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Endoscopic mucosal resection: still a reliable therapeutic option for gastrointestinal neuroendocrine tumors
Get PDFBackground: Neuroendocrine tumors (NETs), as a rare and heterogeneous category of solid tumors, feature various morphologies and behaviors. In recent years, the incidence of NETs has continued to increase. Endoscopic mucosal resection (EMR) is one of the therapeutic modalities for the treatment of gastric and rectal NETs. Methods: We evaluated patients with well-differentiated NETs of the stomach, duodenum, or rectum between 2011 and 2018. In this study, all cases with tumors confined to the mucosal or submucosal layers and smaller than 20 mm were resected using the EMR technique. We used EUS, CT scan, or MRI to exclude patients with advanced disease. All patients were actively monitored for recurrence according to the recommended protocols. Results: A total of 36 patients with NETs entered the study; 17 (47.2) were female and the remaining 19 (52.8) were male, with a total age range of 20�74 years (mean: 52.47 ± 13.47 years). Among the tumors, 31 cases (86.1) were G1 and the remaining 5 (13.9) were G2. Based on the pathology reports, 22 tumors (61.1) were smaller than 1 cm, while the remaining 14 (38.9) were between 1�2 cm. Twenty-two patients (61.1) had a margin of specimen involved with the tumor. No recurrence was observed during the mean follow-up time of 63.5 ± 19.8 months (range: 39�103 months). All 36 cases survived during the study period. Conclusion: Conventional EMR procedure provides low chance of R0 (complete resection) achievement in gastrointestinal NETs smaller than 20 mm and limited to the mucosa or sub mucosa. However, it could be an option if patients are closely followed. Postoperative marginal involvement is not a reliable predictor of disease recurrence, which may be explained by the deleterious effect of heat coagulation and cauterization applied during tumor removal. © 2021, The Author(s)
Spinach consumption and nonalcoholic fatty liver disease among adults: a case�control study
Get PDFBackground: Spinach has high antioxidants and polyphenols and showed protective effects against liver diseases in experimental studies. We aimed to assess the association between dietary intake of spinach and odds of nonalcoholic fatty liver disease (NAFLD) in a case�control study among Iranian adults. Methods: Totally 225 newly diagnosed NAFLD patients and 450 controls, aged 20�60 years, were recruited in this study. Participants� dietary intakes were collected using a valid and reliable 168-item semi-quantitative food frequency questionnaire (FFQ). The logistic regression test was used for assessing the association between total, raw, and boiled dietary spinach with the odds of NAFLD. Results: The mean (SD) age and BMI of participants (53 male) were 38.1 (8.8) years and 26.8 (4.3) kg/m2, respectively. In the final adjusted model for potential confounders, the odds (95 CI) of NAFLD in individuals in the highest tertile of daily total and raw spinach intake was 0.36 (0.19�0.71), P_trend = 0.001 and 0.47 (0.24�0.89), P_trend = 0.008, respectively compared with those in the lowest tertile. Furthermore, in the adjusted analyses, an inverse association was observed between the highest yearly intake versus no raw spinach consumption and odds of NAFLD (OR 0.41; 95% CI 0.18�0.96), P for trend = 0.013. However, there was no significant association between higher boiled spinach intake and odds of NAFLD. Conclusions: The present study found an inverse association between total and raw spinach intake with the odds of NAFLD. © 2021, The Author(s)
Gastrointestinal bleeding in COVID-19 due to low personal protective equipment of a nurse; A case report
No full textIt is important to diagnose coronavirus disease 2019 (COVID-19) by the clinical symptoms, although they are not specific. Clinical symptoms of COVID-19 in pediatrics are less severe and milder than in adults, which can be threatening to the health staff. In this case study, we report a 23-year old female pediatric nurse who developed COVID-19 with the rare symptom of gastrointestinal bleeding (GIB). The case of interest was affected by two children who had a positive reverse transcription-polymerase chain reaction (RT-PCR). The patient had no respiratory symptoms. Despite the use of an N95 mask and face shield, the nurse was infected because the gastrointestinal symptoms were predominant. Medical staff should pay attention to silent symptoms in pediatrics. Neglecting the use of personal protective equipment in dealing with pediatric patients can be hazardous. © 2021 Journal of Cellular and Molecular Anesthesia. All rights reserved
Histopathologic changes and cellular events of organs systems in COVID-19
No full textA better understanding of histopathologic and cellular events of COVID-19 can help us to choose more proper management strategies and treatments. There are several ways to cellular and histopathologic evaluations; including, tissue sampling from living people as biopsies or dead people as autopsies or necropsies. In this study, we tried to evaluate the histopathologic concordance between findings of various tissue samplings derived from different sites that may work as a mirror of each other, especially mucocutaneous findings which may be indicative of similar events of other parts. Based on the main keywords, we searched databases of PubMed, Scopus, Google Scholar, Medscape, and CEBD coronavirus dermatology resource of Nottingham University and included the most relevant and well-designed studies with a higher level of pieces of evidence and higher sample size. In this study, selected pathological samples from different tissues of patients with COVID-19, including skin and mucosa, lungs, gastrointestinal tract, and kidneys were studied and summarized. Cellular changes and pathological findings in these patients were included by organ and listed by prevalence. Tissue sampling in patients with COVID-19 may help understand the pathophysiology of the disease as much as possible. Although most of these samples are taken after dying the patients, sampling before the more advanced stages of the disease could also show signs of tissue involvement before appearing the full systemic symptoms. © 2021 Journal of Cellular and Molecular Anesthesia. All rights reserved
Community readiness for collecting stray dogs in Aradan County: a quantitative�qualitative study
Get PDFBackground: Paying more attention to free-roaming dogs� population control seems to be necessary because of public health and environmental problems. The present study used the community readiness model to determine the readiness of Aradan County in terms of collecting stray dogs. Methods: This study is a quantitative-qualitative research study conducted in Aradan County in Semnan Province of Iran. The semi-structured questionnaire uses the six dimensions of the Community Readiness Model as guideline, with 36 items used for the interview. The interviews lasted 45 to 100 minutes with 11 key members including the governor, prefect, mayor�s assistant, city council chairman, key trustees, officials responsible for environmental health network, officials responsible for environmentalism of the city, and governors of a rural district. In quantitative part two, assessors read the interviews carefully and assigned scores based on the rating-scale form suggested by the guideline itself for scoring each dimension. A qualitative directed content analysis with deductive approach was used for analyzing the collected qualitative data. Results: The study involved 11 key members of Aradan County, all of whom were male. Most of the participants were over 40 years old and with five years of work experience (73.6 ). The mean score of each six dimensions in Aradan County were: Community efforts (4.78), Community knowledge of efforts (4.28), Leadership (4.90), Community climate (4.38), Community knowledge about the issue (4.20) and Resources related to the issue (3.29) respectively. Community readiness in Aradan County and Aradan City was generally estimated to be in the preplanning stage, whereas vague public awareness was found in the rural areas. In the qualitative part, 870 initial open codes, 589 refund codes, 19 subcategories and 6 themes emerged, including (a) community efforts, (b) community knowledge of the efforts (c) leadership, (d) community climate, (e) community knowledge of the issue, and (f) resources related to the issue. Conclusions: For improving the process of collecting the stray dogs, it is necessary to focus on holding educational sessions for the public to increase their partnership and justify the responsible organizations� activities to collaborate and provide the necessary financial resources. © 2021, The Author(s)
Correction to: A combination of herbal compound (SPTC) along with exercise or metformin more efficiently alleviated diabetic complications through down-regulation of stress oxidative pathway upon activating Nrf2-Keap1 axis in AGE rich diet-induced type 2 diabetic mice (Nutrition & Metabolism, (2021), 18, 1, (14), 10.1186/s12986-021-00543-6)
Get PDFFollowing the publication of the original article 1, the authors identified an error in the funding note. Incorrect funding note: A part of this research was funded partially by NIMAD (National Institute for Medical Research Development) no. 971130. © 2021, The Author(s)
Lifetime and past-month substance use and injection among street-based female sex workers in Iran
Get PDFBackground: Street-based female sex workers (FSWs) are highly at risk of HIV and other harms associated with sex work. We assessed the prevalence of non-injection and injection drug use and their associated factors among street-based FSWs in Iran. Methods: We recruited 898 FSWs from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Correlates of lifetime and past-month non-injection and injection drug use were assessed through multivariable logistic regression models. Adjusted odds ratios (AOR) and 95 confidence intervals (CI) were reported. Results: Lifetime and past-month non-injection drug use were reported by 60.3 (95 CI 51, 84) and 47.2 (95 CI 38, 67) of FSWs, respectively. The prevalence of lifetime and past-month injection drug use were 8.6 (95 CI 6.9, 10.7) and 3.7 (95 CI 2.6, 5.2), respectively. Recent non-injection drug use was associated with divorced marital status (AOR 2.00, 95 CI 1.07, 3.74), temporary marriage (AOR 4.31 1.79, 10.40), had > 30 clients per month (AOR 2.76 1.29, 5.90), ever alcohol use (AOR 3.03 1.92, 6.79), and history of incarceration (AOR 7.65 3.89, 15.30). Similarly, lifetime injection drug use was associated with ever alcohol use (AOR 2.74 1.20�6.20), ever incarceration (AOR 5.06 2.48�10.28), and ever group sex (AOR 2.44 1.21�4.92). Conclusions: Non-injection and injection drug use are prevalent among street-based FSWs in Iran. Further prevention programs are needed to address and reduce harms associated with drug use among this vulnerable population in Iran. © 2021, The Author(s)
An injectable anisotropic alginate hydrogel containing oriented fibers for nerve tissue engineering
No full textThere is a growing research interest on designing a tissue regenerative matrix that can be injected and forms an anisotropic network for effective nerve injury repair. Here, an injectable alginate hydrogel composed of magnetic polycaprolactone (PCL) short nanofibers were fabricated. Nanocomposite PCL centrifugal spun fibers containing superparamagnetic iron oxide nanoparticles (SPIONs) were cut into short nanofibers (SFs) through micro-cutting technique and subsequently incorporated into alginate hydrogels. Doping SPION into short PCL fibers allows the SFs alignment by external magnetic fields in the millitesla (mT) order within the hydrogel. The effect of SFs lengths (5, 25 and 50 µm) as well as magnetic short fibers (M.SFs) concentration (0.5, 1, 2.5, 5 and 10 mg / ml) inside alginate hydrogel on fiber orientation under external magnetic field were investigated by measuring angular deflection of nanofibers. The results revealed that 5 and 25 µm M.SFs with 5 mg/ml concentration have the lowest angular deflection of 1.1� and 6.8�, respectively. The mechanical properties of prepared hydrogels revealed that both oriented 5 and 25 µm M.SFs, have higher storage modulus (G�) and loss modulus (G�) values than the random ones and by increasing M.SFs length from 5 µm to 25 µm, G� and G� values displayed descending trend. The fluorescence microscopy of olfactory ecto-mesenchymal stem cells (OE-MSCs) encapsulated in hybrid hydrogels containing oriented M.SFs showed the possibility of preserving cell viability after 7 days. Following 14-day of induction, the oriented 25 µm M.SF led to the acceleration of neural differentiation of OE-MSCs versus the random one. Therefore, it was expected that ordered injectable alginate/M.SFs hybrid hydrogels function as a minimal invasive constructs for the regeneration of neural tissues. © 2021 Elsevier B.V
Loss of vision after transurethral resection of prostate: A case report
Get PDFThe overall complication rate of Transurethral resection of prostate (TURP) is about 11.1. Amongst all complications, ocular complications are one of the rarest. In this paper, we present a case of vision loss due to paradoxical embolism as a rare complication following TURP. Ocular complications are very rare in urological surgeries but can happen due to paradoxical embolism following patent foramen ovale. Therefore, we recommend the early diagnosis and treatment of PFO prior to this type of surgery. © 202
A positive effect of egg consumption on macular pigment and healthy vision: a systematic review and meta-analysis of clinical trials
No full textIncreasing macular pigment optical density (MPOD) as a result of increased macular concentration of lutein and zeaxanthin may reduce the risk of age-related macular degeneration (AMD). The aim of the present study was to determine whether the consumption of eggs, a rich source of dietary lutein and zeaxanthin, influences MPOD and serum lutein. In this systematic review and meta-analysis we searched PubMed, Scopus, and ISI Web of Science up to July 2020, for relevant randomized clinical trials. Using a random-effects model, pooled weighted mean differences, and standard deviations (SDs) for each outcome were obtained. The quality of the eligible studies was assessed by the Cochrane Collaboration's tool. A meta-analysis of five trials (296 participants) revealed that egg consumption significantly increased MPOD (weighted mean differences (WMD): +0.037; 95 CI: 0.004, 0.069; P = 0.027) and serum lutein (WMD: +0.150 μmol L�-1; 95 CI: 0.037, 0.263; P = 0.009). Subgroup analyses showed that egg consumption: (a) had a larger effect on MPOD in studies with a parallel design; and (b) increased serum lutein to a greater extent in a healthy population. We did not detect any heterogeneity between studies. Daily egg consumption has beneficial effects on MPOD and serum lutein is inversely associated with reduced AMD progression. Further clinical trials are required to confirm the results of this study. © 2021 Society of Chemical Industry. © 2021 Society of Chemical Industr