Adaptation and validation of the Iranian version of Angina Pectoris characteristics questionnaire

Research aimed at evaluating Angina Pectoris (AP) symptoms in patients with Coronary Heart Disease (CHD) requires a comprehensive assessment tool applicable to this population. Because no single existing measure assessed the full range of symptom characteristics important to our study, we combined two measures (the modified Rose Questionnaire (MRQ), and the Short Form‐McGill Pain Questionnaire (SF‐MPQ) and added one item to examine specific aspects of AP symptoms (Accompanying Symptom Checklist). The purposes of this study are: (i) to describe the process of translating the SF‐MPQ, MRQ and accompanying symptom checklist from English to the Farsi language; and (ii) to evaluate substantial psychometric works (content and construct validity) for the entire instrument and each part of it (SF‐MPQ, MRQ and accompanying symptom checklist). A cross‐cultural adaptation of the instrument was carried out before developing the final version of it. To these ends, one hundred and 10 CHD patients with AP were assessed by this hybrid measure in an initial study. An analysis of the results indicated that a content valid instrument had been developed. There was a significantly high correlation between scores in the SF‐MPQ and there were associations between items in the MRQ. The Iranian version of AP characteristics questionnaire is valid; it is capable of describing characteristics of AP symptoms. However, the reliability of the instrument needs to be assessed through further research.     

Vascular mechanisms of cyanidin-3-glucoside response in streptozotocin-diabetic rats

Background and objective: Considering the high incidence of cardiovascular disorders in diabetes mellitus and some evidence on the antioxidant and antidiabetic potential of cyanidin-3-glucoside (C3G), this study was conducted to evaluate the possible beneficial effect of C3G administration on vascular reactivity of isolated thoracic aorta in diabetic rats and some of its underlying mechanisms. Materials and methods: Male diabetic rats received C3G (10 mg/kg; i.p.) on alternate days for 8 weeks one week after streptozotocin (STZ) diabetes induction. Results: It was found out that treatment of diabetic rats with C3G exerted a hypoglycaemic effect and attenuated the increased malondialdehyde (MDA) content and reduced the activity of superoxide dismutase (SOD) in aortic tissue. Maximum contractile response of endothelium-intact aortic rings to phenylephrine (PE) was significantly lower in C3G-treated diabetic rats relative to untreated diabetics and endothelium removal abolished this difference. Meanwhile, endothelium-dependent relaxation to acetylcholine (ACh) was significantly higher in C3G-treated diabetic rats as compared to diabetic group. Conclusion: Chronic treatment with C3G may prevent some diabetes-related changes in vascular reactivity observed in diabetic rats directly and/or indirectly due to its hypoglycaemic effect and attenuation of lipid peroxidation and through endothelial-derived factors.     

Hepatitis B and liver transplantation: Molecular and clinical features that influence recurrence and outcome

Hepatitis B virus (HBV) continues to be a major cause of morbidity and mortality worldwide. It is estimated that about 350 million people throughout the world are chronically infected with HBV. Some of these people will develop hepatic cirrhosis with decompensation and/or hepatocellular carcinoma. For such patients, liver transplantation may be the only hope for cure or real improvement in quality and quantity of life. Formerly, due to rapidity of recurrence of HBV infection after liver transplantation, usually rapidly progressive, liver transplantation was considered to be contraindicated. This changed dramatically following the demonstration that hepatitis B immune globulin (HBIG), could prevent recurrent HBV infection. HBIG has been the standard of care for the past two decades or so. Recently, with the advent of highly active inhibitors of the ribose nucleic acid polymerase of HBV (entecavir, tenofovir), there has been growing evidence that HBIG needs to be given for shorter lengths of time; indeed, it may no longer be necessary at all. In this review, we describe genetic variants of HBV and past, present, and future prophylaxis of HBV infection during and after liver transplantation. We have reviewed the extant medical literature on the subject of infection with the HBV, placing particular emphasis upon the prevention and treatment of recurrent HBV during and after liver transplantation. For the review, we searched PubMed for all papers on the subject of “hepatitis B virus AND liver transplantation”. We describe some of the more clinically relevant and important genetic variations in the HBV. We also describe current practices at our medical centers, provide a summary and analysis of comparative costs for alternative strategies for prevention of recurrent HBV, and pose important still unanswered questions that are in need of answers during the next decade or two. We conclude that it is now rational and cost-effective to decrease and, perhaps, cease altogether, the routine use of HBIG during and following liver transplantation for HBV infection. Here we propose an individualized prophylaxis regimen, based on an integrated approach and risk-assessment.     

Collagenous matrix supported by a 3D-printed scaffold for osteogenic differentiation of dental pulp cells

Objective

A systematic characterization of hybrid scaffolds, fabricated based on combinatorial additive manufacturing technique and freeze-drying method, is presented as a new platform for osteoblastic differentiation of dental pulp cells (DPCs).

Association of Left Ventricular Diverticula and Sinus Venosus Atrial Septal Defect

Left ventricular diverticula are congenital anomalies and are not as rare as previously thought. In adults, cardiac diverticula are generally accidental findings during imaging modalities, but concomitant disorders might frequently coexist. The pathophysiology, management, prognosis, and natural history of cardiac diverticula remain poorly understood and controversial. Definite diagnosis is often challenging due to similarities in appearance to other more common anomalies such as aneurysms, pseudoaneurysms, endocarditis, cysts, and hypertrophied trabeculations. We herein report a rare case of an adolescent presenting with sinus venosus atrial septal defect, partial anomalous venous connection, and left ventricular diverticula.     

Behcet's disease in Iran: analysis of 6500 cases

Objective: To identify the clinical picture of Behcet’s disease in a large cohort of patients (6500) in Iran, over a period of 35 years, and compare them with other large series from around the world. Methods: Patients with Behcet’s disease from all over Iran were seen in the Behcet’s Disease Research Unit by a multidisciplinary team (rheumatologists, dermatologists, and ophthalmologists). Diagnosis was based on ‘expert opinion’. Data were collected on a standardized data sheet (105 items), and stored in an electronic database. Data were updated at each follow‐up. Results: Male to female ratio was 1.22 : 1.00. The mean age at onset was 26 years ± 11.3. The frequency of symptoms were: oral aphthosis 97.3%, genital aphthosis 64.6%, skin manifestations 64.9% (pseudofolliculitis 54.5%, erythema nodosum 22.5%, other lesions 7%), pathergy phenomenon 52.5%, ophthalmologic manifes‐tations 56.8% (anterior uveitis 41.2%, posterior uveitis 44.9%, retinal vasculitis 32.1%), joint manifestations 37.4% (arthralgia 17.2%, monoarticular arthritis 7.6%, oligoarthritis 16.8%, ankylosing spondylitis 2%), neurological manifestations 3.8% (central manifestations 3.5%, mononeuritis multiplex 0.3%), gastrointestinal manifestations 7.4%, vascular involvement 8.3% (phlebitis 5.7%, superficial phlebitis 2.2%, large vein thrombosis 1.1%, arterial thrombosis 0.154%, aneurysm 0.5%), epididymitis 4.7%, cardiac involvement 0.6%, and pulmonary involvement 0.9%. Sedimentation rate was normal in 46.5% of patients. Abnormal urine sediment was detected in 12.2%. HLA‐B5 was present in 53.3% and HLA‐B51 in 47.9% of patients. Conclusion: Behcet’s disease is mainly seen in young people. The most frequent symptoms are mucocutaneous, ocular and joint manifestations. Comparison with large series did not show major differences.     

Systemic lupus erythematosus in Iran: a study of 2280 patients over 33 years

Objective: Systemic lupus erythematosus (SLE) as a chronic autoimmune disease has a worldwide distribution. There is a wide variation in the natural history of SLE among different ethnic and geographic groups. The aim of this study was to show the manifestations of SLE in Iranian patients. Methods: The study was on manifestations of SLE according to the database of the Rheumatology Research Center (RRC), Tehran, Iran, on registered patients during the period of 1976 to 2009. Results: A total of 2280 SLE patients (2052 female and 228 male) were studied. The female : male ratio was 9 : 1 and the mean age at presentation was 24.4 ± 10.4 years. Prevalence of manifestations included: musculoskeletal (83.2%), cutaneous (81.1%), renal (65.4%), neuropsychiatric (23.4%), pulmonary (21.5%), cardiac (17.2%), and hematologic (66.4%) symptoms. There was positive antinuclear antibodies in 86.4% and anti‐DNA in 82.3% of patients. Overlap syndrome and positive family history with other autoimmune diseases were detected in 7.6% and 3.4% of patients, respectively. Conclusion: In our patients the prevalence of cutaneous involvement was similar to those of nearby countries (with similar climate). Renal involvement was seen more than some other countries especially more than European countries, while other manifestations (such as hematologic and joint involvement) were similar to European countries (with similar ethnicity). We may conclude that genetic and/or climatic factors may lead to different presentations of lupus.