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Background A gluten-free diet (GFD) is the only effective treatment for celiac patients and assessing adherence to this diet is important. Celiac disease Adherence Test (CDAT) is a valid English-language questionnaire that is used for assessing the adherence to the GFD. In the present study, we aimed to translate the CDAT questionnaire in Persian and evaluate its validity and reliability. Methods In the present cross-sectional study, CDAT was translated and back-translated by three bilingual professional translators. Content validity was evaluated by 12 gastroenterologists and nutritionists. To assess the construct validity, 230 patients with celiac disease were randomly selected from the national celiac disease registry database. Internal consistency of the items and test-retest reliability were assessed by Cronbach’s alpha and Intraclass Correlation Coefficient (ICC). To assess the convergent validity of the questionnaire, the correlation coefficient between the CDAT score and anti-tissue transglutaminase immunoglobulin A (anti-t-TG-IgA) titer was assessed. Results The content validity index, content validity ratio, and impact score of the Persian version of CDAT (Pv-CDAT) were 0.97, 0.95, and 4.61 respectively. Three significant factors were extracted and according to the confirmatory factor analysis the three-factor model had adequate fitness (chi-square p -value of 0.74, root mean error of approximation: 0.001 [95% CI: 0.001–0.083], comparative fit index: 1, standardized root mean squared residual: 0.04, and coefficient of determination: 0.78). The questionnaire had good feasibility with the floor effect of 3.1% and the ceiling effect of 0.4%. Moreover, it has high internal consistency (Cronbach-alpha: 0.71) and test-retest reliability (ICC: 0.78). The correlations between CDAT categories and anti-tTG-IgA categories showed a significant correlation between the two tests ( r = 0.53; P < 0.001). Conclusions The results of the present study showed that the Pv-CDAT questionnaire with high validity, reliability, and internal consistency can be used for assessing adherence to the GFD in adult celiac patients in Iran.

Backgrounds sequence type 131 (ST131) of E. coli is a pandemic clone which drives the increasing rates of antibiotic resistance. While the pervasiveness of ST131 clade C, especially subclades C2 and C1-M27 has been demonstrated in numerous global surveys, no report about the ST131 clades and its virotypes has been published from Iran, so far. Methods A collection of 73 consecutive ST131 isolates from extraintestinal specimens were investigated for determination of virotypes, antibiotic susceptibility patterns, resistance/ virulence determinants and clades subsets. Results Most of isolates belonged to subclade C2 (33/73 [45.2%]) with the highest virulence factor (VF) scores and resistance rates, followed by C1-M27 [18, (24.6%)], C1-non-M27 [14, (19.1%)] and A [8, (10.9%)]. The distinctive profiles of subclade C2 virulence genes were revealed by “principle coordinates analysis” (PcoA) test. The distribution of hlyA virulence gene among subclade C2 was not uniform, so that positive strains [21 (63.6%)] showed significantly higher rates of resistance (blaCTX-M-15, blaOXA-1, aac(6')-Ib-cr, aac(6')-Ib , aac(3)-IIa) and virulence (hra, tia/hek, K5, cnf, papGII, papC) markers, and gentamicin/tobramycin resistance. Virotype C as the most common virotype [34, (46.5%)] was predominant among subclade C1 population, while virotypes E and F [21, (28.7%)] were detected among subclade C2, with the highest VF scores and aminoglycoside resistance rates. Conclusions Appearance of virotypes E and F among subclade C2 strains with higher rates of aminoglycoside resistance/virulence genes content shows the shifting dynamics of this pandemic clone in response to antibiotic selection pressure by establishing subsets with higher survival potential.

Breast cancer is the most frequently diagnosed cancer among women worldwide. 1 The incidence of breast cancer in Iran is about 20 new cases per 100 000 women-years. 2 This cancer often leads to complete removal of breast tissue, chemotherapy, radiotherapy and hormonotherapy. 3 Several internal and external factors contribute to the development of this cancer. Internal factors such as age, hormonal effects, lifestyle, obesity, alcohol consumption, smoking, gender, anxiety and stress, genetic predisposition (mutation in BRCA1, 2 and other genes) and family history of breast cancer. 4,5 Exogenous factors include infection with oncogenic viruses such as mouse mammary tumor virus (MMTV), human papilloma virus (HPV) and Epstein-Barr virus (EBV). Oncogenic viruses are contributing to 20% of human cancers. 6 EBV is a human gamma-1 herpes virus which has a double-stranded DNA genome comprised of approximately 170-kilobases that codes more of 85 genes, belonging to the c herpes virus family. 7,8 EBV is mostly transmitted from the host to another host via saliva and infects over 90% of the world population and remains in the body for life. 9 Breast epithelial cells can be infected with EBV by cell to cell contact. 10 This virus is accepted as a major contributor to 20% Burkitt lymphoma, 50% Hodgkin′s lymphoma, 10% stomach carcinomas and almost all endemic nasopharyngeal carcinoma. 11

Introduction:Breast cancer is one of the most common malignancies in women. Although the etiology of breast carcinoma is not completely understood, exposure to Epstein-Barr virus (EBV) is suggested as a risk factor for breast cancer. Studies have reported since 1995 that EBV is involved in the development of breast cancer. The aim of this study was to assess the presence of EBV in patients with breast cancer in Isfahan province. Methods:This study was performed using 40 paraffin-embedded tumor tissues and 40 tumorfree breast tissues from women with breast cancer in Isfahan province. After extraction of the DNA using salting-out method and the amplification of housekeeping gene beta-actin, all samples were examined for EBV DNA using PCR (polymerase chain reaction) method. Data were analyzed with chi-square test using SPSS 16software.Results: EBV was detected by PCR in 20 out of 40 (50%) cases of breast cancer samples and 5 out of 40 (12.5%) control samples. The chi-square statistics for the analysis of EBV infection in tumor and normal samples was 0.000 indicating a significant relationship between breast cancer and EBV infection in Isfahan province. Conclusion:The presence of EBV gene in a significant subset of women with breast cancer in Isfahan province shows EBVcan be one of the reasons for breast cancer, but more studies are needed to demonstrate the relationship between the virus and breast cancer. ‫تابستان‬ 7931 ‫سلحشورنیا‬ ‫زهرا‬ ‫همکاران‬ ‫و‬ 71 ‫پژوهشي‬ ‫مقاله‬ ‫فصلنامۀ‬ ‫بیماري‬ ‫ايران،‬ ‫پستان‬ ‫هاي‬ ‫سال‬ ‫يازدهم‬ ‫شماره‬ ، ‫دوم‬ ، ‫تابستان‬ 7931 ‫؛‬ ( 42 -71 )