Comparison of clinicodemographic characteristics and pattern of vascular involvement in 126 patients with Takayasu arteritis: a report from Iran and Turkey.

Takayasu arteritis (TA) is an extremely uncommon vasculitis that primarily affects the aorta and its branches. Due to the genetic and ethnicity effect, a diverse array of TA clinical manifestations has been reported worldwide. The purpose of the present study was to compare the clinicodemographic characteristics and pattern of vascular involvement of Iranian and Turkish TA patients. This study was a retrospective, cross-sectional investigation of 126 TA patients in Iran and Turkey. All of the variables analyzed were extracted from historical medical records. In 126 TA patients, the ratio of females to males was 8.6:1, and the average age at onset of disease was 30.5±11.1 years. Fatigue (49.2%) and a weak or absent pulse (79.4%) were the most prevalent symptoms and signs, respectively. The most prevalent angiographic classifications were types V and I in Iranian patients (41.09%) and type I in the Turkish population (47.7%) The left subclavian artery was the vessel most frequently affected by TA (66.6%). Our findings indicated that there were no significant differences between the two countries in terms of clinicodemographic characteristics or vascular involvement. Some clinical manifestations, such as claudication, were more prevalent in the Turkish population due to a higher incidence of occlusive lesions in the right subclavian artery.

Effects of free and nano-encapsulated bovine lactoferrin on the viability and acid production by Streptococcus mutans biofilms.

Tooth decay is one of the most common diseases that humans face during their lifetime. Streptococcus mutans is one of the most critical factors of early tooth decay. These bacteria may produce biofilms in the mouth, which are more resistant to antimicrobial agents. Streptococcus mutans may also demineralize tooth enamel by producing lactic acid. In this study, the effect of nanoliposomes containing lactoferrin at three different concentrations (1·5, 3 and 6 mg ml-1 ) on the biofilm formed by S. mutans was investigated. Nanoliposomes were prepared using the thin-layer hydration method. An active attachment model was used to evaluate biofilm and lactic acid production. The results showed that nano-encapsulated lactoferrin could reduce CFU of biofilm more effectively than free lactoferrin. Lactoferrin-containing nanoliposomes also significantly reduced lactic acid production by S. mutans. Therefore, nano-encapsulated lactoferrin may be used along with other dental caries control methods to increase anti-caries efficacy.

Diversity and species composition of mosquitoes (Culicidae: Diptera) in Noor County, northern Iran.

Mosquitoes are highly important as public health problem due to their blood sucking habits and transmitting malaria, arboviruses and other diseases to humans. The present research was undertaken to determine the fauna, abundance, monthly distribution and activity of Culicidae mosquito larvae and adults in Noor County, northern Iran. This cross-sectional, descriptive study was conducted from August 2012 to November 2013 in the rural and urban outskirts of Noor. In each area, natural larval breeding places such as river beds, shallow wells, pits, sewer, marsh, small holes, tracks of animals as well as man-made breeding places like pools and rice paddy fields have been visited monthly for larval collection. To collect adult mosquitoes, human and animal dwellings including bedrooms, store rooms, toilets, barns, stables and pen were surveyed using WHO standard methods. A total of 844 larvae and 1484 adult mosquitoes were caught. Of the 665 Culicinae larvae, 501 were Cx. pipiens (75.3%), 108 Cx. mimeticus (16.2%) and 56 Cx. theileri (8.4%). Of the 179 Anophelinae larvae, 96 were An. hyrcanus (53.6%) and 83 An. maculipennis s.l. (46.4%). Among 889 adult Culicinae, 495 were Cx. pipiens (55.7%), 238 Cx. mimeticus (26.8%), 156 Cx. theileri (17.6%), and from 595 adult Anophelinae 371 were An. hyrcanus (62.4%) and 224 An. maculipennis (37.7%). Anopheles hyrcanus with 96 larvae (53.6%) and 371 adults (62.4%) and Cx. pipiens with 501 larvae (75.3%) and 495 adults (55.7%) showed the highest abundance and distribution in the county calling for more studies on their population, ecology, behavior and probable roles as vectors of various diseases.

Empirical evaluation of the Q-Genie tool: a protocol for assessment of effectiveness.

INTRODUCTION: Meta-analyses of genetic association studies are affected by biases and quality shortcomings of the individual studies. We previously developed and validated a risk of bias tool for use in systematic reviews of genetic association studies. The present study describes a larger empirical evaluation of the Q-Genie tool. METHODS AND ANALYSIS: MEDLINE, Embase, Global Health and the Human Genome Epidemiology Network will be searched for published meta-analyses of genetic association studies. Twelve reviewers in pairs will apply the Q-Genie tool to all studies in included meta-analyses. The Q-Genie will then be evaluated on its ability to (i) increase precision after exclusion of low quality studies, (ii) decrease heterogeneity after exclusion of low quality studies and (iii) good agreement with experts on quality rating by Q-Genie. A qualitative assessment of the tool will also be conducted using structured questionnaires. DISCUSSION: This systematic review will quantitatively and qualitatively assess the Q-Genie's ability to identify poor quality genetic association studies. This information will inform the selection of studies for inclusion in meta-analyses, conduct sensitivity analyses and perform metaregression. Results of this study will strengthen our confidence in estimates of the effect of a gene on an outcome from meta-analyses, ultimately bringing us closer to deliver on the promise of personalised medicine. ETHICS AND DISSEMINATION: An updated Q-Genie tool will be made available from the Population Genomics Program website and the results will be submitted for a peer-reviewed publication.

Knowledge and Attitude of Iranian Physicians towards Organ and Tissue Donation.

BACKGROUND: Nowadays, organ transplantation is the treatment of choice for end-stage organ failure, which increases the importance of organ procurement. It seems that the attitude towards organ donation and transplantation affects people's satisfaction. Moreover, health care personnel, especially physicians, should be familiar with transplantation rules and standards. It seems that understanding the knowledge and attitude of this group can affect the transplantation center policies. OBJECTIVE: To assess knowledge and attitude of a group of Iranian physicians towards organ and tissue donation. METHODS: In a cross-sectional study, 560 Iranian physicians including nephrologists, urologists and internists were asked to fill out a validated questionnaire containing their demographics, knowledge and attitude towards organ and tissue donation and transplantation. RESULTS: Of 560 participants, 435 (78%) agreed with organ donation after death and 285 (51%) agreed with living kidney donation. The most common reason provided by those who agreed with donation was "helping people" whereas the most common cause of disagreement was "to honor the body." Only 32 (6%) physicians had no knowledge about transplantation rules. Complete awareness about theoretical basis and financial issues of transplantation was observed in 265 (47%) and 221 (40%) participants, respectively. CONCLUSION: Physicians had a good attitude towards organ and tissue transplantation although less than half of them had knowledge of transplantation rules and its theoretical basis and financial issues; therefore, additional awareness and education of physicians is needed in all areas of the organ donation process in Iran.

Male erectile dysfunction following spinal cord injury: a systematic review.

STUDY DESIGN: Systematic review. OBJECTIVE: To review sexuality in persons with spinal cord injuries (SCIs), and to report the effectiveness of erectile interventions. METHODS: Reports from six databases (1966-2003), selected annual proceedings (1997-2002) and manufacturer's information were screened against eligibility criteria. Included reports were abstracted and data pooled from case-series reports regarding intracavernous injections and sildenafil. RESULTS: From 2127 unique reports evaluated, 49 were included. Male sexual dysfunction was addressed in these reports of several interventions (behavioural therapy, topical agents, intraurethral alprosatadil, intracavernous injections, vacuum tumescence devices, penile implants, sacral stimulators and oral medication). Penile injections resulted in successful erectile function in 90% (95% CI: 83%, 97%) of men. Sildenafil resulted in 79% (95% CI: 68%, 90%) success; the difference in efficacy was not statistically significant. Five case-series reports involving 363 participants with penile implants demonstrated a high satisfaction rate, but a 10% complication rate. CONCLUSIONS: A large body of evidence addressing sexuality in males focuses on erection. Penile injection, sildenafil and vacuum devices generally obviate the need for penile implants to address erectile dysfunction. Interventions may positively affect sexual activity in the short term. Long-term sexual adjustment and holistic approaches beyond erections remain to be studied. Rigorous study design and reporting, using common outcome measures, will facilitate higher quality research. This will positively impact patient care. SPONSORSHIP: Agency for Healthcare Research and Quality, US Department of Health and Human Services, 2101 East Jefferson Street, Rockville, MD 20852, USA.

Fertility following spinal cord injury: a systematic review.

STUDY DESIGN: Systematic review. OBJECTIVES: To review systematically fertility of persons with spinal cord injuries (SCI) and their partners. METHODS: Reports from six databases (1966-2003), selected annual proceedings (1997-2002) and manufacturer's information were screened against eligibility criteria. Searches covered female obstetrical issues, and the efficacy of vibration and electroejaculation for males, as well as advanced fertility (AF) treatments for partners of SCI males. Data were pooled from case-series reports on SCI males' ejaculation, and pregnancies and live births for partners of SCI males. RESULTS: In all, 2,127 unique reports were evaluated, of which 66 reports were included. No studies investigated fertility in SCI females. Ejaculation interventions in the last decade resulted in response rates of 95% (95% confidence intervals (CI) 91%, 99%), with 100% response rate reported in several recent publications. A total of 13 studies (1993-2001) yielded pregnancy rates of 51% (95% CI 42%, 60%) in partners of SCI males. Of these, 11 studies (1993-2003) yielded live birth rates of 41% (95% CI 33%, 49%). CONCLUSIONS: Fertility of SCI males is extensively studied. Semen for fertility purposes can generally be obtained using vibration and electroejaculation. AF techniques are increasing pregnancy rates. Research is needed to improve sperm quality. Freezing of sperm is unlikely to significantly improve fertility rates. Fertility of SCI females is addressed only in case reports and opinion articles. The opinion that female fertility is unaffected by SCI should be further investigated using appropriate research methodology.