The effect of behavioral intervention and nutrition education program on serum lipid profile,body weight and blood pressure in Iranian individuals with spinal cord injury: A randomized clinical trial

Objective: The efficacy of nutrition education on body weight and serum lipids has not yet been described in patients with spinal cord injury (SCI). In the present study, we examined the effect of a 7-month nutrition education program on lipid profile and body weight in individuals with SCI.

Design: Randomized clinical trial.

Setting: A tertiary rehabilitation center.

Participants: Patients with SCI who were referred to Brain and Spinal Cord Injury Research Center.

Intervention: The nutrition education program consisted of 5 education sessions during a period of 7 months.

Outcome measures: Body weight and serum concentrations of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measure at the beginning of the trial and after 7 months. Two-way repeated measure analysis of variance (ANOVA) was used.

Results: Total of 57 patients (27 in control group and 30 in education group) participated. Nutrition education program showed no significant effect on the levels of TC, TG, LDL-C and HDL-C (P: 0.224, 0.172, 0.107 and 0.081, respectively). No significant changes in weight and waist circumflex have been observed as well (P: 0.970 and 0.361, respectively).

Conclusion: Our findings do not support a significant influence of nutrition education program on weight and lipid profile. It seems that the nutrition education program alone is not adequately effective to have beneficial influence on weight and lipid profile.

Clinical trial registration No.: IRCT201406215968N3     

Comparative analysis of anthropometric indices with serum uric acid in Iranian healthy population

BackgroundThe relationship between elevated serum uric acid (SUA) levels and hypertension, metabolic syndrome and cardiovascular disease has been established. In this study, the relation of SUA levels to anthropometric indices, blood cell count and lipid profile was examined.MethodsAnthropometric parameters including body‐mass index, waist circumference, waist to height ratio, waist to hip ratio, waist to pelvic ratio, neck circumference (NC), body fat mass (BFM), basal metabolic rate (BMR), visceral fat level (VFL) and percent body fat (PBF), along with complete blood cell count, lipid profile and SUA were obtained from 2921 young and middle‐aged Iranian healthy subjects. To assess the normality of data, the Kolmogorov–Smirnov test was used. Mann‐Whitney, Kruskal‐Wallis, Chi‐square and Spearman correlation tests were used for evaluating the association between variables. Simple and multiple regression analyses were also performed.ResultsThe results of data analysis showed all studied factors were correlated with SUA level except VFL, BFM, and platelet‐to‐lymphocyte ratio. The highest correlation was with NC, BMR, hematocrits (HCT) and triglycerides (TG). The backward method revealed that TG, LDL, HDL, neutrophil, lymphocyte, platelet, HCT, BMR and skinfold fat thickness were factors related to SUA.ConclusionsAccording to the finding of this study, SUA level is related to anthropometric indices, lipid profile and neutrophil to lymphocyte ratio in healthy population. SUA measurement might be advisable to identify those at increased risk of health problems whom might benefit from further evaluation.     

Relationship between pregnancy outcomes and maternal vitamin D and calcium intake: A cross-sectional study

Poor maternal vitamin D status affects fetal and infant skeletal growth. The aim of the present study was to determine the association between newborn outcomes and maternal calcium and vitamin D intakes. Four hundred and forty-nine pregnant women, healthy at the point of delivery, and their newborns were enrolled in the study, which was performed in three university hospitals in Tehran in March 2004. Maternal anthropometric data and energy, protein, calcium and vitamin D intakes were collected, and newborn outcomes (weight, length, head circumference and 1-min Apgar score) were determined. Almost two-thirds of the mothers (64.3%) took no supplements during pregnancy. Only one-third of the mothers (33.8%) had adequate intakes of calcium and vitamin D (from supplements and foods) compared with the Recommended Dietary Allowances. Mean length at birth and 1-min Apgar score were higher in newborns whose mothers had adequate calcium and vitamin D intake than in newborns whose mothers had inadequate intake (p = 0.03 and p = 0.04, respectively). Significant correlations were found between adequate maternal calcium and vitamin D intake and both appropriate birth weight and 1-min Apgar score of newborns and weight gain of mothers during pregnancy. Informing mothers of the critical importance of consuming adequate amounts of calcium and vitamin D seems necessary.     

Determining of antibiotic resistance profile in Staphylococcus aureus isolates

ObjectiveTo determine the pattern of antibiotic resistance among Staphylococcus aureus (S. aureus) isolates from clinical specimens and to identify community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in specimens that have been collected from patients referring to one of the hospitals of Ahvaz.MethodsS. aureus isolates from a hospital in Ahvaz were screened for resistance to various antibiotics including methicillin. The susceptibility of the isolates was determined by Kirby-Bauer disc diffusion method. The MRSA was also treated with ethidium bromide to find the origin of resistance.ResultsAmong the bacterial isolates, all of 11 S. aureus were resistant to methicillin and cefixime, 2 were resistant to ciprofloxacine, 6 were resistant to tetracycline and the reminder were sensitive or intermediate to other antibiotics. The treated isolates were reminded resistant to methicillin and this suggested that the plasmid was not the origin of resistance in these isolates.ConclusionsThese results showed that infection due to MRSA is widespread in Ahvaz and with respect to the spread of vancomycin resistance among MRSA and appearance of overwhelming infections. It is necessary to identify continuously the profile of antibiotic resistance among S. aureus isolates in other regions and finding appropriate antibiotic for infection control and eradication.     

Evaluation of a HER2-targeting affibody molecule combining an N-terminal HEHEHE-tag with a GGGC chelator for <Superscript>99m</Superscript>Tc-labelling at the C terminus

Affibody molecules are a class of small (ca.7 kDa) robust scaffold proteins with high potential as tracers for radionuclide molecular imaging in vivo. Incorporation of a cysteine-containing peptide-based chelator at the C terminus provides an opportunity for stable labelling with the radionuclide ^99mTc. The use of a GGGC chelator at the C terminus has provided the lowest renal radioactivity retention of the previously investigated peptide-based chelators. Previously, it has also been demonstrated that replacement of the His₆-tag with the negatively charged histidine-glutamate-histidine-glutamate-histidine-glutamate (HEHEHE)-tag permits purification of affibody molecules by immobilized metal ion affinity chromatography (IMAC) and provides low hepatic accumulation of radioactivity of conjugates site-specifically labelled at the C terminus using several different nuclides. We hypothesized that the combination of a HEHEHE-tag at the N terminus and a GGGC chelator at the C terminus of an affibody molecule would be a favourable format permitting IMAC purification and providing low uptake in excretory organs. To investigate this hypothesis, a (HE)₃-Z_HER2:342-GGGC affibody molecule was generated. It could be efficiently purified by IMAC and stably labelled with ^99mTc. ^99mTc-(HE)₃-Z_HER2:342-GGGC preserved specific binding to HER2-expressing cells. In NMRI mice, hepatic uptake of ^99mTc-(HE)₃-Z_HER2:342-GGGC was lower than the uptake of the control affibody molecules, ^99mTc-Z_HER2:2395-VDC and ^99mTc-Z_HER2:342-GGGC. At 1 and 4 h after injection, the renal uptake of ^99mTc-(HE)₃-Z_HER2:342-GGGC was 2–3-fold lower than uptake of ^99mTc-Z_HER2:2395-VDC, but it was substantially higher than uptake of ^99mTc-Z_HER2:342-GGGC. Further investigation indicated that a fraction of ^99mTc was chelated by the HEHEHE-tag which caused a higher accumulation of radioactivity in the kidneys. Thus, a combination of a HEHEHE-tag and the GGGC chelator in targeting scaffold proteins was found to be undesirable in the case of ^99mTc labelling due to a partial loss of site-specificity of nuclide chelation.     

Efficacy of Atorvastatin and Antihistamines in Comparison with Antihistamines plus Placebo in the Treatment of Chronic Idiopathic Urticaria: A Controlled Clinical Trial

Chronic Idiopathic Urticaria is defined as recurrent hives occurring for at least 6 weeks. In the majority of cases, there is no identifiable underlying etiology despite extensive evaluation. A subset of these patients is classified as having autoimmune urticaria defined by the presence of a functional IgG antibody to the α subunit of the high-affinity IgE receptor (FceRIa) or to IgE. The aim of this study was to evaluate the effects of the drug atorvastatin in patients with chronic urticaria compared to the placebo.In this single-blind study, 50 patients suffering from chronic urticaria (15-45 years old) were selected and divided into two groups by simple randomization method. The first group was treated with atorvastatin and antihistamines and the second group (control group) was treated with placebo and antihistamines for 3 months. Urticaria severity was measured by score index, before and after the treatment course: ASST (Autologous serum skin test) was performed for all patients and sera were collected to measure cytokines. In cases, IL-5 decreased and IL-10 increased after treatment compared to the time point before treatment (p<0.05). All patients with severe utricaria according our scoring, had positive ASST.The patients with severe urticaria identified by urticaria score and ASST positivity had chronic idiopathic urticaria. By prescribing the Atorvastatin plus antihistamines in severe and resistant forms of urticaria, the use of more toxic medications like cytotoxic drugs may be avoided.     

TLR7 stimulation augments T effector-mediated rejection of skin expressing neo-self antigen in keratinocytes

Immunotherapy generally fails to induce tumour regression in spontaneously arising tumours. Failure is attributed to both tumour-related factors and an ineffective immune response. As a model of tumour immunotherapy, without the confounding effects of potential tumour-determined mechanisms of immune evasion, we studied the requirements for rejection of skin grafts expressing a neo-self antigen in somatic cells and not in antigen-presenting cells. When antigen expression was restricted to somatic cells, both CD4(+) and CD8(+) effector cells were required for graft rejection. Although freshly placed grafts were spontaneously rejected, healed grafts established under the cover of T cell depletion were not rejected even after T cell numbers recovered to a level where freshly placed grafts on the same animal were rejected, suggesting that healed skin grafts expressing a neo-self antigen only in somatic cells could not be rejected by primed recipients with functional effector T cells. Local TLR7 ligation induced inflammatory responses and rejection of healed grafts exposed to the TLR agonist but did not induce rejection of untreated healed grafts on the same animal. Thus, local pro-inflammatory signalling via TLR7 can promote effector T cell function against skin cells displaying their nominal antigen.     

Assessing the Influence of Food Insecurity and Retail Environments as a Proxy for Structural Racism on the COVID-19 Pandemic in an Urban Setting

A collaborative partnership launched the Great Grocer Project (GGP) in March 2021 in Detroit, Michigan where health inequities, including deaths due to COVID-19, have historically been politically determined and informed by socially entrenched norms. Institutional and structural racism has contributed to a lack of diversity in store ownership among Detroit grocers and limited access to high-quality, affordable healthy foods as well as disparate food insecurity among Detroit residents. The GGP seeks to promote Detroit’s healthy grocers to improve community health and economic vitality through research, programs, and policies that have the potential to advance health equity. A cross-sectional design was used to explore relationships between scores from the Nutrition Environment Measures Surveys-Stores (NEMS-S) in 62 stores and city-level data of COVID-19 cases and deaths as well as calls to 211 for food assistance. Regression and predictive analyses were conducted at the ZIP code level throughout the city to determine a relationship between the community food environment and food insecurity on COVID-19 cases and deaths. COVID-19 cases and deaths contributed to greater food insecurity. The use of ZIP code data and the small sample size were limitations within this study. Causation could not be determined in this study; therefore, further analyses should explore the potential effects of individual grocery stores on COVID-related outcomes since a cluster of high-scoring NEMS-S stores and calls to 211 for food security resources inferred a potential protective factor. Poor nutrition has been shown to be associated with increased hospitalizations and deaths due to COVID-19. It is important to understand if a limited food environment can also have a negative effect on COVID-19 rates and deaths. Lessons learned from Detroit could have implications for other communities in using food environment improvements to prevent an uptick in food insecurity and deaths due to COVID-19 and other coronaviruses.