Radioimmunoassay Inhibition Method for Confirming the Specificity of Positive Hepatitis B Surface Antigen Reactions and for Survey of Antibodies to the Antigen1

Abstract. Studies were conducted to determine the hepatitis B surface antigen antibody (anti-HB_S) levels and antibody subtype specificities required in order for anti-HB_S sera of human origin to be suitable for use in radioimmunoassay (RIA) inhibition tests for determining the specificity of positive reactions for hepatitis B surface antigen (HB_SAg.) Also, the RIA inhibition method was evaluated for detection of anti-HB_S in sera of laboratory personnel. Only anti-HB_S sera with complement-fixing (CF) antibody titers of 1:32 or higher effectively inhibited HB_SAg-positive sera with demonstrable CF activity, and complete inhibition was obtained only for antigens having CF titers of 1:64 or lower. Higher-titered antigens could be inhibited when diluted 1:10-1: 100. The low-titered HB_SAg preparation supplied with AusRIA kits (Abbott Laboratories) was effectively inhibited by low-titered anti-HB_S sera, and when used in RIA inhibition tests on sera from laboratory personnel, the tests detected anti-HB_S in approximately 14% of the individuals tested, a slightly greater number than those showing anti-HB_s in passive hemagglutination tests. Inhibition of HB_SAg-positive sera by the anti-HB_S sera could not be related to the d and y subtype specificities of the antigens or antisera; the antisera were no more effective in inhibiting antigens of the homologous subtype than those of the heterologous subtype.     

Electrocardiogram abnormalities and risk of cardiovascular mortality and all-cause mortality in old age: The Kahrizak Elderly Study (KES)

Resting electrocardioghic (ECG) abnormalities might be value for mortality prediction. The aim of this study is to evaluate whether ECG abnormalities are associated with increased mortality in older residents of Kahrizak Charity Foundation (KCF). A total of 247 participants ≥60-years of KES were enrolled in this study. Adjudicated all cause mortality was collected over 3 years between 2006 and 2009. The subjects were classified as having major, minor or no ECG abnormalities according to the Minnesota Code. The addition of ECG to risk factors were examined to predict cardiovascular diseases (CVD) and all-cause mortality by using Cox proportional hazards regression models. At baseline, 104(42.1%) had major ECG abnormalities and 73(29.6%) had minor abnormalities. During a median follow-up of 3.2 years, 73 participants died from all-cause mortality and 31deaths from CVD. Major ECG abnormalities were associated with an increased risk of CVD mortality in all models. The associations between minor ECG abnormalities at baseline and CVD mortality were not statistically significant. After adjustment for age and sex, Body mass index (BMI), smoking, diabetes, hypertension (HTN), hyperlipidemia and history of CVD, the participants with the major ECG abnormalities had higher risks of CVD mortality (HR: 3.12(95% CI, 1.02-9.57) and all-cause mortality (HR: 2.45(95% CI, 1.23–4.85) compared with those with normal ECG.     

Reduced serum osteocalcin concentrations are associated with type 2 diabetes mellitus and the metabolic syndrome components in postmenopausal women: the crosstalk between bone and energy metabolism

Although it has been shown that osteocalcin functions as a hormone in the regulation of glucose metabolism and fat mass, no population-based study to date has addressed serum osteocalcin levels in relation to energy metabolism concurrent with bone metabolism in postmenopausal women. In a population-based study, cardiovascular risk factors, high-sensitivity C-reactive protein (hs-CRP), osteoprotegerin, receptor activator of nuclear factor-??B ligand, osteocalcin, CrossLaps, alkaline phosphatase, and bone mineral density (BMD) at the lumbar spine (L2?CL4) and the proximal femur were measured in 382 Iranian postmenopausal women. In multiple logistic regression analysis, lower osteocalcin and CrossLaps levels were associated with a higher odds ratio (OR) of having type 2 diabetes mellitus when adjustments were made for age, hs-CRP, cardiovascular risk factors, BMD, and markers of bone metabolism [OR 5.17, CI (2.66?C10.04), p?<?0.0001 and OR 2.51, CI (1.37?C4.61), p?=?0.003, respectively]. However, lower alkaline phosphatase levels were associated with a lower OR of having type 2 diabetes mellitus [OR 0.28, CI (0.15?C0.52), p?<?0.0001] in regression analysis. No significant difference was found between serum osteocalcin levels of those with and without metabolic syndrome. Among the metabolic syndrome components, low osteocalcin levels had significant associations with elevated blood glucose [OR 1.89, CI (1.16?C3.07), p?=?0.010] and elevated waist circumference [OR 2.53, CI (1.13?C5.67), p?=?0.024] in multivariate analyses. In conclusion, serum osteocalcin was independently associated with glucose intolerance and abdominal obesity as the components of metabolic syndrome and type 2 diabetes mellitus in postmenopausal women. Since CrossLaps and alkaline phosphatase levels were independently associated with the presence of type 2 diabetes mellitus, the unique contribution of osteocalcin in glucose metabolism could not be concluded.     

Treatment of moderate to severe keratoconus with 6-mm Intacs SK

AIM: To evaluate the effect of Intacs SK corneal ring segment implant for treatment of patients with moderate to severe keratoconus, who have clear central cornea and cannot tolerate contact lens. METHODS: In this prospective, non-comparative, interventional case series study performed in Dena Hospital, Shiraz, Iran, thirty-seven eyes of thirty-six patients with moderate to severe keratoconus, clear central cornea, and contact lens intolerance were enrolled and underwent Intacs SK corneal ring segment implantation. Preoperatively, uncorrected distance visual acuity (UCDVA), best-corrected distance visual acuity (BCDVA), central corneal thickness(CCT) and average keratometry (Av-K) were measured and compared with post-operative results at one week, one month, three months, and six months. RESULTS: Mean preoperative UCDVA and BCDVA were (1.32±0.31)logMAR and (1.07±0.27)logMAR, respectively. Av-K was (52.13±0.39)D, and the CCT was (432±39.5)μm. Post-operative examinations showed a clinically significant improvement in both UCDVA and BCDVA (P<0.001). There was also a significant effect based on the time of assessment on both UCDVA and BCDVA and both parameters had a continuous improvement during the follow-up period. Three months after operation there was a statistical significant reduction of Av-K (P=0.0001), but there were no significant changes in CCT (P=0.149). CONCLUSION: Intacs SK corneal ring segment implants seem to be a safe and effective treatment option for patients who have keratoconus, clear central cornea, and contact lens intolerance.     

Barriers to health information seeking in Iranian patients with cardiovascular disease: A qualitative study

Objective

Providing patients with health care information is a critical component of the process of cardiovascular disease (CVD) management. The purpose of this study was to explore obstacles to seeking health care information among cardiovascular patients from the perspectives of patients, their family caregivers, and health care providers.

Methods

This study was conducted with a qualitative approach using conventional qualitative content analysis. The study included 31 Iranian participants including 16 cardiovascular patients, 5 family members, and 10 health care providers (multidisciplinary). Data were collected with semi-structured interviews and continued to the point of data saturation. Analysis of the data was performed continually and concurrently with data collection of using a comparative method.

Results

Five themes emerged including ‘poor quality of information provision,’ ‘mutual ambiguity,’ ‘beliefs, faith, and expectations,’ ‘from routine life to obtaining information,’ and ‘conditions governing information seekers.’ Seven sub-themes indicated participants' experiences and understandings of obstacles in health care information seeking.

Conclusion

Health care information seeking in cardiovascular patients and their family members occurs as a result of the influence of beliefs, interaction with numerous information sources, and in the context and structure that the care and information are provided. Understanding the nature of obstacles to health information seeking will help health care policy makers to provide evidence-based, reliable, and patient-centered information to encourage cardiovascular patients' involvement in treatment decisions.     

Design,synthesis, biological evaluation,and molecular dynamics of novel cholinesterase inhibitors as anti‐Alzheimer's agents

A series of novel chroman‐4‐one derivatives were designed and synthesized successfully with good to excellent yield ( 3a–l ). In addition, the obtained products were evaluated for their cholinesterase (ChE) inhibitory activities. The results show that among the various synthesized compounds, analogs bearing the piperidinyl ethoxy side chain with 4‐hydroxybenzylidene on the 3‐positions of chroman‐4‐one ( 3l ) showed the most potent activity with respect to acetylcholinesterase (anti‐AChE activity; IC₅₀ = 1.18 μM). In addition, the structure–activity relationship was studied and the results revealed that the electron‐donating groups on the aryl ring of the 3‐benzylidene fragment ( 3k , 3l ) resulted in the designed compounds to be more potent ChE inhibitors in comparison with those having electron‐withdrawing groups ( 3h ). In this category, the strongest ChE inhibition was found for the compound containing piperidine as cyclic amine, and a hydroxyl group (for AChE, compound 3l ) and fluoro group (for butyrylcholinesterase (BuChE, compound 3i ) on the para‐position of the aryl ring of the benzylidene group. The molecular docking and dynamics studies of the most potent compounds ( 3i and 3l against BuChE and AChE, respectively) demonstrated remarkable interactions with the binding pockets of the ChE enzymes and confirmed the results obtained through in vitro experiments.     

Multifocal cranial plasmablastic lymphoma as a rare manifestation of posttransplant lymphoproliferative disorder

We present an unusual case of a young woman who developed multiple cranial masses and unilateral facial palsy 10 years after a successful living-unrelated kidney transplant. She was diagnosed with diffuse large B-cell plasmablastic differentiated lymphoma, a rare form of posttransplant lymphoproliferative disorder. She responded to 5 cycles of cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy with resolution of all cranial masses. However, her facial palsy did not resolve, and she died 6 months after diagnosis with pneumonia and sepsis.