جستجوی مقالات مرتبط با کلیدواژه "2" در نشریات گروه "پزشکی"

Researchers and healthcare providers can advance the field of phosphorus control, ultimately improving patient outcomes and enhancing the overall quality of care for ESKD patients.

Percutaneous Trans hepatic biliary drainage (PTBD) is a successful palliative treatment for malignant obstructive jaundice. Despite the past that PTBD complications occur more frequently. Currently, with the help of an ultrasound guide, these side effects and possibility of adjacent organ damages have decreased interestingly. One of the rare complications of this procedure is acute pancreatitis.

We discuss an uncommon case of acute pancreatitis following PTBD in an elderly woman who presented to the hospital with jaundice and anorexia. Conservative therapy without decatheterization was the treatment of choice in our patient. Eventually after receiving conservative therapy for her pancreatitis, she was discharged from the hospital in good general condition and she has not experienced any episodes of abdominal pain again.

Acute pancreatitis is one of the causes of sepsis during PTBD catheterization. Early management of this complication after PTBD can decrease morbidity and mortality of the patients.

Among mesenchymal tumors arising in the gastrointestinal tract, gastrointestinal stromal tumors are the most common. GISTs that do not have metastatic spread are treated surgically. Our case report aims to describe a newer & less invasive approach for resection of GISTs & early gastrointestinal tumors.

An Iranian woman 41 years old with stomach stromal tumor is presented. Her complaint was minor epigastric discomfort. Tumor en-bloc resection was performed using a hybrid endoscopic-laparoscopic approach. She was doing very well & discharged the day after the operation.

GISTs and early gastrointestinal tumors can be treated with hybrid endoscopic and laparoscopic en-bloc resections instead of invasive surgery.

Renal Cell Carcinoma is one of the most common malignancies worldwide. To date, multiple attempts had been made to accurately diagnose it and predict its behavior. One of the most intriguing biomarkers that have been assessed since 90s, is galectin-3. This study aimed to increase the prior knowledge of galectin-3 expression association with patient's clinicopathologic factors.

In this single-center cross-sectional study, 71 patient samples from hospital archive were assessed for galectin-3 expression by immunohistochemistry assay. Pathologic slides were evaluated for histologic subtype, grade, stage, tumor size, presence of necrosis, and invasion of the renal vein. By adding cytoplasmic staining score to the color intensity score, a final score was recorded as galectin-3 positivity score.

 88 pathological slides of patients with confirmed RCC were screened and 71 were finally assessed. The mean age of the patients was 58.52 years (lowest 30 and highest 87). 67.6% were males and 32.4% were females. 68% of tumors were clear cell carcinoma, and only one oncocytoma was present. All 9 chromophobe cases showed a strong galectin-3 expression. Except for female gender (47.8% vs 18.8% in men; P=0.01), no statistically significant association was found between patient age, tumor grade, tumor size, tumor stage, and renal vein invasion with the level of galectin-3 expression.

Considering the contradictory findings between this study and other similar studies, it can be concluded that the physiological role of galectins is very complex and the need for larger and more comprehensive evaluations is felt.

Anemia in pregnancy is associated with psychiatric symptoms and poor psychiatric symptoms, this study investigates the 6-month trends of anxiety and birth outcomes. Considering the controversies surrounding the impact of anemia on psychiatric symptoms, this study investigates the 6-month trends of anxiety and depression in anemic pregnant women with threatened abortion (TA).

A case-control retrospective cohort study conducted among 282 participants who enrolled in a registry of pregnant women with TA in Babol city from December 2022 to October 2023. Fifty individuals with anemia (hemoglobin < 11 g/dL) who were matched with 50 without anemia based on age, pregnancies, education, and gestational age, were included. The BSI-18 (Brief Symptom Inventory) was used to assess depression, anxiety, and psychological distress at the beginning, three and six-month follow-ups.

The prevalence of anemia among women diagnosed with TA was found to be 17.7%. At the beginning, compared to normal individuals, anemic women had higher rates of depression (32% vs. 14%), anxiety (34% vs. 22%), and psychological distress (66% vs. 48%). Moreover, at 3- and 6-month follow-ups, the frequency of psychiatric symptoms in anemic women was significantly higher. The Generalized Estimating Equations model showed that although both groups had a decreasing trend of frequency anemic women experience a slower rate of decrease in psychiatric symptoms compared to non-anemic women.

Anemia in women with TA is associated with high rates of depression, anxiety, and psychological distress, as well as a slow recovery rate.

The aim of this study was to investigate the diagnostic accuracy of mean platelet volume (MPV) in predicting SBP in cirrhotic patients.

This was an observational, analytical, and retrospective study conducted on cirrhotic patients with abdominal ascites referred to the emergency department (ED) over a 1-year period. The cirrhotic patients with ascites were divided into two groups with or without SBP. The diagnostic accuracy of MPV for detecting SBP was measured and compared with the analysis of the ascites fluid obtained by paracentesis as a gold standard procedure in the absence of any secondary causes of peritonitis. The required data were documented in a checklist.

A total of 252 patients, 126 with SBP and 126 without SBP, were included in the study. The mean MPV in these patients was 8.36 ± 0.92 fL. Patients with SBP had a significantly longer duration of cirrhosis, more severe fever and abdominal pain, and higher ascites WBC and PMN counts and higher mean MPV (p<001). At the most appropriate cut-off point (i.e., 8.3 fL), MPV provided the sensitivity, specificity, positive predictive value, negative predictive value, and the diagnostic accuracy of 69.84%, 53.97%, 60.27%, 64.15%, and 61.90%, respectively, for the diagnosis of SBP. The receiver operating characteristic (ROC) curve showed that MPV had an acceptable diagnostic accuracy (AUC = 0.677).

Mean platelet volume, as a non-invasive, simple, and accessible laboratory parameter, with acceptable diagnostic accuracy in cirrhotic patients with ascites may have a predictive role in the diagnosis of SBP.

Drugs used in chemotherapy specifically target and kill the cancer cells during the breast cancer treatment. However, the majority of anti-cancer therapies are non-specific, which will harm the innate cells. Our research work assessed the impact of chemotherapy with adriamycin/cytoxan (AC) on the influence of antioxidant enzymes and hematopathological profiles in the diagnosis and prognosis of breast cancer treated with chemotherapy.

40 breast cancer patients treated with AC chemotherapy (Adriamycin 60 mg/m2, Cytoxan 600 mg/m2) between July 2020 and March 2021 are part of this prospective study. The first sample was taken prior to chemotherapy, the second after the intervention's three cycles, and the third after the intervention's last cycle. Spectrophotometric technique was used to evaluate the amounts of antioxidant enzymes in serum samples. Patients’ demographic variables, clinical features, biochemical andhematogical parameters data were noted. The data was compared before and after treatment using the Paired-t test.

55% of the patients were detected with carcinoma on left breast and majority was in Grade 3 clinical stage 37.5%. Most of the patients express estrogen and progesterone receptors 72.5%. Our findings demonstrated that a significant decrease in the mean values of antioxidant enzymes MDA, NO, TAS, CAT, GPx, GR, SOD and GST along with hematological parameters after three cycles of AC treatment in breast carcinoma individuals. The p-value is < 0.05.

Our research demonstrates that the body's oxidant/antioxidant system, particularly reduction levels and antioxidant enzyme activity, is drastically altered by AC chemotherapy in breast carcinoma individuals.

Anti-CD20 are among the high-efficacy DMTs commonly used in treating multiple sclerosis (MS). Long-term safety data on anti-CD20s are limited. There is convincing evidence of hypogammaglobulinemia in the long-term use of anti-CD20s, raising the likelihood of infection. Accordingly, there is an unmet need for de-escalation therapy in stable patients to reduce adverse events. Herein we aimed to describe our experience with ten relapse-remitting MS (RRMS) patients who were switched from anti-CD20s to the low-moderate efficacy DMTs.

This cohort study was conducted between January 2020 and February 2023 at the MS Research Center of Sina Hospital, Tehran, Iran, to identify the characteristics of RRMS patients who were switched from anti-CD20s to low-moderate efficacy DMTs within 12 months of the last anti-CD20 infusion. Patients were then followed up to 18 months after de-escalation.

All patients were females, with a mean age of 39.3±2.53-year-old and a mean disease duration of 9.7±1.39 years. After a mean of 2.95±0.44 years of treatment with anti-CD20s, patients were de-escalated to INF-β1a (n=5), dimethyl fumarate (DMF) (n=3), fingolimod (n=1), and teriflunomide (n=1). The main reason for anti-CD20 discontinuation was an infectious concern. Within 18 months of follow-up, no patient developed clinical or MRI activity. Additionally, we did not find evidence of disability progression in any patients (P=0.13).

The present study is a real-world experience of de-escalating anti-CD20s to low-moderate efficacy DMTs, which suggests that at short-term follow-up, de-escalating anti-CD20s appeared to be effective and safe in RRMS patients.

The diagnosis of ulcerative colitis (UC) today is limited to a small number of biomarkers. Trimethylamine-N-oxide (TMAO) is the product of reactions resulting from the degradation of dietary-free choline, phosphatidylcholine, and carnitine metabolism by the intestinal microbiota. Earlier studies showed his involvement in the pathogenesis of UC. To study the association of TMAO with clinical, laboratory, and endoscopic indicators of UC activity.

an observational cross-sectional comparative study was conducted based on the NCJSC “KMU” clinic, Karaganda, Kazakhstan. High-performance liquid chromatography measured TMAO concentration in 63 patients with UC (age Me 37 (30-52) and 38 healthy individuals (age Me 38 (28.5-49.5).

Median TMAO level in patients with UC-0.286 μmol/l was significantly lower than in the control group Me 0.646 μmol/l (p<0.0001). TMAO had significant differences in groups with clinically active and inactive colitis (P=0.003). TMAO correlated with disease activity by Montreal scale (r=-0.389, P=0.002) and severity of attack by Truelove-Witts (r=-0.301, P=0.027 respectively), patient’s age (r=0.377, P=0.003), stool frequency (r=-0.427, P=0.001); laboratory parameters: WBC (r=-0.31, P=0.042), blood albumin (r=0.379, P=0.002) and fecal calprotectin (r=-0.314, P=0.022). TMAO did not differ between groups divided by the extent of the pathological process and endoscopic activity.

in patients with UC, TMAO levels decrease compared with healthy individuals and differences in groups depend on the disease activity. These results give reason to consider changes in TMAO levels as a potential marker of UC and the severity of its course.

Type 2 diabetes mellitus (T2DM), the most prevalent metabolic disorder worldwide, has genetic, epigenetic, and environmental contributors. Among them, circulating microRNAs (miRNAs/miRs) have attracted considerable attention. This study aimed to investigate the regulatory role of miR-103 in T2DM development.

The miR-103 expression was evaluated in 33 participants with T2DM compared with 38 healthy controls using quantitative real-time polymerase chain reaction (q-RT PCR). Fasting blood glucose (FBS), fasting insulin (Fin), hemoglobin A1c (HbA1c), triglycerides (TG), and cholesterol (Chol) were also determined in serum. Basal insulin resistance and sensitivity were determined using the homeostasis model assessment insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI), respectively.

There was a significant decrease in miR-103 levels in patients with T2DM (p<0.002). Serum miR-103 expression levels showed a strong correlation with age, FBS, HbA1c, TG, Chol levels, and HOMA-IR and QUICKI indices.

The downregulation of miR-103 in T2DM patients suggests the diagnostic potential of miR-103 evaluation in conjunction with other diagnostic approaches.

Oral candidiasis is the most common infection of oral mucosa caused by Candida albicans. A common predisposing factor for candidiasis is immune system suppression in specific diseases such as AIDS and various cancers. This study aimed to analyze the effect of Kefir probiotic products on the count of C. Albicans in the saliva of chemotherapy patients.

In this single-blinded clinical trial, 50 patients were selected who have signed informed consent forms. Patients aged 20-60 years with colon or breast cancer who received the same chemotherapy regimen were included and those with a history of radiation therapy, underlying diseases, using antibiotics, anti-fungal and GCSF medicines were excluded. Matched patients in test and control groups received 100 ccs Kefir probiotic and mineral water, respectively at a specific daily time for five weeks. Blood and saliva samples were collected in five steps. Data were analyzed using SPSS Version 21 and the significance level was set at p< 0.05.

In saliva samples, the count of C. Albicans in the test group dropped significantly (p<0.05), while there were no significant differences between test and control groups in blood samples (p>0.05). Comparing the follow-up sessions, in the test groups, WBC and Neutrophil, and in the control groups, WBC count and hematocrit showed significant differences (p< 0.05).

Based on the results, using probiotic products daily over a short-term period drops the count of oral C. Albicans. Therefore, Kefir probiotic products can be used as an additional treatment for chemotherapy patients.

Acute pulmonary embolism can quickly cause hemodynamic collapse and death. Recent studies have shown that different characteristics of electrocardiogram (ECG) can be used to predict the prognosis of patients. This study aimed to investigate the relative frequency of fragmented QRS in the ECG of patients with pulmonary embolism and its prognostic value.

This study was conducted retrospectively. The files of 106 patients hospitalized with a diagnosis of pulmonary embolism from January 2016 to the end of March 2020 were selected and reviewed. The findings of the ECG, including the ST elevation in V1-V4 leads with and without T invention, right axis deviation, right bundle branch block (RBBB), PR, QRS, QTc intervals, type of treatment (thrombolysis or embolectomy), cardiogenic shock, mortality were collected. Finally, the data were recorded and analyzed in SPSS software Version 16.

Hypertension, dyslipidemia, and diabetes mellitus were the most frequent risk factors among the patients. The relative frequency of fragmented QRS, at least in one lead, was 26.2%. The use of thrombolysis, mechanical ventilation, embolectomy, cardiogenic shock, and in-hospital death was significantly higher among patients who had fragmented QRS (P<0.001). CTNI was significantly higher in patients with fragmented QRS (P=0.001). In patients with fragmented QRS large vessels, involvement was significantly higher.

This study showed that the presence of fragmented QRS in the ECG of acute embolism patients has a significant relationship with cardiogenic shock, hospital mortality, and the need for advanced treatment methods such as intubation, embolectomy, and the use of thrombolysis.

Diabetes mellitus (DM) is highly consequential to global health among chronic diseases. Due to a limited researches that have examined relationships between liver enzymes and DM, this study aimed to investigate the link between elevated liver enzymes and diabetes among Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan cohort study (PGCS) population.

This cross-sectional study was conducted on 10519 individuals. The demographic and clinical information of the participants was recorded. The changes in alanine aminotransferases (ALT) and aspartate aminotransferases (AST), alkaline phosphatase (ALP), and γ-glutamyltransferase (GGT) were evaluated. IBM SPSS Version 21 was used to analyze the data, with a significance level < 0.05.

The frequency of diabetes was 24.1% and was more prevalent in women than men (27.4% vs. 20.2%, p< 0.001). After removing all confederates, patients with elevated ALT, AST, GGT, and ALP levels were 1.27, 1.27, 1.52, and 1.46 times more likely to have diabetes, respectively. The likelihood of developing diabetes rose in correlation with the number of elevated liver enzymes, up to almost 1.77-fold among subjects with three or four increased liver enzymes.

Patients diagnosed with diabetes exhibited significantly increased levels of liver enzymes compared to those without diabetes. Also, impairment of three or four liver enzymes demonstrated a positive correlation with an elevated likelihood of DM. This indicates the importance of considering the liver status in the management of the DM population.