Effect of a Breathing Exercise on Respiratory Function and 6-Minute Walking Distance in Patients Under Hemodialysis: A Randomized Controlled Trial.

BACKGROUND: Pulmonary disorders and poor functional capacity are common complications in patients under hemodialysis. Although breathing exercise is frequently prescribed to improve respiratory function, its efficacy in this patient community is not well established. PURPOSE: Our study was designed to determine the effectiveness of a breathing exercise on respiratory function and 6-minute walk (6MW) distance in patients under hemodialysis. METHODS: A randomized controlled trial approach was used. The sample consisted of 52 patients under hemodialysis from a university teaching hospital in Iran. The experimental group (n = 26) received the breathing exercise program and was encouraged to perform incentive spirometry for 2 months. The control group (n = 26) received only routine hospital care. The respiratory function test and 6MW test were performed at baseline and at 2 months after the intervention (posttest). RESULTS: The two groups were homogeneous in terms of respiratory function parameters, 6MW distance, and demographic characteristics at baseline. Forced expiratory volume in 1 second and forced vital capacity were significantly better in the experimental group compared with the control group at 2 months after intervention. No significant difference was found in 6MW distance between the groups at the 2-month posttest. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The 2-month breathing exercise effectively improved pulmonary function parameters (forced vital capacity, forced expiratory volume in 1 second) in patients under hemodialysis but did not affect 6MW distance. Hemodialysis nurses should strengthen their clinical health education and apply breathing exercise programs to reduce the pulmonary complications experienced by patients under hemodialysis.

The most common allergens according to skin prick test: The role of wheal diameter in clinical relevancy.

The skin prick test (SPT) could be applied as a useful in vivo method for the detection of sensitization in epidemiological and diagnostic studies if the wheal size is ideally evaluated. We focused on SPT wheal size to identify sensitization pattern to common inhalant and food allergens. In this cross-sectional study, SPT results were obtained from a total of 972 allergic patients. Common allergen extracts for SPT were selected according to the type of allergic diseases, and the geographical pattern. SPT with food allergens was performed for patients with atopic dermatitis (AD) and chronic urticaria (CU). A total of 461 male (47.4%) and 511 female (52.6%) participated in this study (median age: 31 years). The majority of individuals were affected with allergic rhinitis (AR) (n = 624) and asthma (n = 224); while 129 and 67 patients suffered from AD and CU, respectively. The most common aeroallergens were Russian thistle (52.1%) and lamb's quarter (50.7%) with the largest wheal diameter. The wheal size of lamb's quarter was significantly different between patients with asthma and AR (P<.001). In addition, a significant difference was detected in wheal diameter in response to the Russian thistle between patients with AR and AD (P = .001). Shrimp (23.6%) and Peanut (22.5%) caused the most common food sensitization in patients with AD and CU. Having in mind the most common weed pollens including the Russian thistle and lamb's quarter, preventive strategies, such as, removing unwanted weeds or preventing them from growing, avoidance, and specific immunotherapy may be crucial for better disease control.

The Effectiveness of Workshop and Multimedia Training Methods on the Nurses' Decision-Making Skills Regarding Weaning From Mechanical Ventilation.

BACKGROUND: Nurses can safely and effectively wean patients from mechanical ventilation (MV) by the use of proper instruments and planning. OBJECTIVE: The aim of this study was to compare the effectiveness of 2 training methods on the decision-making skill of intensive critical care (ICU) nurses with regard to weaning from MV. METHODS: In this quasi-experimental study, 80 nurses working in ICUs participated in 1 of 2 educational groups in 2016. The interventions were workshop and multimedia training for decision-making skill regarding weaning from MV. The data were gathered from a questionnaire based on the Burns Weaning Assessment Program tool before and 1 month after the intervention. Data were analyzed by independent t test, the χ test, and the Fisher exact test using the software SPSS v. 17. RESULTS: The decision-making skill with regard to awareness of weaning factors (physiological and respiratory) increased in both groups after the intervention (P ≤ .001), but the difference between the 2 groups was not statistically meaningful. Considering the mean scores before and after the intervention, the general skill of decision-making regarding weaning from MV was higher in the multimedia training group compared with the workshop training group (P ≤ .001). CONCLUSION: The multimedia training method, which has been more successful, is recommended owing to its characteristics of virtual education, such as accessibility, flexibility, learner centeredness, and expansibility, as well as nurses' lack of time.

Effects of a Theory Based Intervention on Physical Activity Among Female Employees: A Quasi-Experimental Study.

BACKGROUND: Regular physical activity has been highlighted as an important factor in decreasing about 25 factors harmful to health, such as obesity, diabetes, heart failure, depression and osteoporosis. Female office workers, because of the long hours they stay seated in their workplace, are seriously threatened by immobility. The Theory of Planned Behavior has been successfully used several times to predict PA behaviorphysical activity (PA). The TPB studies also have identified perceived behavioral control as the key determinant of walking intentions. OBJECTIVES: The present study aims to assess the effectiveness of an intervention based on TPB to improve attitude, perceived behavioral control, Subjective norms, behavioral intention and PA behavior among female office workers. MATERIALS AND METHODS: The present study is an interventional, quasi-experimental study. Participants were 95 female office workers of the Tehran University that divided randomly in two case and control groups. Using the theory of planned behavior questionnaire and the International physical activity questionnaire, the participants were evaluated before the training and three months after that. The training was provided in the form of four 90-minute training sessions and some electronic messages sent through office automation system once every two weeks. RESULTS: The intervention increased PBC, attitudes, intentions and objectively measured PA behavior. The effects of the intervention on intentions and behavior were mediated by PBC. CONCLUSIONS: The present study has provided some of the data toward understanding determinants of physical activity behavior in female office workers. Specifically, the results suggest that interventions designed to promote physical activity in this population should focus on the development of PBC as well as positive attitude toward PA.

Survival Factors in Patients With End-stage Renal Disease in Mazandaran Province, Iran.

INTRODUCTION: Survival analysis for patients with end-stage renal disease and factors influencing their survival is crucial due to the increase in the number of these patients along with their high mortality rate. This study aimed to analyse the survival rate of patients in north of Iran undergoing hemodialysis and to assess factors influencing their survival. MATERIALS AND METHODS: A historical cohort study was conducted on 500 patients on maintenance hemodialysis in 3 hospitals of 2 cities (Sari and Babol) in Mazandaran province during a 6-year period from 2007 to 2013. The Cox regression analysis was used to assess the impact of sex, age, education, smoking habit, primary cause of kidney failure, living with family, cardiovascular diseases, weight, age at diagnosis, and age at initiating hemodialysis on survival of the patients. RESULTS: The median survival time for the 500 hemodialysis patients was 108 months. Death occurred in 174 patients (34.8%). History of smoking, age, being unemployed, being illiterate, and renal cyst, congenital diseases, and unspecified diseases as the cause of kidney failure were the associated factors with survival of the patients. The 1-, 2-, 3-, 5-, 10-, and 12-year survival for these patients was estimated to be 84%, 77%, 71%, 58%, 43%, and 33%, respectively. CONCLUSIONS: This study showed a high level of mortality and poor survival prognosis for patient undergoing maintenance hemodialysis. History of smoking, age, being unemployed, being illiterate, and renal cyst, congenital diseases, and unspecified conditions as the cause of kidney failure were the associated factors with survival of these patients.

Asthma Economic Costs in Adult Asthmatic Patients in Tehran, Iran.

BACKGROUND: High prevalence and increasing rate of asthmatic patients around the word witnesses the high burden of asthma. We have limited data on asthma burden and economic costs in Iran. This study aimed to find direct and indirect economic costs of asthma and their association with some background factors in one of the referral tertiary centers for adult patients with asthma. METHODS: We surveyed asthma related economic costs of 197 adult patients who referred to Milad Hospital, Tehran, Iran from Jun 2007 to January 2010. The patients were followed up for a period of one-year ±1 month and asthma related costs and its control status were registered. RESULTS: Patients were consisted of 125 (64.1%) females and 70 (35.9%) males. Total cost of asthma was 590.22 ±32.18 USD for one patient per one year, the cost of drug, paraclinic, doctor visit, hospitalization, emergency, transportation, and absent days were 327.02, 4.76, 35.44, 3.82, 0.26, 113.03, 105.89 USD respectively. Men showed a significant elevation in their total (P=0.009) and drug costs (P=0.028). In addition, we found significant differences between total asthma costs and asthma control status (P=0.002). CONCLUSIONS: According to the high proportion of asthma, related cost compare to Total Income of an Iranian family, the necessity of public coverage of health assurance is quite clear. We suggest that improving asthma management and accessibility to specialized treatment centers can result in decreasing asthma medication and transportation costs as major direct and indirect asthma related costs.

Spatial clustering of tuberculosis incidence in the North of Iran.

BACKGROUND AND PURPOSE: Tuberculosis (TB) poses a serious threat to public health throughout the world but disproportionately afflicts low-income nations. The aim of this study is to identify the high-risk areas in Mazandaran province (northern Iran) in helping the heath programmer for the best intervention. MATERIALS & METHODS: This is an ecological study conducted from 1999 through 2008. The sample included 2444 Tuberculosis (TB) patients. The variables were age, gender, type of disease and residential location, analyzed by descriptive statistical methods and spatial analysis to identify cluster of disease incidence. Geographical information system software applied to map of smooth rate of TB. RESULTS: Of 2444 registered patients, 1283 (52.5%) were male. The data showed 61% urban and 96.4% of them with the Iranian nationality. There was insignificant difference between genders, but the main difference was observed between locations that are the incidence rate in the Tonekabon and Behshahr cities were 30% higher than mean incidence rate of Mazandaran province (P-value<0.05). The comprising chance of acquiring infection between urban and rural was 1.46 with confidence interval of 95% (1.35, 1.59). CONCLUSION: Geostatistical method showed spatial variability of TB incidence rate in all districts and identifying high-risk area (core areas). The most important core of TB incidence has been noticed in the eastern boundary of Mazandaran in the city of Behshahr which is due to proximity to Golestan Province. The incidence rate of TB in Behshahr city is about two times more than the number observed in Mazandaran province. Lower TB incidence rate has been observed in Golestan province is because there is usually a delay in the diagnosis of the disease especially in the positive smear patients.

Investigating the effects of a family-centered care program on stroke patients' adherence to their therapeutic regimens.

UNLABELLED: Abstract Background: Stroke survivors have residual neurological impairment, which requires long-term support and care. In this situation family involvement in care process is necessary. However, as the family caregivers of stroke survivors are not necessarily supported by the health-care professionals, and they often feel inadequately prepared to deal with the physical, cognitive and emotional needs of the stroke survivors. AIM: The aim of this study was to investigate the effects of a family-centered care program on stroke patients' adherence to their therapeutic regimens. METHODS: This is a posttest-only randomized controlled trial study, conducted on stroke patients and their family caregivers. The control group (N = 30) received only routine hospital services and the experimental group (N = 30) received routine hospital services plus a family-centered care program consisting of four steps; need assessment, educating families based on patients' needs, follow-ups by short phone interviews, and referral service. The data were collected via a demographic data form and 'Adherence to the Therapeutic Regimens (ATR)' questionnaire between July 2011 and March 2012 and lasted 2 months for each subject. Data were assessed and analyzed with SPSS version 18. FINDINGS: Study findings showed that the levels of adherence to the different components of the therapeutic regimens, including rehabilitations, medications and dietary regimen are significantly higher in the experimental group compared to the control group (P < 0.001). CONCLUSION: By empowering patients' families and improving their ATRs, family-centered care programs will be able to play an important role in management of physical and mental health of stroke patients.

Investigating the effects of a family-centered care program on stroke patients' adherence to their therapeutic regimens.

Abstract Background: Stroke survivors have residual neurological impairment, which requires long-term support and care. In this situation family involvement in care process is necessary. However, as the family caregivers of stroke survivors are not necessarily supported by the health-care professionals, and they often feel inadequately prepared to deal with the physical, cognitive and emotional needs of the stroke survivors. Aim: The aim of this study was to investigate the effects of a family-centered care program on stroke patients' adherence to their therapeutic regimens. Methods: This is a posttest-only randomized controlled trial study, conducted on stroke patients and their family care-givers. The control group (n = 30) received only routine hospital services and the experimental group (n = 30) received routine hospital services plus a family-centered care program consisting of four steps; need assessment, educating families based on patients' needs, follow-ups by short phone interviews, and referral service. The data were collected via a demographic data form and "Adherence to the therapeutic regimens" Questionnaire between July 2011 to March 2012 and lasted two months for each subject. Data were assessed and analyzed with SPSS version 18. Findings: Study findings showed that the levels of adherence to the different components of the therapeutic regimens, including rehabilitations, medications and dietary regimen are significantly higher in the experimental group compared to the control group (P value< 0.001). Conclusion: By empowering patients' families and improving their adherence to the therapeutic regimens, family-centered care programs will be able to play an important role in management of physical and mental health of stroke patients.

Mannan-binding lectin serum levels in 593 healthy Iranian children and adults.

Mannan-binding lectin (MBL) is a vital protein of innate immune system and has two critical functions: complement activation through the lectin pathway and opsonization. MBL deficiency has been classified as the most common inherited immunodeficiency known in humans (about 30% of the population), and is associated with predisposition to infections and high risk of some autoimmune diseases. The purpose of this study was to determine the profile of MBL serum level in Iranian healthy population in association with sex and age groups for the first time. We studied the serum concentration of MBL in 593 Iranian healthy cases: 340 males and 235 females in 4 different age groups by using enzyme-linked immunosorbent assay. The mean serum levels of MBL were 3.854 ± 2.77 µg/ml at the age of less than 6 months, 4.147 ± 3.54 µg/ml at 6 months to 2 years of age, 4.410 ± 3.09 µg/ml at 2-6 years and 2.207 ± 1.73 µg/ml in adults. There was significant differences in the mean concentration of MBL among different age groups of children and also between children and adults (p<0.05). No association was observed between sex and MBL concentrations. MBL serum levels of Iranian population seem to be different from some of other populations which may be explained by genetic variations. The MBL values in this study can be used as a normal reference range for future studies in Iranian population.

The relation of multiple sclerosis with allergy and atopy: a case control study.

Multiple Sclerosis (MS) and Allergy are believed to up regulate T helper cell type 1 (Th1) and T helper cell type 2 (Th2)  responses, respectively. It has been shown that disequilibrium in the ratio of Th1/Th2 activities may increase frequency of one disease and decrease the frequency of the other. The aim of this study was to investigate the relation of MS with allergy and atopy in new diagnosed MS patients. This case-control study was conducted on 40 new diagnosed MS patients and the same number of normal controls. All of the patients were diagnosed (according to McDonald criteria) at most 2 years prior to the study. Demographic data and clinical characteristics of both groups were recorded in a questionnaire. The total IgE and allergen specific IgE in the serum were measured in all the cases. Forty MS patients (female/male: 4.71) with mean age of 30.55±9.5 years and 40 healthy controls entered in this study. History of allergy was observed in 20(50%) of MS patients (including 15 (37.5%) rhinitis, 6 (15%) conjunctivitis, 3 (7.5%) urticaria and eczema, 1 (2.5%) asthma), and 20 (50%) of the controls (including 8 (20%) rhinitis, 4 (10%) conjunctivitis, 7 (17.5%) urticaria and eczema, 1 (2.5%) asthma). The differences between the two groups were not statistically significant. Neither the serum total IgE, nor the frequency of specific IgE against Weed mix, Grass Mix, Tree mix1, Tree mix 2, Dermatophagoides Farinae, Dermatophagoides pteronyssinus and Epidermal and animal proteins mix differed statistically between the two groups. There was also no significant relationship between MS clinical manifestations and allergy prevalence and also between MS and atopy. The results of this study as some other similar studies showed the same prevalence of allergy in MS patients and controls and also demonstrated no relation between MS and atopy.

Coping strategy in adolescents with premenstrual syndrome: application of the construal level theory and the precaution adoption process model.

This study aimed to apply the construal level theory (CLT) to increase the relaxation adoption as a coping behavior in adolescents with premenstrual syndrome (PMS). The theory offers a framework that assumes decision-making about adoption of any given behavior depends on perceived temporal distance from the desired or recommended behavior and thus individual might perceive any information or intervention, at two levels (low or high). In doing so, a trial was conducted on 1578 high school students suffering from PMS. The precaution adoption process model was applied to categorize students in six stages, based on their intention to adopt a behavior. The focus of this study was on students who were in stage 3 of the model (undecided to adopt a behavior that was relaxation). Overall, 411 students were identified and randomly assigned to the three study groups: group 1 (n = 98) who received a CLT-driven intervention containing detailed information about relaxation (low-level construal, LLC); group 2 (n = 150) who received a CTL-driven intervention containing general information about relaxation (high-level construal, HLC); and group 3 (n = 163) who received nothing (control group). The progression from stage 3 toward stage 6 (action) was considered as the desired outcome and it was hypothesized that LLC intervention would be more effective than HLC intervention. Compared to participants in the control group, participants in the high and low construal groups were significantly more likely to advance to the action stage (P < 0.001). In addition, students in the low construal group had made an apparent higher stage progression as compared to the high construal group, although this difference was not statistically significant (P = 0.33). The findings suggest that, for people who are undecided to adopt a new health action, LLC intervention might be more effective.

Health related quality of life among adolescents with premenstrual disorders: a cross sectional study.

BACKGROUND: Premenstrual disorders usually refer to premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). This study was designed to evaluate health-related quality of life (HRQOL) in a sample of Iranian adolescents with premenstrual disorders. METHODS: This was a cross sectional study. A sample of adolescent schoolgirls aged between 14 and 19 years were included in the study. Premenstrual disorders were indicated according to the International Classification of Diseases (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Health-related quality of life was measured using the Short Form Health Survey (SF-36). The data were analyzed in a descriptive fashion and were compared among subgroups of the study sample. RESULTS: In all 602 female students were studied. All students reported at least one premenstrual symptom. Of these, 224 (37.2%) met the diagnostic criteria for premenstrual dysphoric disorder (PMDD). Comparing the SF-36 scores between female students with and without PMDD, it was found that there were significant differences between these two groups in all measures (P < 0.001) except for physical functioning (P = 0.274). These differences were more evident on role emotional, role physical, social functioning and bodily pain. CONCLUSION: The study findings affirm the fact that adolescents with premenstrual disorders suffer from poor health-related quality of life. In order to improve quality of life in female adolescents appropriate support should be provided for this population especially for those who suffer from more severe premenstrual disorders.

Risk factors of long-term graft loss in renal transplant recipients with chronic allograft dysfunction.

OBJECTIVES: Graft loss owing to chronic allograft dysfunction is a major concern in renal transplant recipients. We assessed the affect of immune and nonimmune risk factors on death-censored graft loss in renal transplant recipients with chronic allograft dysfunction. MATERIALS AND METHODS: We performed a retrospective, single-center study on 214 renal transplant recipients with chronic allograft dysfunction among 1534 renal transplant recipients at the Urmia University Hospital from 1997 to 2005. Data registry includes details from all renal transplants. The renal transplant recipient information is regularly updated to determine current graft function, graft loss, or renal transplant recipient's death. The selection criteria were a functional renal allograft for at least 1 year and a progressive decline in allograft function. RESULTS: Increasing donor age (RR=1.066; P < .001), recipient age (RR=1.021, P = .00), recipient weight (RR=1.024; P = .029), and waiting time on dialysis to transplant (RR=1.047; P = .006), pretransplant hypertension (RR=3.126; P < .001), pretransplant diabetes (RR=5.787; P < .001), delayed graft function (RR=6.087; P < .001), proteinuria (RR=2.663; P = .001), posttransplant diabetes (RR=2.285; P = .015), posttransplant hypertension (RR=2.047; P = .017), and AR (RR=3.125; P < .001). Patients in stage 2 at the beginning of chronic allograft dysfunction relative to stage 1 (RR=4.823; P < .001) and patients in stage 3 at the beginning of chronic allograft dysfunction relative to stage 1 (RR=123.06; P < .001) were significant risk factors for death-censored graft loss. Using mycophenolate mofetil versus azathioprine reduced death-censored graft loss (RR=0.499; P = .001). CONCLUSION: We found that age of donor, pretransplant hypertension, pretransplant diabetes, type of immunosuppression (mycophenolate mofetil vs azathioprine), delayed graft function, proteinuria, and stage of allograft dysfunction at the start of chronic allograft dysfunction are the major risk factors for late renal allograft dysfunction.

Long-term progression pattern of chronic allograft dysfunction among kidney transplant recipients.

INTRODUCTION: There is little data about the pattern of disease progression in kidney transplant recipients with chronic allograft dysfunction (CAD). Extrapolating the current classification of chronic kidney disease for CAD, we studied the pattern of progression of CAD in 5 stages among our kidney transplant recipients. MATERIALS AND METHODS: We performed a retrospective cohort study on 214 kidney transplant recipients with CAD. The selection criteria were a functioning kidney allograft for at least 1 year after transplantation and a progressive decline in allograft function. An event history analysis in survival data was carried out based on the stages of CAD at baseline and the end of the study. RESULTS: At the beginning of the study, 54.7% of the patients had CAD stage 1; 37.9%, stage 2, and 7.5%, stage 3. At the end of study, 10.3% were in stage 2; 39.7%, stage 3; 23.4%, stage 4; and 26.6%, stage 5. Patients with CAD stage 5 were 17.1% of those in stage 1, 32.1% of those in stage 2, and 67.7% of those in stage 3 at baseline. There was a significant correlation between stage of CAD at the beginning of the study and the stage of CAD at the end (r = 0.465, P < .001). CONCLUSIONS: Because the decline in kidney allograft function was relatively faster in advanced stages of CAD, strategies to increase allograft survival by improving the baseline level of allograft function can be more effective than strategies to slow down progression of advanced stages of CAD.

Adverse drug reactions in patients in an Iranian department of internal medicine.

PURPOSE: Adverse drug reactions (ADRs) are a major cause of hospital admission and inpatient morbidity. The department of internal medicine is not an exception to this issue. This study was performed to determine the nature and frequency of ADRs in an internal medicine ward in Iran. METHODS: This survey was a prospective observational study based on admissions of 400 patients to the internal medicine ward over a 15-week period. Patients were intensively followed in order to assess any ADR as a cause of admission or occurring during hospitalization. Any suspicious ADR was confirmed by a pharmacist/pharmacologist. RESULTS: There were 47 patients of 400 patients (11.75%) that experienced at least one ADR. ADR leading to the admission was seen in seven cases (1.75%) and in 40 (10%) it occurred during hospitalization. ADRs were identified as preventable reactions in 50% of cases and as predictable in 94.3%. The severity of 18.6% of the ADRs was identified as mild, 62.9% as moderate, 14.3% as severe and 4.3% as lethal. Gastrointestinal system disorders (44.3%) represented the most frequent ADRs. The therapeutic groups that most commonly associated with suspected ADRs were antineoplastic, immunosuppressive and medicines used in palliative care (54.8%). CONCLUSIONS: ADRs are common among hospitalized patients in department of internal medicine and can be severe and even lethal. Since most ADRs occurred during hospitalization in studied patients and half of them were preventable, prevention strategies should be considered in hospitals. Also, our findings confirmed the role of hospital pharmacists in the reducing ADRs.

Prevalence of type I allergy to natural rubber latex and type IV allergy to latex and rubber additives in operating room staff with glove-related symptoms.

There is lack of data on the prevalence of latex allergy in the health care setting in Iran. This study was performed to determine the prevalence of type I latex allergy and type IV allergy to latex and rubber additives among the operating room staff with glove-related symptoms in 13 general hospitals in Tehran. Skin-prick tests with commercial latex extract, patch tests with latex and 25 rubber additive series, and total and latex-specific IgE detection were performed on the operating room staff who reported latex glove-related symptoms. Five hundred twelve self-administered questionnaires (100%) were completed by all operating room staff and latex glove-related symptoms were reported by 59 (11.5%) employees. Among all symptomatic operating room staff tested, the prevalence of type I latex allergy was 30.5% and the prevalence rates of type IV allergy to latex and rubber additives were 16.7 and 14.6%, respectively. The most positive patch test result with rubber additives was related to tetramethylthiuram monosulfide (38.5%). The risk factors for type I latex allergy were female sex (p = 0.009) and positive patch test with rubber additives (p = 0.012). Subjects who had positive patch test with latex were significantly more likely to have positive patch test with rubber additives (p < 0.0001). Our results showed a high prevalence of type I latex allergy and type IV allergy to latex and rubber additives. Based on this study, we recommend eliminating powdered latex gloves from the operating rooms of the 13 studied general hospitals and support the substitution of powder-free latex gloves.

Decreased T cell response to mitogen and increased anti-cytoplasmic antibody in drug-free schizophrenic patients.

BACKGROUND: Apart from genetic and environmental factors, activation of autoreactive mechanisms has been proposed to play a role in the pathogenesis of schizophrenia. In recent years, considerable work has been carried out to understand the role and contribution of the immune system in this disease. OBJECTIVE: To investigate the T cell response to phytohaemagglutinin (PHA) and determine the serum levels of anti-nuclear antibody (ANA), anti-cytoplasmic antibody (ACA), and circulating immune complexes (CIC) in schizophrenic patients. METHODS: A total of 30 drug-free schizophrenic patients and 42 healthy controls were enrolled in this study. T cell proliferation in response to PHA was measured using Methyl Thiazol Tetrazolium test. ANA and ACA were measured by indirect immunofluorescence. CIC concentration was determined using poly ethylene glycol precipitation assay. RESULTS: Mean PHA response was 1.96 +/- 0.83 in patients and 3.72 +/- 1.39 in healthy controls (p< 0.001). ANA and CIC concentrations were not significantly different between two groups. In addition, ACA was detected only in patients. CONCLUSION: Increased production of ACA together with lower T cell response to mitogens in our patients provides evidence for the involvement of autoimmune mechanisms in the pathogenesis of schizophrenia.