury (Glasgow coma scale < or =8), no mass lesion required evacuation and no history of coagulopathy. The clinical findings, laboratory data, computed tomography (CT) scans and Glasgow outcome scale after 1 month were assessed and compared in two groups. RESULTS: Out of 90 patients, 44 received FFP and 46 received N/S. The development of new intracerebral hematoma in follow-up CT scans were more common in the FFP group than the N/S group (p=0.012). Both groups showed similar frequency of poor outcome (p=0.343). The mortality was significantly more common in the FFP group than in the N/S group (63% versus 35%, p=0.006). CONCLUSION: The result of this study revealed that early empirical infusion of FFP in patients with severe head injury may lead to adverse effects, such as an increase in the frequency of DTICH and an increase in the mortality.     

Role of ATP-sensitive potassium channels in the biphasic effects of morphine on pentylenetetrazole-induced seizure threshold in mice

Although several studies have indicated that the opioid receptor agonist morphine exerts biphasic effects on clonic seizure threshold, as yet little is known of the underlying mechanisms in this effect. In the present study, using the specific ATP-sensitive K(+) (K(ATP)) channel blocker glibenclamide and the specific K(ATP) channel opener cromakalim, the possible involvement of K(ATP) channels in the effects of morphine on pentylenetetrazole (PTZ)-induced seizure threshold in mice was investigated. Acute administration of lower doses of morphine (1, 3 and 7.5 mg/kg, i.p.) increased and higher doses of morphine (30 and 60 mg/kg, i.p.) decreased the PTZ-induced seizure threshold. Glibenclamide (2.5-5 mg/kg) increased the PTZ-induced seizure threshold. Non-effective dose of cromakalim (0.1 microg/kg) inhibited anticonvulsant effect of glibenclamide (5 mg/kg). Acute administration of non-effective dose of glibenclamide (1 mg/kg) interestingly inhibited both anticonvulsant and pro-convulsant effects of morphine and this effect was significantly reversed by cromakalim (0.1 microg/kg). These results support the involvement of K(ATP) channels in the modulation of seizure threshold by morphine.     

Estimating the relapse risk of Plasmodium vivax in Iran under national chemotherapy scheme using a novel method

OBJECTIVES: This study aimed to estimate the relapse risk of Plasmodium vivax under national chemotherapy scheme using a novel method, and assessed its pattern in Kahnooj, a malaria endemic area in Iran. METHODS: The authors traced repeated episodes of malaria attack between 1994 and 2001 and then, estimated the risks of secondary attack of P. vivax, classified by the species in their primary attack. It is suggested that the difference between the secondary attack rate in those who were infected by P falciparum and P. vivax in their primary attack may estimate the P. vivax relapse rate indirectly. RESULTS: This method showed that the relapse risk of P. vivax with in one and two years after the primary attack were 16.8 and 24.5% respectively. The risks of relapse before three or after 18 months were very low. INTERPRETATION & CONCLUSION: The relapse pattern of P. vivax was compatible with the dominant pattern in most of the temperate areas. In addition, the relapse risk was very close to the estimated relapse risks in clinical trials on anti-relapse drugs. Therefore, we concluded that the anti-relapse therapy in the study area was effective; also, this method may estimate the relapse risk of P. vivax accurately.     

Histopathologic features of a unilateral renal dysplasia in a cat (Felis domestica)

Renal dysplasia is a rare congenital anomaly that has been reported in human and some species of animals. This study shows congenital renal dysplasia that was detected in a stray cat. The present report describes the primary microscopic features that are essential to renal dysplasia diagnosis. Histopathologic examination showed a narrow renal cortex, decreased numbers of glomeruli, underdeveloped glomeruli, marked medullary mesenchymal connective tissue, and disorganized primitive tubules in the cortex and medulla. It is the first report of this anomaly that explains microscopic lesions of renal dysplasia in cat.     

Mercury induces inflammatory mediator release from human mast cells

Background  

Mercury is known to be neurotoxic, but its effects on the immune system are less well known. Mast cells are involved in allergic reactions, but also in innate and acquired immunity, as well as in inflammation. Many patients with Autism Spectrum Disorders (ASD) have "allergic" symptoms; moreover, the prevalence of ASD in patients with mastocytosis, characterized by numerous hyperactive mast cells in most tissues, is 10-fold higher than the general population suggesting mast cell involvement. We, therefore, investigated the effect of mercuric chloride (HgCl₂) on human mast cell activation.     

Prevalence of HIV/HCV/HBV infections and drug-related risk behaviours amongst IDUs recruited through peer-driven sampling in Iran

BackgroundThe control of blood-borne infections including HIV and hepatitis C (HCV) amongst injecting drug users (IDUs) is a challenge for health authorities in Iran. Hence, more reliable estimates of the levels of blood-borne infections and their associated factors are critically needed.MethodsActive IDUs were recruited using peer-driven sampling in a bio-behavioural survey in 2008. Over 8 weeks, data were collected from adults living in a city in Isfahan Province who had injected drugs in the past month. Participants provided a whole blood sample and answered questions on sexual and drug-related risk characteristics. Participants were provided post-test counselling and a non-monetary incentive for their participation. Excluding two inactive cases, the initial recruits resulted in 2–8 waves of recruitment.ResultsOverall, 118 IDUs including three females participated. The estimated population proportions of HIV, hepatitis B, and HCV infections were 0.7% (95% CI, 0.6–2.3), 0.7% (95% CI, 0.1–2.1), and 59.4% (95% CI, 47.4–68.7), respectively. Responses indicated that 31% (95% CI, 20–44.5) of the IDUs ever shared a needle/syringe for drug injection, and 77% (95% CI, 65–84) had ever injected an addictive solution marketed widely as Temgesic. Multivariate analyses revealed that the high prevalence of HCV infection amongst IDUs is associated with the lifetime duration of drug injection (AOR, 1.17; 95% CI, 1.01–1.34) and with having injected Temgesic (AOR, 4.73; 95% CI, 1.52–14.69).ConclusionOur experience in Iran indicates that IDUs can be recruited effectively in a bio-behavioural survey through peer-driven sampling and using only a single primary incentive. The high prevalence of HCV associated with injecting Temgesic is important evidence for harm-reduction policies in Iran.     

Needle and syringe sharing practices of injecting drug users participating in an outreach HIV prevention program in Tehran,Iran: A cross-sectional study

HIV infection rates have reached epidemic proportions amongst injecting drug users (IDUs) in Iran. Although a number of community-based interventions have being implemented in the country, there is little information on the risk behaviors of IDU participants in these programs. This cross-sectional report aimed to compare the risk behaviors of injecting drug users with differential exposure rates to an HIV outreach program in Tehran, Iran. Results indicated that shared use of needle/syringe in the past month was significantly lower among IDUs who received estimated ≥ 7 syringes per week than those who did not [adjusted odds ratio (OR) = 14.36, 95% confidence interval (CI) 2.30–89.56]. While the effectiveness of this outreach program needs further evaluation through a longitudinal investigation, our preliminary findings suggest that the outreach program in Tehran may have been beneficial in reducing direct sharing among those who received more than several needles/syringes from the program.     

Nonisthmic communicating uteri. Report of 3 new types in a new subclass of communicating uteri

OBJECTIVE: To describe 3 new malformations and propose a new subclass of malformations, nonisthmic communicating uteri. STUDY DESIGN: Review of 17,511 hysterosalpingograms revealed 19 cases of communicating uteri. Three cases were identified that showed nonisthmic communications, previously unreported. RESULTS: The 3 new types of communicating uteri were (1) bicornuate uterus with 2 sites of communication, midcervical and isthmic; (2) septate uterus with a midcorporeal communication; and (3) bicornuate uterus with a low cervical communication and atretic hemicervix. CONCLUSION: The 3 new types of nonisthmic communicating uteri constitute a new subclass of communicating uteri. We are aware of only 1 other reported type of nonisthmic communicating uteri. Nonisthmic communications may arise from a different mechanism than isthmic communications.