Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Diagnostic Values of Ultrasound and Mammography on Prediction of Lymphovascular Invasion in Breast Cancer
No full textObjectivesTo study the role of ultrasound and mammogram features on the prediction of lymphovascular invasion (LVI) in known cases of breast cancer.MethodsThe mammographic and sonographic findings of 187 cases of breast cancer from a single institution were classified into two groups by their LVI status. Then, ultrasound findings such as tumor margin, calcification, and vascularity were compared. Also, mammographic findings including tumor calcification, density, and shape were assessed between them. Pathological markers including estrogen receptor, progesterone receptor, HER-2, and KI-67 were compared to find a possible correlation with positive LVI.ResultsMalignant lesions with mammographic approved calcifications are correlated with positive LVI (p-value = 0.01). On ultrasound, tumors with positive color Doppler vascularity have significantly more LVI versus vascularity negative mass lesions (p-value = 0.008). In immunohistochemical findings, LVI is significantly positive in tumors with a high level of KI-67 (p-value = 0.01).ConclusionSome mammographic and sonographic features are independent risk factors for tumor lymphovascular invasion. These findings can be used together as a predictor for the patient outcome and prognosis by determining the LVI status, as soon as possible
Diagnosis of Granulomatosis With Polyangiitis in a 39-Year-Old Woman With a Recent History of Traveling to Malaria-Endemic Region: A Case Report
No full textGranulomatosis with Polyangiitis (GPA) is a rare vasculitis that can complicate the diagnostic process, especially in patients with complex medical histories. This case report details a 39-year-old woman with situs inversus totalis, Kartagener syndrome, and hypothyroidism, who presented to the emergency department with intermittent petechiae, purpura in the lower limbs, and fever following a trip to a malaria-endemic region. Initial investigations suggested an infectious etiology, but extensive testing for malaria and other infections returned negative results. A transition to autoimmune disease assessment was prompted by the positive results of rheumatologic tests. Pulse doses of Methylprednisolone Sodium Succinate and Rituximab were initiated, and the treatment was continued with Prednisolone, Azathioprine, and Calcium D tablets. The patient's signs and symptoms have improved after this treatment. This case underscores the necessity of considering a comprehensive differential diagnosis and advocating for a meticulous and systematic approach in complex clinical presentations
Designing a Registration System for Kidney Transplant Patients with BK Virus Infection in the Transplant Centers of Isfahan Province: Objectives, Design, and Introducing Under Study Indices
No full textBackground:Notice to the importance of BK virus infection in kidney transplant patients, the present study aimed to present a protocol related to design aspects and implement a registration system for kidney transplant patients with BK virus infection in Isfahan Province, Iran.Method:The design process and different aspects of implementation and preparation of the platform for the registration of kidney transplant patients with BK virus infection were presented in this study. Indices related to the diagnosis, monitoring of the course of the disease, and the most important criteria related to the disease caused by BK virus and treatment of BK virus infection in kidney transplant patients were searched in reliable scientific databases such as PubMed, Scopus, Up-To-Date, ScienceDirect, and Web of Science. A team consisting of experts in nephrology, biostatistics, and epidemiology evaluated the specified variables as an expert panel and evaluated the content validity of the checklists designed quantitatively and qualitatively to finalize them.Results:The checklist was finalized in three sections: 1) demographic variables (age, gender, education,& mldr;), 2) clinical variables (primary cause of kidney failure, disease history, history of kidney disease in the family, laboratory and diagnostic parameters, clinical manifestations & mldr;), and 3) microbiologic information of BK virus infection. This information can be used for the diagnosis, treatment, and follow-up of the patient.Conclusions:Our registry for kidney transplant patients with BK virus infection among the few ones in the world can provide a comprehensive valuable information collection about the risk factors and the course of changes in various indices in these patients and may improve the treatment process
3D printed magnetoactive nanocomposite scaffolds for bone regeneration
No full textSimulating the natural cellular environment using magnetic stimuli could be a potential strategy to promote bone tissue regeneration. This study unveiled a novel 3D printed composite scaffold containing polycaprolactone (PCL) and cobalt ferrite/forsterite core-shell nanoparticles (CFF-NPs) to investigate physical, mechanical and biological properties of magnetoactive scaffold under static magnetic field. For this purpose, core-shell structure is synthesized through a two-step synthesis strategy in which cobalt ferrite nanoparticles are prepared via sol-gel combustion method and then are coated through sol-gel method with forsterite. The characterization regarding CFF-NPs reveals that Mg2SiO4-coated CoFe2O4 nanoparticles is successfully synthesized with a core-shell structure. Afterwards, CFF-NPs are embedded within the PCL with different percentages, ultimately 3D printed scaffolds were fabricated. The in vitro assessments demonstrated that the incorporated CFF-NPs are able to cause a decrease in contact angle which was responsible for modulating purposefully the degradation rate of PCL scaffold, resulting in providing the obligatory environment for bone growth. In addition, it was observed that scaffolds including PCL combined with CFF-NPs are susceptible to improve the mechanical performance of nanocomposite scaffolds, up to a certain concentration (50 CFF-NPs and 50 PCL) with compressive modulus of 42.5 MPa. Moreover, when being exposed to simulated body fluid (SBF) solution, hydroxyapatite deposition on the surface of scaffolds was observed. Thus, these compositions may be useful for improving the osteointegration between the implant and bone tissue after implantation. Finally, the simultaneous effect of magnetic nanoparticles and magnetic field of 125 mT evaluated on cellular behavior of scaffolds. The results showed that the cell viability of all groups under magnetic field were better than that for standard condition. Likewise, SEM images of cultured cells on scaffolds confirmed that the combined effect of these factors could be lead to promote better cell adhesion, dispersion, and bone regeneration
Articaine buccal infiltration for mandibular first molars with symptomatic irreversible pulpitis: is it as effective as inferior alveolar nerve block with lidocaine? a systematic review and meta-analysis
No full textObjectivesThis systematic review and meta-analysis aimed to compare the anesthetic efficacy of 4 articaine buccal infiltration (BI) with 2 lidocaine inferior alveolar nerve block (IANB) for mandibular first molars with symptomatic irreversible pulpitis.MethodsRandomized clinical trials (RCTs) comparing the anesthetic efficiency of one cartridge of 4 articaine BI (as the primary injection) with one cartridge of 2 lidocaine IANB in permanent first mandibular molars with symptomatic irreversible pulpitis were searched in five databases. The risk of bias (RoB) was evaluated using the RoB2 (Cochrane Risk of Bias Tool). A fixed-effects meta-analysis was performed using STATA software. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.ResultsOut of 780 records, five RCTs were included. The meta-analysis revealed no significant difference in the success rates of articaine BI and lidocaine IANB Risk ratio (RR) = 1.06, 95% confidence interval (CI) = (0.93, 1.20), I2 = 24.51%). The certainty of the evidence was graded as "moderate".ConclusionsThe moderate certainty of evidence suggests that the anesthetic efficacy of 4% articaine BI is comparable to 2% lidocaine IANB for mandibular first molars with symptomatic irreversible pulpitis. However, more clinical trials are needed.Clinical relevanceBI with 4% articaine for mandibular first molars with symptomatic irreversible pulpitis can be an alternative for clinicians compared with 2% lidocaine IANB
Role of IGFBP-3 in Human Diseases Relying on Different Cell Signaling Pathways
No full textInsulin growth factor protein 3 (IGFBP-3) is a member of the binding protein family which is known as the main carrier of insulin-like growth factors in human serum. Through the existence of multiple IGFBP-3 binding partners such as insulin growth factors (IGFs), transmembrane receptor 219 (TMEM219) protein, retinoid X receptors (RXRs), and other proteins, in IGF-dependent and IGF-independent cell signaling pathways, IGFBP-3 exerts the various key roles associated with physiological processes such as cell growth prevention and differentiation, apoptosis induction and have several metabolic activities such as regulating blood glucose, lipid metabolism, regulating bone, and chondrocyte growth as well. Moreover, IGFBP-3 plays an important role in the pathophysiology of a variety of human diseases including ischemia, Alzheimer's disease, diabetes mellitus, asthma, and cancer. Therefore, in this current study, we intend to describe the IGFBP-3 role depending on its effect on the pathophysiology of human illnesses
Attitudes toward end-of-life concerns and associated factors among hospitalized older adults with end-stage cancer in Iran
No full textBackground: Nurses play a crucial role in delivering end-of-life care; however, patients' attitudes significantly influence the care process. Positive attitudes facilitate patient engagement and understanding of end-of-life options, while negative attitudes can induce fear and distress. Addressing patient concerns and associated factors is essential for enhancing care during the end-stage period. Objectives: This study aimed to evaluate attitudes toward end-of-life concerns and associated factors among hospitalized older adults. with end-stage cancer. Methods: This cross-sectional study was conducted from November 2022 to March 2023 at Omid Hospital in Isfahan, Iran. A sample of 150 participants was selected through consecutive sampling. Data were collected using questionnaires on demographic characteristics, attitudes toward end-of-life issues, and the Mini-Mental State Examination. Statistical analyses were performed using SPSS version 22, including independent t-tests, chi-square tests. Fisher's exact test, and binomial logistic regression. Results: The mean age of participants was 71.95 +/- 6.04 years. The mean score for end-of-life concerns was 67.11 out of 135. A majority of participants preferred physician-led decision-making (76.7) and did not support euthanasia as a personal choice (72). Furthermore, most participants disagreed with the notion of dying alone (78.7) and expressed a preference for home care (78.7). Logistic regression identified three significant factors associated with end-of-life concerns: time since diagnosis (OR=27.914, CI: 1.144-680.922, P<0.001), marital status (OR=0.847, CI: 0.811-0,884, P=0.041), and family caregiver status (OR=2.603, CI: 0.419-0.866, P=0.006). Conclusion: Healthcare professionals should recognize and address end-of-life concerns by offering personalized support to older adults. Nurses should focus on supporting decision-making, pain management, preferred care settings, and the regulation of living wills
Psychosocial Health Promotion-Related Needs in Adolescent Girls With Substance Abuse: A Qualitative Study
No full textIntroduction: Adolescent girls involved in drug use are highly vulnerable to health and social welfare-related threats. Providing effective interventions and formulating specific health and social welfare policies require a comprehensive examination of the needs and problems of this group in different dimensions. Objective: The present study aimed to identify psychosocial health promotion-related needs of adolescent Iranian girls with substance abuse. Methodology: The present study was conducted with a qualitative approach and with conventional content analysis methodology. The participants consisted of 26 adolescents with history of substance use, health professionals (i.e., psychologists and psychiatrists), and officials affiliated with social welfare organizations, and NGO organizations support socially vulnerable children and adolescents, as well as the families of teenage girls. Data were collected using semistructured qualitative interviews and then coded after transcribing using MAX QDA software. Results: The identified psychosocial health promotion needs were placed in 12 subcategories and three main categories, including detection and repair of the boundaries of adolescent vulnerability, psychosocial development of the family, and promoting social accountability in the delivery of social services. Conclusion: Programs and services to promote psychosocial health in girls involved in drug use should include the dimensions of the individual and the family, as well as the departments that provide the services; so that while identifying and repairing people's injuries and facilitating the optimal functioning of families, it can provide them with the necessary and appropriate services at the right time
Resuscitation-promoting factors: Novel strategies for the bioremediation of crude oil-contaminated soils
No full textSoil contamination with petroleum hydrocarbons is a major environmental concern. The bioremediation of these soils can be restricted because of the entry of potential microbial degraders into the viable but nonculturable (VBNC) state under unfavorable environmental conditions. Resuscitation agents can stimulate the resuscitation and growth of the bacterial population, improving their degradation capabilities. This study evaluated the efficacy of resuscitation-promoting factor (Rpf) in enhancing the biodegradation of total petroleum hydrocarbons (TPHs) in crude oil-contaminated soils, with a focus on both indigenous and augmented bacterial communities without prior resuscitation. Unlike earlier studies that focused solely on Rpf-treated populations, this study investigated the simultaneous application of Rpf and traditional biostimulation and bioaugmentation processes. Additionally, this work is the first to compare Rpf with other resuscitation agents, including supernatant Rpf (SRpf) and Micrococcus luteus. The results indicated that Rpf-supplemented biostimulation (BS + Rpf) and bioaugmentation (BAS + Rpf) processes achieved 67 and 75 degradation of 31,408 mg kg-1 TPHs within 91 days, respectively, whereas 49 and 64 degradation occured by the BS and BAS processes, respectively. Rpf stimulated the growth of bacterial populations, contributing to enhanced bioremediation of contaminated soil. Furthermore, phytotoxicity decreased with decreasing TPH concentration. These findings also demonstrated that, compared with Rpf, SRpf and M. luteus presented similar TPH removal efficiencies and seemed to be suitable alternatives to recombinant Rpf. These results provide novel insights into the activation of native bacteria by the application of resuscitation agents, demonstrating a promising approach for the bioremediation of crude oilcontaminated soils
