Iranian Red Crescent Medical Journal
Volume:21 Issue: 9, Sep 2019

The process of direct radiation to the tumor or tumor residue during surgery known as Intraoperative Radiation Therapy (IORT) is a new promising technique in the treatment of different cancers. For a detailed review of IORT application and effectiveness in breast cancer, we conducted a review of the present literature in the field. Evidence Acquisition: In this study, the most important technologies for IORT were identified through a comprehensive study. Relevant, critical, and highly cited articles and studies were selected based on experts’ opinions. Data were summarized in sections of technology and physics, protocols, and treatment outcomes.

Electron beam and low-energy X-ray technologies were explained, and the physique of IORT was discussed. Due to the uncertainties of this modality and geometric complexities of post-excision treatment site, specialized treatment planning systems for IORT are necessary. In breast cancer treatment, regardless of the employed technology, IORT is applied with two main protocols: Partial Breast Irradiation and Intraoperative Boost Irradiation, each with their own advantages and disadvantages.

Despite the controversies in acceptance and effectiveness of IORT, this technique seems to be promising for increased survival of breast cancer patients.

Levodopa treatment is the gold standard in Parkinson’s disease but has the risk of dyskinesias. Selegiline delays the introduction of levodopa and pramipexole is used as a symptomatic treatment in Parkinson’s disease.

This study aimed to compare the effectiveness of pramipexole with selegiline in Parkinson’s disease patients.

Data regarding motor and cognitive impairments and plasma phospholipids of 500 Chinese patients with confirmed Parkinson’s disease from medical records of 1 January 2015 to 1 June 2016 were retrospectively evaluated. Patients received either pramipexole (PP cohort, n = 250) or selegiline (SG cohort, n = 250). Also, data regarding hospitalization, adverse effects, and expenditure were collected and analyzed from records of the follow-up period.

After 3-years of treatments, selegiline and pramipexole both improved motor and cognitive impairments and decreased plasma phospholipid levels (P < 0.05 for all). The intensity of improvement in motor and cognitive impairments and a decrease in the level of plasma phospholipids for pramipexole was higher than those of selegiline (P < 0.05 for all). Pramipexole caused muscle weakness (P = 0.015) and peripheral edema (P = 0.0004). While, selegiline caused cardiovascular disease (P = 0.008). Higher numbers of patients in the SG cohort were hospitalized during 3-years of treatment than those in PP cohort (11 vs. 1, P = 0.009). Selegiline treatment is more expensive than pramipexole (4,457 ± 345 ¥ vs. 3,649 ± 301 ¥/patient/year, P < 0.0001).

Pramipexole treatment may have better improvement in motor and cognitive impairments than selegiline with neuroprotective action and manageable side effects (Level of Evidence: III).

Autism Spectrum Disorder (ASD) is a common neurodevelopmental disorder. Several susceptibility genes were found in the genome-wide study of ASD. There are few reports of the association between granzyme B (GZMB) and ASD.

This study aimed to investigate the association between ASD and GZMB polymorphism in the northeast Han Chinese population.

A case-control study was conducted in Changchun city, a northeast city of China, from June 2014 to November 2014. We enrolled 268 Han population Chinese children in a case-control study, including 85 ASD patients and 183 healthy controls. We also recruited 67 nuclear family trios. Three single-nucleotide polymorphisms (SNPs) (rs2236338, rs10873219, and rs8192917) were selected and genotyped. The association between the GZMB SNPs and ASD was analyzed using the Transmission Disequilibrium Test (TDT).

No statistical differences were found in allele and genotype frequency of the three SNPs of the GZMB gene between the case and control groups (all P > 0.05). Our study showed that rs2236338-rs10873219-rs8192917 G-T-G (P = 0.41) and G-G-G (P = 0.59) haplotypes were not associated with ASD. Moreover, TDT showed negative results (P = 0.885 for rs2236338, P = 0.900 for rs10873219, and P = 0.900 for rs8192917).

There was no association between the three SNPs in GZMB and ASD. Further studies need to determine and verify the relationship between the GZMB gene and ASD.

Selenium (Se) and Electrical stimulation (ES) play an important role in maintaining the integrity of various body functions after spinal cord injury (SCI).

This study aimed to investigate the effect of Se and ES on the sperm parameters and the repair of the damaged spinal cord in a rat model.

A total of 50 male Wistar rats were randomly divided into five groups (n = 10 per each group, including control, sham, SCI, Se, and ES. After SCI in the T10 space, the BBB and Von Frey test were used to evaluate the motor and sensory functions. Six weeks after the treatment, the assessment of sperm parameters was done.

The treatment with Se, compared to the SCI group, significantly increased the sperm concentration (38.66 ± 14.81 vs. 18.50 ± 7.02, P < 0.001), motility (55.00 ± 3.0 vs. 8.33 ± 1.16, P < 0.001) and viability (81.66 ± 8.16 vs. 19.16 ± 1.06, P < 0.001). ES compared to the SCI group, significantly increased sperm motility (60.00 ± 6.32 vs. 8.33 ± 1.16, P = 0.001) and viability (70.83 ± 9.70 vs. 19.16 ± 1.06, P < 0.001). Se and ES revealed no significant effects on sperm morphology (P > 0.05). A significant increase was observed in the BBB locomotor Score and Von Frey test in the SE and ES groups compared to the SCI group and between the Se and ES groups. However, no significant difference was observed between the Se and ES groups in the Von Frey test.

The effect of Selenium on sperm parameters and motor function was superior than that of the Electrical stimulation, but the effective effect on repairing the sensory function was the same.

Gastrointestinal (GI) dysmotility is a common problem among preterm neonates with very-low-birth-weight and is manifested as feeding intolerance, and in this situation, total parenteral nutrition (TPN) is needed for several complications. Erythromycin is a prokinetic antibiotic that neonatologists widely prescribe for the treatment of GI dysmotility in high and low doses.

This study aimed to evaluate the effects of an intermediate dose of Erythromycin in the treatment of feeding intolerance in preterm neonates.

This study is a randomized clinical trial on preterm neonates admitted in two university-affiliated hospitals in Isfahan, Iran, during 2016 - 2017. Feeding is started for all neonates with 20 mL/kg/day doses and if they tolerate it, 20 mL/kg/day is added daily to receive toreach 150 mLcc/kg/day. The infants were divided into two groups, which received either Erythromycin (5 mg/kg/dose every 6 hours) or placebo for eight days. These outcomes were evaluated: time duration to reach 75, 110, and 150 mL/kg/day feeding volume, lavage count after the intervention, time duration of oxygen dependency and hospitalization, the incidence of necrotizing enterocolitis, intraventricular hemorrhage, patent ductus arteriosus, chronic lung disease, cholestatic icterus, sepsis, and hypertrophic pyloric stenosis.

Sixty-four neonates (female 38 (59.3%) and male 26 (40.6%)) with the mean gestational age 30.10 ± 2.49 weeks were evaluated. The mean time duration to reach 75, 110, and 150 mL/kg/day feeding volume was significantly lower in the Erythromycin group (4.19 vs. 6.84 days, P < 0.001, 6.35 vs. 9.08 days, P < 0.001 and 9 vs. 11.46 days, P < 0.001 in the Erythromycin vs. placebo groups, respectively). Also the number of lavages were significantly lower in the Erythromycin group (0.35 ± 0.56 vs. 3.03 ± 3.08 in the Eerythromycin and placebo groups; P < 0.001).

Intermediate dose of Erythromycin can reduce the time duration to reach full feeding volume and is safe for preterm neonates.

Myocardial infarction can be associated with irreversal myocardial ischemia and the necrosis of the affected site of the heart. Curcumin has a protective effect on Myocardial Ischemia.

Our study aimed to combine a regenerative medicine with a traditional antioxidant effects as an adjuvant for the treatment of isoproterenol-induced MI.

This experimental study conducted on 36 adult male Wistar rats in an university-affiliated animal lab, Urmia, Iran, in 2016. Male rats were divided into six groups of six rats, including control, MI (ISO 100 mg/kg), curcumin (80 mg/kg by oral gavage), Bone Marrow Mesenchymal Stem Cells (BMSCs; 4 × intravenous injection), and Cur-BMSCs. The efficiency of these methods was evaluated by histopathological examination, immunohistochemistry, measurement of heart rate, heart to body weight ratio, size of infarction, and serum levels of CK-MB, LDH, MDA, and SOD.

The benefit of curcumin was apparent in two recipient groups. The rats that received curcumin or were treated with BMSCs showed significant reductions in heart to body weight ratio (P < 0.001). The elevation of serum levels of CPK, LDH, MDA, and SOD (P < 0.001) was done in curcumin treatment groups. Decreases in the number of apoptotic cells were significant in cur (P < 0.001) and cur-BMSCs (P = 0.023) groups; histopathological injuries were recognized significantly in cur (P < 0.001) and cur-BMSCs (P = 0.012) groups, and infarct size was significant in both curcumin groups (P < 0.001).

Curcumin pretreatment of Bone Marrow Mesenchymal Stem Cells helps in stem cells transplantation and acts as a synergist.

Sophocarpine (SC) is a major alkaloid extracted from Sophora alopecuroides L. Our previous study showed that SC has analgesic effects on neuropathic pain induced by chronic constriction injury (CCI). However, the exact analgesic mechanism of SC on neuropathic pain has not yet been elucidated.

The current study aimed to examine the anti-neuropathic pain effects of SC on the HMGB1/TLR4/NF-κB signaling pathway to explore its analgesic mechanism in neuropathic pain.

In this experimental study, the neuropathic pain mouse model was established by CCI of the sciatic nerve in a universityaffiliated animal lab, China, 2016. Mechanical withdrawal threshold (MWT), thermal withdrawal latency (TWL), cold withdrawal threshold (CWT), and tail-curling latency (TCL) were used to assess the antinociceptive effect of SC in neuropathic pain mice. The mRNA and protein expression levels of HMGB1, TLR4, NF-κB, p-NF-κB, TNF-α, and IL-6 in the spinal cord of neuropathic pain mice were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting.

Treatment with 40 and 20 mg/kg of SC was effective in increasing MWT, lengthening TWL, reducing CWT, and prolonging TCL in mice with neuropathic pain induced by CCI. Compared to the neuropathic-pain model group, treatment with 40 mg/kg of SC could effectively down-regulate HMGB1, TLR4, NF-κB, p-NF-κB, TNF-α, and IL-6 mRNA and protein expression levels in the spinal cord of mice with neuropathic pain induced by CCI.

Our results showed that SC has analgesic effects on neuropathic pain induced by CCI, and its analgesic mechanism may be related to down-regulating the HMGB1/TLR4/NF-κB signaling pathway.

Breast cancer is the most common cancer in women, which has not been completely cured yet. The traditional approaches have low accuracy for breast cancer detection. However, intelligent techniques have been recently used in medical research to distinguish infected individuals from healthy ones, accurately.

In this study, we aim to develop an ensemble machine learning (ML) method to distinguish tumor samples from healthy samples robustly.

We used an Imperial Competitive Algorithm coupled with a Fuzzy System (ICA-Fuzzy-SR) to identify the most influencing features to recognize tumor samples. To evaluate the proposed method, we used the publicly available Wisconsin Breast Cancer Dataset (WBCD).

Benchmarking with the current existing leading methods indicates that our proposed method achieves 95.45% prediction accuracy, which is 3% better than those reported in previous studies.

Such results achieve while our model is significantly faster than previously proposed models to solve this problem.

In Spring 2018, due to intense rainfalls in Iran, plenty of mushrooms had grown, some of which were poisonous and their consumption had induced poisoning in people of different provinces; 1151 mushroom poisoning cases were reported within 25 days from 12 May to 9 July 2018.

This study aimed to address this issue from the public health perspective. The study further aimed at reporting the mortality and morbidity associated with mushroom poisoning and ascertaining the reasons behind the increase in the numbers of the affected persons.

This report was based on the review of official reports and a field assessment in the areas affected bymushroom poisoning in the western part of Iran.

There were 1151 mushroom poisoning cases, out of which 1133 (98.4%) were hospitalized, and unfortunately, 18 (1.56%) died. Kermanshah province had the highest rate of mushroom poisoning casualties, out which seven people died. A total of 12 provinces were affected.

Lack of knowledge of local people about the types of mushroom and their inability to differentiate between the toxic and non-toxic mushrooms, as well as lack of a swift and convenient immediate warning system has caused this incident of massive mushroom poisoning. However, planning and proper management can help to resolve these problems.

Fluoxetine is used commonly as an antidepressant and celecoxib is widely used for pain relief and reducing inflammation in various chronic conditions. Both of them can cause liver injury, but it is a rare adverse reaction of their interactions. Here we report a case of liver injury possibly induced by fluoxetine and celecoxib in a female patient.

A 55-year-old woman who was given fluoxetine for three months and celecoxib for seven days was transferred to the Department of Emergency, the first affiliated hospital of Jilin University, Changchun, China, on March 2019, with icterus on the skin, dark brown urine and pain in the upper abdomen. Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels were elevated. According to follow-up examination, liver injury and cholecystitis were diagnosed. After discontinuing the two drugs and starting symptomatic treatment, her ALT and AST levels returned to normal.

The mechanism of liver injury induced by fluoxetine and celecoxib remains unclear. Inhibitors and substrates of CYP2D6, CYP2C9, CYP3A4, and CYP2C19 might participate in this situation. The interaction between fluoxetine and celecoxib, as well as other inhibitors and substrates with similar metabolic pathways, are noteworthy.