Book Reviews

Aim: The aim of the study was to create reference values for weight, height and body mass index (BMI) of school children living in Tehran.

Method and samples: The study subjects consisted of 1420 girls between 6 and 17 years of age and 1515 boys between 6 and 15 years of age. Samples were collected by a multistage sampling method from schools in different areas of Tehran. All participants were established to be healthy and their height, weight and BMI evaluated. Reference standard values estimated by the LMS method using LMS Light software and 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 97th and 85th (only for BMI) centiles were constructed and the results compared with US reference values.

Results: The centiles provided a good fit to the data. In boys, there were some significant differences of mean standard deviation scores (SDS) of height and BMI from zero, but there were no significant differences in weight. In girls, the mean SDS of height, weight and BMI were significantly lower than zero, especially for 7–9 years of age. Among 12–13-year-old girls, the mean SDS of height, weight and BMI came closer to zero, and the differences were not significant. Thereafter, although girls seemed to be shorter than US reference measures, their weight and BMI did not differ from reference values significantly.

Conclusion: Our results for boys between 6 and 15 years are comparable with US reference values; however, the US reference values, especially for height, are not applicable for Iranian girls between 6 and 17 years.

Résumé.Objectif: Cette étude a pour but d’établir les valeurs de référence du poids, de la stature et de l’indice de masse corporelle (IMC) des écoliers vivant à Téhéran.

Méthode et Echantillons: Les échantillons?: 1420 filles entre 6 et 17 ans et 1515 garçons entre 6 et 15 ans, rassemblés par une méthode d’échantillonnage a stades multiples dans des écoles de différentes parties de Téhéran. On a mesuré la stature, le poids et l’IMC après s’être assuré que tous les participants étaient en bonne santé. Les valeurs des standards de référence ont été estimées par la méthode des moindres carrés au moyen du programme LMS Light. Les 3^ème, 5^ème, 10^ème, 25^ème, 50^ème, 90^ème, 97^ème centiles et le 85ème (uniquement pour l’IMC) ont été construits et les résultats comparés avec les références US.

Résultats: Les centiles permettent un bon ajustement des données. Chez les garçons on observe quelques écarts au zéro significatifs des scores d’écart-type moyen (SETM) pour la stature et l’IMC, mais non pour le poids. Chez les filles, les SETM de la stature, du poids et de l’IMC sont significativement inférieurs à zéro, en particulier pour les sujets entre 7 et 9 ans. Chez les filles âgées de 12 à 13 ans, le SETM de la stature, du poids et de l’IMC sont plus proches de zéro et les différences ne sont pas significatives. Par suite, bien que les filles paraissent plus faibles que les valeurs de référence CDC, leur poids et IMC ne diffèrent pas significativement des valeurs de référence.

Zusammenfassung.Ziel: Das Ziel dieser Studie war, Referenzwerte für Gewicht, Körperhöhe und Körpermasse-Index (body mass index, BMI) für Schulkinder aus Teheran zu konstruieren.

Methode und Stichproben: Die Probanden dieser Studie bestanden aus 1420 Mädchen zwischen 6 und 17 Jahren und 1515 Knaben zwischen 6 and 15 Jahren. Die Stichproben wurden mit einer mehrstufigen Erhebungsmethode in Schulen aus verschiedenen Gegenden von Teheran zusammengestellt. Alle Teilnehmer wurden hinsichtlich Körperhöhe, Gewichts und BMI als gesund betrachtet. Es wurden die Referenzstandardwerte mit LMS-Methode unter Verwendung der LMS Light software bestimmt, die 3., 5., 10., 25., 50., 75., 90., 97. und 85. (nur für BMI) Perzentile konstruiert und die Ergebnisse mit US-Amerikanischen Referenzwerten verglichen.

Ergebnisse: Die Perzentilen ermöglichten eine gute Datenanpassung. Bei Knaben gab es einige signifikante Unterschiede der mittleren z-Werte (standard deviation scores, SDS) für Körperhöhe und BMI von Null, aber es gab keine signifikanten Gewichtsunterschiede. Bei den Mädchen lagen die mittleren SDS für Körperhöhe, Gewicht und BMI signifikant unter Null, besonders im Alter von 7--9 Jahren. Bei den 12--13-jährigen Mädchen lagen die mittleren SDS für Körperhöhe, Gewicht und BMI näher bei Null, und die Unterschiede waren nicht signifikant. Obgleich Mädchen kleiner erschienen als die CDC-Referenzmessungen, waren ihre Gewichte und BMI im späteren Verlauf nicht signifikant von den Referenzwerten verschieden.

Resumen. Objetivo: El objetivo del estudio fue crear valores de referencia para el peso, la estatura y el índice de masa corporal (IMC) de los escolares residentes en Teherán.

Método y Muestras: Los sujetos estudiados fueron 1.420 chicas de entre 6 y 17 años de edad, y 1.515 chicos de entre 6 y 15 años de edad. Las muestras se recogieron mediante el método de muestreo multietapa en escuelas de diferentes áreas de Teherán. Todos los participantes estaban sanos y se evaluó su estatura, peso e IMC. Los valores estándares de referencia fueron estimados con el método LMS, utilizando el programa LMS Light, y se construyeron los centiles 3, 5, 10, 25, 50, 75, 90, 97 y 85 (sólo para el IMC); los resultados fueron comparados con valores de referencia estadounidenses.

Resultados: Los centiles proporcionaron un buen ajuste de los datos. En los chicos, había algunas diferencias significativas de las SDS de la estatura y el IMC con respecto al cero, pero no había diferencias significativas en el peso. En las chicas, las SDS medias de la estatura, el peso y el IMC fueron significativamente menores que cero, especialmente entre los 7-9 años de edad. Entre las chicas de 12-13 años, las SDS medias de la estatura, peso e IMC estaban próximas a cero, y las diferencias no fueron significativas. Por tanto, aunque las chicas parecían ser más bajas que las medidas CDC de referencia, su peso e IMC no diferían significativamente de los valores de referencia.     

Risk factors associated with endometriosis among infertile Iranian women

Introduction

Endometriosis is defined as overgrowth of endometrial tissue outside the uterine cavity. Endometriosis may be asymptomatic or associated with dysmenorrheal symptoms, dyspareunia, pelvic pain, abnormal uterine bleeding and infertility. The aim of this study was to explore the risk factors related to endometriosis among infertile Iranian women.

Material and methods

In this case control study, infertile women referred for laparoscopy and infertility workup to two referral infertility clinics in Tehran, Iran were studied. According to the laparoscopy findings, women were divided into case (women who had pelvic endometriosis) and control (women with normal pelvis) groups. The case group was divided into two subgroups: stage I and II of endometriosis were considered as mild while stage III and IV were categorized as severe endometriosis. A questionnaire was completed for each patient.

Results

Logistic regression showed that age, duration of infertility, body mass index (BMI), duration of menstrual cycle, abortion history, dyspareunia, pelvic pain and family history of endometriosis are independent predictive factors for any type of endometriosis. In addition, it was shown that education, duration of infertility, BMI, amount and duration of menstrual bleeding, menstrual pattern, dyspareunia, pelvic pain and family history of endometriosis are independent predictive factors of severe endometriosis. The AUCs for these models were 0.781 (0.735-0.827) and 0.855 (0.810-0.901) for any type of endometriosis and severe endometriosis, respectively.

Conclusions

It seems that any type of endometriosis and severe ones could be predicted according to demographic, menstrual and reproductive characteristics of infertile women.     

The Information Security Needs in Radiological Information Systems—an Insight on State Hospitals of Iran, 2012

Picture Archiving and Communications System (PACS) was originally developed for radiology services over 20 years ago to capture medical images electronically. Medical diagnosis methods are based on images such as clinical radiographs, ultrasounds, CT scans, MRIs, or other imaging modalities. Information obtained from these images is correlated with patient information. So with regards to the important role of PACS in hospitals, we aimed to evaluate the PACS and survey the information security needed in the Radiological Information system. First, we surveyed the different aspects of PACS that should be in any health organizations based on Department of Health standards and prepared checklists for assessing the PACS in different hospitals. Second, we surveyed the security controls that should be implemented in PACS. Checklists reliability is affirmed by professors of Tehran Science University. Then, the final data are inputted in SPSS software and analyzed. The results indicate that PACS in hospitals can transfer patient demographic information but they do not show route of information. These systems are not open source. They don’t use XML-based standard and HL7 standard for exchanging the data. They do not use DS digital signature. They use passwords and the user can correct or change the medical information. PACS can detect alternation rendered. The survey of results demonstrates that PACS in all hospitals has the same features. These systems have the patient demographic data but they do not have suitable flexibility to interface network or taking reports. For the privacy of PACS in all hospitals, there were passwords for users and the system could show the changes that have been made; but there was no water making or digital signature for the users.     

Immunogenicity of recombinant <Emphasis Type="Italic">Mycobacterium bovis</Emphasis> bacille Calmette–Guèrin clones expressing T and B cell epitopes of <Emphasis Type="Italic">Mycobacterium tuberculosis</Emphasis> antigens

Recombinant Mycobacterium bovis bacille Calmette–Guèrin (rBCG) expressing three T cell epitopes of Mycobacterium tuberculosis (MTB) Ag85B antigen (P1, P2, P3) fused to the Mtb8.4 protein (rBCG018) or a combination of these antigens fused to B cell epitopes from ESAT-6, CFP-10 and MTP40 proteins (rBCG032) were used to immunize Balb/c mice. Total IgG responses were determined against Mtb8.4 antigen and ESAT-6 and CFP-10 B cell epitopes after immunization with rBCG032. Mice immunized with rBCG032 showed a significant increase in IgG1 and IgG2a antibodies against ESAT-6 and MTP40 (P1) B cell epitopes and IgG3 against both P1 and P2 B cell epitopes of MPT40. Splenocytes from mice immunized with rBCG018 proliferated against Ag85B P2 and P3 T cell epitopes and Mtb8.4 protein whereas those from mice-immunized with rBCG032 responded against all Ag85B epitopes and the ESAT-6 B cell epitope. CD4⁺ and CD8⁺ lymphocytes from mice immunized with rBCG018 produced primarily Th1 type cytokines in response to the T cell epitopes. Similar pattern of recognition against the T cell epitopes were obtained with rBCG032 with the additional recognition of ESAT-6, CFP-10 and one of the MTP40 B cell epitopes with the same pattern of cytokines. This study demonstrates that rBCG constructs expressing either T or T and B cell epitopes of MTB induced appropriate immunogenicity against MTB.     

Polarization of naive T cells into Th1 or Th2 by distinct cytokine-driven murine dendritic cell populations: implications for immunotherapy

Dendritic cells (DCs) activate T cells and regulate their differentiation into T helper cell type 1 (Th1) and/or Th2 cells. To identify DCs with differing abilities to direct Th1/Th2 cell differentiation, we cultured mouse bone marrow progenitors in granulocyte macrophage-colony stimulating factor (GM), GM + interleukin (IL)-4, or GM + IL-15 and generated three distinct DC populations. The GM + IL-4 DCs expressed high levels of CD80/CD86 and major histocompatibility complex (MHC) class II and produced low levels of IL-12p70. GM and GM + IL-15 DCs expressed low levels of CD80/CD86 and MHC class II. The GM + IL-15 DCs produced high levels of IL-12p70 and interferon (IFN)-gamma, whereas GM DCs produced only high levels of IL-12p70. Naive T cells stimulated with GM + IL-4 DCs secreted high levels of IL-4 and IL-5 in addition to IFN-gamma. In contrast, the GM + IL-15 DCs induced higher IFN-gamma production by T cells with little or no Th2 cytokines. GM DCs did not induce T cell polarization, despite producing large amounts of IL-12p70 following activation. A similar pattern of T cell activation was observed after in vivo administration of DCs. These data suggest that IL-12p70 production alone, although necessary for Th1 differentiation, is not sufficient to induce Th1 responses. These studies have implications for the use of DC-based vaccines in immunotherapy of cancer and other clinical conditions.     

Clinical and immunological features of 65 Iranian patients with common variable immunodeficiency

Common variable immunodeficiency (CVID) is a primary immunodeficiency disease characterized by hypogammaglobulinemia and recurrent bacterial infections. The records of 65 patients with CVID (37 males and 28 females) in the age range of 24 to 537 months were reviewed. By the year 2003, 11 patients had died and seven patients could not be located. The total follow-up period was 221 patient-years. The median diagnostic delay (time between onset and diagnosis) in our patient group was 60 months. At the time of diagnosis, the baseline serum immunoglobulin G (IgG), IgM, and IgA levels were below the level normal for the patients' age; the medians for this group were 120, 10, and 0 mg/dl, respectively. All of the patients presented with infectious diseases at the time of onset, the most common of which were otitis media, diarrhea, pneumonia, and sinusitis. Acute and recurrent infections were also found in almost all of the patients, particularly involving respiratory and gastrointestinal systems. The most common infections, before diagnosis and during follow-up, were pneumonia, acute diarrhea, acute sinusitis, and otitis media. CVID should be considered in any patient with a history of recurrent infections and decreased levels of all serum immunoglobulin isotypes.     

Cross state-dependent retrieval between histamine and lithium

Histamine and lithium state-dependent (StD) retrieval of passive avoidance task and their interactions was examined in mice. The pre-training or pre-test intracerebroventricular (i.c.v.) injection of histamine (20 microg/mouse) impaired retrieval when it was tested 24 h later. In the animals, in which retrieval was impaired due to histamine pre-training administration, pre-test administration of histamine, with the same dose, restored retrieval. The H1 blocker, pyrilamine (20 microg/mouse, i.c.v.), but not the H(2) blocker; ranitidine prevented the restoration of retrieval by pre-test histamine. The pre-training (5 and 10 mg/kg) or pre-test (5 mg/kg) injection of lithium also impaired retrieval, when it was tested 24 h later. In the animals that received lithium (5 mg/kg) or histamine (20 microg/mouse) as pre-training treatment, administration of histamine, clobenpropit or lithium, respectively, resulted in restoration of memory retrieval. Neither pyrilamine nor ranitidine prevented the restoration of retrieval by pre-test lithium. In conclusion, histamine or lithium can induce state-dependent retrieval and a cross-StD exists between these drugs, which may be mediated through the inositol pathway.     

Cu/Zn superoxide dismutase expression in the postnatal rat brain following an excitotoxic injury

Background  

In the nervous system, as in other organs, Cu/Zn superoxide dismutase (Cu/Zn SOD) is a key antioxidant enzyme involved in superoxide detoxification in normal cellular metabolism and after cell injury. Although it has been suggested that immature brain has a different susceptibility to oxidative damage than adult brain, the distribution and cell-specific expression of this enzyme in immature brain and after postnatal brain damage has not been documented.     

Persistence of antibody to hepatitis B surface antigen among vaccinated children in a low hepatitis B virus endemic area

Background  

A potential problem of hepatitis B immunization is that vaccine-induced antibody to hepatitis B surface antigen (anti-HBs) declines to low levels with age. This study investigated the persistence of anti-HBs in vaccinated children in a low hepatitis B virus (HBV) endemic area.