Journal of Research in Medical Sciences
Volume:25 Issue: 12, Dec 2020

DNA methylation was considered to play an important role in hypertension. However, the direct association between dihydrofolate reductase (DHFR) promoter methylation and hypertension remains unclear. We thus aimed to investigate the relationship between DNA methylation of DHFR promoter and hypertension.

A total of 371 hypertensive patients (diastolic blood pressure ≥90 mmHg and/or systolic blood pressure ≥140 mmHg or a history of antihypertensive treatment) and 320 age‑ and sex‑matched healthy controls from the Hypertension Management Information System in Nanshan Community Health Service Centers were included in this case–control study. Quantitative methylation‑specific polymerase chain reaction was used to measure the level of DHFR promoter methylation, which was presented as the percentage of methylated reference (PMR). A multivariate logistic regression model was used to explore the risk of DHFR promoter methylation.

Our results indicated that the level of DHFR promoter methylation was higher in hypertensive patients (median PMR, 34.32%; interquartile range, 11.34–119.60) than in healthy controls (median PMR, 18.45%; interquartile range, 8.16–35.40) (P < 0.001). Multivariable analysis showed that the risk of DHFR promoter hypermethylation was significantly higher in hypertensive patients than in healthy controls (odds ratio = 3.94, 95% confidence interval = 2.56–6.02, P < 0.001). Furthermore, hypermethylation was positively associated with sex, high blood homocysteine levels, and alcohol drinking. In particular, the area under the receiver operating characteristic curve was 0.688 (0.585–0.668) for the male hypertensive patients, suggesting the potential diagnostic value of DHFR promoter methylation in male hypertension.

Our results demonstrated that DHFR promoter hypermethylation is positively associated with the risk of hypertension in Chinese.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder which its treatment is still a question. According to the literature, the use of antidepressants is common for IBS, while its efficacy in this regard is controversial. This study has been raised to assess the efficacy of venlafaxine in IBS patients.

In this double‑blind, randomized clinical trial, 33 patients with moderate‑to‑severe IBS were included and randomly divided into two groups by using permuted block randomization process of size 4 for each block to receive Venlafaxine or placebo. Venlafaxine in 37.5 mg/day for 2 weeks, followed by 75 mg/day for the next 2 weeks and then 150 mg/day until the end of the study was prescribed. Gastrointestinal symptoms severity, depression, anxiety, stress as main, and quality of life (QoL) as the secondary outcomes were evaluated at the study initiation, within 2, 6, and 12 weeks after treatment and 3 months after intervention cessation.

The gastrointestinal symptoms severity, depression, anxiety, stress, and QoL scores significantly improved in patients who received Venlafaxine but not in placebo group; although after treatment discontinuation they experienced relapse (P < 0.05). Patients treated with venlafaxine experienced significant improvement in IBS symptoms, all three psychological disorders and QoL than placebo group (P < 0.01). The frequency of observed side effects in venlafaxine group including vomiting, nausea, and sleep disturbance was higher than placebo.

Venlafaxine could be considered as an effective treatment for improving gastrointestinal symptoms severity, depression, anxiety, stress, and QoL of patients with IBS. Further studies with larger sample size and longer treatment duration are recommended.

Celiac disease (CD) is one of the most common disorders, resulting from both environmental (gluten) and genetic factors. The clinical features of the Iranian CD are still unknown and there is insufficient information about the atypical presentation of CD from Iran. As, many previous reports revealed an association between controlled protozoal infections and the CD according to cytokines production, the aim of this study was to determine the prevalence of CD and possible co‑infection with the most prevalent protozoal infections including Tropheryma whipplei, Cryptosporidium, and Giardia duodenalis among CD samples.

In this study, from April 2014 to November 2016, 524 samples were obtained from small intestine of patients with gastrointestinal diseases referring to the Pathology Department of Namazi Hospital, Shiraz, Iran. Multiplex polymerase chain reaction assay was then performed on the histological positive CD samples for the prevalence of the microorganisms.

Sixty‑four (12.21%) patients were diagnosed as having CD by histopathological examination. The prevalence of T. whipplei and Cryptosporidium spp. was 19 (29.69%) and 8 (12.5%) respectively, among CD positive samples there was no positive sample for Giardia lamblia.

The prevalence of CD among the southwestern Iranian population was high and comparable with other areas of Iran as well as many other countries. Furthermore, no significant association between the presence of T. whipplei, Cryptosporidium spp., and level of the histopathological changes of villi in the CD was observed (P > 0.05).

Preeclampsia (PE) is a high blood pressure disorder accompanied by proteinuria during pregnancy. It remains unclear whether dietary trans‑fatty acid (TFA) can influence PE risk. We examined the effect of low TFA dietary intakes during pregnancy on the risk of PE.

We conducted a randomized open‑label controlled trial on 800 pregnant women admitted to public health centers from May 2014 to August 2016. In the intervention group, participants received a diet with TFA <1% and those in the comparison group, participants had dietary intakes with no change on TFA content. Dietary intakes were assessed by 24‑h recalls at the first prenatal care visit (<8 weeks) and at gestational ages of 13, 25, and 35 weeks. The hazard ratio (95% confidence interval [CI]) for PE was calculated using the Cox proportional-hazards model.

There were statistically significant differences in intakes of daily TFAs between the groups (P < 0.05). The hazard ratio (95% CI) for the incidence of PE in the intervention group was 0.56 (0.33–0.93).

Low TFA dietary intake during pregnancy reduced the risk of PE

Rheumatoid arthritis (RA) is the most prevalent autoimmune disease, in which CCL2 and CCL5 are critically involved. The objective was to evaluate the therapeutic effects of bone marrow‑derived mesenchymal stem cells (MSCs) on the foregoing chemokines in RA patients.

Thirteen RA patients were evaluated in terms of clinical manifestations, paraclinical factors, gene expression, and plasma levels of CCL2 and CCL5 prior to treatment and 1 and 6 months after intervention. Real‑time‑polymerase chain reaction and enzyme‑linked immunosorbent assay were employed to assess the gene expression and plasma levels of CCL2 and CCL5 at different time points after MSC therapy. Statistical analysis was performed by SPSS 16 and Prism 7.

The CCL2 gene expression had statistically significantly increased (P = 0.034), and its plasma level had insignificantly reduced after 1 month. Furthermore, the gene expression and plasma level of CCL5 had statistically significantly decreased (P = 0.032, P < 0.001). The CCL5 gene expression had statistically significantly increased after 6 months (P = 0.001) and its plasma level had insignificantly reduced.

The most significant inhibitory effects of MSC therapy on the gene expression and plasma level of CCL5 were observed at the end of 1 month. The differences between the gene expression and protein levels during the treatment might be related to microRNA effects or the insufficient number of MSC injection.

The evidence base regarding the association between urinary potassium and blood pressure (BP), or risk of hypertension, is inconsistent. Therefore, we sought to conduct a qualitative and quantitative literature review on the association between potassium excretion and BP.

Medline, Scopus, Web of Science, Science Direct, and Google Scholar were searched up to June 2020. All observational studies that reported BP and measured potassium excretion in overnight or 24‑h urine samples were included. Correlation coefficients, mean urinary potassium excretion, and odds ratio (ORs) of hypertension were extracted from the included studies. There were no language or publication date restrictions.

Overall, twelve observational studies, including 16,174 subjects, were identified for inclusion in the present meta‑analysis, and 21 effect sizes were extracted. Pooled mean potassium excretion was 3.46 mmol/24 h higher in normotensive individuals compared with hypertensive subjects (95% confidence interval [CI]: 0.61, 6.31). High urinary potassium excretion was not associated with the risk of hypertension (OR: 0.95; 95% CI: 0.79, 1.13). The pooled correlation coefficient between BP and urinary potassium was not significant (ES: 0.01; 95% CI: −0.03, 0.05). However, a subgroup analysis by age indicated a significant positive correlation between urinary potassium and systolic BP in children (ES: 0.12; 95% CI: 0.04, 0.19).

24 h urinary potassium excretion was not correlated to BP and risk of hypertension. In contrast, mean urinary potassium excretion was higher in normotensive individuals compared with hypertensive counterparts. Future studies should focus on the association between different sources of dietary potassium and BP.

Intraductal papillary mucinous neoplasm of the biliary tract (B‑IPMN) is an intraductal growing mucin producing tumor that is precursor of cholangiocarcinoma. Dilation of both upstream and downstream biliary ducts is the radiological key feature that is respectively caused by intraductal obstructive growth and massive mucin production. Although B‑IPMN is rare, if the radiologist is familiar with its manifestation, can lead to early diagnosis when surgical resection can be curative. Here, we report a long standing pathologically proved case of B‑IPMN with emphasis on radiological manifestation during a long time of 13 years across different imaging modalities.