Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Preparation and In vitro/In vivo Evaluation of Fingolimod hydrochloride Loaded Polymeric Mixed Nano-Micelles for Treatment of Multiple Sclerosis
No full textFingolimod (FYN) is one of the approved medicines for treatment of multiple sclerosis (MS) while exhibiting several side effects such as liver enzyme elevation and cardiac damage. This study was aimed to prepare the mixed micelles of ascorbyl palmitate (AP) and alpha-tocopherol polyethylene glycol succinate (TPGS) as a delivery system for FYN. The mixed micelles were prepared by thin film hydration method at different ratios of AP/TPGS. Saturation solubility of the micelles was compared with the pure drug. The optimized formulation was characterized by scanning electron microscopy (SEM) and subjected for stability study at 5 +/- 3 degrees C for 3 months. The effect of the prepared fingolimod loaded micelles (FYN-Micelle) was finally assessed by experimental autoimmune encephalomyelitis (EAE) model at the dose of 0.3, 1, and 3 mg/kg of fingolimod, which was administrated intraperitoneally. The results indicated that the prepared mixed micelles at the AP/TPGS ratio of 1:5 showed a particle size, zeta potential, and an entrapment efficiency of 116.86 +/- 2.41 nm, 23.61 +/- 4.56 mV, and 63.28 +/- 5.31, respectively. Also, this formulation was stable after a 3-month incubation at 5 +/- 3 degrees C. SEM images displayed an amorphous state of the drug in the micelles. Animal studies confirmed that this formulation at the dose of 1 mg/kg could enhance the myelin density of the brain while reducing cardiac and hepatic impairment. Therefore, these findings suggested that FYN-Micelle could be exploited as an effective delivery system for fingolimod hydrochloride to treat MS
The association between type 2 diabetes and dietary antioxidant index: a cross-sectional study in the Iranian population
No full textOBJECTIVE: This study aims to explore the association between dietary antioxidant index (DAI) and type 2 diabetes (T2D) in the Iranian population. SUBJECTS AND METHODS: The present cross- sectional study comprised 4,241 participants aged from 35 to 70. A food frequency questionnaire (FFQ) was used to assess dietary intake. The DAI score was determined using Wright's method, which quantifies the antioxidant content of the diet. Logistic and linear regression analyses were used to determine the link between DAI and T2D after adjusting for confounding variables. RESULTS: Negative associations were found between T2D with total score of DAI (OR = 0.67, CI95: 0.55-0.81, P = 0.001) and DAI score of zinc (OR = 0.53, CI95: 0.40-0.72, P = 0.001), manganese (OR = 0.77, CI95: 0.68-0.88, P = 0.001), and selenium (OR = 0.88, CI95: 0.78-0.98, P = 0.010) after adjustments for age, sex, BMI, education level, marital status, occupation, physical activity, and calorie intake. CONCLUSION: These results indicate the significance of an antioxidant-rich diet in preventing T2D and its complications. Nevertheless, additional investigation is required to validate these findings and explore the fundamental mechanisms of the association of T2D and dietary antioxidants
Frequency of tremor in people with multiple sclerosis: A systematic review and meta-analysis
No full textBACKGROUND: Multiple sclerosis (MS) is a chronic neurodegenerative disorder causing various symptoms, including tremors, which significantly affect the quality of life and disability in people with MS (PwMS). Previous studies report a wide range of tremor frequency in PwMS, necessitating a comprehensive review for reliable estimates. OBJECTIVES: This review aimed to elucidate the frequency rate of tremor among PwMS. METHOD: A systematic search was conducted in PubMed/MEDLINE, Embase, Scopus, and Web of Science up to April 27, 2024, to identify studies evaluating various types of tremors in PwMS. The Meta-proportion method implemented in R software version 4.0.0, utilizing a random-effects model, was employed to estimate the pooled frequency rates of tremor, with its 95 confidence interval (CI), among PwMS. RESULTS: From 3780 studies, 14 studies encompassing 17,458 PwMS (71.5 female) were included. The mean age was 46.4 years, with a disease duration of 9.3 years and an Expanded Disability Status Scale (EDSS) score of 3.4. The pooled frequency of tremor was 33.32 (95 CI: 23.47 to 44.88 ; I(2) = 98 ; p-heterogeneity < 0.01). Subgroup analysis by sample size revealed that the pooled frequency of tremor in PwMS was significantly lower (p-value < 0.01) in studies with over 200 participants (22.46, 95 CI: 15.69 to 31.08 , I(2) = 99 ; p-heterogeneity < 0.01) compared to those with fewer than 200 participants (47.65, 95 CI: 31.97 to 63.81 , I(2) = 91 ; p-heterogeneity < 0.01). CONCLUSION: Tremor is a prevalent complaint in PwMS. These findings highlight the necessity for targeted supportive, therapeutic, and rehabilitative interventions to effectively address this prevalent issue in PwMS
Artificial Intelligence-Powered Cognitive Behavioral Therapy Chatbots, a Systematic Review
No full textObjective: This review identifies the characteristic features of artificial intelligence (AI) chatbots and their therapeutic effect; assesses their efficacy in treatment of depression, anxiety, and other mental health disorders; and establishes levels of user engagement and satisfaction. Method : Searches were conducted on the PubMed, Embase, MEDLINE, CENTRAL, CINAHL, PsycINFO, and Google Scholar databases using a set of keywords such as, not limited to, AI cognitive behavioral therapy (AI CBT), Youper, Wysa, Woebot, and other related terms. We included studies that were empirical, peer-reviewed, conducted between January 2017 and June 2024, and primarily focused on efficacy regarding the interventions and therapeutic outcomes. Data were then extracted and analyzed using both qualitative and quantitative methods concerning the mental health outcome. Results: Our review identified large improvements across the three chatbots in symptoms of mental health, as supported by the 10 included studies: five on Woebot, four on Wysa, and one on Youper. Woebot showed remarkable reductions in depression and anxiety with high user engagement; Wysa demonstrated similar improvements, especially in users with chronic pain or maternal mental health challenges; Youper also presented a significant symptom reduction, including a 48 decrease in depression and a 43 decrease in anxiety. Common benefits of all chatbots were the therapeutic alliance and a high rate of satisfaction among users. We have also discussed the included studies' limitations; that is, study design shortcomings and lack of sample diversity. Conclusion: AI CBT chatbots, including but not limited to Woebot, Wysa, and Youper, are highly promising because of their availability and effectiveness in mental health support. They provide a useful complement to standard therapy when professional help is unavailable, and offer constant engagement with tailored interventions. However, it is necessary that further studies investigate their potential impact as long-term intervention models and explore how they may be integrated into holistic mental health care systems
Association of childhood obesity on retinal microvasculature and the role of biochemical markers for its early detection
No full textBACKGROUND: Childhood obesity is a growing public health concern, associated with several systemic disorders including changes in retinal microvasculature. This study aims to assess the relationship between body composition, biochemical markers, and retinal microvascular changes in obese children. METHODS: In this cross-sectional study, 45 overweight and obese children and 46 age- and sex-matched healthy individuals were evaluated. In addition to physical examination, anthropometric measurements were obtained using a body composition analyzer. A comprehensive ophthalmic assessment was conducted for all participants, which included advanced optical biometry, autorefractometry, visual acuity testing, and slit-lamp examination. Retinal microvasculature was assessed using optical coherence tomography angiography (OCT-A). Biochemical markers, including lipid profile, liver function tests, and CRP (as marker of inflammation), were also analyzed. RESULTS: The mean ages were 10.18 and 9.40 years in the obese/overweight and normal weight groups, respectively. Increased foveal thickness (p = 0.04) and foveal vessel density (p = 0.01) in the superficial capillary plexus, and decreased vessel density in the inferior parafoveal region of the deep capillary plexus (p = 0.03) were observed in obese/overweight children. Adjusted and crude regression analysis showed significant associations between body mass index, percent body fat, fasting blood glucose, and serum alanine transaminase levels with foveal vessel density, as well as between body mass index and serum triglycerides levels with foveal thickness. CONCLUSIONS: Our findings suggest that childhood obesity is associated with significant alterations in retinal microvasculature. We propose that retinal health assessments and biochemical evaluations be considered in the clinical management of obese children
Advances in bioengineered CAR T/NK cell therapy for glioblastoma: Overcoming immunosuppression and nanotechnology-based strategies for enhanced CAR T/NK cell therapy
No full textGlioblastoma is a strong challenge in the worldwide field of central nervous system malignancies. GBM's inherent heterogeneity, along with the formation of an immunosuppressive tumor microenvironment, supports its resistance to current therapy methods. Immunotherapeutic methods have emerged as potential options in recent years. However, because of the inherent limits of traditional immunotherapeutic techniques innovative approaches are required. Advances in cut-edge techniques provide a possible route for improving effector cell effectiveness. This review gives insight into the complicated immunosuppressive pathways in GBM, with a particular emphasis on CAR T/NK-cell treatment as a potential achievement. Recognizing and addressing these concerns might open the way for more effective and focused glioblastoma therapies, providing hope for the future with the aim of improved outcomes for patients. In addition, this review presents valuable insights into the integration of nanotechnology into CAR T/NK cell therapy for enhanced efficiency of these personalized gene therapy products
Author Correction: Microbial safety and chemical characteristics of sausage coated by chitosan and postbiotics obtained from Lactobacillus bulgaricus during cold storage
No full textFilaggrinopathies-FLG/FLG2: Diagnostic Complexities and Immunotherapy
No full textFLG and FLG2 proteins are expressed in the outer layers of the epidermis, where they are vital in epidermal differentiation and skin barrier formation. Filaggrinopathies involving dysfunctions in these proteins are associated with a spectrum of phenotypic presentations, from monogenic to multifactorial conditions. This review examines biosynthesis and function of FLG and FLG2 proteins and evaluates their molecular pathogenesis in filaggrinopathies. Moreover, genotype-phenotype correlations are assessed, emphasizing genetic diagnosis complexities and diverse immune dysregulation patterns. Finally, it examines ongoing immunotherapeutic approaches by targeting different cytokines as promising treatment options for filaggrinopathies management
Cost-effectiveness of hysterectomy, first- and second-generation endometrial ablation, and levonorgestrel-releasing device for treatment of heavy menstrual bleeding: a systematic review
No full textOBJECTIVES: This study aims to provide a clear understanding of the relative economic evaluation of hysterectomy, first- and second-generation endometrial ablation, and levonorgestrel-releasing intrauterine device for treatment of heavy menstrual bleeding. METHODS: A comprehensive search was conducted without restrictions until October 5, 2023, across databases including PubMed, EMBASE, Scopus, Cochrane, and others. The review included studies using full economic evaluation methods to compare treatments, excluding review articles, editorials, abstracts, and non-English articles. Methodological quality of included studies was assessed using the QHES checklist and analyzed with Incremental Cost-Effectiveness Ratios. RESULTS: Out of 156 articles assessed for full-text evaluations, 23 publications were selected for qualitative analysis. Two studies deemed to be of low quality were excluded from the final analysis, while the majority of studies showcased high quality. The findings presented diverse perspectives on the most cost-effective treatment, with LNG-IUD frequently emerging as the preferred choice. CONCLUSION: There are diverse methodologies in economic evaluations, impacting reported health economic outcomes due to varying perspectives, time horizons, and modeling approaches. The review highlighted the need for further research to establish optimal HMB treatment strategies and to guide healthcare resource allocation. REGISTRATION: PROSPERO (CRD42024530176)
Review of Association between Urinary Tract Infections and Immunosuppressive Drugs after Heart Transplantation
No full textManagement of infections in heart transplant recipients is complex and crucial. In this population, there is a need for a better understanding of immunosuppressive trough levels (C0), infectious complications, and urinary tract infections (UTIs). The purpose of this review was to understand the association between immunosuppressive trough levels and UTIs after heart transplantation. A review of scientific literature (n= 100) was conducted based on the topic of interest by searching PUBMED.Gov (https://pubmed.ncbi.nlm.nih.gov/), Web of Science, and Scopus. The analysis of bacterial pulmonary infection required the occurrence of new or deteriorating pulmonary infiltrates and the development of organisms in cultures of sputum specimens. The diagnosis of UTIs was based on the result of related signs, pyuria, and a positive urine culture. The incidence of UTIs was reported as 0.07 episodes/1000 regarding heart transplantation days. An eightfold increase in the rate of rejection was noted in heart transplant recipients with higher variability in tacrolimus C0. There are associations between C0 of immunosuppressive drugs and clinical presentation of infection complications. Recipients with a low metabolism of immunosuppressive drugs are more susceptible to infectious complications. Attention to the biology of herpes viruses, Escherichia coli, Enterococcus spp., Pseudomonas aeruginosa, and Staphylococcus saprophyticus after heart transplantation are important, in which some of them are the most common pathogens responsible for UTIs. Pneumocystis and cytomegalovirus affect all transplant recipients. Pneumonia due to bacterial, viral, protozoa, and fungal infections, in addition to UTIs, are more specific reported types of infections in heart transplant recipients. Bacterial infections produced by extensively drug-resistant Enterobacteriaceae, vancomycin-resistant enterococci, and non-fermenting gramnegative bacteria were reported to increase after transplantation