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Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are multisystemic autoimmune diseases with multifactorial nature. Considering limitations of the current conventional serological tests for diagnosis of these diseases, researchers strive to find new and more valid biomarkers. The methylation level of interferon-induced protein 44-like (IFI44L) promoter was evaluated in 69 patients with SLE, 61 patients with RA, and 71 healthy subjects. Quantitative methylation of the promoter region of IFI44L gene was measured in DNA extracted from peripheral blood mononuclear cells (PBMCs) with methylation-quantification endonuclease-resistant DNA (MethyQESD) method. Our findings revealed a substantial hypomethylation of IFI44L promoter in SLE and RA patients compared with healthy volunteers (mean: 60.36%±64.54%, 47.59%±30.34%, and 89.17%±76.96%, respectively; PSLE= 0.018, PRAIFI44L promoter methylation had a sensitivity of 84/06% and 93/65% and specificity of 32/39% and 29/58, respectively. The promoter methylation level was not meaningfully different between SLE and RA patients (P > 0.05). Moreover, our analysis revealed that the methylation level of IFI44L promoter was not statistically significantly different between SLE disease activity and renal involvements (P > 0.05). While RA patients with a higher concentration of CRP had a lower DNA methylation level (P = 0.012). The methylation level of IFI44L promoter was lower in PBMCs of Iranian patients with SLE and RA than that control group. Furthermore, DNA methylation level of IFI44L promoter had a negative correlation with RA disease activity. However, there was not a significant association between clinical characteristics of SLE.

A.M. Mehrez 1,2, mehrez.ahmed@hotmail.com, ORCID: 0000-0001-8274-9274, M. Salesi 1, mhsnsls@gmail.com, ORCID: 0000-0003-2969-9102, M. Koushkie 1, koushkie53@yahoo.com, ORCID: 0000-0001-9563-9461, M. Akbarzadeh3, m_akbarzadeh@sums.ac.ir, ORCID: 0000-0001-7646-2162 1Shiraz University, Shiraz, Iran, 2Tishreen University, Lattakia, Syria, 3Shiraz University of Medical Sciences, Shiraz, Iran Ахмад М. Мехрез, аспирант по направлению «Физиология упражнений», кафедра спортивных наук, Ширазский университет, г. Шираз, Иран; Тишринский университет, г. Латакия, Сирия. E-mail: mehrez.ahmed@hotmail.com, ORCID: 0000-0001-8274-9274. Мохсен Салези, PhD в области физиологии упражнений, доцент кафедры спортивных наук, Ширазский университет, г. Шираз, Иран. E-mail: mhsnsls@gmail.com, ORCID: 0000-0003-2969-9102. Мариам Джахроми Коушки, PhD в области физиологии упражнений, профессор кафедры спортивных наук, Ширазский университет, г. Шираз, Иран. E-mail: koushkie53@yahoo.com, ORCID: 0000-0001-9563-9461. Марзие Акбарзадех, PhD в области пищевых наук, доцент кафедры общественного питания, Школа питания и пищевых наук, Ширазский медицинский университет, г. Шираз, Иран. E-mail: m_akbarzadeh@sums.ac.ir. ORCID: 0000-0001-7646-2162. Aim. The Objective of this study was to investigate the effect of short-term diet modification on plasma levels of fatigue indices (including serotonin, dopamine, serotonin/dopamine ratio, ammonia, and lactate) following a two-hour tennis match. Materials and methods. 32 semi-professional male tennis players participated in a randomized cross-over design in the form of short-term diet modification (DM) and non-modification (N-DM) interventions. They played a formal two-hour match and plasma levels of fatigue indices and RPE scores of participants were determined before and after each tennis match. Results. The results of this study showed that after the match, the serotonin, dopamine, lactate, and ammonia increased significantly compared to pre-match in both interventions (p < 0.001) and that the increase in serotonin/dopamine ratio was only significant in N-DM (p < 0.001). However, the increase in ammonia (p < 0.001) and serotonin (p < 0.05) as well as the serotonin/dopamine ratio (p < 0.05) in DM was significantly lower than in N-DM. Although the change in lactate and dopamine levels was respectively 21% and 8% higher than in N-DM after the match, these changes were not significant. A large and moderate correlation was found between RPE and serotonin/dopamine ratio (p < 0.001) and other variables (p < 0.001) respectively, which was negative for dopamine (p < 0.05). Conclusion. In this study, it was shown that short-term diet modification, could modulate the majority of fatigue indices. Therefore, diet modification can be recommended to alleviate fatigue and maintain performance among tennis players. It was also shown that the serotonin/dopamine ratio can be the most reliable among fatigue indices. Цель. Целью данного исследования было определение влияния кратковременной смены диеты на плазменные показатели утомляемости (плазменные концентрации серотонина и дофамина, соотношение серотонин / дофамин, содержание аммиака и лактата) после часового теннисного матча. Материалы и методы. Рандомизированное перекрестное исследование с участием 32 полупрофессиональных теннисистов, поделенных на две группы в зависимости от режима питания (со сменой диеты и без смены диеты). Все участники исследования сыграли двухчасовую партию в теннис. До и после теннисной партии у всех участников были определены плазменные показатели утомляемости и показатели субъективно воспринимаемой напряженности. Результаты. Результаты исследований показывают статистически значимый прирост (p < 0,001) плазменных концентраций серотонина, дофамина, лактата и аммиака в обеих группах по сравнению с исходными значениями, при этом статистически значимое (p < 0,001) увеличение соотношения серотонин / дофамин было зарегистрировано только в группе без изменения диеты. Увеличение концентраций аммиака (p < 0,001) и серотонина (p < 0,05), а также увеличение соотношения серотонин / дофамин (p < 0,05) в группе со сменой диеты было значительно ниже по сравнению с показателями контрольной группы. Хотя концентрации лактата и дофамина после партии в группе со сменой диеты были выше на 21 и 8 % соответственно, данные изменения не были статистически значимыми. Сильная и умеренная корреляция была зарегистрирована между показателями субъективно воспринимаемой напряженности и соотношением серотонин / дофамин (p < 0,001) и прочими переменными (p < 0,001) соответственно, при этом для дофамина была обнаружена отрицательная корреляция (p < 0,05). Заключение. По результатам исследования было установлено, что кратковременная смена диеты может повлечь изменения большинства показателей утомляемости. Таким образом, изменение режима питания может быть рекомендовано для контроля утомляемости и поддержания результативности теннисистов. Наиболее информативным показателем утомляемости может считаться соотношение концентраций серотонина и дофамина.

Background: Anti-cyclic citrullinated peptide (CCP) antibodies are highly specific and predictive for rheumatoid arthritis (RA). Recently, existence of anti-CCP in several other inflammatory conditions from psoriatic arthritis to neurodegenerative disorder like Alzheimer's disease (AD) has been reported. We compared the level of anti-CCP titer between the patients with mild cognitive impairment (MCI) and Alzheimer's disease; then, we compared it between the patients with mild rheumatoid arthritis and Alzheimer's disease. Methods: In this cross-sectional study, 40 patients with rheumatoid arthritis, 29 patients with Alzheimer's disease, 30 patients with mild cognitive impairment and 30 healthy controls were enrolled. Anti-CCP titer was measured by solid phase enzyme immunoassay kit. Statistical analysis was performed using one-way analysis of variance and post-hoc Tukey tests. Findings: Level of anti-CCP titer (mean ± SD) was higher significantly in patients with Alzheimer's disease (13.6 ± 1.6) was higher than healthy subjects (4.2 ± 1.1) and patients with mild cognitive impairment (4.8 ± 1.3) (P = 0.0100 for both). Anti-CCP serum level in 32.1% of patients with Alzheimer's disease and 95.5% of patients with mild rheumatoid arthritis was higher than normal range. In addition, the antibody level was significantly higher in patients with rheumatoid arthritis (54.7 ± 4.8) compared to patients with Alzheimer's disease (P = 0.0001). Conclusion: We obviously observed differences in Anti-CCP titer between patients with Alzheimer's disease and those with mild rheumatoid arthritis. It was expected since anti-CCP has a high specificity for rheumatoid arthritis and become positive in early stages of disease with a high predictive value. However, we found that in early stages of cognitive impairment, we could not use this biomarker as a diagnostic test but during disease progression, a significant difference was observed between patients with mild cognitive impairment and those with Alzheimer's disease. It needs more studies to confirm the role of anti-CCP antibody production in patients with Alzheimer's disease.

Background: The role of obesity in clinical curse of rheumatoid arthritis (RA) is not clear. We investigated the association of obesity and adiposity with disease activity and clinical response to combination therapy in RA patients. Materials and Methods: Active RA patients with the disease activity score using 28 joint counts (DAS28) > 2.6 were studied. Height, weight, and waist and hip circumferences were measured and body mass index (BMI) and waist to hip ratio were calculated. Patients were treated with methotrexate (7.5 to 10 mg/week) plus hydroxychloroquine (200 to 400 mg/day) and prednisolone (2.5 to 10 mg/day) and were followed by DAS28 for up to 24 weeks. Results: One hundred and six patients were studied; age = 48.5 ± 13.8 years, 87.7% female, disease duration = 4.4 years [SE = 0.48]. DAS28 was decreased from 4.5 ± 1.6 to 2.9 ± 1.4 (P < 0.001) after 24 weeks of treatment. Only in patients with disease duration of ≤2 years, BMI (r = -0.415, P = 0.005) and waist circumference (r = -0.296, P = 0.05) were correlated with baseline DAS28. Although BMI (r = -0.337, P = 0.025) and waist circumference (r = -0.315, P = 0.038) were correlated with change in DAS28 after therapy, these correlations were disappeared after controlling for baseline DAS28. Conclusion: Obesity and adiposity are associated with less severe disease activity in early stage of RA, but are not associated with response to combination therapy with methotrexate plus hydroxychloroquine in RA patients.

Physical Education being applied in nature, the role of scientific research has been widely challenged in this field. Applying a bibliometric analysis method, the present study tries to investigate scientific achievement in sports and exercises and examine its relation to practical performance, using scholarly papers indexed in ISI as substitutes of scientific productivity and medals won in olympic competitions for representations of athletic performance. The results showed that Sport Sciences is a small scientific community with a limited body of literature but a great number of contributing countries. The counts of sports scientific publications revealed to be exponentially increasing, signifying a stable annual growth comparable to that of the global science system. There is also a significant correlation between countries' success in olympic games and their scientific productivity. However, the former is found to have no significant correlation with the counts of sports-specific publications. It implies that though the scientific productivity in sports have no direct effect on athletes' performance in olympic games, the overall development of countries determine their performance in competitions. Consequently, to reach superiority in sports a complete evolution in all aspects of science, sports, economy and human development is necessary.

Background: Rheumatoid arthritis (RA) is commonly associated with abnormalities in plasma lipoprotein levels, especially a significantly low level of high density lipoprotein (HDL). Most treatments for RA, particularly biological drugs, decrease atherogenic index. Improvement in lipoprotein profile has been found to be associated with decrease in inflammation in RA patients. This study was designed to survey the relationship between lipid profile and RA activity index. Methods: This cross-sectional study included a total of 200 randomly selected RA patients. After blood sampling, plasma levels of triglyceride (TG), cholesterol, low density lipoprotein (LDL), HDL were measured. The correlations between these indices and disease activity index were then evaluated using disease activity score calculator (DAS28). The collected data was statistically analyzed by SPSS18. Pierson and Spearman correlation coefficients were applied for data analysis. Multiple regression test and factorial model were used to control bias.. Findings: Examination of the relation between LDL levels and RA criteria revealed a direct significant association of 0.13. A significant association of 0.17 was also found between pain intensity (based on visual analogue scale) and LDL levels. Moreover, LDL and tender joints were significantly associated (0.16). There were no statistically significant associations between LDL, joint swelling and erythrocyte sedimentation rate (ESR). HDL levels did not show significant relations with ESR, pain intensity and tender joints (P > 0.05). However, there was a significant reverse association between HDL levels and joint swelling (0.16). Conclusion: This study showed that lipid profile and RA were significantly related in many aspects. This finding was in accordance with the results of other similar studies. Therefore, it seems advisable to check the lipid profile of patients with chronic inflammatory diseases, especially RA, on a regular basis.

Background: Limited studies have shown that the administration of Bromocriptine leads to clinical improvement in a number of rheumatic patients. Low price of Bromocriptine and its trivial side effects lead the authors to investigating the effect of Bromocriptine on rheumatoid arthritis (RA) disease activity. Methods: In a randomized controlled double-blinded quasi-experimental study the effectiveness of Bromocriptine in treating rheumatoid arthritis was evaluated. 80 patients were divided in two groups (experiment and placebo. The inclusion criteria were the presence of active rheumatoid arthritis (DAS > 3.2) in spite of medical treatment. In addition to the standard medications, the case group received single oral doses of 5 mg bromocriptine and the control group received placebo tablet and were followed up for three months. Independent T-test was used to compare DAS28 in the two groups. P < 0.05 was considered significant. Finding: The mean ages of the experiment and placebo groups were 46.2 ± 13.0 and 45.9 ± 12.5 respectively. Before the starting pf the intervention in the experiment group, the mean values of PRL and DAS were 11.7 ± 6.9 and 4.2 ± 1.2, and the mean values of PRL and DAS in the placebo group were 11.3 ± 6.2 and 4.6 ± 1.4 respectively (P > 0.05). After the intervention the mean values of serum PRL level and DAS in the experiment group were 10.6 ± 7.1 and 3.7 ± 1.3 respectively, that were different with those of before the intervention (P < 0.05). Conclusion: Our findings suggest that Bromocriptine might be effective in decreasing the rheumatoid arthritis disease activity index, without any concerns about side effects.

Background: We can prevent developing osteoporosis in rheumatoid arthritis (RA) patients with compounds containing calcium and vitamin D. In some of the studies, patients who received more vitamin D had better disease control. Our aim in this study was to observe whether the vitamin D could be effective on the rheumatoid arthritis disease activity or not? Methods: This study was a double blind randomized controlled clinical trial on 117 patients with rheumatoid arthritis. In Intervention group, in addition to drug therapy, vitamin D 50000 units per week were prescribed. Control group also received placebo tablets. In the end of study, results in both groups compared. Data analysis was performed by paired t-test, Student t-test and General linear Model. Finding: There were no significant differences in baseline disease severity, and DAS-28 in both groups. DAS-28 in intervention and control groups was 5.4 ± 1.1 and 5.5 ± 1.3, respectively (P > 0.05). In both groups, all clinical and laboratory parameters after intervention were reduced. The amount of reductions in intervention group was more than the placebo group but it is not significant. Conclusion: According to this research vitamin D can use as an adjuvant therapy for rheumatoid arthritis.

In recent years the high cost of medicines and the lack of it were one of the major problems in developing countries that despite numerous efforts to solve the root causes of this problem, the issue remains, unfortunately. Therefore, this study aimed to assess the impact of antibiotics and corticosteroids prescription on the medicines expenditures. This was descriptive-analytical study that conducted to assess the function of medical expenditures through prescription letters and analysis the factors affecting medicine expenditures. We used the data of 91,994,667 selected prescription letters that were collected by the Ministry of the Health and Medical Education (MOHME) throughout the country in the year 2011 which was analyzed through a logarithmic regression model and OLS estimator. The average number of prescription items in each prescription letter were varied from 2.7 to 3.6, and the average price of each letter was varied from 30223 to 69986 Rials. Between 39 to 61 percent of prescription letters containing antibiotic items and between 15 and 35% of them contain corticosteroids. Also, the impact of antibiotic and corticosteroid prescriptions on the average expenditure of prescription letters were -1.4 and 0.032 respectively. Excessive and irrational prescribing had the greatest impact on medicine expenditures. On the other hand, the expenditure of prescription letters had the negative elasticity to antibiotics prescription and relatively inelastic for corticosteroids. So, raising the price of medications to reduce the use of them could not play a successful role in a control policy.

Background: Patients with rheumatoid arthritis may be resistant to conventional treatment with disease-modifying antirheumatic drugs (DMARDs). On the other hand, biologic therapy is costly and may be inconvenient for many patients. Pamidronate is a potent bisphosphonate with the capacity of modifying the biological activity of the immune system cells. It may thus be used as an anti-inflammatory agent in patients with inflammatory joint diseases. Materials and Methods: To assess the effectiveness of pamidronate in the management of rheumatoid arthritis, we selected 38 patients with rheumatoid arthritis to enroll in a pilot study to receive pamidronate and conventional treatment with prednisolone and DMARDs in combination. These patients received 60 mg of pamidronate for 3 consecutive months and were followed for 6 months since the first infusion. Results: The mean visual analogue score (VAS) and disease activity score (DAS28) fell steadily until one month after the third infusion. However, no improvements were observed during the 3 months after the last infusion of the drug. All patients, except one, reported decreased pain in response to 3 consecutive pulses of pamidronate and most had improvements in the assessed laboratory and clinical indices. The drug was tolerated well in our patients. Conclusion: Pamidronate infusions had beneficial effects on various clinical and laboratory parameters of patients, but alleviation of symptoms were temporary and did not last for more than 6 months. This treatment option can be a choice for difficult cases of rheumatoid arthritis with severe pain and osteoporosis.

Background: Patients undergoing renal transplantation consume immunosuppressive drugs to prevent graft rejection. Cardiovascular complications and reduced quality of sleep are among the side effects of these drugs. Studies have indicated that the use of non-therapeutic methods such as exercise is important to reduce these complications. Objective: To evaluate the effect of a period of exercise training, as a non-therapeutic method, on quality and quantity of sleep and lipid profile in renal transplant patients. Methods: 44 renal transplant recipients were selected to participate in the study and randomized into exercise (n=29) and control (n=15) groups. The exercise group participated in a cumulative exercise program 3 days a week for 10 weeks in 60–90-minute exercise sessions. Control group subjects did not participate in any regular exercise activity during this period. Sleep quality of the subjects was evaluated using Pittsburgh Sleep Quality Index (PSQI) questionnaire; the sleep quantity was assessed by recording the duration of convenient nocturnal sleep of the subjects. Physiological sleep-related variables (serum triglyceride [TG], and total, high-density lipoprotein [HDL], and low-density lipoprotein [LDL] cholesterol) were measured before and after 10 weeks of exercise training. Results: In exercise training group, sleep quality of the subjects was improved by 27%; the sleep quantity was increased by 30 minutes (p