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Reviews in Clinical Medicine - Volume:3 Issue: 3, Summer 2016

Reviews in Clinical Medicine
Volume:3 Issue: 3, Summer 2016

  • تاریخ انتشار: 1395/06/03
  • تعداد عناوین: 8
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  • Afsoon Fazlinejad, Ali Samadzade, Ramin Khameneh Bagheri, Nayere Tousi, Amin Rezaeian Page 53
    Introduction
    Left ventricular remodeling is a relatively prevalent complication of acute myocardial infarction (AMI), and it is associated with higher rates of medical issues and mortality. Left ventricle ejection fraction (LVEF) and wall motion score index (WMSI) are unable to detect accurately minor lesions following AMI. Global longitudinal strain (GLS), which is obtained through 2D-speckle tracking echocardiography (2D-STE), provides an angle-dependent measurement by which the infarcted area can be assessed as a means of identifying potential dysfunction. The main objective of this study was to evaluate whether GLS could adequately predict LV remodeling in AMI patients.
    Methods
    The MEDLINE database from database inception to May 6th, 2015, was searched for relevant keywords and the reference lists of systematic reviews and eligible studies were also screened. All studies involving patients with their first reported case of AMI were examined for GLS by 2D-STE and were evaluated for LV remodeling at a three-month follow-up point. Four English-language prospective cohort studies were eligible for inclusion in this study.
    Result
    A total of 291 AMI patients (mean age=57.92 years) were investigated across four different studies. The main finding of this study was that the most reliable and consistent measurement for the purposes of predicting LV remodeling in AMI patients is GLS obtained at the time of discharge, especially in STEMI patients.
    Discussion
    In addition to their poor reproducibility, inability to stratify risks, and inter-observer variability, compensatory hyperkinesis of intact myocytes and myocardial stunning after an AMI are among the main reasons why LVEF and WMSI may not be the most effective predictors of LV remodeling in AMI.
    Conclusion
    GLS obtained by 2D-STE at the time of discharge could be used as a reliable predictor of LV remodeling in AMI patients.
    Keywords: Myocardial infarction, Remodeling, Speckle, tracking, echocardiography, Strain
  • Farhad Heydarian, Hamid Ahanchian, Maryam Khalesi, Saeed Ebrahimi Pages 87-92
    Introduction
    Asthma is a chronic inflammatory airway disorder that is distinguished by coughing, wheezing, and dyspnea. It is the most common chronic disease among children. Epidemiological trials have suggested that there may be a correlation between vitamin C intake and the incidence of asthma. Specifically, according to these studies, a rapid increase in the occurrence of asthma may be caused by a decreased intake of dietary antioxidants and various vitamins such as vitamin C. A systematic review was performed to determine the role that vitamin C, in terms of both dietary intake and serum levels, had on asthma in children.
    Methods
    PubMed and Scopus databases were searched for studies that provide information on the effects of vitamin C on asthma in children aged between 1 and 17 years. The inclusion criteria specified that the studies involved needed to be cohort and case series involving at least ten patients. Exclusion criteria were non-English articles, case reports, and articles involving children who were aged below or above the age 1 and 17 respectively.
    Result
    A total of 13 studies involving 6503 patients met the inclusion criteria. Dietary vitamin C intake was lower in people with asthma than in those without asthma. Lower quantity dietary intakes and serum levels of vitamin C were also associated with increased incidents of asthma.
    Conclusion
    According to the extracted data, a relatively low dietary intake of vitamin C is associated with an increased risk of asthma and wheezing. Moreover, asthmatic patients who consumed vitamin C exhibited an improvement in their diseases.
    Keywords: Ascorbic acid, Asthma, Children, Wheezing
  • Mortaza Talebi Doluie, Hamidreza Reihani, Vahide Farzam Pages 93-97
    Introduction
    Resuscitation should be initiated immediately in shock. Early goal-directed therapy is an established algorithm for the resuscitation in septic shock. The first step is to maintain cardiac preload. Central venous pressure (CVP) plays an important role in goal-directed therapy. Central venous catheterization is invasive and time-consuming in emergency conditions. There are some alternative and noninvasive methods for estimating the intravascular volume such as measuring the inferior vena cava (IVC) diameter by ultrasonography.
    Methods
    We searched PubMed, Google scholar, and Scopus databases with keywords (central venous pressure OR venous pressure OR CVP) AND (ultrasonography OR sonography) AND (sepsis OR septic shock) AND (inferior vena cava OR IVC).
    Result
    The search resulted in 2550 articles. The articles were appraised regarding the relevance, type of article, and statistical methods. Finally, 12 articles were selected. The number of patients was between 30 and 83 cases (mean age=57-67 years), intubated and non-intubated in each study. The IVC diameter was measured in respiratory cycle by bedside ultrasonography in longitudinal subxiphoid view and caval index was calculated, then they were compared with the CVP measured by central venous catheter.
    Discussion
    CVP is an indicator of intravascular fluid status and right heart function. CVP measurement is an invasive method and of course with some complications. The IVC is the biggest vein of venous system with low-pressure; expansion of the vein reflects intravascular volume.
    Conclusion
    It seems that IVC diameter measured by ultrasonography could be used as an alternative method for the determination of CVP in the emergency or critical patients.
    Keywords: Inferior Vena Cava, Intravascular volume, Septic Shock, Ultrasonography
  • Abbas Esmaeilzadeh, Kambiz Akhavan Rezayat, Hooman Masannen Mozaffari, Ali Bahari, Omid Ghanaei, Azita Ganji, Ali Mokhtarifar, Mahla Rahmani Khorram, Ladan Goshayeshi Pages 98-104
    Introduction
    Colorectal cancer (CRC) is the third leading cause of cancer deaths in the world, and hereditary factors and family history are responsible for the incidence and development of the disease in 20 to 30% of cases. Lynch syndrome, or hereditary nonpolyposis colorectal cancer (HNPCC), is the most common hereditary form of CRC that is inherited in an autosomal dominant manner. This study consisted of a systematic literature review of research articles that described the prevalence of HNPCC in Iranian patients with CRC.
    Methods
    A systematic literature search was conducted in the PubMed, Scopus, IranMedex, and Google Scholar databases to identify relevant articles that describe HNPCC or Lynch syndrome in patients with CRC in Iran. For this purpose, a keyword search of the following terms was employed: (((Hereditary nonpolyposis colorectal cancer OR HNPCC OR Lynch syndrome)) AND (colorectal cancer OR familial colorectal cancer OR colon cancer OR rectal cancer OR bowel cancer)) AND IRAN. All eligible documents were collected, and the desired data were qualitatively analyzed.
    Result
    Of the 67 articles that were found via the initial database search, only 12 were deemed to be of relevance to the current study. These articles included a total population of 3237 and this sample was selected and qualitatively analyzed. The findings of the review revealed that the frequency of mutation in MLH1, MSH2, PMS2, and MSH6 genes varied between 23.1% and 62.5% among the studied families. This indicated that HNPCC is linked with up to 5.5% of the total cases of colorectal cancers in Iran.
    Conclusion
    The results of this study revealed that the hereditary form of HNPCC or Lynch syndrome is significantly high among patients with CRC in Iran.
    Keywords: DNA mismatch repair, Hereditary nonpolyposis, colorectal cancer
  • Farah Ashrafzadeh, Mehran Beiraghi Toosi, Mohammad Hasan Mohammadi Pages 105-110
    Introduction
    Autism spectrum disorder (ASD) is a syndrome of social communication deficits and repetitive behaviors or restricted interests. While the impairments associated with ASD tend to deteriorate from childhood into adulthood, it is of critical importance that the syndrome is diagnosed at an early age. One means of facilitating this is through understanding how the brain of people with ASD develops from early childhood. Magnetic resonance imaging (MRI) is the method of choice for in vivo and non-invasive investigations of the morphology of the human brain, especially when the subjects are children. In this study, we conducted a systematic review of existing structural MRI studies that have investigated brain size in ASD children of up to 5 years old.
    Methods
    In this study, we systematically reviewed published papers that describe research studies in which the brain size of ASD children has been examined. PubMed and Scopus databases were searched for all relevant original articles that described the use of MRI techniques to study ASD patients who were between 1 and 5 years old. To be included in the review, all studies needed to be cohort and case series that involved at least 10 patients. No time limitations were placed on the searched articles within the inclusion criteria. The exclusion criteria were non-English articles, case reports, and articles that described research involving subjects that were not within the qualifying age range of 1-5 years old.
    Result
    After an initial screening process through which the title, abstracts, and full text of the articles were reviewed to confirm they met the inclusion criteria, a total of 10 relevant articles were studied in depth. All studies found that children with ASD who were within the selected age range had a larger brain size than children without ASD.
    Discussion
    The findings of recent studies indicate that the vast majority of ASD patients exhibit an enlarged brain; however, the extent of the enlargement varies from study to study. As such, further studies are required to develop an understanding of the areas of the brain in which enlargement manifests in children with ASD before the age of five and to verify the significance of the prognostic value of MRI as a non-invasive diagnostic technique that can be employed to detect ASD in young children.
    Conclusion
    Based on the extracted data, brain size was related to the emergence and presence of autism in children who were below school age. The use of MRI represents a functional and non-invasive method of confirming ASD in children who have an initial ASD diagnosis.
    Keywords: Autism, Brain size, Children
  • Kavian Ghandehari, Marjan Erfani, Elnaz Kiadarbandsari, Meysam Pourgholami Pages 117-121
    Introduction
    The aim of this research was to systematically review all the randomized controlled trials that have evaluated the effect of transcranial direct current stimulation (tDCS) on post-stroke dysphagia.
    Methods
    Three electronic databases were searched for relevant articles that were uploaded from their inception to March 2015: PubMed, Cochrane Library (Cochrane Central Register of Controlled Trials), and Scopus. All data was that was related to the location of the cerebrovascular accident (CVA), the parameters of tDCS, post-stroke time to commencement of tDCS, the stimulated hemisphere, stimulation dose, any outcome measurements, and follow-up duration were extracted and assessed. Finally, a number of observations were generated through a qualitative synthesis of the extracted data.
    Result
    Three eligible randomized controlled trials were included in the systematic review. All three trials reported that, in comparison to a placebo, tDCS had a statistically significant effect on post-stroke dysphagia.
    Discussion
    The results of our systematic review suggest that tDCS may represent a promising novel treatment for post-stroke dysphagia. However, to date, little is known about the optimal parameters of tDCS for relieving post-stroke dysphagia. Further studies are warranted to refine this promising intervention by exploring the optimal parameters of tDCS.
    Conclusion
    Since brainstem swallowing centers have bilateral cortical innervations, measures that enhance cortical input and sensorimotor control of brainstem swallowing may facilitate recovery from dysphagia.
    Keywords: Dysphagia, Stroke, tDCS
  • Sona Sepahi, Bamdad Riahi, Zanjani, Adel Ghorani, Azam Pages 122-127
    Introduction
    Psoriasis is a chronic, inflammatory skin disease that is related to many genetic, and environmental factors, as well as infectious pathogens. Findings suggest that the Candida species, particularly Candida albicans, may play a role in the pathogenesis of psoriasis vulgaris. In this study, we aimed to systematically review the possible association between C. albicans and the prevalence of psoriasis.
    Methods
    A systematic search of existing literature was performed in the PubMed, Scopus and Google Scholar databases and the Google search engine using the following search strategy ((Candida albicans OR C. albicans OR Candida)) AND (psoriasis vulgaris OR plaque psoriasis OR psoriasis) to find relevant articles that described a possible positive or negative association between C. albicans and the incidence or progression of psoriasis. The search was not limited to articles that were published within a specific time period; however, only those written in the English language were included in the review.
    Result
    Of the 499 articles in total that were identified during the initial database search, 491 were excluded from the review because they failed to meet the inclusion/exclusion criteria. The total number of people involved in the selected studies, including both patients and healthy controls, was 1260. The analysis of the results of the included documents showed that the colonization of C. albicans is more prevalent in biological specimens taken from psoriatic patients.
    Conclusion
    Studies show that C. albicans, opportunistic yeast, like diploid fungus, may be involved in the pathogenesis of psoriasis.
    Keywords: Candida albicans, Psoriasis, Skin diseases
  • Roshanak Salari, Mahdi Yousefi, Masoumeh Salari Pages 141-145
    Chronic constipation is a very common disease that is particularly commonplace among members of the elderly population. It is one of the most widespread bowel disorders, and it causes significant pain and discomfort; as such, it usually requires medical attention. The major causes of constipation are slow colonic movements and/or functional gastrointestinal disorders.
    This review aimed to examine the pharmacological treatments that are currently available for chronic constipation. To develop insights into the causes and treatments of chronic constipation, relevant review articles that were published on the Pubmed, Cochrane database, and Embase websites, were examined. The outputs of these studies indicated that high daily intake of fibers and fluids in addition to regular exercise can be very helpful in avoiding and treating constipation. The pharmacological treatments that are administered to treat this disease typically increase the water content of the bowel lumen, and this leads to more regular bowel movements. Novel drugs have been introduced to treat constipation, and many of these are now subject to formal research studies. Since constipation can facilitate the development of other gastrointestinal diseases, it is important that we develop an understanding the therapeutic treatments that are available with the intention of identifying which of these may represent the most effective method for treating this disease. With that objective in mind, this review was undertaken to review the clinical effectiveness of the different pharmacological treatments that are employed to treat or prevent constipation.
    Keywords: Chronic constipation, Pharmacological actions, Signs, symptoms