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Purpose: This study is striving to test the hypothesis that a low dosage of myo-inositol supplementation may decrease the likelihood of gestational diabetes in overweight, pregnant women. Methods: A randomized, double-blind, controlled trial was performed on 60 eligible overweight, pregnant women at 12-14 weeks of gestation at two Iranian obstetric clinics. The participants were divided into two groups based on blocked randomization. The myo-inositol group, receiving 2000 mg plus 200 μg folic acid daily and the control group, receiving 400 μg of folic acid daily from 14 - 24 gestational weeks. The occurrence of gestational diabetes was determined based on 75-g 2-hour oral glucose tolerance test (OGTT) at 24–28 gestational weeks, which was the primary outcome of the study. The secondary outcomes were: the evaluation of insulin therapy, insulin resistance, and lipid profile, gestational weight gain, as well as fetal and maternal outcomes. Results: The incidence of gestational diabetes in myo-inositol group was noticeably minimized compared with that of the control group (RR 0.29, 95% CI 0.09-0.94, p= 0.037). There were no differences between the two groups in terms of fasting blood sugar, fasting insulin, HOMA-IR, insulin therapy, and triglyceride. There was no report of severe adverse drug reactions, either.Conclusions: The absolute risk reduction and the ‘‘Number-Needed-to-Treat’’ for gestational diabetes were 26.8% (95% CI, 5.6–48) and 3.7 (95% CI, 2.1–18.0), respectively. Hence, it can be concluded that approximately one out of every four overweight pregnant women receiving myo-inositol benefitted from its daily intake.

Background. The prevalence of obesity and metabolic syndrome (MetS) is increasing, worldwide. Using a simple, efficient and reliable tool for predicting MetS is an essential approach in preventive health programs. The aim of this study was to compare the different anthropometric indices in predicting metabolic syndrome in older adults. Methods. This cross-sectional study is a part of the Amirkola Health and Ageing cohort Project (2011–2016). Of total, 1,488 older people aged 60–92 years were entered to the study. Medical and personal information of participants were collected by a questionnaire. After measuring the height, weight, waist circumference, hip circumference and neck circumference, body mass index, waist to hip ratio, waist to height ratio, abdominal volume index and conicity index were calculated. Independent t-test, chi-square and ROC curve were used to analyze the data. Results. Based on ATPIII-2005 diagnostic criteria, the prevalence of metabolic syndrome was 71.57%.The prevalence in female was higher than male. All of examined anthropometric indices, except neck circumference (p = 0.10), showed a significant difference in people with MetS compared to the individuals without metabolic syndrome (p Conclusion. Waist to height ratio was the best predictor of MetS in older adults.

BACKGROUND: This study was aimed to investigate the risk factors for mortality in patients with COVID-19. METHODS: For this retrospective cohort study, we included 121 deceased and 436 discharged cases with COVID-19 in Babol, Northern Iran. The cases were between March 1 to April 1, 2020. RESULTS: Multivariate Poisson regression analysis revealed that older age (aRR: 1.03, 95% CI: 1.01, 1.05, p < 0.001), hospital length of stay (aRR: 0.94, 95% CI: 0.90, 0.97, p = 0.003), ICU admission (aRR: 4.34, 95% CI: 2.95, 6.37, p < 0.001), cerebrovascular disease (aRR: 1.96, 95% CI: 1.20, 3.19, p = 0.007), ventilator-associated pneumonia (VAP) (aRR: 2.09, 95% CI: 1.22, 3.55, p = 0.006), septic shock (aRR: 2.98, 95% CI: 1.44, 6.19, p = 0.003), acute respiratory distress syndrome (ARDS) (aRR: 3.80, 95% CI: 2.28, 6.31, p < 0.001), acute kidney failure (AKF) (aRR: 1.45, 95% CI: 1.12, 3.76, p = 0.021), acute heart failure (AHF) (aRR: 1.63, 95% CI: 1.01, 2.62, p = 0.043) and lymphocyte count (aRR: 3.01, 95% CI: 1.99, 4.57, p < 0.001) were associated with mortality. CONCLUSION: Findings showed that elderly with comorbidities such as cerebrovascular diseases had an increased risk of death. Some complications such as: pneumonia, septic shock, ARDS, AHF, and AKF played crucial roles as well death (Tab. 2, Ref. 25).

Background and purpose: Type 2 diabetes mellitus (T2DM) is the most common form of diabetes, and a metabolic disorder affecting patients' general health in various ways. The present study aimed to evaluate the oral health-related quality of life (OHRQoL) among older adults of Amirkola, Northern Iran. Materials and Methods: A case-control study was conducted with a sample of 500 elderly people (250 with T2DM and 250 healthy controls) who answered geriatric oral health assessment index (GOHAI) questionnaire and a questionnaire evaluating xerostomia. Then, all participants underwent clinical dental examinations. The obtained data were then analyzed by t-test, chi-square test, and Pearson's correlation coefficient, and p < 0.05 was considered significant. Results: The prevalence of xerostomia was not statistically significant between the T2DM patients and control groups (p < 0.079). Greater number of patients suffering T2DM reported xerostomia according to the records; however, the correlation between this disorder and periodontal disease index (PDI), Plaque index (PI), oral health index-simplified (OHI-S), and geriatric oral health assessment index (GOHAI) in the subjects of the two study groups was not significant (p < 0.0001). Conclusion: In the present study, there was no significant relationship between GOHAI and periodontal indices, demonstrating no difference in the OHRQoL of elderly patients with T2DM and older healthy adults.

The factors affecting the dynamics of lengthening of symptoms and serologic responses are not well known. In order to see how the serologic responses change in relation to the clinical features, we selected a group of 472 adults with a positive IgM/IgG antibody test result from a baseline study of the anti-SARS-CoV-2 seropositivity, assessed their COVID-19 and past medical histories, and followed them up in about 3 months. Nearly one-fourth of the subjects were asymptomatic at the baseline; 12.8% subjects became symptomatic at the follow-up (FU) when 39.8% of the subjects had some persisting symptoms. At the baseline, 6.1% showed anti-SARS-CoV-2 IgM positive, 59.3% only for IgG, and 34.5% for both. At the FU, these figures declined to 0.6, 54.0, and 4.4%, respectively, with the mean IgM and IgG levels declining about 6.3 and 2.5 folds. Blood group A was consistently linked to both sustaining and flipping of the gastrointestinal (GI) and respiratory symptoms. The baseline IgM level was associated with GI symptoms and pre-existing cirrhosis in multivariate models. Both of the baseline and FU IgG levels were strongly associated with age, male, and lung involvement seen in chest computed tomography (CT)-scan. Finally, as compared with antibody decayers, IgM sustainers were found to be more anosmic [mean difference (MD): 11.5%; P = 0.047] with lower body mass index (BMI) (MD: 1.30 kg/m2; P = 0.002), while IgG sustainers were more commonly females (MD: 19.2%; P = 0.042) with shorter diarrhea duration in the FU (MD: 2.8 days; P = 0.027). Our findings indicate how the anti-SARS-CoV-2 serologic response and COVID-19 clinical presentations change in relation to each other and basic characteristics.

Summary Background Rapid increases in cases of COVID-19 were observed in multiple cities in Iran towards the start of the pandemic. However, the true infection rate remains unknown. We aimed to assess the seroprevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 18 cities of Iran as an indicator of the infection rate. Methods In this population-based cross-sectional study, we randomly selected and invited study participants from the general population (from lists of people registered with the Iranian electronic health record system or health-care centres) and a high-risk population of individuals likely to have close social contact with SARS-CoV-2-infected individuals through their occupation (from employee lists provided by relevant agencies or companies, such as supermarket chains) across 18 cities in 17 Iranian provinces. Participants were asked questions on their demographic characteristics, medical history, recent COVID-19-related symptoms, and COVID-19-related exposures. Iran Food and Drug Administration-approved Pishtaz Teb SARS-CoV-2 ELISA kits were used to detect SARS-CoV-2-specific IgG and IgM antibodies in blood samples from participants. Seroprevalence was estimated on the basis of ELISA test results and adjusted for population weighting (by age, sex, and city population size) and test performance (according to our independent validation of sensitivity and specificity). Findings From 9181 individuals who were initially contacted between April 17 and June 2, 2020, 243 individuals refused to provide blood samples and 36 did not provide demographic information and were excluded from the analysis. Among the 8902 individuals included in the analysis, 5372 had occupations with a high risk of exposure to SARS-CoV-2 and 3530 were recruited from the general population. The overall population weight-adjusted and test performance-adjusted prevalence of antibody seropositivity in the general population was 17·1% (95% CI 14·6–19·5), implying that 4 265 542 (95% CI 3 659 043–4 887 078) individuals from the 18 cities included were infected by the end of April, 2020. The adjusted seroprevalence of SARS-CoV-2-specific antibodies varied greatly by city, with the highest estimates found in Rasht (72·6% [53·9–92·8]) and Qom (58·5% [37·2–83·9]). The overall population weight-adjusted and test performance-adjusted seroprevalence in the high-risk population was 20·0% (18·5–21·7) and showed little variation between the occupations included. Interpretations Seroprevalence is likely to be much higher than the reported prevalence of COVID-19 based on confirmed COVID-19 cases in Iran. Despite high seroprevalence in a few cities, a large proportion of the population is still uninfected. The potential shortcomings of current public health policies should therefore be identified to prevent future epidemic waves in Iran. Funding Iranian Ministry of Health and Medical Education. Translation For the Farsi translation of the abstract see Supplementary Materials section.

Background: World Health Organization estimated that 1 in 4 men and 1 in 5 women have hypertension (HTN). Considering the impact of high blood pressure (BP) identification to prevent its related complications. Objectives: This study was performed to describe the first national BP screening program conducted in Babol, north of Iran. Methods: In this historical cohort carried out at Babol University of Medical Sciences, data related to the 2019 BP screening mass campaign in adult people ≥ 30 years were collected. BP less than 120/80 mm Hg was considered as normal, and mean BP ≥ 140/90 mm Hg or taking antihypertensive medication was defined as hypertension. When the systolic pressure was 120 - 139 or the diastolic pressure was 80 - 90 mm Hg, the person was classified as a prehypertensive case. Results: Totally, 220,241 adult people, with a mean age of 49.82 ± 14.26 years were screened, of whom 42,107 cases (19.1%; 95% CI: 18.95 - 19.28%) had hypertension, 112,406 cases (51.0%) had normal BP, and 65,728 cases (29.8%) were diagnosed as prehypertensive cases. After controlling for demographic covariates, the logistic regression models showed significantly higher odds of hypertension for married individuals (adjusted OR = 1.23; 95% CI: 1.19 - 1.27; P < 0.0001) and those living in urban regions (adjusted OR = 1.84; 95% CI: 1.79 - 1.88; P < 0.0001). The prevalence of hypertension showed no significant difference between men and women (P = 0.476). Conclusions: As nearly one in five adults had hypertension, and nearly 30% were diagnosed as prehypertensive individuals, a continuous BP screening program is recommended in this region. High BP was observed more in older and married cases and in people living in urban regions.

Introduction: COVID-19 is a viral disease of the coronavirus family. The virus first attacks the respiratorysystem and then infects important organs such as the heart, liver, brain, kidneys, blood and immune system.This study aimed to evaluate the effectiveness of a diet plan for lung diseases based on traditional Persianmedicine (PM) in patients with pulmonary dysfunction with possible infection with COVID-19.Materials and Methods: This study was performed as a randomized clinical trial in 2020 in the Sevome-Shaban Hospital and Shohada Gomnam Hospital in Tehran, Iran. In this study, patients admitted to thesehospitals were randomly entered into the study. A total of 80 people were included in this study. A normaldiet and a traditional medicine diet were considered for each group of patients. The effectiveness of the dietdesigned for patients was assessed in such a way that the primary outcome of changes in oxygen levels ofCovid 19 patients and the secondary consequences of the number of days of hospitalization and the degree ofchange in respiratory symptoms at discharge compared to hospitalization were examined. Also in this study,the general condition of patients including marital status, type of job, medical history, and drug use wereexamined. Patients enter the study after obtaining consent and will be excluded from the study at any time ifthey wish. Finally, the collected data were evaluated using G-Power. 3.1.9.2 software.Results: The results showed that there is a significant relationship between the use of diet based on traditionalmedicine and length of hospital stay, which has a correlation coefficient of 1.060 at the alpha level of 0.05.There is also a significant relationship between the use of diet based on traditional medicine and the amountof oxygen needed by patients at the alpha level of 0.05 has a correlation coefficient of 1.046. There is anothersignificant relationship between the use of diet based on traditional medicine and the rate of patients’ cough.At the alpha level of 0.05, it has a correlation coefficient of 1.451.Conclusion: According to the results, it can be concluded that the effective use of diet based on traditionalmedicine significantly increases the health of patients (reducing the length of hospital stay, reducing cough,and reducing the severity of oxygen demand in the study group (control In other words, the modified meanof these two groups in these three components (reduction of hospital stay, reduction of cough and reductionof the intensity of oxygen demand) were significantly different.

Background Extracorporeal blood purification has been proposed as one of the therapeutic approaches in patients with coronavirus infection, because of its beneficial impact on elimination of inflammatory cytokines. Methods This controlled trial has been conducted on critically ill COVID-19 patients admitted in the state hospital affiliated to Babol University of Medical Sciences, Iran who received different antiviral and antibacterial drugs, and different modalities of respiratory treatments and did not have positive clinical improvement. No randomization and blindness was considered. All of the participants underwent three sessions of resin-directed hemoperfusion using continuous renal replacement therapy with a mode of continuous venovenous hemofiltration (CVVH). Results Five men and five women with a mean age of 57.30 ± 18.07 years have been enrolled in the study; and six of them have improved after the intervention. Peripheral capillary oxygen saturation (SpO2) changed after each session. Mean SpO2 before the three sessions of hemoperfusion was 89.60% ± 3.94% and increased to 92.13% ± 3.28% after them (p p = 0.073); and c-reactive protein decreased from 136.25 ± 84.39 to 78.25 ± 38.67 mg/L (P = 0.016). Conclusions Extracorporeal hemoadsorption could improve the general condition in most of recruited patients with severe coronavirus disease; however, large prospective multicenter trials in carefully selected patients are needed to definitely evaluate the efficacy of hemoperfusion in COVID-19 patients. Trial registration The research protocol has been registered in the website of Iranian Registry of Clinical Trials with the reference number IRCT20150704023055N2.

Background Metabolic syndrome (MetS) as an important risk factor arising from insulin resistance accompanying abnormal adipose deposition and function has become a major challenge to public health around the world. Objectives This research was conducted to evaluate the association of MetS and its components with survival of older adults. Methods This prospective study is a part of the Amirkola Health and Ageing Cohort Project (2011 - 2017) conducted among 1562 older adults (aged 60 years and over) living in Amirkola, north of Iran. MetS was defined according to four sets of definition: Iranian definition, International Diabetes Federation (IDF) definition, 2001 Adult Treatment Panel (ATP) III and 2005 Adult Treatment Panel (ATP) III. Results Eight hundred sixty-three (55.2%) males and 699 (44.8%) females with a mean age of 69.3 ± 7.4 years were included in the research. The results showed that 71.9%, 74.3%, 68.8% and 66.7% of older adults had MetS based on 2005 ATP III, Iranian, IDF and 2001 ATP III diagnostic criteria, respectively. Only raised fasting plasma glucose (FPG) had a significant association with a five-year survival rate of older adults (FPG ≥ 110mg/dL: adjusted HR: 2.05; 95% CI: 1.51 - 2.78; P < 0.001). Other MetS components did not show any significant associations with survival (P > 0.05). Nevertheless, MetS itself significantly decreased the survival rate of older adults after adjusting age, gender and number of chronic diseases (HR = 1.67; 95% CI: 1.16 - 2.41; P = 0.006). Conclusions MetS and one of its components, high FPG, have significant associations with survival of older adults.

Trichinellosis, caused by the parasitic nematode Trichinella spp. is a widespread foodborne zoonotic disease and is a public health concern in many countries. Wild boar is the second most important source of trichinellosis for humans. We conducted a systematic review and meta-analysis to evaluate the global seroprevalence of Trichinella infection among wild boar. We searched five major databases for studies reporting Trichinella spp. seroprevalence in wild boar between January 1995 and January 2018. Inclusion and exclusion criteria were applied. A random-effects model was used to estimate the pooled seroprevalence of Trichinella in wild boar. A total of 21 studies involving 16,327 wild boar from 15 countries were included in this meta-analysis. The pooled seroprevalence for Trichinella infection in wild boar was 6% (95% CI: 3–10%; 1084/16327). The estimated seroprevalence in North America was 9% (95% CI, 1–25%), in Europe 7% (95% CI, 3–13%), in Asia 3% (95% CI, 0.0–11%) and in Oceania 3% (95% CI, 2–4%). Geographical location, gender and age were not significantly associated with seropositivity. In sub-group analysis, the pooled seroprevalence of Trichinella infection in wild boar when ELISA was used as the diagnostic test (16%; 95% CI, 4–34%) was significantly higher when compared to western blot (4%; 95% CI, 0–12%). These results emphasize that wild boars are a potential source for acquisition of Trichinella infection in humans, and surveillance programs should be implemented in high-risk countries.

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations., A high-resolution, global atlas of mortality of children under five years of age between 2000 and 2017 highlights subnational geographical inequalities in the distribution, rates and absolute counts of child deaths by age.

Background: We conducted a meta-analysis to investigate the possible effects of vitamin D deficiency on clinical outcomes of critically-ill children.Methods: We searched Scopus-Embase and PubMed-Medline databases to find eligible observational articles. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the strength of associations.Results: Seventeen articles (eighteen studies) involving 2987 critically ill patients met our inclusion criteria. Vitamin D deficiency was not associated with increased mortality. A significant association was only observed in very high developed countries between vitamin D deficiency and risk of sepsis [OR (95%CIs): 2.65 (1.30, 5.41)] and ventilation support requirement [OR (95%CIs): 1.35 (1.03, 1.77)].Conclusion: Our findings suggest that vitamin D deficiency is not associated with higher mortality among critically ill children but increases susceptibility to sepsis and the need for ventilator support in critical care settings.

Background and Objective: Hyperhomocysteinemia is a well-known risk factor for cardiovascular disease. Although metformin therapy can increase homocysteine (Hcy) levels, it frequently is used as an oral medicine in women with polycystic ovary syndrome (PCOS), who might be at risk of catching diabetes mellitus. The aim of this study was to investigate the effect of metformin on the levels of serum Hcy, vitamin B12 (vit B12), and folic acid in patients with PCOS. Materials and Methods: An interventional study was designed with 18 patients with PCOS at the Fatemehzahra infertility Hospital in Babol, Iran. Metformin treatment (500 mg twice daily) was initiated in all patients for a period of consecutive 6 months. The levels of serum Hcy, vit B12, and folic acid were measured in the participants before and after metformin treatment. Results: The mean vit B12 level showed a significant decrease in patients after 6 months of metformin treatment (P = 0.002). However, there was no significant difference in serum folic acid levels. The mean Hcy levels increased after treatment, but this difference not was statistically significant. When patients were stratified into four subgroups by their insulin sensitivity and body mass index (BMI), relatively similar results were obtained in the subgroups, except that Hcy levels in the overweight/obesity group (BMI > 25 kg/m2) after treatment showed a significant increase (P = 0.01). Conclusion: These findings indicate that metformin increases the serum Hcy concentration in patients with PCOS especially in the women with BMI > 25 kg/m2. The possible mechanism for this effect would be the obvious reduction in the levels of vit B12.

Background and objectives Overweight and obesity are among the important challenges in health issues and survival of elderly people. The current study aimed to evaluate the survival rate of elderly patients with diabetes, and its influencing factors, on the basis of body mass index (BMI). Methods and materials The design of the current study was based on the Amirkola Health and Aging Project (AHAP) cohort. The 5–year survival rate of elderly people with diabetes and the factors that influence the mortality rate by Cox regression model were analyzed. Results Out of 1616 elderly people who were evaluated in the current study, 501 (31%) had diabetes. The results showed that diabetes significantly increased the mortality rate (adjusted hazard ratio [HR] = 2.10; 95% confidence interval [CI]: 1.57–2.81; P

To evaluate the relevance of body mass index (BMI), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and LH/FSH ratio with clinical symptoms in polycystic ovary syndrome (PCOS) women. Methods: We reviewed the medical records of all women visited in the PCOS Clinic of Babol (Iran) from 2008 to 2012. A retrospective cross-sectional study was conducted on 175 PCOS women; aged 18–38 years diagnosed based on the Rotterdam criteria. Among the PCOs women, the prevalence of oligomenorrhea, acne, and hirsutism were found to be 92.0%, 31.4%, and 78.9%, respectively. Positive finding of polycystic ovaries was observed in 89.1% of PCOS women with by using sonography. A total of 69.2% overweight/obesity patients had polycystic ovary morphology on ultrasound image. Compared with non- overweight/obesity, the adjusted OR of PCOS women for sonographic view of polycystic ovaries was 4.33 (95% CI, 1.42-13.15, p=0.001), Nevertheless, the adjusted odds ratio (OR) showed no significant associations between LH, FSH, and LH/FSH ratio with clinical symptoms in these women. The findings of this study indicated that the overweight/obese women with PCOS are at an increased risk for sonographic view of polycystic ovaries. Therefore, it is suggested that successful weight loss is the most effective method of restoring ovulation, menstruation that should be used as major advice in obese PCOS patients.

Kazuyuki Arakawa,1,2 Akihiro Hosono,2 Kiyoshi Shibata,3 Reza Ghadimi,4 Mizuho Fuku,5 Chiho Goto,6 Nahomi Imaeda,7 Yuko Tokudome,8 Hideki Hoshino,9 Mitsuhiro Marumoto,1,2 Masaaki Kobayashi,10 Sadao Suzuki,2 Shinkan Tokudome1,2,11 1Department of Health and Nutrition Policy, 2Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; 3Department of Public Health and Nutrition, Aichi Gakusen University, Okazaki, Japan; 4Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran; 5Department of Rehabilitation Medicine, Yokohama Stroke and Brain Center, Yokohama, Japan; 6Department of Health and Nutrition, Nagoya Bunri University, Inazawa, Japan; 7Department of Food Science and Nutrition, Nagoya Women’s University, Nagoya, Japan; 8Department of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin, Japan; 9Department of Early Childhood Studies, Aichi Bunkyo Women’s College, Inazawa, Japan; 10Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; 11National Institute of Health and Nutrition, Tokyo, Japan Abstract: We studied changes in blood markers of 18 nonprofessional, middle-aged runners of a 2-day, 130 km ultramarathon. Blood was sampled at baseline, after the goals on the first and second day, and at three time points (1, 3, and 5/6 days) after the race. Blood indices showed three patterns. First pattern indices showed essentially no changes after the two goals and after the race, including red blood cell indices, gamma-glutamyl transferase, and tumor necrosis factor-α. Second pattern markers, including the majority of indices, were elevated during the race (and also after the race for some parameters) and then returned to baseline afterward, including hemolysis/red blood cell destruction markers (indirect bilirubin) and an iron reservoir index (ferritin), muscle damage parameters (uric acid, creatine kinase, lactate dehydrogenase, and aspartate aminotransferase), renal function markers (creatinine and blood urea nitrogen), liver injury index (alanine aminotransferase), lipid metabolism indices (free fatty acid), reactive oxygen species and inflammation parameters (white blood cells, interleukin-6, and C-reactive protein), and energy production and catecholamines (adrenaline, noradrenaline, and dopamine). Third pattern index of a lipid metabolism marker – triglyceride – decreased during the race periods and started returning to baseline from then onward. Some hormonal markers such as insulin, leptin, and adiponectin showed unique patterns. These findings appeared informative for nonprofessional athletes to know about an optimal physical activity level, duration, and total exercise for elevating physical performance and monitoring physical/mental conditioning as well as for prevention of overtraining and physical injuries. Keywords: long-distance running, blood biochemical markers, anemia, muscle damage, lipid metabolism, inflammation

Accelerated intimal and medial calcification and sclerosis accompany the increased cardiovascular mortality of dialysis patients, but the pathomechanisms initiating microcalcifications of the media are largely unknown. In this study, we systematically investigated the ultrastructural properties of medial calcifications from patients with uremia. We collected iliac artery segments from 30 dialysis patients before kidney transplantation and studied them by radiography, microcomputed tomography, light microscopy, and transmission electron microscopy including electron energy loss spectrometry, energy dispersive spectroscopy, and electron diffraction. In addition, we performed synchrotron x-ray analyses and immunogold labeling to detect inhibitors of calcification. Von Kossa staining revealed calcification of 53% of the arteries. The diameter of these microcalcifications ranged from 20 to 500 nm, with a core-shell structure consisting of up to three layers (subshells). Many of the calcifications consisted of 2- to 10-nm nanocrystals and showed a hydroxyapatite and whitlockite crystalline structure and mineral phase. Immunogold labeling of calcification foci revealed the calcification inhibitors fetuin-A, osteopontin, and matrix gla protein. These observations suggest that uremic microcalcifications originate from nanocrystals, are chemically diverse, and intimately associate with proteinaceous inhibitors of calcification. Furthermore, considering the core-shell structure of the calcifications, apoptotic bodies or matrix vesicles may serve as a calcification nidus.

The aim of this study is to evaluate hepatitis B vaccine protection in those adults who have taken one or two does of vaccine before. It was a retrospective cross sectional study was conducted on fifty-six military personnel in Tehran, Iran in the spring 2007. Demographic data such as age, marital status, education level, number of vaccine doses injected and, type of vaccine and date of last vaccination was collected. Their serum was tested for HBs Ab, HBc Ab and HBs Ag and finally the results were analyzed by SPSS software. All individuals were male with the mean age of 33.9+/-8.9 years. Twelve individuals who had only received one dose of injected vaccine had no antibody against HBsAg and no protection against hepatitis B virus. Of forty-four individuals that had received two doses of injected vaccine, 27 persons (61.4%) were protected and had serum HBsAb more than 10 MIU mL(-1). In conclusion one dose of HBV vaccine cannot produce immunity for five years but two doses of HBV vaccine can produce immunity for five years. However, HBsAb should be tested to make sure of immunity.

We investigated the possible influence of an exhaustive physical exercise on mental stress biomarkers (serotonin, tryptophan, and beta-endorphin) along with dopamine, noradrenaline and free fatty acids in an ultramarathon race in which 45 km was run on the first day and 90 km on the second. We obtained serum samples at 6 different time points during and after the race from 18 Japanese male runners who completed the marathon. Overall changes of serum serotonin and tryptophan concentrations were statistically significant according to ANOVA for repeated measurements (p < 0.05). Serum serotonin levels elevated rapidly on the first day with the post hoc Tukey's test. Tryptophan concentrations inversely decreased during the race, possibly because of utilization for synthesis of serotonin. Levels of beta-endorphin appeared to increase on the first and second days, but were not statistically significant. In conclusion, serum serotonin, tryptophan and beta-endorphin appeared to be used for mental stress markers in physical exercise.

To clarify host and environmental factors for gastric carcinogenesis, we obtained information about gastric cancer mortality in Babol, in the North of Iran, and recruited 130 participants aged 30-80 years from the general population of Babol in 2004. A urea breath test, assessment of IgG antibodies to Helicobacter pylori, a pepsinogen test, a marker of chronic atrophic gastritis, and determination of urinary excretions of sodium and potassium were performed. Diet and lifestyle information was also obtained using a questionnaire. The stomach cancer mortality rate for men in Babol (38.2/10 5 ) was found to be somewhat lower than that for Japanese men (45.1 /10 5 ), while the mortality for women (26.9/10 5 ) was higher than for Japanese women (20.9/10 5 ). Positive rates for the urea breath test were 77.5 and 81.8% for Iranian men and women, respectively. Helicobacter pylori IgG antibodies were present in 68.7 and 73.7% of Iranian men and women, respectively, both values being marginally higher than for Japanese. We also found 51.0 and 52.8% to be positive for a pepsinogen test, significantly higher than the Japanese values. Urinary excretions of salt and potassium in this population appeared approximately the same as the consumption in Japanese. The elevated gastric cancer mortality in both men and women in Babol seems, by and large, to be related to higher H. pylori infection rates and prevalence of chronic atrophic gastritis. Certain factors, including H. pylori DNA diversity, host factors and their interactions, together with the level of medical practice, prevalence of and access to secondary prevention of stomach cancer, may also be associated with the relatively high mortality.

The gastric cancer incidence in Semarang, Indonesia, is exceedingly low: only approximately 1/100th of the level in Japan. To elucidate the reason, we carried out an ecological study recruiting 69 male and 102 female participants from the general populace in January 2005. Positive urea breath tests were 0% for both men and women, and Helicobacter pylori (H. pylori) IgG antibodies were found in 2% (0–5, 95% confidence interval) of men and 2% (0–4) of women, significantly lower than the 62% (58–65) and 57% (53–60), respectively, in Japan. Furthermore, there were no positive findings with the pepsinogen tests in Semarang, again significant in comparison with the 23% (22–25) and 22% (20–23) in Japan. Variation in smoking levels and consumption of NaCl, vegetables and fruit were found, but not to an extent that would allow explanation of the major differences in gastric cancer incidence. We may conclude that the very low prevalence of H. pylori infection and thus chronic atrophic gastritis account for the rarity of stomach cancer in Semarang, Indonesia. (Cancer Sci 2005; 96: 873–875)

factors for cardia andnoncardia stomach and esophageal cancer from EPIC-EURO-GAST, a large prospective study. Vegetable intake was foundto be related to a lowered risk of intestinal type gastric cancerand adenocarcinoma of the esophagus, and citrus fruit con-sumption appeared to have a role in protection against cardiagastric cancer and adenocarcinoma of the esophagus.