Relationship between endocrine changes and bone markers in pediatric thalassemic patients after hematopoietic stem cell transplantation.

BACKGROUND: Beta thalassemia major and its treatment by hematopoietic stem cell transplantation can have deleterious effects on bone integrity and a main part of such effects is due to their deleterious effects on endocrine systems. So, we assessed the effects of endocrine changes during HSCT (Hematopoietic Stem Cell Transplantation) on growing bones of pediatric thalassemic patients. METHODS: Bone-specific alkaline phosphatase and osteocalcin (bone formation markers), N-terminal telopeptide (NTX, bone resorption marker), calcium (Ca), phosphorus (P), alkaline phosphatase (Alk ph), parathyroid hormone (PTH), vitamin D (vit D), prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroxine (T4), triiodothyronine (T3), thyroid-stimulating hormone (TSH), insulin-like growth factor 1 (IGF-1), testosterone (in males) or estradiol (in females), measured in 20 major thalassemic patients with mean age of 10.8±3.9 years. Parameters at the baseline (before HSCT), and 1 month and 3 months after HSCT. RESULTS: After stem cell transplantation, changes of mean serum levels of NTX, osteocalcin, prolactin, LH, T4, IGF-1, testosterone (in males), Ca, Alk ph, PTH, and vit D were not significant, but bone specific Alk ph, P, T3, TSH, FSH and estradiol changed significantly (P=0.013, P=0.001, P=0.48, P=0.02, P=0.04 and P=0.001, respectively). After one month, there was a significant positive relationship between osteocalcine and T3 (p= 0.009). After 3 months, also, there was a significant positive relationship between osteocalcine and T3 and T4 as well as a negative one with IGF-1 (P<0.001, P<0.02 and P<0.03, respectively). CONCLUSIONS: Endocrine disorders do not appear to have an overall positive or negative effect on bone metabolism (anabolism or catabolism) in HSCT pediatric thalassemic patients in short term (three months).

Nitric Oxide in the Pathogenesis and Treatment of Tuberculosis.

Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis (TB), is globally known as one of the most important human pathogens. Mtb is estimated to infect nearly one third of the world's population with many subjects having a latent infection. Thus, from an estimated 2 billion people infected with Mtb, less than 10% may develop symptomatic TB. This indicates that the host immune system may constrain pathogen replication in most infected individuals. On entering the lungs of the host, Mtb initially encounters resident alveolar macrophages which can engulf and subsequently eliminate intracellular microbes via a plethora of bactericidal mechanisms including the generation of free radicals such as reactive oxygen and nitrogen species. Nitric oxide (NO), a key anti-mycobacterial molecule, is detected in the exhaled breath of patients infected with Mtb. Recent knowledge regarding the regulatory role of NO in airway function and Mtb proliferation paves the way of exploiting the beneficial effects of this molecule for the treatment of airway diseases. Here, we discuss the importance of NO in the pathogenesis of TB, the diagnostic use of exhaled and urinary NO in Mtb infection and the potential of NO-based treatments.

Self Management Behaviors in Rheumatoid Arthritis Patients and Associated Factors in Tehran 2013.

INTRODUCTION: Rheumatoid Arthritis (RA) is a systemic, autoimmune and inflammatory disease with an unknown etiology that is associated with progressive joint degeneration, limitation of physical activity and disability. The aim of the study was to evaluate self-management behaviors and their associated factors in RA patients. MATERIAL & METHOD: This cross-sectional study was performed in 2013 on185 patients in Iran. Data were selected through convenient sampling. The collected data included demographic variables, disease related variables, Arthritis Impact Measurement Scale 2 (AIMS-2SF), and Self-Management Behaviors (SMB). Data were analyzed by SPSS17 using Spearman correlation and logistic regression test. RESULT: In this study drug management, regular follow-up, and food supplement were used as the most frequently applied SMB and aquatic exercise, diet, massage therapy, and relaxation were the least common SMBs. Age, education, health status, occupation, marital status, sex, DAS28 (Disease Activity Score 28 joints), and PGA (Physician Global Assessment) were significantly related with SMB. CONCLUSION: The result of the study highlight the influence of demographic variables, health status, and disease related data on SMB. Thus, more studies are required to find factors influencing SMB in order to improve SMB.