Association of plasma nitric oxide concentration and endothelial nitric oxide synthase T-786C gene polymorphism in coronary artery disease

Nitric oxide (NO) is synthesized from l-arginine by endothelium nitric oxide synthase (NOS3) and plays important roles in many physiologic and pathologic processes. NO involved in the pathogenesis of coronary atherosclerosis. In the present study we hypothesized that polymorphisms of NOS gene might be associated with increased risk of coronary artery disease (CAD) and plasma NO concentrations. The eNOS gene polymorphism was investigated in 241 unrelated CAD patients with positive coronary angiograms and 261 ages matched control subjects without a history of symptomatic CAD. The NOS3 gene polymorphisms were analyzed by RFLP. Plasma NO, lipid profile and other risk factors were also assessed. The genotype frequencies for T-786C polymorphism differed significantly between CAD patients and controls (p=0.041). The mean plasma NO(x) concentrations showed significant differences according to genotypes of T-786C polymorphism in total population only. The mean plasma NO(x) increased in those individuals that are homozygote for C allele in promoter compared with those individuals are heterozygote for this allele and homozygote for T allele in total population and Controls, but no in CAD patients. The present study provides evidences that T-786C polymorphism of the NOS3 gene is associated with CAD. T-786C polymorphism was not associated with increased plasma NO in CAD patients.     

In Vitro and In Vivo Potential of RH Strain of Toxoplasma gondii (Type I) in Tissue Cyst Forming

Background

Based on recent studies, there are controversial reports on the capacity of tissue cyst forming of Toxoplasma gondii RH strain. In this study, the capacity was evaluated by in vivo and in vitro experiments.

Methods

RH strain was subcutaneously inoculated to ten Wistar rats. After one month, their blood, brain, tongue and diaphragm were collected and evaluated by MAT, PCR, pathological and bioassay methods. The parasite was cultivated in the cell monolayer. To change to bradyzoite, the media pH was altered to 6.8. Biological aspect of the bradyzoites was evaluated by incubation in acidic pepsin and it''s inoculation in ten BALB/c mice.

Results

All rats showed antibodies to Toxoplasma at titers ≥1:320 but no DNA and tissue cyst were detected in the tissues. Following intraperitoneal inoculation of rats’ brain homogenate into BALB/c mice, no infection was established in none of the animals. During presence of cell culture, in acid media for a 3-5 days period, cyst-like structures were noticed when they were stained with PAS. The visible bradyzoites in the cysts that were incubated in acid pepsin medium were not able to kill any mice.

Conclusion

This study confirmed that Iranian RH strain has lost the potential of tissue cyst forming in rats and bradyzoites cultivated in cell culture lost their resistance to acidic condition, so this strain can be a candidate for future vaccine researches.     

Celecoxib as adjunctive treatment to risperidone in children with autistic disorder: a randomized, double-blind, placebo-controlled trial

Rational

Autism is associated with activation of the inflammatory response system.

Objective

This study aims to assess the efficacy of a cyclooxygenase-2 inhibitor, celecoxib, as adjunctive therapy in the treatment of autism

Methods

In a 10-week randomized double-blind placebo-controlled study, 40 outpatient children with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision clinical diagnosis of autism were randomly allocated to celecoxib plus risperidone or placebo plus risperidone. The dose of risperidone and celecoxib were titrated up to 3 and 300 mg/day, respectively. Patients were assessed at baseline and after 2, 4, 6, and 10 weeks of starting medication using the Aberrant Behavior Checklist-Community (ABC-C) Rating Scale. Primary outcome measure was the change in irritability subscale of ABC-C.

Results

Significant time?×?treatment interaction was observed for Irritability (F (1.658, 63.021)?=?13.580, P?<?0.001), Lethargy/Social Withdrawal (F (1.948, 74.032)?=?16.811, P?<?0.001), and Stereotypic Behavior (F(1.742, 66.198)?=?12.104, P?<?0.001), but not for Hyperactivity/Noncompliance (F (2.564, 97.424)?=?1.469, P?=?0.232), and Inappropriate Speech subscales (F (1.607, 61.075)?=?0.173, P?=?0.794). By week 10, patients in the celecoxib group showed significantly greater improvement in the Irritability (P?<?0.001), Lethargy/Social Withdrawal (P?<?0.001), and Stereotypic Behavior (P?<?0.00) but not in Hyperactivity/Noncompliance (P?=?0.202) and Inappropriate Speech (P?=?0.802) subscales than the placebo group. Complete response was achieved by four (20 %) patients in the placebo group and 11 (55 %) patients in the celecoxib group (χ ² (1)?=?5.227, P?=?0.022). Frequency of side effects was similar between the two groups.

Conclusions

Combination of risperidone and celecoxib was superior to risperidone alone in treating irritability, social withdrawal, and stereotypy of children with autism. (Registration, www.irct.ir; IRCT138711091556N2)     

Infliximab for patients with neuro-Behcet's disease: case series and literature review

This study aims to report the therapeutic effects of anti-tumor necrotic factor antibody, infliximab, for treatment of neuro-Behcet's disease (NBD) and to review the literature. We described four patients (all male, median age 40 years old) who fulfilled the International Study Group criteria for Behcet's disease (BD) and presented with neurological complication. Demographic and clinical characteristics of the patients, dose, therapeutic effects, and adverse drug reaction (ADR) of infliximab were reported. Two patients had secondary progressive, one relapsing progressive, and one primary progressive course (median duration of BD and NBD 11 and 2 years, respectively). Two patients each received infliximab with 3 and 5 mg/kg infusions, respectively. The patients received infliximab for median of 22 weeks. Clinical responses were unsatisfactory for two patients on 3 mg/kg regimen; and good in two patients on 5 mg/kg and monthly intravenous 500–1,000 mg cyclophosphamide. Varicella zoster infection was seen as a major ADR in one patient. Our results with infliximab were not as promising as the previous reports. Infliximab, 5 mg/kg per dose with adjuvant immunosuppressive therapy, is probably more effective than other regimens.     

Factors associated with nonbenzodiazepine antiepileptic drug intoxication: Analysis of 9,809 registered cases of drug poisoning

Purpose: Antiepileptic drug (AED) intoxications are common due in part to wide clinical application and availability. Because AEDs usually depress central nervous system function, overdosing may be potentially life‐threatening or lead to a range of adverse outcomes. The aim of this study was to identify risk factors for nonbenzodiazepine AED (NBAED) intoxication. Methods: In this cross‐sectional study, all consecutive adult and adolescent (>12 years old) poisoned patients who presented to the Loghman‐Hakim Poison Hospital (LHPH) during a 6‐month period were evaluated. Patients with NBAED intoxication were identified and compared to a control group of those other pharmaceutical intoxications. The risk factors for AED intoxication were identified using univariate analyses and multivariate modeling. Results: Among 9,809 cases of pharmaceutical agent overdose, there were 474 cases (4.8%) with NBAED intoxication. Mean age of the subjects was 24.5 ± 8.9 years. The most frequent NBAED was carbamazepine (n = 117), followed by phenobarbital (n = 77) and sodium valproate (n = 51). The most frequent motivation was intentional intoxication (95.3%). Multivariate analysis revealed that presence of medical disorders, a history of psychological events, and loneliness were associated with AED intoxication, whereas educational level had a protective effect. There was no association between previous history of parasuicide, sex, age, occupation status, and AED intoxication. Discussion: In conclusion, this study showed that the majority of AED intoxications are due to deliberate self poisoning. The presence of psychological events, medical disorders, and loneliness are risk factors for AED intoxication, whereas higher education level has a protective effect.     

Seroepidemiology of hepatitis E virus infection in patients undergoing maintenance hemodialysis: Systematic review and meta‐analysis

Patients undergoing regular hemodialysis (HD) are at an extreme risk of acquiring bloodstream infections compared to the general population. Hepatitis E virus (HEV) infection is an important emerging health issue in these patients. To date, numerous studies have investigated the seroprevalence of HEV among HD patients across the world; however, the data are conflicting. The present study aimed to measure the exposure rate of HD patients to HEV infection by estimating the overall seroprevalence of HEV in this high‐risk group. A systematic literature search was carried out using five electronic databases from inception to January 10, 2020, with standard keywords. Pooled seroprevalence estimates with 95% confidence intervals (CIs) were calculated using a random intercept logistic regression model. The seroprevalence of HEV increased from 6.6% between the years of 1994 and 2000 to 11.13% from 2016 to 2020. Blood transfusion was associated with a nearly 2‐fold increase in the rate of HEV seropositivity (OR = 1.99; 95% CI: 1.50‐2.63, P < .0001, I² = 6.5%). HEV seroprevalence among patients with HD for more than 60 months was significantly higher than those with HD for less than 60 months (27.69%, 95% CI: 20.69%‐35.99% vs 15.78%, 95%CI: 8.85%‐26.57%, respectively) (P = .06). Our results indicated increased exposure of HD patients with HEV infection over the last decade. We concluded that blood transfusion and duration of HD are considerable risk factors for acquiring HEV infection among HD patients.     

Phytotherapy of Opioid Dependence and Withdrawal Syndrome: A Review

Development of tolerance and dependence is a major problem associated with opioid treatment. Withdrawal syndrome is common between medical and illicit users of these agents. Phytomedicine has shown promise in the treatment of this complicated psychosomatic condition. In this study, the effects of plant extracts and active components on morphine dependence and withdrawal syndrome are discussed. Proper keywords were used to search through PubMed, Google Scholar, and SciVerse, as well as two local scientific databases, www.iranmedex.com and www.SID.com . All relevant results (original articles, meeting abstracts, patents, etc.) published from 2000 to 2013 were chosen for final review. A total of 35 plant species were studied on this subject. Plants from Lamiaceae, Ranunculaceae, and Apiaceae families were especially effective. A few studies were carried out on human subjects and the rest in animal models. Opioid dependence and withdrawal syndrome remain an intimidating challenge. Nonetheless, plants and their derivatives are suitable sources for their treatment. Although there are several plants shown to be effective in animal models, few clinical studies are available. Copyright © 2013 John Wiley & Sons, Ltd.