Assessment of Questionnaire of Physical Activity at Workplace Based on the Social Cognitive Theory (PAWPQ-SCT): A Psychometric Study in Iranian Gas Refinery Workers

Background

This study aimed to develop and assess the psychometric features of the Physical Activity at Workplace Questionnaire (PAWPQ) based on the Social Cognitive Theory (SCT) to evaluate employees' physical activity (PA) behaviors at the workplace.

Methods

This psychometric cross-sectional study was conducted on 455 employees working in one of the gas refineries in Iran. The participants were selected using the proportional stratified sampling method in 2019. The data collection tools were a demographic information questionnaire, the short form of the International Physical Activity Questionnaire (IPAQ), and a questionnaire developed based on the SCT, whose psychometric features were confirmed in terms of validity and reliability. Data were analyzed using SPSS22 and AMOS20 software.

Results

The first version of PAWPQ-SCT had 74 items. After evaluating content and face validity, nine items were removed. The results of the content validity index (0.98), content validity ratio (0.86), and impact score (3.62) were acceptable for the whole instrument. In exploratory factor analysis, after removing seven items-58-item final version of the scale-six factors could explain 73.54% of the total variance. The results of structural equation modeling showed the acceptable fit of the model into the data (RMSEA = 0.052, CFI = 0.917, NFI = 0.878, TLI = 0.905, IFI = 0.917, CMIN/DF = 2.818). Cronbach's alpha coefficient and Intraclass Correlation were 0.90 and 0.86, respectively.

Conclusion

This study confirmed that the psychometric features of the 58-item final version of PAWPQ-SCT constructs were acceptable in a sample of Iranian employees. This questionnaire can be used as a valid and reliable tool to evaluate Iranian employees' PA behaviors and develop effective educational interventions for workers and managers.

Potential lethality of suicide attempts in youth

Rates of suicide in youth have increased over the last 50 years, yet our ability to predict suicidal behaviours has not significantly improved during this time. Examining predictors of suicide attempt lethality can enhance our understanding of suicidality in youth, yet research has focused on actual medical lethality (the actual danger to life resulting from a suicide attempt) rather than potential lethality (the potential for death that is associated with a suicide attempt). Thus, the aim of the present study was twofold: first, we quantified the percentage of youth for whom the severity of suicide attempt was misclassified by considering only actual lethality; second, we tested whether key variables that predict the actual lethality of suicide attempts also predict the potential lethality of suicide attempts in youth. We examined these questions in a sample of children and adolescents admitted to a psychiatric inpatient unit following a suicide attempt. Over 70% of youth who made serious suicide attempts would have been misclassified by assessments relying on only actual lethality. Although several variables relevant to the construct of actual lethality significantly predicted potential lethality (e.g., male sex, substance use disorder), others did not. In addition, we found that the subset of youth who would have been misclassified as low risk based on actual lethality had a disproportionately high need for healthcare resources due to future hospital admissions. The present study provides evidence to suggest that considering potential lethality may lead to improved detection and prediction of suicide risk in youth, and in doing so supports recent calls to broaden considerations of the lethality associated with suicide attempts.

Serological Determination of Toxoplasma gondii among Sheep (Ovis aries) in Guilan Province, Iran

Toxoplasma gondii is one of the most common foodborne protozoan parasite causing congenital infection, abortion, and stillbirth in humans and animals. The temperate and humid climate is one of the most important factors in the high prevalence of T. gondii. Sheep are among the important sources of meat production in Guilan province, Iran. Therefore, the consumption of raw and half-cooked meat is one of the major risk factors for T. gondii infection. Toxoplasmosis in patients with intact immune systems is usually asymptomatic; however, it but can be life-threatening in patients with a weak immune system (for example, patients with the human immunodeficiency viruses/acquired immunodeficiency syndrome or cancer and transplant recipients). Guilan is divided into three geographical regions of plains with a temperate climatic condition, hillsides with a semi-humid climate, and heights with cold mountainous climate. Climate situations play a role in the prevalence of toxoplasmosis. The present study aimed to investigate the seroprevalence of T. gondii infection among sheep in Guilan province, north of Iran. In the current cross-sectional study, a total of 400 sheep sera samples were tested for the determination of immunoglobulin G (IgG) antibody against T. gondii using the enzyme-linked immunosorbent assay. The samples were divided into different groups according to the geographical location and animal age. T. gondii antibody (i.e., IgG) was detected in 166 sheep (41.5%). The highest frequency of T. gondii infection (72.7%; n=56) was observed for the age group of > 4 years; the difference was statistically significant in this regard (P=0.0001) in comparison to that reported for other groups. In addition, the seroprevalence of T. gondii was significantly higher in the plains (53.9%) than that of the hillsides and heights (P=0.0001). Consequently, the seroprevalence of T. gondii infection in Guilan was high indicating a significant relationship with geographical location and animal age.

Viscoplastic fingering in rectangular channels

We experimentally study the viscous fingering problem of viscoplastic fluids in channels of rectangular cross section. We find that a yield stress-dependent capillary number (Ca^{*}) and an aspect ratio-dependent Bond number (Bo^{*}) can classify the finger shape into ramified and unified fingering patterns, and the finger flow regime into yield stress, viscosity, and aspect ratio-buoyancy-dominated regimes. For these regimes, we provide the transition boundaries using Ca^{*} and Bo^{*} and propose simple relations to predict the finger width, for a wide range of flow parameters, versus the capillary number, the channel aspect ratio, and the rheology of the viscoplastic fluid.

Removal of dibutyl phthalate from aqueous environments using a nanophotocatalytic Fe, Ag-ZnO/VIS-LED system: modeling and optimization

An (Fe, Ag) co-doped ZnO nanostructure was synthesized by a simple chemical co-precipitation method and used for the degradation of dibutyl phthalate (DBP) in aqueous solution under visible light-emitting diode (LED) irradiation. (Fe, Ag) co-doped ZnO nanorods were characterized by powder X-ray diffraction, Fourier transform infrared spectroscopy, UV-VIS diffuse reflectance spectroscopy, elemental mapping, Field emission scanning electron microscopy, transmission electron microscope and Brunauer-Emmett-Teller surface area analysis. A Central Composite Design was used to optimize the reaction parameters for the removal of DBP by the (Fe, Ag) co-doped ZnO nanorods. The four main reaction parameters optimized in this study were the following: pH, time of radiation, concentration of the nanorods and initial DBP concentration. The interaction between the four parameters was studied and modeled using the Design Expert 10 software. A maximum reduction of 95% of DBP was achieved at a pH of 3, a photocatalyst concentration of 150 mg L^-1 and a DBP initial DBP concentration of 15 mg L^-1. The results showed that the (Fe, Ag) co-doped ZnO nanorods under low power LED irradiation can be used as an effective photocatalyst for the removal of DBP from aqueous solutions.

Cultural Adaptation and Psychometric Properties of the Persian Version of Self-Efficacy in Chronic Disease Patients

INTRODUCTION

Self-efficacy is an essential factor for effective self-management in chronic-disease patients. Therefore, the measurement of self-efficacy with a valid and reliable instrument is required. In this study, cultural adaptation and psychometric properties of the Persian version of "Self-Efficacy for Managing Chronic Disease" (SES6G) are illustrated in a sample of Iranian chronic-disease patients.

MATERIALS AND METHODS

This was a cross-sectional study in which translation and backward translation was performed by bilingual translators. The final version of the Persian scale was assessed to determine the content validity index (CVI) and the content validity ratio (CVR). A panel of experts reviewed items of the scale. Factor analysis was performed for the final version of the Persian scale to assess internal consistency and construct validity among chronic-disease patients attending government health care centers from March 2015 to June 2015 in Isfahan, Iran (n = 483).

RESULTS

CVI and CVR scores were 0.87 and 0.89, respectively. There were no eliminated items in the cross-cultural adaptation process. Internal consistency met the criterion for a reliable measure (Cronbach's alpha = 0.89). An initial factor analysis produced a one-dimensional scale (6 items) with Eigenvalues more than 1 that explained 69.49% of the extracted variance.

CONCLUSIONS

The SES6G is a reliable and valid instrument to assess patients' self-efficacy for managing chronic diseases in Persian language. Because the self-efficacy score determines the educational strategies to have effective educational programs, the use of this simple and brief scale could be considered among Persian patients.

A microfluidic method and custom model for continuous, non-intrusive biofilm viscosity measurements under different nutrient conditions

Straight, low-aspect ratio micro flow cells are used to support biofilm attachment and preferential accumulation at the short side-wall, which progressively reduces the effective channel width. The biofilm shifts downstream at measurable velocities under the imposed force from the constant laminar co-flowing nutrient stream. The dynamic behaviour of the biofilm viscosity is modeled semi-analytically, based on experimental measurements of biofilm dimensions and velocity as inputs. The technique advances the study of biofilm mechanical properties by strongly limiting biases related to non-Newtonian biofilm properties (e.g., shear dependent viscosity) with excellent time resolution. To demonstrate the proof of principle, young Pseudomonas sp. biofilms were analyzed under different nutrient concentrations and constant micro-flow conditions. The striking results show that large initial differences in biofilm viscosities grown under different nutrient concentrations become nearly identical in less than one day, followed by a continuous thickening process. The technique verifies that in 50 h from inoculation to early maturation stages, biofilm viscosity could grow by over 2 orders of magnitude. The approach opens the way for detailed studies of mechanical properties under a wide variety of physiochemical conditions, such as ionic strength, temperature, and shear stress.

Wrist circumference as a novel negative risk factor for cardiovascular disease among adult men: a median follow-up of 9 years

PURPOSE

Wrist circumference is an easy to measure anthropometric index of body frame and bone size. The aim of this study was to examine the association of wrist circumference with incidence of cardiovascular disease (CVD) among adult men.

METHODS

For this study 2531 male participants aged ≥30 years, without any history of CVD were selected and followed from 1999 to 2011. Cox proportional hazard models and logistic regression were used to examine the relation of wrist circumference with incident CVD.

RESULTS

A total of 339 cases of CVD were reported throughout a median follow-up of 9.4 years. In the multi-variable Cox model, 1 unit increase of wrist circumference was inversely associated with incident CVD with a HR (95 % CI) of 0.84 (0.72-0.98, P value = 0.02). The receiver operating characteristics curve in a logistic regression model for wrist circumference in prediction of CVD showed a cutoff of 17.75 cm, beyond which was associated with a lower risk for CVD.

CONCLUSION

In a population with a high prevalence of CVD risk factors, it was shown that a higher wrist circumference was associated with lower risk for incident CVD. Further studies are needed to explore the underlying mechanisms of this inverse relation.

Validation of Hearts-Map, A Psychosocial Assessment Tool Applied to Children and Youth with Mental Health-Related Paediatric Emergency Visits

BACKGROUND: Mental health-related pediatric emergency department (PED) visits are increasing annually, and there is a need for a validated comprehensive standardized assessment tool to better manage these patients.

OBJECTIVES: The primary objective of this study was to evaluate HEARTSS-MAP, a psychosocial assessment tool, in terms of inter-rater agreement among clinicians as well as the tool’s performance in predicting needs for acute psychiatric consultation for hospitalization.

DESIGN/METHODS: The HEARTSS-MAP evaluation was done in two phases. We retrospectively reviewed 101 cases randomly sampled from a cohort of patients who sought care at the BC Children’s Hospital (BCCH) PED for mental health complaints. Narratives pertaining to each patient’s psychosocial assessment were recorded. Clinicians, including two emergency physicians, a bedside nurse, a nurse practitioner, and two psychiatrists, were blinded to the patients' outcomes, and individually applied the HEARTSS-MAP tool to the clinical narratives. The inter-rater agreement was calculated using Cohen’s kappa statistics. We then evaluated the tool’s sensitivity and specificity in predicting admission for the retrospective cohort, as well as a prospective cohort of 62 patients assessed and managed by a PED clinician using the HEARTSS-MAP.

RESULTS: There was substantial agreement between the two pediatric emergency reviewers (κ=0.7), and moderate agreement between the pedi-atric emergency physicians and the nurse practitioner (κ=0.6), and the bedside nurse (κ=0.5). Pediatric psychiatrists had fair agreement between themselves (κ=0.3), and between psychiatrists and emergency physicians (κ=0.4). Based on retrospective data, HEARTSS-MAP had a sensitivity of 91% (95%CI: 71 to 99%), and a specificity of 41% (95%CI: 30 to 53%). When applied to prospectively collected data, the sensitivity was 100% (95%CI: 75 to 100%), and specificity was 33% (95%CI: 20 to 48%).

CONCLUSION: HEARTSS-MAP, the first standardized psychosocial assessment tool to be implemented at BCCH PED, demonstrates strong inter-rater reliability between emergency clinicians, with a high sensitivity in identifying patients with mental health complaints requiring hospital admission.

Interface Mobilities for Characterization of Structure-Borne Sound Sources with Multi-Point Coupling

The concept of source descriptor and coupling function is commonly recognized to form a rigorous basis for structure-borne sound source characterization. While this concept initially is valid for the single-point case only, it can be extended to sources with multi-point coupling by including the interface mobility approach. By considering a continuous interface that passes all contact points, the velocities, forces and mobilities are series expanded into interface orders by means of a spatial Fourier decomposition. The use of a continuous formulation for the multi-point case, however, can be problematic from a practical point of view. This paper discusses a reformulation of the interface mobility approach for a simplified calculation and clarified interpretation of the interface orders. With a discrete Fourier series as a basis for the interface mobility approach, the interface is reduced to a set of points and the interface orders are shown to describe the interplay of the data at the contact points. A discrete formulation furthermore yields simplified equations and a strict upper bound for the number of orders that have to be included, thus enhancing the practicability of interface mobilities for source characterization.

Benzimidazole -Resistance in Haemonchus contortus: New PCR-RFLP Method for the Detection of Point Mutation at Codon 167 of Isotype 1 β-Tubulin Gene

BACKGROUND

Due to the lack of a suitable and economic test for the analysis of the polymorphism at codon 167, we developed a new PCR-RFLP technique, based on a modified forward primer (UT-HC167 MF-primer), to identify simultaneously the SNPs at codons 167 and 200 of isotype 1 β-tubulin gene of Haemonchus contortus.

METHODS

There already are several safe and easy methods for identification of point mutations at codons 198 and 200. Due to the lack of a reliable and easy method for the detection of the single nucleotide polymorphism (SNP) at codon 167, we developed an innovative PCR-RFLP technique based on a modified forward primer (UT-HC167 MF-primer), in which the nucleotide T at the position 443 was substituted through a nucleotide A creating a restriction site for restriction endonuclease SnaB I in the nucleotide sequences including codon 167. A total of 138 adult male H. contortus were collected from three different geo-climatic areas of Iran. The isolated genomic DNA of each single worm was amplified by PCR using primers flanking codon 167. The PCR product (527 bp) was then amplified by semi-nested PCR using the UT-HC167 MF-primer and the reverse primer achieving a PCR product of 451 bp in length. This PCR product was subsequently digested with the restriction endonucleases SnaB I and TaaI for analysis of the mutations at codons 167 and 200, respectively.

RESULTS

All worms had two alleles encoding for phenylalanine (BZ(ss) homozygote) for both codons.

CONCLUSION

Using the UT-HC167 MF-primer and a suitable reverse primer designed upstream from codon 200, it is possible to amplify a PCR product which can be used for analysis of the SNPs at all three mentioned codons using RFLP.

Amphistome species in cattle in South coast of caspian sea

BACKGROUND

Knowledge about the amphistomid fauna in Iranian domestic ruminants depends on the studies conducted almost 30 years ago. The last situation in cattle is introduced here in the provinces in south coast of Caspian Sea.

METHODS

Amphistomid species were collected from cattle at slaughter houses of the provinces Gilan and Mazanderan in 2010. Median sagittal sections were prepared by the conventional method. Species were identified by the histomorphological pecularities of the muscular argans.

RESULTS

Five amphistomid species, Paramphistomum cevri, P. gotoi, Calicophoron calicophorum, Carmyerius spatiosus and Gastrothylax compressus, recovered. Calicophoron calicophorum is a new species for Iran. Criteria used in identification of the species were illustrated.

CONCLUSION

Iran has a rich amphistomid fauna and mostly under the influence of oriental conditions.

Infection of Anisakids Larvae in Long Tail Tuna (Thunnus tonggol) In North Persian Gulf

BACKGROUND

The aim of this paper was to study the prevalence and intensity of Anisakids larvae in the long tail tuna fish captured from Iranian shores of Persian Gulf.

METHODS

Different organs including skin, abdominal cavity, stomach and intestinal contents, stomach sub serous tissues, liver, spleen, gonads and 20 grams of muscles of 100 long tail tuna fish (Thannustonggol) caught from waters of the north parts of Persian Gulf were searched for anisakid nematodes larvae. Twenty grams of around the body cavity muscles were digested in artificial gastric juice. Different organs and digested muscles were examined with naked eyes for the presence of anisakids larvae. The collected larvae were preserved in 70% alcohol containing 5% glycerin, and cleared in lactophenol for identification.

RESULTS

Our findings revealed that 89% of fish harbored 3(rd) stage larvae of Anisakis sp. of which 2% were infected with both Anisakis and Raphidascaris. All inspected organs except that of skin were found to be infected, while stomach sub serous tissues were the most infected organ (80%) followed by abdominal cavity (10%), liver (4%), testicle (3%), stomach contents and spleen (2%) and intestinal contents (1%). Intestine and abdominal cavity were the organs harbored Raphidascaris sp. Digested muscles were free of parasite. Mean intensity was low for both species and ranged between 1.5 for Raphidascaris sp. and 3.67 for Anisaki sp.

CONCLUSION

Anisakids larvae especially Anisakis are very prevalent in some fish including tunas of Persian Gulf, and consumption of infected fish if it is not properly cooked may lead to human anisakiasis.

Evaluation of Benzimidazole Resistance in Haemonchus contortus Using Comparative PCR-RFLP Methods

BACKGROUND

In order to deworm the ruminants especially of sheep in Iran, consumption of benzimidazoles has more than 2 decades history and today farmers are using imidazothiazoles, macrocyclic lactones and mostly benzimidazole compounds (BZs) to treat infected farm animals. It has been demonstrated that the most common molecular mechanism leading to BZsresistance in Haemonchus contortus is a single mutation at amino acid 200 (phenylalanine to tyrosine) of the isotype 1 of beta tubulin gene. According to the report of such mutations in Iranian Teladorsagia circumcincta isolates with Restriction Site Created PCR-RFLP, we decided to evaluate the frequency of such mutations in H. contortus in three different geographical areas of Iran.

METHODS

A total of 102 collected adult male H. contortus were evaluated with PCR-RFLP (using PSP1406I as restriction enzyme). By means of a second step to compare function of different methods and to increase sensitivity of detection mechanism, a third of samples were examined by another PCR-RFLP method (using TaaI as restriction enzyme) and finally beta tubulin gene of two samples was sequenced.

RESULTS

All of samples were detected as BZss homozygote. Finally, beta tubulin gene sequencing of two samples showed no point mutation at codon 200.

CONCLUSION

It seems that BZresistance of H. contortus in Iran is not a serious problem as anticipated before.

Gastrointestinal Helminths of Magpies (Pica pica), Rooks (Corvus frugilegus) and Carrion Crows (Corvus corone) in Mazandaran Province, North of Iran

BACKGROUND

Corvidae is a cosmopolitan family of oscine birds including crows, rooks, magpies, jays, chough, and ravens. These birds are migratory species, especially in the shortage of foods, so they can act like vectors for a wide range of microorganisms. They live generally in temperate climates and in a very close contact with human residential areas as well as poultry farms. There is no available information in the literature concerning the parasitic infections of these three species of corvidae in Mazandaran Province, northern Iran, so this study was conducted to clarify this.

METHODS

As there are three species of corvid birds in Mazandaran Province, 106 birds including 79 magpies, 11 rooks, and 16 carrion crows were examined between winter 2007 and spring 2008 at post mortem for gastrointestinal helminths. The helminths were drawn and identified morphologically in the Laboratory of Parasitology, Islamic Azad University, Science and Research Branch, Tehran and also partly in the School of Public Health, Tehran University of Medical Sciences, based on the reference books and identification keys like Soulsby, Khalil et al. and Anderson et al.

RESULTS

Four species of nematodes, 2 species of cestodes, 1 species of trematodes and 1 species of acanthocephalans were identified in these three corvid species.

CONCLUSION

Five species of the helminths are identified for the first time in Iran, and the acanthocephalan species is new host record for rooks. It is clear that these corvid birds have diverse range of helminths and can act as carriers for infecting the domestic fowls.

Epidemiological aspects of canine dirofilariasis in the north of iran

BACKGROUND

Dirofilaria immitis is an important parasite in dog and other carnivores. Our objective was study on incidence and periodicity of heartworm in north of Iran and using other methods for its diagnosis in addition to Parasitology exam.

METHODS

This survey spanned two years, between 2006 and 2008. Blood samples were collected from 431 stray dogs distributed along north of Iran, the coastal areas of the Caspian Sea. The Knott's modified test was used for diagnosis of D. immitis and other filariae. Meanwhile, the periodicity of microfilaria in peripheral blood circulation was calculated and the imaging diagnosis techniques of four dogs that had positive results were done.

RESULTS

Diagnostic parasitology results indicated that 16.01% of stray dogs were microfilaremic. Two different microfilariae were diagnosed: D. immitis in 13.69%, Dipetalonema reconditum in 1.86% and in 0.46% both of them. There was no statistically significant between infection to fiariae with sex and age of dogs. Also study on the periodicity of the presence of microfilaria in peripheral circulation showed that the highest rate of those was at 1 am and the lowest rate at 12 pm. Radiographic study showed distinctive signs with varied degrees of severity included: Tortuous and enlargement of main and lobar pulmonary artery, pulmonary parenchymal lesions and Right side heart enlargement that confirmed in electrocardiography. Also in echocardiographic images observed short parallel-sided images with the appearance of equal signs that indicated the presence of the heartworm.

CONCLUSION

These results showed that to obtain a reliable diagnosis of heartworm infection, imaging tests could support parasitological exams.

Helminth infections of stray dogs from garmsar, semnan province, central iran

BACKGROUND

The aim was to study the gastro-intestinal helminths of stray dogs of Garmsar, Semnan Province, Central Iran, and its impacts on human health and animal production.

METHODS

During 2006, the alimentary tracts of 50 stray dogs at necropsy, selected from villages around Garmsar, were removed, and examined for helminth infections. Subsequently helminths were collected from the contents of each part and scraped sample of small intestines of washed materials in a 100-mesh sieve. To identify the species of helminths, the nematodes were cleared in lactophenol and cestodes were stained using carmine acid.

RESULTS

Mixed infection was the rule and 40 dogs (80%) harbored more than one species of helminth. Taenia hydatigena was the most prevalent species (80%) followed by Echinococcus granulosus (64%), Toxocara canis (22%), Mesocestoides lineatus (12%), Taenia multiceps (10%) and Dipylidium caninum (4%). The mean intensity of worm infection was low (1-3) except for that of E. granulosus (645). No significant difference was noticed between sex, age and most helminth infections except for that of sex and T. hydatigena (P=0.001) as well as age and T. canis (P=0.001).

CONCLUSION

Although human infection with T. hydatigena is unlikely, but other helminths reported in this study are of zoonotic importance, and may pose a threat to community health, and reduce the productions of ruminants harboring taeniid metacestodes.

Natural radioactivity levels of (226)RA and (40)K in soil of Zanjan province, Iran

Radioactivity concentration of naturally occurring radionuclides, (226)Ra and (40)K, in soil samples of Zanjan province, in north-west of Iran and from 21 geographical areas was measured by gamma spectrometry. The activity concentration of (226)Ra ranged from 58.4 + or - 1.8 to 132 + or - 3.1 Bq kg(-1) with the mean value of 88.5 + or - 22.9 Bq kg(-1). The activity concentration of (40)K ranged from 267 + or - 5.9 to 791 + or - 8.1 Bq kg(-1) with the mean value of 497.4 + or - 162.6 Bq kg(-1). The mean values for absorbed dose rate in air and annual effective dose were determined as 62.6 + or - 16.5 nGy h(-1) and 0.076 + or - 0.02 mSv, respectively.

Incidence and Genetic Characterization of Gongylonema pulchrum in Cattle Slaughtered in Mazandaran Province, Northern Iran

BACKGROUND

The gullet worm, Gongylonema pulchrum Molin, 1857, is a thread-like spirurid nematode found in a variety of mammals worldwide. Its incidences in Iranian cattle of different breed or age have not been reported. The aims of the present study are to disclose the infection status of G. pulchrum in cattle slaughtered in northern region of Iran.

METHODS

Full-length esophagi of cattle of 97 native dairy breed and 41 Holstein-Friesian breed were collected at four local abattoirs in Mazandaran Province, northern Iran, from March 2006 to August 2007, and were examined parasitologically. Eight overlapping segments of the small- and large-subunits of rDNA were amplified by PCR, and the obtained nucleotide sequences were characterized.

RESULTS

The incidences of G. pulchrum in female and male native dairy breed were 38.9% and 24.0%, respectively, whereas those in female and male Holstein-Friesian breed were 4.2% and 0%, respectively. The first internal transcribed spacer (ITS1) region of G. pulchrum rDNA showed an intra-individual variation in the sequence and length, and the variation was ascribed to some unstable repeats of "A" or "CA".

CONCLUSION

Distinct incidences of G. pulchrum infection in native dairy breed and Holstein-Friesian breed might be ascribed to different animal husbandry manners for each breed in Iran; the former breed grazes freely in the pasture, but the latter breed is usually held in a pen. The rDNA sequence of Iranian G. pulchrum, obtained for the first time by us, might facilitate a reliable species identification of the parasite with a wide spectrum of morphological variations.

Iron lung versus mask ventilation in acute exacerbation of COPD: a randomised crossover study

OBJECTIVE

To compare iron lung (ILV) versus mask ventilation (NPPV) in the treatment of COPD patients with acute on chronic respiratory failure (ACRF).

DESIGN

Randomised multicentre study.

SETTING

Respiratory intermediate intensive care units very skilled in ILV.

PATIENTS AND METHODS

A total of 141 patients met the inclusion criteria and were assigned: 70 to ILV and 71 to NPPV. To establish the failure of the technique employed as first line major and minor criteria for endotracheal intubation (EI) were used. With major criteria EI was promptly established. With at least two minor criteria patients were shifted from one technique to the other.

RESULTS

On admission, PaO(2)/FiO(2), 198 (70) and 187 (64), PaCO(2), 90.5 (14.1) and 88.7 (13.5) mmHg, and pH 7.25 (0.04) and 7.25 (0.05), were similar for ILV and NPPV groups. When used as first line, the success of ILV (87%) was significantly greater (P = 0.01) than NPPV (68%), due to the number of patients that met minor criteria for EI; after the shift of the techniques; however, the need of EI and hospital mortality was similar in both groups. The total rate of success using both techniques increased from 77.3 to 87.9% (P = 0.028).

CONCLUSIONS

The sequential use of NPPV and ILV avoided EI in a large percentage of COPD patients with ACRF; ILV was more effective than NPPV on the basis of minor criteria for EI but after the crossover the need of EI on the basis of major criteria and mortality was similar in both groups of patients.

Assessment of annual effective dose due to natural gamma radiation in Zanjan (Iran)

The outdoor and indoor measurement of natural gamma radiation in Zanjan province (Iran) was made using a Geiger-Muller dosemeter. The average outdoor and indoor dose rates were determined as 127 +/- 20 and 135 +/- 23 nSv h(-1), respectively. The average annual effective dose was calculated as 0.82 mSv, which is more than the same value worldwide.

Sédation au pentobarbital par voie rectale pour enregistrement des PEA chez l'enfant

OBJECTIVES

The aim of our study was to determine if rectal sedation with pentobarbital sodium provides safe and effective sedation for children undergoing auditory brainstem response (ABR) testing.

MATERIAL AND METHODS

A prospective study was conducted in the ENT pediatric department of Robert Debre's hospital (APHP, Paris). 68 children under 8 years of age were given rectal pentobarbital for ABR testing at a dosage of about 5 mg/kg.

RESULTS

61 children of 68 (89.7%) were adequately sedated with rectal pentobarbital. The mean elapsed time from drug administration to full sedation was 36,1 minutes. No adverse event was reported in 84.1% of children.

CONCLUSION

Pentobarbital provides safe and effective sedation. Rectal administration is easy, painless and with brief duration of action. It's a good alternative to general anesthesia for young children undergoing ABR testing.

The predatory capability of Arthrobotrys cladodes var. macroides in the control of Haemonchus contortus infective larvae

One hundred compost samples were examined for the presence of nematophagous fungi on the sheep farms of Mazanderan, province, Iran. Arthrobotrys cladodes var. macroides (IRAN 677C=CBS 143565) was isolated from 3% of the samples examined. Nematophagous activity of this fungus which was shown for the first time in this study, revealed the addition of 1000, 8000, 20000 and 100000 conidia per gram of feces of sheep reduced significantly (P<0.001) the number of Haemonchus contortus infective larvae in the feces by 41.71%, 63, 27%, 73.49% and 94.96%, respectively. These results show that A. cladodes var. macroides is a promising candidate for biological control of H. contortus.

An open, comparative pilot study of thiamphenicol glycinate hydrochloride vs clarithromycin in the treatment of acute lower respiratory tract infections due to Chlamydia pneumoniae

The aim of this study was to evaluate the efficacy and tolerability of thiamphenicol glycinate hydrochloride (TGH) i.m. versus clarithromycin in acute lower respiratory infections due to Chlamydia pneumonia. 113 patients with suspected pneumonia were screened. 40 patients with IgM and/or IgA titers > or = 1:16 and/or IgG titers > or = 1:512 were assigned to 10 days of treatment with TGH 1500 mg daily or clarithromycin 1000 mg daily. 34 patients were considered a clinical success. 33 patients were a radiological success. 22 patients showed a decrease in IgG values. 3 patients had an increase in IgG values. Blood/urine values presented no clinically significant variations. Clinical efficacy was similar in both treatment groups. These are the first results confirming in vivo the recent in vitro evidence that TGH is effective against acute lower respiratory tract infections due to C. pneumoniae, thus representing an alternative therapy to clarithromycin.

Basis for nebulized antibiotics: droplet characterization and in vitro antimicrobial activity versus Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa

The aims of this study were to (1) quantify the particle size characteristics of several antibiotics considered suitable for aerosol therapy after aerosolization with the PARI IS/2 nebulizer (Pari GmbH, Sarnberg, Germany) and (2) determine the degree to which in vitro antimicrobial activity of these antibiotics is maintained after nebulization. The aerosolized drugs were tobramycin sulfate, streptomycin, and imipenem, with saline solution as the control. Mean mass aerodynamic diameter of the nebulized drugs was 3.25 microns for tobramycin, 2.26 microns for imipenem, and 2.38 microns for streptomycin. In vitro tests showed that tobramycin and imipenem were unaltered in their bacteriostatic activity against strains of Escherichia coli (American Type Culture Collection [ATCC] 25922) and Staphylococcus aureus (ATCC 29213) as well as against Pseudomonas aeruginosa (ATCC 27853) with minimal inhibitory concentration (MIC) values less than 0.3 microgram/mL. Nebulized streptomycin showed significantly higher MIC values against P. aeruginosa (ATCC 27853). These results suggest that tobramycin and imipenem may be prescribed as an aerosol generated by jet nebulization (PARI IS/2) to treat S. aureus, E. coli, and P. aeruginosa infections without any risk of altering the drugs minimum bacteriostatic activity by the nebulization process. Aerosolization of streptomycin with this nebulizer may not be as effective against P. aeruginosa because it seems to alter the bacteriostatic activity.

Myasthenic inspiratory vocal cord dysfunction: efficacy of nasal continuous positive airway pressure treatment

Myasthenic vocal cord dysfunction (VCD), presenting with severe inspiratory stridor, was successfully treated with nasal continuous positive airway pressure (nCPAP), thus giving the medical staff time to make the diagnosis and avoiding intubation or tracheostomy. An important sign leading to diagnosis was the very high MEF(50)/MIF(50) ratio calculated from the flow-volume loop. nCPAP treatment induced prompt remission of stridor and a sharp reduction in the MEF(50)/MIF(50) ratio from 9.90 to 1.36. A review of the literature has shown that VCD with inspiratory stridor is an unusual onset symptom of myasthenia gravis and that nCPAP treatment may avoid emergency oral/tracheal intubation and tracheostomy. After diagnosis, the patient underwent thymectomy, and today, 3 years later, he is well without any further therapy.

Morphological and developmental characteristics of Echinococcus granulosus derived from sheep, cattle and camels in Iran

Echinococcus granulosus is widely distributed throughout Iran, where a variety of animals act as intermediate hosts. In this study, the development and morphological characteristics of E. granulosus of sheep, cattle and camel origin were compared and, overall, the characteristics of larval and adult isolates from sheep and cattle, although similar, showed significant differences from those of the camel isolates, especially with respect to the size of rostellar hooks. Differences in the fertility rates of hydatid cyst in sheep, cattle and camel were recorded as 88%, 19% and 70% respectively. In dogs experimentally infected with the three 'strains' of E. granulosus, the rate of development was more rapid in the camel than in the sheep and cattle 'strain'. In addition, adult E. granulosus derived from the camel demonstrate differences in worm length, segmentation and size, shape, number and arrangement of the genitalia when compared with worms derived from sheep and cattle. The epidemiological significance of these findings is discussed in relation to human hydatid infections in Iran.

Indication of the presence of two distinct strains of Echinococcus granulosus in Iran by mitochondrial DNA markers

Sixteen isolates of Echinococcus granulosus, collected from Iranian patients at surgery, and from domestic animals, including sheep, goats, cattle, and camels at slaughterhouses in Tehran and central and southern Iran were analyzed for DNA nucleotide and predicted amino acid sequence variation within regions of the mitochondrial cytochrome c oxidase I (COI) and NADH dehydrogenase subunit I (NDI) genes. A polymerase chain reaction-restriction fragment length polymorphism method, based on the DNA sequence variation in the NDI gene, was also used to rapidly survey the E. granulosus isolates. The isolates were categorized into two distinct and uniform genotype groupings. The analysis clearly indicated that the camel/dog strain (G6 genotype) of E. granulosus as well as the cosmopolitan, common sheep strain (G1 genotype) occur in Iran. The G1 genotype was found present in all four human isolates examined and it was more prevalent in domestic animals than the camel-restricted G6 genotype. In E. granulosus-endemic areas of Iran it is evident, therefore, that the majority of E. granulosus-infected livestock animals can potentially act as reservoirs of human infection, and this has important implications for hydatid control and public health.

Echinococcus granulosus infection of farm dogs of Iran

The prevalence and distribution of Echinococcus granulosus in sheepdogs was studied in 13 provinces of Iran, where 90% of the Iranian sheep and goat populations and, thus, sheepdogs are found. Worms were found in 27.17% of 390 dogs successfully purged with 4 mg/kg arecoline hydrobromide. The highest prevalence was detected in dogs from the rural areas of Isfahan (central part of Iran) and the lowest, in dogs from those of Sistan (Southeast Iran). The frequency distribution of E. granulosus was overdispersed, with only a few animals harboring heavy infections.

Nasal-continuous positive airway pressure in the treatment of near-drowning in freshwater

In patients who have experienced near-drowning, hypoxemia is the major clinical consequence. We report two cases of patients who have experienced near-drowning in freshwater who were successfully treated with nasal-continuous positive airway pressure (N-CPAP) plus oxygen therapy. Both patients presented a radiographic appearance of bilateral pulmonary edema. We suggest the use of N-CPAP as an easier and less costly alternative to tracheal intubation for treating near-drowning in patients who are breathing spontaneously and who have not experienced loss of consciousness.

Macrophage activation by N-acetyl-cysteine in COPD patients

The effect of in vivo and in vitro N-acetylcysteine (NAC) treatment on destructive activity of macrophages against Candida from COPD patients has been evaluated. Patients received NAC (600 mg) or placebo orally 3 times a day for 15 days and bronchoalveolar lavage (BAL) fluid and peripheral blood were collected before and at the conclusion of treatment. In our system, NAC treatment was not able to modulate antifungal activity of alveolar macrophages, peripheral blood monocytes (PBM), and polymorphonuclear leukocytes. On the contrary, in vitro NAC treatment at appropriate doses (10 micrograms/ml) significantly enhanced antifungal activity of PBM from COPD patients. This phenomenon is mediated by augmented phagocytic activity and phagosome-lysosome fusion. The lack of correlation between in vivo and in vitro studies could be ascribed to differences in the intracellular concentration of the drug that in vivo does not reach levels capable of inducing macrophage activation. We speculate that in COPD patients who undergo long-term NAC treatment, appropriate schedules and doses of the drug could augment resistance against microbial infections which are often life-threatening in these patients.

99mTc-DTPA-surfactant inhalation in adult respiratory distress syndrome (ARDS): a new diagnostic-therapeutic tool

ARDS is a life-threatening pulmonary disease with a rapidly progressive decline due mainly to multi-organ failure. Death occurs in 50-75% of ARDS cases. The diagnosis and therapy should start in the first six days of this fatal disease when mortality is at its lowest level. The 99mTc-DTPA-measured pulmonary alveolar epithelial permeability (PAEP) is strikingly increased in ARDS even in comparison to heavy smokers. Furthermore, surfactant inhalation has been shown to be of therapeutic value. In five ARDS patients with increased PAEP (T0.5 = 12% pred.) 20 mg/kg of aerosolized surfactant determined a dramatic improvement in blood gases and PAEP (51.8% pred.) No patient remained dependent on ventilatory treatment.

Mild prematurity and respiratory functions

Pulmonary function tests and bronchial reactivity to methacholine (MCH) were measured in 34 randomly selected prematures (21 males, 13 females; mean age 11.6 years; mean gestational age 34.9 weeks; mean birth weight 1980 g) and in 34 siblings (22 males, 12 females; mean age 12.5 years, mean gestational age 39.5 weeks; mean birth weight 3030 g). None had suffered neonatal respiratory distress syndrome or had been artificially ventilated. Prematurely born children had a residual volume (RV) and residual volume/total lung capacity (RV/TLC) significantly (P < 0.01) increased compared to controls, although the mean values of both groups were still within the upper limits of normal. Furthermore, an increase of closing volume/vital capacity and closing capacity/total lung capacity (CC/TLC) was observed in most patients with increased RV and RV/TLC. No significant difference was observed for bronchial responsiveness to MCH between prematurely born and control children (11.8% and 5.9% of hyperreactive subjects, respectively). Maternal smoking during pregnancy was prevalent in prematures with impaired respiratory functions. In conclusion clinically normal children of smoking mothers who have survived prematurity but present some respiratory function impairment compared to their born-at-term siblings, should be fully informed and protected from risk factors for chronic obstructive pulmonary disease (COPD) in adult life.

Interferon-gamma (r-IFN-gamma) induced activation of alveolar macrophages (AM) from anergic patients with chronic obstructive pulmonary disease (COPD)

Forty-six anergic patients (37 males and 9 females, age range 55-79 yr) were selected from ninety-one patients suffering from COPD due to frequent exacerbations and impaired delayed cutaneous reactivity (43.9%). The phenotype of circulating lymphocytes, their proliferative response to a panel of polyclonal T-cell activators and the candidacidal activity (CA) of circulating PMNs (polymorphonuclear cells) were measured. In 13 patients presenting a defective CA of circulating PMNs, the in vitro response of alveolar macrophage CA to r-IFN-gamma was also determined. We found: 1) a significant reduction in the CL response to PHA in COPD patients vs controls; 2) a low PMN-CA in 23 (57%) COPD patients; 3) a non-significant difference in phenotype analysis in patients and controls; 4) lower CA of AMs in COPD patients than in controls; 5) restoration in vitro of CA by r-IFN-gamma in the group of anergic COPD patients presenting depressed CA. We conclude that a defective cell-mediated immunity could be the basis of the enhanced susceptibility to infectious exacerbations in many COPD patients and that, in vitro, it could be reversed by r-IFN-gamma treatment.

Helminth parasites of wild boar, Sus scrofa, in Iran

Fifty-seven wild boars (Sus scrofa) from protected regions of Iran were examined for helminths. Sixteen species of helminths were collected; there were ten nematodes, one acanthocephalan, two trematodes and three larval cestodes. New host and distribution records were established for all helminths except of Taenia solium cysticerci. Wild boar shared nine of these helminths with domestic pigs, six with ruminants and three with human beings in Iran. Metastrongylus pudendotectus and M. salmi are reported for the first time from Iran.

[A rare cause of pulmonary coin lesion: Rendu-Osler-Weber disease]

The diagnosis of lung coin lesions (peripheral lesions with a diameter of no more than 6 cm) is one of the most important problems in pneumology. Among the numerous causes of coin lesions, the presence of malignancies must always be excluded. The Authors describe an unusual case of lung arteriovenous fistula in a patient suffering from Rendu-Osler-Weber disease. The importance of a multi-step diagnosis, starting with non-invasive procedures is stressed; this is to avoid life threatening complications which may occur after lung trans-thoracic biopsies of previously undiagnosed vascular abnormalities.

Biphasic calcium phosphate ceramic combined with fibrillar collagen with and without citric acid conditioning in the treatment of periodontal osseous defects

The purpose of this study is to determine whether the combination of biphasic calcium phosphate ceramic (BCP) and collagen and citric acid root conditioning would promote accelerated new attachment of periodontal tissue to the root surface in dogs. Intrabony defects were surgically produced for each animal and were made chronic for 16 weeks. These defects were assigned to two study treatment and one control group: ceramic-collagen without citric acid (CO-CE); ceramic-collagen with citric acid (CO-CE-CA); and control (surgical debridement and root planing only). Results showed that all groups gained new attachment level as demonstrated both clinically and histometrically. The treatment groups showed a significant mean gain greater than the control (P less than .005), but no significant difference was found between treatment groups. Small areas of ankylosis was also found in both treatments but there was no evidence of active root resorption. It is concluded that the use of combined BCP and fibrillar collagen is beneficial in promoting new attachment of periodontal tissues to the root surface in dogs. Although citric acid root conditioning did as well or better than ceramic and collagen alone, its benefits are still speculative and need further experimentation.

Oral manifestations of Ehlers-Danlos syndrome: report of case

First described in the beginning of this century, Ehlers-Danlos syndrome is a hereditary connective tissue disorder. This case report describes an 11-year-old girl who had frequent unexplainable bruises. During an initial orthodontic evaluation, characteristic symptoms were spotted, and a subsequent diagnosis made.