Background: Delirium is a common problem in elderly patients. Recently, therapists have shifted their attention away from treatment towards prevention; therefore, investigation of related risk factors is essential in these patients. Methods: In this prospective cohort study, newly admitted elderly patients, with a Glasgow Coma Scale score above 10, were screened and enrolled. The patients were evaluated for delirium using the Neecham Confusion Scale (NCS). The risk factors included four major domains: patient characteristics (age, gender, and substance abuse), chronic diseases, acute diseases, and blood biochemical factors. Results: A total of 100 patients were assessed for delirium. The mean age of the participants was 79.9 ± 15.1 years (24% female). The proportion of in-hospital deaths was 12%, with a cumulative three-month mortality of 40%. The rate of delirium development was significantly associated with underlying factors, including cancer, hypertension, cerebrovascular accident, cirrhosis, dementia, and substance abuse. The laboratory results showed a blood urea nitrogen (BUN) level ≥ 50 mg/dL in 33% of patients with delirium. There was a significant association between BUN level and NSC score (P < 0.05). Among other laboratory variables, higher erythrocyte sedimentation rate and C-reactive protein level were significantly associated with delirium. Moreover, Kaplan-Meier survival curves for effective factors, such as drug effect, cancer, cirrhosis, dementia, and BUN, showed significant differences. Conclusions: In elderly patients, symptoms of delirium persist for three months after diagnosis. Private nursing care at home or nursing home placement, besides the assessment of delirium risk factors, is important for optimal care of elderly patients after hospitalization.
Brucellosis is a chronic and debilitating disease that affects various organs and has many negative consequences in the field of health and economy in Iran. Brucella outer membrane proteins, especially OMP31, OMP28, are important in vaccine design, production of required antigens, serum diagnostics, production of safe recombinant proteins with appropriate immunogenicity, and cost-effective production. Selecting the appropriate expression and hosting system for the expression of these recombinant proteins that can be produced safely, massively and economically is one of the main priorities in the production of vaccines and antigens used. In this study, plasmid pnz8149 was extracted from Lactococcus lactis. Brucella OMP31 gene was then amplified into specific vectors after amplification with specific primers and digestion of nco1 and bmh1 enzymes. Using electroporation, the plasmid containing the gene was transferred to Lactococcus lactis. In order to select transformant lactococci, lactococci containing recombinant plasmid pNZ8149 + OMP31 were transferred to Elliker medium. Finally, the presence of recombinant plasmid pNZ8149 + OMP31 in Lactococcus lactis was investigated by PCR, enzymatic digestion and sequencing. The quantity and purity of pnz8149 extracted plasmid were 123.8 ng and 1.93 μg, respectively. Due to the design of specific primers for amplification of OMP31 gene of this fragment, the target of Brucella bacterium genome was successfully amplified to 723 bp. OMP31 gene insertion in pnz8149 vector was successfully performed and the presence of recombinant plasmid pNZ8149 + OMP31 in Lactococcus lactis was confirmed. Given that the product of the OMP31 gene is a valuable candidate for the production of vaccine, this gene can be of significant target in research associated with vaccine production for treatment of brucellosis.
The segment A of an Infectious bursal disease virus (IBDV) isolate from Iran was amplified by reverse transcription-polymerase chain reaction (RT-PCR), sequenced and compared with published sequences of 26 IBDV isolates from other parts of the world. The Iranian isolate showed 8 unique amino acid differences. In addition, 9 common amino acid differences, namely 3 in VP2, (222 Ala, 256 lIe and 294 lIe), 3 in VP4 (685 Asn/Ser, 715 Ser and 751 Asp), 2 in VP3 (990 Val and 1005 Ala), and 1 in VP5 (49 Arg) were found. Phylogenetic analysis indicated that the Iranian isolate is closely related to highly virulent (hv) IBDV isolates from Asian countries. Nevertheless, it may share a common origin with hv isolates from other parts of the world.
Abstract: Plasmid DNA (pDNA)-based vaccines have emerged as effective subunit vaccines against viral and bacterial pathogens. In this study, a DNA vaccine, namely plasmid internal ribosome entry site-HN/F, was applied in ovo against Newcastle disease (ND). Vaccination was carried out using the DNA vaccine alone or as a mixture of the pDNA and dextran-spermine (D-SPM), a nanoparticle used for pDNA delivery. The results showed that in ovo vaccination with 40 µg pDNA/egg alone induced high levels of antibody titer ( P <0.05) in specific pathogen-free (SPF) chickens at 3 and 4 weeks postvaccination compared to 2 weeks postvaccination. Hemagglutination inhibition (HI) titer was not significantly different between groups injected with 40 µg pDNA + 64 µg D-SPM and 40 µg pDNA at 4 weeks postvaccination ( P >0.05). Higher antibody titer was observed in the group immunized with 40 µg pDNA/egg at 4 weeks postvaccination. The findings also showed that vaccination with 40 µg pDNA/egg alone was able to confer protection against Newcastle disease virus strain NDIBS002 in two out of seven SPF chickens. Although the chickens produced antibody titers 3 weeks after in ovo vaccination, it was not sufficient to provide complete protection to the chickens from lethal viral challenge. In addition, vaccination with pDNA/D-SPM complex did not induce high antibody titer when compared with naked pDNA. Therefore, it was concluded that DNA vaccination with plasmid internal ribosome entry site-HN/F can be suitable for in ovo application against ND, whereas D-SPM is not recommended for in ovo gene delivery. Keywords: Newcastle disease, DNA vaccine, in ovo vaccination, Newcastle disease virus, dextran-spermine nanoparticle, hemagglutinin and fusion
Brucellosis is a debilitative disease that imposes costs on both economy and society. It is shown that although the vaccine can prevent abortion, it does not provide complete protection against infection. In Iran, Brucella melitensis is a common causative agent for brucellosis and BP26 protein of this bacterium having a good antigenesity and an important vaccine candidate. In this study B. melitensis bp26 gene was cloned first in to PTZ57R/T vector and accessed on the PET28a vector and sequenced. Recombinant vector transformed and expressed in to E. coli BL21 (DE3) and then recombinant protein was purified with Ni-NTA column of chromatography against His tag. Obtained rOmp28 could be used as a research experimental tool to find its potential as a detection kit and vaccine candidate.
Background : The request for lumbosacral MRI in Iran based on previous studies is high (almost half of all MRI cases), so, our study is concerned with investigating the necessity of lumbosacral MRI request in patients with low back pain that is covered by complementary health insurance in Tehran through comparing MRI practice with valid guidelines. Methods : Information of 274 complementary insured patients at Dana Insurance Company in Tehran, who had undergone low back MRI was studied. A portion of information in the questionnaire including age, sex, the physician’s field of specialty, and MRI report, was derived from the medical records. Other information based on guidelines indications, including duration of the prolonged back pain, record of associated infection, malignancy or trauma, saddle anesthesia, lower limb motor deficit and incontinence of urine or feces, was elicited from patients orally. Results : Males represented 35% and females 65% of patients. Also, males were on average 10 years younger than females. Over 90% of MRI scans were requested by three fields of specialty (orthopedic, neurosurgery and neurology). Considering the indications of lumbar spine MRI request (prolonged back pain of more than one month duration, incontinence of urine or feces, lower limb motor deficit, saddle anesthesia, recent related trauma, infection and malignancy), approximately 20% of lumbar spine MRI scans were prescribed in accordance with guidelines. Conclusion : Out of every five cases of lumbar spine MRI, four cases were not requested based on guidelines, suggesting needs for local guideline design and revising the manner in which MRI scans are prescribed for low back pain in complementary health insured patients in Tehran.
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