Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Hypoxia signaling in cancer: HIF-1α stimulated by COVID-19 can lead to cancer progression and chemo-resistance in oral squamous cell carcinoma (OSCC)
No full textThe potential implications of Coronavirus disease-2019 (COVID-19) on oral squamous cell carcinoma (OSCC) development, chemo-resistance, tumor recurrence, and patient outcomes are explored, emphasizing the urgent need for tailored therapeutic strategies to mitigate these risks. The role of hypoxia-inducible factor 1-alpha (HIF-1 alpha) in OSCC studies has highlighted HIF-1 alpha as a crucial prognostic marker in OSCC, with implications for disease prognosis and patient survival. Its overexpression has been linked to aggressive subtypes in early OSCC stages, indicating its significance as an early biomarker for disease progression. Moreover, dysplastic lesions with heightened HIF-1 alpha expression exhibit a greater propensity for malignant transformation, underscoring its role in early oral carcinogenesis. Cancer patients, including those with OSCC, face an elevated risk of severe COVID-19 complications, which may further impact cancer progression and treatment outcomes. Understanding the interplay between COVID-19 infection, HIF-1 alpha activation, and OSCC pathogenesis is crucial for enhancing clinical management strategies. So, insights from this review shed light on the significance of HIF-1 alpha in OSCC tumorigenesis, metastasis formation, and patient prognosis. The review underscores the need for further research to elucidate the precise mechanisms through which HIF-1 alpha modulates cancer progression and chemo-resistance in the context of COVID-19 infection. Such knowledge is essential for developing targeted therapeutic interventions to improve outcomes for OSCC patients
Your right to choose: parents' preferences toward a pediatric dental center
No full textBackgroundTimely dental care during childhood can effectively prevent many dental issues and their potential long-term complications.AimTo identify factors associated with the selection of clinics providing dental care and services for children from parental perspective.Design methodA thematic qualitative study was conducted, involving parents of children aged 6-12 years who visited pediatric dentists in public/private dental centers in Isfahan city from December 2022 to July 2023. Twenty semi-structured face-to-face interviews were conducted in private rooms within the selected centers. A thematic analysis method was used to analyze interview transcripts.ResultsSeven main theme and 20 sub-themes were identified. They included accessibility (geographical location, proximity to residential area, parking), familiarity with pediatric dental center (recommendations from other dentists, recommendations from other patients, previous visits), amenities (general amenities, visual amenities), appointment arrangements (center's working hours, waiting queue, appointment booking), treatment cost (tariffs of dental care and services, installment plans, contracts with insurance companies), quality of medical equipment (supervision over treatment, quality of dental materials, diagnostic equipment, adherence to hygiene protocols), and staff (administrative and treatment staff). Treatment cost (tariffs of dental care and services, installment plans, contracts with insurance companies).ConclusionParents consider various aspects of pediatric dental centers to select ones that best in line with their priorities and needs. Specifically, parents focus on both financial aspects of pediatric treatments-and non-financial considerations
Immunotherapy and vaccine-based approaches for atherosclerosis prevention: a systematic review study
No full textIntroductionCardiovascular disease is a major global health issue, and atherosclerosis is a leading cause of cardiovascular conditions. Traditional approaches for managing atherosclerosis have limitations, creating a need for alternative preventive strategies such as vaccines.MethodsThe authors conducted a systematic review following Cochrane Handbook and PRISMA guidelines. They searched multiple databases for studies on preventive vaccines against atherosclerosis, including clinical trials and experimental models. The search period was from 1950 to August 2024.ResultsAfter screening and evaluation, 47 studies were included in the systematic review. The studies investigated various vaccine candidates and immunization strategies. Vaccination goals involve targeting proteins that are found in higher quantities in individuals with atherosclerosis, such as oxidized low-density lipoprotein (LDL), apolipoprotein B-100, proprotein convertase subtilisin/kexin type-9 serine protease (PCSK9), cholesteryl ester transfer protein (CETP), and heat shock proteins HSP60 and HSP65. The review highlights the potential of vaccines in preventing atherosclerosis by targeting specific antigens, modulating lipoprotein metabolism, and enhancing immune responses. Promising approaches included PCSK9 inhibitors, virus-like particle (VLP)-based vaccines, and gene-editing techniques. Monoclonal antibodies like alirocumab, designed to inhibit PCSK9, were also effective in reducing LDL cholesterol levels.ConclusionThis systematic review provides insights into the progress, challenges, and future directions of preventive vaccine research against atherosclerosis. The findings support the development of effective vaccines to complement existing preventive strategies and reduce the global burden of cardiovascular diseases.Clinical trial numberIt is not applicable
The Role of Metacaspases and Other Proteins Involved in the Apoptosis of Leishmania: Review Article
No full textBackground: Apoptosis, a determined form of programmed cell death (PCD), occurs in multi-cellular and single-celled organisms. Given that a general understanding of apoptosis in single-cell Leishmania is crucial for designing disease control policies, we reviewed the apoptosis mechanism and the proteins involved. Methods: The information was obtained from articles published in PubMed, SciELO, Science Direct, Scopus, Google Scholar, and Web of Science databases (1998-2021). Search terms used were(" )apoptosis(" )or(" )Leishmaniasis("). Results: The 77 subjects were included in the study that revealed the significance of the apoptosis process for Leishmania survival. Although, various stimuli induce Leishmania apoptosis, the proteins involved in apoptosis have been poorly understood. Metacaspases in Leishmania instead of caspase and death receptors in mammals play the same role in the PCD pathways. Also, other apoptotic proteins in Leishmania such as endonuclease G (EndoG), caspases- like cysteine proteases, TSN (Tudor Staphylococcal Nuclease), and Zinnia endonuclease 1 (ZEN1) lead to phenotype similar to mammalian apoptosis. Furthermore, there are differences in these mechanisms between the different species of Leishmania and studies to illustrate downstream events related to the serine phosphatidylcholine exposure, cytochrome C secretion, etc. remain an ongoing challenge. Conclusion: Determining the essential regulatory proteins in the Leishmania apoptosis and the specific present of metacaspases in parasite, is effective for designing new therapeutic strategies against leishmaniasis and vaccine development
Optimizing Clinical Reasoning: Unpacking the Impact of Virtual Patient Educational Duration in Cancer Care and Nursing Students' Experiences
No full textBackground:Teaching clinical reasoning to nursing students is essential for professionalizing and improving cancer patient care. This study investigates how training duration with Virtual Patients (VPs) impacts clinical reasoning and learners' evaluation of their experiences.Materials and Methods:The present semi-experimental study was conducted with a pretest-post-test design and a control group. Through the census sampling method, 74 nursing students from Isfahan University of Medical Sciences, Iran, (in their 4th and 5th semester) who had taken the cancer course were selected (2019-2022) and, upon obtaining their consent, were enrolled in the study. The study began with a pretest, followed by engagement in five VP scenarios over 6 weeks, which was followed by the post-test phase. Data were collected via 23-item tests and the Huwendiek Questionnaire. The collected data were analyzed in SPSS software using correlation tests and t-tests.Results:The outcomes revealed a noteworthy disparity between the mean scores recorded in the pre-test and post-test stages after training, for both the 4th and 5th semester cohorts (p <= 0.001). Moreover, a notable discrepancy surfaced between the duration of training with VPs and the average post-test score (p <= 0.001). The correlation coefficient, for the 4th semester, stood at 0.65, while for the 5th semester, it was 0.213. Notably, the participants exhibited contentment with the learning experience through VPs.Conclusions:The survey found that 85.60 of participants prefer using VPs for clinical reasoning education. Our study underscores the link between the duration of VP interaction and improved clinical reasoning skills in nursing students
UiO-66 Metal-organic Framework (MOF) as an Osteogenic Stimulant in the Poly-3-hydroxybutyrate-zein/UiO-66 Electrospun Composite Scaffold for Bone Tissue Engineering Applications
No full textMetal-organic frameworks have recently become popular in biomedical applications due to their high surface areas, porosity, suitable mechanical properties, controlled degradability, and selective compositions. Among them, UiO-66 is particularly noteworthy for its exceptional stability, biodegradability, low toxicity, and osteogenic properties. Herein, UiO-66 was synthesized via a solvothermal method and characterized employing FTIR, XRD, FESEM, and TEM analyses. Subsequently, poly-3-hydroxybutyrate-zein/UiO-66 electrospun composite scaffolds were fabricated. Regarding the SEM, mechanical analyses, and water contact angle results, the scaffold containing 2 wt UiO-66 exhibited the optimum characteristic. EDS and TEM examinations confirmed UiO-66's presence and distribution, TGA validated its claimed amount in the scaffold, and FTIR revealed the possible interactions between ingredients. Incorporating 2 wt UiO-66 reduced the fiber diameter and water contact angle by about 54 nm and 20 degrees, respectively, while increasing surface roughness and crystallinity. UiO-66 significantly enhanced ultimate tensile stress and Young's modulus by approximately 90 and 101, respectively. It also boosted the biomineralization of the scaffold and hastened the degradation rate. Eventually, adding UiO-66 led to noticeable increases in viability, proliferation, attachment, ALP activity, and ECM mineralization, as well as upregulation of COL Iota, RUNX2, and OCN genes of MG-63 cells seeded on the scaffolds. In conclusion, incorporating UiO-66 not only reinforced the composite scaffold but also stimulated osteogenesis, making it an advantageous candidate for bone tissue engineering applications
A qualitative study on elderly patients' preferences for inpatient psychiatric services
No full textIntroductionMental illnesses have a high prevalence among elderly patients. It is estimated that half of the elderly do not utilize the psychiatric care that they need. Paying attention to patient preferences can improve treatment adherence and patient outcomes. This study aims to qualitatively identify the preferences of elderly patients hospitalized in the psychiatric wards of hospitals regarding their inpatient psychiatric treatments.MethodThis qualitative study was conducted at Khorshid Hospital in Isfahan, Iran. The study sample included patients in the age range of 60 years or above who had already been hospitalized due to diagnosed psychiatric diseases. Twenty-one semistructured interviews were conducted from March to September 2023. A thematic analysis method was used to analyze the data.ResultsThe study extracted three overarching themes, including patients' preferences regarding hospital features, patients' preferences regarding hospital staff, and patients' preferences regarding service delivery.ConclusionThe findings of this study showed that elderly patients consider different preferences when choosing inpatient psychiatric services. The findings provide new insights for decision-makers and health providers in designing and implementing psychiatric treatments by considering elderly patients' preferences, which in turn might help improve treatment outcomes and increase patient satisfaction
Diagnostic Value of Mean Platelet Volume, Neutrophil-to-Lymphocyte Ratio, and Platelet to Lymphocyte Ratio for Late-Onset Neonatal Sepsis
No full textBackground:Neonatal sepsis (NS) is the most common cause of neonatal mortality, currently confirmed with blood culture as the diagnostic gold standard. However, being time-consuming, false-negative results, being affected by even a single dose of antibiotics, and expensiveness are negative aspects. Therefore, we aimed to investigate the diagnostic value of complete blood count (CBC) parameters: mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) which have been suggested in previous studies.Methods:A total of 100 term and preterm neonates (age >= 32 weeks) hospitalized in Alzahra and Shahid Beheshti hospitals in Isfahan, Iran, were studied. Fifty neonates with late neonatal sepsis were placed in the case group, and 50 neonates with other diagnoses were placed in the control group. Neonatal blood samples were sent to the laboratory, and MPV, NLR, and PLR were measured.Results:The mean (standard deviation) of MPV was 7.20 (4.39) in the case group and 9.55 (0.87) in the control group, and there was a significant difference between them (P value = 0.001). At the cutoff point of 8.25 in MPV, the area under the curve (AUC) was 0.594 with a sensitivity of 100 and specificity of 30. The mean (standard deviation) of NLR was 1.79 (1.21) in the case group and 2.28 (1.25) in the control group, and there was no significant difference between them (P value = 0.692). The mean (standard deviation) of PLR was 62.58 (34.57) in the case group and 65.11 (28.55) in the control group, and there was no significant difference between them (P value = 0.836).Conclusions:MPV, unlike NLR and PLR, can be used as a sensitive and cost-effective primary screening index in late NS at the cutoff point of 8.25 due. However, low specificity suggests a poor diagnostic value
The effect of anesthesia on postoperative cognitive dysfunction in adults undergoing cataract surgery: a systematic review
No full textBackgroundWe systematically reviewed the evidence on the effect of anesthetic methods and drugs on the incidence of postoperative cognitive dysfunction (POCD) after cataract surgery.MethodsThe Web of Science, PubMed, and Scopus databases were searched for relevant English reports published from 2000 to August 2024. After full-text screening and checking the quality assessment of each article using the JBI checklist, 9 relevant articles were included in this study. The included articles were reviewed to explain how different anesthetic modalities and drugs may affect the incidence of POCD after cataract surgery. Our study aimed to systematically investigate the relationship between various methods of anesthesia and POCD for people undergoing cataract surgery.ResultsWe included 9 clinical trials with 1014 participants, which analyzed the incidence of POCD after anesthetic interventions. Four articles compared the effect of anesthetic modality interventions on POCD and five studies compared the effect of anesthetic drugs on POCD. The studies used various cognitive measurement scales, including the Mini-Mental State Examination, Neurobehavioral Rating Scale, Blessed Orientation-Memory-Concentration Test, Iowa Satisfaction with Anesthesia scale, PALT, and VF test. All articles that compared local and topical anesthesia found no statistically significant difference in the incidence of cognitive dysfunction at postop days 1 and 7. General anesthesia may cause POCD approximately twofold than local anesthesia. Ketamine, Midazolam, or Dexmedetomidine seemed to reduce postoperative cognitive complications compared to the control group.ConclusionsThis systematic review investigates how different anesthetic techniques and drugs may affect the incidence of POCD. The available literature is far from being conclusive and further studies are needed to reach any significant conclusions. It is necessary to adopt an appropriate anesthesia method for elderly and high-risk patients, especially people who have a history of cognitive problems undergoing elective cataract surgery, to reduce cognitive complications after surgery
Optimal timing of sentinel node detection using 99mTc Tc-phytate lymphoscintigraphy: A study of 100 breast cancer patients
No full textIntroduction: Sentinel lymph node biopsy guided by preoperative lymphoscintigraphy is an established technique for axillary staging in breast cancer. However, the optimal timing for lymphoscintigraphic imaging remains unclear. Earlier acquisition may expedite surgery while later imaging improves detection rates by allowing radiotracer transit. Defining the timeframe maximizing accuracy and minimizing burden is needed. Objective: To evaluate optimal acquisition timings for 99mTcTc-Phytate lymphoscintigraphy in sentinel lymph node mapping for breast cancer. Methods: Hundred breast cancer patients underwent periareolar injection of 1-2 mCi 99mTc Tc-Phytate and lymphoscintigraphy at 5,10, 30, 60 and 120 min post-injection. Lymph node visualization was assessed by experienced nuclear medicine physicians based on retrospective review of scintigraphy images. Descriptive statistics characterized patient demographics and time to sentinel lymph node detection. Correlation analyses evaluated relationships between visualization parameters and factors such as age, sex and surgical history. Results: Lymph nodes were typically visible within 10 min (median). Regression found no significant predictors of prolonged transit time among age, sex, surgical history. Age is not a statistically significant predictor of node visualization (p = 0.129). Also sex and surgery history are not significant predictors of longer time (p > 0.05). Conclusion: Sentinel lymph node biopsy guided by lymphoscintigraphy is an important technique for axillary staging in breast cancer. Standardizing acquisition timing could optimize the accuracy and efficiency of lymphoscintigraphy for axillary staging. (c) 2025 SESPM. Published by Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies