Publications by authors named "Hamidreza Aghaei-Meybodi"

16 Publications

  • Page 1 of 1

Epidemiology of hyperthyroidism in Iran: a systematic review and meta-analysis.

J Diabetes Metab Disord 2018 Dec 16;17(2):345-355. Epub 2018 Nov 16.

1Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Hyperthyroidism is a systemic disorder that causes severe morbidity and is even fatal. Several studies have been performed in Iran to determine the epidemiologic properties of hyperthyroidism; however, they did not use a systematic approach or meta-analysis to evaluate the results. Therefore, this systematic review and meta-analysis aimed to evaluate the epidemiologic data on hyperthyroidism in Iran.

Methods: In order to find all relevant papers published by October 2017, we searched both international (Web of Science, Scopus, PubMed, Embase, and Cochrane library) and Persian databases (Scientific Information Database, Magiran, and Barekat Knowledge Network System). Meta-analysis was performed using metaprop random effects analysis for prevalence and metaprop fix effect analysis for incidence by Stata statistical software. I was used for the demonstration of heterogeneity.

Results: Of 7667 published papers or conference proceeding, 7448 studies were removed after eliminating duplicates and reviewing titles/abstracts. Finally, after reviewing 219 full texts, 18 papers met the inclusion and exclusion criteria. The pooled prevalence of total, overt, and subclinical hyperthyroidism in general population were 2.43% (95% CI: 0.23-4.63%), 0.69% (95% CI: 0.21-1.18%), and 1.52% (95% CI: 0.14-2.89%), respectively. The pooled annual incidence of total hyperthyroidism was 2.2 (95% CI: 1.1-3.3) per 1000 population: 0.8 (0.1-1.4) and 1.3 (0.4-2.2) per 1000 population for overt and subclinical hyperthyroidism, respectively.

Conclusions: This is the first systematic review and meta-analysis, which investigated the epidemiology of hyperthyroidism in Iran. It seems that the prevalence and incidence of hyperthyroidism among the general population in Iran is similar to that in other parts of the world.
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http://dx.doi.org/10.1007/s40200-018-0367-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405392PMC
December 2018

Factitious Hypoglycemia Caused by a Unique Pattern of Drug Use: A Case Report.

Int J Endocrinol Metab 2018 Jan 20;16(1):e62591. Epub 2017 Dec 20.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Factitious hypoglycemia, caused by the surreptitious use of insulin and sulfonylureas, is one of the most challenging differential diagnoses of hypoglycemia. Diagnosis is usually established via exclusion with respect to the special patterns of plasma insulin and C-peptide during hypoglycemic episodes.

Case Presentation: We report a case of recurrent hypoglycemic episodes and confusing patterns of insulin and C-peptide levels. In the primary evaluations, insulinoma was suspected considering the high plasma concentrations of insulin and C-peptide, besides negative urine and plasma sulfonylureas during hypoglycemic episodes. Considering the normal imaging studies and refractory hypoglycemia to medical therapy, distal pancreatectomy was performed. The patient had no episodes of hypoglycemia after the surgery. Five months later, similar episodes recurred. Further investigations revealed different plasma concentrations of insulin and C-peptide in each hypoglycemic episode. Regarding various biochemical patterns during hypoglycemia and absence of evidence supporting other differential diagnoses, we suspected factitious causes. Close observation revealed that the patient had a history of intermittent glyburide consumption and analog insulin injection.

Discussion: Most commercial insulin immunoassays can only detect human insulin and lack the ability to identify synthetic analog insulin. In addition, common detection methods for sulfonylureas and meglitinides are of low diagnostic value in the human plasma and urine. These laboratory defects can lead to the misdiagnosis of insulinoma or noninsulin-mediated hypoglycemia due to the surreptitious use of insulin secretagogues or analog insulin, respectively. Therefore, due to the lack of any definitive laboratory findings, clinical suspicion is the best strategy for diagnosis.
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http://dx.doi.org/10.5812/ijem.62591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5961186PMC
January 2018

Bushehr Elderly Health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II).

BMJ Open 2017 Aug 4;7(8):e013606. Epub 2017 Aug 4.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Musculoskeletal disorders and cognitive diseases are prevalent, and they are significant determinants of morbidity and mortality in older adults. The aim of this study is to investigate the prevalence of musculoskeletal and cognitive diseases and their risk factors and also to assess their associations during future follow-ups.

Methods And Analysis: Bushehr Elderly Health (BEH) programme is a population-based prospective cohort study being conducted in Bushehr, a southern province of Iran. A total of 3000 older people aged ≥60 years participated in the first stage from which 2772 were eligible to participate in the second stage, which started after 2.5 years. Data including demographic status, lifestyle factors, general healthandmedical history, and mentalandfunctional health are collected through a questionnaire. Anthropometric measures, performance testsandmuscle strength, blood pressure and and body composition measurements are done. A total 25 cc venous blood is taken, and sera are stored at -80°C for possible future analyses.

Ethics And Dissemination: The study protocol was approved by the ethics committee of Endocrinology and Metabolism Research Institute, affiliated to Tehran University of Medical Science as well as the Research Ethics Committee of Bushehr University of Medical Sciences. A written informed consent was signed by all the participants. The study findings will show the prevalence of musculoskeletal disease, cognitive impairment and their risk factors in an elderly population. The participants will be followed during the study to measure the occurrence outcomes.This study will also have the potential to inform the development of beneficial interventions to improve the management of musculoskeletal and cognitive impairment in Iran and other countries in the Middle East.Our findings will be disseminated via scientific publication as well as presentation to stakeholders, including the patients, clinicians, the public and policymakers, via appropriate avenues.
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http://dx.doi.org/10.1136/bmjopen-2016-013606DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577871PMC
August 2017

Role of Obesity Variables in Detecting Hypertension in an Iranian Population.

High Blood Press Cardiovasc Prev 2017 Sep 22;24(3):305-312. Epub 2017 Jun 22.

Endocrinology and Metabolism Research Center (EMRC), Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, 1411413137, Tehran, Iran.

Introduction: As the high incidence of hypertension has been in conjunction with dramatic increase in the prevalence of obesity, many studies have suggested obesity as its underlying cause in diverse race and ethnic groups.

Aim: The present study was designed to quantify the relationship between obesity variables and hypertension in Iranian population. A ROC curve analysis was also used to determine an optimal BMI cutoff for obesity with the aim of representing elevated incidence of hypertension in this population.

Methods: The study population comprised of apparently healthy men and women who participated in the Iranian Multi-centric Osteoporosis Studies (IMOS), a multi-centric cross-sectional study carried out in urban areas of five great cities (Tehran, Tabriz, Mashhad, Shiraz and Bushehr). The anthropometric (weight, height, waist and hip circumferences) and blood pressure measures were reported in some 5724 subjects. The influence of these factors on systolic and diastolic blood pressure was assessed based on a list-wise method.

Results: There was a significant difference in the studied subjects anthropometric (weight classes (BMI), WC and HC, and WHR) and blood pressure variables; age, gender and weight, however, were the only factors significantly influencing SBP and DBP. Furthermore, BMI showed a significant impact on the overall risk of developing hypertension.

Conclusion: General obesity rather than abdominal obesity is directly linked with higher blood pressure levels in Iranian population.
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http://dx.doi.org/10.1007/s40292-017-0219-yDOI Listing
September 2017

Clinical Clerkship Education Improves With Implementing a System of Internal Program Evaluation Using Medical Students' Feedbacks.

Acta Med Iran 2016 Aug;54(8):530-535

Department of Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Quality of clinical education for medical students has always been a concern in academic medicine. This concern has increased in today's time-squeeze while faculty members have to fulfill their complementary roles as a teacher, researcher, and practitioner. One of the strategies for program evaluation is obtaining trainees' feedbacks since they are the main customers of educational programs; however, there are debates about the efficacy of student feedback as a reliable source for reforms. We gathered Likert scores on a 16-item questionnaire from 2,771 medical students participating in all clerkship programs in a multidisciplinary teaching hospital. An expert panel consisting of 8 attending physicians established content validity of the questionnaire while a high Cronbach's Alpha (0.93) proved its reliability. Summary reports of these feedbacks were presented to heads of departments, clerkship program directors, and hospital administrators, at the end of each semester. Analysis of variance was used for comparing hospital scores across different time periods and different departments. Significant changes (P<0.001) were observed in mean scores between different semesters (partial η2=0.090), different departments (partial η2=0.149) as well as the interaction term between departments and semesters (partial η2=0.111). A significant improvement in mean clinical education score is noticeable after three semesters from the beginning of the survey. Periodic, systematic trainee's feedback to program directors can lead to an improved educational performance in teaching hospitals.
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August 2016

Bushehr Elderly Health (BEH) Programme, phase I (cardiovascular system).

BMJ Open 2015 Dec 16;5(12):e009597. Epub 2015 Dec 16.

The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.

Purpose: The main objective of the Bushehr Elderly Health Programme, in its first phase, is to investigate the prevalence of cardiovascular risk factors and their association with major adverse cardiovascular events.

Participants: Between March 2013 and October 2014, a total of 3000 men and women aged ≥ 60 years, residing in Bushehr, Iran, participated in this prospective cohort study (participation rate=90.2%).

Findings To Date: Baseline data on risk factors, including demographic and socioeconomic status, smoking and medical history, were collected through a modified WHO MONICA questionnaire. Vital signs and anthropometric measures, including systolic and diastolic blood pressure, weight, height, and waist and hip circumference, were also measured. 12-lead electrocardiography and echocardiography were conducted on all participants, and total of 10 cc venous blood was taken, and sera was separated and stored at -80 °C for possible future use. Preliminary data analyses showed a noticeably higher prevalence of risk factors among older women compared to that in men.

Future Plans: Risk factor assessments will be repeated every 5 years, and the participants will be followed during the study to measure the occurrence of major adverse cardiac events. Moreover, the second phase, which includes investigation of bone health and cognition in the elderly, was started in September 2015. Data are available at the Persian Gulf Biomedical Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran, for any collaboration.
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http://dx.doi.org/10.1136/bmjopen-2015-009597DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691780PMC
December 2015

Biochemical Markers of Bone Turnover and their Role in Osteoporosis Diagnosis: A Narrative Review.

Recent Pat Endocr Metab Immune Drug Discov 2015 ;9(2):79-89

EMRI, Shariati Hospital, Kargar st, Tehran, Iran.

Osteoporosis diagnosis, which is nowadays generally made based on bone mineral density (BMD) measurements, suffers from certain limitations. Thus it is believed that bone turnover markers (BTMs) can help improve osteoporosis detection. The shifting interest toward this topic made us perform a review to gather information on existing markers and their role in osteoporosis diagnosis. Based on the results, in this review, a list of existing markers and some of their characteristics is provided. Moreover, a brief explanation of different types of variability met while using these markers is also described. Finally some of the patents provided for the diagnosis of these markers are presented. While the use of BTMs in osteoporosis diagnosis has certain advantages over BMD and clinical risk assessment tools, more studies are needed before they can be used as a separate tool in this regard. It could be concluded that despite the fact that BTMs are better than BMD not only in monitoring treatment but also in identifying those at-risk, the diagnostic value of BTMs in predicting osteoporosis is low, and thus a model is needed to assess several BTMs at the same time with higher accuracy and lower variability to overcome this limitation.
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http://dx.doi.org/10.2174/1872214809666150806105433DOI Listing
October 2016

A Suggested Prototype for Assessing Bone Health.

Arch Iran Med 2015 Jul;18(7):411-5

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Osteoporosis is becoming a health concern worldwide. Considering the fact that prevention plays an important role in reducing the burden of this silent disease and in view of the limited resources available, many countries have adopted certain programs to fight osteoporosis through shifting their attention towards at-risk individuals. The Iranian Multicenter Osteoporosis Study (IMOS) is one of these programs. The program aims to assess bone health and the prevalence of vitamin D deficiency in different parts of Iran with various altitudes, latitudes and lifestyle habits in a way that the results could be generalized to the country.

Method: The present article presents the protocol used in the third phase of the study. It was designed based on the experiences gathered in the previous phases to overcome the shortcomings particularly subject loss. The questionnaire applied in this study was developed based on a thorough literature review of the risk factors and secondary causes of osteoporosis and was approved by an expert panel.

Results: While the majority of the existing studies aim to study a certain aspect of osteoporosis, the present protocol provides the information needed for policy makers and researchers to study different osteoporosis-related issues.

Conclusion: The authors believe the protocol, to be implemented with small modifications, can help policymakers in different parts of the world, particularly developing countries, gather accurate information on different aspects of bone health at the national level.
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http://dx.doi.org/0151807/AIM.004DOI Listing
July 2015

Metabolic syndrome and inflammatory biomarkers in adults: a population-based survey in Western region of iran.

Int Cardiovasc Res J 2014 Dec 1;8(4):156-60. Epub 2014 Dec 1.

Imam Khomeini Hospital, Lorestan University of Medical Sciences, Khorramabad, IR Iran.

Background: There is evidence that inflammation may be involved in pathogenesis of MetS. Inflammatory biomarkers are moving to the forefront as the potent predictors of MetS.

Objectives: The present study aimed to evaluate the association between MetS and some inflammatory biomarkers.

Patients And Methods: This community-based cross-sectional study was conducted on 800 subjects aged above 35 years selected through random sampling in Borujerd (west of Iran) from 2011 to 2013. MetS was defined based on ATP III criteria and the subjects were divided into two groups (MetS and non-MetS groups). Waist circumference and Body Mass Index (BMI) were calculated. In addition, blood samples were taken and C-Reactive Protein (CRP), lipid profile, Fasting Blood Sugar (FBS), and Bleeding Time (BT) were measured. Then, the correlations between MetS and the above-mentioned variables were estimated. After all, the data were entered into the SPSS statistical software (v. 17) and analyzed using T-test, chi-square, median test, and spearman's rank correlation.

Results: In this study, 344 subjects (43%) met the ATP III criteria. The results showed a significant difference between MetS and non-MetS groups regarding BMI, white blood cell, total cholesterol, LDL, platelet, and high-sensitivity CPR (hs-CRP) (P < 0.0001, P = 0.040, P < 0.0001, P < 0.0001, and P = 0.045, respectively). Besides, waist circumference, Triglyceride (TG), FBS, and systolic and diastolic blood pressure were significantly higher, while HDL was significantly lower in the MetS group (P < 0.0001).

Conclusions: The incidence rate of MetS in our survey was higher compared to the previous reports. In addition, this incidence rate was higher in females in comparison to males. The results also showed a significant correlation between inflammatory biomarkers and MetS and that the higher levels of hs-CRP were associated with higher rate of MetS.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302503PMC
December 2014

Effect of folic acid on bone metabolism: a randomized double blind clinical trial in postmenopausal osteoporotic women.

Daru 2014 Sep 16;22:62. Epub 2014 Sep 16.

Background: In spite of several studies, the impact of homocysteine level and folic acid supplementation on bone metabolism is yet to be recognized. In this registered clinical trial (IRCT2014042217385N1), we aimed to find out the power of 6-month folic acid supplementation on homocysteine level and bone metabolism.

Methods: Forty postmenopausal osteoporotic women (50 to 87 years) were enrolled in the study. All participants were randomized to receive folic acid 1 mg (n = 17) or placebo (n = 14). At baseline, 3 months, and finally 6 months post intervention, the level of homocysteine, vitamin B12, and bone biomarkers were measured.

Results: Both groups were similar at baseline. The homocysteine decreased in both groups but statistically non-significant (P > 0.05). The changes of the serum level of vitamin B12, osteocalcin, and β cross laps were significant between groups after 6 months (P ≤ 0.05).

Conclusion: The trend of changes of bone biomarkers after 6 months folic acid supplementation shows that homocysteine concentration and/or folic acid supplementation have impact on the rate of bone metabolism. However, further investigations by larger sample size and differentiating age and gender are still needed to clarify the exact role of folate, homocysteine and vitamin B12.
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http://dx.doi.org/10.1186/s40199-014-0062-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172791PMC
September 2014

Is lipid profile associated with bone mineral density and bone formation in subjects with spinal cord injury?

J Osteoporos 2014 21;2014:695014. Epub 2014 Aug 21.

Endocrinology and Metabolism Research Institute (EMRI), Tehran University of Medical Sciences, Tehran, Iran.

Purpose. The association between serum lipids and bone mineral density (BMD) has been investigated previously but, up to now, these relationships have not yet been described in spinal cord injury (SCI). We tried to assess the correlation between serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) and BMD in male subjects with SCI. Methods. Dual-energy X-ray absorptiometry (DXA) was used to assess BMD in femoral neck, trochanter, intertrochanteric zone, and lumbar vertebras. Blood samples were taken to measure serums lipids and bone biomarkers including osteocalcin, cross-linked type I collagen (CTX), and bone alkaline phosphatase (BALP). Partial correlation analysis was used to evaluate the relationships between mentioned measurements after adjustment for weight and age. Results. We found a positive correlation between HDL and femoral neck BMD (P: 0.004, r = 0.33). HDL was negatively correlated with osteocalcin (P: 0.017, r = -0.31) which was not in consistency with its relationship with BMD. TC and LDL were not related to CTX, BALP and BMD. Conclusion. This study does not support a strong association between serum lipids and BMD in subjects with SCI. Moreover it seems that positive association between HDL and BMD is not mediated through increased bone formation.
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http://dx.doi.org/10.1155/2014/695014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158290PMC
September 2014

Evaluation of bone mineral loss in patients with chronic traumatic spinal cord injury in Iran.

J Spinal Cord Med 2014 Nov 21;37(6):744-50. Epub 2014 Jan 21.

Objectives: We described the associations between demographic and injury-related factors on bone mineral density (BMD) of the spine and the hip among adult patients with chronic spinal cord injury (SCI).

Design: BMD in spinal and femoral bone sites were assessed. Multivariate analysis was performed to evaluate the relationship between anthropometric and injury-related factors with BMD. Serum level and amount of dietary intake of calcium, phosphor, and 25-hydroxy vitamin D were measured.

Setting: A referral tertiary rehabilitation center in Iran.

Participants: Patients with SCI who had no previous history of endocrine disorders and were not on specific medications entered the investigation. Those with non-traumatic SCI, pregnant, or with substance dependency were excluded as well.

Interventions: No interventions were applied. MAIN STUDY OUTCOME MEASURES: Dual X-ray absorptiometry was performed to estimate BMD. Body mass index was positively associated with higher femoral (P < 0.01, r = 0.56) and hip (P < 0.0001, r = 0.82) BMD only in female participants. The high prevalence of vitamin D deficiency (60%) was noticeable.

Results: Older male patients revealed lower BMD only in spinal vertebrae (P < 0.02, r = -0.21). A significant higher BMD loss in lumbar vertebras in male patients with complete spinal cord lesion (P < 0.009) was detected. Spinal reduction of BMD was more severe when the level of injury was above T6 (P < 0.02).

Conclusion: Along with the clarification of age, gender, post injury duration, and the other factors' effect on the BMD in the SCI patients, here we have also shown the noticeable prevalence of the 25-hydoxy vitamin D deficiency in these patients which needs attention.
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http://dx.doi.org/10.1179/2045772313Y.0000000192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231962PMC
November 2014

The impact of alendronate on bone mineral density of osteoporotic patients.

Acta Med Iran 2013 ;51(12):855-60

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

The present study assessed the real life therapeutic effects of weekly doses of alendronate in treating a group of osteoporotic patients in Iran. The present historical cohort was conducted on patients who had undergone two or more bone mineral densitometry within an interval of 1.5-2 years in Shariati Hospital bone mineral density department between 2002 and 2010.patients were asked by phone about consumption of alendronate. The mean increase in the BMD values at different sites was calculated. There was a significant increase in the body mass index (BMI) values of both the individuals taking alendronate and the control group (P<0.001). Taking the weekly dosage of the drug was associated with a 7.67% increase in the BMD values at the femoral neck, 8.68% at the total hip, and 3.17% at the lumbar spine. Moreover, our results showed a significant difference between the height decline in the two groups (alendronate taking: 0.7±2.4 vs. control: -0.7±2.6, P<0.001). Comparing the results of the present study with that of previous ones revealed the drug is beneficial in improving bone mineral density in Iranians; as well alendronate is more effective in Iranian postmenopausal women when compared with the Americans.
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September 2014

Giant prolactinoma: case report and review of literature.

J Diabetes Metab Disord 2013 Jan 8;12(1). Epub 2013 Jan 8.

EMRC (Endocrinology and Metabolism Research Institute), Shariati Hospital,Tehran university of medical science, North Karegar St, Tehran, Iran.

"Invasive giant prolactinoma" is a large prolactinoma (>4 cm in dimension) presenting with serum prolactin levels of >1000 ng/dL and mass related clinical symptoms. Here we report a patient with a giant prolactinoma presented with central hypogonadism, suppressed adrenal and thyroid function, supra sellar extension, visual field impairment and high prolactin level.The patient was treated with cabergoline, levothyroxin and prednisolone. After 18 months, tumor size markedly reduced, associated with adrenal function and visual field improvement, but central hypogonadism and secondary hypothyroidism persisted.Previous studies showed normalization of thyrotropin secretion after treatment but it remained low in our patient even after 18 months follow up.
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http://dx.doi.org/10.1186/2251-6581-12-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3598222PMC
January 2013

The effects of n-3 fatty acids on inflammatory cytokines in osteoporotic spinal cord injured patients: A randomized clinical trial.

J Res Med Sci 2012 Apr;17(4):322-7

Nutrition Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; Brain and Spinal Injury Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: Clinical studies have reported that osteoporosis after spinal cord injury (SCI) can be the inflammation-induced base condition and n-3 polyunsaturated fatty acids (PUFAs) suppress the production of pro-inflammatory cytokines. This study documents the effects of n-3 PUFAs on cytokines in a group of patients after chronic SCI.

Methods: This double-blind, placebo- controlled trial was designed in 82 (69 males and 13 females) osteoporotic patients with SCI for 4 months. All participants received 1000 mg calcium and 400 IU vitamin D daily. The patients received two MorDHA capsules (435 g of DHA and 65 mg of EPA per day) or two placebo capsules (one with lunch, and the other with dinner) in the treatment and control groups, respectively. Serum interleukins and Dietary intakes were assessed in the beginning and end of the study. Mean difference for each group was compared by using Student's t test.

Results: A total of 75 (13 females, 62 males) participants completed the study over 4 months. The supplemented and control groups did not show any difference in their baseline characteristics. There were significant difference neither between two groups at the end of the study nor in each group between beginning and end of the study.

Conclusins: MorDHA supplementation for 4 months had no significant effect on inflammatory markers. Although mean difference in all pro-inflammatory cytokines were not significant in both treatment and control groups during the study (P>0.05), the decrease in treatment group was weakly higher that it may be important in point of clinical view.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526123PMC
April 2012

The effect of inhaled corticosteroids on hypothalamic-pituitary-adrenal axis.

Indian J Pharmacol 2012 May;44(3):314-8

Department of Pulmonology, Tehran University of Medical Science (TUMS), Tehran, Iran.

Objectives: The aim of this study was to compare systemic effects of high-dose fluticasone propionate (FP) and beclomethasone dipropionate (BDP) via pressurized metered dose inhaler on adrenal and pulmonary function tests.

Materials And Methods: A total of 66 patients with newly diagnosed moderate persistent asthma without previous use of asthma medications participated in this single blind, randomized, parallel design study. FP or BDP increased to 1 500 μg/d in 62 patients who had not received oral or IV corticosteroids in the previous six months. Possible effects of BDP and FP on adrenal function were evaluated by free cortisol level at baseline and after Synacthen test (250 μg). Fasting plasma glucose and pulmonary function tests were also assessed. Similar tests were repeated 3 weeks after increasing dose of inhaled corticosteroids to 1 500 μg/d.

Results: No statistically significant suppression was found in geometric means of cortisol level post treatment in both groups. After treatment in FP group, mean forced expiratory volume in one second (FEV1) and mean forced vital capacity (FVC) values improved by 0.17 l (5.66% ± 13.91, P=0.031) and 0.18 l (5.09% ± 10.29, P=0.010), respectively. Although FEV1 and FVC improved in BDP group but was not statistically significant. Oral candidiasis and hoarseness were observed in 6.5% patients receiving BDP, but hoarseness was found in 3.2% patients in FP group (P=0.288).

Conclusions: The results indicate that safety profiles of high doses of BDP and FP with respect to adrenal function are similar, but FP is more efficacious than that of BDP in improving pulmonary function test.
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http://dx.doi.org/10.4103/0253-7613.96300DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371451PMC
May 2012