مجله دانشکده پزشکی اصفهان
پیاپی 275 (هفته چهارم فروردین 1393)

Due to high rates of mortality from pneumonia in the elderly, using a simple model for determining the prognosis of pneumonia can lead to a decrease in the mortality rate in this group. This study aimed to determine the validity of confusion, uremia, respiratory rate, blood pressure, and age ≥ 60 years (CURB-60) and confusion, respiratory rate, blood pressure, and age ≥ 60 (CRB-60) models in determining the prognosis of community-acquired pneumonia in the elderly and comparison them with models of the pneumonia severity index (PSI), CURB-65, and CRB-65. This cross-sectional study was conducted in 2013 in Arak University of Medical Sciences, Iran. Data of 141 patients with the age of 60 years and older with community-acquired pneumonia who had inclusion criteria were included in the study and analyzed. P-value < 0.05 was considered significant. The mean age of patients was 68.9 ± 7.6 with the median of 65.0 years. 76 patients (53.9%) were men and sex ratio of men/women was 1.17. 71.6% of patients were in urban areas. The most common comorbidity was cardiovascular disease (37.6%) and the most common sign and symptom were respiratory rale (92.2%), hypothermia or hyperthermia (88.7%), respectively. Sensitivity, specificity and positive predictive value of PSI and CURB-60 model for third day recovery were higher than the other models. The highest positive predictive value of intensive care unit (ICU) admission until the fourteenth day and 30-day mortality were in the models of CURB-65 and CRB-60. To determine the severity and prognosis of community-acquired pneumonia in the elderly, CURB-60 and CRB-60 models can be used.

Multiple sclerosis (MS) is one of the most common diseases in neurology and mostly occurs in young adults. The disease is clinically characterized by the involvement of different parts of the central nervous system at different times. Not a cause for the disease has been obtained, and this study aimed to intend benefiting from geographical information system (GIS) to explore a possible link between the disease and environmental factors. In this research, regions of cities of Najaf Abad, Isfahan, and Mobarake in the west of Isfahan Province were studied. Several soil samples were taken from each area and to measure the lead (Pb) and zinc (Zn) concentrations, atomic absorption spectrophotometer model (Pye Unicam, SPQ) was used. The epidemiology of multiple sclerosis during 2008-2012 was obtained from Isfahan Health Center and the GIS maps of material dispersion and the disease were traced. A significant portion of multiple sclerosis was consistent with the distribution of lead in the study areas; but the disease had little to do with the distribution of zing. The mapping showed that areas with a high prevalence of multiple sclerosis are consistent with the high contaminants such as lead; this adaptation can explain the association of the disease and environmental factors.

A major bottleneck in the production of recombinant proteins in conventional linear method is the heterogeneity in number of transgene copies in the genome of the host cell that lead to variable levels of transgene expression. Aside from the low efficiency of the random integration, other phenomena such as positional effect contribute to low efficiency of transgene expression. PiggyBac is a class of DNA transposons which can transpose through “cut and paste” mechanism in host genome. Some specific characteristic of this transposon makes it promise vector in gene transfer studies. High capacity of transgene transposition and flexibility in molecular engineering of transposase are characteristics of PiggyBac transposons that are important in recombinant protein and gene therapy approaches. The aim of this study was estimation of transgene copy number based on helper-dependent and independent PiggyBac transposition system in human embryonic kidney (HEK) cells.

Plasmid containing interferon gamma inducible protein 10 (IP-10) coding sequence flanked by PiggyBac terminal repeat element and plasmid containing transposase system and a unit plasmid containing both transposae and IP-10 coding sequence were used for generating recombinant cells in helper-dependent and independent system, respectively. Human embryonic kidney cells were transfected by each group. After clonal selection, absolute quantitative real-time polymerase chain reaction was used for estimation of transgene copy number.

Estimation of IP-10 copy number has revealed 5 and 2 copies per cell in helper-independent and dependent system, respectively.

Here, we report activity of PiggyBac transposition in human embryonic kidney cell line. PiggyBac helper-independent and dependent system was used for generation of stable cell line producing mouse IP-10 protein and our data confirmed permanent expression of this transgene with the mean of about 5 transgene copies per each cell.

Genotyping of Crithidia species is of high importance in the selection of an appropriate method to control and prevent cutaneous leishmaniasis (CL), determination of the best therapeutic effect of drugs, and preparation and evaluation of the vaccines. In order to identify the strains of Crithidia, sampling was done in one of the endemic regions of wet or rural type zoonotic cutaneous leishmaniasis (ZCL) in Isfahan city and surrounding areas, Iran. Samples were 602 patients with wet cutaneous leishmaniasis referred to Isfahan Leishmaniasis Research Center or other health centers in the vicinity of Isfahan. Sampling in Novy-MacNeal-Nicolle medium (NNN) medium, extraction of DNA from promastigotes, implementation of the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, amplification of internal transcribed spacer (ITS1), and application of HaeIII enzyme were performed. 201 patients (33.39%) were found with two species of Crithidia, 27 cases of Crithidia fasciculata (13.44%) and 11 cases of Crithidia luciliae (5.47%). The rest of the cases, however, were trypanosomatidae with accession number of GQ331988; molecular analysis showed 92% had tendency of homology with Crithidia fasciculata and 89% with Crithidia luciliae (163 cases or 81.9%). Out of 351 patients (58.31%), leishmaniasis parasite was isolated, and out of 50 patients (8.31%), neither Leishmania nor Crithidia were isolated; therefore, their report was negative following cultured samples. The results of the present study suggested that Crithidia not only contaminates leishmania culture but also enjoys genetic polymorphism in Isfahan and surrounding areas.

Herpes simplex virus (HSV) is a virus rarely can involve the gastrointestinal tract, particularly in individuals with underlying endogenous or exogenous immunosuppressant.Case Report: Patient, a 26-year old man with a history of ulcerative colitis was referred with severe abdominal pain, treat-refractory hematochezia and use of simultaneous immunosuppressive drug. Once suspected and investigated, HSV was known to be the cause of the acute episode. Therefore, the patient underwent treatment with acyclovir whereupon in a matter of days his symptoms healed.

Today, HSV is considered as the cause of fulminant attack or resistance of inflamatory bowel diseases to immunomodulator treatment; it can be identified using immunohistochemistry and polymerase chain reaction of tissue samples. Timely antiviral therapy can prevent severe attacks and damage.