Association of interleukin-17 gene polymorphisms and susceptibility to brucellosis in Hamadan, western Iran.

IL-17is one of the most important inflammatory cytokines that stimulate immunity responses in humans infected with Brucella species, acting as a regulator that reduces release of γ-IFN, thus increasing resistance to brucellosis. Gene polymorphisms in the regulatory regions of cytokine-encoding genes affect the amountsof cytokines produced and play a fundamental role in infectious diseases. The aim of this study was to determine the association between IL-17 gene polymorphisms and susceptibility to brucellosis. In this case-control study, 86 patients with brucellosis and 86 healthy persons in Hamadan, western Iran, from September 2014 to September 2016, were included. IL-17 genetic variants at positions rs4711998 A/G, rs8193036 C/T, rs3819024 A/G, rs2275913 A/G, rs3819025 A/G, rs8193038 A/G, rs3804513 A/T, rs1974226 A/G and rs3748067 A/G were analyzed by restriction fragment length polymorphism-PCR. Serum IL-17 titers were measured by sandwich ELISA. GG genotypes at positions rs4711998 and rs3748067 were present significantly more frequently in patients with brucellosis than in controls (P < 0.05). The AA genotype at positions rs4711998, rs2275913 and rs3748067 and GG genotype at position rs19744226 were present significantly more frequently in controls than in the patient group. These results suggest that the AA genotype at positions rs3748067, rs3819025 and rs4711998 and GG genotype at position rs3819024 are likely protective factors against brucellosis, whereas the GG genotype at positions rs3748067, rs3819025 and rs4711998 and AA genotype at position rs3819024 may be risk factors against the disease. No significant relationships were found between serum IL-17 titers and genotypes of the single-nucleotide polymorphisms.

The ability of bispectral-guided management compared to routine monitoring for reflecting awareness rate in patients undergoing abdominal surgery.

BACKGROUND: Awareness during general anesthesia in different types of surgery is an important described adverse event. Bispectral (BIS) monitoring is one of the recent techniques proposed to monitor the depth of anesthesia. OBJECTIVES: The present study tested the hypothesis that the awareness rate and changes in hemodynamic parameters within anesthesia would be lower in patients allocated to BIS-guided management than those allocated to routine monitoring. MATERIALS AND METHODS: In total, 333 adult patients with the American Society of Anesthesiologists (ASA) physical status I-III, aged between 18 and 65 years scheduled for elective abdominal surgery under general anesthesia were included in this randomized double-blind placebo controlled trial. Patients were randomly allocated to BIS monitoring (n = 163) or routine monitoring (n = 170). BIS values and hemodynamic parameters including systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and SPO2 were marked before induction (control value), after intubation and laryngoscopy, at intubation, after incision, and also during the operation every 15 minutes until extubation. RESULTS: The overall incidence of awareness in the BIS and routine monitoring groups were 5.5% and 4.1%, which was not significantly different. There were no significant differences in hemodynamic indices including SBP, DBP, HR, and SPO2 before induction of anesthesia between the two groups. These between-group differences in the studied indices remained insignificant at different time points after anesthesia induction as well as post ICU hospitalization. Furthermore, the trend of changes in hemodynamic parameters was comparable in the two groups. CONCLUSIONS: BIS-guided management may not be superior to routine monitoring protocols to prevent awareness as well as hemodynamic changes during general anesthesia in patients undergoing abdominal surgeries.