Hematotoxicity induced by simultaneous exposure to noise and toluene in New Zealand white rabbits: Synergistic and antagonistic effects.

Exposure to numerous pollutants is prevalent in workplaces. Examination of combined exposure to different harmful physical factors and chemicals has offered new insights into toxicology in recent years. This study aimed to investigate the hematological alterations caused by exposure to noise and toluene. Twenty-four New Zealand white rabbits were exposed to 1000 ± 50 ppm toluene and/or 100 ± 5 dB noise for 14 consecutive days. Exposure to noise and toluene changed a number of parameters of white blood cells (WBC), red blood cells (RBC), and platelets on different days after the exposure. Simultaneous exposure to noise and toluene increased WBC, and exposure to noise and toluene alone decreased RBC. Exposure to noise and toluene alone increased basophile, monocyte, and neutrophil counts. The coefficient of variation of red blood cell distribution width (RDW-CV) and the standard deviation of red blood cell distribution width (RDW-SD) significantly increased after co-exposure to noise and toluene. Platelet levels increased in the noise-exposed and the co-exposed groups and decreased in the toluene-exposed group. Furthermore, co-exposure to noise and toluene induced dissimilar synergistic and antagonistic effects on the hematological indices. According to the results of this study, simultaneous exposure to toluene and noise can aggravate some hematotoxic effects compared to exposure to noise or toluene alone. The results also demonstrated the vital role of the modulatory mechanisms of the body in controlling the detrimental effects of stressors.

Effects of alpha lipoic acid on iron overload, lipid profile and oxidative stress indices in ß-thalassemia major patients: A cross-over randomised controlled clinical trial.

AIMS: ß-Thalassemia major (ß-TM) is associated with iron overload, abnormal lipid levels and oxidative stress. Alpha lipoic acid (ALA) showed anti-oxidant and iron chelating properties, but its effect in ß-TM patients is unclear. We investigated the effects of ALA on iron levels, lipid profile and oxidative stress. METHODS: In this cross-over randomised clinical trial, 26 ß-TM patients were assigned to receive 600 mg/d ALA or placebo (corn starch), for 8 weeks with a 21-days washout period. Serum ferritin, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), LDL-C/HDL-C, total antioxidant capacity, malondialdehyde (MDA) and MDA/LDL-C were assessed at baseline and the end of each intervention phase. RESULTS: Twenty-two patients completed the study. Serum ferritin (P = .004), MDA (P = .025) and MDA/LDL-C ratio (P =.002) were decreased and HDL-C (P =.035) increased significantly during ALA consumption. In comparison with placebo, ALA decreased the serum ferritin significantly (P = .02). Also, the changes in serum ferritin between ALA and placebo (-123.1 ± 40.0 vs -34.3 ± 21.0, P =.03) was significant in women subgroup. ALA had no significant effects on the other biomarkers. CONCLUSION: The results of this study indicated that supplementation with 600 mg/d ALA may decrease serum ferritin in ß-TM. Further studies are needed to confirm the findings.

A Conditional Probability Model to Predict the Mortality in Patients With Breast Cancer: A Bayesian Network Analysis.

BACKGROUND: The aim of this study was to compute the event rate of patients with breast cancer (BC) using Bayesian network (BN) structure. METHOD: Data for 1,154 patients newly diagnosed with BC were recruited in this study during 2007 and 2016 in Iran. The database was linked to the regional death registration system and active follow-up was performed by referring to hospital information system or calling the patients. BN structure with inverse probability of censoring weighting (IPCW) approach was used to assess the relationship between event rate and underlying risk factors. RESULTS: The median (25th, 75th percentiles) of patients' survival time was 46.8 (32.6, 69.3) months. There were 217 (18.8%) deaths from BC by the end of the study. The optimal BN structure (Akaike Information Criteria = -8743.66 and Bayesian Information Criteria = -8790.80) indicated that being male (conditional probability [CP] = 0.316), age >50 (CP = 0.215), higher grades (CP = 0.301) and lower survival times (CP = 0.566) had higher event rate. Also lobular carcinoma (CP = 0.157) and ductal carcinoma (CP = 0.178) type of morphology had lower event rate while other types (CP = 0.316) had higher. CONCLUSIONS: The BN structure in which time was as a mediator of predictors-event relationship could be presented as the optimal tool to compute the event rate of BC. The findings could be used to identify the high risk patients and recommend for health policy making, prevention and planning for decrease the mortality in patients with BC.

Gender Differences in the Associations Between Health Literacy and Medication Adherence in Hypertension: A Population-Based Survey in Heris County, Iran.

OBJECTIVE: We examined the gender-based associations of health literacy (HL) with self-reported medication adherence (MEDA) among patients with primary hypertension (pHTN). PATIENTS AND METHODS: The subjects were recruited from the general population through all health centers of the Heris county, east Azarbaijan. They were to be adults (30+ years age), with pHTN of any stage, of any gender, and without comorbid illness. All underwent detailed face-to-face interview. We used valid questionnaires for HL and MEDA. Hierarchical regression was done to establish the association between MEDA, socio-demographic variables, and nine HL domains by gender. Other statistical procedures were also done. RESULTS: A total of 300 (48.6% males, mean age: 56.7±9.3) subjects participated; 43.0% were uneducated, 73.0% had moderate socioeconomic status, 68.0% had poor HL, and 7.0% maintained high adherence. Men were better in reading skills (p=0.002), and accessing (p=0.01) and using (p=0.02) health information, but women were better in health knowledge (p=0.004). The average regression estimate (±standard deviation) between HL and MEDA was 0.37±0.09, lower among men (0.361±0.11) than women (0.396±0.08), p=0.003. Upon hierarchical regression, the association between HL and MEDA was significant for communication and decision-making skills alone among both men (34.5%) and women (40.6%), individually. CONCLUSION: HL had substantial association with MEDA among those with HTN, for both men and women, particularly the communication and decision-making. With considerations on gender differences, this association should be confirmed through interventional studies to help make HL a formal mitigating strategy for MEDA and other public health goals.