Shahid Beheshti University of Medical Sciences and Health Services

About: Shahid Beheshti University of Medical Sciences and Health Services is a education organization based out in Tehran, Iran. It is known for research contribution in the topics: Population & Medicine. The organization has 19456 authors who have published 33659 publications receiving 365676 citations.

Improving Multi-Epitope Long Peptide Vaccine Potency by Using a Strategy that Enhances CD4+ T Help in BALB/c Mice.

Abstract: Peptide-based vaccines are attractive approaches for cancer immunotherapy; but the success of these vaccines in clinical trials have been limited. Our goal is to improve immune responses and anti-tumor effects against a synthetic, multi-epitope, long peptide from rat Her2/neu (rHer2/neu) using the help of CD4+ T cells and appropriate adjuvant in a mouse tumor model. Female BALB/c mice were vaccinated with P5+435 multi-epitope long peptide that presents epitopes for cytotoxic T lymphocytes (CTL) in combination with a universal Pan DR epitope (PADRE) or CpG-oligodeoxynucleotides (CpG-ODNs) as a Toll-like receptor agonist adjuvant. The results show that vaccination with the multi-epitope long peptide in combination with the PADRE peptide and CpG-ODN induced expansion of subpopulations of CD4+ and CD8+ cells producing IFN-γ, the average tumor size in the vaccinated mice was less than that of the other groups, and tumor growth was inhibited in 40% of the mice in the vaccinated group. The mean survival time was 82.6 ± 1.25 days in mice vaccinated with P5+435 + CpG+ PADRE. Our results demonstrate that inclusion of PADRE and CpG with the peptide vaccine enhanced significant tumor specific-immune responses in vaccinated mice.

A single test of antimullerian hormone in late reproductive-aged women is a good predictor of menopause.

Abstract: Objective: The aim of this study was to assess the capability of a single measurement of antimullerian hormone (AMH) to predict menopause status in late reproductive-aged women. Methods: A group of 147 women, naturally fertile, aged 40 to 50 years with regular menstrual cycles were selected from the Tehran Lipid and Glucose Study cohort. Participants were assessed three times at 3-year intervals (TI-T3), and their blood levels of AMH were measured. The World Health Organization classification was used to define menopause status. The area under the receiver operating characteristics curve was calculated to assess the ability of AMH at T1 to discriminate between women who have reached menopause status and those who have not. Cutoff points and their relevant sensitivity, specificity, and positive and negative predictive values were calculated. Results: Of 147 women, menopause occurred in 60. With use of the AMH level at Tl, the probability of an accurate prediction of not reaching menopause status within the next 6 years for women aged 40 to 50 years was 88% (area under the receiver operating characteristics curve, 0.88; 95% CI, 0.83-0.94; P < 0.001). A threshold of 0.39 ng/mL for AMH had the optimal combined sensitivity and specificity for prediction with a positive predictive value of 0.90 (95% CI, 0.81-0.96) and negative predictive value of 0.76 (95% CI, 0.65-0.86). Results for a slightly lower (0.365 ng/mL) and higher (0.49 ng/mL) AMH threshold had negligible effect. Stratified analysis for women aged 40 to 44 and 45 to 49 years produced similar results. Conclusions: Of every 10 women in late reproductive age with AMH levels greater than 0.39 ng/mL, only one will reach menopause status within the next 6 years. A single AMH measurement is a good predictor for the onset of menopause.

Validity of an adapted Household Food Insecurity Access Scale in urban households in Iran.

Abstract: Objective: To assess the validity of a locally adapted Household Food Insecurity Access Scale (HFIAS) in the measurement of household food insecurity (FI) in the city of Tehran. Design: A cross-sectional study. Setting: Urban households were selected through a systematic cluster sampling method from six different districts of Tehran. The socio-economic status of households was evaluated using a questionnaire by means of interviews. An adapted HFIAS was used to measure FI. Content validity was assessed by an expert panel, and the questionnaire was then tested among ten households for clarity. Criterion validity was assessed by comparing the measure with a number of determinants and consequences of FI. Internal consistency was evaluated by Cronbach’s a and exploratory factor analysis. For repeatability, the questionnaire was administered twice to twenty-five households at an interval of 20 d and Pearson’s correlation coefficient was calculated. Subjects: A total of 416 households. Results: In all, 11? 8% , 14? 4% and 17?5 % of the households were severely, moderately and mildly food insecure, respectively. Cronbach’s a was 0?855. A significant correlation was observed between the two administrations of the questionnaire (r 5 0?895, P , 0?001). Factor analysis of HFIAS items revealed two factors: the first five items as factor 1 (mild-to-moderate FI) and the last four as factor 2 (severe FI). Heads of food-secure households had higher education and higher job position compared with heads of food-insecure households (P , 0?001). Income and expenditure were lower in food-insecure households compared with food-secure households.

A View Beyond HbA1c: Role of Continuous Glucose Monitoring.

Abstract: Hemoglobin A1C (HbA1c) is used as an index of average blood glucose measurement over a period of months and is a mainstay of blood glucose monitoring. This metric is easy to measure and relatively inexpensive to obtain, and it predicts diabetes-related microvascular complications. However, HbA1c provides only an approximate measure of glucose control; it does not address short-term glycemic variability (GV) or hypoglycemic events. Continuous glucose monitoring (CGM) is a tool which helps clinicians and people with diabetes to overcome the limitations of HbA1c in diabetes management. Time spent in the glycemic target range and time spent in hypoglycemia are the main CGM metrics that provide a more personalized approach to diabetes management. Moreover, the glucose management indicator (GMI), which calculates an approximate HbA1c level based on the average CGM-driven glucose level, facilitates individual decision-making when the laboratory-measured HbA1c and estimated HbA1c are discordant. GV, on the other hand, is a measure of swings in blood glucose levels over hours or days and may contribute to diabetes-related complications. In addition, addressing GV is a major challenge during the optimization of glycemia. The degree of GV is associated with the frequency, duration, and severity of the hypoglycemic events. Many factors affect GV in a patient, including lifestyle, diet, the presence of comorbidities, and diabetes therapy. Recent evidence supports the use of some glucose-lowering agents to improve GV, such as the new ultra-long acting insulin analogs, as these agents have a smoother pharmacodynamic profile and improve glycemic control with fewer fluctuations and fewer nocturnal hypoglycemic events. These newer glucose-lowering agents (such as incretin hormones or sodium–glucose cotransporter 2 inhibitors) can also reduce the degree of GV. However, randomized trials are needed to evaluate the effect of GV on important diabetes outcomes. In this review, we discuss the role of HbA1c as a measure of glycemic control and its limitations. We also explore additional glycemic metrics, with a focus on time (duration) in glucose target range, time (duration) in hypoglycemia, GV, GMI, and their correlation with clinical outcomes.