Adverse events included four patients with infections requiring admission, one drug-related rash, five CD surgeries and two CD exacerbations. Conclusions Ustekinumab was well tolerated in a complex UK CD population and demonstrated benefit to patients in terms of clinical response and improvement of biomarkers and with some patients attaining clinical remission. No unexpected safety signals were seen. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.Background and aims Recent studies suggest that sedation provided by anaesthesia professionals may be less protective against serious adverse events than previously believed, however, data are lacking regarding endoscopic retrograde cholangiopancreatography (ERCP). Using the clinical outcomes research initiative national endoscopic database (CORI-NED), we aimed to assess whether mode of sedation was associated with rates of unplanned interventions (UIs) during ERCP. Patients and methods All subjects from CORI-NED undergoing ERCP from 2004 to 2014 were identified and stratified into three groups based on the initial mode of anaesthesia endoscopist-directed sedation (EDS), monitored anaesthesia care without an endotracheal tube (MAC-WET) and general endotracheal anaesthesia (GEA). The primary outcome was UIs. To assess the impact of sedation mode on UIs, multivariable logistic regression models were created adjusting for demographic, physician and procedure-level variables. Design Population-based study. Results 26 698 ERCPs were analysed (7588 EDS, 8395 MAC-WET, 10 715 GEA). UIs occurred in 320 ERCPs (1.2%). EDS was associated with a higher risk of UIs compared with sedation administered by an anaesthesia professional (OR 1.86, 95% CI 1.44 to 2.42). Additional factors associated with a higher risk of UIs included ASA class IV compared with class II (OR 3.18, 95% CI 2.00 to 5.06) and ERCPs done in community (OR 1.41, 1.04 to 1.91) and health maintenance organisations (OR 3.75, 2.01 to 6.99) hospitals. Conclusion EDS is associated with a higher risk of UIs during ERCP compared with sedation administered by an anaesthesia professional. Higher ASA class and procedures performed in non-university hospitals were also associated with a higher risk of UIs. This study suggests that, when available, sedation using an anaesthesia professional should be utilised for ERCP. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.MUC1 is an attractive target for cancer vaccines as a result of its over-expression and aberrant glycosylation pattern on many tumor cells. However, the low immunogenicity of MUC1 and immune tolerance have limited its application. Herein, we designed MUC1-based tricomponent antitumor vaccines adjuvanted with fibroblast stimulating lipopeptide 1 (FSL-1). Immunological results indicate that the glycosylated tricomponent vaccine candidate has elicited both humoral and cellular immune responses. The induced antibodies could effectively bind to MCF-7. Furthermore, the vaccine exhibited an obvious reduction in tumour burden. This journal is © The Royal Society of Chemistry 2019.The aim of this study was to investigate the anti-inflammatory effects of two new isoxazoline-acylhydrazone derivatives N’-(4-methoxybenzylidene)-6-(4-nitro-benzoyl)-3a,5,6,6a-tetrahydro-4H-pyrrolo[3,2-d]isoxazole-3-carbohydrazide (R-123) and N’-(4-chlorobenzylidene)-6-(4-chlorobenzoyl)-3a,5,6,6a-tetrahydro-4H-pyrrolo[3,2-d]isoxazole-3-carbohydrazide (R-99). An air pouch induced by carrageenan was used for screening the best dose of R-99 and R-123. Using this mouse model, leukocyte migration and cytokine levels (TNF-α and IL-1β) were determined. Paw edema induced by several phlogistic agents and vascular permeability induced by acetic acid were employed to investigate the mechanism of action of the isoxazoline-acylhydrazone derivatives. A docking study was performed with the human histamine H1 receptor to investigate potential antihistaminic activity. Treatment with the compounds reduced leukocyte migration in the air pouch at all doses tested. TNF-α and IL-1β levels were similarly reduced by the two compounds. Vasoactive amines were inhibited in models of paw edema induced by several agents and vascular permeability induced by acetic acid. The docking study suggests that R-99 and R-123 may be inhibitors of the histamine H1 receptor. In conclusion, the results indicate that R-99 and R-123 exhibit promising anti-inflammatory activity related to their ability to inhibit TNF-α, IL-1β, and vasoactive amine production, as well as reduce leukocyte migration and inhibit mast cell degranulation. This journal is © The Royal Society of Chemistry 2019.Background Depression and obesity are among the increasingly publicized health problems, both being related to critical complications, and increasing the risk of substantial morbidity and mortality. An increasing number of documents indicate that obesity affects mental status, low serum cholesterol levels, and is related to depressive symptoms. The purpose of the present study was to evaluate the possible significant difference in lipid profile levels, body mass index (BMI), waist circumference (WC), and blood pressure (BP), between depressive and nondepressive older adults. Methods This was a case-control study where 107 patients, over 65-year-old, were enrolled in this study. Serum total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG), BP, and fasting blood sugar were measured. Data were analyzed using the statistical SPSS software version 22. Independent t-test was used to compare the results between the two groups and the Chi-square test was used to compare categorical variables. In addition, nonparametric Mann-Whitney test was used to evaluate the data. Results The depressive group showed significant lower BMI, WC, LDL-C, and TG (P less then 0.001, P less then 0.001, P less then 0.016, and P less then 0.014). Furthermore, the findings showed significantly higher systolic and diastolic BP in participants who had shown depressive symptoms (P less then 0.035 and P less then 0.024). Conclusions The findings suggest that a low BMI, serum LDL-C, and TG are related to depressive symptoms the Iranian elderly. Copyright © 2019 International Journal of Preventive Medicine.Background Health literacy is a major factor for health promotion and well-being. In spite of several researches on health literacy, information on the subject of the status of health literacy in Asian countries such as Iran is inadequate. Therefore, this study aimed to assess the inequality of health literacy in an Iranian population and its influencing factors. Methods In this cross-sectional study, 736 families were selected by cluster random sampling. A validated questionnaire was used to measure the health literacy of participants. Socioeconomic status (SES) was calculated by asset-based approach, and principal component analysis (PCA) was performed to estimate the families’ SES. Concentration index and curve were used to measure SES inequality in health literacy, and after that decomposed into its determinants. The data were analyzed by Stata software. Results The mean age of the participants was 34.81 years (standard deviation = 5.98 years). The value of concentration index for health literacy equals 0.2292 (95% confidence interval = 0.168-0.283), and this value indicates that there is inequality in distribution of health literacy in Iran and the inequality disfavors the poor. Conclusions The results of this study revealed that there is inequality in distribution of health literacy in Iran, and people of higher economic status in Iran enjoy from better health literacy levels. Copyright © 2019 International Journal of Preventive Medicine.Background Many studies have focused on the relationship between naloxone and seizure in tramadol poisoning but the results are in conflict. We performed a meta-analysis study to see whether naloxone prevents or increase the risk of seizure in tramadol poisoning. Methods Bibliographic literature searches were conducted in the ISI Web of Science, Excerpta Medica Database (EMBASE), PubMed, and Cochrane from January 1990 to December 2017 for relevant articles. Pooled data were analyzed by calculating odds ratios (ORs) with 95% confidence intervals (CIs). The outcome includes seizure. To investigate the publication bias, Begg’s and Egger’s tests were used along with funnel plot as a graphical test. Results Seven studies met the inclusion criteria. The meta-analysis showed I 2, 27%, (P value, 0.23) indicating no significant heterogeneity. As a result, using the fixed effect, the OR was 1.14 (95% CI = 0.60-2.18, P value, 0.69) which was not significant, means naloxone did not increase the risk of seizure. Conclusions Naloxone therapy did not increase the risk of seizure significantly in the treatment of acute tramadol poisoning. We suggest considering the risk/benefit when administration naloxone, especially for the seizure risk factors including previous history of seizure, tramadol misuse, and co-ingestion. Copyright © 2019 International Journal of Preventive Medicine.Background To test whether gender moderates the effects of baseline depressive symptoms and chronic medical conditions (CMCs) on risk of receiving subsequent psychiatric diagnosis among older adults. Methods Data came from ten waves of the Health and Retirement Study, a nationally representative longitudinal study. We followed 9794 individuals older than 52 years without any diagnosed psychiatric disorder at baseline for up to 18 years. Baseline depressive symptoms and CMC were the predictors, time to receiving an emotional diagnosis was the outcome, baseline demographics and socioeconomics were controls, and gender was the moderator. We used Cox proportional hazards models for data analysis. Results In the pooled sample, female gender increased the effect of baseline depressive symptoms (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.26-2.00) and reduced the effect of baseline CMC (HR, 0.78; 95% CI, 0.63-0.97) on time to receiving a psychiatric diagnosis. Among men, baseline depressive symptoms (HR, 2.36; 95% CI, 1.87-2.97) increased and baseline CMC (HR, 0.81; 95% CI, 0.69-0.95) decreased time to receiving a psychiatric diagnosis. Among women, depressive symptoms (HR, 1.49; 95% CI, 1.21-1.83) but not CMC (HR, 1.06; 95% CI, 0.91-1.23) were associated with time to receiving a psychiatric diagnosis over time. Conclusions Men and women differ in how depressive symptoms and CMC influence their risk of receiving a psychiatric diagnosis over time. Depressive symptoms are more salient promotor for men than women while CMC is only a barrier for men. Copyright © 2019 International Journal of Preventive Medicine.Introduction Cisplatin is a widely used anti-cancer drug that is commonly administered for the treatment of various cancers. However, nephrotoxicity is the most important side effect of this drug which limits its use. This study aimed to investigate the protective effect of Cystone against nephrotoxicity induced by Cisplatin in patients with cancer. Methods This pilot clinical trial study was conducted on 43 cancer patients treated with Cisplatin (75 mg/m2 for a period of six months). The subjects were divided into treatment group (receiving Cystone, two per 8 hours; n = 21) and control group (n = 22). The two groups were compared with each other in terms of demographic and laboratory variables. Results In the intervention group receiving Cystone, serum creatinine-based GFR level (P = 0.453) and 24-hour urine creatinine-based GFR level (P = 0.397) did not change significantly during the studied period, but in the control group, serum creatinine-based GFR level (P = 0.013) and 24-hour urine creatinine-based GFR level (P = 0.