Bajos niveles de inhibidores de la coagulación: un factor de alto riesgo trombogénico en pacientes talasémicos / Low levels of coagulation inhibitors: a high-risk thrombotic factor in thalassemic patients

ANTECEDENTES Y OBJETIVO: La β-talasemia mayor (β-TM) se define como una enfermedad hereditaria relacionada con las células rojas sanguíneas. En los pacientes adultos, los eventos trombóticos se asocian con la talasemia. Así, el objetivo de esta investigación fue examinar algunos de los parámetros hemostáticos, incluyendo la antitrombina III (AT-III), la proteína C (PRC) y la proteína S (PRS), en pacientes β-TM. MÉTODOS: Se seleccionó a 30pacientes β-TM remitidos para un ingreso de seguimiento de rutina en la clínica de talasemia del Centro Especial de Enfermedades Kerman, junto con otros 30 sujetos sanos. Tras el registro y 3 semanas después de la última transfusión, se recogieron especímenes de sangre periférica, y se midió la concentración plasmática de AT-III, PRC y PRS. RESULTADOS: Hemos observado que la concentración de inhibidores naturales de la coagulación (PRC y PRS) estaba ligeramente disminuida en los pacientes β-TM (p < 0,05), mientras que el nivel plasmático de AT-III no era muy diferente en los pacientes β-TM cuando se los comparaba con los sujetos sanos. CONCLUSIÓN: Conforme a los hallazgos obtenidos en el presente trabajo, podríamos considerar los cambios significativos en las PRC, PRS y AT-III, que se observan en pacientes β-TM multitransfundidos, como factores de riesgo críticos para el desarrollo de eventos tromboembólicos futuros a lo largo de su vida

BACKGROUND AND AIM: The β-thalassemia major (β-TM) is defined as a hereditary red blood cell-related disease. Thrombotic events are associated with thalassemia in adult patients. Thus, the present investigation was aimed to examine some hemostatic parameters, including anti thrombin-III (AT-III), protein-C (PRC) and protein-S (PRS) in β-TM patients. METHODS: Thirty B-TM patients who referred for routine follow-up admission to the thalassemia clinic of Kerman Special Disease Center alongside with 30 healthy subjects were selected and enrolled in the present study. Further registration, the peripheral blood specimens were collected after 3 weeks of last transfusion and then the plasma concentrations of AT-III, PRC and PRS were measured in them. RESULTS: We have observed that the concentrations of natural coagulation inhibitors (PRC and PRS) were significantly attenuated in β-TM patients (P<0.05), while the plasma level of AT-III was not remarkably differed in β-TM patients in compare to healthy subjects. CONCLUSION: According to the findings of present work, significant changes in the PRC, PRS and AT-III which could be observed in multi transfused β-TM patients may attribute as critical risk factors for the development of upcoming thromboembolic events in their future life

Low levels of coagulation inhibitors: A high-risk thrombotic factor in thalassemic patients. / Bajos niveles de inhibidores de la coagulación: un factor de alto riesgo trombogénico en pacientes talasémicos.

BACKGROUND AND AIM: The ß-thalassemia major (ß-TM) is defined as a hereditary red blood cell-related disease. Thrombotic events are associated with thalassemia in adult patients. Thus, the present investigation was aimed to examine some hemostatic parameters, including anti thrombin-III (AT-III), protein-C (PRC) and protein-S (PRS) in ß-TM patients. METHODS: Thirty B-TM patients who referred for routine follow-up admission to the thalassemia clinic of Kerman Special Disease Center alongside with 30 healthy subjects were selected and enrolled in the present study. Further registration, the peripheral blood specimens were collected after 3 weeks of last transfusion and then the plasma concentrations of AT-III, PRC and PRS were measured in them. RESULTS: We have observed that the concentrations of natural coagulation inhibitors (PRC and PRS) were significantly attenuated in ß-TM patients (P<0.05), while the plasma level of AT-III was not remarkably differed in ß-TM patients in compare to healthy subjects. CONCLUSION: According to the findings of present work, significant changes in the PRC, PRS and AT-III which could be observed in multi transfused ß-TM patients may attribute as critical risk factors for the development of upcoming thromboembolic events in their future life.

Regulatory effects of the novel synthesized Indole-3-carbaldehyde on expression of cell cycle genes: A study on Cyclin D and P21 expression by acute promylocytic leukemia cell line (NB4)

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Coronary angiogenesis during morphine and nicotine withdrawal in two-kidney one clip hypertensive (2K1C) rats.

OBJECTIVE: This study was aimed to investigate the effects of addiction to nicotine and morphine and their withdrawal on coronary angiogenesis and serum NO concentrations in two-kidney one-clip hypertensive (2K1C) rats. METHODS: Male hypertensive rats were divided into the two below groups: Group (1): Rats received saline for 8 weeks (N=8); Group (2): Rats received morphine and nicotine for 8 weeks (n=32). At the end of 8 weeks, the groups (2) were divided into the four sub-groups, which three of them were treated with withdrawal drugs. Following treatments, blood pressure, heart rate, plasma renin activity (PRA), NO concentration and capillary density were measured. RESULTS: Results showed that blood pressure was significantly reduced in the addicted group when compared to non-addicted (p<0.05). The withdrawal completely reversed blood pressure to the level observed pre-addiction (p<0.05). Coronary angiogenesis was significantly lower in the addicted group in comparistion to normal (p<0.05) but withdrawal of addiction did not improve angiogenesis. CONCLUSION: On the basis of the present findings, it may be indicative that the risk of cardiovascular complications in addiction is concurrent to chronic hypertension, which shows the importance of early diagnosis and treatment in clinical condition (Fig. 4, Ref. 59).

Morphine and nicotine addiction and withdrawal influence baroreflex sensitivity and blood pressure in two-kidney one clip hypertensive (2K1C) rats.

OBJECTIVE: This study aimed to investigate the effects of addiction to morphine and nicotine as well as their withdrawal on both baroreflex sensitivity and blood pressure in hypertensive rats. METHODS: In this experimental study 40 male rats were divided into two main groups as follows: in group I, hypertensive rats received saline for 8 weeks; in group II, hypertensive rats were treated with morphine and nicotine for 8 weeks. At the end of 8 weeks group II rats were divided into four sub-groups including, 3 sub-groups of those were put on drug withdrawal protocol. At the end of experiment, blood pressure, heart rate, plasma renin activity (PRA), serum NO concentration and baroreflex sensitivity (BRS) were measured. RESULTS: RESULTS demonstrated that BP and BRS were significantly lower in addicted to morphine and nicotine hypertensive rats compared to control (p < 0.05). Addiction withdrawal (in morphine and nicotine withdrawal rats) completely reversed BP and BRS to the pre-addiction levels (p < 0.05). Withdrawal in the only nicotine treated group lowered BP and BRS compared to group that had received morphine and nicotine together (p < 0.05). CONCLUSION: RESULTS of current study may propose simultaneous morphine and nicotine withdrawal can prevent cardiovascular complications raised due to withdrawal (Fig. 5, Ref. 58).

Hepatitis B virus genotype, HBsAg mutations and co-infection with HCV in occult HBV infection.

BACKGROUND: The association between mutations in the hepatitis B surface antigen (HBsAg) gene and the occurrence of occult HBV (OBI) in patients has not been studied adequately to determine if the two are correlated. The current study was aimed to investigate HBsAg mutations, the genotype of HBV and co-infection with HCV in OBI in the central part of Iran to determine any possible associations. MATERIAL AND METHODS: In this study, 3700 plasma samples were examined for the presence of HBsAg, anti-HBc and HBV-DNA. All HBsAg(-)/anti-HBc(+)/HBV-DNA(+) samples were regarded as OBI. The genotype of HBV was identified using Gap-PCR and RT-PCR was used to determine possible co-infection with HCV. Finally, direct sequencing was performed to analyse mutations within the surface antigen gene of HBV in occult versus acute HBV infection. RESULTS: Of the 3700 patient samples analysed, 352 (9.5%) cases were determined to be HBsAg(-)/anti-HBc(+) in which HBV-DNA was detected in 57 (16.1%), these latter patients were classified as OBI. All of the patients studied carried the D genotype. Direct sequencing of the S-gene from occult and acute HBV patients revealed one silent and one glycine to arginine mutation but the acute HBV patients showed an additional mutation (alanine to threonine). All the mutations were outside the range of the α-determinant. Furthermore, none of the OBI patients were co-infected with HCV. CONCLUSIONS: The absence of conformational mutations in the α-determinant of HBsAg confirmed that this antigen could be detected by commercial Elisa kits and therefore was not responsible for false negatives during blood screening. However, it can be concluded that suitable amounts of HBsAg were not expressed by HBV in the OBI patients to be detected by Elisa. Low level expression of HBsAg might be related to the D genotype of the virus. Furthermore, our results suggest that OBI is not related to co-infection with HCV.

Nutritional status in a sample of the Afghan immigrant children within Iran.

Anthropometric studies in Afghan immigrants in Iran have not been yet performed; therefore the aim of the present study is to identify Body Mass Index (BMI) in a sample of Afghan immigrant children in Iran during the year 2005. In this cross-sectional study 606 Afghan children aged between 6-14 years have been randomly selected within Shahriar County of Tehran Province of Iran and their weight and height have been measured. Then, using BMI formula BMI = Weight (kg)/Height (m2) their BMI was calculated and based on CDC (Centers for Disease and Prevention Control) indices, children were categorized as: under weight, normal and obese. Results of this study showed that 97 cases (16%) had low weight whereas, 429 cases (81.2%) had normal weight and 17 cases (2.8%) had over weight. More percentage of girls had lower weight than the boys (15.2 versus 16.9%), Afghan children who were born in Iran had also lower weight (17.3%) than those who were born in Afghanistan (15.2%) and third and upper birth order children had lower weight compared to first and second birth order (17 versus 15.3%). However, none of these differences were statistically significant. The researchers suggest that due to high incidence of malnutrition in Afghan immigrant children in Iran interventional and educational programs are needed in order to improve their level of health and nutritional status.

Evaluation of IFN-gamma serum level in nephropatic type 2 diabetic patients.

The present study was aimed to examine the serum level of IFN-gamma in type 2 diabetic patients with nephropatic complications. In this experimental study, serum samples were obtained from 100 type 2 diabetic patients suffering from nephropathy and 100 healthy controls. Serum level of IFN-gamma was analyzed by ELISA. Results of this study showed that the mean serum level of IFN-gamma was 16.09 +/- 2.04 and 4.03 +/- 1.00 pg mL(-1) in nephropathic patients and healthy controls, respectively. Statistical analysis of data showed that the difference in the IFN-gamma serum level was significant between nephropathic patients and controls. Due to the elevated level of IFN-gamma in nephropathic patients, it can be possibly concluded that IFN-gamma is involved in nephropathy complication of type 2 diabetes.

Serum levels of high-sensitivity C-reactive protein (hs-CRP)in Helicobacter pylori-infected peptic ulcer patients and its association with bacterial CagA virulence factor.

OBJECTIVE: CRP is a marker of inflammation and infection of the gastric mucosa with Helicobacter pylori, which causes an inflammatory reaction. It has been reported that CagA(+) H. pylori strains induce more severe gastric inflammation and are also associated with higher risks of peptic ulcer and gastric cancer. The purpose of this study was to compare serum concentrations of hs-CRP in H. pylori-infected peptic ulcer (PU) patients, H. pylori infected asymptomatic (AS) carriers, and a healthy control group, and their association with bacterial virulence factor CagA. MATERIAL AND METHODS: A total of 60 H. pylori infected PU patients (30 patients were positive for anti-CagA antibody and 30 were negative for anti-CagA antibody), 53 H. pylori-infected AS carriers (25 subjects were positive for anti-CagA antibody and 28 were negative for anti-CagA antibody), and 22 healthy H. pylori-negative subjects (as a control group) were enrolled in the study. Serum concentrations of hs-CRP were measured by use of an ELISA method. RESULTS: The mean serum level of hs-CRP in all PU patients (124.9±32.4 µg/dl) was significantly higher than that in all AS subjects (18.6±2.6 µg/dl; P<0.001) and the healthy uninfected control group (10.7±2.9 µg/dl; P<0.0001). Moreover, the mean serum level of hs-CRP in the AS group was significantly higher than that observed in the uninfected control group (P<0.04). No significant difference was observed between mean serum levels of hs-CRP of PU patients with positive test for anti-CagA antibody (132.6±49.4 µg/dl) and PU patients with negative test for anti-CagA antibody (117.1±42.9 µg/dl). Moreover, mean serum levels of hs-CRP were similar in AS subjects with positive test for anti-CagA (18.4±3.1 µg/dl) and in those who were negative for anti-CagA antibody (18.9±4.1 µg/dl). CONCLUSION: The results of this study showed that mean serum concentrations of hs-CRP in PU patients and in H. pylori infected AS carriers were higher than in a healthy control group. Although H. pylori infection is associated with higher serum levels of hs-CRP, serum concentrations of this inflammatory marker were not affected by expression of bacterial CagA virulence factor.