مجله دانشکده پزشکی اصفهان
پیاپی 246 (هفته چهارم شهریور ماه 1392)

Infection، especially pulmonary infection and pneumonia، is a major cause of morbidity and mortality in patients with cancer treated with chemotherapy. Chest X-ray (CXR) is an initial guide، quick، inexpensive، available and low-radiation dose widely performed when pneumonia is suspected. According to various studies، the role of routine CXR in the diagnostic evaluation of febrile neutropenic patients without pulmonary symptoms is unclear. The purpose of this study was to evaluate the diagnostic yield of routine CXR in asymptomatic pulmonary neutropenic patients. 118 neutropenic patients (59 men and 59 women) with the age of more than 18 years were studied. History، physical examination، complete blood count (CBC)، blood culture، urine analysis (U/A)، and urine culture (U/C) were checked. In both، symptomatic and asymptomatic patients، 2 CXRs [Posterior-Anterior (PA) and lateral] were obtained and one radiologist studied CXRs without knowing about the physical examination. The incidence of pneumonia in was 17. 8% in the entire population and 6. 8% in asymptomatic pulmonary group. The incidence of pneumonia was significantly higher in men than in women (P = 0. 04); the incidence of pneumonia significantly increased with age increasing (P = 0. 01). Comparing our findings to similar studies، routine CXR in febrile neutropenic men with the age of more than 50 years is recommended.

Bacterial infections and antibiotic resistance of their etiologic agents are among the most important challenges facing the burn units. Updated information of bacterial agents causing infection and their resistance patterns has an important role in control and empirical treatment of burn infections. The aim of this study was to determine the frequency and resistance patterns of bacterial isolates from burn wounds infections in hospitalized patients in Emam Mousa Kazem Burn Center in Isfahan، Iran. In a descriptive study of a five-month period، 227 clinical specimens from hospitalized patients in Emam Mousa Kazem Burn Center were examined. Identification of isolates was done using standard method in bacteriology. The susceptibility of the isolates toward antibiotics was tested by agar disk diffusion method. A total of 227 burn wound samples were collected from 131 (57. 7%) men and 96 (42. 3%) women. Pseudomonas aeruginosa (44. 69%) was the most common microorganism causing infection and Acinetobacter spp. (18. 5%) and Staphylococcus aureus (11. 01%) were in next places. According to the results of antimicrobial sensitivity test، 81% of isolates were multidrug resistant (MDR) and high resistance of isolates observed toward co-trimoxazole. This study showed high frequency of infection in burn wounds، specifically، the rising incidence of Acinetobacter infections. Also، high levels of antibiotics resistance of isolates were shown; so، strategies to control the spread of multidrug-resistant strains and review of treatment of burn infection have to be designed and evaluated.

Recurrent spontaneous abortion (RSA)، defined as two or more consecutive pregnancy losses before the 20th week of gestation. Foxp3 is a regulatory T-cell-dependent transcription factor that is essential for function of these cells. The aim of this study was to identify the polymorphism Foxp3 (-3279) gene in the women with recurrent abortion and controls. In this case-control study، 80 women with history of at least two spontaneous abortion before the 20th week of gestation determined as case; they were negative for genetic، infectious، anatomic and hormonal disorders. Eighty non-pregnant healthy women with no history of abortion and having at least one child that referred to Yazd centeral laboratory for check-up were selected as control. The Foxp3 gene 3279 polymorphism using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was performed. Data analysis was performed by chi-square. The frequency of CC، AC and AA genotypes were 58. 8، 25، and 16. 2 percent in women with RSA and 52. 5، 21. 2 and 26. 2 percent in controls، respectively. No significant difference was found between the groups (P = 0. 3). In this study، a statistically significant difference was not seen in the prevalence of polymorphisms rs3761548C/A between control and recurrent abortion groups.

Infertility is one of the most common reproductive disorders occurring in approximately 15% of the couples. Male factor accounts for about half of these cases. The causes of reproductive defects in infertile men are multifactorial and many environmental and genetic factors affect male infertility. Genetics factors cause an account for 10-15% of male infertility، including chromosomal aberrations and single gene mutations. The current review will focus on genetics aspect of male infertility، including chromosomal disorder، single gene mutation and polymorphism، role of mitochondrial DNA and microRNA. We also take a look at last reported new genes causes of infertility.

Preeclampsia، a pregnancy specific syndrome، is a major cause of maternal and infant morbidity/mortality and preterm delivery worldwide. It is characterized by the onset of hypertension and proteinuria after 20 weeks of gestation. Despite a fairly high incidence، the underlying etiology of preeclampsia is still incomplete. In the present study، adipokines leptin and adiponectin، the metabolite homocysteine and the importance of antioxidants in preeclampsia was reviewed. The PubMed and Scopus databases were used for searching the relevant studies. The majority of studies reported hyperleptinemia in preeclampsia and suggested a pathological role and also a compensatory response for it. There were some conflicting findings of maternal circulating levels of adiponectin in women with preeclampsia with relevant explanations. Recent studies indicated that hyperhomocysteinemia might be associated with an increased risk of preeclampsia. The majority of trials to date have found routine antioxidant supplementation during pregnancy to be ineffective in reducing the risk of preeclampsia. More studies are needed to explore possible antioxidant property of adiponectin in preeclampsia. It might be proposed exploring the mechanism of hyperhomocysteinemia on the pathogenesis of preeclampsia. Further clinical trials are needed to address the importance of using antioxidants during pregnancy for the prevention or treatment of preeclampsia.