Comparison of gut microbiota profiles between patients suffering from elderly frailty syndrome and non-frail elderly individuals.

BACKGROUND: Frailty syndrome is a state of increased vulnerability to stressors, marked by lowered physical strength and increased dependence on others. The well-established changes in gut microbiota associated with old age suggest a probable relationship between gut microbiota and frailty. METHODS AND RESULTS: This study was aimed at finding the relationship between gut microbiota and frailty syndrome, by comparing the sociodemographic data and the gut microbiota profiles of 23 non-frail and 14 frail elderly individuals. We used the quantitative polymerase chain reaction method (qPCR) to determine the bacterial loads of Bifidobacteria, Lactobacillus, Bacteroidetes, Prevotella, and Escherichia coli in stool samples from test subjects. We discovered a significant increase in the bacterial load of Prevotella in frail elderly individuals aged 70 or above. Other bacterial loads and ratios were not significantly different between the two groups. CONCLUSIONS: More comprehensive studies with larger sample sizes and encompassing a wider range of inflammation-related bacteria need to be performed to discover the existence and exact nature of these relations.

The potential role of protein disulfide isomerases (PDIs) during parasitic infections: a focus on Leishmania spp.

Leishmaniasis is a group of vector-borne diseases caused by intracellular protozoan parasites belonging to the genus Leishmania. Leishmania parasites can employ different and numerous sophisticated strategies, including modulating host proteins, cell signaling, and cell responses by parasite proteins, to change the infected host conditions to favor the parasite persistence and induce pathogenesis. In this sense, protein disulfide isomerases (PDIs) have been described as crucial proteins that can be modulated during leishmaniasis and affect the pathogenesis process. The effect of modulated PDIs can be investigated in both aspects, parasite PDIs and infected host cell PDIs, during infection. The information concerning PDIs is not sufficient in parasitology; however, this study aimed to provide data regarding the biological functions of such crucial proteins in parasites with a focus on Leishmania spp. and their relevant effects on the pathogenesis process. Although there are no clinical trial vaccines and therapeutic approaches, highlighting this information might be fruitful for the development of novel strategies based on PDIs for the management of parasitic diseases, especially leishmaniasis.

Association of Interleukin-17A rs2275913 Polymorphism with Recurrent Miscarriage: A Systematic Review and Meta-Analysis Study.

Recurrent miscarriage (RM) is a condition defined as having three or more consecutive pregnancy losses before the 20 weeks of pregnancy. The present study was undertaken to investigate association of Interleukin-17A (IL-17A) rs2275913 polymorphism with RM. To this end, we searched the international databases (Web of Science, PubMed, Embase, and Scopus) and extracted studies investigating the association of IL-17A rs2275913 polymorphism with RM using the appropriate keywords. The collected data were analyzed with the random-effects model and STATA (version 14). A total of five studies met the eligibility criteria, and total sample size was 998 subjects. Mean age of the cases and controls were 31.41 ± 4.16 and 30.56 ± 3.5 years, respectively. Our results disclosed a significant relationship of the IL-17A rs2275913 AA genotype [odds ratio (OR)=1.68; 95% confidence interval (CI)=1.16- 2.43; I2=19; P=0.294) with RM. There was no statistically significant correlation between IL-17Ars2275913 GG genotype (OR=1.04; 95% CI=0.64-1.7; I2=59.5; P=0.042) and GA genotype (OR=0.85; 95% CI=0.65-1.12; I2=19.1; P=0.293) with RM. Our findings revealed that the IL-17A rs2275913 polymorphism is associated with RM, and the AA genotype of this polymorphism increased possibility of being involved in RM.

Comparison of the outcomes of normal vaginal delivery with and without spinal anesthesia in mothers admitted to the maternity ward of Firoozabadi Hospital.

Introduction and Objective: The study of the methods of controlling labor pain is very important. One of the methods of pain relief is spinal anesthesia. Due to the different opinions about the effects of spinal anesthesia on the delivery process and maternal and fetal consequences, this study aimed to evaluate the effects of spinal anesthesia and compare it with normal vaginal delivery without spinal anesthesia. Methods: In this retrospective cohort study, 120 mothers, who were admitted to the maternity ward of Firoozabadi Hospital for delivery, were examined. The patients who met the inclusion criteria were divided into two groups of 60 people, one group receiving spinal anesthesia and one without spinal anesthesia, and then, were evaluated in terms of clinical variables and complications of the mother and fetus. Data were analyzed using SPSS statistical software. Results: The mean age of the mothers was 26.6 ± 5.9 years. Five mothers (4.2%) who received spinal anesthesia underwent emergency cesarean section and a significant difference was shown between the two groups (P = 0.02). The mean duration of the active phase of labor did not show a statistically significant difference between the two groups (P = 0.2), but the duration of the second phase of labor was significantly longer in the mothers who received spinal anesthesia (P = 0.008). Conclusion: Spinal anesthesia can be used as a low-complication method in vaginal delivery to reduce pain.

Geriatric Syndromes among Patients with Rheumatoid Arthritis: A Comparison between Young and Elderly Patients.

Background: In the general geriatric population, Geriatric syndromes (GSs) predict greater likelihood of hospitalization, increased health care use and cost. The present study aimed to compare GSs among young and elderly patients with rheumatoid arthritis (RA). Methods: In a cross-sectional study a total of 98 participants, including 65 elderly (≥60 years) and 33 young adult patients (<60 years) with RA who referred to the geriatric and rheumatologic clinic were enrolled. Patients were categorized into three groups (healthy elderly, n=27; elderly with RA, n=38; and young people with RA, n=33). GSs were assessed using mini-mental state exam (MMSE), five-item geriatric depression scale-15 (GDS-15), mini nutritional assessment (MNA), and asking patients about history of falls in the past year. The RA activity in patients was assessed using disease activity for rheumatoid arthritis score-28 (DAS-28) scale, serum ESR (mm/h) level. Results: There was a statistically significant differences in terms of DAS-28 (2.23±1.01 vs. 0.64±0.97, P=0.025) and ESR (28.10±6.64 vs. 23.09±7.65 mm/h, P=0.042) between healthy elderly and RA elderly patients. Elderly patients with RA were significantly more prone to have cognitive impairment (P=0.002), fall (P=0.005), malnutrition (P<0.001), urinary incontinence (P<0.001), and functional disability (P=0.021) compared to healthy elderlies and young RA patients. The results of binary logistic regression revealed that in elderly RA patients, higher DAS-28 score [odds ratio (OR) = 1.96; 95% CI 1.03, 3.84; P=0.041] was an independent risk factors for the GSs. Conclusion: The prevalence of some features of GSs were higher in the elderly RA patients than healthy elderly and young RA patients.

The impact of socially accountable health professional education: Systematic review.

Medical education is socially responsible for a global educational movement that transforms the development and presentation of medical schools in higher education. Therefore, in the present systematic review, we aimed to evaluate the impact of socially accountable health professional education. Published research articles were reviewed by searching the relevant terms invalid databases. In the initial search, 2340 records were obtained. At this stage, 1482 records were deleted due to duplication, and 773 records were removed due to indirect connection with the subject. Then, 85 articles were retrieved for full-text review. Finally, the complete review led to the selection of nine studies that met all inclusion criteria. Based on the results of the present systematic review, among the nine reviewed articles, four studies (44.44%) evaluated the effectiveness of social accountability on increasing the sense of empowerment, self-confidence, competencies such as teamwork, communication skills, and readiness for work. Three studies (33.333%) assessed the effectiveness of social accountability on providing further and better medical services and reducing infant mortality. Also, in two articles (22.22%), students' lack of knowledge about social accountability was studied. Social accountability can help cultivate a healthy and skilled medical workforce and be effective in improving health services provided to the people. On the other hand, there are different perceptions and views on what social responsibility really is and how its effectiveness can be measured. Also, it is highly important to provide awareness in this regard for students.

The effects of helicobacter pylori eradication on modification of metabolic syndrome parameters in patients with functional dyspepsia.

BACKGROUND: Helicobactor pylori (H. pylori) have the potential role in the pathogenesis of various extra-gastric disorders such as metabolic disorders. But, it is now questioned about whether H. pylori eradication reduces or induces the risk for metabolic disorders especially in patients with dyspepsia. Hence, the present study aimed to assess the effects of H. pylori eradication on criteria of metabolic syndrome. METHODS: H. pylori infected patients with dyspepsia were included. The patients were treated with omeprazole (20mg, q12h), amoxicillin (1g, q12h), and clarithromycin (500mg, q12h) for two weeks, then H. pylori eradication was evaluated by C14 Breathing test (UBT) 6 weeks after the end of the treatment. Demographic data, clinical manifestation and metabolic parameters were recorded before and three months after completing treatment regimen. The data was analyzed by SPSS version 16.0. RESULTS: Of 110 patients were initially enrolled, 91 patients completed the study. Overall eradication rate was 61.5%. Significant differences in the serum level of total cholesterol(180.7±34 vs. 172.1±28, p=0.001), LDL(107.0±25 vs. 100.8±20, p<0.001), HDL(46.2±8.7 vs. 48.9±8.6, p<0.001), fasting blood sugar (93.7±12 vs. 90.9±10, p=0.001), hemoglobin A1c(5.37±0.52 vs 5.25±0.53, p=0.006), and as well as for waist circumference(92.2±14 vs. 91.4±13.9, p=0.03) was found after treatment. Data for body weight, systolic and diastolic blood pressure and triglyceride level remained without any significant changes. CONCLUSION: H. pylori eradication could relatively reduce the risk of metabolic syndrome criteria such as fasting blood sugar, hemoglobin A1c, lipid profile and waist circumference.