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Recovery of the lumbar multifidus muscle size in chronic low back pain patients by strengthening hip abductors: A randomized clinical trial
No full textIntroduction: Decrease in cross-sectional thickness of lumbar multifidus (MF) muscles during prolonged low back pain episodes commonly occurs. Restoration of the MF muscle size can be an effective way of treating chronic low back pain (CLBP) patients. Traditionally, clinicians apply muscle stabilization exercises for these patients. Recent studies support the need for active strengthening exercises for treatment of the CLBP patients. Objective: The MF muscles provide lumbar stability, and therefore we hypothesized that strengthening of these muscles can be more effective than the MF muscle stabilization exercises in restoration of the muscle size. Design: Study design was a randomized allocation control trial with two groups of adult female CLBP patients (n = 12 each; age range of 20�45). Patients in the control group underwent stabilization exercises and the patients in the intervention group underwent the hip abductor strengthening exercises. Setting: For all subjects of each group, the trials continued in 24 sessions distributed over 8 weeks and the MF muscles were measured in the beginning of the first session and one week after completion of the last session. Main outcome measures: Statistical significance (p-value) of the change in the average MF muscle thickness, pain, and disability scores along with for each group were estimated. Results: Both regimens of exercises can significantly decrease the pain and disability: average pain and disability reductions of 46 (p-value of 0.001) and 33 (p-value of 0.02) via stabilization versus average pain and disability reductions of 65 (p-value of 0.001) and 59 (p-value of 0.001) via hip abductor strengthening. However, the hip abductor strengthening is the sole statistically significant exercise regimen (p-value of 0.014 vs 0.94) for increasing the MF muscle size. Conclusion: Replacement of the traditional stabilization exercises with the hip abductor strengthening exercises for effective treatment of female adults with CLBP is recommended. © 2020 Elsevier Lt
More attention on glial cells to have better recovery after spinal cord injury
Get PDFFunctional improvement after spinal cord injury remains an unsolved difficulty. Glial scars, a major component of SCI lesions, are very effective in improving the rate of this recovery. Such scars are a result of complex interaction mechanisms involving three major cells, namely, astrocytes, oligodendrocytes, and microglia. In recent years, scientists have identified two subtypes of reactive astrocytes, namely, A1 astrocytes that induce the rapid death of neurons and oligodendrocytes, and A2 astrocytes that promote neuronal survival. Moreover, recent studies have suggested that the macrophage polarization state is more of a continuum between M1 and M2 macrophages. M1 macrophages that encourage the inflammation process kill their surrounding cells and inhibit cellular proliferation. In contrast, M2 macrophages promote cell proliferation, tissue growth, and regeneration. Furthermore, the ability of oligodendrocyte precursor cells to differentiate into adult oligodendrocytes or even neurons has been reviewed. Here, we first scrutinize recent findings on glial cell subtypes and their beneficial or detrimental effects after spinal cord injury. Second, we discuss how we may be able to help the functional recovery process after injury. © 2021 The Author
Drug-induced pemphigus: A systematic review of 170 patients
No full textPemphigus encompasses a rare heterogeneous group of autoimmune blistering diseases characterized by cutaneous and/or mucosal blistering. Multiple factors, such as some specific types of drugs, have been found to be involved in the induction of pemphigus. Here, we have designed a systematic review by searching PubMed/Medline and Embase databases to find the drugs, involved in pemphigus induction and exacerbation (updated on 19 August 2019). From 856 initially found articles, 134 studies (198 patients; 170 patients in the drug-induced patients and 28 in exacerbation group) have been included. Regarding drug-induced cases, the mean age was 57.19 ± 16.9-year-old (ranged 8�105), and patients had developed pemphigus within a mean of 154.27 days. Pemphigus vulgaris (38.9), pemphigus foliaceus (33.5), and paraneoplastic pemphigus (3.6) were the most common subtypes. Furthermore, penicillamine (33.1), captopril (7.7), and bucillamine (6.5) were the most reported drugs related to pemphigus induction; penicillamine was associated with the most persistent disease. Regardless of disease subtype, cutaneous, mucocutaneous, and mucosal involvements were reported in 68.6, 30.1, and 1.3 of patients, respectively. In total, the IgG deposition in the pathological studies, being positive for autoreactive antibodies in the serum against desmoglein 3 (Dsg3), and desmoglein 1 (Dsg1), were reported in 93, 34.9, and 72.7 of reported patients, respectively. Regarding the management of such patients, in 75 of healed cases, treatment (mainly transient systemic and topical corticosteroids and/or azathioprine) was needed besides stopping the probable pemphigus-inducing culprit drug, while drug cessation was enough to control the disease in 25. As the outcomes, the lesions in 129 of 147 (87.8) patients had been healed, while in 18 (12.2), no healing was reported; fifteen out of 18 had died. In conclusion, some specific groups of treatments can induce pemphigus, including penicillamine, captopril, and bucillamine; despite the similar clinical and pathological manifestations to classical pemphigus, most of the cases are less severe and have a better prognosis. © 2020 Elsevier B.V
Clinical features of pregnant women in Iran who died due to COVID-19
Get PDFBackground: To evaluate the clinical presentation of pregnant women in Iran who died due to COVID-19. Methods: Data were evaluated of pregnant women who died following a laboratory diagnosis of COVID-19. The data were obtained from electronic medical records. Additionally, a questionnaire was completed for each patient, including demographic, clinical, laboratorial, imaging, and treatment data. In case of missing information, a member of the research team contacted the first-degree relatives via phone. Results: Of 32 pregnant women who tested positive for COVID-19, 15 were enrolled into the study (mean age 30.0 ± 5.0 years). The mean time from first symptoms to death was 12 ± 7.0 days. Pre-existing comorbidities were seen in six patients. The main presentations at admission were fatigue and coughing, but most of the women had a fever below 38 °C. Increased white blood cell count and neutrophils were noticeable. A significant drop of saturation of O2 with ground glass and consolidation seen in both lungs were prominent. The most common complications were acute respiratory distress syndrome followed by respiratory failure. Conclusion: Computed tomography findings, O2 pressure, and regular blood assessment may be considered suitable indicators for the surveillance of patients. © 2020 International Federation of Gynecology and Obstetric
The possible role of CREB-BDNF signaling pathway in neuroprotective effects of minocycline against alcohol-induced neurodegeneration: molecular and behavioral evidences
No full textAbuse of alcohol triggers neurodegeneration in human brain. Minocycline has characteristics conferring neuroprotection. Current study evaluates the role of the CREB-BDNF signaling pathway in mediating minocycline's neuroprotective effects against alcohol-induced neurodegeneration. Seventy adult male rats were randomly split into groups 1 and 2 that received saline and alcohol (2 g/kg/day by gavage, once daily), respectively, and groups 3, 4, 5, and 6 were treated simultaneously with alcohol and minocycline (10, 20, 30 and 40 mg/kg I.P, respectively) for 21 days. Group 7 received minocycline alone (40 mg/kg, i.p) for 21 days. Morris water maze (MWM) has been used to assess cognitive activity. Hippocampal neurodegenerative and histological parameters as well as cyclic AMP response element-binding protein (CREB) and brain-derived neurotrophic factor (BDNF) levels were assessed. Alcohol impaired cognition, and concurrent therapy with various minocycline doses attenuated alcohol-induced cognition disturbances. Additionally, alcohol administration boosted lipid peroxidation and levels of glutathione in oxidized form (GSSG), tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), and Bax protein, while decreased reducing type of glutathione (GSH), Bcl-2 protein, phosphorylated CREB, and BDNF levels in rat hippocampus. Alcohol also decreased the activity in the hippocampus of superoxide dismutase (SOD), glutathione peroxidase (GPx), and glutathione reductase (GR). In comparison, minocycline attenuated alcohol-induced neurodegeneration; elevating expression levels of P-CREB and BDNF and inhibited alcohol induced histopathological changes in both dentate gyrus (DG) and CA1 of hippocampus. Thus, minocycline is likely to provide neuroprotection against alcohol-induced neurodegeneration through mediation of the P-CREB/BDNF signaling pathway. © 2020 Société Française de Pharmacologie et de Thérapeutiqu
Association of ACE Gene Insertion/Deletion Polymorphism with Suicidal Attempt in an Iranian Population
No full textDeregulation of the renin�angiotensin system (RAS) plays an important role in suicide. Angiotensin converting enzyme (ACE) gene is a key component in this system. The relationship between insertion/deletion (I/D) polymorphism of ACE gene with suicide attempt (SA) is controversial. According to previous studies, allele D in this polymorphism has been considered as a potential risk factor for suicide. However, no study has been conducted in Iran to investigate this matter. This case�control study has focused on investigating the association of ACE I/D polymorphism (rs1799752) with SA in an Iranian population. The frequency of genotypes was 14 for II, 55 for ID, and 31 for DD in the case group (100 persons), and 18 for II, 74 for ID, and 8 for DD in control group (100 persons). Results show there was a significant difference in the distribution of ACE I/D polymorphism genotypes in men with SA compared to controls, as well as in women with SA compared to controls. Also, there was a significant association between DD genotype and the risk of SA compared to II genotype as reference. The severity of depression was significantly different between DD and II genotypes in SA group. According to the results, we suggest that the presence of DD genotype is possibly associated with an increased risk of SA. Maybe part of that is related to severity of depression in DD genotypes carriers of ACE I/D polymorphism. © 2020, Springer Science+Business Media, LLC, part of Springer Nature
Retinoblastoma presentation, treatment and outcome in a large referral centre in Tehran: a 10-year retrospective analysis
No full textBackground/objectives: Early diagnosis, care and treatment of retinoblastoma is a challengeable issue for Iranian health system. This study was designed and conducted in a referral multidisciplinary centre in the capital city of Iran to evaluate management, care, prognosis and survival rates of paediatric patients with retinoblastoma. Methods: In this retrospective study, a total number of 309 patients younger than 15 years, diagnosed with retinoblastoma, who referred for diagnosis and treatment to MAHAK�s Pediatric Cancer Treatment and Research Center (MPCTRC) from 2007 to 2017 were evaluated. All data were analyzed via SPSS version 22 software in regard of parametric and non-parametric data. Survival rates were analyzed using the Kaplan�Meyer method. Results: The mean age of patients was 20 months and the majority of patients (77) had leukocoria as a common clinical symptom at the time of diagnosis. Primary treatment methods were systemic chemotherapy (94), laser (35) and primary enucleation (28). Relapses occurred in nearly 42 of cases, and the median time from diagnosis to the first relapse was 9 months. At the time analyzing the data, 11 of patients died. Patients� 5-year OS and RFS rates were 79.6 and 41.5, respectively. Conclusion: Comparing results with other conducted studies identifies that the recurrence rate was high in our considered patients. Also, OS and RFS rates in our study were not as considerable as other reports. Screening methods, updating protocols and follow-up of patients may lead to improvements in survival rates of patients with retinoblastoma. © 2020, The Author(s), under exclusive licence to The Royal College of Ophthalmologists
Prevention of anthracycline-induced cardiotoxicity: a systematic review and network meta-analysis
No full textBackground Anthracycline based chemotherapy is commonly used in many malignancies. While life expectancy increases with the use of this medication, cardiac toxicity causes a risk for patients� health due to anthracyclines. Objective This systematic review and meta-analysis emphasizes on prevention of anthracycline-associated cardiotoxicity in breast cancer and lymphoma patients. Methods We conducted a systematic review of electronic databases including PubMed, Medline, EMBASE, ClinicalTrials.gov, Web of Science, and the Cochrane Library from inception to June 2019 collecting published articles on primary prevention of anthracycline-associated cardiotoxicity in breast cancer and lymphoma patients. We conducted a network meta-analysis and a pairwise meta-analysis in order to compare direct and indirect cardiac agents group with control group calculate left ventricular ejection fraction change. Primary studies results were pooled using random effects model, frequent network meta-analyses, and performed pairwise meta-analysis using netmeta and meta packages respectively in R software version 3.5.1. Results Twelve studies reported left ventricular ejection fraction outcome among 526 patients in the cardiac agent group and 508 in the control group. Based on Surface Under the Cumulative Ranking cure result, spironolactone was the best in left ventricular ejection fraction change and based on meta-analysis, cardiac group had 1.98 unit left ventricular ejection fraction more than the control group (MD = 1.98, 95 CI 0.15�3.81, p value = 0.03). Conclusions The amount of left ventricular ejection fraction used by cardiac agents in anthracycline-based chemotherapy was reduced to a lesser extent. The effective and ineffective drugs were spironolactone and metoprolol, respectively. © 2020, Springer Nature Switzerland AG
Removal of polycyclic aromatic hydrocarbons (Pahs) from contaminated sewage sludge using advanced oxidation process (hydrogen peroxide and sodium persulfate)
No full textThis study has been carried out with the aim of evaluating the treatability of polycyclic aromatic hydrocarbon compounds of PAHs available in urban and industrial sewage sludge utilizing advanced chemical oxidation methods contingent on free sulfate radicals using hydrogen peroxide and heat activation methods. For this purpose, various parameters including (3, 5, 7, 9, and 10), persulfate�s concentration (2, 10, 5, 15, and 20 mmol), the ratio of peroxide to persulfate (1, 0.5, 0.3, 0.2, and 0.1), sludge temperature (25°C, 35°C, 45°C, and 55°C) and the primary concentration of PAHs were considered at the 20 d reaction periods. Through making use of gas chromatography� mass spectrometry (GC-MS), after 40-min period, the quality and quantity of the compounds available in the samples were determined using a mass detector and the drawn standards curve. After examining the effectiveness of eliminating PAH compounds in various conditions, the chemical oxygen demand test was carried out for the samples related to optimal removal of PAH compounds to determine the real efficiency of the process in eliminating intermediate compounds originated from PAHs oxidation. The results demonstrate that the advanced chemical oxidation method (persulfate-peroxide) can effectively result in the elimination of PAH compounds from the sludge. © 2021 Desalination Publications. All rights reserved
Dietary and lifestyle inflammatory scores and risk of incident diabetes: a prospective cohort among participants of Tehran lipid and glucose study
Get PDFBackground: Inflammation is a precursor of chronic disease, which is affected by lifestyle and dietary habits. Recently empirical dietary inflammatory patterns (EDIP), dietary inflammation scores (DIS), and lifestyle inflammation scores (LIS) were developed to indicate lifestyle and dietary contributions in systemic inflammation. The current study aimed to investigate the associations between these indices and the incidence of diabetes among Tehranian adults. Methods: A total of 4624 individuals, aged 20�75 years, who were free of diabetes at baseline (2008�2011), were followed for 5.71 years (2014�2017) to ascertain incident diabetes. Dietary intakes were collected at baseline using the food frequency questionnaire. The hazard ratio (HR) of diabetes was calculated by Cox proportional hazards regression across quartiles of EDIP, DIS, and LIS, adjusted for potential confounders. Results: The mean ± SD for the age and BMI of the study population (45.1 male) were 40.8 ± 12.7 years and 27.1 ± 4.1 Kg.m2, respectively. At the end of the follow-up, 329 (7.1) diabetes cases were identified. In the multivariable-adjusted model, individuals in the highest compared to the lowest quartile of EDIP (HR = 0.83; 95CI:0.59�1.15, p for trend = 0.286), and LIS (HR = 2.41; 95CI:1.61�3.60, P for trend < 0.001) had increased risk of diabetes. However, no significant associations were found between the score of DIS and diabetes incidents (HR = 0.83; 95CI:0.59�1.15, p for trend = 0.286). Conclusion: Greater adherence to EDIP and LIS scores was associated with a higher risk of diabetes, while no significant association was found between the DIS score and diabetes incident. © 2021, The Author(s)