فهرست مطالب
Archives of Iranian Medicine
Volume:20 Issue: 2, Feb 2017
- تاریخ انتشار: 1396/01/05
- تعداد عناوین: 10
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Page 1BackgroundMatrix metalloproteinases (MMPs) are a family of proteinases and have the vigorous capacity to degrade all parts of the extracellular matrix. MMP enzymes strongly participate in physiological processes such as normal tissue remodeling and wound healing and in pathology of pulmonary diseases. They are released in response to environmental stimuli such as toxins and regulated by endogenous tissue inhibitors of metalloproteinases (TIMPs). Sulfur mustard (SM) is a chemical toxic which can cause severe permanent damages to lung tissues. The aim of this study was assessing the possible role of MMP-9 and TIMPs in SM-induced lung symptoms and signs in exposed patients 20 years after exposure.MethodsTotally, 372 male volunteers with a history of SM exposure and 128 age- and sex-matched unexposed controls participated and were divided into three groups: normal, mild and moderate-severe. All participants underwent clinical evaluation and pulmonary function tests and serum concentrations of MMP-9 and its inhibitors were measured using the ELISA technique.ResultsSerum level of MMP-9 was increased in the SM exposed group who had moderate-severe pulmonary complications compared with the SM exposed with normal lung (2.321 ± 2.836 vs. 1.546 ± 2.176, P = 0.001) while only the MMP-9/TIMP-4 complex was elevated in the SM exposed with normal lung individuals compared to its corresponding control group (85 ± 265 vs. 82 ± 222, P = 0.025). Although MMP-9 and its inhibitors did not show any correlation with spirometry findings, elevated circulating MMP-9 was detected in SM exposed patients with chronic chough and hemoptysis (P = 0.013 and P = 0.013 respectively).ConclusionHigh level of tissue disruption and remodeling mediators could influence lung structure in long-term after SM exposure. The correlation of clinical evaluation with these factors efficiently helps us to identify important effectors.Keywords: Lung, Mustard gas, MMP-9, TMIPs
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Page 2IntroductionTransfusion of packed red blood cells (pRBC) with appropriate indications is not only important for patient safety and well-being but is also crucial for proper utilization of resources and health care-related cost reduction. We aimed to investigate the clinical appropriateness of blood transfusion in Shariati Hospital, one of the largest academic medical centers in Tehran.MethodsIn this prospective observational study, 1000 transfusions of allogenic pRBCs from April 1st to October 31st, 2015 were included. The patients characteristics, reason for hospitalization, indications for pRBC transfusions and ordering wards were collected.ResultsThe mean level of hemoglobin before transfusion was 7.4 ± 2.3 g/dL in the emergency department, 7.5 ± 1.0 g/dL in medical wards, 10.4 ± 2.6 g/dL in surgical wards, and 9.1 ± 2.2 g/dL in the intensive care unit. The baseline hemoglobin levels differed significantly between the departments (PConclusionDespite current international guidelines emphasizing the importance of restricted transfusion policy, the transfusion of pRBC with insufficient indications occurred frequently in Shariati Hospital, particularly in surgical wards.Keywords: Blood cell, erythrocyte transfusion, packed
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Page 3BackgroundAcne vulgaris is a very common chronic inflammatory disorder, yet its pathogenesis is not clearly understood. As part of the SICS, this study was conducted to evaluate the association between the incidence of acne vulgaris in sulfur mustard-exposed subjects (20 years after the exposure) and serum levels of proinflammatory cytokines (IL-1α, IL-1β, IL-1Ra, IL-6, IL-8, IL-12 and RANTES) in an attempt to better understand the pathogenesis of long-term skin disorders of these individuals.MethodsSerum concentrations of cytokines (IL-1α, IL-1β, IL-1Ra, IL-6, IL-8, IL-12 and RANTES) were measured using sandwich ELISA technique.ResultsThe median of serum levels of IL-1β, IL-8 and RANTES were significantly higher in the exposed patients with acne than those without acne (P = 0.05, 0.03 and 0.001 respectively). There was no significant difference in serum levels of IL-1α, IL-1Ra and IL-6 between the exposed subgroups.ConclusionWe found a positive association between serum levels of pro-inflammatory cytokines (IL-1β, IL-8, IL-12 and RANTES) and acne among sulfur mustard-exposed population.Keywords: Acne, cytokines, mustard gas, Sardasht, Iran cohort study
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Page 4BackgroundColorectal cancer (CRC) is one of the most common causes of cancer-related mortality worldwide. Early diagnosis of this neoplasm is critical and may reduce patients mortality. MicroRNAs are small non-coding RNA molecules whose expression pattern can be altered in various diseases such as CRC.MethodsIn this study, we evaluated the expression levels of miR-142-3p, miR-26a-5p (their reduced expression in plasma samples of CRC patients was previously confirmed), miR-4478 and miR-1295-3p (their reduced expression in stool samples of CRC patients was previously confirmed) in tissue samples of CRC patients in comparison to healthy subjects.
To achieve this purpose, total RNA including small RNA was extracted from 53 CRC and 35 normal subjects Formalin-fixed, Paraffin-embedded (FFPE) tissue samples using the miRNeasy FFPE Mini Kit. The expression levels of these four selected miRNAs were measured using quantitative Reverse Transcriptase Polymerase Chain Reaction (qRT-PCR).ResultsWe found that the expression levels of miR-4478 and miR-1295b-3p (two previously down-regulated fecal miRNAs) were significantly decreased in FFPE samples of CRC patients compared to healthy controls. On the other hand, no significant differences were seen in expression levels of miR-142-3p and miR-26a-5p (two previously down-regulated circulating miRNAs) in FFPE samples between these two groups.ConclusionRegarding current findings, it may be concluded that to diagnose CRC patients based on the miRNAs approach, stool samples are more likely preferable to plasma samples; nevertheless, additional studies with more samples are needed to confirm the results.Keywords: Biomarker, colorectal cancer, early detection, tissue microRNA -
Page 5BackgroundDue to increased consumption of canola oil and hydrogenated oil containing palm and palm olein, and their possible effects on serum lipoproteins, the present study was conducted to determine the effects of these oils on lipids and lipid oxidation level.MethodsIn this experimental study, 88 Wistar rats were randomly assigned to four groups. Control group (A) was on a normal diet. Groups B, C, and D, in addition to normal diet, were fed with hydrogenated oil-contained palm oil, pure palm olein oil, and canola oil, respectively for 4 weeks. Serum Biochemical factors [total cholesterol (TC), triglyceride (TG), LDL, HDL, LDL/HDL ratio, oxLDL, paraoxanase-1 (PON1), and malondialdehyde (MDA)] were measured.ResultsThe lowest mean serum TC was seen in the control group and the highest in the group B. There were differences in TC, TG, HDL, MDA, and PON1 between the control group and other groups (P0.05). MDA was higher in groups C and D.ConclusionCanola oil, hydrogenated oil-containing palm and palm olein may increase atherosclerosis risk through decreasing PON1 activity and elevating oxLDL. Palm olein oils in rat's diets cause a considerable decrease in LDL and help to increase HDL.Keywords: HDL, malondialdehyde, oxidized LDL, palm olein, paraoxonase1
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Page 6BackgroundAssisted reproductive treatment (ART) cycle is an expensive procedure with low implantation and pregnancy rate; therefore, it is necessary to evaluate the predictors of success in these patients.ObjectiveThe relationship between endometrial echopattern and pregnancy rate was evaluated.MethodsThe endometrial echopattern was analyzed prospectively on the day of human chorionic gonadotropin (HCG) administration in 280 in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles with 814 mm endometrial thickness at Royan institute in 20132014. Based on echopattern, three groups were developed: pattern A (Triple line), pattern B (Heterogeneous-echogen) and pattern C (Homogeneous-echogen). Pregnancy rate (PR) was compared between all groups. Data was analyzed using SPSS (v.18, Chicago, IL, USA), and descriptive tests such as Chi-square and analytical tests like logistic regression, for controlling confounder variables like age.ResultsAmong 280 patients finally evaluable, the distribution of endometrial echopattern on the day of HCG administration was 127 patients (45.4%) in group A, 98 patients (35%) in group B and 55 patients (19.6%) in group C. The highest PR per transfer pertained to group A (49.6%), and the lowest to group B (32.7%).ConclusionThe presence of pattern A (Triple line) appears more likely to favor pregnancy. Therefore, ultrasonographic evaluation of endometrial echopattern on the day of HCG administration has prognostic value in clinical settings for predicting implantation in ART cycle.Keywords: Assisted reproductive treatment (ART), endometrial echopattern, human chorionic gonadotropin (HCG), in vitro fertilization (IVF), transvaginal ultrasound (TVUS)
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Page 7BackgroundRestless legs syndrome (RLS) is a chronic condition characterized by odd sensations in the body, most commonly in the legs and an irresistible urge to move them. More than half of the patients with RLS have a family history. Most of the RLS cases are women and most of the families show characteristics of an autosomal dominant pedigree. Here, we shall present a family consisting only of women; to our knowledge, such a family has not been reported yet.MethodsThe family presented here met the diagnosis criteria specified by International Restless Legs Syndrome Study Group (IRLSS). Clinical characteristic are described along with demographic properties.ResultsThe patients were between 12 and 59 years of age with a mean age of 35.3 ± 14.4 years. All 7 cases were women. The pedigree of the patients exhibited an autosomal dominant inheritance pattern.ConclusionsThe present family tree indicates that familial RLS can exhibit a heredity pattern which shows autosomal dominant inheritance. The present family is still under follow-up. Future research is required to support the present data.Keywords: Autosomal dominant inheritance, familial, pedigree, restless legs syndrome
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Page 8BackgroundThe relation between diet and stress has not been widely explored. In this study, we examined the association between the inflammatory potential of diet and levels of stress among adolescent girls in Iran.MethodsA total of 299 adolescent girls aged 1518 years were recruited during 20142015. Stress was assessed using the Depression, Anxiety and Stress Scale (DASS)-21 scale. Data were analyzed as continuous DASS scores and as a dichotomous outcome with a cut-off value of 9. The dietary inflammatory index (DII) is a literature-derived population-based dietary. DII scores were index computed from dietary intake assessed using a validated food frequency questionnaire. Multivariable linear and logistic regressions were used to calculate beta estimates and odds ratios adjusting for potential confounding factors.ResultsIn total, 84 girls (28% of the entire study sample) had at least a moderate level of stress symptoms (DASS > 9). Girls with the most pro-inflammatory diet (tertile 3) had higher DASS stress scores (β = 2.75; 95% CI = 1.05, 4.46) and were at 3.48 times (95% CI = 1.33, 9.09) risk of having at least moderate level of stress compared to girls with the most anti-inflammatory diets (tertile 1).ConclusionThese data suggest that Iranian adolescent girls with a pro-inflammatory diet, as shown by higher DII scores, had higher levels of stress and greater odds of having at least a moderate level of stress symptoms.Keywords: Dietary inflammatory index, diet, Iran, inflammation, stress
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Page 9BackgroundGonad shielding has been extensively advocated during pelvic radiography at or below reproductive ages. The popular practice of gonad shielding is placement of a lead shield in the midline of the pelvis. The aim of this study was to address the prevalence of gonad shielding and find out whether the current practice of gonad shielding can be considered as an effective method to reduce radiation exposure in patients undergoing pelvic radiography.MethodsNational and international electronic databases, including PubMed, MEDLIN, EMBASE, and Google-Scholar, were searched up to January 2016. The database searches were supplemented with manual searches of reference lists. Two authors independently assessed the eligibility of all studies and extracted data.ResultsThe searches yielded a total of 243 publications. After assessing each identified study against specific inclusion exclusion criteria, 18 studies were deemed as relevant for this review. The total prevalence rate of gonad shielding was estimated at 58% (95% CI: 40 to 74%). It was estimated that only 34% (95% CI: 25 to 44%) of the radiographs had correct positioning of the shield. Also, incorrect positioning of the shield was statistically significantly higher in females than males (85% vs. 52 %; P-valueConclusionsOur study demonstrates that the current practice of gonad shielding during female pelvic radiography should be no longer considered as an effective method to reduce radiation exposure. Training the best qualified radiographers is the key to accurate positioning of the shield in male subjects.Keywords: Gonad shielding, Pelvic radiography, Radiation protection
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Page 10Acute pancreatitis is characterized by activation of digestive enzymes inside the pancreas. In severe pancreatitis, necrosis of pancreas and surrounding tissues may occur. Acute necrotizing pancreatitis commonly presents as pancreatic abscess occasionally with systemic complications. Rarely, necrotic tissue may be drained from scrotum due to retroperitoneal extension of necrotic process. Here, we report a case of acute necrotizing pancreatitis in a 29-year-old man who presented with severe abdominal pain, nausea and vomiting. A computerized tomography (CT) scan confirmed necrotizing pancreatitis with multiple abscesses spreading bilaterally in the pelvic cavity. Several surgical operations were performed, including necrosectomy and drainage. Subsequently, the patient developed a scrotal abscess, which was drained surgically. The patients condition was complicated by pleural effusion, acute respiratory distress syndrome, colocutaneous and scrotal fistulas, and incisional hernia. It seems that the scrotal abscess is a very rare complication of necrotizing pancreatitis.Keywords: Acute Necrotizing, pancreatitis