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Diabetic cataract in the Nile grass rat: A longitudinal phenotypic study of pathology formation
No full textDiabetes is a major risk factor for cataract, the leading cause of blindness worldwide. There is an unmet need for a realistic model of diabetic cataract for mechanistic and longitudinal studies, as existing models do not reflect key aspects of the complex human disease. Here, we introduce and characterize diabetic cataract in the Nile grass rat (NGR, Arvicanthis niloticus), an established model of metabolic syndrome and type 2 diabetes (T2D). We conducted a longitudinal study of cataract in over 88 NGRs in their non-diabetic, pre-diabetic, and diabetic stages of metabolism. Oral glucose tolerance test (OGTT) results distinguished the metabolic stages. Diverse cataract types were observed in the course of diabetes, including cortical, posterior subcapsular (PSC), and anterior subcapsular (ASC), all of which succeeded a characteristic dotted ring stage in all animals. The onset ages of diabetes and cataract were 44 ± 3 vs 29 ± 1 (P <.001) and 66 ± 5 vs 58 ± 6 (not significant) weeks in females and males, respectively. Histological analysis revealed fiber disorganization, vacuolar structures, and cellular proliferation and migration in cataractous lenses. The lens epithelial cells (LECs) in non-diabetic young NGRs expressed the stress marker GRP78, as did LECs and migrated cells in the lenses of diabetic animals. Elucidating mechanisms underlying LEC proliferation and migration will be clinically valuable in prevention and treatment of posterior capsule opacification, a dreaded complication of cataract surgery. Marked changes in N-cadherin expression emphasized a role for LEC integrity in cataractogenesis. Apoptotic cells were dispersed in the equatorial areas in early cataractogenesis. Our study reveals diverse cataract types that spontaneously develop in the diabetic NGR, and which uniquely mirror the cataract and its chronic course of development in individuals with diabetes. We provide mechanistic insights into early stages of diabetic cataract. These unique characteristics make NGR highly suited for mechanistic studies, especially in the context of metabolism, diabetes, and aging. © 2021 Federation of American Societies for Experimental Biolog
Therapeutic challeng es of COVID-19 in a patient admitted to the psychosomatic ward: A case report
Get PDFIntroduction: Early diagnosis of 2019-nCoV infection is of great importance and can be challenging in psychiatric patients, especially when a mental illness such as somatoform disorder causes one or more bodily symptoms because the clinical features of this group of patients may be more confusing compared with non-psychiatric patients. On the other hand, treating this infection in psychiatric patients faces some challenges. Case Presentation: A case of the 2019-nCoV infection is reported in a patient who was admitted to the psychosomatic ward with a diagnosis of somatic symptom disorder. The patient had a history of numerous unexplained physical complaints, usually complained of some new physical symptoms when informed of the time of his discharge. Although the possibility of misdiagnosis was high, based on examinations and some paraclinical evaluations, the patient underwent a simultaneous diagnosis of COVID-19. Unlike usual, he did not complain of any new physical complaints after informing of the 2019-nCoV infection and was willing to be discharged. Some diagnostic and therapeutic challenges regarding 2019-nCoV infection in the patient were examined. Conclusions: There are three clinically relevant learning points to be noted from this case report. Firstly, the importance of paying attention to the patient�s complaints in any mental patient, even disorders related to unexplained physical complaints. Secondly, the introduction highlights the differences in the care of patients with COVID-19 between psychiatric and non-psychiatric patients and the need for a multidisciplinary approach. Third, this introduction identifies a crucial diagnostic role for CT thorax in symptomatic patients with suspected COVID-19 because the false-negative rate with RT-PCR COVID-19 nasopharyngeal swabs is high. Copyright © 2021, Author(s)
Warning signals of elevated prediabetes prevalence in the modern Iranian urban population
No full textBackground: We sought to estimate the prevalence of diabetes mellitus (DM) and pre-DM and their associated factors among a sample of the Iranian urban population between 2017 and 2019. Methods: The present investigation is a sub-study on the HAMRAH cohort study, a longitudinal population-based cohort study to assess the 10-year risk of cardiovascular diseases and their related risk factors in the adult population of the Iranian capital, Tehran. Via a multistage cluster randomized sampling method, 2123 adults aged between 30 and 75 years who had no history of cardiovascular diseases were selected for the study. With the aid of the 2010 American Diabetes Association criteria for the definition of DM and pre-DM, age and sex-specific prevalence rates were estimated. Results: The estimated overall prevalence of DM was 14.3 (95 CI: 13.1�15.8): 10.4 known DM (95 CI: 9.1�11.8) and 4 newly diagnosed DM (95 CI: 3.1�5.1). Pre-DM was detected in about 29.2 of the study participants (95 CI: 22.9�36.3). Our logistic regression analysis revealed that increasing age, higher systolic blood pressure, higher levels of triglycerides, and lower levels of high-density lipoprotein were significantly associated with DM. Conclusions: DM and pre-DM follow a notable incremental pattern among the Iranian urban population. This finding underscores the significance of the need to improve prevention and screening strategies in the Iranian urban population. © 2021 Primary Care Diabetes Europ
Dietary intake of B vitamins and their association with depression, anxiety, and stress symptoms: A cross-sectional, population-based survey
No full textBackground: B vitamins have vital roles in the development, maintenance, and functioning of the brain, while severe deficiencies have been linked to increased psychological disorders. However, no published studies have examined the association between dietary intake of vitamin B and depression, anxiety, and stress symptoms in a general population. Methods: This cross-sectional study was done on 7387 Iranian adults aged 20-70 years within the population-based cohort study framework. A validated semi-quantitative Food Frequency Questionnaire (DS-FFQ) was used to ascertained vitamin B intake. Participants completed the Iranian validated version of depression, anxiety, and stress scale questionnaire 21 (DASS 21) to assess their psychological health. Multivariable logistic regression analysis was performed to analyze the association between vitamin B intake and psychological disorders. Results: After adjustment for a wide range of confounders, higher intake of biotin was associated with a lower odds of depression (OR 0.71, 95 CI 0.55-0.91, P-trend=0.008), anxiety (0.71, 0.56-0.89, P-trend=0.003), and stress (0.58, 0.39-0.87, P-trend=0.01). An inverse relationship was found between B6 and stress risk (0.50, 0.28-0.90, P-trend= 0.01). Moderate intake of thiamin (0.76, 0.61-0.94, P-trend=0.20), niacin (0.78, 0.62-0.97, P-trend=0.41), and pantothenic acid (0.80, 0.65-0.99, P-trend=0.05) were related to lower odds of anxiety. Additionally, moderate folic acid intake was associated with lower odds of depression (0.78, 0.61-0.99, P-trend=0.71). A subgroup analysis based on sex revealed that biotin's dietary intake reduced the risk of depression, anxiety, and stress, but this association was not significant in the male population. Limitations: Cross-sectional nature of the data prevents causal associations. Conclusions: This study suggests that a higher intake of dietary B vitamins, especially biotin, was associated with a lower prevalence of depression, anxiety, and stress symptoms. The role of B vitamins requires further investigation in randomized controlled trials. © 202
The effect of the virtual social network-based psycho-education on the hope of family caregivers of clients with severe mental disorders
No full textPsycho-education may have a positive effect on family caregivers of clients with mental disorders, and promote positive psychological states such as hope. The present study aims to investigate the effect of virtual social network-based psycho-education on the hope of family caregivers of clients with severe mental disorders. This study is a quasi-experimental research with a control and experimental groups. The participants of the study were 72 family caregivers of clients with severe mental disorders (36 in each group). Data were collected using demographic questionnaire and Adult Hope Scale before the study, immediately after the end of the training (first post-test), and 4 weeks afterwards (second post-test). The experimental group received psycho-education through Telegram App for four weeks. The results of the demographic questionnaire showed that both groups were homogeneous. The results of the Adult Hope Scale indicated that the mean score of both control and experimental groups were statistically significant and increased in the experimental group (P < 0.001). In addition, the changes of hope score in the experimental group were statistically significant in the first post-test than the pre-test, and in the second post-test than the first post-test and pre-test (P < 0.001). The findings of this study suggested that virtual social network-based psycho-education promotes the hopes of the family caregivers of clients with severe mental disorders. Due to the low cost and fast access of people to virtual networks, the content of this educational program can be widely used for family caregivers. © 2021 Elsevier Inc
The impacts of C1q/TNF-related protein-15 and adiponectin on Interleukin-6 and tumor necrosis factor-α in primary macrophages of patients with coronary artery diseases
No full textAtherosclerosis is a progressive inflammatory disease characterized by the accumulation of lipids in the arterial wall. Inflammation plays a key role in the pathogenesis of atherosclerosis and some previous studies have shown the role of adipokines during the inflammatory process of atherosclerosis. Therefore, the present study aimed to evaluate the impacts of adiponectin and CTRP15 on inflammatory cytokines secretions from THP1 and primary macrophages. Methods: THP1 monocytes were differentiated to macrophages and primary monocytes were then isolated from patients with coronary artery disease and controls who were differentiated to macrophages. Macrophages were treated with LPS, LPS+adiponectin, and LPS+CTRP15. Results: Adiponectin and CTRP15 have reduced IL-6 and TNF-α secretions from LPS-induced THP1 macrophages, and the CTRP15 indicated a more potent anti-inflammatory property compared to adiponectin. In addition, adiponectin reduced cytokines� expressions and secretions in primary macrophages of both patient and control groups. However, CTRP15 has only reduced cytokines� expressions and secretions in controls and it was not able to ameliorate inflammation in macrophages of CAD patients. Conclusion: The results of the present study indicate anti-inflammatory impact of adiponectin and CTRP15, while this property was stronger for CTRP15. In addition, it seems likely that anti-inflammatory CTRP15�s impact on macrophages in the CAD patients was weaker than macrophages from the controls. © 2021 Elsevier Lt
Will stem cells from fat and growth factors from blood bring new hope to female patients with reproductive disorders?
No full textFemale reproductive system disorders (FRSD) with or without infertility are prevalent women's health problems with a variety of treatment approaches including surgery and hormone therapy. It currently considering to sub-branch of regenerative medicine including stem cells or growth factors injection-based delivery treatment might be improved female reproductive health life. The most common products used for these patients treatment are autologous cell or platelet-based products from patients, including platelet-rich plasma, plasma rich in growth factor, platelet-rich fibrin, and stromal vascular fraction. In this review, we discuss each of the above products used in treatment of FRSD and critically evaluate the clinical outcome. © 202
Role of interdigital sensory nerve conduction study as a noninvasive approach for early diagnosis of diabetic peripheral neuropathy
No full textPurpose: Diabetes mellitus is amongst the most common causes of polyneuropathy worldwide that can eventually terminate to irreversible complications. The remarkable impact of diabetic polyneuropathy as a debilitating condition on the healthcare system and total costs of diabetes care is undeniable. Despite the existence of numerous diagnostic tools such as routine electrophysiologic procedures, its early detection is challenging. This study designed to compare more distal techniques of electrodiagnostic testing, including interdigital sensory nerve conduction studies (NCSs), with conventional approaches and to investigate its role in confirming the early stages of polyneuropathy. Methods: This cross-sectional study was performed in the Physical Medicine and Rehabilitation Department of Hazrat Fatemeh Reconstruction Surgery Hospital. Thirty one symptomatic diabetic outpatients and 23 asymptomatic nondiabetic subjects included in our study. We performed nerve conduction studies on five sensory nerves consist of the dorsal sural nerve, medial plantar nerve, digital branches of the interdigital nerves to toes I, II, and III (as a new antidromic technique). In this study, all techniques applied with a surface stimulator and pick-up electrodes. Results: In the group of patients, 9 (29) and 22 (71) subjects had impaired and normal routine NCSs, respectively. Interestingly, the results of interdigital nerve studies were abnormal in the 17 out of 22 patients with normal routine NCSs. Also, 11 and 13 subjects had impaired medial plantar nerve and dorsal sural nerve conduction studies, respectively. Accordingly, with this new method, the prevalence of detectable diabetic neuropathy increased from 46 to 83. Discussion: We conducted this study intending to demonstrate the application of a new technique for early diagnosis of diabetic polyneuropathy, especially in the presymptomatic and subclinical neuropathies. The digital sensory branches of IDNs known as the most distal sensory nerves, which can be easily evaluated with new antidromic SNAP technique. Our method is simple, non-invasive, suitable, sensitive, and reproducible. There is no need to needle electrode or averaging technique to record an appropriate amplitude of IDN. Thus, it is recommended as a convenient electrophysiological option for early diagnosis of DPN. © 2020, Springer Nature Switzerland AG
Type 2 diabetes: patient assessment of chronic illness care
No full textObjective: We tried to assess perception of chronic illness care in people with type 2 diabetes and to determine whether demographic variables, self-care behavior, as well as affective variables were related with perception of chronic illness care. Methods: We conducted a secondary analysis of the previously published cross-sectional study in 441 Iranian people with type 2 diabetes. Chronic illness care was assessed with the validated tool of patient assessment of chronic illness care (PACIC). Different aspects of care according to the chronic care model are measured on a scale of 1�5, with 5 being highest perception of care. The association between perception of chronic illness care and measured variables were tested using spearman correlation test as well as univariate and multiple linear regression analysis. Results: Finally, 380 filled out the PACIC questionnaire, completely (53.4 female, mean age: 54.73 ± 8.0 years, mean PACIC score: 2.52 ± 0.87). In spearman correlation test, considering PACIC score as the dependent variable, chronic illness care was inversely associated with level of education and distress, whereas, insulin treatment, wellbeing, family-social support and self-management were positively associated with chronic care (All p value<0.05). In the multiple linear regression analysis, family-social support was positively related to chronic care while level of education, marital status, diabetes-related distress, and high density lipoprotein had significant negative relationship with PACIC score (All p value<0.05). Conclusions: Family-social support, level of education, marital status, and diabetes-related distress are the major determinants of patient experience of chronic illness care in people with type 2 diabetes. © 2021, Springer Nature Switzerland AG
Decomposition of gendered socioeconomic-related inequality in outpatient health care utilization: A cross-sectional study from Iran
No full textIntroduction: Unequal access to required health care services could deteriorate inequality in health outcomes and increase mortality and morbidity, especially among disadvantaged groups. One of the most debated factors in shaping health care inequalities is gender. This study aimed to measure and explains gendered socioeconomic-related inequality in outpatient health care utilization in Iran. Methods: This is a cross-sectional research conducted at a national level in Iran. The required data was obtained from an Iranian health care utilization household survey conducted in 2015. Erreygers Concentration Index (ECI) was used to measure the socioeconomic inequality in outpatient health care utilization. A regression-based decomposition analysis was also used to explain socioeconomic-related inequalities. Results: There was a significant pro-rich inequality in outpatient health care utilization between males (ECI = 0.115, SE = 0.014) and females (ECI = 0.083 SE = 0.011) indicating that utilization of these services was concentrated on the better-offs. The decomposition analysis revealed that economic status (males = 50.58, females = 37.42) was the main contributor to the observed inequality. Location of residence, health insurance and education were other main driver of these inequalities. Conclusions: Different factors have different contribution to socioeconomic-related inequality in utilization of outpatient health care services and these could be diversified considering gender. Hence, it seems that policy makers could be able to address these inequalities effectively through gender-oriented policies. © 2021 John Wiley & Sons Ltd