Diagnostic accuracy of body mass index and fasting glucose for the prediction of gestational diabetes mellitus after assisted reproductive technology

Background: The aim of the present study was to determine the maternal pre-pregnancy body mass index [BMI], first-trimester fasting blood sugar [FBS], and the combination of [BMI+FBS] cut-points for at-risk pregnant women conceived by assisted reproductive technology [ART] to better predict the risk of developing gestational diabetes mellitus [GDM] in infertile women

Materials and Methods: In this nested case-control study, 270 singleton pregnant women consisted of 135 [GDM] and 135 [non-GDM] who conceived using ART were assessed. The diagnosis of GDM was confirmed by a one-step glucose tolerance test [O-GTT] using 75 g oral glucose. BMI was classified base on World Health Organization [WHO] criteria. The relationship between BMI, FBS, and BMI+FBS with the risk of GDM development was deter- mined by logistic regression and adjusted for confounding factors. Receiver operating characteristic [ROC] curve analysis was performed to assess the value of BMI, FBS, and BMI+FBS for the prediction of GDM

Results: The GDM group had significantly higher age, BMI, family history of diabetes, and history of polycystic ovary syndrome in comparison with the non-GDM group [P<0.05]. Overweight and obese women had 3.27, and 5.14 folds increase in the odds of developing GDM, respectively. There was a 17% increase in the risk of developing GDM with each 1 mg/dl increase in fasting glucose level. The cut points for FBS 84.5 mg/dl [72.9% sensitivity, 74.4% specificity], BMI 25.4 kg/m2 [68.9% sensitivity, 62.8% specificity], and BMI+FBS 111.2 [70.7% sensitivity, 80.6% specificity] was determined

Conclusion: The early screening and high-quality prenatal care should be recommended upon the co-occurrence of high FBS [>/=84.5 mg/dl] in the first-trimester of the pregnancy and the BMI [=25.4 kg/m2] in pre-pregnancy period in women undergone ART. The combination of BMI and FBS is considered a better prediction value

Compare CPM-RMI trial: intramyocardial transplantation of autologous bone marrow-derived cd133+ cells and mononuclear cells during coronary artery bypass grafting in patients with recent myocardial infarction: a phase II/III, multicenter, placebo-controlled, randomized, double-blind clinical trial

Objective: The regenerative potential of bone marrow-derived mononuclear cells [MNCs] and CD133+ stem cells in the heart varies in terms of their pro-angiogenic effects. This phase II/III, multicenter and double-blind trial is designed to compare the functional effects of intramyocardial autologous transplantation of both cell types and placebo in patients with recent myocardial infarction [RMI] post-coronary artery bypass graft

Materials and Methods: This was a phase II/III, randomized, double-blind, placebo-controlled trial COMPARE CPM-RMI [CD133, Placebo, MNCs - recent myocardial infarction] conducted in accordance with the Declaration of Helsinki that assessed the safety and efficacy of CD133 and MNCs compared to placebo in patients with RMI. We randomly assigned 77 eligible RMI patients selected from 5 hospitals to receive CD133+ cells, MNC, or a placebo. Patients underwent gated single photon emission computed tomography assessments at 6 and 18 months post-intramyocardial transplantation. We tested the normally distributed efficacy outcomes with a mixed analysis of variance model that used the entire data set of baseline and between-group comparisons as well as within subject [time] and group×time interaction terms

Results: There were no related serious adverse events reported. The intramyocardial transplantation of both cell types increased left ventricular ejection fraction by 9% [95% confidence intervals [CI]: 2.14% to 15.78%, P=0.01] and improved decreased systolic wall thickening by -3.7 [95% CI: -7.07 to -0.42, P=0.03]. The CD133 group showed significantly decreased non-viable segments by 75% [P=0.001] compared to the placebo and 60% [P=0.01] compared to the MNC group. We observed this improvement at both the 6- and 18-month time points

Conclusion: Intramyocardial injections of CD133+ cells or MNCs appeared to be safe and efficient with superiority of CD133+ cells for patients with RMI. Although the sample size precluded a definitive statement about clinical outcomes, these results have provided the basis for larger studies to confirm definitive evidence about the efficacy of these cell types

Five-year follow-up of the local autologous transplantation of CD133+ enriched bone marrow cells in patients with myocardial infarction

The implantation of a CD133+ bone marrow cell population into an ischemic myocardium has emerged as a promising therapeutic modality for myocardial regeneration and restoration of ventricular contractility. While previous studies have documented the short-term safety and efficacy of CD133+ cell transplantation in patients with acute myocardial infarction, there are few reports of long-term follow-up results. Here, we present the results of long-term follow-up of our acute myocardial infarction patients who were treated with intra-myocardial injection of CD133+ cells after coronary bypass graft. After five years, 13 patients in the cell transplantation group and 5 patients in the control group underwent safety and efficacy investigations by New York Heart Association classification and two-dimensional echocardiography [2D echo]. During the five-year study period, no major cardiac adverse events were reported among patients who received CD133+ stem cells. Regarding efficiency, we observed no statistically significant treatment effects for the echocardiographic parameters [left ventricular end-diastolic and end-systolic volumes, and resting ejection fraction] measured during the follow-up period. However, detailed analysis of regional wall motion revealed an improvement in the Wall Motion Score Index from baseline to the six month follow-up, which was maintained during the follow-up period. Taken together, the long-term results of the present study indicate that transplantation of CD133+ is a safe and feasible procedure; however, we could not show any major benefits in our patients. Thus, this issue needs to be addressed by conducting other studies with more patients

[ cross-sectional study of Latex allergy among operation room staff of hospitals of Tehran university of medical sciences, 1380-1381]

Latex allergy is a major occupational disease with prevalence nearly 5-17% among the health care workers. To determine the prevalence of latex glove allergy and its contributing factors among operation room staff. In this study, 512 operation room staff were evaluated for latex allergy, using a complete questionnaire. Those suspected to have latex allergy underwent these tests: Eosinophils counting, measurement of serum total and latex specific IgE, latex skin prick test, latex and glove additives patch test. From evaluated staff, 178 [34.8%] had a history of sensitivity to latex gloves, from which 59 persons underwent the tests voluntarily. According to the results of the tests, 13 [22%] had type I allergy to latex, 3 [5.1%] had type IV allergy to latex and 9 [15.3%] had both allergies. There were no significant relationship between latex allergy and age, sex, job, season, family and personal history of allergies. Significant relationship was found between type I allergy to latex and allergy to kitchen gloves and also between type IV allergy and allergy to other plastic clothing. Prevalence of latex allergy in this study is much higher than similar studies, which demands more evaluation to determine the contributing factors

study of malnutrition in Iranian patients with primary antibody deficiency

Nutrition is an important factor that influences immunity, and nutritional deficiencies can impair resistance to infections. Malnutrition is the most common cause of immunodeficiency worldwide. Trace elements such as zinc, selenium, iron, and copper can influence several components of immunity. Primary antibody deficiency disorders are a group of disorders characterized by an unusual susceptibility to infections and malnutrition. Impaired nutritional status has been reported in immunodeficient patients. The aim of this study was to determine anthropometric indices and trace elements status in these patients. Thirty-eight children [28 males, 10 females, aged 2-18 years] with primary antibody deficiency referring to Children's Medical Center of Tehran University of Medical Science were enrolled in this research. Primary immunodeficiency disorders consisting of CVID, XLA, IgA deficiency, IgG subclass deficiency, and hyper IgM were assessed. Anthropometric indices, comprised of height, weight that were measured and body mass index [BMI] was calculated. Height-for-age [HAZ], weight-for-height [WHZ] and weight-for-age [WAZ] were determined according to Z-score to study mild, moderate and severe malnutrition. Serum copper, zinc, selenium and iron levels were measured by an atomic absorption spectrometer. The most common disorders were CVID 52.5% and X-linked agammaglobulinaemia 27.5%. Based on BMI measurements 21.1% of patients had malnutrition. According to HAZ, 13.2%, 13.2% and 36.8% had severe, moderate and mild malnutrition, respectively. According to WAZ, 10.5%, 18.4% and 28.6% had severe, moderate and mild malnutrition, respectively. Regarding to WHZ, 14.3% and 28.6% had moderate and mild malnutrition, respectively. Low selenium levels and high copper levels were observed in 37.5% and 70.3%, respectively. Anthropometric data showed that the frequency of malnutrition in these patients was higher than the CDC standard. Low serum selenium levels and high serum copper levels were observed, suggesting further research is needed on these parameters. Most of the patients had serum zinc and iron levels within the normal range. It is recommeded that clinical immunologists and nutritionists should make a collective effort to provide these patients with standard or specialized diets so as to decrease the risk of infection