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Biomedical subjects

M Janghorbani

Publications and source records attributed to M Janghorbani.

At least 19 recordsLinked to original sources

A randomized, double-blind trial of bromocriptine efficacy in nonfluent aphasia after stroke.

The authors assessed the efficacy of bromocriptine in nonfluent aphasia after stroke in a 16-week, randomized, double-blind, placebo-controlled clinical trial conducted from June 2002 to April 2004. In all 38 patients after 4 months of treatment, improvement in both the bromocriptine and placebo treatment groups was observed (p < 0.001). The analysis of repeated-measures analysis of variance revealed bromocriptine did not improve nonfluent aphasia.

Adult↗

Is neighbourhood deprivation a risk factor for gestational diabetes mellitus?

AIMS: To assess the relationship between neighbourhood deprivation and the rate of gestational diabetes mellitus (GDM) using routinely collected data from a clinical information system, in Plymouth, UK. METHODS: Between 1 January 1996 and 31 December 1997, 3933 women residing within the Plymouth Primary Care Trust (PCT) were screened for GDM using indices of neighbourhood deprivation and prevalence of GDM. Areas (n = 43) were classified according to the Townsend index, measuring material deprivation. Pregnant women with and without GDM were compared. RESULTS: The prevalence of GDM was 1.7%[95%, confidence interval (CI) 1.20, 2.11]. The prevalence of GDM ranged from 1.05% (95% CI 0.60, 1.70) in the most deprived to 2.10% (95%, CI 1.34, 3.13), in the least deprived neighbourhood. Crude rates decreased by 50%[relative prevalence (RP) (95% CI) 0.50 (0.27, 0.94); P = 0.06] amongst those living in the most-deprived compared with those living in the least-deprived areas. Using a stepwise binary logistic regression model, older age at delivery significantly increased the risk of developing GDM. [RP (95%, CI) 1.09, (1.04, 1.13)]. Townsend deprivation score had no significant independent association with GDM when other covariates were considered. CONCLUSION: These data suggest that the neighbourhood context in which women live has no impact on the risk of GDM. Diabet.

Adult↗

Comparison of Betaferon, Avonex, and Rebif in treatment of relapsing-remitting multiple sclerosis.

OBJECTIVES: To compare the relative efficacies of Betaferon, Avonex, and Rebif in the treatment of relapsing-remitting multiple sclerosis (RRMS). METHODS: Ninety patients with RRMS were randomly allocated to the three treatment groups. The first group received Betaferon, the second group received Avonex, and the third group received Rebif for 24 months. Response to treatment was assessed at 6, 12, and 24 months after start of therapy. RESULTS: Of the 30 patients treated with Betaferon, the mean (standard deviation, SD) of relapse rate decreased from 2.2 (0.7) to 0.7 (0.7) episodes. Correspondingly, in the 30 patients treated with Avonex, the mean (SD) of relapse rate decreased from 2.0 (1.2) to 1.2 (0.9) (P < 0.001). In the 30 patients treated with Rebif, the mean (SD) of relapse rate decreased from 2.4 (1.0) to 0.6 (0.9) (P < 0. 01). After 2 years, 43.3% of patients receiving Betaferon and 56.7% of patients receiving Rebif remained relapse-free compared with 20% of those given Avonex. Expanded Disability Status Scale (EDSS) decreased by 0.7 U in Betaferon-treated patients (P < 0.001), 0.3 U in Rebif-treated patients (P < 0.05), and remained stable in Avonex patients. CONCLUSION: Treatment with Betaferon, Avenox, and Rebif significantly reduce relapse rate and EDSS score in patients with RRMS.

Adjuvants, Immunologic↗

Peripheral neuropathy in type 2 diabetes mellitus in Isfahan, Iran: prevalence and risk factors.

BACKGROUND: To estimate the prevalence and risk factors of peripheral neuropathy (PN) in people with type 2 diabetes mellitus. METHODS: A total of 810 patients with type 2 diabetes (289 men and 521 women) from Isfahan Endocrinology and Metabolism Research Centre outpatient clinics, Iran, were examined. Part of examination included an assessment of neurological function including neuropathic symptoms and physical signs and nerve conduction velocity. RESULTS: The prevalence of PN was 75.1% (95% confidence interval 72.1, 78.0). PN was associated with age, proteinuria, and duration of diabetes, insulin-treatment, and presence of any retinopathy and ischaemic heart disease (IHD). The age-adjusted prevalence rate of PN was 78% higher among patients with IHD, 64% higher among patients with any retinopathy, 66% higher among insulin-treated type 2 diabetes, and it was greater with duration of diabetes. Using a stepwise binary logistic regression model, age, duration of diabetes and proteinuria were significant independent predictors of PN. CONCLUSION: Peripheral neuropathy is a common complication in this population of Iranian type 2 diabetic patients. It increases with age, duration of diabetes and proteinuria.

Adult↗

Public opinion on smoke-free policies in restaurants and predicted effect on patronage in Hong Kong.

BACKGROUND: The Hong Kong government has proposed legislation for smoke-free policies in all restaurants and bars. This is opposed by certain sections of the catering industry. OBJECTIVE: To assess public opinion on smoke-free restaurants and to estimate changes in patronage. DESIGN: A population based, cross sectional random digit dialling telephone survey conducted from November 1999 to January 2000. SETTING AND PARTICIPANTS: 1077 randomly selected subjects age 15 years or over (response fraction of 81.6%). RESULTS: 68.9% (95% confidence interval (CI) 66.2% to 71.7%) supported a totally smoke-free policy in restaurants. Experiences of discomfort or symptoms from second hand smoke in restaurants were common. The majority (77.2%, 95% CI 74.7% to 79.7%) anticipated no change in their frequency of use of restaurants after a smoke-free policy. Increased use was predicted by 19.7% (95% CI 17.3% to 22.1%) of respondents, whereas 3.2% (95% CI 2.2% to 4.4%) stated that they would dine out less often. In multivariate analyses, non-smokers (adjusted odds ratio (OR) 4.9), people who ate three times or less per week in restaurants as compared to those who ate >10 times per week (OR 2.1), those who had previous experience of discomfort from exposure to passive smoking in restaurants (OR 2.8), or who had avoided restaurants in the past because of smoking (OR 1.9), were more likely to support a totally smoke-free policy in restaurants. Smoke-free policies do not appear to have an adverse effect on restaurants, and may increase business by a considerable margin. CONCLUSION: This comprehensive survey-the first in Asia-shows strong community support for smoke-free dining and predicts an overall increase in the patronage of restaurants after the introduction of legislation for totally smoke-free restaurants.

Adolescent↗

Iron absorption during recovery from malnutrition.

OBJECTIVE: In infants and children recovering from severe malnutrition, iron deficiency is common, and the ability to absorb iron during such recovery is uncertain. The objective of this study was to determine iron absorption during recovery from malnutrition. METHODS: During the later stages of recovery from malnutrition, erythrocyte incorporation of orally administered 58Fe was determined as a surrogate for iron absorption. Based on four indices, subjects were classified as iron-sufficient, iron-deficient or indeterminate. RESULTS: Of the 25 subjects, 9 were classified as iron sufficient, 5 as indeterminate and 11 as iron deficient; all but 5 had evidence of inflammation or infection. Geometric mean erythrocyte incorporation of 58Fe was 32.0% of the dose in the iron-deficient subjects, which was not significantly different (p = 0.073) than the 13.1% in the iron-sufficient subjects. Incorporation of 58Fe by the iron-sufficient subjects did not differ significantly from that by normal subjects in the same age range. Surprisingly, we found no correlation of erythrocyte incorporation of 58Fe and reticulocyte count. CONCLUSIONS: Even in the presence of infection or inflammation, iron absorption by children during a late stage of recovery from malnutrition is not impaired.

Absorption↗

Incidence of and risk factors for diabetic retinopathy in diabetic clinic attenders.

The incidence and risk factors for the development of diabetic retinopathy during a mean (SD) follow-up period of 4.6 (2.9) (range 1-12.4) years have been examined among 3424 patients (1878 males and 1546 females) with diabetes mellitus from three outpatient clinics at the University Hospital, Nottingham. The mean (SD) age of participants was 49.2 (17.9) years with a mean (SD) duration of diabetes of 7.3 (9.0) years at initial registration. Among the 3424 patients free of retinopathy at initial registration who attended the clinic at least twice in the period 1979-1992, the incidence of any retinopathy was 59.6 (57.8 male and 61.8 female) per 1000 person-years based on 15,571 person-years of follow-up. The incidence rate of retinopathy was 72% higher among insulin-treated than among non-insulin-treated noninsulin-dependent diabetes mellitus (NIDDM) clinic attenders. Using a Cox's Proportional Hazards Model for insulin-dependent diabetes (IDDM) and NIDDM (insulin and non-insulin-treated) diabetes separately, longer duration of diabetes, higher systolic blood pressure and poor metabolic control were significant independent predictors of retinopathy for all three groups. Never smoking was a significant independent predictor of retinopathy for the insulin-dependent diabetes groups. Lower body mass index, proteinuria and age were predictors of retinopathy only for non-insulin-treated NIDDM patients. Gender and creatinine had no significant independent association with retinopathy when other covariates were considered. These findings will help the identification of those patients at particular risk of retinopathy so that clinic time for screening of eyes can be appropriately focused.

Ambulatory Care Facilities↗

Incidence of and risk factors for proliferative retinopathy and its association with blindness among diabetes clinic attenders.

BACKGROUND: Proliferative diabetic retinopathy (PDR), a prevalent late-stage complication of diabetes, is associated with severe visual loss. The objectives of this report were to estimate the incidence of and risk factors for PDR using routinely collected data from a clinical information system at University Hospital Nottingham for insulin- and non-insulin-dependent (insulin-treated and non-insulin-treated) diabetes separately. We also attempted to assess the risk of blindness in these diabetes clinic attenders. METHODS: During a mean (standard deviation (SD)) follow-up period of 5.1 (2.9) (range 0.5-12.4) years, 3482 diabetic patients (1915 male and 1567 female) from three outpatient clinics at University Hospital, Nottingham were examined. The mean (SD) age of the participants was 49.3 (17.9) years with a mean duration of diabetes of 7.1 (8.7) years at registration. RESULTS: Among the 3482 patients who attended the clinic at least twice in the period 1979-1992, and who were free of PDR at registration, the overall incidence of PDR was 16.2 per 1000 person-years, based on 17,618 person-years of follow-up. The incidence rate of PDR was nearly three times as high among patients with non-proliferative diabetic retinopathy (NPDR) as in those without any retinopathy (42.1 vs. 15.0 per 1000 person-years). Based on a Cox's Proportional Hazards Model, significant independent predictors of PDR recorded at baseline were glycosylated haemoglobin (HbA1), systolic blood pressure, and longer duration of diabetes for patients without PDR or any retinopathy among insulin-dependent patients. Longer duration of diabetes was the only independent predictor of PDR for patients without PDR or any retinopathy in both insulin- and non-insulin-treated non-insulin-dependent patients. These clinic-based data clearly indicate the higher risk of PDR in non-insulin-dependent patients. Gender, age, BMI, creatinine, proteinuria and cigarette smoking, had no significant independent association with PDR when other covariates were considered in all groups. The risk of blindness was greater among those with PDR than those with NPDR in all three types of diabetes, but was substantial even for those without retinopathy. CONCLUSION: These data are of value in identifying those diabetes clinic attenders who may be most at risk.

Adult↗

Effect of dietary selenium restriction on selected parameters of selenium status in men with high life-long intake.

The influence of selenium (Se) restriction on disposition in plasma and urine fractions of infused (74)Se (selenite) was studied when adult males (Enshi City, Hubei Province, PRC) whose habitual daily Se intake is approximately 480 microg per day were transferred to Lichuan County, where the daily intake is approximately 30 microg. The subjects received an infusion (106 microg Se) on the day before consuming foods low in Se and a second infusion (113 microg Se) 63 days later. Blood and 24-hour urine samples were collected each day for 7 days after the first infusion and on days 22, 43, and 62 following the first infusion. Urine and blood were also collected daily for the next 7 days after the second infusion. Plasma total Se concentration increased for 7 days after each of the two infusions and urine Se decreased exponentially following both the first and second infusions. The excretion of trimethylselenonium followed the same pattern as the total urinary Se. Surprisingly, there was not a significant difference in selenite retention between the two infusion periods, and the data indicated that, regardless of the chemical form of Se present in various organs, its catabolism leading to excretion in urine followed the same pathway as that of selenite. Labeled Se was incorporated predominantly in the plasma selenoprotein P fraction and the half-life of Se in this fraction was determined to be 1.9 to 2.9 days. Thus, a longer depletion period is required in these subjects to obtain more significant changes.

Journal Article↗

Metabolism of selenite in men with widely varying selenium status.

OBJECTIVE: This study was undertaken to investigate the metabolism of selenite in men with life-long intakes of deficient, adequate and excess selenium. METHODS: Stable isotopes of selenium were infused for five hours into Chinese men living in deficient, adequate or excessive selenium areas, and 24-hour urine and blood samples were collected daily for the next seven days. Stable isotopic selenium excretion was determined in urine and in whole plasma and plasma fractions. RESULTS: Even though there was a positive correlation of selenium intake with the urinary excretion of this element, this relationship was not linear over the entire range (deficient, adequate, excessive) of selenium intake. When the urine excretion was normalized internally within each group, a sharp increase in the slope of this relationship was found when long-term intake increased to adequate amounts, but the slope reached a plateau when the daily intake exceeded the adequate group. The plasma selenoprotein P fraction was labeled initially, but the incorporation in the glutathione peroxidase fraction subsequently increased by a small amount. A two-month dietary restriction of selenium of the subjects from the excess area did not result in a reduction of urinary excretion of infused selenite. CONCLUSION: A complex relationship exists between long-term intake of selenium and selenium status, and subjects living in the excess area are more saturated with selenium than anticipated. More than two months of depletion are required to affect urinary excretion of selenium.

Adult↗

Quantitative significance of measuring trimethylselenonium in urine for assessing chronically high intakes of selenium in human subjects.

The purpose of the present study was to investigate the effects of Se restriction on the excretion of Se in men who had consumed high levels of this element during their entire lives. With the use of stable isotopes of Se as selenite, the excretion of methylated Se in urine was investigated in Chinese men (n 10) who had habitual chronic high intakes of this element. The relationship between either urine Se or trimethylselenonium (TMSe) to the estimated long-term Se intake was not linear over the entire range of intake, which was also true for the infusion of labelled selenite. A non-linear relationship was also found between urine TMSe and urine Se both for TMSe arising from catabolism of endogenous body Se and that from infused selenite. The data suggest a close precursor-product relationship of urine Se and its TMSe component based on the nearly identical specific activities for these two selenocompounds. Although dimethylselenide in breath was not measured in the present study, combining urinary TMSe with this breath test may be more useful in the assessment of long-term Se status.

Adult↗

Prevalence of overweight and thinness in high-school girls in Kerman, Iran.

OBJECTIVE: The prevalence of obesity and thinness is unknown among Iranian high-school age girls. We determined the prevalence of overweight and underweight among Iranian high-school girls from Kerman (south-east province of Iran). DESIGN: A cross-sectional study of indicative cluster sample. MEASUREMENTS: Weight, height, body mass index (BMI), chest, waist, abdomen, hip and thigh circumference of 1000 Iranian high-school girls aged 14-21 y (mean (standard deviation, s.d.) 16.2 (1.3)) were measured. The criteria for very underweight, underweight, desirable weight, grade 1, 2 and 3 overweight used in the present study were: BMI in kg/m2 < 15, 15-19.9, 20-24.9, 25-29.9, 30-39.9 and > or = 40, respectively. RESULTS: 4.6% (95% confidence interval (CI): 3.4%-6.1%) were grade 1 overweight (BMI = 25.0-29.9), 0.7% (95% CI: 0.3%-1.4%) were grade 2 overweight (BMI = 30-39.9), and none were grade 3 overweight (BMI > or = 40), while 54.6% (95% CI: 51.5%-57.7%) were underweight (BMI = 15-19.9) and 1.6% (95% CI: 0.9%-2.6%) were very underweight (BMI < 15). The mean (s.d.) BMI was 19.8 (2.9) (95% CI: 19.6-20.0). The mean (s.d.) waist-to-hip ratio (WHR), abdomen-to-hip ratio and chest-to-hip ratio values were 0.8 (0.06) (95% CI: 0.8-0.81), 0.8 (0.07) (95% CI: 0.8-0.81) and 0.9 (0.07) (95% CI: 0.9-0.91), respectively, in this sample. CONCLUSION: The results suggest a low prevalence of overweight among Iranian young women.

Adolescent↗

Long-term measurement of organ copper turnover in rats by continuous feeding of a stable isotope.

Utilizing the continuous feeding of a single stable isotope and inductively coupled plasma mass spectrometry, we have developed a method that allows the measurement of organ copper turnover in the rat for at least 8 weeks. Previous methods, based on tracer studies using radioisotopes of copper, were severely limited by the short half-lives of the radioisotopes (12.8 and 61.8 h). Taking advantage of the known ratio of the two naturally occurring stable isotopes of copper (63Cu and 65Cu), dietary copper was replaced by a single isotope of copper (63Cu) for the entire 8-week period. Disappearance of the other isotope (65Cu) from tissues was then monitored as a measure of copper turnover. Because this method is not a tracer study, it has the unique advantage of uniformly labeled physiological and kinetic compartments. Half-lives of individual first-order kinetic compartments within organs and plasma were obtained by analysis of the 8-week copper turnover curves in copper-adequate and copper-restricted rats. Mean decreases in organ copper following 56 days of copper restriction were plasma, 99%; liver, 62%; heart, 3%; muscle, 26%; kidney, 66%; and brain, < 1%. Comparison of normal organ turnover to turnover in copper-restricted rats revealed that this method can be used during periods of severe copper restriction and that copper conservation during these periods is organ specific.

Animals↗

A prospective population based study of gender differential in mortality from cardiovascular disease and "all causes" in asymptomatic hyperglycaemics.

There have been few prospective epidemiological studies of asymptomatic hyperglycaemia as a risk factor for cardiovascular disease and all causes mortality in women. Gender-specific all causes, cardiovascular disease (CVD), ischaemic heart disease (IHD) and stroke mortality rates and relative risks for asymptomatic hyperglycaemics (top 5%) have been compared to normoglycaemics (bottom 95%) during a mean follow-up of 11.6 years (range 10-14) among 4696 men and 5714 women aged 45-64 at entry in the west of Scotland. Univariate analysis showed that asymptomatic hyperglycaemia was associated with increased risk of all causes, CVD, IHD and stroke mortality in both genders. The degree of this association was greater in women than in men. Using multiple logistic regression (MLR) analysis to take into account differences in age, systolic (SBP) and diastolic blood pressure (DBP), serum cholesterol, body mass index (BMI), and cigarette smoking, high causal blood glucose level was still a significant risk factor for CVD mortality in both genders. It was also a significant risk factor for all causes, IHD and stroke mortality in women but not in men. This study shows that to a lesser degree asymptomatic hyperglycaemia shows the same gender differentials in risk of mortality as have been demonstrated amongst known diabetics.

Cardiovascular Diseases↗

Measles epidemics in Kerman City, Iran.

In early 1990 an outbreak of measles occurred in Kerman City (population 257,284), Iran. Overall 745 cases were identified, four of whom died (case fatality ratio was 5.4 per thousand). Illness was limited, primarily, to children below 15 years of age: 166 (22.3%) cases were in children under five years, 573 (77%) in those aged between five and 14 years and six (0.8%) were above 15 years of age. The age of the cases ranged from 5 months to 35 years. The age-specific attack rates were 3.9, 1.8, 7.3 and 2.8 per 1,000 for children under 1, 1-4, 5-9 and 10-14 years of age respectively. Overall 14 (1.9%) children with measles were hospitalized for severe complications which consisted mainly of pneumonia, otitis and gastroenteritis. Based on 745 cases with available immunization records, vaccine efficacy was calculated at 88% indicating a slight problem with the cold chain or vaccine. The outbreak was primarily related to low immunization coverage during the last 10 years and indicates the need to improve vaccine coverage with the AIK-C existing vaccine. It also highlights the urgent need for an effective single-dose measles vaccine (Edmondson-Zagreb) for children below nine months of age.

Adolescent↗

Dysprosium as a nonabsorbable marker for studies of mineral absorption with stable isotope tracers in human subjects.

Two studies were conducted to determine if dysprosium (Dy) could be used as a quantitative fecal marker for studies of zinc-70 (70Zn), copper-65 (65Cu) and magnesium-26 (26Mg) absorption in humans. In the first experiment, Dy excretion was shown to be complete (104 +/- 9%; mean +/- SD, n = 6) and the kinetics of fecal Dy excretion closely paralleled that of 70Zn but not 65Cu. Because of the similarity in 70Zn and Dy excretion kinetics, a method for estimating 70Zn absorption was developed which used 70Zn and Dy data from only the first two stools passed after isotope administration. Average estimates of 70Zn absorption based on the two-stool (partial pool) vs total pool (5-day composite) method were not different (28.0 +/- 5.2 vs 24.4 +/- 4.1%, respectively; means +/- SEM; p > 0.10). In the second study, the same questions was addressed relative to 26Mg absorption. 26Mg and Dy also exhibited nearly identical excretion patterns. Average estimates of 26Mg absorption based on the partial pool vs total pool method were comparable yielding mean values of 22.7 +/- 3.4 vs 23.2 +/- 2.5% and 26.1 +/- 1.8 vs 24.3 +/- 1.8%, respectively, from magnesium-26 oxide (26MgO) and 26Mg glycinate. Advantages and limitations of the partial pool method for estimating mineral absorption are discussed.

Absorption↗

Gender differential in all-cause and cardiovascular disease mortality.

The gender differential in mortality from all causes, cardiovascular disease (CVD), ischaemic heart disease (IHD) and stroke during the mean follow-up of 11.6 years (range 10-14) was examined among 4696 men and 5714 women aged 45-64 at entry in West of Scotland. Overall mortality was 19.4/1000 person-years of observation among men and 10.8/1000 person-years among women. A multiple logistic regression model was used to control the influence of gender, along with seven other cardiovascular risk factors simultaneously. The risk factors considered were age, systolic (SBP) and diastolic blood pressure (DBP), serum cholesterol, causal blood glucose, body mass index (BMI) and cigarette smoking. Both the prevalence of risk factors and relative mortality risk associated with them differed by gender. Adjustment slightly reduced the gender differential in overall mortality from 2 to 1.9 and from 1.5 to 1.4 for stroke deaths. Multiple logistic regression increased minimally the gender differential for mortality from 2.4 to 2.8 for CVD and from 2.8 to 3.4 for IHD, suggesting that these cardiovascular risk factors do not account for the overall gender difference in mortality rates. Age, SBP, DBP, blood glucose and cigarette smoking were significant predictors of mortality for both genders. Serum cholesterol was a statistically significant predictor of CVD death only for men.

Age Factors↗

Using the Community Health Index, general practitioner records and the National Health Service Central Registry for a 14 year follow-up of a middle-aged cohort in the west of Scotland.

Record linkage provides an opportunity for relatively inexpensive follow-up in cohort studies. Most studies have used hospital records. However, the Community Health Index, which is a computer-held list of all patients registered with General Practitioners (GPs), now offers opportunities for measuring morbidity at the primary care level. Searching for patients individually on this computer-held Index, we identified 96% of a middle-aged cohort recruited 14 years earlier in a longitudinal study in the West of Scotland. Of these, information was obtained for 78% through direct postal survey and for 87% through contact with GPs. In total, follow-up information was obtained on 903 (92%) of those thought to be alive. The National Health Service Central Registry records data and cause of death and will pass this information to special studies which have 'flagged' individuals' records. Seven per cent of the deaths in this sample had been missed by this process. This may need to be taken into account in previous studies of mortality for this cohort. New studies could expect successful long-term follow-up through record linkage to the Index or the Registry, and automatic record linkage with the Index would be worth investigating.

Cohort Studies↗