Differences in morphine-induced antinociception in male and female offspring born of morphine exposed mothers

Objective:

Antinociceptive effect of morphine in offspring born of mothers that received saline or morphine during the gestation period was investigated.

Materials and Methods:

Wistar rats (200-250 g) received saline, morphine 0.5 mg/kg or 5 mg/kg during gestation days 14-16. All pups after weaning were isolated treatment/sex dependently and were allowed to fully mature. The antinociceptive effect of morphine was assessed in formalin test. Morphine (0.5-7.5 mg/kg) or saline (1 ml/kg) was injected intraperitoneally 10 min before formalin (50 μl of 2.5% solution in right hind-paw).

Results:

Male offspring born of saline-treated mothers were less morphine-sensitive than females. On the contrary, male offspring exposed prenatally to morphine (5 mg/kg) were more sensitive to morphine-induced antinociceptive response in formalin test. However, no difference in antinociceptive effect was observed amongst offspring of either sex born of mothers treated with morphine 0.5 mg/kg, identifying a lower dose effect of the opioid.

Conclusion:

The exposure to morphine during the developmental period may result in altered development of tolerance to morphine and thus involved in drug abuse.KEY WORDS: Formalin test, gestation, morphine, offspring, pain     

The effective use of plerixafor as a real-time rescue strategy for patients poorly mobilizing autologous CD34(+) cells

Plerixafor enhances CD34⁺ cell mobilization, however, its optimal use is unknown. We hypothesized that plerixafor could “rescue” patients in the midst of mobilization when factors indicated a poor CD34⁺ yield. Of 295 consecutive autologous peripheral blood mobilization attempts at our center, 39 (13%) used plerixafor as rescue strategy due to a CD34⁺ cell concentration <10/μl (median 5.95/μl, n = 30), low CD34⁺ cell yield from prior apheresis day (median 1.06 × 10⁶ CD34⁺ cells/kg, n = 7), or other (n = 2). Patients received a median of one plerixafor dose (range: 1–4). Thirty‐four (87%) collected =2 × 10 ⁶ CD34⁺ cells/kg and 26 (67%) collected =4 × 10 ⁶ CD34⁺ cells/kg. Median collections for lymphoma (n = 24) and myeloma (n = 15) patients were 4.1 × 10⁶ and 8.3 × 10⁶ CD34/kg, respectively. A single dose of plerixafor was associated with an increase in the mean peripheral blood CD34⁺ concentration of 17.2 cells/μl (P < 0.001) and mean increased CD34⁺ cell yield following a single apheresis of 5.11 × 10⁶/kg (P < 0.03). A real‐time rescue use of plerixafor is feasible and may allow targeted use of this agent. J. Clin. Apheresis, 2012. © 2012 Wiley Periodicals, Inc.     

The effect of literacy level on health related-quality of life, self-efficacy and self-management behaviors in diabetic patients

Illiteracy in studies on quality of life (QOL) and self-efficacy (SE) of diabetic patients has been ignored. Illiteracy and diabetes have high rates in developing countries. The aim of this study was to identify the effect of literacy level on health outcomes. To achieve this, we studied health outcomes such as SE, self-management behaviors and Health-Related Quality of Life (HRQOL) in diabetic patients. A cross-sectional study was carried out in an Iranian urban federally-funded diabetes clinic (with 1400 diabetes patients) in Bandar Abbas, a city located in south of Iran. 256 Non Insulin Dependent Diabetic Mellitus patients were chosen during June, July and August 2007. Patients were grouped as illiterates, low-literates and literates. SE and QOL were measured by standard questionnaires. HbA1C was measured by calorimetric method. Data was collected with interview. Data analysis was carried out with one way ANOVA Post Hoc, and bivariate analysis method. Literacy level among the three groups from the view points of age, physical domain, psychological domain, environmental domain and SE were significant. There was no significant difference for the level of HbA1C among three groups. Literacy level does not have any effects on glycemic control. There is a strong relationship between self-efficacy and QOL domains.     

Economic Burden of Smoking in Iran: A Prevalence-Based Annual Cost Approach

Objectives: The burden of smoking on the health system and society is significant. The current study aimed to estimate the annual direct and indirect costs of smoking in Iran for the year 2014. Methods: A prevalence-based disease-specific approach was used to determine costs associated with the three most common smoking-related diseases: lung cancer (LC), chronic obstructive pulmonary disease (COPD) and ischaemic heart disease (IHD). Data on healthcare utilization were obtained from an original survey, hospital records and questionnaires. The number of deaths was extracted from the global burden diseases study (GBD). The human capital approach was applied to estimate the costs of morbidity and mortality due to smoking-related diseases, classified as direct (hospitalization, outpatients and non-medical costs) and indirect (mortality and morbidity). Results: The total economic cost of the three most common smoking-attributable diseases in Iran was US$1.46 billion in 2014, including US$1.05 billion (71.7%) in indirect and US$0.41 billion (28.3%) in direct costs. Direct costs of the three smoking-related diseases accounted for 1.6% of total healthcare expenditures and total costs were about 0.26% of Iran’s gross domestic product (GDP) in 2014. Conclusions: Our study indicated that smoking places a substantial economic burden on Iranian society. Therefore, sustained smoking cessation interventions and tobacco control policies are required to reduce the magnitude and extent of smoking-attributable costs in Iran.     

Update on occult hepatitis B virus infection

The event of mutations in the surface antigen gene of hepatitis B virus(HBV) results in undetectable hepatitis B surface antigen with positive/negative anti-hepatitis B core(anti-HBc) antibody status in serum and this phenomenon is named occult hepatitis B infection(OBI). The presence of anti-HBc antibody in serum is an important key for OBI tracking, although about 20% of OBI cases are negative for anti-HBc antibody. The diagnosis of OBI is mainly based on polymerase chain reaction(PCR) and real-time PCR assays. However, real-time PCR is a more reliable method than PCR. OBI is a great issue for the public health problem and a challenge for the clinical entity worldwide. The persistence of OBI may lead to the development of cirrhosis and hepatocellular carcinoma. With regard to OBI complications, the screening of HBV DNA by the highly sensitive molecular means should be implemented for:(1) patients with a previous history of chronic or acute HBV infection;(2) patients co-infected with hepatitis C virus/human immunodeficiency virus;(3) patients undergoing chemotherapy or anti-CD20 therapy;(4) recipients of organ transplant;(5) blood donors;(6) organ transplant donors;(7) thalassemia and hemophilia patients;(8) health care workers;(9) patients with liver related disease(cryptogenic);(10) hemodialysis patients;(11) patients undergoing lamivudine or interferon therapy; and(12) children in time of HBV vaccination especially in highly endemic areas of HBV. Active HBV vaccination should be implemented for the close relatives of patients who are negative for OBI markers. Thus, the goal of this review is to evaluate the rate of OBI with a focus on status of high risk groups in different regions of the world.     

Leishmania tropica-isolated patient with visceral leishmaniasis in southern Iran

Visceral leishmaniasis (VL) is caused by various strains of Leishmania donovani, Leishmania infantum, and Leishmania chagasi with different geographical distribution. The aim of this study was to identify the strains of Leishmania that can cause VL in southern Iran. DNA of Leishmania were extracted from the slides of bone marrow aspirates (#42) and spleen punctures (#22), which were positive for leishman body from the patients who were referred to the hospitals affiliated with Shiraz University of Medical Sciences. Differences in Leishmania strains were determined by size difference of the polymerase chain reaction (PCR) amplification as visualized on agarose gel. PCR results and smears had 100% correlation. The dominant strain of Leishmania was L. infantum (63 out of the 64 cases), but one case of L. tropica was also detected. VL mostly involves children below 2 years of age in Iran, therefore infection with L. infantum was expected, but this study is the first report of VL that is caused by L. tropica in Iran.     

Piperacillin/tazobactam in treatment of brain abscess

Central nervous system (CNS) infection is a common complication following renal transplantation. Successful management of a brain abscess usually requires a combination of antibiotics and surgical drainage for both diagnostic and therapeutic purposes. We report the successful treatment of a patient with multiple brain abscesses with piperacillin/tazobactam without surgical intervention.     

Family history of cancer and renal cell cancer risk in Caucasians and African Americans

Background:

The association between renal cell carcinoma (RCC) risk and family history of cancer has not been examined with an adequate number of African Americans (AAs).

Methods:

In a population-based case–control study, unconditional logistic regression was used to calculate the association between RCC risk and a family history of cancer among 1217 RCC cases and 1235 controls.

Results:

Increased RCC risk was shown for subjects with at least one first-degree relative with kidney cancer (odds ratio=2.29; 95% confidence interval=1.31–4.00). No differences in risk were observed when analyses were stratified by race. For Caucasians, excess risk was observed among those reporting a sibling with kidney cancer, whereas for AAs, increased risk occurred among subjects reporting either a sibling or parent affected with the disease. A family history of non-renal cancers, and those related to smoking or to the von Hippel–Lindau syndrome, revealed no association with RCC risk.

Conclusion:

The RCC risk associated with a family history of kidney cancer is similar among Caucasians and AAs.