جستجوی مقالات مرتبط با کلیدواژه "sentinel 5" در نشریات گروه "پزشکی"

Correctly estimating the prevalence of sexually transmitted infections (STIs) is crucial for monitoring and managing these diseases effectively.

This study aimed to estimate the prevalence of STI syndromes and evaluate the surveillance systems for STIs in Marvdasht.

We conducted a cross-sectional study in 2018 involving a population-basedrandomsampleof 3 879 participants aged 18-50 in Marvdasht city. Genital ulcers and secretions in both genders were used as the primary outcomes to assess the completeness of the system and calculate the correction factor. A mathematical model was developed to estimate the correction factor for the prevalence of selected syndromes in each gender. The correction factor was determined by dividing the cases estimated through the mathematical model by the cases reported by the surveillance systems.

The estimated prevalence (with 95% confidence intervals [CI]) of urethral discharge in men and women, based on the model, was 25.32% (23.08 - 27.56) and 47.03% (39.93 - 54.13), respectively, and for genital ulcers, it was 5.16% (4.06 - 6.86) for men and 15.50% (9.5 - 21.5) for women. In both genders and for both syndromes, the reported prevalence by the care system (men: discharge 0.09% [0.07 - 0.11], ulcer 0.04% [0.03 - 0.06]; women: discharge 0.12% [0.1 - 0.15], ulcer 0.19% [0.16 - 0.22]) was severely underestimated. The highestandlowest underreporting correction ratios in the national STI monitoring system were observed for urethral discharge in men (124.5) and genital ulcers in women (7.26), respectively.

The study revealed that the reported prevalence of STI syndromes in Iran is significantly underestimated compared to the actual prevalence in the population. Fundamental revisions are necessary to enhance the system’s validity and completeness in detecting and reporting STIs.

 Sentinel lymph node biopsy (SLNB) with injection of radiopharmaceuticals is now the standard of care for staging the axilla in patients with breast cancer. Sulfur or antimony colloids labeled with 99mTechnetium (Tc) are used globally for the procedure, with a detection rate of 94%. However, in Iran, Tc phytate has been used because it is more easily producible in the country. The detection rate with Tc phytate has not been well determined in large-scale studies.

 We performed this study to report the detection rate of SLNB with Tc phytate, its advantages and disadvantages using large multicentric data.

 This is a retrospective cross-sectional multicenter study. Participants were breast cancer patients without previous history of axillary surgery, who underwent sentinel node biopsy using Tc phytate on the morning of surgery or the day before. The detection rate was calculated as the number of patients with histologically positive sentinel nodes to all patients with histologically positive lymph nodes; we compared those injected on the day of surgery and those injected on the day before.

 Overall, 2663 women aged 50.2±11.6 years were included. The detection rate was 91.8% (806 out of 878). The false negative rate was 8.2% overall, and statistically similar for injections on the day or the day before surgery (2.9 vs 2.1; P=0.32).

 Tc phytate has a good detection rate for breast radio-guided SLNB with similar result for injections on the surgery day or the day before it.

The HIV Sentinel Surveillance (HSS) conducted by National AIDS Control Organization (NACO) is the predominant data source for HIV estimations in India. While the HSS targets the key populations at risk of HIV infection, the National Family Health Survey (NFHS) measures the communitybased HIV prevalence. Improvised HIV estimates in India were attributed to the HIV prevalence data obtained from the NACO-HSS and NFHS.

Bayesian analysis was performed to determine the state-level prevalence of HIV among females in seven South Indian States. The analysis involved plotting the prior, likelihood, and posterior distributions, facilitating a visual assessment of the data. The HIV prevalence among females calculated from the NFHS (2015-16) survey data was used for prior distributions. HIV prevalence among pregnant women obtained from the HIV Sentinel Surveillance 2019 was used for likelihood. Bayesian analysis was performed using the R programming (RStudio 2022.02.0). A posterior probability distribution was obtained using the prior distribution and the likelihood by applying the Bayes theorem. Graphical representation was achieved through R's plotting functions. Kerala and Pondicherry were not included in the analysis due to zero or very low prevalence reported in both NFHS and HSS.

The Bayesian estimates of HIV prevalence among females were 0.38 % [95% CI:0.29 - 0.47] in Andhra Pradesh, 0.28 [95% CI:0.23 - 0.35] in Karnataka, 0.27 [95% CI:0.20 - 0.34] Odisha, 0.27 % [95% CI:0.19 - 0.36] in Telangana and 0.19 [95% CI:0.15 - 0.24] in Tamil Nadu.

Bayesian techniques present a versatile and robust strategy for modelling and analysing HIVrelated data, offering a flexible and powerful approach to data analysis.

Air quality improvement was an unparalleled environmental consequence of the Covid-19 global crisis in many regions. Numerous researches have been conducted on the influence of national quarantines on air pollution and the relationship between the abundance of infected cases and mortality caused by this pandemic with air pollutants; however, these investigations are limited in Iran. The present study aims to investigate the correlation between Covid-19 cases and air pollution from a statistical viewpoint in order to evaluate the performance of multiple national lockdowns from February 2020 to August 2021 through measuring changes in air pollutants in the 31 provinces of Iran.

We applied a remote sensing method by employing Sentinel-5P satellite data to analyze changes in PM2.5, CO, and O3 during the three public quarantine periods and their two months earlier.

We recognized a considerable positive correlation between PM2.5 and the infected cases (r=0.63, p=0.001) and victims (r=0.41, p=0.001). Moreover, we compared the efficiency of lockdowns and supposed lockdown 2 (November-December 2020) as an only effective quarantine due to a dramatic reduction in PM2.5 (21.2%), CO (0.8%), the infected cases (48.7%), and victims (66.9%) in comparison to the average of its next two months.

Governments should handle the outbreak of Covid-19 by implementing efficient quarantines, as well as environmental conservation strategies.

According to the several scientific resources, Iran is considered to be among the melioidosis-endemic regions of the world; this is in stark contrast to the domestic stance in Iran, where the risk of melioidosis is speculated only as an emerging infectious disease in a non-endemic area. Recently, we have had devastating flash floods in the most provinces of Iran; the changing of soil structure may facilitate the cultivation of bacteria in the upper layers of the ground, consequently causes exposure and re-emergence of the disease. Considering previous isolation and identification of Burkholderia mallei, Burkholderia Pseudomallei, and Burkholderia cepacia complex from human, animal, and environment samples in Iran, it is urgently necessary to upgrade and equip infrastructures to identify and distinguish between pathogenic Burkholderia and commensals in the context of the One Health surveillance system. In the present perspective, the history of melioidosis in the country is presented to attract attention to the negligence of disease over the last four decades.

Lymph node metastases are the most significant prognostic factor in localized non-small cell lung cancer (NSCLC). Identification of the first nodal drainage site (sentinel node) may improve detection of metastatic nodes. Extended surgeries, such as lobectomy or pneumonectomy with lymph node dissection, are among the therapeutic options of higher acceptability. Sentinel node biopsy can be an alternative approach to less invasive surgeries. The current study was conducted to evaluate the accuracy of sentinel node mapping in patients with NSCLC using an intraoperative radiotracer techniques. This prospective study was conducted on 21 patients with biopsy-proven NSCLC who were candidates for sentinel node mapping during 2012-2014. All patients underwent thoracoabdominal computed tomography, based on which they had no lymph node involvement. Immediately after thoracotomy and before mobilizing the tumor, peritumoral injection of 2mCi/0.4 mL Tc-99m- phytate was performed in 4 corners of tumor. After mobilization of the tumoral tissues, the sentinel nodes were searched for in the hillar and mediastinal areas using hand-held gamma probe . Any lymph node with in vivo count twice the background was considered as sentinel node and removed and sent for frozen section evaluation. All dissected nodes were evaluated by step sectioning and hematoxylin and eosin staining (H&E).The recorded data included age, gender, kind of pathology, site of lesion, number of dissected sentinel nodes, number of sentinel nodes, and site of sentinel nodes. Data analysis was performed in SPSS software (version 22). The mean age of the patients was 58.52±11.46 years with a male to female ratio of 15/6. The left lower lobe was the most commonly affected site (30.09%). Squamous cell carcinoma and adenocarcinoma were detected in 11 and 10 subjects, respectively. A total of 120 lymph nodes were harvested with the mean number of 5.71±2.9 lymph nodes per patient. At least one sentinel node was identified in each patient, resulting in a detection rate of 95.2%. The mean number of sentinel nodes per patient was 3.61±2. Frozen section results showed 100% concordance with the results of hematoxylin and eosin staining. Based on the findings, sentinel node mapping can be considered feasible and accurate for lymph node staging and NSCLC treatment.

This study sought to determine the diagnostic yield of SPECT/CT in localizing axillary sentinel lymph nodes (SLNs) in early breast cancer patients where planar scintigraphy (PS) was equivocal or negative.
Prospective analysis of early stage breast cancer patients with nonpalpable axillary nodes undergoing SLN localization prior to nodal sampling for axillary staging. PS findings were categorized as: Category A: non-visualization of SLN; Category B: unusual uptake location; Category C: equivocal uptake / difficult interpretation. The K-coefficient of Cohen was used to evaluate the correlation between PS and SPECT/CT results. PS and SPECT/CT images were interpreted separately, and SLN identification on each of the modalities was correlated to BMI (Body mass index) and peroperative radio guided results.
Between April 2015 and January 2017, 1028 early breast cancer cases underwent sentinel lymphoscintigraphy. Of total, 134 (13%) patients underwent SPECT/CT in addition to PS. All were females with mean age of 48.15 years (range: 26-82 years). Right sided in 68, left in 64 and 2 with bilateral carcinoma. By TNM classification: 49 (37%) T1, 78 (58%) T2 and 7 (5%) had DCIS/Paget’s disease. Overall SLNs were detected on both PS and SPECT/CT in 60% cases. Of category A (n=54); 35/54 (64%) SLN localized on SPECT/CT; 32 were level-I; 2 Level-II; 1 Level-III nodes. In 19, SLN was not localized. Of category B (n=18), 5 had prior lumpectomy, SPECT/CT localized tracer uptake to 17 level-I sentinel nodes, 3 level-II and level III / IMC in 9. Of category C (n=62), 29 had prior lumpectomy. SPECT/CT confirmed SLN in all the cases. Radio-guided surgery confirmed SPECT/CT results. The correlation between the two techniques was low (K=0.34). Where PS was negative; SPECT/ CT localized nodes in statistically significant number of cases (P=0.01). PS identified SLN uptakes in 80/134 (60%) cases with a mean BMI of 21.6±4.8 kg/ m2 while SPECT/CT detected ‘‘hot’’ nodes in 115/134 (86%) cases with a mean BMI of 29.6±5.6 kg/m2. For overweight/obese patients (n=59) (BMI>25 kg/m2), PS failed to identify SLNs in 49 and SPECT/CT failed to do so in 18 (P SPECT/CT has diagnostic yield and helps in precise SLN localization where planar imaging is negative or shows unusual site of uptake.

To investigate the epidemiologic distribution of foodborne diseases in Wenzhou City from 2014-2015, we analyzed the characteristics and main pathogens of foodborne disease outbreaks to provide a reference for the prevention, control, and early warning of foodborne diseases.
A total of 9139 patients with foodborne diseases were included in the database of active monitoring from sentinel hospitals in Wenzhou City, China. Salmonella, Shigella, Vibrio parahaemolyticus, enteropathogenic Escherichia coli, and norovirus in the stool samples collected from patients with foodborne diseases were detected according to national standards.
There were 82 cases of Salmonella, 6 cases of Shigella, 393 cases of V. parahaemolyticus, 9 cases of diarrhoeagenic E. coli, and 143 cases of norovirus in the 9139 stool and anal swab samples, for a total detection rate of 6.98%. The peak season in which foodborne diseases occurred was from Jun-Oct. The high-risk populations were the 0-5, 16-25, 26-35, 35-45, and 46-55 yr age groups. Aquatic products accounted for the greatest proportion of suspected food, followed by meat, poultry, fruits, and vegetables.
V. parahaemolyticus was the main pathogen of foodborne diseases in the Wenzhou urban area; Salmonella and norovirus were also foodborne disease pathogens. To prevent foodborne diseases, it is necessary to strengthen active monitoring, especially the sanitary management of seafood.

The sentinel lymph node (SLN) is defined as the first chain node in the lymphatic basin that receives primary lymphatic flow. If the SLN is negative for metastatic disease, then other nodes are expected to be disease-free. SLN techniques have been extensively applied in the staging and treatment of many tumors, including melanoma, breast and vulvar cancers. This study aims to evaluate our technique in SLN mapping in early stage endometrial and cervical cancers. We scheduled a cross-sectional pilot study for patients undergoing staging surgery for endometrial and cervical cancer from November 2012 to February 2014 in Beheshti and Sadoughi Hospitals. Our SLN mapping technique included h preoperative or intraoperative injection of 4 ml of 1% methylene blue dye in the tumor site. At the time of surgery, blue lymph nodes were removed and labeled as SLNs. Then systematic lymph node dissection was completed, and all of the nodes were sent for pathologic examination concerning metastatic involvement. All of the sentinel nodes were first stained with hematoxylin and eosin and examined. Those negative in this study were then stained with immunohistochemistry using anti-keratin antibody. Descriptive statistics, sensitivity, negative predictive values (NPV), false negative (FN) and detection rates were calculated. Twenty-three patients including 62% endometrial and 38% cervical cancers enrolled in the study. Median of SLN count in the endometrial and cervical cancers was 3 and 2, respectively. Among endometrial and cervical cancers, detection rate of metastatic disease was 80% and 87.5%, respectively. The FN rate for this technique was 0 and the sensitivity and NPV are 100% for both endometrial and cervical cancers. Considering the lower risk of metastases in early stage of both endometrial and cervical cancers, SLN technique allows for confident and accurate staging of cancer.

Herein, we report a case of sentinel lymph node mapping in a uterine cervix cancer patient, referring to the nuclear medicine department of our institute. Lymphoscintigraphy images showed inappropriate intra‐cervical injection of radiotracer. Blue dye technique was applied for sentinel lymph node mapping, using intra‐cervical injection of methylene blue. Two blue/cold sentinel lymph nodes, with no pathological involvement, were intra‐operatively identified, and the patient was spared pelvic lymph node dissection. The present case underscores the importance of lymphoscintigraphy imaging in sentinel lymph node mapping and demonstrates the added value of blue dye injection in selected patients. It is suggested that preoperative lymphoscintigraphy imaging be considered as an integral part of sentinel lymph node mapping in surgical oncology. Detailed results of lymphoscintigraphy images should be provided for surgeons prior to surgery, and in case the sentinel lymph nodes are not visualized, use of blue dye for sentinel node mapping should be encouraged.

Sentinel lymph node biopsy has shown to be a good alternative procedure for axillary lymph node dissection and to lead to lower frequency of morbidity, though this technique has its own side effects. It needs especial equipment and may not be available in some medical centers, especially in developing countries. This study aimed to identify a subgroup of patients with higher probability of metastasis to sentinel lymph node that can be excluded from indications of this procedure. In this cross-sectional study, the clinical data of 195 patients with breast cancer who underwent sentinel lymph node biopsy in Tehran, Iran, between 2009 and 2011 were reviewed. Whenever tumor features showed significant association with sentinel node metastasis in univariate analyses, logistic regression was used to identify independent predictors. Univariate analyses revealed that tumor size and lymphovascular invasion have significant association with sentinel lymph node metastasis (P = 0.009 and P < 0.001, respectively). Moreover, age had an significant association with positive sentinel lymph node biopsy (SLNB) (P = 0.004). Other factors, including tumor grade, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2, were not associated with positive sentinel lymph node biopsy in univariate analysis. All factors that showed significant association in univariate analysis remained statistically significant predictors of positive SLB in multivariate analysis. It seems that young breast cancer patients, those who have tumors larger than 5 cm and those with lymphovascular invasion, are at an increased risk of sentinel lymph node metastasis.

In the current study we evaluated the incremental value of lateral pelvic lymphoscintigraphy imaging of endometrial or cervical cancer patients who underwent sentinel node mapping. Operable endometrial and cervical cancer patients without clinical or paraclinical evidence of lymph node involvement were included in the study. The day before surgery the patients were sent to the nuclear medicine department for injection of the radiotracer. All patients received two intra-cervical injection of 1 mCi/0.2 cc radiotracer in the 6 and 12 hour locations. 18-24 hours after the radiotracer, lymphoscintigraphy imaging in anterior/posterior and lateral views was done. After induction of anesthesia, 2 mL Methylene blue in two aliquots was injected intra-cervically in the same location as the radiotracers. During operation, any hot and/or blue node was harvested as sentinel nodes. Overall 40 patients were included in the study (30 endometrial and 10 cervical cancers). Sentinel node visualization was achieved in 30 patients. These sentinel nodes were all visualized on the ANT/POST views. Only in 7 patients sentinel nodes could be visualized on the lateral views. Intra-operative sentinel node detection rate was 38 out of 40 (95%). Radiotracer detection rate was 37/40 (92.5%) and blue dye detection rate was 17/40 (42.5%). Anterior/Posterior pelvic lymphoscintigraphy imaging is sufficient for imaging in cervical and endometrial cancer patients undergoing sentinel node mapping. Lateral views can be omitted due to limited valued of these projections.

Vulvar cancer is a rare gynecological malignancy with mainly lymphatic spread. Sentinel node mapping plays an important role in the management of this gynecological malignancy. In the current study, we reported our experience in sentinel node mapping of vulvar cancer and review the literature accordingly. Since the introduction of sentinel node mapping to the surgical oncology community of our university in 2004, we had two operable vulvar cancer patients who were candidate for sentinel node mapping for inguinal lymph node staging. In the current study, we reported these two cases in details and a brief review of literature on sentinel node mapping in vulvar cancer was done. We specifically discussed the overall accuracy, importance of blue dye injection, learning curve effect, frozen section, excisional biopsy and location of the tumors. Overall sentinel node mapping is a safe and effective method for inguinal lymph node staging in vulvar cancers. In order to perform sentinel node mapping efficiently, paying attention to the details is of utmost importance.

Several radiotracers are being used for sentinel node mapping in patients with breast cancer. In the current study, we reported our experience with 99m-Tc Phytate for sentinel node mapping in Mashhad University of Medical Sciences. All breast cancer patients who underwent sentinel node mapping using 99m-Tc Phytate were included. All patients received intradermal peri-areolar injection of 0.5 mCi/0.1cc 99m-Tc Phytate. Lymphoscintiraphy was performed for 145 patients 5-10 minutes post-injection. The sentinel nodes were found during surgery using a hand-held gamma probe as well as blue dye technique. In total 165 patients were evaluated. Lymphoscintigraphy showed axillary sentinel nodes in 135 out of 145 patients (93%) following imaging. At least one sentinel node could be detected in all these 135 patients during surgery. In the remaining 10 patients with sentinel node non-visualization, 5 had sentinel node harvesting failure during surgery. Median number of sentinel nodes on the lymphoscintigraphy images was 1. Sentinel node detection rate was 95% (157/165). In the 8 patients with sentinel node harvesting failure, 7 had pathologically involved axilla. Median number of harvested sentinel nodes was 1. Mean sentinel node to background count ratio was 10±2. 99m-Tc Phytate is an effective and highly successful radiotracer for sentinel node mapping. Sentinel node can be visualized in a short time after 99m-Tc Phytate injection on the lymphoscintigraphy images. The sentinel to background count during surgery is high which results in more convenient sentinel node harvesting and high detection rate.