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Associations between dietary patterns and the incidence of cardiovascular events in women with breast cancer: A cohort study
No full textBackground: Breast cancer survivors face an increased risk of post-diagnostic comorbidities, particularly cardiovascular disease (CVD). Objectives: This study aims to evaluate the association between dietary patterns and the risk of CVD events during a one-year follow-up period in women with breast cancer. Methods: A prospective cohort study was conducted involving 387 women with breast cancer who were referred to the Isfahan Cardio-Oncology Clinic between February 2021 and October 2022. Dietary intake was assessed at baseline using a Food Frequency Questionnaire (FFQ), and key dietary patterns were identified through exploratory factor analysis. Participants were followed for one year, during which any new cardiac dysfunction was classified as a CVD event. To analyze the association between dietary patterns and CVD events, generalized linear models (GLMs) with log-linear Poisson distribution (LPD) were employed, and incidence risk ratios (IRRs) were calculated. Results: The ages of participants at recruitment ranged from 26 to 87 years. During follow-up, 56 (14.47) and 14 (3.6) participants. experienced CVD events at six months and one year, respectively, with left ventricular systolic dysfunction being the most common event (41.47). Three primary dietary patterns were identified: Western diet, Mediterranean diet, and animal product-rich diet. No significant association was found between dietary patterns and CVD events. For instance, in the crude model, the IRRs for the second and third tertiles of the Mediterranean diet were 1.23 (95 CI: 0.71-2.1) and 0.78 (95 CI: 0.41-1.48), respectively. Conclusion: Over the one-year follow-up period, no significant association was observed between dietary patterns and CVD risk in women with breast cancer. However, the third tertile of the Mediterranean diet exhibited a lower IRR compared to other tertiles. Future studies with larger sample sizes or extended follow-up periods, as well as comparisons with non-cancer control groups, may be necessary to more accurately assess the impact of dietary habits on CVD outcomes in breast cancer survivors
Association between nutritional status, daily nutrition delivery and clinical outcomes of critically ill adult patients admitted to the intensive care unit: a protocol for Isfahan multicentre prospective observational cohort ICU study (the Isfahan-ICU study)
No full textIntroduction There is currently limited information regarding the association between the modified Nutrition Risk in Critically Ill (mNUTRIC) score, nutrition delivery and clinical outcomes in critically ill patients admitted to the intensive care unit (ICU) section. Methods and analysis The Isfahan-ICU study is a multicentre, prospective observational cohort study that will be conducted on critically ill adults treated in the trauma or medical ICU sections of six hospitals to investigate whether clinical outcomes, including length of ICU stay and 30-day survival, vary by the mNUTRIC score at admission or the 7-day nutrition delivery. This paper outlines the Isfahan-ICU study protocol approved by the ethics committee of Isfahan University of Medical Sciences, Iran. Patient confidentiality is ensured, and study results will be shared at conferences and in medical papers. Ethics and dissemination This study protocol was reviewed and approved by the ethics committee of the Isfahan University of Medical Sciences, Isfahan, Iran (IR.MUI.RESEARCH.REC.1401.184). The patient's identity will be considered confidential and will not be revealed or published under any circumstances; all provisions of laws governing personal data protection will be observed. Patient data recorded in the electronic survey will be documented pseudonymously using de-identified patient ID codes, and authorised staff at each participating site will have access to only their identifiable data. Results from the study will be disseminated at national and international conferences and in medical papers. Trial registration number Ethics committee of the Isfahan University of Medical Sciences, Isfahan, Iran (IR.MUI.RESEARCH.REC.1401.184)
Brain-Derived Neurotrophic Factor (BDNF) as a Potential Biomarker in Brain Glioma: A Systematic Review and Meta-Analysis
No full textBackgroundThis systematic review and meta-analysis evaluates peripheral and CNS BDNF levels in glioma patients.MethodsFollowing PRISMA guidelines, we systematically searched databases for studies measuring BDNF in glioma patients and controls. After screening and data extraction, we conducted quality assessment, meta-analysis, and meta-regression.ResultsEight studies were included. Meta-analysis showed significantly reduced plasma BDNF levels in glioma patients versus controls (SMD: -1.0026; 95 CI: -1.5284, -0.4769, p = 0.0002). High-grade gliomas had lower plasma BDNF (p = 0.0288). Tissue BDNF levels were higher in glioma patients (SMD: 1.9513; 95% CI: 0.7365, 3.1661, p = 0.0016) and correlated with tumor grade (p = 0.0122). Plasma BDNF levels negatively correlated with patient age (p = 0.0244) and positively with female percentage (p = 0.0007).ConclusionBDNF is a promising biomarker in glioma, showing significant changes in plasma and tissue levels correlating with tumor grade, patient age, and gender
Increasing and Alarming Prevalence of Trichophyton indotineae as the Primary Causal Agent of Skin Dermatophytosis in Iran
No full textBackgroundTrichophyton indotineae, formerly described as T. mentagrophytes rDNA-ITS genotype VIII, has recently been identified as a novel species within the T. mentagrophytes complex. It has rapidly replaced T. rubrum as the predominant dermatophyte. In this study, skin dermatophyte isolates collected from patients in Iran were sequence-analysed for species identification. Additionally, the current prevalence of T. indotineae was compared with data from the previous decade.MethodsA total of 194 dermatophyte isolates were collected from patients in four cities across Iran between July and December 2023, with 73 isolates of the T. mentagrophytes complex from the past decade also included. DNA was extracted from fresh colonies, and the internal transcribed spacer (ITS) 1-5.8S rDNA-ITS2 region was PCR-amplified and sequenced, followed by bioinformatic sequence analysis.ResultsOut of the 194 dermatophyte isolates, 132 samples (68.04) were identified as T. indotineae, followed by T. tonsurans (14.43), T. rubrum (7.22), Microsporum canis (4.64), T. interdigitale (3.61), T. mentagrophytes (1.55) and Arthroderma benhamiae (0.51). Sequence analysis of 73 isolates from the past decade showed T. indotineae as the most frequently identified species (43.83), followed by T. interdigitale (32.88), T. mentagrophytes (21.92) and Nannizzia fulva (1.37). These findings indicate an increasing prevalence of T. indotineae in Iran in recent years. We analysed 214 T. mentagrophytes/T. interdigitale isolates, identifying 164 as T. indotineae, including 26 with nucleotide variations. A phylogenetic tree highlighted the genetic diversity within the species complex.ConclusionThe alarmingly high prevalence of the potentially drug-resistant species T. indotineae signals the necessity of continuous surveillance of skin dermatophytosis in the community
Association between Mediterranean diet and metabolic health status among adults was not mediated through serum adropin levels
No full textBackgroundPrevalence of metabolic disorders has been increased in recent years around the world. The relationship between Mediterranean diet (MD) with metabolic health status and serum adropin levels has been less examined in Iranian adults. We investigated the association between MD compliance with metabolic health status and adropin hormone in Iranian adults.MethodsThis observational study was conducted on 527 men and women. Food intakes were evaluated by a validated food frequency questionnaire. Blood pressure and anthropometric parameters were measured. Fasting blood samples were drawn to measure serum adropin concentrations, blood glucose, triglycerides, high-density lipoprotein cholesterol, high sensitive C-reactive protein and insulin. Metabolic unhealthy (MU) status was defined as having >= 2 cardio-metabolic risk factors.ResultsAfter adjustments for potential confounders, subjects in highest versus lowest tertile of MD had 52 lower odds of MU status (OR = 0.48, 95CI: 0.23-0.97). Stratified analysis revealed a significant association in normal-weight participants (OR = 0.12; 95CI: 0.02-0.64), but not in those with overweight/obesity (OR = 0.66, 95CI: 0.27-1.57). By excluding each component of MD, the association disappeared, except for three components (vegetables, nuts and grains). MD adherence was not significantly related to serum adropin levels in multivariable-adjusted model (unstandardized B= -0.19, 95CI: -4.97, 4.59; P = 0.94). Serum adropin hormone levels were also not substantially different among metabolic healthy versus unhealthy subjects (P = 0.66).ConclusionsThis cross-sectional study showed an inverse association between adherence to MD and odds of MU status, especially in subjects with normal-weight. Serum adropin concentrations were not associated with MD adherence or metabolic health status
Impact of bariatric surgery on liver fibrosis indices among type 2 diabetes patients in a national cohort
No full textObesity is related to liver fibrosis, a condition marked by the collection of scar tissue in the liver due to the development of a profibrotic environment, which includes increased hepatocellular death and elevated reactive oxygen species production. The aim of study is to evaluate the effect of bariatric surgery on the association between liver fibrosis indices and obesity. This is a retrospective cohort, evaluating 1205 individuals diagnosed with type 2 diabetes (T2D) and living with obesity, who experienced bariatric surgery. These patients living with T2D and obesity were monitored after bariatric surgery for two years. The trajectory of biochemical markers and liver fibrosis indices were evaluated at five visits. These liver indices were Fibrosis-4 (FIB-4) index, aspartate aminotransferase (AST) to platelet ratio index, and non-alcoholic fatty liver disease (NAFLD) fibrosis score. FIB-4 index demonstrated notable trends based on its values. It showed an initial increase observed at the three-months visit, followed by a decline up to one year with a slight increase at the last follow-up (P-trend = 1.3 (pre-operation) did not exceed the value of 2.00, which is lower than the cut-off value of high risk for liver cirrhosis (FIB-4 >= 2.67). In addition, the NAFLD fibrosis score (NFS) demonstrated a substantial decline from - 0.32 +/- 1.32 pre-operation to -0.86 +/- 1.15 at the two-year mark (P-trend < 0.001). Finally, the AST to platelet ratio index (APRI) decreased from 0.27 +/- 0.20 pre-operation to 0.23 +/- 0.12 at the 12-month follow-up. Bariatric surgery significantly improves NFS and cause alterations in APRI and Fib-4 index levels without increasing the risk of liver cirrhosis development among patients with T2D and obesity
The trend of atherogenic indices in patients with type 2 diabetes after bariatric surgery: a national cohort study
No full textBackground: Bariatric surgery has profound effects on weight loss, metabolic regulation, and gut hormone modulation, which make it an efficient tool for managing obesity and improving diabetes outcomes. Objectives: The objective of this study is to evaluate the atherogenic indices, including atherogenic index of plasma (AIP), atherogenic coefficient (AC), Castelli's risk index II (CRI-II), and lipoprotein combine index (LCI) in individuals with type 2 diabetes (T2D) living with excess weight, who have undergone bariatric surgery. Setting: Three types of surgery including one-anastomosis gastric bypass/mini gastric bypass (OAGB/MGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) were performed on patients with obesity and T2D in the period of August 2009 to February 2021 at the Surgical Department of Hazrat-e Rasool Hospital (University Hospital), Tehran, Iran. Methods: In this retrospective cohort, 1246 individuals with obesity and T2D who underwent 3 types of bariatric surgery including RYGB, SG, and OAGB/MGB were studied for 2 years after the surgery; the data were derived from the National Iranian Obesity Surgery Database. Afterward, the trend of biochemical parameters, total weight loss (TWL), and atherogenesis-related indices were evaluated from baseline up to 2 years in 5 follow-up visits. Results: A total of 1246 patients with T2D and obesity who underwent bariatric surgery were included in this study. The trend of all atherogenesis-related indices, including AIP, LCI, CRI-II, and AC, showed a significant reduction (49.2, 53.4, 20.8, 22, respectively) 2 years after the bariatric surgery (P < .05). In the 6-month follow-up, 1-year follow-up, and 2-year follow-up, 1023 (83.10), 719 (57.70), and 341 (27.36) individuals participated, respectively. In addition, a significant increase in high-density lipoprotein cholesterol levels was observed 2 years after the surgery in both sexes (P <.05). Conclusions: The bariatric surgery significantly reduced the levels of atherogenic indices including AIP, CRI-II, LCI, and AC. (c) 2025 Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery
MRI-derived radiomics models for prediction of Ki-67 index status in meningioma: a systematic review and meta-analysis
No full textPurpose: The Ki-67 marker reflects tumor proliferation and correlates with meningioma prognosis. Here we aim to evaluate the performance of MRI-derived radiomics for Ki-67 index prediction in meningiomas. Methods: After a comprehensive search in Web of Science, PubMed, Embase, and Scopus, data extraction and risk of bias assessment was performed. Pooled sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR) were computed. The summary receiver operating characteristic (sROC) curve was generated and area under the curve (AUC) was calculated. Separate metaanalyses were conducted for radiomics models and combined models. Heterogeneity was evaluated using the I2 statistic, and subgroup analysis was performed to identify potential sources of heterogeneity. Sensitivity analysis was carried out to detect possible outliers. Results: Seven studies were included, with six studies analyzed for radiomics model and four for combined model. For radiomics model, the pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 67 , 82 , 8.61, 3.54, 0.43, and 0.79, respectively. For combined model, pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 78 , 78 , 12.19, 3.47, 0.30, and 0.79, respectively. Sensitivity analysis identified no outliers. In radiomics model, potential sources of heterogeneity included mean age and the application of N4ITK bias correction. For combined model, heterogeneity was influenced by mean age, application of N4ITK bias correction, and the use of external validation. Conclusion: Radiomics shows promising ability to predict the Ki-67 index status in meningioma patients, potentially enhancing clinical decision-making and management strategies
The association between consumption of dairy products and risk of type 2 diabetes
No full textBackgroundThe effects of dairy products on type 2 diabetes mellitus (T2DM) are unclear. Some studies have revealed the beneficial effects, whereas others found harmful effects of dairy products on the risk of T2DM. The objective of the present study was to investigate the association of different types of dairy products with risk of T2DM in Iranian adults.MethodsThis cross-sectional study included a total of 4241 individuals. Among these participants, 1804 were diagnosed with T2DM or prediabetes, whereas the remaining 2437 individuals were without T2DM. A validated food frequency questionnaire was used to assess the consumption of different types of dairy products.ResultsA positive association was found between T2DM with dietary intake of milk odds ratio (OR): 1.16, 95% confidence interval (CI): 1.11-1.23, P = 0.008 and cheese (OR: 1.90, 95% CI: 1.41-2.29, P = 0.001) after adjustment for age, sex, physical activity, BMI, education level, energy, and fat intake. There was no significant association between T2DM and dietary intake of total dairy, yogurt, ayran (yogurt drink), and curd.ConclusionA positive association was found between the consumption of some dairy products including milk and cheese and the risk of T2DM. Further longitudinal studies are warranted to approve this finding
The effect of a comprehensive intervention on anthropometric indices, dietary intake, and physical activity of adolescent boys with overweight
No full textBackground Non-communicable diseases in adulthood are reported to be strongly associated with adolescent obesity. The present study aimed to assess the effect of a comprehensive lifestyle modification intervention on the anthropometric indices, dietary intake, and physical activity of adolescent boys with overweight. Methods This pragmatic trial was conducted on 126 adolescent boys with overweight. A comprehensive school-based intervention was carried out at two levels for four months: at the school level based on the Ottawa Charter framework and at the personal level including individualized diet and physical activity. Results The percentage of mean difference of BMI and BF loss in the intervention group were 1.20 (P < 0.05) and 6.41 (P < 0.01), respectively. The intervention group had a lower intake of calorie (2350 +/- 861 vs. 2634 +/- 917 kcal/d), carbohydrate (255.68 +/- 41 vs. 286.97 + 47 g/d), and fat (112.67 +/- 78 vs. 217.72 +/- 86 g/d) after the intervention compared to the control group (All P < 0.05). The intervention resulted in a significant increase in physical activity parameters including distance (3501 +/- 287 vs. 614 +/- 56 m/d), duration (203 +/- 35 vs. 72 +/- 10 min/d), and calorie expenditure (359.24 +/- 62.4 vs. 46.74 +/- 7.5 kcal/d) in the intervention group compared to the control group (P < 0.01). Conclusion A comprehensive lifestyle modification intervention which covers both school and individual levels may positively influence BMI, body fat, calorie intake, and distance and duration of physical activity in adolescents. Thus, adopting multifaceted strategies using the Ottawa Charter framework may be considered as an effective approach to managing obesity in adolescents