Virulence factors, biofilm formation and antibiotic resistance pattern in Enterococcus faecalis and Enterococcus faecium isolated from clinical and commensal human samples in Isfahan, Iran.

BACKGROUND: The aim of this study was to determine and compare antibiotic resistance profile, biofilm formation ability and frequency of agg and ace genes in Enterococcus spp strains isolated from patients and healthy individuals. METHODS: A total of 90 non-duplicate Enterococcus spp isolates were isolated from patients and healthy individuals. Antibiotic susceptibility pattern was determined by disk diffusion and E-test method. Virulence genes and two species of enterococci were determined by PCR amplification. The capacity of biofilm formation was also evaluated by microtiter plate technique. RESULTS: E. faecalis was the predominant species among our clinical isolates (80%). The prevalence of agg and ace genes was 37.8% and 73.3% in clinical and 8.9% and 11.1% in "healthy" samples, respectively. The rate of Multiple Drug Resistant strains was 73.3% and 11.1% in clinical and "healthy" isolates, respectively. The ability of biofilm formation was significantly higher in clinical compared to "healthy" isolates (100% vs 75.6%, P < 0.05). CONCLUSION: The frequency of ace and agg genes, antibiotic resistance and biofilm formation ability were significantly higher in clinical than in "healthy" isolates (P < 0.05). Existence of agg and ace genes, biofilm formation and antibiotic resistance among the healthy enterococci isolates has a special importance since, in case these strains spread through clinical environments or reach water sources, this issue can be considered as a risk factor for health and sanitation of societY.

Applicability of universal Bacteroidales genetic marker for microbial monitoring of drinking water sources in comparison to conventional indicators.

Water quality monitoring is essential for the provision of safe drinking water. In this study, we compared a selection of fecal indicators with universal Bacteroidales genetic marker to identify fecal pollution of a variety of drinking water sources. A total of 60 samples were collected from water sources. The microbiological parameters included total coliforms, fecal coliforms, Escherichia coli and fecal streptococci as the fecal indicator bacteria (FIB), Clostridium perfringens and H2S bacteria as alternative indicators, universal Bacteroidales genetic marker as a promising alternative fecal indicator, and Salmonella spp., Shigella spp., and E. coli O157 as pathogenic bacteria. From 60 samples analyzed, Bacteroidales was the most frequently detected indicator followed by total coliforms. However, the Bacteroidales assay failed to detect the marker in nine samples positive for FIB and other alternative indicators. The results of our study showed that the absence of Bacteroidales is not necessarily an evidence of fecal and pathogenic bacteria absence and may be unable to ensure the safety of the water. Further research, however, is required for a better understanding of the use of a Bacteroidales genetic marker as an indicator in water quality monitoring programs.

Influence of Tyrphostin AG490 on the expression of diabetes-associated markers in human adipocytes.

Tyrosine kinase inhibitors (TKi) hold promise as a treatment for a variety of disorders ranging from those in oncology to diseases thought as immune mediated. Tyrphostin AG490 is a potent Jak-Stat TKi shown effective in the prevention of allograft transplant rejection, experimental autoimmune disease, as well as the treatment of cancer. However, given its ability to modulate this important but pleiotropic intracellular pathway, we thought that it is important to examine its effects on glucose metabolism and expression of major transcription factors and adipokines associated with insulin insensitivity and diabetes. We investigated the metabolic effects of AG490 on glucose levels in vivo using an animal model of diabetes, nonobese diabetic (NOD) mice, and transcription factor expression through assessment of human adipocytes. AG490 treatment of young nondiabetic NOD mice significantly reduced blood glucose levels (p = 0.002). In vitro, treatment of adipocytes with rosiglitazone, an insulin sensitizer that binds to peroxisome proliferator-activated receptor (PPAR) receptors and increases the adipocyte response to insulin, significantly increased the expression of the antidiabetic adipokine adiponectin. Importantly, the combination of rosiglitazone plus Tyrphostin AG490 further increased this effect and was specifically associated with significant upregulation of C-enhanced binding protein (C/EBP) (p < 0.0001). In terms of the mechanism underlying this action, regulatory regions of the PPARγ, ADIPOQ, and C/EBP contain the Stat5 DNA-binding sequences and were demonstrated, by gel shift experiments in vitro. These data suggest that blocking Jak-Stat signaling with AG490 reduces blood glucose levels and modulates the expression of transcription factors previously associated with diabetes, thereby supporting its potential as a therapy for this disease.

Effect of Health Belief Model based intervention on promoting nutritional behaviors about osteoporosis prevention among students of female middle schools in Isfahan, Iran.

BACKGROUND: Osteoporosis is a systemic skeletal disorder characterized by reduction of one mass, deterioration of bone structure, increasing bone fragility, and increasing fracture risk. Prevention of osteoporosis during childhood and adolescence is one of the most important issues in World Health Organization. The purpose of this study was to determine the effect of Health Belief Model based intervention on promoting nutritional behaviors about preventive osteoporosis among the second grade middle school girl students. MATERIALS AND METHODS: This was an experimental intervention study, the research population being 130 students who were randomly divided into groups, experimental (66) and control (64). Before the educational program, Health Belief Model based standard questionnaire and Food Frequency Questionnaire (FFQ) questionnaire were filled up by both the groups. The standard questionnaire was completed three times (before, immediately, and 2 months after education) and FFQ questionnaire was completed two times (before and 2 months after education) by the students. After pre-test, four educational session classes in the experimental group were performed. Finally, data collected were analyzed by SPSS 18 computer software. RESULTS: The result of this study showed a significant increase in the mean score of knowledge, perceived susceptibility, seriousness, benefits, barriers, as well as taking health action among girl students in the experimental group. CONCLUSION: The findings of the present study confirmed the practicability and effectiveness of the Health Belief Model based educational program in promoting nutritional behaviors about prevention of osteoporosis.

Predictive indicators of the safety of swimming pool waters.

Many outbreaks related to swimming pools could have been prevented or reduced if the pool had been well managed and effectively monitored. The aim of this study was to evaluate physicochemical and microbial parameters that can be proposed as an indicator for the safety of swimming pools. A total of 234 water samples, over a 10-month period in 2006-2007, were collected from indoor swimming pools in Isfahan. All water samples were analyzed for physicochemical and microbial parameters including temperature, pH, turbidity, conductivity, free chlorine, heterotrophic plate count (HPC), total (TC) and fecal coliforms (FC), fecal streptococci (FS) Staphylococcus aureus (Sa) and Pseudomonas aeruginosa (Pa). The highest isolation of microbial indicators was for total coliforms (38%) and the lowest for fecal streptococci (3%). The correlation analyses indicated that free chlorine concentration had a significant negative relationship with the heterotrophic bacteria population and total coliforms. Total coliforms presented a significant correlation with the other microbiological indicators. The results clearly showed that the hygienic quality of the swimming pools was dependent on the efficacy of disinfection. Thus, the free chlorine and pH were good operational indices for the quality control of swimming pools and must be maintained in the recommended range to ensure optimal disinfection. The results also showed that TC and HPC were reliable and practical indicators for routine quality surveillance and assessment of the efficiency of the disinfection process and safety of swimming pools.

Conjugal multiple sclerosis in Isfahan, Iran: a population-based study.

Conjugal multiple sclerosis (MS) is a rare form of MS in which both spouses are affected, and at least one is affected after marriage. Among 1606 definite MS patients, 1076 were in marital relationship, among whom we identified six conjugal pairs, giving the conjugal rate of 0.5%. This rate is 12.5 times higher than the estimated risk of MS for the general population (0.04%). The observed conjugal rate suggests an increased risk of developing MS for MS patients' spouses, this could be due to transmission or, more likely, to the same environmental factors shared in adult life.

Floristic study of Ghasemloo (Shohada) Valley Forest reserve and adjacent area.

In this survey flora of protected region of Ghasemloo valley Forest reserve and adjacent areas has been studied. The study area includes about 577 ha and is located at south of Urmia. The method which used for plant collection is the same as regional floristic studies. Collected plants were recognized and determined as families, genera and species by using of indispensable references. Alphabetical list of taxa in this region was provided on the base of families, genera and species. The life form of plant species was determined by using of Raunckier's method and chorotype of plant species was determined by indispensable references. In this research 50 family, 165 genera and 204 species were identified. The largest plant family is Compositae with 21 genera and 26 species and the largest genera is Astragalus from Papilionaceae family with 6 species. The main biological forms respectively are: Therophytes and hemichryptophytes. The most extended chorotype with 61.28% is related to Irano-Turanian.

Ecological study in forest reserve of Ghasemloo (Shohada) valley and it's adjacent areas, Urmia-Iran.

Forest reserve of Ghasemloo valley (Shohada) and it's adjacent areas with 577 hectare surface area has located in south of Urmia and is known as an important natural plant station of Urmia. It is studied with respect the important factors which influencing vegetation cover in whole, particularly, with refer to composition and Formation of plant communities. To study the area, Brown-Blanquet's method was used. Plant samples were collected from 77 sample plots. The study resulted in recognition of four herbaceous types and seven shrub communities in study area. In addition, the investigation led to the fact that the most important factors which influencing the vegetation cover, are: geographical orientation, altitude, gradient and soil texture. More over, the study also resulted to preparation ofa colour vegetation map with 1/20000 scale.

1H, 13C, NH, HH, CH COSY, HH NOESY NMR and UV-vis studies of Solophenyl red 3BL dye azo-hydrazone tautomerism in various solvents.

Azo-hydrazone tautomeric behavior of polyazo Solophenyl red 3BL (C.I. Direct 80) dye in different solvents (water, methanol and DMSO) was investigated using 1H, 13C, NH, HH, CH COSY, HH NOESY NMR techniques and UV-vis spectroscopy. Two-dimensional NMR experiments were used to assign 1H, 13C and 15N NMR lines unambiguously. Results showed that the hydrazone-form proton NMR signal appeared in the weakest field with respect to tetramethylsilane, in comparison with the amide and phenolic proton NMR signals. UV-vis absorption spectroscopic evidences showed that azo-hydrazone mixture exists in water and DMSO solvents, but in methanol, only azo tautomer was dominant, which was in a good agreement with NMR spectroscopic results.

A survey on the extent of medication storage and wastage in urban Iranian households.

BACKGROUND: Prescription and nonprescription medications constitute a substantial proportion of the health care costs of countries. National drug policies and attitudes toward medication use may play a role in irrational prescribing and consumption of medicines, leading to drug wastage. The limited resources of developing countries warrant more careful assessments of current national drug policies. OBJECTIVE: This study quantified the amounts and types of medications that are stored in a sample of urban Iranian households and estimated the extent of drug wastage in these families. METHODS: A literature search was conducted using MEDLINE and International Pharmaceutical Abstracts for 1966 to 2004 to identify articles on drug utilization and wastage. Randomly selected households in a large city in Iran were visited to determine the amounts and types of medicines stored in these households. A questionnaire was used to collect information about medication use in these families. RESULTS: A total of 512 households were assessed. The mean (SD) family size of household respondents was 4.3 (1.6) members. Mothers were responsible for managing medications in 58.1% (291/501) of families. Presence of chronic illness, insurance coverage, higher economic status, literacy among fathers, and siblings without medically related jobs were the variables that showed a significant relationship with the amount of medicines found in the households. The mean (SD) numbers of unit doses of medicines and of drug products found in these households were 238.5 (198.6) and 22.99 (20.1), respectively. The most common therapeutic classes of medications kept at home were central nervous system agents, anti-infectives, and gastrointestinal medications. The real and potential medication wastage was estimated to be 38.8% and 53.8%, respectively. CONCLUSIONS: Medications were stored in large quantities in these urban Iranian households, and a large percentage was being wasted. Drug-use assessments and a comprehensive evaluation of the current national drug policies are warranted to curtail this problem.

Psychological problems in Turkish asthmatic children and their families.

BACKGROUND: Asthma is a chronic respiratory disorder characterized by recurrent episodes of impaired breathing. The disease causes psychological problems due to hospitalization, long-term medication use, and restricted social life. OBJECTIVE: The aim of this study was to investigate the relationship between the severity and duration of asthma and psychological problems in asthmatic children, as well as the probability of maternal anxiety. METHODS: Thirty-seven children with mild asthma, 55 with moderate asthma and eight with severe asthma were compared with 50 healthy children. The severity of asthma was evaluated using the Pearlman-Bierman classification. Psychological adjustment was measured using the Achenback child Behavior checklist and Spielberger's scale. RESULTS: Emotional factors and family dynamics were found to be triggering factors for disease attacks in 16% of children with mild asthma, 38% of those with moderate asthma and 63% of those with severe asthma (p < 0.05). There was no significant difference in the mean maternal anxiety score between the disease severity groups (p > 0.05). The mean depression score was significantly higher in children with moderate and severe asthma than in those with mild asthma (p < 0.05). Disease duration showed no effect on depression and anxiety. CONCLUSION: Both asthmatic children and their mothers are negatively affected by the disease.

Psychological problems in turkish asthmatic children and their families

Background: Asthma is a chronic respiratory disorder characterized by recurrent episodes of impaired breathing. The disease causes psychological problems due to hospitalization, long-term medication use, and restricted social life. Objective: The aim of this study was to investigate the relationship between the severity and duration of asthma and psychological problems in asthmatic children, as well as the probability of maternal anxiety. Methods: Thirty-seven children with mild asthma, 55 with moderate asthma and eight with severe asthma were compered with 50 healthy children. The severity of asthma was evaluated using the Pearlman-Bierman classification. Psychological adjustment was measured using the Achenback child Behavior checklist and Spielberger's scale. Results: Emotional factors and family dynamics were found to be triggering factors for disease attacks in 16 % of children with mild asthma, 38 % of those with moderate asthma and 63 % of those with severe asthma (p < 0.05). There was no significant difference in the mean maternal anxiety score between the disease severity groups (p > 0.05). The mean depression score was significantly higher in children with moderate and severe asthma than in those with mild asthma (p < 0.05). Disease duration showed no effect on depression and anxiety. Conclusion: Both asthmatic children and their mothers are negatively affected by the disease (AU)

Antecedentes: El asma es un trastorno respiratorio crónico caracterizado por episodios recurrentes de dificultad para respirar. La enfermedad causa algunos problemas psicológicos por la necesidad de hospitalización, el uso de medicación a largo plazo y la limitación de la vida social. Objetivo: El objetivo de este estudio era investigar la relación entre la gravedad y la duración del asma y los problemas psicológicos en niños asmáticos y la probabilidad de ansiedad de las madres. Métodos: Se comparó a 37 niños con asma leve, 55 con asma moderada y 8 con asma grave con 50 niños sanos. La gravedad del asma se evaluó utilizando la clasificación de Pearlman-Bierman. La adaptación psicológica se midió empleando la lista de comprobación de comportamiento infantil de Achenback y la escala de Spielberger. Resultados: Se comprobó que los factores emocionales y la dinámica familiar eran factores desencadenantes de las crisis de asma en el 16 por ciento de los pacientes con asma leve, el 38 por ciento de los enfermos con asma moderada y el 63 por ciento de los pacientes con asma grave (p 0,05).En los grupos con asma moderada y grave se observó que la puntuación media de depresión era significativamente mayor que en el grupo con asma leve (p < 0,05). Se apreció que la duración de la enfermedad no influía en la depresión y la ansiedad. Conclusión: La enfermedad afecta negativamente a los niños asmáticos y a las madres (AU)

Local and systemic reactions during immunotherapy with adsorbed extracts of house dust mite in children.

BACKGROUND: We retrospectively evaluated the incidence of local and systemic reactions to injections of adsorbed extracts of house dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae) applied according to a conventional schedule in children. METHOD: Eighty-eight patients aged 6 to 15 years, suffering from allergic asthma or asthma together with rhinitis, at various stages of treatment with immunotherapy from January 1989 to November 1997 were included. RESULTS: Out of 5,760 injections, 5,542 (96.21%) were not associated with a reaction, 206 injections (3.57%) caused local reactions (144, <20 mm in diameter; 62, >20 mm), and systemic reactions were seen after 12 injections (0.2%). Twelve patients experienced 12 systemic reactions. Of these, 7 patients (58.3%) experienced no local reactions prior to a systemic reaction. Eleven males and one female had systemic reactions. Most of both local and systemic reactions occurred within less than 30 minutes after the injection. CONCLUSIONS: Our study supports the safety of immunotherapy with house dust mites in children. The majority of reactions were local. Although five of 12 patients who experienced systemic reactions had local reactions prior to a systemic reaction, in general the presence of local reactions was not helpful in predicting which patients would develop systemic reactions. Males and patients with asthma together with rhinitis appeared to be at greater risk for systemic reactions.

Prevalence of bronchial asthma and allergic rhinitis in Istanbul school children.

The aim of this study was to determine the prevalence of asthma, allergic rhinitis and their related symptoms in Istanbul and to investigate the effect of socioeconomic status on the prevalence of asthma and allergic rhinitis and whether there are differences between the prevalence of childhood asthma in the same and different regions as found in previous studies and our own. The study period was the 1996-1997 school year in three primary schools in Istanbul. For proportional representation of high, middle, and low socioeconomic levels, the schools were selected from three different regions of Istanbul. A translated version of the International Study of Asthma and Allergies in Childhood (ISAAC) was used. The questionnaire was distributed to the parents of 2600 students aged 6-15 years. All of the 2276 children whose parents responded were included in the survey. The overall cumulative and current prevalences of wheezing were 13.7 and 7.2% respectively and the overall cumulative prevalence of allergic rhinitis was 17.6%. There was no statistically significant difference between asthmatics and non-asthmatics by sex, socioeconomic status and passive smoking. Family history of atopy was found to be significantly higher in asthmatics. Although there are differences in the results of studies concerning the prevalence of asthma and allergic rhinitis not only between different countries but also between different regions of the same city, by using a standardized international method, the actual values may be obtained.

Latex allergy: the incidence among Turkish children with atopic disease and with neural tube defects.

BACKGROUND: latex allergy occurs mainly in people exposed to latex products because of their occupation or because of repeated surgery. Atopy is a strong predisposing factor. Identification of latex sensitive individuals can be life saving. METHODS: to investigate the incidence of latex hypersensitivity, 212 children with atopic disease, 85 with neural tube defects and 200 normal children aged 2 to 14 years were interviewed and prick skin tests were performed. RESULTS: latex allergy was found in 10.8% of atopic children, 30.5% of children with neural tube defects, and 1% of normal children. Latex allergy incidence in operated children with neural tube defects was found 3.5 times more frequently in compare with non-operated patients. CONCLUSIONS: atopic children and children with neural tube defects should carefully be followed up for latex allergy specially if recurring itching, urticaria, eczema, rhinitis and eye symptoms are present.

The effects of long-term anticonvulsive treatment on serum lipid profile.

Serum lipids were determined in 10 untreated patients with recently diagnosed epilepsy, 21 patients treated with carbamazepine (CBZ), 10 patients treated with valproate (VPA) and in 15 healthy children. In relation to the controls, patients receiving CBZ showed increased serum high-density lipoprotein cholesterol (HDLc), apolipoprotein A (Apo-A) and apolipoprotein B (Apo-B). Patients receiving VPA showed increased Apo-B levels. There were no significant differences in total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDLc) or very low-density lipoprotein cholesterol (VLDLc) between all groups. The changes in lipid metabolism may be associated with the induction of liver enzymes during anti-epileptic drug metabolism. The CBZ-induced change in serum lipid levels was considered to be a possible factor against atherosclerosis and coronary heart disease in epileptic patients.

Rupture of the uterus.

Sixty-four cases of rupture of the uterus were managed from March 1967 to March 1977. The maternal morbidity was 81.0%, and there were six maternal deaths (9.4%). Fifty-two patients (85.5%) had hysterectomies. The average hospital stay for patients who survived was 15.5 days. The fetal mortality rate was 89%. The etiology, diagnostic evaluation and the mode of prevention are discussed.