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Crocin Supplementation on Inflammation and Oxidative Stress: A Systematic Review and Meta-Analysis
No full textSaffron is the dried stigma of Crocus sativus L. flowers. The yellow-orange color of saffron comes from crocin, a water-soluble carotenoid that can be ingested. Crocin is known for its anti-inflammatory and antioxidant potential. It is believed to affect inflammation and oxidative stress, making it a promising therapeutic option. However, research on its impact is inconclusive. This meta-analysis aimed to assess the benefits of crocin supplementation and its specific effects on inflammation and oxidative stress markers. A comprehensive search of the literature was conducted up to February 2024 in PubMed/Medline, Scopus, and Web of Science to find suitable randomized clinical trials (RCTs). All participants were adults who were supplemented with crocin as part of the study intervention. The selected trials were subjected to heterogeneity tests using the I (2) statistic. Random effects models were examined based on the heterogeneity tests, and the pooled data were calculated as weighted mean differences (WMD) with a 95 confidence interval (CI). Of the 519 papers that remain after duplications were removed, 13 eligible RCTs were included in the present meta-analysis. Our findings indicated that crocin supplementation significantly reduced c-reactive protein (CRP) levels (SMD: -0.50; 95CI: -0.86 to -0.13; p = 0.008), tumor necrosis factor-alpha (TNF-alpha) (SMD: -1.96; 95CI: -2.72 to -1.19; p /= 30 mg/day and an intervention duration >/= 12 weeks. However, more studies are needed for definitive conclusions
Distal median nerve dysfunction and carpal tunnel syndrome in people with multiple sclerosis treated with teriflunomide: an electrodiagnostic study
No full textBACKGROUND: Trials demonstrated an increased risk of distal median nerve dysfunction (DMND) and carpal tunnel syndrome (CTS) associated with teriflunomide in people with multiple (pwMS). OBJECTIVE: To estimate the real-world prevalence of clinical CTS and electrodiagnostic DMND in teriflunomide-treated pwMS. METHODS: Cross-sectional study on selected teriflunomide (WHOATC code: L04AK02)-treated, risk factor-free pwMS at the Isfahan MS clinic in 2022. CTS was diagnosed through history and physical examination, and DMND was diagnosed by nerve conduction studies (NCS). Outcome consisted of an ordinal scale of DMND as follows: no DMND, all values within normal limits; mild, sensory conduction velocity 6.5ms with amplitude > 0.2mV; and very severe, motor amplitude 0.05). CONCLUSION: A considerable proportion of teriflunomide-treated pwMS had DMND in at least one hand. The etiology, along its optimal management strategy, remains to be explored
Diagnostic accuracy of radiomics and artificial intelligence models in diagnosing lymph node metastasis in head and neck cancers: a systematic review and meta-analysis
No full textINTRODUCTION: Head and neck cancers are the seventh most common globally, with lymph node metastasis (LNM) being a critical prognostic factor, significantly reducing survival rates. Traditional imaging methods have limitations in accurately diagnosing LNM. This meta-analysis aims to estimate the diagnostic accuracy of Artificial Intelligence (AI) models in detecting LNM in head and neck cancers. METHODS: A systematic search was performed on four databases, looking for studies reporting the diagnostic accuracy of AI models in detecting LNM in head and neck cancers. Methodological quality was assessed using the METRICS tool and meta-analysis was performed using bivariate model in R environment. RESULTS: 23 articles met the inclusion criteria. Due to the absence of external validation in most studies, all analyses were confined to internal validation sets. The meta-analysis revealed a pooled AUC of 91 for CT-based radiomics, 84 for MRI-based radiomics, and 92 for PET/CT-based radiomics. Sensitivity and specificity were highest for PET/CT-based models. The pooled AUC was 92 for deep learning models and 91 for hand-crafted radiomics models. Models based on lymph node features had a pooled AUC of 92, while those based on primary tumor features had an AUC of 89. No significant differences were found between deep learning and hand-crafted radiomics models or between lymph node and primary tumor feature-based models. CONCLUSION: Radiomics and deep learning models exhibit promising accuracy in diagnosing LNM in head and neck cancers, particularly with PET/CT. Future research should prioritize multicenter studies with external validation to confirm these results and enhance clinical applicability
Repurposing doxycycline for a case of CONDSIAS Syndrome with a novel ADPRHL2 missense mutation
No full textImaging findings in cardiovascular involvements of IgG4-related disease: a systematic review study
No full textBACKGROUND: Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition characterized by IgG4-positive plasma cell infiltration that can affect multiple organs, including the cardiovascular system. The diagnosis of IgG4-RD relies on a combination of clinical, serological, radiological and pathological findings. However, due to the varied and insidious clinical presentations, normal IgG4 levels in a significant percentage of patients and frequent multi-organ involvement, imaging plays a crucial role in the diagnosis of IgG4-RD. The aim of this study is to comprehensively examine the imaging findings in IgG4-related cardiovascular disease for accurate diagnosis and appropriate treatment. METHODS: A systematic search was conducted across the electronic databases PubMed, Scopus, Embase and Web of Science, to 1 September 2023, following PRISMA guidelines, searching for studies reporting detailed cardiovascular imaging findings in IgG4-RD. RESULTS: The search yielded 68 studies (60 case reports, 5 case series, 2 cross-sectional, 1 case-control) with 120 cases of cardiovascular IgG4-RD. Most of the cases were male, averaging 62.8 years. The common initial symptoms were dyspnoea and chest pain. The most common imaging finding was vasculopathy, including vessel wall thickening, periarteritits, periaortitis, aortitis, stenosis, ectasia, aneurysm formation, intramural haemorrhage, fistula formation and dissection, followed by pericardial involvement and mediastinal masses. Case series and cross-sectional studies also showed vasculopathy to be the most common finding on various imaging modalities, including angiography and PET/CT, highlighting the complex pathology of IgG4-RD. CONCLUSION: This study evaluated current IgG4-RD articles, revealing a higher prevalence in men and vasculopathy as the most common cardiovascular complication
Macular Optical Coherence Tomography Angiographic Study in Children with a History of Prematurity: A Systematic Review and Meta-Analysis
No full textPURPOSE: to assess the changes in the macular structure in children with history of prematurity and to find the relationship between retinopathy of prematurity (ROP) treatment and macular ultrastructural changes found in optical coherence tomography angiography study. METHODS: a search for identifying relevant studies published in English using PubMed, Google Scholar, Scopus, and Web of Science databases from the date of inception to 21 October 2022 was conducted. Studies were included if their subjects were >5 years and used Optovue device for imaging. Twelve studies were included for final analysis. After extracting data, foveal avascular zone (FAZ), vessel density (VD) of superficial capillary plexus (SCP) and deep capillary plexus (DCP) in the foveal and parafoveal area, central foveal thickness (CFT), and visual acuity (VA) were compared between the study groups. RESULTS: in individual who were born full term the FAZ was significantly larger. The SCP and DCP VD was significantly higher in children with history of ROP treatment. Superficial parafoveal VD was significantly lower in term children than both treated groups. The CFT was significantly higher in children with history of ROP (treated and untreated) than the terms. VA was lower in laser and IVI treated children than terms and it was related to the changes in CFT, foveal superficial and deep VD and FAZ area. CONCLUSIONS: Patients with a history of ROP treatment have a significantly greater CFT, higher VD of foveal SCP and DCP, and lower VA than the term-born children. Furthermore, the FAZ is negatively associated with VA and CFT
Integration of Diabetes Mellitus and Hypertension on Major Cardiovascular Events: An Experience From a 15-year Follow-up Cohort Study in EMR
No full textINTRODUCTION: Patients with hypertension and diabetes are more susceptible to cardiovascular diseases (CVD) and mortality. This study aimed to evaluate the individual and combined effects of hypertension and diabetes on cardiovascular events and mortality in a Middle Eastern population-based cohort. METHODS: Fifteen-year follow-up data were collected for 6323 adults aged 35 years and older who were free from CVD at baseline. The subjects were categorized into different groups according to hypertension and diabetes at baseline. Cox proportional hazards regression was implemented to estimate hazard ratios (HRs) of hypertension and diabetes for cardiovascular events (CVE), CVD mortality, and all-cause mortality. Population-attributable hazard fraction (PAHF) was used to assess the proportion of hazards of CVE and mortality attributable to hypertension or diabetes. RESULTS: The incidence rates (95 CI) of CVE, CVE mortality, and all-cause mortality in the total population were 13.77(12.84-14.77), 3.01(2.59-3.49), and 9.92(9.15-10.77) per 1000 persons per year respectively. The HR of hypertension for CVE in the diabetic population was 1.98 (1.47-2.66) with a PAHF of 27.65(15.49-39.3). When the HRs and PAHF of diabetes were evaluated in hypertensive patients, they were statistically significant for CVE, CVE mortality, and all-cause mortality. CONCLUSION: Our study indicated that the joint effect of diabetes and hypertension is the dramatic increased risk of CVE. A considerable fraction of the excess risk of CVE in patients with diabetes was attributable to hypertension, on the other hand, diabetes was associated with a substantial hazard fraction of CVE and mortality in hypertensive patients
Discovery of non-peptide GLP-1r natural agonists for enhancing coronary safety in type 2 diabetes patients
No full textThis study explores the computational discovery of non-peptide agonists targeting the Glucagon-Like Peptide-1 Receptor (GLP-1R) to enhance the safety of major coronary outcomes in individuals affected by Type 2 Diabetes. The objective is to identify novel compounds that can activate the GLP-1R pathway without the limitations associated with peptide agonists. Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular disease (CVD) and mortality, which is attributed to the accumulation of fat in organs, including the heart. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are frequently used to manage T2DM and could potentially offer cardiovascular benefits. Therefore, this study examines non-peptide agonists of GLP-1R to improve coronary safety in type 2 diabetes patients. After rigorous assessments, two standout candidates were identified, with natural compound 12 emerging as the most promising. This study represents a notable advancement in enhancing the management of coronary outcomes among individuals with type 2 diabetes. The computational methodology employed successfully pinpointed potential GLP-1R natural agonists, providing optimism for the development of safer and more effective therapeutic interventions. Although computational methodologies have provided crucial insights, realizing the full potential of these compounds requires extensive experimental investigations, crucial in advancing therapeutic strategies for this critical patient population
Introduction of Microextraction by Packed Sorbent and a Review of its Applications in Toxicology and Human Biological Monitoring: A Short Review
No full textSample preparation is a crucial step in the separation and determination of desired components from complex matrices. It significantly influences the reliability and accuracy of the analysis as well as the quality of the data. This process is often the most labor-intensive and error-prone aspect of analytical methodology, which can impact the quantification of target analytes. Recent trends in sample preparation include miniaturization, automation, high-throughput performance, online coupling with analytical instruments, and low-cost operation using little or no solvent consumption. Over the past decade, microextraction by packed sorbent (MEPS) has emerged as a simple, rapid, and online sample preparation technique. The automation offered by MEPS is a notable advantage, along with the significantly smaller volumes of samples, solvents, and dead volumes within the system. Additional benefits include the speed and simplicity of the sample preparation process. This review provides an overview of the MEPS technique, covering its fields of application in toxicology, common formats, and sorbents, as well as its major advantages, limitations, and future trends. © 2025, Isfahan University of Medical Sciences(IUMS). All rights reserved
Protective effects of silymarin on preventing vancomycin nephrotoxicity in infectious patients: a randomized, double-blinded, placebo-controlled, pilot clinical trial
No full textNephrotoxicity is one of the most common complications of vancomycin use in clinical practice. Silymarin has potential to be a renoprotective agent for nephrotoxic drugs due to its antioxidant, anti-inflammatory, and anti-apoptotic effects. The aim of this clinical study is evaluating the potential effects of silymarin on preventing vancomycin nephrotoxicity. A multicenter, randomized, double-blinded, placebo-controlled, clinical trial was conducted on patients with the indication of systemic vancomycin for at least 7 days. Patients were screened daily and those who met the inclusion criteria were selected and randomly assigned into either silymarin or placebo groups. Accordingly, 140 mg silymarin tablet (Livergol®) or placebo was given orally three times daily. Silymarin or placebo were provided in conjunction with vancomycin for at least 7 days. If vancomycin therapy was extended beyond 7 days, the administration of silymarin or placebo was continued until the end of vancomycin treatment. Malondialdehyde, glutathione, and total antioxidant capacity were measured in the serum on days 0 and 7. A trough level of vancomycin was assessed 30 min before the fifth dose of vancomycin. Acute kidney injury (AKI) was monitored in each patient daily during the course of vancomycin treatment. The causality assessment of all identified cases of vancomycin associated AKI was performed by the Naranjo scale. The primary endpoint was vancomycin nephrotoxicity. It was defined based on the KDIGO 2012 criteria for AKI as either an increase of 0.3 units or more in serum creatinine level during 48 h or 50 (1.5-fold) or more during 7 days compared to baseline values. During the study period, 34 patients in the silymarin group and 32 patients in the placebo group completed the clinical trial. Demographic, baseline clinical, and laboratory characteristics were comparable between placebo and silymarin groups. The number of patients with AKI on days 5, 6, 7, 11,12, 13, and 14 in the placebo group was significantly higher than that in the silymarin group (p-value < 0.05). The incidence of acute tubular injury on the day 5 and 7 of vancomycin treatment was significantly lower in the silymarin group (p-value = 0.005 and p-value = 0.032, respectively). Antioxidant indexes including serum total antioxidant capacity and glutathione significantly increased in the silymarin group (p-value < 0.001 for both indexes). In contrast, serum malondialdehyde as an end product of lipid peroxidation pathway significantly decreased in the silymarin group during 7 days (p-value < 0.001). The results of the present pilot, clinical trial suggested that silymarin co-administration may prevent vancomycin nephrotoxicity. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024