Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Relationship between sleep disorders and information processing speed in multiple sclerosis
No full textObjectives: It is estimated that up to 65 of pwMS (people with multiple sclerosis) experience varying degrees of cognitive impairment, the most commonly affected domain being Information Processing Speed (IPS). As sleep disturbance is a predictor of detriments in IPS, the authors aimed to study the association between the severity of Restless Legs Syndrome (RLS) and Obstructive Sleep Apnea (OSA) symptoms with IPS in pwMS. Methods: In a cross-sectional study, the authors enrolled people with relapsing-remitting and secondary progressive MS referred to the comprehensive MS center of Kashani Hospital in Isfahan, Iran. The authors used Berlin and STOP-Bang questionnaires for assessing OSA symptoms, and the International Restless Legs Syndrome Study Group (IRLSSG) scale for the presence and severity of symptoms of RLS. The authors used the Integrated Cognitive Assessment (ICA) test, a language and education-independent tool, to assess visual processing speed. Results: The authors included 211 pwMS, with a mean age of 36.73 +/- 8.9 (81.9 female). PwMS with higher RLS scores showed lower IPS, with ICA indexes of 0.66 +/- 0.09 vs. 0.61 +/- 0.12 in low- and high-risk RLS groups, respectively (p < 0.01). There were no significant associations between IPS as measured by the ICA index and OSA symptom severity. Conclusion: The authors found impairments in IPS in pwMS to be linked with the severity of RLS symptoms, but not with OSA. Considering the high prevalence and underdiagnosis of RLS in pwMS, and the profound impact of IPS on quality of life, this association highlights the importance of screening and treating RLS in this population
Bowenoid Papulosis of the Genitalia in an Older Individual: A Case Report
No full textBowenoid papulosis (BP) is an uncommon condition caused by human papillomavirus, presenting as an asymptomatic lesion on the anogenital region. We report a case of BP in a 63-year-old male, an unusual demographic for this condition. Clinically, BP lesions resemble viral warts. Although BP has a low risk of progression to invasive squamous cell carcinoma (SCC), prompt diagnosis and management are crucial to prevent malignant transformation. Treatment options include topical therapies, laser therapy, and surgical excision. This case highlights the importance of recognizing BP and implementing appropriate management strategies, especially in atypical age groups and individuals with predisposing factors
Rifampin-loaded Mesoporous Silica Nanoparticles Improved Physical and Mechanical Properties and Biological Response of Acrylic Bone Cement
No full textBackground:Acrylic bone cement, which is used to fix implants in the knee and hip, is prone to contamination with various types of infections. Adding small amounts of different antibiotics to the cement can help prevent and treat infections. Rifampin antibiotic has been added to bone cement to create an appropriate antimicrobial response in the treatment of resistant coagulase-negative staphylococci (CoNS) biofilms, but there are some challenges such as reducing mechanical properties and prolonging the setting time of the cement. Loading the antibiotic in the nanoparticle could eliminate these challenges.Methods:In this study, rifampin-loaded mesoporous silica nanoparticles (MSNs) were added to bone cement, and the polymerization components, mechanical properties, drug release, antibacterial activity, and cellular response were investigated and compared with commercial pure cement and the cement containing free rifampin.Results:Loading rifampin into MSN improved compressive strength by 57.52. Cement containing rifampin loaded into MSN showed remarkable success in antibacterial activity. The growth inhibition zone created by it in the culture medium of Staphylococcus aureus and CoNS was 15.44 and 11.8 greater, respectively, than in the cement containing free rifampin. In other words, according to the results of spectrophotometric analysis of cement samples over 5 weeks, MSNs caused a 33.2 +/- 0.21-fold increase in rifampin washout from the cement. Cellular examination of the cement containing rifampin loaded into MSN compared to commercial pure cement showed an acceptable level of cell viability.Conclusion:Rifampin loading in MSN limited the reduction of cement strength. It also improved the drug release pattern and prevented antibiotic resistance
Assessing the association between dairy consumption and the 10-year Framingham Risk Score in women
No full textPurposeCardiovascular diseases are a significant health concern for women in Iran, with previous research suggesting a potential link between dairy consumption and these diseases. This study aims to explore the relationship between the consumption of various dairy products and cardiovascular risk factors, as well as the Framingham Risk Score (FRS) among Iranian women. Various dairy products, including milk, yogurt, cheese, and drinkable yoghurt (dough), were considered, with a focus on dairy fat content (low-fat vs. high fat). MethodsIn this cross-sectional study, 371 women aged 18 to 50 years were recruited. Dietary intake was assessed using a validated and reliable food frequency questionnaire. FRS was then employed to estimate each participant's 10-year risk of developing cardiovascular diseases. ResultsAfter adjusting for confounding variables, participants in the highest tertile of low-fat dairy consumption had significantly lower FRS compared to those in the lowest tertile (FRS: -0.26 +/- 0.30 vs. 1.06 +/- 0.29, P < 0.0001). Higher yogurt consumption was associated with a significantly lower likelihood of having high triglycerides (TAG) (OR: 0.05, 95 CI: 0.003-1.09, P = 0.02) and high LDL-C (OR: 0.19, 95 CI: 0.01-3.2, P = 0.003). Participants in the highest tertile of cheese consumption had significantly lower odds of high fasting blood sugar (FBS) (OR: 0.35, 95 CI: 0.07-1.62, P = 0.001) and high TAG (OR: 0.05, 95 CI: 0.003-1.09, P = 0.04). Additionally, consumption of drinkable yogurt (dough) and high-fat dairy products was inversely associated with LDL-C levels (OR: 0.19, 95 CI: 0.01-3.2, P < 0.0001 and P = 0.02, respectively). ConclusionOur findings suggest that both high-fat and low-fat dairy consumption are associated with beneficial cardiovascular effects. Higher low-fat dairy, is associated with lower FRS, indicating a reduced 10-year cardiovascular disease risk among women. Additionally, yogurt and cheese consumption were linked to improved lipid profiles, including lower triglycerides and LDL-C levels, which are key contributors to cardiovascular risk. These findings highlight the potential cardioprotective role of dairy consumption, supporting the need for further research to better understand its long-term impact on cardiovascular health
Determining the Diagnostic Value of DWIBS in the Diagnosis of Breast Lesions Compared to Dynamic Contrast-Enhanced MRI: A Retrospective Observational Study
No full textBackground:Diffusion-weighted imaging with background body signal suppression (DWIBS) is a new imaging tool for the diagnosis of breast lesions. This study aims to compare DWIBS with contrast-enhanced magnetic resonance imaging (CE-MRI) sequences.Materials and Methods:Eighty consecutive patients underwent both CE-MRI and DWIBS images. DWIBS was assessed qualitatively and quantitatively using the apparent diffusion coefficient mapping. A threshold of 1.44 x 10-3 mm2/s was considered as a cutoff value between malignant and benign lesions. CE-MRI images were evaluated based on a combination of kinetic and morphological information and reported using Breast Imaging Reporting and Data System lexicon. Statistical analysis was performed for both sequences based on pathologic findings as a gold standard.Results:Fifty-five out of 80 lesions (69) were benign, and 25 malignant lesions (31) have been reported. The sensitivity, specificity, positive predictive value, and negative predictive value for CE-MRI were 100, 38, 42, and 100, respectively, and those for DWIBS were 77, 70, 53, and 87, respectively. By comparing DWIBS and CE-MRI data, no statistically significant difference was reported.Conclusion:DWIBS can be used as an effective alternative for breast CE-MRI in cases of contradictions of IV contrast injection
Prevalence of subclinical hypothyroidism in polycystic ovary syndrome and its impact on insulin resistance: a systematic review and meta-analysis
No full textBackgroundAlthough recent studies indicate a high prevalence of subclinical hypothyroidism (SCH) in women with polycystic ovary syndrome (PCOS), the reported prevalence rates vary widely. Therefore, we conducted this study to estimate the pooled prevalence of SCH among women with PCOS. Additionally, emerging evidence suggests that SCH may negatively impact insulin resistance in PCOS. Thus, we examined its effect on insulin resistance indices as our secondary objective.MethodsWe searched PubMed, Web of Science, Scopus, and Embase from their inception to February 25, 2024. Observational studies reporting the prevalence of SCH among women with PCOS were included. Joanna Briggs Institute's (JBI) critical appraisal checklist for prevalence studies was adopted for the risk of bias assessment. The random-effects model was employed to estimate the pooled prevalence with its 95 confidence intervals (CI). The weighted mean difference (WMD) was used to compare the insulin resistance indices between PCOS patients with and without SCH.ResultsTwenty-nine studies comprising 5765 women with PCOS were included. The meta-analysis demonstrated that 19.7 (95 CI: 16.1; 23.5) of women with PCOS have SCH. PCOS patients with SCH had significantly higher HOMA-IR (WMD = 0.78, 95 CI: 0.34; 1.22) and fasting insulin (WMD = 2.38, 95 CI: 0.34; 4.42) levels than those without SCH. Differences in fasting plasma glucose and 2-hour postprandial glucose did not reach statistical significance.ConclusionThis systematic review and meta-analysis found that approximately 20 of women with PCOS have SCH. This underscores the need for regular thyroid function testing in these patients. The prevalence of SCH is influenced by the TSH cut-off used for diagnosis, highlighting the need for establishing a standardized TSH cut-off value. Furthermore, SCH significantly elevates the HOMA-IR index and fasting insulin levels, highlighting its potential impact on insulin resistance. Whether these metabolic changes are clinically important and put these individuals at higher risk of developing type 2 diabetes mellitus and cardiovascular disease requires further investigation.Systematic review registration number in PROSPEROCRD42024510798.Clinical trial numberNot applicable
Challenges of Cross-Cultural Validation of Clinical Assessment Measures: A Practical Introduction
No full textAims: This paper explores the methodological challenges associated with cross-cultural validation of clinical assessment measures and proposes strategies to enhance the validity and reliability of these assessments. Design and Methods: Methodological discussion. Results: Three main phases require consideration in the cross-cultural validation of assessment instruments: (1) Linguistic translation of the assessment instrument and confirmation of its equivalence, which includes conceptual, item, semantic and operational equivalence; (2) Empirical validation of the translated version's accuracy; (3) Adjusting the scores to fit the cultural context. Conclusion: Achieving cross-cultural equivalence of assessment instruments is a complex and challenging process that can only be achieved through methodological rigour. It requires interdisciplinary collaboration of both linguistic and subject experts with strong statistical knowledge and a willingness to explore the nuances of the target population. By enhancing methodological rigour, we can improve the validity of clinical assessment measures across cultures, ultimately leading to better health outcomes for diverse populations. Implications for the Profession: The implications of cross-cultural validation of clinical assessment measures/tools for nursing are significant and multifaceted. Overcoming challenges to cross-cultural validation contributes to the professional growth of nurses by equipping them with greater cultural awareness and confidence in the tools' reliability for patient assessment and evaluation. This not only aids in their clinical practice but also fosters a commitment to evidence-based practice, enhancing their overall effectiveness as healthcare providers. Reliable and valid assessment tools enable nurses to confidently engage in research literature that reflects the realities of diverse populations. This can inform healthcare policies and practices, ensuring they are inclusive and equitable. Impact: While researchers endeavour to reach a consensus on the definition of cross-cultural equivalence and how it should be determined, this practical introduction discusses challenges and proposes strategies to enhance the validity and reliability of these measures/tools. Patient or Public Contribution: No patient or public contribution
Chemical pregnancy in fresh and cryopreserved cycles, using day 3 (cleavage stage) and day 4 embryos (morula stage)
No full textWith the advancement in the embryo culture media, which supports nutrient requirements of embryos up to 5 to 6 days, there's a chance to select more viable embryos, which are more likely to result in pregnancy, compared to earlier stages. Also, there is a controversy regarding the frozen embryo transfer compared to the fresh type. To compare the chemical pregnancy rates between fresh embryo transfer (ET), and frozen embryo transfer (FET), on day 3 (cleavage), and day 4 (morula) of development. In this retrospective study, data of 242 fresh and 758 frozen embryo transfer cycles were obtained in one infertility center in Isfahan, Iran. The study's groups were assigned based on the day of fresh or frozen embryo transfer (day 3, or day 4 embryos) and the embryo grading. Chemical pregnancy was the main outcome measurement (implantation rates). The chemical pregnancy rate was higher in the good quality frozen embryo day 3 and transfer on day 4 group (40.1). This rate was near the results of transferring the good quality frozen embryo on day 4 (39.2 ). There was no significant difference in the chemical pregnancy rate related to the number of transferred embryos (p = 0.55). The higher PRs, when the embryos were transferred on day 4, provided further support for the morula stage embryo transfer, possibly because of better synchrony with the endometrium. It is concluded that morula/compact embryos are good candidates for embryo transfer, which simultaneously reduces the number of transferred embryos
Computerized cognitive rehabilitation in patients with multiple sclerosis (MS): A systematic review and meta-analysis
No full textBackground: Cognitive impairment (CI) is one of the main features of multiple sclerosis (MS). Cognitive rehabilitation (CR) programs are crucial for improving cognition and computer-assisted cognitive rehabilitation is considered as an effective method for cognition rehabilitation. To assess the effects of computer-based cognitive rehabilitation program on cognition in patients with multiple sclerosis (MS). Methods: We performed a comprehensive search in PubMed, Scopus, Web of Science, EMBASE, and Google Scholar databases along with gray literature up to September 2021. Randomized clinical trials, articles had been published in the English language. We evaluated the risk of potential bias via the Cochrane Collaboration's tool for assessing the risk of bias. Standardized mean difference (SMD) was calculated. Results: The preliminary search retrieved 2302 articles by literature search, after deleting duplicates 2248 remained. Eight articles remained for meta-analysis. Totally, 235 patients in intervention group and 192 in control group were evaluated. Mean age ranged from 43.5-52 years. The SMD of PASAT (Paced Auditory Serial Addition Test) (Case-control) test was 0.35 (95CI:0.1-0.66) (I2:24.4, P=0.2). The SMD of SDMT (Case-control) test was 0.07 (95CI:-0.18-0.33). The SMD of PASAT before and after intervention in case group was 0.68 (95CI:0.45-0.91) (I2:40, P=0.15). The SMD of SDMT before and after intervention in case group was 0.44 (95CI:0.21-0.66) (I2:40, Conclusions: The results of this systematic and meta-analysis showed that computerized cognitive rehabilitation program is effective in improving PASAT score
Studying breast cancer lung metastasis using a multi-compartment microfluidic device with a mimetic tumor-stroma interaction model
No full textBackground: Understanding the mechanisms underlying the metastasis of breast cancer cells to the lungs is challenging, and appropriate simulation of the tumor microenvironment with mimetic cancer-stroma crosstalk is essential. (34 integrin is known to contribute to triggering a variety of different signaling cues involved in the malignant phenotype of cancer but its role in organ-specific metastasis needs further study. In this work, a multi- compartment microfluidic tumor model was developed to evaluate cancer cell invasion. Materials and methods: To model the primary tumor microenvironment, breast cancer cells (MCF7) and cancer- associated fibroblasts (CAFs) were co-cultured within the tumor compartment of the microfluidic chip while normal lung fibroblasts (NLFs) were seeded in a different compartment, as the secondary tumor site, separated from the tumor compartment via a MatrigellM layer resembling the extracellular matrix. Results: The cytotoxic effect of (34 integrin blockade on cancer cells gradually increased after 48 and 72 h of co- culture. Invasion of breast cancer cells in both single and coculture models was characterized in response to (34 integrin blockade. The invasion rate and gap closure of MCF7/CAFNLF was significantly higher than MCF7NLF (P < 0.0001). (34 integrin inhibition reduced the rate of gap closure and invasion of both (P < 0.0001). Conclusions: Biomimetic microfluidic-based tumor models hold promise for studying cancer metastasis mechanisms. Precise manipulation, simulation, and analysis of the cancer microenvironment are made possible by microfluidics