فهرست مطالب

Archives of Iranian Medicine
Volume:20 Issue: 2, Feb 2017

  • تاریخ انتشار: 1396/01/05
  • تعداد عناوین: 10
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  • Sara Ghaffarpour, Tooba Ghazanfari *, Sussan Kabudanian Ardestani, Shahryar Pourfarzam, Faramarz Fallahi, Jalaleddin Shams, Ensieh Sadat Mirsharif, Ali Mohammad Mohseni Majd, Soghrat Faghihzadeh Page 1
    Background
    Matrix 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.
    Methods
    Totally, 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.
    Results
    Serum 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).
    Conclusion
    High 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
  • Anahita Sadeghi, Safieh Belali, Ali Ali Asgari, Zahra Morovat, Reza Malekzadeh *, Ashkan Emadi Page 2
    Introduction
    Transfusion 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.
    Methods
    In 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.
    Results
    The 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 (P
    Conclusion
    Despite 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
  • Nayere Askari, Tooba Ghazanfari *, Roya Yaraee, Mohammad Reza Vaez Mahdavi, Mohammad Reza Soroush, Zuhair Mohammad Hassan, Zohre Khodashenas, Jalaleddin Shams, Soghrat Faghihzadeh Page 3
    Background
    Acne 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.
    Methods
    Serum concentrations of cytokines (IL-1α, IL-1β, IL-1Ra, IL-6, IL-8, IL-12 and RANTES) were measured using sandwich ELISA technique.
    Results
    The 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.
    Conclusion
    We 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
  • Reza Ghanbari, Sama Rezasoltani, Javad Hashemi, Ashraf Mohamadkhani, Arash Tahmasebifar, Ehsan Arefian, Naser Mobarra, Jahanbakhsh Asadi *, Ehsan Nazemalhosseini Mojarad, Yaghoub Yazdani, Sakari Knuutila, Reza Malekzadeh Page 4
    Background
    Colorectal 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.
    Methods
    In 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).
    Results
    We 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.
    Conclusion
    Regarding 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
  • Seyed Asadollah Amini *, Keihan Ghatreh Samani, Arash Habibi Kohi, Laleh Jafari Page 5
    Background
    Due 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.
    Methods
    In 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.
    Results
    The 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.
    Conclusion
    Canola 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
  • Firoozeh Ahmadi *, Farnaz Akhbari, Mina Zamani, Fariba Ramezanali, Rezvaneh Cheraghi Page 6
    Background
    Assisted 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.
    Objective
    The relationship between endometrial echopattern and pregnancy rate was evaluated.
    Methods
    The 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 8–14 mm endometrial thickness at Royan institute in 2013–2014. 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.
    Results
    Among 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%).
    Conclusion
    The 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)
  • Cetin Kursad Akpinar *, Hande Turker, Dursun Aygun, Emrah Aytac Page 7
    Background
    Restless 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.
    Methods
    The family presented here met the diagnosis criteria specified by International Restless Legs Syndrome Study Group (IRLSS). Clinical characteristic are described along with demographic properties.
    Results
    The 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.
    Conclusions
    The 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
  • Nitin Shivappa, James R. Hebert, Bahram Rashidkhani * Page 8
    Background
    The 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.
    Methods
    A total of 299 adolescent girls aged 15–18 years were recruited during 2014–2015. 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.
    Results
    In 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).
    Conclusion
    These 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
  • Vahid Karami, Mansour Zabihzadeh *, Nasim Shams, Amal Saki Malehi Page 9
    Background
    Gonad 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.
    Methods
    National 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.
    Results
    The 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-value
    Conclusions
    Our 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
  • Seyyedhadi Mirhashemi *, Mohsen Soori, Gholamhossein Faghih, Hassan Peyvandi, Omid Shafagh Page 10
    Acute 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 patient’s 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