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OBJECTIVES: This study aimed to investigate the impact of air pollution on birth outcomes in the USA over several decades. STUDY DESIGN: Approximately 70 million birth records were assessed for the years 1980-2020. This study focussed on seven measures of birth outcomes, including birth weight, low birth weight, very low birth weight, full-term birth weight, foetal growth, gestational age and very premature birth. METHODS: An instrumental variable identification strategy was used that exploited within county-month and within month-year of birth variations in exposure to precipitation-induced changes in air pollution. RESULTS: Air pollution was found to have negative and large effects on a wide range of birth outcomes. The study findings suggest that a one-standard-deviation increase in ozone was associated with a 6.4% and 12.8% increase (from the mean) in the proportion of low birth weight and very preterm birth infants, respectively. Further analyses suggest that these effects were heterogeneous across trimesters of pregnancy and reveal larger impacts during the second and third trimesters. CONCLUSIONS: The results suggest that the ordinary least square estimates of previous studies considerably underestimate the true effects of pollution on birth outcomes. Policies that aim to improve the health capital of future generations should allocate more resources and initiatives to improving environmental air quality.
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Poluentes Atmosféricos , Poluição do Ar , Nascimento Prematuro , Efeitos Tardios da Exposição Pré-Natal , Gravidez , Feminino , Recém-Nascido , Lactente , Humanos , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Nascimento Prematuro/epidemiologia , Poluição do Ar/efeitos adversos , Peso ao Nascer , Avaliação de Resultados em Cuidados de Saúde , Material ParticuladoRESUMO
Many cases of aseptic meningitis or meningoencephalitis, unresponsive to antimicrobial treatments, have been reported recently in patients with established/new-onset central nervous system (CNS) inflammatory demyelinating diseases (CNSIDDs). Given the higher probability of infectious etiologies, CNSIDDs are rarely considered among the differentials in meningitis or meningoencephalitis cases. We gathered and tabulated cases of non-infectious, steroid-responsive meningitis or meningoencephalitis associated with neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein-associated disease (MOGAD). This conceptual review highlights the need to bolster routine infectious workups with immunological workups in cases of meningoencephalitis or meningitis where potential autoimmune etiologies can be suspected. Although differentiating CNSIDDs with meningeal involvement from infectious meningitis may not substantially affect acute treatment strategies, long-term management and follow-up of the two are entirely different. We also discuss future research directions and hypotheses on how CNSIDDs may be associated with meningitis-like presentations, e.g. overlapping glial fibrillary acidic protein astrocytopathy or autoimmune encephalitis, alterations in regulatory T-helper cells function, and undetected viral agents.
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Encefalite , Meningite Asséptica , Meningoencefalite , Neuromielite Óptica , Humanos , Neuromielite Óptica/diagnóstico , Neuromielite Óptica/terapia , Neuromielite Óptica/complicações , Encefalite/complicações , Glicoproteína Mielina-Oligodendrócito , Meningite Asséptica/etiologia , Meningite Asséptica/complicações , Meningoencefalite/diagnóstico , Meningoencefalite/etiologia , AutoanticorposRESUMO
OBJECTIVES: To gather, synthesize, and meta-analyze data regarding the risk factors associated with a severe course of COVID-19 among patients with multiple sclerosis (pwMS). METHODS: MEDLINE, Embase, Scopus, and WoS were searched in May 2021. Briefly, the eligibility criteria included: 1) studies assessing COVID-19 severity among adult pwMS; 2) definitive diagnoses or high clinical suspicion of COVID-19; 3) a categorization of COVID-19 severity into at least two categories; 4) quantitative effect size and precision measurements; and 5) English language; and 6) clear effect size/precision measures. internal validity of studies was assessed using the NIH Quality Assessment Tools. A list of possible risk factors was created based on the search results and was later used in extraction, synthesis, and meta-analysis of the data. RESULTS: Thirteen studies were included in the syntheses. Outcome measures were either extracted from the papers, obtained from the primary researchers or calculated manually. The meta-analyses showed a significantly (P<0.05) increased odds of a severe COVID-19 in pwMS with all of the assessed risk factors, except smoking and most DMTs. CONCLUSION: This study facilitates evidence-based risk/benefit assessments in practice. Older men with progressive MS on anti-CD20 therapies are more at risk of an unfortunate COVID-19 outcome.
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COVID-19 , Esclerose Múltipla , Adulto , Idoso , Humanos , Masculino , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/epidemiologia , Fatores de Risco , SARS-CoV-2RESUMO
BACKGROUND: Neuromyelitis optica spectrum disorders (NMOSDs) are a group of neuroinflammatory diseases, which mainly affect the optic nerve and spinal cord. NMOSD is an astrocytic channelopathy involving the aquaporin-4 (AQP4) water channels in the central nervous system. Patients can present with seizure attacks as a first manifestation or relapse. However, compared with multiple sclerosis (MS) or myelin oligodendrocyte glycoprotein encephalomyelitis (MOG-EM), seizure attacks are less frequent in NMOSD. METHODS: In this study, we aimed to find out the incidence of seizure attacks during the disease course of 137 NMOSD patients who were registered in our centre from January 2011 till January 2020. Furthermore, we reviewed the literature for NMOSD cases with seizure attacks during their follow-up, in order to investigate the reason for this low incidence of seizures. RESULTS: Only one of our patients (0.72%) experienced an episode of generalised tonic-clonic seizure during his follow-up. CONCLUSION: Reviewing the literature revealed that although seizures are rare in NMOSD, AQP4 disruption possibly increases the risk of seizure attacks. We therefore concluded that the role of AQP4 in seizures is controversial and needs more investigation.
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Neuromielite Óptica , Convulsões , Autoanticorpos , Humanos , Incidência , Glicoproteína Mielina-Oligodendrócito , Neuromielite Óptica/complicações , Convulsões/etiologiaRESUMO
BACKGROUND: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) with varied prevalence rates among populations with different ethnic backgrounds. Therefore, studies done on minorities have shed more light on the risk factors. OBJECTIVE: Comparing MS prevalence in Georgian-based population immigrated to Iran and other Iranians. METHODS: All records of MS patients enrolled in the two biggest registry systems were investigated. All of the patients born in Fereydunshahr and Buin va Miandasht (2 biggest cities with Georgian immigrants) were interviewed and their baseline characteristics were obtained. Patients' ethnic background information were obtained from the Iran National organization for civil registration. RESULTS: Forty-one patients from Fereydunshahr and Buin va Miandasht were identified. The population of the two cities combined and the estimated number of Georgian-based patients in both cities were reported 59817 and 12000, respectively. The estimated ethnicity-adjusted prevalence among the Georgian-based individuals was 2.3 times higher than the non-Georgian ones. Baseline characteristics were also compared. CONCLUSION: There was a higher prevalence of multiple sclerosis among the Georgian minority of Isfahan. Due to the ethnic background of the Georgian minority, genetic risk factors should be considered more as a risk factor.
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Emigrantes e Imigrantes/estatística & dados numéricos , Esclerose Múltipla/etnologia , Esclerose Múltipla/genética , Adulto , Estudos Transversais , Feminino , Seguimentos , Predisposição Genética para Doença/etnologia , República da Geórgia/etnologia , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/epidemiologia , Prevalência , Fatores de Risco , Adulto JovemRESUMO
This article has been withdrawn at the request of the authors and editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
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Optimization methods are used to study and survey the optimal values for input factors and effect of optimized parameters on response variables. In this study, the effect of different factors on ciprofloxacin (CIP) removal of water soluble was studied. In this regard, a multi-objective optimization was performed utilizing the Taguchi method based on a grey relational analysis. Optimum levels of factors were determined to optimize three responses simultaneously with grey Taguchi. Meanwhile, grey relational analysis was applied to model and optimize three target responses, namely, CIP removal, chemical oxygen demand (COD) removal, and sludge to iron ratio. Multi-objective optimization results obtained based on grey relational analysis showed that the optimal value of the input factors were CIP concentration of 100 mg/L, H2O2 concentration of 100 mM, Fe(II) concentration of 10 mM, pH of 3, and a reaction time of 15 min. To confirm the results, the values obtained through a confirmation test were examined. Multi-objective optimization results from process factors were determined by analysis of variance (ANOVA) analysis and grey Taguchi method. Based on ANOVA analysis for the grey relational grade, Fe(II) concentration and H2O2 concentration were found to be the most influencing factors.
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Antibacterianos/química , Ciprofloxacina/química , Poluentes Químicos da Água/química , Purificação da Água/métodos , Água/químicaRESUMO
The trade-off between performance and complexity of the device manufacturing process should be balanced to enable the economic harvest of solar energy. Here, we demonstrate a conceptual, yet practical and well-regulated strategy to achieve efficient solar photocatalytic activity in TiO2 through controlled phase transformation and disorder engineering in the surface layers of TiO2 nanotubes. This approach enabled us to fine-tune the bandgap structure of undoped TiO2 according to our needs while simultaneously obtaining robust separation of photo-excited charge carriers. Introduction of specific surface defects also assisted in utilization of the visible part of sunlight to split water molecules for the production of oxygen. The strategy proposed here can serve as a guideline to overcome the practical limitation in the realization of efficient, non-toxic, chemically stable photoelectrochemical systems with high catalytic activity at neutral pH under visible illumination conditions. We also successfully incorporated TiO2 nanotube arrays (TNTAs) with free-based porphyrin affording a pathway with an overall 140% enhanced efficiency, an oxygen evolution rate of 436 µL h(-1) and faradic efficiencies over 100%.
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PURPOSE: Covid-19 has affected all people, especially those with chronic diseases, including Parkinson's Disease (PD). Covid-19 may affect both motor and neuropsychiatric symptoms of PD patients. We intend to evaluate different aspects of Covid-19 impact on PD patients. METHODS: 647 PD patients were evaluated in terms of PD-related and Covid-19-related clinical presentations in addition to past medical history during the pandemic through an online questioner. They were compared with an age-matched control group consist of 673 individuals and a sample of the normal population consist of 1215 individuals. RESULTS: The prevalence of Covid-19 in PD patients was 11.28%. The mortality was 1.23% among PD patients. The prevalence of Covid-19 in PD patients who undergone Deep Brain Stimulation (DBS) was 18.18%. No significant association was found between the duration of disease and the prevalence of Covid-19. A statistically significant higher prevalence of Covid-19 in PD patients who had direct contact with SARS-CoV-19 infected individuals was found. No statistically significant association has been found between the worsening of motor symptoms and Covid-19. PD patients and the normal population may differ in the prevalence of some psychological disorders, including anxiety and sleeping disorders, and Covid-19 may affect the psychological status. CONCLUSION: PD patients possibly follow tighter preventive protocols, which lead to lower prevalence and severity of Covid-19 and its consequences in these patients. Although it seems Covid-19 does not affect motor and psychological aspects of PD as much as it was expected, more accurate evaluations are suggested in order to clarify such effects.
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COVID-19 , Estimulação Encefálica Profunda , Doença de Parkinson , Humanos , Doença de Parkinson/epidemiologia , Doença de Parkinson/terapia , Doença de Parkinson/diagnóstico , COVID-19/epidemiologia , Estimulação Encefálica Profunda/métodos , EncéfaloRESUMO
OBJECTIVE: To review cases of optic neuritis after COVID-19 vaccination and add similar cases to the literature. METHODS: Thorough PubMed and Scopus searches were conducted, and data from studies describing optic neuritis after COVID-19 vaccination were extracted, tabulated, pooled, and reviewed. RESULTS: We present 6 cases of optic neuritis following COVID-19 vaccination. Our literature search yielded 48 similar cases. All 54 cases were divided into 3 groups with respect to their serostatus: (1) double-seronegative or unknown serostatus optic neuritis cases, (2) myelin oligodendrocyte glycoprotein (MOG)-associated optic neuritis cases, and (3) aquaporin-4-associated optic neuritis cases. Data from each group were separately pooled and reviewed. While the most frequent vaccine among the anti-AQP4+ subgroup was BNT162b2 (Pfizer-BioNTech) (2/3), recombinant vaccines, e.g., AZD122 and Ad26.Cov2.s were mostly injected in the other subgroups (23/51). No significant gender inclination was seen among different subgroups. The mean interval from vaccination to symptom onset was less than one month in all subgroups; symptom manifestations mainly occurred after the first dose (28/54). Almost all cases showed improvement after steroid therapy±plasma exchange (52/54). CONCLUSION: Despite having rare side effects such as optic neuritis, vaccination remains our most helpful protection against SARS-CoV-2. Nevertheless, larger studies are needed to ascertain the pathophysiology of such adverse effects. Likewise, the association between COVID-19 vaccination and optic neuritis warrants further investigation.
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The structural evolution of nanocrystalline TiO2 was studied by X-ray diffraction (XRD) and the Rietveld refinement method (RRM). TiO2 powders were prepared by the sol-gel technique. Post annealing of as-synthesized powders in the temperature range from 500 degrees C to 800 degrees C under air and argon atmospheres led to the formation of TiO2 nanoparticles with mean crystallite size in the range of 37-165 nm, based on the Rietveld refinement results. It was found that the phase structure, composition, and crystallite size of the resulting particles were dependent on not only the annealing temperature, but also the annealing atmosphere. Rietveld refinement of the XRD data showed that annealing the powders under argon atmosphere promoted the polymorphic phase transformation from anatase to rutile. Field emission scanning electron microscopy (FESEM) was employed to investigate the morphology and size of the annealed powders.
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Cristalização/métodos , Nanoestruturas/química , Nanoestruturas/ultraestrutura , Titânio/química , Atmosfera , Dureza , Temperatura Alta , Substâncias Macromoleculares/química , Teste de Materiais , Conformação Molecular , Tamanho da Partícula , Transição de Fase , Pós , Propriedades de SuperfícieRESUMO
PURPOSE: Covid-19 has affected all people, especially those with chronic diseases, including Parkinson's Disease (PD). Covid-19 may affect both motor and neuropsychiatric symptoms of PD patients. We intend to evaluate different aspects of Covid-19 impact on PD patients. METHODS: 647 PD patients were evaluated in terms of PD-related and Covid-19-related clinical presentations in addition to past medical history during the pandemic through an online questioner. They were compared with an age-matched control group consist of 673 individuals and a sample of the normal population consist of 1215 individuals. RESULTS: The prevalence of Covid-19 in PD patients was 11.28%. The mortality was 1.23% among PD patients. The prevalence of Covid-19 in PD patients who undergone Deep Brain Stimulation (DBS) was 18.18%. No significant association was found between the duration of disease and the prevalence of Covid-19. A statistically significant higher prevalence of Covid-19 in PD patients who had direct contact with SARS-CoV-19 infected individuals was found. No statistically significant association has been found between the worsening of motor symptoms and Covid-19. PD patients and the normal population may differ in the prevalence of some psychological disorders, including anxiety and sleeping disorders, and Covid-19 may affect the psychological status. CONCLUSION: PD patients possibly follow tighter preventive protocols, which lead to lower prevalence and severity of Covid-19 and its consequences in these patients. Although it seems Covid-19 does not affect motor and psychological aspects of PD as much as it was expected, more accurate evaluations are suggested in order to clarify such effects.
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The antibacterial activity of Eucalyptus globulus leaf extract was determined for 56 isolates of Staphylococcus aureus, 25 isolates of Streptococcus pyogenes, 12 isolates of Streptococcus pneumoniae and seven isolates of Haemophilus influenzae obtained from 200 clinical specimens of patients with respiratory tract disorders. MIC50s for these species were 64, 32, 16 and 16 mg/L, respectively; MIC90s were 128, 64, 32 and 32 mg/L, respectively; and MBCs were 512, 128, 64 and 64 mg/L, respectively. These results suggest that further studies to clarify the possible therapeutic role of E. globulus leaf extract in the treatment of respiratory tract infection are warranted.
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Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Eucalyptus/química , Extratos Vegetais/farmacologia , Infecções Respiratórias/microbiologia , Adolescente , Adulto , Bactérias/isolamento & purificação , Feminino , Haemophilus influenzae/efeitos dos fármacos , Haemophilus influenzae/isolamento & purificação , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/isolamento & purificação , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/isolamento & purificação , Streptococcus pyogenes/efeitos dos fármacos , Streptococcus pyogenes/isolamento & purificaçãoRESUMO
This study in Teheran, Islamic Republic of Iran, investigated the prevalence of Ureaplasma urealyticum and Mycoplasma species in men with non-gonococcal urethritis. Urethral swab samples were collected from 125 cases and 125 healthy men as a control group. The samples were then investigated by culture methods. The rates of detected bacteria in case and control groups were 19.2% and 7.2% for U. urealyticum, 7.2% and 0.8% for M. genitalium, and 2.4% and 1.6% for M. hominis respectively. Statistical analysis showed a significant difference between case and control groups in the prevalence of U. urealyticum and M. genitalium but not M. hominis. It is concluded that in men, U. urealyticum and M. genitalium may have an etiologic role in non-gonococcal urethritis.
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Infecções por Mycoplasma , Mycoplasma genitalium , Infecções por Ureaplasma , Ureaplasma urealyticum , Uretrite , Adolescente , Adulto , Distribuição por Idade , Estudos de Casos e Controles , Causalidade , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/microbiologia , Mycoplasma hominis , Vigilância da População , Prevalência , Infecções por Ureaplasma/epidemiologia , Infecções por Ureaplasma/microbiologia , Uretrite/epidemiologia , Uretrite/microbiologiaRESUMO
Brucellosis is a significant health problem in countries where control of zoonoses is inadequate. During 1993-98, we analysed sera and cultures from 792 suspected brucellosis patients who presented with histories of fever, chills, night sweating, weakness, malaise and headache to the referral hospital in Yazd. Cases were investigated by tube agglutination test (TAT) and 2-mercaptoethanol test (2-MET) and a questionnaire was completed for each.TAT titre was > or = 1:1 60 for 745 patients (94.1%) and 2-MET was positive for 42 (5.3%). Of 745 confirmed cases, 460 were from 1996-1997. Prevalence was highest in summer (39.5%) and more common males than among females. Prevalence was highest among those aged 10-19 years (27.7%). Most patients had a history of infected cheese, milk and milk product consumption (98%).
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Brucelose/epidemiologia , Saúde da População Urbana/estatística & dados numéricos , Adolescente , Adulto , Testes de Aglutinação , Anticorpos Antibacterianos/sangue , Brucella/imunologia , Brucelose/sangue , Brucelose/imunologia , Brucelose/transmissão , Distribuição de Qui-Quadrado , Criança , Laticínios/microbiologia , Feminino , Microbiologia de Alimentos , Humanos , Imunoglobulina G/sangue , Irã (Geográfico)/epidemiologia , Masculino , Mercaptoetanol , Pessoa de Meia-Idade , Vigilância da População , Fatores de Risco , Estações do Ano , Estudos Soroepidemiológicos , Distribuição por Sexo , Inquéritos e QuestionáriosRESUMO
Powdery mildew of wheat caused by Blumeria graminis f. sp. tritici (Bgt) is one of the most important fungal diseases in Iran. During the years 1998-2001, wheat fields in Sistan province were surveyed and powdery mildew infected samples were collected from various areas and transferred to the laboratory. In the greenhouse, fungal spores were purified and inoculated onto susceptible wheat cultivars using single pustule and single spore procedures. Selected pure isolates were inoculated onto the first leaves of eight differential wheat varieties for identifying physiological races. The results showed the existence of Bgt races 5, 11, 14, 19, 21, 24, 27, 28, 31, 32, 44, 50, 53, 58, 66, 73 and 84 in Sistan. These races were new to Sistan province and Iran as a whole. Among 17 races studied, races 11, 53 and 73 were important dominant races thus constituting 40% of total population. Race 53 constituted 16% of all isolates and was the dominant race in the area with 62.5% pathogenicity. Therefore, this race was introduced as the most virulent race during the period of this study. This study showed that Bgt isolates were compatible with host plant genes pm8, pm3 and pm3b but incompatible with gene pm4b. Powdery mildew resistance was evaluated using race 11 on 70 wheat cultivars during seedling stage as well as adult plant under both greenhouse and field conditions between 1999 and 2001. Among wheat lines tested for resistance against powdery mildew, cultivar Hirmand resembled the differential line Weihenst M1 in that both may possess gene pm4b and showed no symptoms under the greenhouse and field conditions. Cultivar Chamran was found to be highly resistant whereas Sorkhtokhm was susceptible. Other cutivars showed partial and gradual resistance against the powdery mildew disease.
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Ascomicetos/patogenicidade , Triticum/microbiologia , Ascomicetos/classificação , Ascomicetos/genética , Irã (Geográfico) , Doenças das Plantas/microbiologia , Distribuição Aleatória , Esporos Fúngicos/classificação , Esporos Fúngicos/isolamento & purificação , Esporos Fúngicos/patogenicidade , Virulência/genéticaRESUMO
BACKGROUND: Malaria and leishmaniasis are two most significant parasitic diseases which are endemic in Iran. Over the past decades, interest in botanical repellents has increased as a result of safety to human. The comparative efficacy of essential oils of two native plants, myrtle (Myrtus communis) and marigold (Calendula officinalis) collected from natural habitats at southern Iran was compared with DEET as synthetic repellent against Anopheles stephensi on human subjects under laboratory condition. METHODS: Essential oils from two species of native plants were obtained by Clevenger-type water distillation. The protection time of DEET, marigold and myrtle was assessed on human subject using screened cage method against An. stephensi. The effective dose of 50% essential oils of two latter species and DEET were determined by modified ASTM method. ED(50) and ED(90) values and related statistical parameters were calculated by probit analysis. RESULTS: The protection time of 50% essential oils of marigold and myrtle were respectively 2.15 and 4.36 hours compared to 6.23 hours for DEET 25%. The median effective dose (ED(50)) of 50% essential oils was 0.1105 and 0.6034 mg/cm(2) respectively in myrtle and marigold. The figure for DEET was 0.0023 mg/cm(2). CONCLUSION: This study exhibited that the repellency of both botanical repellents was generally lower than DEET as a synthetic repellent. However the 50% essential oil of myrtle showed a moderate repellency effects compared to marigold against An. stephensi.
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Infecções por Actinobacillus/microbiologia , Aggregatibacter actinomycetemcomitans/efeitos dos fármacos , Antibacterianos/farmacologia , Capnocytophaga/efeitos dos fármacos , Eikenella corrodens/efeitos dos fármacos , Ácido Glicirretínico/farmacologia , Infecções por Bactérias Gram-Negativas/microbiologia , Periodontite/microbiologia , Adulto , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Capnocytophaga/isolamento & purificação , Eikenella corrodens/isolamento & purificação , Humanos , Testes de Sensibilidade MicrobianaRESUMO
Helicobacter pylori infection is a risk factor for developing chronic peptic ulcers and gastric cancer. The purpose of this study was to investigate the frequency of Helicobacter pylori vacA genotypes in patients with gastric and duodenal ulcer. A total of 100 biopsy specimens of patients with gastric (n=50) and duodenal (n=50) ulcer were collected. The specimens were cultured on selective media and incubated in a microaerophilic atmosphere at 37 degrees C for 5-10 days. The isolates were characterized to species level by conventional biochemical tests. The extracted DNA from isolates was used to perform a polymerase chain reaction based, simultaneous analysis of the cagA status, allelic variation of the signal regions (s1, s2) and the middle regions (m1, m2) of the vacA gene. H. pylori isolated from 50 specimens of patients and the vacA gene was detected in all isolates. Among vacA genotypes the s1/m1 was the most common in H. pylori isolates from patients with gastric ulcer (56%) and duodenal ulcer (68%). This study demonstrated that vacA slml is common genotype of H. pylori in patients with peptic ulcer and the vacA allele s1 of this bacterium is associated with ulcer.