Osteoporosis management in adults with schizophrenia following index hip fracture event: a 10-year population-based retrospective cohort study, Ontario, Canada.

Little is known about the incidence of osteoporosis testing and treatment in individuals with schizophrenia, who may be more likely to fracture. Using competing risk models, we found that schizophrenia was associated with lower incidence of testing or treatment. Implications are for understanding barriers and solutions for this disadvantaged group. PURPOSE: Evidence suggests that individuals with schizophrenia may be more likely to experience hip fractures than the general population; however, little is known about osteoporosis management in this disadvantaged subpopulation. Our study objective was to compare bone mineral density (BMD) testing and pharmacologic treatment in hip fracture patients with versus without schizophrenia. METHODS: This was a retrospective population-based cohort study leveraging health administrative databases, and individuals aged 66-105 years with hip fracture between fiscal years 2009 and 2018 in Ontario, Canada. Schizophrenia was ascertained using a validated algorithm. The outcome was a composite measure of (1) pharmacologic prescription for osteoporosis; or (2) a BMD test. Inferential analyses were conducted using Fine-Gray subdistribution hazard regression, with mortality as the competing event. RESULTS: A total of 52,722 individuals aged 66 to 105 years who sustained an index hip fracture in Ontario during the study period were identified, of whom 1890 (3.6%) had schizophrenia. Hip fracture patients with vs without schizophrenia were more likely to be long-term care residents (44.3% vs. 18.1%; standardized difference, 0.59), frail (62.5% vs. 36.5%; standardized difference, 0.54) and without a primary care provider (9.2% vs. 4.8%; standardized difference, 0.18). In Fine-Gray models, schizophrenia was associated with a lower incidence of testing or treatment (0.795 (0.721, 0.877)). CONCLUSIONS: In this population-based retrospective cohort study, a schizophrenia diagnosis among hip fracture patients was associated with a lower incidence of testing or treatment, after accounting for mortality, and several enabling and predisposing factors. Further research is required to investigate barriers to osteoporosis management in this disadvantaged population.

Fragility fracture patients with a history of prior fractures more likely to present with multiple risk factors: findings from a province-wide fracture liaison service.

We examined the demographic characteristics and risk factors of FLS fragility fracture patients who had sustained prior fragility fracture(s) and found that this is an important high-risk subgroup that warrants further attention within FLS priority pathways in order to disrupt their fragility fracture cycle. PURPOSE: Our primary objective was to examine whether fragility fracture patients presenting to a provincial fracture liaison service (FLS) having a history of prior fractures, versus those without, differ in demographic characteristics and risk factors for future fracture. A secondary objective was to understand if those who report two or more prior fractures differ from those reporting one prior fracture. METHODS: This cohort study included fragility fracture patients aged 50 + enrolled in the Ontario FLS between July 2017 and September 2019. Patients with versus those without prior fractures were compared on age, sex, index fracture site, biological parents' history of hip fracture, current fracture due to a fall, history of feeling unsteady when walking, history of falls in the past year, smoking, oral steroid use, and comorbid chronic conditions. Pearson's chi-square, Fischer's exact, and analysis of variance tests were used to assess differences. RESULTS: Among 14,454 patients, 16.8% (n = 2428) reported a history of one or more prior fractures after the age of 40. They were significantly more likely to be older, female, with a higher number of comorbidities, with greater incidence of falls, and feel unsteady when walking. Compared to those with one prior fracture, patients with greater than one prior fracture were more likely to report falls in the past year and feel unsteady when walking. CONCLUSION: Findings suggest that FLS fragility fracture patients who had sustained prior fragility fracture are an important high-risk subgroup that warrants further attention within FLS priority pathways in order to disrupt their fragility fracture cycle.

The Mars 2020 Engineering Cameras and Microphone on the Perseverance Rover: A Next-Generation Imaging System for Mars Exploration.

The Mars 2020 Perseverance rover is equipped with a next-generation engineering camera imaging system that represents an upgrade over previous Mars rover missions. These upgrades will improve the operational capabilities of the rover with an emphasis on drive planning, robotic arm operation, instrument operations, sample caching activities, and documentation of key events during entry, descent, and landing (EDL). There are a total of 16 cameras in the Perseverance engineering imaging system, including 9 cameras for surface operations and 7 cameras for EDL documentation. There are 3 types of cameras designed for surface operations: Navigation cameras (Navcams, quantity 2), Hazard Avoidance Cameras (Hazcams, quantity 6), and Cachecam (quantity 1). The Navcams will acquire color stereo images of the surface with a 96 ∘ × 73 ∘ field of view at 0.33 mrad/pixel. The Hazcams will acquire color stereo images of the surface with a 136 ∘ × 102 ∘ at 0.46 mrad/pixel. The Cachecam, a new camera type, will acquire images of Martian material inside the sample tubes during caching operations at a spatial scale of 12.5 microns/pixel. There are 5 types of EDL documentation cameras: The Parachute Uplook Cameras (PUCs, quantity 3), the Descent stage Downlook Camera (DDC, quantity 1), the Rover Uplook Camera (RUC, quantity 1), the Rover Descent Camera (RDC, quantity 1), and the Lander Vision System (LVS) Camera (LCAM, quantity 1). The PUCs are mounted on the parachute support structure and will acquire video of the parachute deployment event as part of a system to characterize parachute performance. The DDC is attached to the descent stage and pointed downward, it will characterize vehicle dynamics by capturing video of the rover as it descends from the skycrane. The rover-mounted RUC, attached to the rover and looking upward, will capture similar video of the skycrane from the vantage point of the rover and will also acquire video of the descent stage flyaway event. The RDC, attached to the rover and looking downward, will document plume dynamics by imaging the Martian surface before, during, and after rover touchdown. The LCAM, mounted to the bottom of the rover chassis and pointed downward, will acquire 90 ∘ × 90 ∘ FOV images during the parachute descent phase of EDL as input to an onboard map localization by the Lander Vision System (LVS). The rover also carries a microphone, mounted externally on the rover chassis, to capture acoustic signatures during and after EDL. The Perseverance rover launched from Earth on July 30th, 2020, and touchdown on Mars is scheduled for February 18th, 2021.

Respectful maternity care during childbirth in India: A systematic review and meta-analysis.

BACKGROUND: Respectful maternity care is a rightful expectation of women. However, disrespectful maternity care is prevalent in various settings. Therefore, a systematic review and meta-analysis were conducted to identify various forms of ill-treatment, determinants, and pooled prevalence of disrespectful maternity care in India. METHODS: A systematic review was performed in various databases. After quality assessment, seven studies were included. Pooled prevalence was estimated using the inverse variance method and the random-effects model using Review Manager Software. RESULTS: Individual study prevalence ranged from 20.9% to 100%. The overall pooled prevalence of disrespectful maternity care was 71.31% (95% CI 39.84-102.78). Pooled prevalence in community-based studies was 77.32% (95% CI 56.71-97.93), which was higher as compared to studies conducted in health facilities, this being 65.38% (95% CI 15.76-115.01). The highest reported form of ill-treatment was non-consent (49.84%), verbal abuse (25.75%) followed by threats (23.25%), physical abuse (16.96%), and discrimination (14.79%). Besides, other factors identified included lack of dignity, delivery by unqualified personnel, lack of privacy, demand for informal payments, and lack of basic infrastructure, hygiene, and sanitation. The determinants identified for disrespect and abuse were sociocultural factors including age, socioeconomic status, caste, parity, women autonomy, empowerment, comorbidities, and environmental factors including infrastructural issues, overcrowding, ill-equipped health facilities, supply constraints, and healthcare access. CONCLUSION: The high prevalence of disrespectful maternity care indicates an urgent need to improve maternity care in India by making it more respectful, dignified, and women-centered. Interventions, policies, and programs should be implemented that will protect the fundamental rights of women.

Risk of colorectal cancer following CT-verified acute diverticulitis: a nationwide population-based cohort study.

AIM: Routine colonoscopy to exclude colorectal cancer (CRC) after CT-verified acute diverticulitis is controversial. This study aimed to compare the incidence of CRC in patients with acute diverticulitis with that in the general population. METHOD: Patients with an emergency admission for diverticular disease to any Norwegian hospital between 1 January 2008 and 31 December 2010 were included through identification in the Norwegian Patient Registry using International Classification of Diseases (ICD-10) codes K57.1-9. To estimate the age-specific distribution of CT-verified acute uncomplicated diverticulitis (AUD) and acute complicated diverticulitis (ACD) in this nationwide study population, numbers from the largest Norwegian emergency hospital were used. Patients diagnosed with CRC within 1 year following their admission for acute diverticulitis were detected through cross-matching with the Cancer Registry of Norway. Based on both Norwegian age-specific incidence of CRC and estimated age-specific distribution of CT-verified diverticulitis, standard morbidity ratios (SMRs) were calculated. RESULTS: A total of 7473 patients with emergency admissions for diverticular disease were identified (estimated CT-verified AUD n = 3523, ACD n = 1206); of these 155 patients were diagnosed with CRC within 1 year. Eighty had a CT-verified diverticulitis at index admission [41 AUD (51.3%); 39 ACD (49.7%)]. Compared with the general population, the SMR was 6.6 following CT-verified AUD and 16.3 following ACD, respectively. CONCLUSION: In the first year after CT-verified acute diverticulitis, especially after ACD, the risk of CRC is higher than in the general population. This probably represents misdiagnosis of CRC as acute diverticulitis. Follow-up colonoscopy should be recommended to all patients admitted with acute diverticulitis.

Severe maternal morbidity among women with a history of cesarean section at a tertiary referral teaching hospital in the southeast of Iran.

OBJECTIVES: Although the cesarean section (C-section) is known as a lifesaving procedure, it can also increase the risk of maternal mortality and morbidity. This study was conducted to achieve two objectives: (1) determination of maternal near miss (MNM) indicators and pregnancy outcomes among women with a history of C-section and (2) investigation of the women's experience of near miss events during childbirth to provide a deeper understanding of the weaknesses of care delivery process. STUDY DESIGN: The present study was conducted using a prospective cross-sectional study using the World Health Organization (organ system dysfunction-based) criteria. METHODS: All subjects were women at more than 22 weeks of gestation who gave birth in Ali ibn Abi Talib Hospital, Zahedan, Iran, and were referred to this hospital for childbirth or those within 42 days of pregnancy termination. Logistic regression was used to predict the risk factors for severe maternal outcomes (SMOs). RESULTS: Nearly 58% of all MNM cases were related to women with a history of C-section. The MNM ratio was estimated at 8.04 per 1000 live births. Moreover, the frequent causes of SMOs were reported as severe hemorrhage (58.3%), severe pre-eclampsia/eclampsia (27.8%), medical condition (8.3%), and sepsis or severe systemic infection (5.6%). Abnormally invasive placenta (61%) was the most common cause of severe hemorrhage. After adjustment for potential confounder variables, the hemoglobin level of <11 g/dl (odds ratio [OR] = 0.18, 95% confidence interval [CI] = 0.09-0.36) and place of residence (OR = 0.41, 95% CI = 0.19-0.90) remained as independent risk factors for SMOs in the final model of multivariate analysis. CONCLUSION: A risk assessment system is needed to diagnose and manage the risk factors for SMOs during prenatal care. In addition, there should be a continuous audit of the indication and number of C-sections performed across health facilities.

4xTrifolium ambiguum and 2xT. occidentale hybridise despite wide geographic separation and polyploidisation: implications for clover breeding.

KEY MESSAGE: The widely divergent species 4xTrifolium ambiguum and 2xT.occidentale are inter-fertile long after speciation (including polyploidisation) has occurred. Tri-species hybrids (T. repens × T. ambiguum × T. occidentale) have the potential to achieve introgression of stress resistant traits from both wild species into white clover. Trifolium ambiguum and T. occidentale are geographically, adaptionally and phenotypically contrasting species in the white clover section (Trifoliastrum) of the genus. T. ambiguum occurs as a high-altitude polyploid series (2x, 4x, 6x) in W Asia and NE Europe. T. occidentale is a diploid coastal species, occurring at sea level in W Europe. This study investigated hybridisation between 4xT. ambiguum and 2xT. occidentale and considered the significance of the hybrids for introgression breeding of white clover. Partially fertile F1 hybrids between 4xT. ambiguum and 2x and 4xT. occidentale were generated by embryo rescue. Hybrid plant morphology and fertility varied widely and hybrids generally expressed traits from both species. Advanced generation (F2-F5) 4x hybrids were highly fertile and constitute a new synthetic allotetraploid species. FISH analyses of 4x hybrids showed multivalent chromosome configurations with homoeologous associations between T. ambiguum and T. occidentale chromosomes. Crosses of the hybrids with T. repens produced fertile tri-species progeny. These very divergent species remain inter-fertile long after speciation (including polyploidisation) has occurred. Tri-species hybrids have the potential to achieve introgression of stress resistance traits from both wild species into white clover.

Fast food consumption and overweight/obesity prevalence in students and its association with general and abdominal obesity.

Nowadays, the prevalence of both fast food consumption and overweight/obesity has been increased. This study aimed to estimate the prevalence of fast food consumption and to assess its association with abdominal and general obesity. In an analytical cross-sectional study, 300 students were selected randomly from two largest universities in Qom, center of Iran, studying in medical and basic sciences fields in 2015. Data collection was conducted by a modified version of NELSON's fast food questionnaire and anthropometric measures including Waist-Hip Ratio (WHR) and Body Mass Index (BMI). Chi-square, independent t-test, and multivariate logistic regression were used for statistical analysis. According to our results, 72.4% (67.4% in females vs 80.7% in males) had at least one type of fast food consumption in the recent month including sandwich 44.4%, pizza 39.7%, and fried chicken 13.8%, The obesity prevalence based on BMI and WHR was 21.3% (95% CI: 19.4, 23.2%) and 33.2% (95% CI: 0.7, 35.7), respectively. Fast food consumption was related to abdominal obesity as WHR (OR: 1.46, 95% CI: 1.11, 2.26), but was not related to general obesity as BMI (OR: 0.97, 95% CI: 0.63, 1.52). The prevalence of fast food consumption and obesity/overweight in Iranian student is high. Fast food consumption was associated with abdominal obesity based WHR, but did not related to general obesity based on BMI.

Anti-Obesity Effect of Arq Zeera and Its Main Components Thymol and Cuminaldehyde in High Fat Diet Induced Obese Rats.

Arq zeera is a distillate product that prepared from four different herbs namely Trachyspermum ammi L., apiaceae, Zingiber officinale Roxb., zingiberaceae, Carum carvi L.,apiaceae and Cuminum cyminum L., apiaceae. The present study aims to determine the antiobesity effect of arq zeera and its main components thymol and cuminaldehyde in high fat diet induced obese rats and to explore its mechanism of action. In current study, orlistat was used as positive controls. Male Wistar rats were fed with HFD for 42 days to induce obesity. HFD-fed rats were administered with arq zeera, thymol, cumic aldehyde, thymol + cuminaldehyde and orlistat for 28 days. During the course of treatment, body weight and food intake frequently observed and after end of treatments, liver weight, visceral fat pad weight, plasma lipid proflie, alanine aminotransferase, aspartate aminotransferase, glucose, insulin, leptin levels and pancreatic lipase activity were studied on all treated obese rats. The histopathology of liver was also studied. After the treatments of arq zeera and its main components, body weight, food intake, liver weight, visceral fat pad weight and the level of lipid profile, alanine aminotransferase, aspartate aminotranferase, glucose, insulin, and leptin were found to be decreased and pancreatic lipase inhibition were increased. Arq zeera showed more potential antiobesity effect than orlistat. According to our present findings, arq zeera and its main components possessed potent antiobesity effect on high fat diet -induced obese rats and excreted anti-obesity effect partly via hypolipidemic, hypoglycemic, hypoinsulinemic, hypoleptinemic and pancreatic lipase inhibition action.

Equal treatment: no evidence of gender inequity in osteoporosis management in a coordinator-based fragility fracture screening program.

We evaluated gender imbalance in osteoporosis management in a provincial coordinator-based fracture prevention program and found no difference by gender in treatment of high-risk fragility fracture patients. This establishes that a systemic approach with interventions for all fragility fracture patients can eliminate the gender inequity that is often observed. INRODUCTION: The purpose of this study was to evaluate an Ontario-based fracture prevention program for its ability to address the well-documented gender imbalance in osteoporosis (OP) management, by incorporating its integrated fracture risk assessments within a needs-based evaluation of equity. METHODS: Fragility fracture patients (≥ 50 years) who were treatment naïve at screening and completed follow-up within 6 months of screening were studied. Patients who underwent bone mineral density (BMD) testing done in the year prior to their current fracture were excluded. All participants had BMD testing conducted through the Ontario OP Strategy Fracture Screening and Prevention program, thus providing us with fracture risk assessment data. Our primary study outcome was treatment initiation at follow-up within 6 months of screening. Gender differences were compared using Fisher's exact test, at p < 0.05. RESULTS: After adjusting for subsequent fracture risk, study participants did not show a statistically significant gender difference in pharmacotherapy initiation at follow-up (p > 0.05). 68.4% of women and 66.2% of men at high risk were treated within 6 months of screening. CONCLUSION: Needs-based analyses show no difference by gender in treatment of high-risk fragility fracture patients. An intensive coordinator-based fracture prevention model adopted in Ontario, Canada was not associated with gender inequity in OP treatment of fragility fracture patients after fracture risk adjustment.

Trend of bacterial meningitis in Bahrain from 1990 to 2013 and effect of introduction of new vaccines

Meningitis is among the 10 commonest infectious causes of death worldwide.This retrospective analysis of reported cases of meningitis in Bahrain aimed to assess the trend in the incidence of bacterial meningitis from 1990 to 2013,before and after the introduction of new vaccines.Of 1455 reported cases of meningitis during the study period 73.1% were viral and 26.9% were bacterial etiology [tuberculous meningitis 8.3%;Streptococcus pneumoniae 4.9%,Haemophiius influenzoe 3.6% and Neisseria meningitidis 1.7%]. There was a peak of meningitis cases in 1995-1996.The incidence of meningitis due to H.influenzae and N.meningitidis showed a marked reduction after the introduction of the corresponding vaccines in 1998 and 2001 respectively,and S.pneumoniae became the predominant organism after Mycobacterium tuberculosis.The changing trend in the etiology of bacterial meningitis points to the need to study vaccination programme modifications,such as pneumococcal vaccine for the adult population,especially high-risk groups

La meningite fait partie des 10 causes de deces par infection les plus courantes dans le monde.La presente analyse retrospective descasde meningite notifies a Bahrein visait a mesurer la tendance de Tincidence de la meningite bacterienne entre 1990 et 2013,avant et apres 1'introduction de nouveaux vaccins.Sur 1 455 cas de meningite rapportes au cours de la periode d'etude,73,1 % etaient d'etiologie virale et 26,9 % d'etiologie bacterienne [meningite tuberculeuse 8,3 % ; Streptococcus pneumoniae 4,9 %,Haemophiius influenzae 3,6 % et Neisseria meningitidis 1,7%]. Un pic de cas de meningite est survenu entre 1995 et 1996.L'incidence des meningites dues a H.influenzae et N.meningitidis a marque une nette reduction apres 1'introduction des vaccins c orrespondants en 1998 et 2001 respectivement,et S.pneumoniae est devenu I'organisme predominant apres Mycobacterium tuberculosis.Ce changement de tendance dans I'etiologie de la meningite bacterienne souligne le besoin d'etudier les possibilites de modifications du programme de vaccination,telle que la vaccination antipneumococcique de la population adulte,notamment pour les groupes a haut risque

يعتبر التهاب السحايا من بين الامراض المعديه المميته الـ 10 الاكثر شيوعا على مستوى العالم ويهدف هذا التحليل الاستعادي لحالات التهاب السحايا المبلغ عنها في البحرين الى تقييم الاتجاه في وقوع التهاب السحايا الجرثومي من عام 1990 الى عام 2013 قبل وبعد ادخال لقاحات جديدة لقد كانت المسببات فيروسيه في 73.1% من حالات التهاب السحايا الـ 1455 التي ابلغ عنها خلال فتره الدراسة وجرثوميه في 26.9% من الحالات ( التهاب سحايا سلي 8.3% وبالعقديه الرئويه 4.9% وبالمستدميه النزليه 3.6% وبالنيسريه السحائيه 1.7%)وكانت هناك ذروة لظهور حالات التهاب السحايا في العامين 1995-1996 واظهر وقوع التهاب السحايا بسبب المستدميه النزليه والنيسريه السحائيه انخفاضا ملحوظا بعد ادخال اللقاحات الموافقه لكل منهما في عامي 1998 و 2001 على التوالي واصبحت العقديه الرئويه الكائن الحي السائد بعد المتفطرة السليه ان الاتجاه المتغير في مسببات التهاب السحايا الجرثومي يشيرالى ضروره اجراء دراسه لادخال تعديلات على برنامج التطعيم مثل لقاح المكورات الرئويه للبالغين لاسيما الفئات عاليه الخطوره

Predicting CCHF incidence and its related factors using time-series analysis in the southeast of Iran: comparison of SARIMA and Markov switching models.

Crimean-Congo haemorrhagic fever (CCHF) is endemic in the southeast of Iran. This study aimed to predict the incidence of CCHF and its related factors and explore the possibility of developing an empirical forecast system using time-series analysis of 13 years' data. Data from 2000 to 2012 were obtained from the Health Centre of Zahedan University of Medical Sciences, Climate Organization and the Veterinary Organization in the southeast of Iran. Seasonal autoregressive integrated moving average (SARIMA) and Markov switching models (MSM) were performed to examine the potential related factors of CCHF outbreaks. These models showed that the mean temperature (°C), accumulated rainfall (mm), maximum relative humidity (%) and legal livestock importation from Pakistan (LIP) were significantly correlated with monthly incidence of CCHF in different lags (P < 0·05). The modelling fitness was checked with data from 2013. Model assessments indicated that the MSM had better predictive ability than the SARIMA model [MSM: root mean square error (RMSE) 0·625, Akaike's Information Criterion (AIC) 266·33; SARIMA: RMSE 0·725, AIC 278·8]. This study shows the potential of climate indicators and LIP as predictive factors in modelling the occurrence of CCHF. Our results suggest that MSM provides more information on outbreak detection and can be a better predictive model compared to a SARIMA model for evaluation of the relationship between explanatory variables and the incidence of CCHF.

Predominance of rotavirus G8 genotype in hospitalized children with acute gastroenteritis in Yasuj, Iran.

BACKGROUND: Rotavirus infection is the most common cause of gastroenteritis among children worldwide. In this study, we were evaluated the occurrence of rotavirus infection and genotypes causing gastroenteritis among children under 5 years in Yasuj, Iran. MATERIALS AND METHODS: This cross sectional-descriptive study was done on 184 fecal samples collected from children aged < 5 years old with acute gastroenteritis. All the stool specimens were tested for group A rotavirus with enzyme immunoassays (EIA). Rotavirus-positive specimens were genotyped by the Nested reverse transcription polymerase chain reaction (RT-PCR) with using different type of specific primers. RESULTS: The prevalence of rotavirus was 28.26% and predominant genotypes were G1 (1.92%), G2 (7.69%), G4 (1.92%), G8 (46.16%), N.T.A (40.39%), mixed infections (1.92%). Predominance of rotavirus G8 genotype in the current survey was reported for the first time in Iran. The highest prevalence of rotavirus infection was observed in autumn (48.08%), and the lowest in spring (5.77%). CONCLUSIONS: The result of study showed that prevalence of rotavirus genotypes in this region of the country is different from that of other regions. The continuous stability of rotavirus in Iran, regarding to the regional differentiates and prevalence of circulating strains, can be useful indication in order to supply and effective vaccine against the rotavirus infections.

Prevalence of metabolic syndrome in adult population from zahedan, southeast iran.

BACKGROUND: The metabolic syndrome (MES) is associated with a high risk of diabetes and cardiovascular disease. The aim of the present study was to determine the prevalence of the metabolic syndrome as well as cut-off points for waist circumference (WC) for diagnosis of MES in Zahedan, southeast Iran. METHODS: Totally, 1802 people (735 men and 1067 women) with metabolic syndrome were surveyed according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and the International Diabetes Federation (IDF) criteria as well as obtained WC cut-off points for IDF criteria. RESULTS: The prevalence of metabolic syndrome was higher in women than in men. In both sexes the prevalence increased with age. The prevalence of metabolic syndrome among 1802 individuals aged ≥19 years according to NCEP ATP III, IDF and IDF -AHA/NHLBI were 21.0% (15.4% in male, 24.9% female), 24.8 (20.0% in male, 28.1% in female) and 23.3% (19.7% in male, 25.8% in female), respectively. Low HDL-C (60.6%) and high WC (43.3%) were the most common components of the metabolic syndrome, followed by high triglycerides (32%), elevated glucose (17.1%) and high blood pressure (13%). CONCLUSION: Our data shows a high prevalence of MES in Zahedan, Southeast Iran, therefore, future health prevention strategies are required for the prevention of MES.

Worldwide predoctoral dental implant curriculum survey.

OBJECTIVE: Predoctoral dental implant education is included in dental school teaching curricula in most of the developed and some developing countries; however, it was not introduced into undergraduate curriculum of some countries and Iranian dental schools. Our purpose was to investigate the status of the predoctoral dental implant education of dental schools in the world. MATERIALS AND METHODS: One hundred-thirty five dental schools were randomly selected representing 62 countries divided into two regions. The first region included North America and Europe, and the second region comprised of Asia, South America and Africa. A questionnaire including onset year, lecture hours, lectures available on the internet, required textbooks, department jurisdictions, the year of dental school the course was offered, clinical and laboratory courses, implant systems used surgically and in restorative phase, and type of restorations treated by predoctoral students was mailed electronically to the predoctoral implant dentistry directors. RESULTS: Ninety-two (68%) schools responded; of which 79 (86%) incorporated implant dentistry in their predoctoral teaching curricula, 39 (49%) offered surgical and prosthodontics courses in which students mainly observe. Of these 39 dental schools, 28 (71%) and 11 (29%) dental schools are from the first and second region, respectively. CONCLUSION: A large percentage of responding schools included implant education in the predoctoral dental curriculum. Onset year of course, topics included in lecture series, lecture hours, faculty to student ratio and practical course vary among schools. Fifty percent of responding dental schools including Iranian dental schools do not have curriculum guidelines for predoctoral implant dentistry.

A2A adenosine receptor deficiency leads to impaired tracheal relaxation via NADPH oxidase pathway in allergic mice.

A(2A) adenosine receptor (A(2A)AR) has been shown to suppress superoxide generation in leukocytes via the cAMP-protein kinase A (PKA) pathway. However, no study has yet explored the role of A(2A)AR in relation to NADPH oxidase in murine tracheas in vitro, which may lead to altered smooth muscle relaxation in asthma. Therefore, the present study evaluated the effects of A(2A)AR deficiency on the NADPH oxidase pathway in tracheas of A(2A) wild-type (WT) and A(2A) knockout (KO) mice. A(2A)WT mice were sensitized with ovalbumin (30 microg i.p.) on days 1 and 6, followed by 5% ovalbumin aerosol challenge on days 11, 12, and 13. A(2A)AR (gene and protein expression), cAMP, and phosphorylated PKA (p-PKA) levels were decreased in A(2A)WT sensitized mice compared with controls. A(2A)KO mice also showed decreased cAMP and p-PKA levels. A(2A)WT sensitized and A(2A)KO control mice had increased gene and protein expression of NADPH oxidase subunits (p47phox and gp91phox) compared with the controls. Tracheal relaxation to specific A(2A)AR agonist, 4-[2-[[6-amino-9-(N-ethyl-beta-d-ribofuranuronamidosyl)-9H-purin-2-yl]amino]ethyl]benzenepropanoic acid hydrochloride (CGS 21680), decreased in A(2A)WT sensitized mice compared with the controls, although it was absent in A(2A)KO mice. Pretreatment with NADPH oxidase inhibitors apocyanin/diphenyliodonium reversed the attenuated relaxation to CGS 21680 in A(2A)WT sensitized tracheas, whereas specific PKA inhibitor (9S,10S,12R)-2,3,9,10,11,12-hexahydro-10-hydroxy-9-methyl-1-oxo-9,12-epoxy-1H-diindolo[1,2,3-fg:3',2',1'-kl]pyrrolo[3,4-i] [1,6]benzodiazocine-10-carboxylic acid hexyl ester (KT 5720) blocked CGS 21680-induced relaxation. Tracheal reactive oxygen species (ROS) generation was also increased in A(2A)WT sensitized and A(2A)KO control mice compared with the controls. In conclusion, this study shows that A(2A)AR deficiency causes increased NADPH oxidase activation leading to decreased tracheal relaxation via altered cAMP-PKA signaling and ROS generation.

MRI of degenerative cysts of the lumbar spine.

Degenerative cysts of the lumbar spine encompass a heterogeneous group of cystic lesions that are presumed to share a common aetiology. Some of these cysts may be incidental findings, whereas others may produce acute or chronic symptoms. These cysts have been categorized using various combinations of topographic and pathological characteristics and by their attachment to or communication with a specific spinal structure.