Pretransplant hepatitis C virus infection and its effect on the post-transplant course of living renal allograft recipients

BACKGROUND: Hepatitis C virus infection (HCV) is a main health problem in end-stage renal disease (ESRD) patients. The effect of pretransplant HCV infection on survival among ESRD patients who have undergone renal transplantation is controversial. We report the results of a large monocenter study that evaluated the effect of hepatitis C on the patient, and on graft survival in renal-transplanted patients who received living donated allograft. METHODS: A historical cohort study, we investigated all 1006 patients who received a living kidney transplant at Baghiatollah Medical Center in Tehran, Iran, between March 1995 and October 2001 (up to 85 months follow up). Patients' sera had been routinely assayed for anti-HCV antibodies and hepatitis B surface antigen (HBsAg) at the time of transplantation. The HBsAg-positive patients were excluded from the survival analysis. Survivals were examined using Kaplan-Meier analysis and compared using the log-rank test. Multivariate analysis was performed using Cox's model. RESULTS: Forty-five patients (4.5%) were anti-HCV-antibody positive. Anti-HCV-antibody-positive patients spent a longer time on dialysis and had a higher rate of retransplantation. There were no differences in recipients' sex and age and donors' age between the two groups. The 7-year patient survival rate was 89.9% in the anti-HCV-antibody-positive group and 95.5% in the HCV-negative group (P = 0.74). Seven-year graft survival was 82.0% and 75.0% in the anti-HCV-antibody-positive and HCV-negative groups, respectively (P = 0.39). In the multivariate analysis, age was the only significant parameter correlated with patient survival (P = 0.02). CONCLUSIONS: HCV infection does not seem to influence patient and graft survival within a medium-time follow up in living allograft recipients, and anti-HCV-antibody positive status (alone) is not a contraindication for renal transplantation. However, further studies are needed to better define the role of HCV infection in long-term prognosis.     

Relation of aortic wall thickness and distensibility to cardiovascular risk factors (from the Multi-Ethnic Study of Atherosclerosis [MESA])

To determine the relation between aortic wall thickness (WT) and aortic distensibility (AD) with traditional cardiovascular risk factors in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, 1,053 participants in MESA who underwent cardiac magnetic resonance imaging were consecutively selected for the measurement of aortic WT and AD. Double inversion-recovery fast spin-echo images of the thoracic aorta were obtained to measure average and maximum WT. AD was measured at the same level using a gradient-echo cine sequence. Average and maximum WT were positively correlated with increasing age, and AD was inversely related to age (p <0.01). Compared with normotensive participants, those with hypertension had significantly greater mean average WT (2.45 vs 2.23 mm, p <0.01) and maximum WT (3.61 vs 3.41 mm, p <0.01) and lower AD (0.15 vs 0.2 mm Hg(-1), p <0.01). In multiple regression analysis, older age and hypertension were significantly associated with higher mean average WT, while older age, male gender, and higher blood pressure were associated with higher mean maximum WT. AD was inversely related to older age, hypertension, current smoking, African American ethnicity, and lower high-density lipoprotein cholesterol level. In conclusion, in the MESA cohort, older age and higher blood pressure were associated with higher aortic WT and lower AD. Decreased AD was further associated with current smoking, African American ethnicity, and higher high-density lipoprotein cholesterol level.     

Hb Dhonburi (Neapolis) [beta126(H4)Val-->Gly] identified in a family from northern Iran

Thalassemias are the most common hereditary diseases in Iran, resulting from synthesis defects in one or more hemoglobin (Hb) subunits. The majority of patients suffer from beta-thalassemia (thal), but cases with microcytic hypochromic anemia and normal electrophoretic patterns are suspected to have alpha- or silent beta-thal. A family from the northern part of Iran, an area highly prevalent for thalassemias, was referred to us for prenatal diagnosis. The hematological data of the father indicated a pattern of beta-thal minor. Reverse hybridization analysis for the most common beta-globin mutations identified IVS-II-1 (G-->A) in the heterozygous state. The maternal laboratory data indicated a case more compatible with alpha-thal. Iron deficient anemia was ruled out, and common alpha-thal point mutations and deletions were investigated. As no mutation was detected, chain synthesis was performed and showed an alpha/beta chain ratio of 2.1, that was in the range of beta-thal minor. DNA sequencing of the entire beta-globin gene identified a heterozygous GTG-->GGG (Val-->Gly) mutation at codon 126, also known as Hb Dhonburi (Neapolis). Prenatal diagnosis of the fetal DNA showed the absence of the IVS-II-1 and codon 126 anomalies. This result demonstrates the importance of screening of individuals with mild microcytic hypochromic anemia for both alpha- and silent beta-thal mutations.     

Serum measures of iron status and HFE gene mutations in patients with hepatitis B virus infection

Aim: We tested associations between HFE mutations and hepatitis B virus (HBV) infection. We also explored measures of total body iron status and their association with chronic HBV infection. Methods: Serum measures of iron status and HFE mutations (C282Y, H63D, and S65C) were assessed in 344 Iranian patients with chronic HBV infection (214 asymptomatic carriers, 130 patients with chronic progressive liver disease [CPLD]) and 302 controls. Results: Frequencies of HFE mutations did not differ between patients with chronic HBV infection and controls (C282Y: P=0.9, H63D: P= 0.8, S65C: P=0.9). By logistic regression, advanced hepatic fibrosis was associated with HFE H63D mutation (OR=13.1, P=0.006; 95% CI=2.0-84.1). Higher levels of serum ferritin and transferrin saturation were observed in patients with CPLD than in healthy controls (P=0.0001 and 0.01, respectively, adjusted for age and sex). None of the serum iron measures was related to liver fibrosis stage or necroinflammatory grade. Conclusion: Serum iron measures are associated with chronic progressive hepatitis B. Carriage of HFE mutations is not associated with the presence of chronic HBV infection or values of serum iron measures in this population, although HFE H63D is associated with more advanced hepatic fibrosis.     

Investigating effects of hydroalcoholic extract of saffron on sex hormones in female rats undergoing chemotherapy with cyclophosphamide

Cyclophosphamide is an antineoplastic medicine that causes disorder in functions of the body systems. Thus, the purpose of this study is to investigate the effect of hydroalcoholic extract of saffron on improving the complications of cyclophosphamide on sex hormones. Fifty-six adult female Wistar rats were randomly divided into seven groups; control, sham (received distilled water, solvent extract, and drug), experimental groups 1, 2, and 3 (received cyclophosphamide (5 mg/kg/bw) + hydroalcoholic extract of saffron (2, 1, and 0.5 g/kg/bw), experimental group 4 (saffron 2 g/kg/bw), and experimental group 5 (cyclophosphamide 5 mg/kg/bw). Cyclophosphamide was given intraperitoneally, and extract by gavage was prescribed for 21 days. At the end of the experiment, after blood and preparation of serum, ELISA method was used for measuring the estrogen, progesterone, FSH, and LH hormones. Data and LSD test were analyzed with SPSS software (version 18). Results show that the concurrent use of low-dose cyclophosphamide and saffron extract can reduce toxic effect of cyclophosphamide on pituitary-gonadal axis and cause estrogen to be produced.     

The effect of spraying different disinfectants on condensational silicone impressions; an in vitro study

Background:

Dentistry equipment are exposed to different types of pathogenic microorganisms. The aim of this study was to investigate the effect of spraying three different types of disinfectants on condensational silicones after 5 and 10 min.

Materials and Methods:

Totally, 66 circular samples of condensational silicone impression materials of 1 cm diameter and 2 mm thickness were contaminated by Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans fungus. Except for control samples, all of them were disinfected with sodium hypochlorite (NaOCl) 0.525%, Deconex and Epimax by spraying method. Afterward, they kept in plastic bags with humid rolled cotton for 5 and 10 min. In order to isolate microbiotas, the samples were immersed in 2% trypsin for 1 h and diluted with normal saline in a portion of 1, 1/2, and 1/4. The trypsin suspensions were transferred to culture plates for incubation and colony-forming unit assay. The data were analyzed by Mann–Whitney test and SPSS software version 16 at a significant level of 0.05.

Results:

There was a meaningful difference between disinfection effects of Epimax-Deconex for all mentioned microorganisms after 5 min (P = 0.034), and between disinfection effects of NaOCl 0.525%-Epimax for S. aureus (P = 0.043) and P. aeruginosa (P = 0.046) after 5 min. Furthermore, there was a meaningful difference between disinfection effects of Epimax-Deconex (P = 0.034) and NaOCl 0.525%-Epimax (P = 0.034) for P. aeruginosa after 10 min.

Conclusion:

Condensational silicone can be effectively disinfected by spraying tested three disinfecting agents. More specifically, Deconex showed the best results compared to the other agents.Key Words: Condensational silicone, disinfection, impression materials, spray     

Phenotypic and functional maturation of murine dendritic cells induced by 18 alpha- and beta-glycyrrhetinic acid

Various studies have described glycyrrhizin (GL), an active triterpenoic saponin extract of licorice roots, as an anti-inflammatory, antiviral, antimicrobial, anti-tumor and immunomodulating agent. The activity of GL has been mainly attributed to its metabolites, 18-alpha (GA) and 18-beta-glycyrrhetinic acid (GB), which their mechanism of action on the immune system cells is not clearly known. In this study, we have investigated the effects of GA and GB on the immune system by targeting dendritic cells and analyzing phenotypic and functional maturity of murine dendritic cells (DCs) after treatment with these components. Stimulation of DCs with GA and GB resulted in up-regulation of CD40, CD86 and MHC-II molecules indicating their effects on the maturation of DCs. These components induced the allogenic immunostimulatory capacity of DCs by stimulating the proliferation of T cells and production of the T helper (h)1-promoting cytokine, IL-12. They also increased the production of IFN-γ by T cells in mixed-lymphocyte reaction. In conclusion, these results indicate that GA and GB may insert their immunomodulatory effects by enhancing DC maturation and modulating Th1/Th2 response through an increase in Th1 responses, implying their beneficial in host defense against infectious diseases.