Association between the copper/selenium ratio and the immune response to SARS-CoV-2 infection.

Aim: To assess the association serum levels of selenium (Se) and copper (Cu) with symptoms and IgG immune response to SARS-CoV-2. Patients & methods/materials: Blood samples and nasopharyngeal swabs were obtained from 126 COVID-19 patients with mild and severe symptoms. The serum levels of Cu and Se were measured by atomic-absorption spectrophotometry. Results & conclusion: Mean Se was higher in patients with mild symptoms and IgG nonresponders, whereas mean Cu was higher in patients with severe symptoms and IgG responders. The Cu/Se ratio was lower in patients with no IgG responses to infection and mild symptoms versus IgG responders with severe symptoms. These results suggest the Cu/Se ratio as a nutritional biomarker of severity and IgG immune response in COVID-19 patients.

The association between the strong immune response to infections and trace elements such as copper (Cu) and selenium (Se) is well documented. Se and Cu are changed under infectious conditions. Since SARS-CoV-2 causes inflammation in the body, this study was conducted to evaluate the association between serum levels of Se and Cu changes with the symptoms and immune response to SARS-CoV-2, and then assess the Cu/Se ratio. Blood samples and nasopharyngeal swabs were obtained from 126 SARS-CoV-2 participants with mild and severe clinical symptoms. The SARS-CoV-2 infection and immune response to the virus were confirmed in the laboratory. Next, the Se and Cu serum levels were measured. Finally, we analyzed our findings. The median Se levels were higher in patients with mild symptoms (115 µg/l) in comparison with the severe symptoms group (99 µg/l), and the mean Se levels were higher in immune nonresponders (110.33 ± 3.38 µg/l) in comparison with the immune responders' group (102.42 ± 1.83 µg/l). However, the median Cu was higher in participants with severe symptoms (124 µg/dl) compared with the mild symptoms group (103 µg/dl), and the mean Cu levels were higher in immune responders (112 ± 9.98 µg/dl) in comparison with the immune nonresponders' group (105.1 ± 9.4 µg/dl). The Cu/Se ratio was lower (ratio <1) in participants with no responses to infection and mild symptoms versus responders with severe symptoms. Our results suggest that the Cu/Se ratio may act as a nutritional biomarker of severity and immune response in SARS-CoV-2-infected patients.

The Iranian National Blood Pressure Measurement Campaign: What Do the Process and Output Evaluation say?

BACKGROUND: The Iranian National Blood Pressure Measurement Campaign (INBPMC) was conducted all over the country to raise awareness in different groups of people regarding the importance of blood pressure and persuading them to manage their blood pressure. The present research aimed at assessing the process and output of this campaign. METHODS: For process evaluation, 31 universities/faculties were selected. Experts from the Ministry of Health and Medical Education assessed the documentation of the campaign implementation using the designed checklist. The output was assessed by including 8274 people and through a telephone survey using the designed instructions. RESULTS: The response rate of the telephone interviews was 82.74% (8274 people). It was found that 79% of the selected groups were aware of the INBPMC. Among them, 64% remembered the messages, 99% of the participants who remembered the messages agreed with those messages, and 89% of the participants who agree with the messages went for a measurement of their blood pressure. In the telephone interviews, 30% of the participants stated that they were diagnosed with hypertension, 97% of these participants received the required consultations for subsequent care, and 86% of them went to the health service centers to receive care. The process evaluation of the INBPMC indicated that the universities of medical sciences obtained 97% of the score of the checklist. CONCLUSION: The INBPMC was successful and accomplished its objectives.

Effect of opium consumption on cardiovascular diseases - a cross- sectional study based on data of Rafsanjan cohort study.

BACKGROUND: There are differences of opinion about the beneficial or detrimental effects of opium consumption on cardiovascular diseases (CVDs). So, we aimed to study the association between opium use and CVDs. METHODS: We used data obtained from the Rafsanjan Cohort Study (RCS), as a part of the prospective epidemiological research studies in IrAN (PERSIAN), with detailed, validated data on opium consumption and some other exposures. A total of 10,000 adults were enrolled in the study. Logistic regression models were used to assess the possible relationships of opium consumption with the prevalence of ischemic heart diseases (IHD) and myocardial infarction (MI). RESULTS: In this study, 9990 participants in the baseline phase of the Rafsanjan adult cohort study were included according to their completed questionnaire. Among all participants, 870 and 296 individuals were found to suffer from IHD and MI, respectively. Opium consumption was found to be relatively high in the RCS participants, especially in men (men = 2150 and women = 228). Opium use was associated with a higher odds of IHD and MI, with the adjusted odds ratios (95% CI) of 1.51 (1.22-1.86) and 1.79 (1.31-2.45), respectively. Also, dose-response increases were observed with the highest odds ratios in the 4th quartile for MI and IHD (p-values for trend < 0.001). Increased odds were observed for the two main methods of opium consumption, i.e. oral and smoking, but oral administration had higher odds ratio. CONCLUSIONS: Opium consumption is associated with the increased odds of both IHD and MI diseases.

The profile of Rafsanjan Cohort Study.

Owning the largest human-made jungle of pistachio, the second largest copper mine, and being located on the trade route of opium transit, distinguish Rafsanjan from many other cities in Iran. The environmental exposures and lifestyle factors associated with these characteristics of Rafsanjan, have raised concern about possible health outcomes for individuals living in and around this city. Thus, local health authorities initiated the Rafsanjan Cohort Study (RCS), as part of the prospective epidemiological research studies in IrAN (PERSIAN). RCS is a population-based prospective cohort of men and women aged 35-70 years, launched in August 2015. Individuals from diverse socioeconomic levels and lifestyles were recruited from four urban and suburban areas of Rafsanjan (participation rate 67.42%). Questionnaire-based interviews regarding demographics, dietary and environmental exposures, medical and occupational history, as well as anthropometric measurements were completed for all participants. Additionally, bio-specimens (blood, urine, hair, and nail) were collected, and dental and eye examinations were performed. The enrollment phase ended in December 2017, and a 15-year follow-up is planned. A total of 9990 individuals were enrolled in RCS (53.41% females). About 26% of men are pistachio farmers. The baseline prevalence of major non-communicable disease (NCD) risk factors such as cigarette smoking, alcohol consumption and opium use were 25.45%, 10.02%, and 23.81%, respectively. The mean ± SD of other common risk factors are as follows: body mass index (27.83 ± 4.89 mm Hg), systolic blood pressure (107.18 ± 17.56 mm Hg) diastolic blood pressure (71.13 ± 10.83), fasting blood sugar (113.27 ± 39.11 mg/dL) and plasma cholesterol (198.78 ± 41.89 mg/dL). These results indicate a concerning prevalence of NCD risk factors in Rafsanjan city, warranting further detailed investigations, particularly regarding the association of NDC with agricultural/industrial pollutants and drug abuse.

Socioeconomic-related inequalities in oral hygiene behaviors: a cross-sectional analysis of the PERSIAN cohort study.

BACKGROUND: Socioeconomic-related inequality in oral hygiene behaviors in Iran is poorly understood. This study aims to measure and decompose socioeconomic-related inequalities in oral hygiene behaviors among middle-aged and elderly adults in Iran. METHODS: A cross-sectional analysis was performed using data from the Prospective Epidemiological Research Studies in IrAN (PERSIAN), a large national cohort study. A total of 130,016 individuals aged 35 years and above from 17 cohort centers in Iran were included in the study. The normalized concentration index (Cn) was used to measure the magnitude of inequality in oral hygiene behaviors, i.e. brushing at least twice and flossing once daily, among middle-aged and elderly Iranian adults included in the cohort centers. Decomposition analysis was performed to quantify the contribution of each determinant to the observed inequality in oral hygiene behaviors. RESULTS: Totally, 65.5% of middle-aged and elderly adults brushed their teeth twice a day or more, 7.6% flossed at least once a day and 3.48% had both habits. The estimated Cn of the two habits combined, i.e. tooth brushing and dental flossing, for all provinces taken part in the PERSIAN cohort study was 0.399 (95% confidence interval [CI]: 0.383 to 0.417), indicating that the prevalence of the two habits combined is more concentrated among individuals with higher socioeconomic status. Inequality in oral hygiene behaviors was pro-rich in all cohort centers. The decomposition results suggested socioeconomic status as the main factor contributing to the overall inequality, followed by the level of education, and the province of residence. CONCLUSION: A low prevalence of oral hygiene behaviors among middle-aged and elderly Iranian adults was observed. There was also a pro-rich inequality in oral hygiene behaviors among middle-aged and elderly adults in all cohort centers. These results suggest an urgent need for targeted policy interventions to increase the prevalence of preventive oral hygiene behaviors among the poor and less-educated middle-aged and elderly adults in Iran.

Prevalence of smoking and high blood pressure, two major risk factors for non-communicable diseases: the SuRF NCD (surveillance of risk factors of non-communicable disease) report 2012.

Introduction: In recent years non-communicable diseases (NCDs) risk factors such as tobacco consumption and high blood pressure (BP) have been increased. This study aimed to determine the frequency of risk factors of the main NCDs among inhabitants of Rafsanjan city. Methods: Our study is a part of NCD surveillance in Iran (SuRF NCD). A total of 640 people enrolled and divided in four age groups in urban and rural areas in Rafsanjan (a city in Kerman province). Data were collected using the standardized stepwise protocol for NCD risk factor surveillance of the World Health Organization (WHO). This study focused on hypertension (HTN) and smoking. Results: A total of 640 people (46.9% male and 53.1% female) participated in this cross-sectional study. The prevalence of HTN was 198 per 1000 population. 4.8% of those were below the age of 44, and 15% between 45 and 70 years old. Mean systolic BP was 127 ± 15.6 in male and 118 ± 19.65 in female and the statistical difference was significant (t = 5.55, P < 0.001). 79 (14.1%) of hypertensive live in urban and 32 (5.7%) live in rural areas (χ2 = 8.004, P = 0.005). The prevalence of current smokers was 112 per 1000 population; among them 56 (88.9%) were daily smokers. The mean age for starting smoking was 21.11 ± 7.16 years. Conclusion: Modifying risk factors such as HTN and smoking behavior through primary and secondary prevention programs by enhancing awareness and knowledge of lay people, improvement screening and treatment interventions, particularly for the youth is highly recommended.

The persistence of anti-HBs antibody and anamnestic response 20 years after primary vaccination with recombinant hepatitis B vaccine at infancy.

Hepatitis B (HB) vaccine induces protective levels of antibody response (anti-HBs≥10 mIU/mL) in 90-99% of vaccinees. The levels of anti-HBs antibody decline after vaccination. The aim of this study was to evaluate the persistence of anti-HBs antibodies and immunologic memory in healthy adults at 20 years after primary vaccination with recombinant HB vaccine. Blood samples were collected from 300 adults at 20 years after primary HB vaccination and their sera were tested for anti-HBs antibody by ELISA technique. A single booster dose of HB vaccine was administered to a total of 138 subjects, whose anti-HBs antibody titer was <10 mIU/mL. The sera of subjects were re-tested for the anti-HBs antibody levels at 4 weeks after booster vaccination. At 20 years after primary vaccination 37.0% of participants had protective levels of antibody with geometric mean titer (GMT) of 55.44±77.01 mIU/mL. After booster vaccination, 97.1% of vaccinees developed protective levels of antibody and the GMT rose from 2.35±6.49 mIU/mL to 176.28±161.78 mIU/mL. 125/138 (90.6%) of re-vaccinated subjects also showed an anamnestic response to booster vaccination. At 20 years after primary vaccination with HB vaccine, low proportion of the subjects had protective levels of antibody. However, the majority of the re-vaccinated subjects developed protective levels of anti-HBs and showed an anamnestic response after booster vaccination. Additional follow-up studies are necessary to determine the duration of immunological memory.

Vitamin D status in female students and its relation to calcium metabolism markers, lifestyles, and polymorphism in vitamin D receptor.

BACKGROUND: Vitamin D is essential for maintiiining bone health and growth throughout life. Vitamin D deficiency not only leads to bone metabolic diseases in children and adults but may increase the risk of many chronic diseases. The aim of this study was to evaluate the prevalence of vitamin D deficiency and its relation with vitamin D receptor (VDR) gene polymorphism. In addition the study included the evaluation of known risk factors and their correlation to the vitamin D status among girls aged 11 - 17 years in Rafsanjan during the winter of 2009. METHODS: In a cross-sectional study, 250 healthy female students (age range, 11 - 17 years) were selected by random sampling method. Fasting blood samples were collected and the concentration of serum 25 (OH) vitamin D3, PTH, ionized Ca, P, ALP, and VDR gene polymorphism (exon 9) were evaluated. Values of 20 nmol/L were considered severe, 20.1 - 37.5 nmol/L moderate, 37.6 - 50 nmol/L mild deficiency, and 25 (OH) vitamin D3 levels higher than 50 nmol/L were considered normal. RESULTS: The results showed 59.6% of students suffered from vitamin D deficiency (14.4% severe, 24.4% moderate, and 20.8% mild deficiency). There was a significant relationship between serum levels of vitamin D with ionized Ca, PTH, ALP, type of clothing, and egg consumption, while no significant relationship was found between serum levels of vitamin D with age, residency, menstruation status, skin color, sun light exposure, body mass index, waist to hip ratio, exercise, physical activity, fish consumption, and polymorphisms in exon 9 of VDR gene. CONCLUSIONS: This study indicated a high prevalence of vitamin D deficiency in female students in a sunny city, Rafsanjan in winter. Low sun light exposure, coverage especially veil, and low intake vitamin D are important factors in vitamin D deficiency in studied subjects.