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Measuring parent satisfaction is an important factor in pediatric health care service programs because parents play a major role in their child's life. The parental decisions are a basis for the success or failure of the child's treatment in many cases. The purpose of this study was to determine levels of parents' satisfaction following the implementation of universal newborn hearing screening (UNHS) program in Iran. In this study, the Persain version of the parent satisfaction questionnaire with neonatal hearing screening program (PSQ-NHSP) was used to measure parents' satisfaction on information of newborn hearing screening program, personnel in charge of the hearing testing, hearing screening activities, and overall satisfaction. Newborns were screened using transient evoked otoacoustic emissions and automatic auditory brainstem response tests within the first 48 h of life for each ear. Of the 312 questionnaires distributed, 217 parents (67%) responded. The mean scores of the "overall satisfaction" items ranged from 4.07 to 4.29, demonstrating high levels of parent satisfaction with this aspect of the program. More than 86% of parents were overally satisfied with the hearing screening program. In open-ended items, 84% of parents comments showed their satisfaction. The findings of the present study revealed that parents were generally satisfied with the UNHS program. The PSQ-NHSP questionnaire is easily employed and effective method for assessing parental satisfaction with newborn hearing screening programs.

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BACKGROUND AND AIM: In recent years, vitamin D deficiency has become a major worldwide problem that can exert harmful effects. The aim of the present study was to evaluate the sex- and age-related prevalence of vitamin D deficiency in people from Mashhad, northeastern Iran. METHODS: In this cross-sectional study conducted over a period of 1 year (2015-2016), 7504 subjects who referred to Mashhad medical centers were randomly enrolled in the study. The study population was divided into four groups based on sex and age, as following: group 1, 6 to 18 years; group 2, 19 to 35 years; group 3, 36 to 50 years; and group 4, 51 to 65 years. Since vitamin D levels <10, 10 to 20, and 20 to 30 ng/mL are considered as severe, moderate, and mild deficiency, respectively, we used these criteria for categorizing our population. RESULTS: Of the total population in our study, 65.26% (4902; 57.81% of men and 72.07% of women) showed some degree of vitamin D deficiency. In addition, we found that vitamin D deficiency was common in all age groups (6-18, 19-35, 36-50, and 51-65 years), and more common in women (58.5%, 80.12%, 63.83%, and 88.44%, respectively) than men (41.66%, 59.86%, 44.97%, and 84.75%, respectively). CONCLUSION: Vitamin D deficiency is a major health problem in all age groups and is more common in women. This information would help to provide a progressive prevention program to maintain health and manage some of the vitamin-related disorders and diseases that especially affect women.

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Macrophages are important player in defense against invading pathogens and their dysfunction is linked to most of inflammatory and autoimmune diseases. Inflammation is a normal and physiological response of the immune system against harmful stimuli such as infection and injury. However, when allowed to continue unchecked, under certain conditions it turns into autoimmune or inflammatory diseases, neurodegeneration, and carcinogenesis. Currently, several safe and effective anti-inflammatory drugs are available with many more drugs in the development pipeline, among which are histone deacetylase inhibitors. In this review we discuss how post-translational modifications of histones influence the innate and adaptive immunity through macrophage survival, proliferation, polarization and functional responses. We also discuss how emerging classes of pharmacological agents which developed for use as anti-cancer agents, have been applied as anti-inflammatory drugs to treat macrophage-mediated inflammatory and autoimmune diseases.

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Macrophages are heterogeneous and their phenotype and functions are regulated by the surrounding micro-environment. Macrophages commonly exist in two distinct subsets: 1) Classically activated or M1 macrophages, which are pro-inflammatory and polarized by lipopolysaccharide (LPS) either alone or in association with Th1 cytokines such as IFN-γ, GM-CSF, and produce pro-inflammatory cytokines such as interleukin-1ß (IL-1ß), IL-6, IL-12, IL-23, and TNF-α; and 2) Alternatively activated or M2 macrophages, which are anti-inflammatory and immunoregulatory and polarized by Th2 cytokines such as IL-4 and IL-13 and produce anti-inflammatory cytokines such as IL-10 and TGF-ß. M1 and M2 macrophages have different functions and transcriptional profiles. They have unique abilities by destroying pathogens or repair the inflammation-associated injury. It is known that M1/M2 macrophage balance polarization governs the fate of an organ in inflammation or injury. When the infection or inflammation is severe enough to affect an organ, macrophages first exhibit the M1 phenotype to release TNF-α, IL-1ß, IL-12, and IL-23 against the stimulus. But, if M1 phase continues, it can cause tissue damage. Therefore, M2 macrophages secrete high amounts of IL-10 and TGF-ß to suppress the inflammation, contribute to tissue repair, remodeling, vasculogenesis, and retain homeostasis. In this review, we first discuss the basic biology of macrophages including origin, differentiation and activation, tissue distribution, plasticity and polarization, migration, antigen presentation capacity, cytokine and chemokine production, metabolism, and involvement of microRNAs in macrophage polarization and function. Secondly, we discuss the protective and pathogenic role of the macrophage subsets in normal and pathological pregnancy, anti-microbial defense, anti-tumor immunity, metabolic disease and obesity, asthma and allergy, atherosclerosis, fibrosis, wound healing, and autoimmunity.

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