Vaccine-associated paralytic poliomyelitis in a patient with MHC class II deficiency.

Vaccine-associated paralytic poliomyelitis (VAPP) is a rare complication of oral polio vaccine. We describe a fatal case of VAPP in an 8-month-old boy with Major Histocompatibility Class II deficiency. The isolated poliovirus was a Sabin type 2-type 1 recombinant that showed 1.4% VP1 divergence from Sabin type 2.     

Effect of renal transplantation on sperm quality and sex hormone levels

OBJECTIVE: To assess the effect of successful renal transplantation on semen variables, sexual function and sex hormone profiles in a clinical trial. PATIENTS AND METHODS: Thirty patients on haemodialysis underwent renal transplantation; before and after surgery, their sperm density, motility and morphology were analysed, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin and testosterone levels measured and compared, and sexual function assessed using an abbreviated version of the International Index of Erectile Function (IIEF), with a successful outcome defined as a level of satisfaction of 4 or 5 on a 5-point scale. The paired t-test was used to assess the statistically significance of differences in all analyses. RESULTS: Sperm motility improved significantly (P < 0.001) but there were no significant changes in morphology or density (P = 0.33 and 0.068, respectively). Testosterone levels increased and FSH, LH and prolactin decreased significantly (P < 0.05) after renal transplantation. The IIEF showed that of the 30 patients, 14 were impotent before surgery and only six remained so afterward (P < 0.05). CONCLUSION: Although sperm morphology and density did not improve after renal transplantation, there were highly significant changes in sperm motility. Hormonal levels in patients on haemodialysis improved after transplantation and returned to nearly normal; sexual function was also significantly better. Further studies are needed to confirm these results.     

The association between urodynamic findings and microvascular complications in patients with long-term type 2 diabetes but without voiding symptoms

Diabetic cystopathy is a common complication of diabetes mellitus, which is assessable by urodynamic study. The purpose of this study was to determine the association between urodynamic findings and microvascular complications (neuropathy, retinopathy, nephropathy) in patients with long-term type 2 diabetes but without voiding symptoms. A total of 66 consecutive patients (26 males and 40 females, age 57.00+/-9.50 years, diabetes duration 14.44+/-6.78 years) with documented type 2 diabetes, low scores at the International Prostate Symptom Score (IPSS) and no subjective complaint of voiding problems were included in the study. Seven urodynamic parameters were considered: detrusor activity, bladder capacity, bladder compliance, first sensation of filling, flow rate, bladder outlet status and post-voiding residue. The following independent associations were found: between female sex and increased bladder capacity (p=0.004), between male sex and both decreased bladder compliance (p=0.023) and bladder outlet obstruction (p=0.001), between old age and both low flow rate (p=0.022) and outlet obstruction (p=0.047), between detrusor instability and shorter duration of diabetes (p=0.044) and between peripheral somatic neuropathy and low flow rate (OR=5.208; 95%CI=1.277-21.277). The Spearman's correlation coefficient for the latter association was 0.356 (p=0.005) and remained significant even after controlling for age, sex, HbA1c and diabetes duration (rho=0.310; p=0.019). In conclusion, searching for microvascular complications might be used to screen for some components of diabetic cystopathy in its asymptomatic phase.     

Temporal analysis of the incidence of meningitis in the Tehran metropolitan area, 1999-2005

Objectives  

The aim of this study was to describe the temporal determinants of meningitis incidence in the population living in the Tehran metropolis.     

Cloning and Expression of the Allergen Cro s 2 Profilin from Saffron (Crocus sativus)

BackgroundProfilin is a panallergen that is recognized by IgE in allergic patients. Allergy to saffron (Crocus sativus) pollen has been described in people exposed to its pollen. Saffron contains a profilin that may cause allergic reactions in atopic subjects. The aim of this study was to describe the cloning, expression and purification of saffron profilin from pollen.MethodsCloning of saffron profilin was performed by polymerase chain reaction using specific primers from saffron pollen RNA. Expression was carried out in Escherichia coli BL21 (DE3) using a vector pET-102- TOPO. A recombinant fusion protein was expressed and the recombinant profilin was purified by metal precipitation. Immunological characterization was performed by immunoblotting experiments.ResultsThe 34 kDa- recombinant saffron profilin, Cro s 2, as a fusion protein was purified. Immunoblotting tested with the sera of allergic patients showed a specific reaction with the recombinant Cro s 2 band.ConclusionsThe sequence of Cro s 2 showed a high degree of identity and similarity to other plant profilins and the recombinant saffron profilin, Cro s 2, may be used for target-specific diagnosis and structural analyses and investigation of cross reactivity of Cro s 2 with other plant profilins.     

Leptin cut-off values for determination of metabolic syndrome: third national surveillance of risk factors of non-communicable diseases in Iran (SuRFNCD-2007)

Leptin is strongly contributed to the clustering of metabolic syndrome (MetS) components and potentially can be regarded as a single predictor of MetS. This population-based study, for the first time, reports the diagnostic accuracy of different leptin cut-points for determining MetS. Further, the current study compares the predictive ability of the appropriate threshold of leptin with insulin resistance. Data of the individuals without history of known diabetes mellitus, aged 25-64 years, from the third national surveillance of risk factors of non-communicable diseases (SuRFNCD-2007) were analyzed. MetS was defined due to either adult treatment panel III (ATPIII) or the modified international diabetes federation (IDF) criteria. Receiver-operating characteristic (ROC) curves were depicted to define cut-off of serum leptin, using the maximum Youden index and the shortest distance methods. Further, the values of leptin cut-offs in prediction of MetS were compared with those of insulin resistance (defined as homeostasis model assessment of insulin resistance >1.775). In men, the optimal cut-offs of leptin for IDF- and ATPIII-defined MetS were 3.6 ng/ml (positive predictive value, PPV: 56.5%; negative predictive value, NPV: 72.7%) and 4.1 ng/ml (PPV: 49.6%; NPV: 78.1%), respectively. In women, the optimal threshold was equal to 11.0 ng/ml (PPV: 53.8%; NPV: 73.0% for IDF criteria and PPV: 60.1%; NPV: 64.9% for ATPIII criteria). The diagnostic accuracy of these values in identifying MetS was similar to that of insulin resistance. Therefore, leptin is comparable to insulin resistance in identifying MetS and can be used as single predictor of MetS.     

Relationship between occurrence of Guillain-Barre syndrome and mass campaign of measles and rubella immunization in Iranian 5-14 years old children

BACKGROUND: Case reports and epidemiologic studies have reported a relation between different vaccines including measles, rubella, mumps and Guillain-Barre syndrome (GBS). In this study we investigated relation between receiving measles and/or rubella vaccines and occurrence of GBS after national immunization campaign in 2003 in Iran. MATERIALS AND METHODS: We used the national surveillance system for acute flaccid paralysis from the beginning of 2002 to the end of 2004 and studied the incidence of GBS disease among 5-14-year-old children. The 3-year time span of the study was divided into fifteen 10 weeks intervals and the number of reported and confirmed GBS case reports in each time period was analyzed supposing their distribution was according to Poisson distribution. RESULTS: From 2002 through 2004 there were 370 patients confirmed GBS case reports among persons 5-14 years of age. The annual incidence in this age group remained relatively constant over the 3-year period and ranged from 0.65 per 100,000 population in 2004 to 0.76 in 2003. The estimated average annual incidence of GBS in persons <15 years of age was 1/100,000 (CI 95%: 0.88-1.13), and 0.7/100,000 in persons 5-14 years of age (CI 95%: 0.58-0.83). No obvious seasonal pattern in GBS occurrence was observed. The mean number of GBS patients during each 10 week study interval was 23.8. Twenty-five patients with GBS were reported in the time period which coincided with national immunization campaign. The probability of occurring >/=25 cases of GBS in that time period according to Poison distribution with expected case numbers of 23-8 is equal to 0.43 (p=0.43). CONCLUSION: The yearly incidence rate of GBS in this study was similar to other studies. According to our results, there was no increase in GBS Incidence in the 4 weeks national Immunization campaign and 6 weeks after it in comparison to other 10 weeks periods before or after this time period.     

Gender difference in albuminuria and ischemic heart disease in type 2 diabetes

Objective

The value of urinary albumin excretion in the prediction of myocardial ischemia in men and women with type 2 diabetes is not well understood. We questioned whether gender influences the albuminuria-ischemic heart disease relationship in patients with type 2 diabetes.

Methods

We designed a matched case-control study of 926 patients with albuminuria (cases) and 926 age and body mass index matched patients without albuminuria (controls). Ischemic heart disease was defined as the presence of (1) history of angina pectoris or angina equivalent symptoms and critical care unit admission, (2) myocardial infarction and/or electrocardiographic evidence of Q-wave myocardial infarction, (3) coronary revascularization and/or stenting, (4) positive myocardial single-photon emission computed tomography scan, (5) ischemic ST-segment or T-wave changes, and (6) positive stress testing.

Results

Patients with albuminuria had a lower glomerular filtration rate and a longer diabetes duration than patients without albuminuria. In the group of cases, there were a greater number of men with ischemic heart disease (120 of 370; 32.4%) compared to women (97 of 559; 17.4%) (P<0.001). The odds ratio of having ischemic heart disease according to the presence or absence of albuminuria was 1.25 [95% CI: 1.01–1.56] (P<0.05) in all studied populations, 0.79 [95% CI: 0.51–1.21] (P=0.14) in women, and 2.84 [95% CI: 1.68–4.79] (P<0.001) in men. We showed that diabetes duration, high-density lipoprotein, low-density lipoprotein, and hemoglobin A_1c influence albuminuria in women, while diabetes duration, fasting blood sugar, and diastolic blood pressure influence albuminuria in men.

Conclusions

Men with albuminuria are at increased risk of ischemic heart disease compared to women. This may be related to the role of high-density lipoprotein on the albuminuria-gender relationship.     

Graves' ophthalmopathy and gene polymorphisms in interleukin-1α, interleukin-1β, interleukin-1 receptor and interleukin-1 receptor antagonist

Purpose: Interleukin‐1 (IL‐1) is known to have an important role in pathogenesis of Graves' ophthalmopathy (GO). Polymorphisms in IL‐1 gene have been associated with autoimmune reactions. This study aimed to investigate the association of GO with single‐nucleotide polymorphisms (SNPs) in the IL‐1 family (IL‐1α, IL‐1β, IL‐1 receptor [IL‐1R] and IL‐1 receptor antagonist [IL‐1RA]). Methods: A total of 57 patients of Graves' disease without GO, 50 patients with GO and 140 healthy controls were enrolled. Patients were recruited consecutively from the outpatient endocrine clinic of a large university general hospital. Cytokine typing was performed by the polymerase chain reaction with sequence‐specific primers assay. The allele and genotype frequencies of the following polymorphisms were determined: IL‐1α (?889C/T), IL‐1β (?511C/T), IL‐1β (+3962C/T), IL‐1R (Pst‐1 1970C/T) and IL‐1RA (Mspa‐1 11100C/T). Genotype distributions among patients were in Hardy–Weinberg equilibrium for all polymorphisms. Results: Among the five SNPs studied, the frequencies of the T allele and the TT genotype of IL‐1α (?889C/T) were significantly higher among patients with GO than those without GO (odds ratio [OR] = 2.16, 95% confidence interval [CI] = 1.25–3.74; P = 0.006 and 5.67, 95% CI = 1.66–49.34; P = 0.005, respectively). For IL‐1RA (Mspa‐1 11100C/T), the frequencies of the C allele and the CC genotype were significantly higher among patients with GO (OR = 2.31, 95% CI = 1.34–4.00; P = 0.004 and 6.73 95% CI = 1.94–23.36; P = 0.004, respectively; P < 0.01). No significant association was found for other SNPs. Conclusion: This is the first study to show a positive correlation between polymorphisms in the IL‐1α and IL‐1RA genes and susceptibility to GO. These findings promote further research into genetic correlates of GO.