Repository of Research and Investigative Information Isfahan University of Medical Sciences
Not a member yet
23244 research outputs found
Sort by
How necessary it is to perform a ventilation scan in patients with a history of COVID-19 to rule out pulmonary thromboembolism?
No full textOBJECTIVES: This study evaluated the necessity of a ventilation scan in patients suspected of PE with a history of COVID-19 infection. METHODS: This was a cross-sectional study of patients with PCR-confirmed COVID-19 and suspected PE at a tertiary care hospital in 2020. They underwent ventilation/perfusion (V/Q) scintigraphy using single-photon emission computed tomography/computed tomography (SPECT/CT) and CT scans with or without contrast. Two blinded nuclear medicine physicians interpreted the images for PE and COVID-19. Clinical and laboratory data were extracted and analyzed. RESULTS: 96 patients with suspected PE and COVID-19 infection. The study excluded eight patients who could not undergo ventilation scans and confirmed PE in five patients with multiple mismatched V/Q defects on SPECT/CT. The study ruled out PE in 83 patients who had either regular perfusion scans, perfusion defects with COVID-19 features, or matched V/Q defects. The study found that the prevalence of PE was 5.68, and the necessity of ventilation scans was 28.40 in this population. CONCLUSION: It was found that PE was present in 5.68 of the patients, and ventilation scans were needed for 28.40 of the patients to confirm or exclude it
The NLRP3 inflammasome: Mechanisms of activation, regulation, and role in diseases
No full textBecause of numerous stress signals, intracellular protein complexes are called inflammasomes. They function as catalysts for the proteolytic transformation of pro-interleukin into the active form of interleukin. Inflammasomes can promote a type of cell death process known as pyroptosis. The NLRP3 inflammasome, comprised of the NLRP3 protein, procaspase-1, and ASC, tightly regulates inflammation. The NLRP3 inflammasome is activated by a variety of stimuli, and several molecular and cellular events, such as ion influx, mitochondrial dysfunction, reactive oxygen species production, and lysosomal damage have been shown to trigger its activation. Inflammation plays a major role in almost all types of human diseases. The NLRP3 inflammasome has been the most widely studied and plays an important pathogenic role in various inflammatory pathologies. This review briefly presents the basic features of NLRP3 inflammasome and their mechanisms of activation and regulation. In addition, recent studies report the role of NLRP3 inflammasome in several diseases have been summarized. Because of numerous stress signals, intracellular protein complexes are called inflammasomes. They function as catalysts for the proteolytic transformation of pro-interleukin into the active form of interleukin. Inflammasomes can promote a type of cell death process known as pyroptosis. The NLRP3 inflammasome, comprised of the NLRP3 protein, procaspase-1, and ASC, tightly regulates inflammation. The NLRP3 inflammasome is activated by a variety of stimuli, and several molecular and cellular events, such as ion influx, mitochondrial dysfunction, reactive oxygen species production, and lysosomal damage, have been shown to trigger its activation. Also, NLRP3 inflammasome plays a role in several different diseases
Electrochemical biosensors for early detection of breast cancer
No full textBreast cancer continues to be a significant contributor to global cancer deaths, particularly among women. This highlights the critical role of early detection and treatment in boosting survival rates. While conventional diagnostic methods like mammograms, biopsies, ultrasounds, and MRIs are valuable tools, limitations exist in terms of cost, invasiveness, and the requirement for specialized equipment and trained personnel. Recent shifts towards biosensor technologies offer a promising alternative for monitoring biological processes and providing accurate health diagnostics in a cost-effective, non-invasive manner. These biosensors are particularly advantageous for early detection of primary tumors, metastases, and recurrent diseases, contributing to more effective breast cancer management. The integration of biosensor technology into medical devices has led to the development of low-cost, adaptable, and efficient diagnostic tools. In this framework, electrochemical screening platforms have garnered significant attention due to their selectivity, affordability, and ease of result interpretation. The current review discusses various breast cancer biomarkers and the potential of electrochemical biosensors to revolutionize early cancer detection, making provision for new diagnostic platforms and personalized healthcare solutions
Painless cost control as a central strategy for universal oral health coverage: A critical review with policy guide
No full textAIM: This study aimed to critically review the methods used to control the significantly increasing costs of dental care. METHODS: Through a comprehensive search of the available literature, the cost control (CC) mechanisms for health services were identified from a healthcare system perspective. The probable applicability of each CC method was evaluated mainly based on its potential contribution to oral health promotion. Each mechanism was then classified and discussed under any of the two headings of financing and service provision. An operational guide was finally presented for policy-making in each of the three main models of healthcare systems, including National Health Services, social/public health insurance and private insurance. RESULTS: From a total of 142 articles/reports retrieved in PubMed, 73 in Scopus and 791 in Google Scholar, 35 were included in the final review after eliminating the duplicates and screening process. Totally ten mechanisms were identified for CC of dental care. Seven were discussed under the financing function, including cost sharing, preauthorization, mixed payment method and an evidence-based approach to benefit package definition, among others. Three further methods were classified under the service provision function, including workforce skill mix with emphasis on primary oral healthcare providers, development of primary healthcare (PHC) network and an appropriate use of tele-dentistry. CONCLUSION: Painless control of dental expenditures requires a smart integration of prevention into the CC plans. The suggested policy guide emphasizes organizational factors; particularly including the development of PHC-based networks with midlevel providers (desirably extended-duty dental hygienists) as the frontline oral healthcare providers
Association between systemic immune-inflammation index and risk of chronic kidney disease; a systematic review and meta-analysis
No full textIntroduction: Inflammation is a hallmark feature of chronic kidney disease (CKD) and the systemic immune-inflammation index (SII) is a potent biomarker for assessing the inflammatory status. Taking note of these, the present systematic review and meta-analysis evaluated the correlation between SII and the risk for CKD. Materials and Methods: ProQuest, Embase, PubMed, Web of Science, Cochrane, and Google Scholar databases were searched until November 20, 2024, without any restriction applied. Data were analyzed in Stata v14.0. The results with P30 kg/m² (OR: 1.05; 95 CI: 1.01, 1.09). Conclusion: Elevated SII values enhanced the risk of CKD, and the SII-CKD association was intensified in females, Americans, and patients with DM, low eGFR, albuminuria, and obesity. Accordingly, high SII levels are a robust indicator of CKD prognosis. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42024619311) and Research Registry (UIN: reviewregistry1925,) websites. © 2025 The Author(s)
Investigating the Effect of Stress Coping Skills Training on Anxiety and Quality of Life in Elderly Individuals with Type 2 Diabetes Referring to Healthcare Centers in Shiraz City, Iran
No full textBackground: A significant increase in the elderly population with chronic diseases, including diabetes, has been accompanied by numerous challenges worldwide. Stress is recognized as one of the influential factors in the occurrence and exacerbation of diabetes complications. Therefore, this study aimed to investigate the effect of stress-coping skills training on the levels of anxiety and quality of life (QOL) in elderly individuals with type 2 diabetes in Shiraz City, Iran, in 2018. Methods: The present study was conducted using a semi-experimental educational intervention design on 100 elderly individuals diagnosed with type 2 diabetes. The participants were randomly divided into two groups: the intervention and control. After conducting pre-tests and blood glucose tests, stress-coping skills training sessions were held over 6 sessions, each lasting 90 minutes, including primary and secondary assessment of diabetes, training on how to deal with the stress caused by the disease in order to reduce the symptoms of the patients, assigning homework with the aim of calming the body, getting familiar with cognitive concepts, a test of dealing with negative thoughts, concentration of thought, and various other materials. Three months after the last session, post-tests and blood tests were conducted for both groups. The control group received their regular treatment program until the end of the study. The assessment tools used included a demographic information questionnaire, the Spielberger State-Trait Anxiety Inventory (STAI), and the Diabetes Quality of Life questionnaire (DQOL). The data were analyzed using SPSS statistical software and independent t-test, paired t-test, and chi-square test. Findings: The intervention and control groups did not have a significant difference in demographic characteristics, and also before the intervention, there was no significant difference in the mean scores of QOL, anxiety, and hemoglobin A1C (HbA1C) levels between the two groups. The findings of the study indicate that after the intervention, the QOL of the intervention group and its dimensions significantly increased, and anxiety significantly decreased (P 0.001). Conclusion: The results of this study indicate that stress-coping skills training has a positive impact on reducing anxiety and improving the QOL in elderly individuals with diabetes and can be considered an effective educational method in this area. However, these skills did not have a significant effect on the level of HbA1C, and further investigation is needed in long-term studies and different age and gender groups. © 2025, Isfahan University of Medical Sciences(IUMS). All rights reserved
Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries
No full textThe consumption of sugar-sweetened beverages (SSBs) is associated with type 2 diabetes (T2D) and cardiovascular diseases (CVD). However, an updated and comprehensive assessment of the global burden attributable to SSBs remains scarce. Here we estimated SSB-attributable T2D and CVD burdens across 184 countries in 1990 and 2020 globally, regionally and nationally, incorporating data from the Global Dietary Database, jointly stratified by age, sex, educational attainment and urbanicity. In 2020, 2.2 million (95 uncertainty interval 2.0–2.3) new T2D cases and 1.2 million (95 uncertainty interval 1.1–1.3) new CVD cases were attributable to SSBs worldwide, representing 9.8 and 3.1, respectively, of all incident cases. Globally, proportional SSB-attributable burdens were higher among men versus women, younger versus older adults, higher- versus lower-educated adults, and adults in urban versus rural areas. By world region, the highest SSB-attributable percentage burdens were in Latin America and the Caribbean (T2D: 24.4; CVD: 11.3) and sub-Saharan Africa (T2D: 21.5; CVD: 10.5). From 1990 to 2020, the largest proportional increases in SSB-attributable incident T2D and CVD cases were in sub-Saharan Africa (+8.8 and +4.4, respectively). Our study highlights the countries and subpopulations most affected by cardiometabolic disease associated with SSB consumption, assisting in shaping effective policies and interventions to reduce these burdens globally. © The Author(s) 2025
Predicting Severe Knee Arthritis Based on Two Inertial Measurement Unit Sensors as a Dynamic Coordinate System Using Classical Machine Learning
No full textBackground:Aging of societies in recent and upcoming years has made musculoskeletal disorders a significant challenge for healthcare system. Knee osteoarthritis (KOA) is a progressive musculoskeletal disorder that is typically diagnosed using radiographs. Considering the drawbacks of X-ray imaging, such as exposure to ionizing radiation, the need for a noninvasive, low-cost alternative method for diagnosing KOA is essential. The purpose of this study was to evaluate the ability of a wearable device to differentiate between healthy individuals and those with severe osteoarthritis (grade 4).Methods:The wearable device consisted of two inertial measurement unit (IMU) sensors, one on the lower leg and one on the thigh. One of the sensors is used as a dynamic coordinate system to improve the accuracy of the measurements. In this study, to discriminate between 1433 labeled IMU signals collected from 15 healthy individuals and 15 people with severe KOA aged over 45, new features were extracted and defined in dynamic coordinates. These features were employed in four different classifiers: (1) naive Bayes, (2) K-nearest neighbors (KNNs), (3) support vector machine, and (4) random forest. Each classifier was evaluated using the 10-fold cross-validation method (K = 10). The data were applied to these models, and based on their outputs, four performance metrics - accuracy, precision, sensitivity, and specificity - were calculated to assess the classification of these two groups using the mentioned software.Results:The evaluation of the selected classifiers involved calculating the four specified metrics and their average and variance values. The highest accuracy was achieved by KNN, with an accuracy of 93.71 +/- 1.1 and a precision of 93 +/- 1.31.Conclusion:The novel features based on the dynamic coordinate system, along with the success of the proposed KNN model, demonstrate the effectiveness of the proposed algorithm in diagnosing between signals received from healthy individuals and patients. The proposed algorithm outperforms existing methods in similar articles in sensitivity showing an improvement of 4 and at least. The main objective of this study is to investigate the feasibility of using a wearable device as an auxiliary tool in the diagnosis of arthritis. The reported results in this study are related to two groups of individuals with severe arthritis (grade 4), and there is a possibility of weaker results with the current method
DCs pulsed with hypochlorous acid-treated tumor cell lysates present antigens efficiently and induce CD8+ T cell activation through cross-presentation
No full textBackground and purpose:In initiating and regulating immune responses, dendritic cells (DCs) play an important role as antigen-presenting cells. When DCs are exposed to tumor cell lysates, they can stimulate T cells to recognize tumor-associated and tumor-specific antigens and generate an immune response against cancer. The purpose of this study was to compare 4 different approaches for preparing breast tumor cell lysates for pulsing DCs.Experimental approach:To prepare tumor cell lysates from 4T1 cells, 4 different methods were used, including freeze-thaw, hypochlorous acid (HOCl), hyperthermia, and ultraviolet-B irradiation. The effects of the tumor lysates were assessed on the maturation of DCs and the secretion of cytokines using flow cytometry and ELISA. Furthermore, DCs pulsed with different lysates were also evaluated for their ability to promote CD8+ T cell proliferation and release cytokines.Findings/Results:The results demonstrated that DCs pulsed with lysate prepared by HOCl exhibited more maturation surface biomarker expression (CD86) than DCs pulsed with freeze-thawed cells or unloaded DCs (control). Furthermore, activated DCs were also found to promote CD8+ T cell proliferation and induce the responses of T cells by producing high levels of IFN-gamma, while inhibiting IL-10.Conclusion and implications:HOCl is capable of releasing tumor antigens while maintaining its ability to stimulate an immune response. DCs-based therapies may be designed based on the findings presented here, demonstrating a cross-presentation of antigens and specific activation of the immune system against breast cancer
Examining the Frequency of Clinical and Paraclinical Symptoms in Opium Addicts Hospitalized Due to Lead Poisoning in Isfahan Province
No full textBackground:Substance abuse and its consequences are major health hazards in the world. Opium addiction is a common form of substance abuse in Iran. The present study aims to examine the frequency of clinical and paraclinical symptoms of lead poisoning in opium users in the city of Isfahan.Materials and Methods:The current study is a cross-sectional study on patients with oral or inhaled consumption of opium or its derivatives, presenting with one of the clinical or laboratory symptoms of lead poisoning. Information related to the age and sex of the patients, duration and manner of opium consumption, clinical symptoms, and laboratory findings of patients were extracted from their files.Results:Three hundred opium user patients poisoned with lead were evaluated. 96.3 of the patients were men. The average age of the participants was 47.67 +/- 11.57 years, and the average duration of opium use was 5.34 +/- 6.95 years. The most frequent clinical symptom was abdominal pain (98), followed by constipation (11.33), nausea (9), and vomiting (8.33). 33.3 of people had an increase in AST, 17.1 of people had an increase in ALT, and 88.3 of people had an increase in ALP.Conclusion:We found that the most frequent clinical symptom was abdominal pain. 33.3 of people had an increase in AST, 17.1 of people had an increase in ALT, 88.3 of people had an increase in ALP and, 4 had an increase in creatine. Further studies are recommended