Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Dietary intake and tissue biomarkers of omega-6 fatty acids and risk of colorectal cancer in adults: a systematic review and dose-response meta-analysis of prospective cohort studies
No full textFindings on the associations of dietary/tissue levels of omega-6 polyunsaturated fatty acids (n-6 PUFAs) with the risk of colorectal cancer (CRC) are conflicting. We conducted a dose-response meta-analysis to assess the associations of dietary/tissue levels of n-6 PUFAs total, linoleic acid (LA), and arachidonic acid (AA) with CRC risk in adults. Twenty prospective cohort studies with a total sample size of 787,490 participants were included. Comparing extreme intake levels of LA revealed the summary relative risks (RR) of 1.15 (95% confidence interval (CI): 1.05-1.27) for CRC, and 1.30 (95% CI: 1.00-1.68) for rectal cancer, indicating a significant positive association for LA. However, neither total n-6 PUFAs nor AA were associated with cancers. A significant positive association was also found between a 1 gr/day increase in dietary LA intake and risk of colon cancer (RR: 1.01, 95% CI: 1.00-1.02). There were no significant associations between tissue levels of total n-6 PUFAs (RR: 0.94, 95% CI: 0.75-1.19), LA (RR: 0.93, 95% CI: 0.61-1.41), and AA (RR: 0.97, 95% CI: 0.70-1.33) and CRC risk. In conclusion, these findings suggest that dietary intake, but not tissue levels, of LA was associated with an increased risk of colorectal, colon, and rectal cancers. (PROSPERO registration: CRD42024516584)
Investigating the Viability of Fat Cells Over 1, 3, and 6 Months After Freezing at -18 degrees C
No full textBACKGROUND: Lipofilling is a natural, low-risk, and long-lasting method for filling, reconstructing, and improving soft tissues such as the face, with minimal discomfort for patients. Many plastic surgeons prefer autologous fat grafting in aesthetic surgery due to its availability, cost-effectiveness, biocompatibility, and absence of allergic and carcinogenic concerns. Despite the advantages of autologous fat injection, one of the main drawbacks is the variable persistence of injected fat tissue. Given the significant implications of this issue in advanced countries, this study aims to investigate the survival of fat cells after freezing at different time intervals (1, 3, and 6 months). METHODS: Thirty female participants were enlisted for this research, and the viability of fat cell specimens was assessed at intervals of 0, 1, 3, and 6 months post-freezing at -18 degrees C. The evaluation of viable adipocytes was conducted using the XTT assay, a live/dead staining method using fluorescence microscopy after staining with fluorescein diacetate (FDA) and propidium iodide (PI), along with histological analysis of fat tissue after freezing at the indicated time intervals. RESULTS: The results showed that the viability of frozen fat samples decreases by 34, 60, and 80 after 1, 3, and 6 months, respectively, compared to non-frozen samples on Day 0. CONCLUSIONS: The findings of this study underscore a rapid decline in adipocyte viability after storage at -18 degrees C at different time intervals (1, 3, and 6 months), at which points only around 60, 40, and 20 of fat cells remained viable, respectively. These results suggest that current fat preservation techniques utilizing either a -18 degrees C freezer are not sufficient for maintaining the long-term viability of adipocytes, and alternative cryopreservation methods are needed to preserve fat cells
Bi-allelic variants in BRF2 are associated with perinatal death and craniofacial anomalies
No full textBACKGROUND: Variants in genes encoding multiple subunits of the RNA Polymerase III complex which synthesizes rRNAs, tRNAs, and other small RNAs were previously associated with neurological disorders, such as syndromic hypomyelination leukodystrophies, pontocerebellar hypoplasia, and cerebellofaciodental syndrome. One new such candidate is BRF2, which encodes a TFIIB-like factor that recruits the RNA polymerase III complex to type 3 promoters to initiate transcription of U6, RnaseP, and 7SK RNAs. METHODS: We combined sequencing with functional analyses to investigate the effects of BRF2 variants. RESULTS: We observe that a previously reported significant underrepresentation of double transmission of a splice variant results in recessive lethality in three large Icelandic families with multiple perinatal losses. Using data aggregation, we identified an additional seven individuals worldwide from three unrelated families carrying biallelic variants in BRF2. Affected individuals present a variable phenotype ranging from severe craniofacial anomalies with early death to intellectual disability with motor and speech development. In silico 3D modelling and functional analyses showed functional impairment of the identified variants, e.g., differences in target loci occupancy. Zebrafish knocked down for the orthologous brf2 presented with abnormal escape response, reduced swimming velocity and head size, and craniofacial malformations. These defects were complemented by the human wild-type but not mutated BRF2 mRNA further demonstrating their deleteriousness. CONCLUSIONS: Overall, our results support the association of biallelic BRF2 variants with a novel neurodevelopmental disease and provide an additional link between RNA polymerase III, its targets and craniofacial anomalies
Clinical Evaluation of Nonsyndromic Scaphocephaly Surgically Corrected by Floating Bilateral Parietal Bone Flaps Technique Between 2001 and 2021, A Retrospective Study
No full textBACKGROUND: Scaphocephaly is a common cranial deformity characterized by a long, narrow head, frontal bossing, and a sharp, prominent occiput. These features can affect brain integrity and potentially lead to neurological impairment. Various techniques for correcting sagittal synostosis have been described, each with its own advantages and challenges. This study aimed to evaluate the efficacy of floating bilateral parietal bone flaps in improving head shape in patients with scaphocephaly. METHODS: This study examined patients with nonsyndromic sagittal synostosis who underwent surgery using the floating biparietal bone flap technique between 2001 and 2021. The patients, aged 6 months to 9 years, received biparietal floating bone flaps without frontal or occipital surgical intervention. Postoperative outcomes were evaluated by 2 consultant plastic surgeons, using preoperative and postoperative clinical photographs and documenting any surgical complications. RESULTS: The study included 30 cases, with ages ranging from 6 to 118 months, and a mean age of 24.7 months. The mean intraoperative blood loss was 90.0+/-31.7 mL, and the average operation time was 246 minutes. The patients were classified with a mean Whitaker score of 1.27+/-0.48 by 2 experts, with no complications reported. All patients achieved satisfactory postoperative outcomes in terms of head shape. CONCLUSIONS: This study demonstrated the functional and aesthetic benefits of using floating parietal bone flaps in scaphocephaly surgery. This simplified technique resulted in minimal calvarial and dural manipulation, reduced intraoperative blood loss and transfusion requirements, shorter operation time, and a decreased length of hospital stay. In addition, no hardware fixation was used
Impact of silver diamine fluoride on composite resin bond strength: An In vitro study with various adhesive systems
No full textAIM: This in vitro study investigates the effects of Silver Diamine Fluoride (SDF) application on the shear bond strength (SBS) of resin composite to sound and demineralized human teeth using different adhesive systems. METHODS: Eighty sound human third molars were sectioned, mounted in acrylic blocks, and prepared to expose a 2 mm thick dentin layer. The teeth were randomly divided into eight groups, each representing a combination of sound or demineralized dentin, SDF application, and adhesive system used. Demineralization was achieved using a pH cycling process. SDF was applied to the designated groups, followed by the use of either an etch-and-rinse or self-etch adhesive system. Resin composite was then applied, and the SBS was measured using a universal testing machine. Data were analyzed using three-way ANOVA and post-hoc tests to identify significant differences. RESULTS: The application of SDF generally led to a significant decrease in bond strength (p 0.05). The bond strength in the demineralized group using Clearfil SE Bond showed no significant difference between SDF application and non-application (p > 0.05). CONCLUSION: SDF application can significantly reduce the bond strength of resin composite to dentin, with the effect being dependent on the type of adhesive system and the state of the dentin. Further in vivo studies are needed to validate these findings
A cerebral clue in the stomach: Brain lesion leads to discovery of hidden gastric cancer
No full textINTRODUCTION AND IMPORTANCE: Brain metastases from gastric adenocarcinoma are exceptionally rare, comprising only 0.1-0.16 of all brain metastases. These cases present unique diagnostic challenges, particularly when neurological manifestations precede gastrointestinal symptoms. Understanding such atypical presentations is crucial for timely diagnosis and appropriate management. CASE PRESENTATION: An 82-year-old male presented with non-specific neurological symptoms including dizziness, fever, and seizures, without any reported symptoms of primary gastric involvement. Initial neuroimaging revealed a left frontal brain lesion, which upon biopsy was confirmed to be an undifferentiated carcinoma. Subsequent positron emission tomography-computed tomography identified a primary gastric tumor with evidence of systemic metastatic spread. CLINICAL DISCUSSION: The case highlights the diagnostic complexity of brain metastases from gastric cancer, particularly when presenting without primary site symptoms. A comprehensive multi-modality diagnostic approach, including neuroimaging, histopathological analysis, and molecular studies, was essential for establishing the definitive diagnosis. Treatment involved a coordinated multi-disciplinary strategy combining systemic chemotherapy (capecitabine and oxaliplatin) with targeted brain radiation therapy. CONCLUSION: This case emphasizes the importance of maintaining a broad differential diagnosis and considering rare metastatic patterns, even in clinically atypical scenarios lacking primary tumor symptoms. It also underscores the value of comprehensive diagnostic evaluation and multi-disciplinary collaboration in managing such complex oncological cases
Prostate puzzle: Unconventional prostatic STUMP findings in a middle-aged patient prompt closer examination
No full textA 41-year-old male presented with obstructive urinary symptoms and an enlarged prostate. Subsequent testing revealed a remarkably high PSA level of 150 ng/mL, considerably above normal limits, raising concern for possible malignancy. Transrectal ultrasound showed an enlarged heterogeneous prostate measuring 74x80x75mm. PSMA PET/CT detected intense tracer uptake. While MRI and biopsy ruled out carcinoma, they indicated Stromal Tumors of Uncertain Malignant Potential (STUMP), an uncommon diagnosis in younger patients. This complex case highlights the essential role of advanced multimodal imaging and immunohistochemistry in diagnosing atypical prostatic lesions of uncertain malignant potential like STUMP, given their histologic similarity to benign conditions posing diagnostic difficulties. A multidisciplinary approach led to the STUMP diagnosis and decision for long-term monitoring instead of radical prostatectomy due to STUMP's unpredictable behavior. This report reinforces the need for diligence when evaluating seemingly benign but diagnostically challenging presentations that could conceal conditions like STUMP, and the importance of a multidisciplinary approach for accurate diagnosis and management of such rare prostatic proliferations
Dietary calcium intake in relation to metabolic syndrome in adults: A systematic review and dose-response meta-analysis of epidemiological studies with GRADE assessment
No full textNumerous studies have examined the relationship of calcium intake and metabolic syndrome (MetS) in adults in previous decades; but the results were inconsistent across different societies. This systematic review and dose-response meta-analysis assessed the relation between calcium consumption and MetS in adults. We did a systematic search of all articles published up to July 2023 in Scopus, PubMed/Medline, ISI Web of Science electronic databases, and Google Scholar. Observational studies investigated the association between dietary calcium (Ca) intake and MetS in adults were eligible to be included. For computing the estimates, a random effects model was applied. Combining 24 effect size from 17 investigations (15 cross-sectional and two cohort studies) with 74,720 participants and 18,200 cases showed that highest versus lowest level of dietary Ca intake was related to 23 significant decreased odds of MetS (OR = 0.77; 95 CI: 0.66, 0.89). Linear dose-response analysis of estimates from 12 investigations showed that each 100 mg/day increment in dietary Ca intake was associated with 3 marginally significant decreased odds in MetS (OR = 0.97; 95CI: 0.93, 1.01). In nonlinear dose-response analysis of 12 studies with 67,896 participants, a significant association between dietary calcium intake and MetS was found (P(nonlinearity) <0.001); such that 500 mg/day dietary calcium intake was related to maximum decrease in odds of MetS. According to this meta-analysis, the likelihood of MetS was significantly lower in adults with higher level of dietary calcium intake. Further large-scale prospective cohort investigations are needed to obtain stronger and more accurate results
Association of obesity status and the risk of long-COVID: Isfahan COVID cohort study
No full textPeople with COVID-19 infection continue to have their symptoms or develop new ones after recovery. This is called long-COVID syndrome. We aimed to examine the association of general and abdominal obesity with long COVID. This study was conducted using Isfahan COVID Cohort (ICC). Totally 4008 including 3213 hospitalized and 795 non-hospitalized patients with positive RT-PCR were included. Body mass index (BMI) and waist circumference (WC) were calculated. BMI >25 kg/m(2) and WC >88 cm in women and 102 cm in men were considered generally and abdominally obese, respectively. By using an open-ended questionnaire, subjects were asked whether they had any new or persistent symptom. Reported symptoms were categorized in three different fields including general, cardiac, and respiratory symptoms. Higher BMI and WC tended to increase general symptoms (odds ratio OR for BMI = 1.16, 95 % confidence interval (95% CI): 0.97, 1.38, and OR for WC = 1.14, 95% CI: 0.99, 1.32). Higher BMI significantly increased cardiovascular (OR = 1.38, 95% CI: 1.14, 1.67) and respiratory symptoms (OR = 1.43, 95% CI: 1.15, 1.78). Compared with patients with normal WC, the risk of cardiovascular (OR = 1.44, 95% CI: 1.24, 1.69) and respiratory symptoms was significantly higher in subjects with abdominal obesity (OR = 1.31, 95% CI: 1.10, 1.56). We found that general and abdominal obesity were associated with increased risk of cardiovascular and respiratory symptoms in patients with long-COVID symptoms. However, only general obesity was associated with increased risk of general symptoms
The association of the Prime Diet Quality Score (PDQS) with depression and anxiety symptoms: the Isfahan functional disorders (ISFUN) cohort study
No full textBACKGROUND: Due to scarce epidemiologic data regarding the Prime Diet Quality Score (PDQS) and mental health disorders, this study aimed to investigate the association of PDQS with depression and anxiety symptoms in Iranian adults. METHODS: This cross-sectional analysis was performed using the baseline data collected for the Isfahan functional disorders (ISFUN) cohort study. ISFUN was established in 2017 and enrolled apparently healthy adults, aged 18-65 years in Isfahan, Iran. Information on usual dietary intakes was collected using a validated Dish-based, 106-item food frequency questionnaire. The severity of depression and anxiety was assessed using a validated Iranian version of the Hospital Anxiety and Depression Scale. RESULTS: A total number of1892 participants were enrolled in the present study. In total, 54.50 of subjects were female. In the fully adjusted model, participants with PDQS lower than median compared with those with PDQS higher than median had higher risk of depression (OR = 1.62; 95 CI: 1.11, 2.37) and anxiety (OR: 1.57; 95 CI: 1.08, 2.27). In stratified analysis by sex, males with PDQS lower than median compared with those with PDQS higher than median had greater risk for depressive (OR: 1.57) and anxiety symptoms (OR = 1.52). However, in females, no significant association was found between PDQS and odds of depression, and anxiety in the fully adjusted model. CONCLUSION: We found evidence indicating a significant inverse association between PDQS and depression and anxiety symptoms among Iranian adults. Further studies, in particular with prospective design, are required to confirm these findings