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Showing papers by "Tehran University of Medical Sciences published in 2008"


Journal ArticleDOI
TL;DR: The high prevalence of diabetes in working-age adults in Iran is an ominous sign for this developing nation, as the relatively young Iranian population ages in the future and urbanization continues or accelerates, the prevalence of Diabetes will likely escalate.
Abstract: OBJECTIVE —Despite concerns regarding a diabetes epidemic in the Middle East, internationally published data on national estimates of prevalent type 2 diabetes in Iran do not exist. With this article, we document a dramatically high prevalence of diabetes in Iran. RESEARCH DESIGN AND METHODS —Our data are based on the results of the first Survey of Risk Factors of Non-Communicable Diseases of Iran, 2005. In this national cross-sectional survey, 70,981 Iranian citizens aged 25–64 years were recruited. RESULTS —We found that 7.7% of adults aged 25–64 years, or 2 million adults, have diabetes, among whom one-half are undiagnosed. An additional 16.8%, or 4.4 million, of Iranian adults have impaired fasting glucose. CONCLUSIONS —The high prevalence of diabetes in working-age adults is an ominous sign for this developing nation. As the relatively young Iranian population ages in the future and urbanization continues or accelerates, the prevalence of diabetes will likely escalate.

401 citations


Journal ArticleDOI
TL;DR: The findings indicated that the women awareness of breast cancer warning signs and effective screening methods i.e. clinical examination, and mammography were very inadequate and health education programmes to rectify the lack of women awareness is urgently needed.
Abstract: Breast cancer remains an important public health problem. This study aimed to investigate about female knowledge of breast cancer and self-reported practice of breast self-examination in Iran. This was a population-based survey carried out in Tehran, Iran. Data were collected via a structured questionnaire containing 15 questions on demographic status, history of personal and family breast problems, subjective knowledge about breast cancer covering its symptoms, the screening methods and practice of breast self-examination (BSE). A trained female nurse interviewed each respondent. Analysis included descriptive statistics and the Chi-squared test where necessary. A total of 1402 women were interviewed. The mean age of respondents was 43.4 (SD = 14.4) years; most were married (85%), and without any personal (94%) and family history (90%) of breast problems. It was found that 64% of the respondents were familiar with breast cancer and 61% (n = 851) believed that 'the disease is relatively common among women in Iran'. Most women (44%) perceived a painless mass as a breast cancer symptom. Overall, 61% of the respondents stated that they knew about breast cancer screening programs and most indicated that electronic media (television 34% and radio 14%) were their source of information. Only 17% of women said that 'they were conducting regular breast self-examination'. The main reason for women not doing breast self-examination was due to the fact that they did not know how to do it (64%). The findings indicated that performing breast self-examination is significantly related to: age, marital status, education, knowledge of breast cancer and knowledge about breast cancer screening programs (p < 0.05), but not to personal (P = 0.2) and family (P = 0.7) history of breast problems. This descriptive study provides useful information that could be utilized by both researchers and those involved in public health programmes. The findings indicated that the women awareness of breast cancer warning signs (painless lump, retraction of nipple, and bloody discharge) and effective screening methods i.e. clinical examination, and mammography were very inadequate. Thus, health education programmes to rectify the lack of women awareness is urgently needed. Indeed the focus of primary health care providers should be to raise awareness about breast care among women and to encourage them to report any unusual changes in their breasts to their family or care physicians.

313 citations


Journal ArticleDOI
TL;DR: The study findings indicate that elderly people living in Tehran, Iran suffer from relatively poor HRQoL; particularly elderly women and those with lower education.
Abstract: As Iran started to experience population ageing, it is important to consider and address the elderly people's needs and concerns, which might have direct impacts on their well-being and quality of life. There have been only a few researches into different aspects of life of the elderly population in Iran including their health-related quality of life. The purpose of this study was to measure health-related quality of life (HRQoL) of elderly Iranians and to identify its some determinant factors. This was a cross-sectional survey of a random sample of community residents of Tehran aged 65 years old and over. HRQoL was measured using the Short From Health Survey (SF-36). The study participants were interviewed at their homes. Uni-variate analysis was performed for group comparison and logistic regression analysis conducted to predict quality of life determinants. In all, 400 elderly Iranian were interviewed. The majority of the participants were men (56.5%) and almost half of the participants were illiterate (n = 199, 49.8%). Eighty-five percent of the elderly were living with their family or relatives and about 70% were married. Only 12% of participants evaluated their economic status as being good and most of people had moderate or poor economic status. The mean scores for the SF-36 subscales ranged from 70.0 (SD = 25.9) for physical functioning to 53.5 (SD = 29.1) for bodily pain and in general, the respondents significantly showed better condition on mental component of the SF-36 than its physical component (mean scores 63.8 versus 55.0). Performing uni-variate analysis we found that women reported significantly poorer HRQoL. Multiple logistic regression analysis showed that for the physical component summary score of the SF-36, age, gender, education and economic status were significant determinants of poorer physical health-related quality of life; while for the mental component summary score only gender and economic status were significant determinants of poorer mental health-related quality of life. The analysis suggested that the elderly people's economic status was the most significant predictor of their HRQoL. The study findings, although with a small number of participants, indicate that elderly people living in Tehran, Iran suffer from relatively poor HRQoL; particularly elderly women and those with lower education. Indeed to improve quality of life among elderly Iranians much more attention should be paid to all aspects of their life including their health, and economic status.

286 citations


Journal ArticleDOI
TL;DR: This study investigates the relation between 25‐hydroxyvitamin D concentrations and insulin resistance in pregnant women and concludes that 1,25‐dihydroxyv vitamin D has a role in the regulation of insulin secretion.
Abstract: Background The serum level of 25-hydroxyvitamin D deficiency has long been suspected as a risk factor for glucose intolerance and perhaps 1,25-dihydroxyvitamin D has a role in the regulation of insulin secretion. This study investigates the relation between 25-hydroxyvitamin D concentrations and insulin resistance in pregnant women. Methods A cross-sectional study was conducted on 741 pregnant women referred to five educating hospital clinics. Universal screening was performed with a GCT-50 g, and those with plasma glucose levels ≥ 7.2 mmol/L were diagnosed as GDM if they had an impaired GTT-100 g based on Carpenter and Coustan criteria. The levels of insulin and C-peptide were measured during OGTT-100 g test. The homeostasis model assessment index (HOMA) equation was used as the insulin resistance index. The concentrations of 25-hydroxyvitamin D, and PTH were also measured. Results Total prevalence of vitamin D deficiency (<25 nmol/L) was found in 70.6% of pregnant women. Prevalence of severe vitamin D deficiency (<12.5) in GDM patients was higher than in normoglycaemic pregnancies. The regression model revealed a strong correlation between the HOMA index and serum levels of vitamin D. Conclusions These results show that a positive correlation of 25(OH) vitamin D concentrations with insulin sensitivity and vitamin D deficiency could be a confirmative sign of insulin resistance. Copyright © 2007 John Wiley & Sons, Ltd.

266 citations


Journal Article
TL;DR: The large urban COPCORD study in Iran showed a high prevalence of rheumatic complaints in the population over the age of 15 years, 41.9%.
Abstract: ### Objective To find the prevalence of musculoskeletal complaints and rheumatic disorders in Iran. ### Methods Tehran, with one-ninth of the population of Iran and of mixed ethnic origins, was selected as the field. Subjects were randomly selected from the 22 districts. Interviews were conducted once a week, on the weekend. The 3 phases of stage 1 were done on the same day, in parallel, like the fast-track Community Oriented Program for Control of Rheumatic Diseases (COPCORD). ### Results Four thousand ninety-six houses were visited and 10,291 persons were interviewed. Musculoskeletal complaints during the past 7 days were detected in 41.9% of the interviewed subjects. The distribution was: shoulder 14.5%, wrist 10%, hands and fingers 9.4%, hip 7.1%, knee 25.5%, ankle 9.8%, toes 6.1%, cervical spine 13.4%, and dorsal and lumbar spine 21.7%. Degenerative joint diseases were detected in 16.6% of subjects: cervical spondylosis 1.8%, knee osteoarthritis (OA) 15.3%, hand OA 2.9%, and hip OA 0.32%. Low back pain was detected in 15.4% and soft tissue rheumatism in 4.6%. Inflammatory disorders were rheumatoid arthritis 0.33%, seronegative spondyloarthropathies 0.23%, ankylosing spondylitis 0.12%, systemic lupus erythematosus 0.04%, and Behcet’s disease 0.08%. Fibromyalgia was detected in 0.69% and gout in 0.13% of the studied population. ### Conclusion The large urban COPCORD study in Iran showed a high prevalence of rheumatic complaints in the population over the age of 15 years, 41.9%. Knee OA and low back pain were the most frequent complaints.

259 citations


Journal Article
TL;DR: The author’s email address is : h.kaviani@usa.edu.com.
Abstract: نفلت : 4 55419151 email: h.kaviani@usa.com فده و هنيمز : همانشسرپ يياياپ و يياور شجنس فده اب قيقحت نيا شجنـس بارطـضا BAI تـيعمج رد كـب و راـميب راميبريغ دش ماجنا يناريا . يسررب شور : نومزآ زا سپ نارگ رذگ ود ندنا يشزومآ هر انرب م ه هدش يزير ، ناـنيمطا زا سـپ و اهنآ يگدامآ زا ، دـندرك هـعجارم لزاـنم هب ،رهش فلتخم قطانم يارب هدش نييعت يسنج و ينس لوادج ساسا رب . نـيا هـب ،بيترت 1513 هورگ رد درم و نز رفن ينس ياه يسنج نارـهت فلتخم يفداصـت روـط هـب هـشوخ يا نوـمزآ BAI رـپ ار ندومن د . نينچمه 261 هعجارم يبارطضا راميب هاگنامرد هب هدننك دنتشاد تكرش هعلاطم رد ينامرد زكارم و اه . ت يراـمآ ليلح ب اب ه يربگراك SPSS تساريو 14 ب يارب ه و ينورد يگنهامه بيرض ندروآ تسد متـيآ ليلحت تـفرگ تروـص اـه . يارـب هب نومزآ يياياپ بيرض ندروآ تسد ،نومزآزاب 112 زا رفن يندومزآ ياه لابق نومزآ هدش راـجنهب تـيعمج زا ةلـصاف رد هلحرم زا هام كي ينامز لوا نومزآ ليمكت هب اددجم تخادرپ اه دن . هب يارب نينچمه يـئاور بيرـض ندروآ تسد Validity ، 150 زا رفن ناراميب ينيلاب بارطضا هب لاتبم تفرگ رارق ينيلاب هبحاصم دروم دن و بايزرا ود يزاوم روط هب كـي ساـسا رب هجرد يمك يدنب 10 0 دندرك يبايزرا ار درف بارطضا نازيم . هب تارمن هب تبسن بايزرا ود زا هدمآ تسد BAI يـب علاـطا دندوب . هتفاي اه : يياور ياراد رظن دروم نومزآ ناشن جياتن ) 001 p< ، 72 / 0 r= ( يياياپ ، ) 001 / 0 p< ، 83 / 0 r= ( يـنورد تابث و ) 92 / 0 Alpha= ( تسا يبسانم . يتن هج يريگ : دتم و هنومن يگدرتسگ هب هجوت اب و ،هدش هتفرگ راك هب يژول هخسن ،عومجم رد يسراف BAI يبايزرا بسانم ريا تيعمج رد يشهوژپ و ينيلاب ياه ا تسا ين . ،يسراف مرف رد نومزآ نيا نتفرگ تسد رد اب يم ناققحم شهوژپ رد ار نآ يرتشيب نانيمطا اب دنناوت دنريگ راك هب دوخ ياه . و يباـيزرا راـك رد اـهنت هـن ،همانشسرپ نيا كمك صيخشت ناسر تسا ، مه هكلب يم نينچ يبايزرا رد دناوت دشاب اشگراك نامرد يشخبرثا شجنس و ينامرد ياه .

237 citations


Journal ArticleDOI
TL;DR: The results suggest that linkage in the pedigree may have been missed had the chips containing less than 100,000 SNPs across the genome been used, and the possible value of interrogating SNPs at higher densities has been considered.
Abstract: Robust SNP genotyping technologies and data analysis programs have encouraged researchers in recent years to use SNPs for linkage studies. Platforms used to date have been 10 K chip arrays, but the possible value of interrogating SNPs at higher densities has been considered. Here, we present a genome-wide linkage analysis by means of a 500 K SNP platform. The analysis was done on a large pedigree affected with Parkinsonian-pyramidal syndrome (PPS), and the results showed linkage to chromosome 22. Sequencing of candidate genes revealed a disease-associated homozygous variation (R378G) in FBXO7. FBXO7 codes for a member of the F-box family of proteins, all of which may have a role in the ubiquitin-proteosome protein-degradation pathway. This pathway has been implicated in various neurodegenerative diseases, and identification of FBXO7 as the causative gene of PPS is expected to shed new light on its role. The performance of the array was assessed and systematic analysis of effects of SNP density reduction was performed with the real experimental data. Our results suggest that linkage in our pedigree may have been missed had we used chips containing less than 100,000 SNPs across the genome.

232 citations


Journal ArticleDOI
TL;DR: The results showed that nanoparticles prepared by the PEC method had higher insulin loading efficiency and zeta potential than those made by the ionotropic gelation method and may subsequently be used for further in vitro, ex vivo and in vivo studies.

225 citations


Journal ArticleDOI
TL;DR: The results of the paper indicate that hospital employees are moderately satisfied with their jobs and committed to their organization, and job satisfaction and organizational commitment were closely inter-related and correlated with turnover intention.
Abstract: The purpose of this descriptive, co-relational and cross-sectional study was to gain a better understanding of the relationships between job satisfaction and organizational commitment of employees, and their impact on turnover intention at Isfahan Hospitals, Isfahan, Iran, in 2005. Data were collected by the distribution of two questionnaires among 629 employees of these hospitals through a stratified random sampling method. The results of the paper indicate that hospital employees are moderately satisfied with their jobs and committed to their organization. Employees’ job satisfaction and organizational commitment were closely inter-related and correlated with turnover intention (P , 0.001). The positive correlation between the two was expected, but there was also unexpected correlation with turnover intention. This may be due to external factors, such as job market conditions, which may influence perceived opportunities for career advancement elsewhere. The impact of such external factors is outside the scope of this study, but will have to be investigated in further research. As job satisfaction and organizational commitment have strong correlation with turnover, it is very important to reinforce them by applying the right human resource policies.

222 citations


Journal ArticleDOI
TL;DR: Some preliminary evidence of the reliability and validity of the WHOQOL-BREF to be used in Iran is provided, though further research is required to challenge the problems of reliability in one of the dimensions and the instrument's factor structure.
Abstract: The objective of the current study was to translate and validate the Iranian version of the WHOQOL-BREF. A forward-backward translation procedure was followed to develop the Iranian version of the questionnaire. A stratified random sample of individuals aged 18 and over completed the questionnaire in Tehran, Iran. Psychometric properties of the instrument including reliability (internal consistency, and test-retest analysis), validity (known groups' comparison and convergent validity), and items' correlation with their hypothesized domains were assessed. In all 1164 individuals entered into the study. The mean age of the participants was 36.6 (SD = 13.2) years, and the mean years of their formal education was 10.7 (SD = 4.4). In general the questionnaire received well and all domains met the minimum reliability standards (Cronbach's alpha and intra-class correlation > 0.7), except for social relationships (alpha = 0.55). Performing known groups' comparison analysis, the results indicated that the questionnaire discriminated well between subgroups of the study samples differing in their health status. Since the WHOQOL-BREF demonstrated statistically significant correlation with the Iranian version of the SF-36 as expected, the convergent validity of the questionnaire was found to be desirable. Correlation matrix also showed satisfactory results in all domains except for social relationships. This study has provided some preliminary evidence of the reliability and validity of the WHOQOL-BREF to be used in Iran, though further research is required to challenge the problems of reliability in one of the dimensions and the instrument's factor structure.

212 citations


Journal ArticleDOI
TL;DR: Nausea, vomiting, Central Nervous System (CNS) depression, tachycardia, and seizure are the most common findings in this kind of poisoning, and cardiopulmonary arrest was found as the cause of death in cases who had ingested more than 5000 mg tramadol.
Abstract: Tramadol as a centrally acting analgesic is extensively used in the management of moderate to severe pain. It slightly affects opioid receptors and inhibits the reuptake of norepinephrin and serotonin in the CNS. There are reports about toxicity and abuse of tramadol. The objective of the present study was to evaluate epidemiology of intentional tramadol intoxications. All poisoning cases that admitted to Loghman-Hakim Hospital Poison Center from April to May 2007 were studied. A total of 114 cases (82 men and 32 women) of intentional tramadol intoxications with the median age of 23.66 +/- 6.87 years (range 16-54 years) were identified. Other illicit drugs were found to be used in combination with tramadol in some of the cases, which among them benzodiazepines were the most common. Tramadol overdose has been one of the most frequent causes of drug poisoning in the country in the recent years, especially in male young adults with history of substance abuse and mental disorders. Nausea, vomiting, Central Nervous System (CNS) depression, tachycardia, and seizure are the most common findings in this kind of poisoning. Cardiopulmonary arrest was found as the cause of death in cases who had ingested more than 5000 mg tramadol.

Journal ArticleDOI
TL;DR: In the present 8 week trial EPA and fluoxetine had equal therapeutic effects in major depressive disorder, and the EPA + fluoxettine combination was superior to either of them alone.
Abstract: Objective: To compare therapeutic effects of eicosapentaenoic acid (EPA), fluoxetine and a combination of them in major depression.Method: Sixty outpatients with a diagnosis of major depressive disorder based on DSM-IV criteria and a score ≥15 in the 17-item Hamilton Depression Rating Scale (HDRS) were randomly allocated to receive daily either 1000 mg EPA or 20 mg fluoxetine, or their combination for 8 weeks. Double dummy technique was used to double blind the study. Patients were assessed at 2 week intervals. Change in HDRS was the primary outcome measure.Results: Analysis of covariance for HDRS at week 8 across treatment groups was performed in 48 patients who completed at least 4 weeks of the study, with the last observation carried forward. Treatment, age of onset and baseline HDRS had a significant effect on HDRS at week 8. EPA + fluoxetine combination was significantly better than fluoxetine or EPA alone from the fourth week of treatment. Fluoxetine and EPA appear to be equally effective in control...

Journal ArticleDOI
TL;DR: This meta-analysis suggest that there is no more than an 1.16-fold increase in congenital malformations, an 2.38- fold increase in stillbirth, a 1.14-foldincrease in spontaneous abortion, an1.35-fold increases in preterm delivery, and an 0.93-fold rise in low birth weight.

Journal ArticleDOI
TL;DR: Gene expression analysis reverse transcription‐polymerase chain reaction of ROR1 revealed that all patients with CLL spontaneously expressed Ror1 mRNA whereas enriched blood B and T cells as well as granulocytes from healthy donors were negative, while normal blood leukocytes were negative.
Abstract: Gene profiling studies of patients with chronic lymphocytic leukemia (CLL) has revealed increased expression of Ror1, a cell surface receptor tyrosine kinase. The aim of present study was to analyze gene and protein expression of Ror1 in CLL cells and normal blood leukocytes. Gene expression analysis reverse transcriptionpolymerase chain reaction of ROR1 revealed that all patients with CLL (n 5 100) spontaneously expressed ROR1 mRNA whereas enriched blood B and T cells as well as granulocytes from healthy donors (n 5 10) were negative. A strong nonphysiological activation signal (PMA/ionomycin) was required to induce expression in vitro in normal lymphocytes. Major genomic aberrations (mutations or truncation) of ROR1 were not observed. Protein expression was analyzed by Western blot using a panel of polyclonal anti-Ror antibodies as well as flow cytometry. Blood lymphocytes from 18/18 CLL patients, but none of the 10 healthy donors, expressed surface Ror1. The majority of CLL cells exhibited Ror1 surface expression (71% mean; range 36–92%) with a mean fluorescence intensity (MFI) of 20 (range 10–45). The corresponding MFI of CD19 on CLL cells was 26 (range 9–48). There was no difference in the Ror1 protein expression comparing IgVH mutated and unmutated cases as well as progressive and nonprogressive CLL patients. Two different variants of the Ror1 protein, 105 and 130 kDa, were identified. The Ror1 protein expression in patients with CLL but not in normal leukocytes merits further studies of its role in the pathobiology of CLL, which may provide a basis for development of Ror1 directed targeted therapy. ' 2008 Wiley-Liss, Inc.

Journal ArticleDOI
TL;DR: Although there was no significant difference in frequency of consumption of the food groups in subjects with different BMI categories, various kinds of physical activities showed a steady decline with increasing BMI, the findings of the present study provide alarming evidence about the very high prevalence of generalised and abdominal obesity in Iran.
Abstract: Objective: To assess the national prevalence of overweight and obesity, as well as some associated lifestyle behaviours, for the first time in Iran. Design and Settings: This population-based study was performed in early 2005 as part of the World Health Organization (WHO) STEPwise approach to noncommunicable diseases’ risk factor surveillance. Dietary and physical activity habits were assessed by WHO questionnaires. Subjects: The study population comprised 89532 subjects aged over 15 years living in the 28 provinces of Iran. Results: Overall, 50.4% (n 545113) of the participants were male and 64.6% (n 557866) were from the urban areas. The national estimates of overweight, obesity and morbid obesity were 28.6%, 10.8% and 3.4%, respectively. Body mass index (BMI) $25kgm 22 in men, women, urban residents and rural residents were found in 37%, 48%, 46.7% and 35.5%, respectively. Abdominal obesity was present in 43.4% of women, 9.7% of men, 28.5% of the urban residents and 23% of the rural residents. Overweight as well as generalised and abdominal obesity were more prevalent in the 45‐64-year age group. Although there was no significant difference in frequency of consumption of the food groups in subjects with different BMI categories, various kinds of physical activities showed a steady decline with increasing BMI. Conclusions: The findings of the present study provide alarming evidence for health professionals and policy makers about the very high prevalence of generalised and abdominal obesity in Iran. The unhealthy lifestyle habits, notably sedentary lifestyles in our community, are the major contributing factors for this emerging public health problem.

Journal ArticleDOI
TL;DR: While free-soluble polymers can reversibly open the tight junctions and increase the permeation of insulin, the nanoparticles had basically only a low effect on the opening of the tight junction and the paracellular transport of insulin across the Caco-2 cell monolayer.

Journal ArticleDOI
TL;DR: The findings suggest that the addition of MSCs to bone derivative/substitute materials may enhance bone formation in the maxillary sinus area and suggest that sinus grafting with HA/TCP in combination with M SCs provide a viable therapeutic alternative for implant placement.
Abstract: Objective Implant placement in the posterior maxilla may often be contraindicated because of insufficient bone volume and presence of the maxillary sinus. In these situations, sinus floor augmentation frequently has been proposed as the best treatment. This clinical study was based on the hypothesis that the clinical effectiveness of adult mesenchymal stem cells (MSCs) loaded to the biphasic scaffold. Methods In this report, the clinical and radiographic results are presented on 6 consecutively treated patients using MSCs in combination with biphasic hydroxyl apatite/ β-tricalcium phosphate (HA/TCP) for sinus elevation. All the patients in the study had less than 3 mm initial bone height in the posterior maxillary area (IBH). MSCs were cultured and expanded from bone marrow aspirate for each patient. Three months after sinus elevation, radiographic evaluation was performed for the patients and the secondary bone height was measured (SBH 1 ). In the second stage surgery, 30 implants were placed. Trephine bur was used as a pilot drill and a core biopsy was obtained from each implant site. Prosthetic rehabilitation of the patients was performed after 4 months. Secondary bone height was measured 9 months after implant placement (SBH 2 ). Results Of 30 implants, 28 (93%) were considered clinically successful. Two implants were removed due to mobility at the time of surgical exposure. Histologic evaluation of the biopsy specimens revealed numerous areas of osteoid and bone formation HA/TCP, with no evidence of inflammatory cell infiltrate. Mean bone regenerate was 41.34%. Clinically, no complications were observed, and all implants were considered clinically osseointegrated after 4 months. Mean bone height was measured 3 and 12 months after sinus grafting (mean of SBH 1 = 12.08 mm and mean of SBH 2 = 10.08 mm). Conclusions These clinical and histological findings suggest that sinus grafting with HA/TCP in combination with MSCs provide a viable therapeutic alternative for implant placement. The findings suggest that the addition of MSCs to bone derivative/substitute materials may enhance bone formation in the maxillary sinus area. Of course more studies with the control groups are needed for the evaluation of this method as a clinical solution for the patients.

Journal ArticleDOI
TL;DR: This double‐blind and placebo‐controlled trial investigated whether saffron (stigma of Crocus sativus L.) could relieve symptoms of premenstrual syndrome (PMS).

Journal ArticleDOI
28 Aug 2008-Leukemia
TL;DR: The prognostic impact of chromosomal aberrations of the MYC gene locus analyzed by interphase fluorescence in situ hybridization in 177 patients with de novo DLBCL treated within the two prospective, randomized trials non-Hodgkin's lymphoma NHL-B1 and NHL- B2 was investigated.
Abstract: Recent retrospective studies of heterogeneously treated patients have suggested that chromosomal aberrations of the MYC gene locus indicate an unfavorable prognosis in diffuse large B-cell lymphoma (DLBCL). Here, we investigated the prognostic impact of MYC aberrations analyzed by interphase fluorescence in situ hybridization in 177 patients with de novo DLBCL treated within the two prospective, randomized trials non-Hodgkin's lymphoma NHL-B1 and NHL-B2. MYC aberrations were detected in 14 DLBCL (7.9%). In a univariate analysis compared with MYC-negative DLBCL, MYC-positive cases showed a significantly shorter overall survival (OS) (P=0.047) and relevantly, though not significantly, shorter event-free survival (EFS) (P=0.062). In a Cox model adjusted for the international prognostic index, the presence of a MYC gene rearrangement was the strongest statistically independent predictor of OS (relative risk 3.4, P=0.004) and EFS (relative risk 2.5, P=0.015), and this also held true when the cell-of-origin signature detected by immunohistochemistry was included in the model.

Journal ArticleDOI
TL;DR: It is concluded that CP-induced toxic effects on androgenesis and spermatogenesis is mediated by free radicals and SKEO protects reproductive system from toxicity of CP through its antioxidant potential and androgenic activity.
Abstract: Cyclophosphamide (CP) as an anticancer alkylating agent has been known as a male reproductive tract toxicant. The aim of this study was to examine whether Satureja khuzestanica essential oil (SKEO) as an established herbal antioxidant, might protect tract rat reproductive system from toxicity of CP. To reach this aim, total antioxidant power (TAP) and lipid peroxidation (LPO) in testis and plasma, blood levels of sex hormones, sperm characteristics, DNA integrity and chromatin quality, and fertility in male rats were tested. Histopathological analysis of testes and epididymides and staining of mast cells were performed for assessment of spermatogenic disorders. CP (6 mg/kg/day) and SKEO (225 mg/kg/day) were administered alone or in combination by gavage for 28 days. In the CP-exposed rats, testicular and plasma LPO increased, TAP decreased, plasma testosterone diminished, and both spermatogenesis and fertility were impaired. In CP-treated rats, a decrease in sperm quality was associated with increased DNA damage and decreased chromatin quality. Coadministration of SKEO significantly improved CP-induced changes in plasma testosterone, sperm quality, spermatogenesis and fertility, toxic stress, and DNA damage. It is concluded that CP-induced toxic effects on androgenesis and spermatogenesis is mediated by free radicals. SKEO protects reproductive system from toxicity of CP through its antioxidant potential and androgenic activity.

Journal ArticleDOI
TL;DR: This meta-analysis fails to demonstrate the efficacy of probiotics in maintaining remission and preventing clinical and endoscopic recurrence in CD, and it is suggested to use probiotic preparations containing a mixture of lactobacillus with E. coli or Saccharomyces.
Abstract: Objective To evaluate whether probiotics maintain remission in patients with Crohn’s disease (CD). Design A meta-analysis of controlled clinical trials. Methods PUBMED and Cochrane Central Register of Controlled Trials were searched for clinical trial studies investigated the efficacy of probiotics for the maintenance of remission in Crohn’s disease. Clinical relapse and endoscopic relapse were the key outcomes of interest. Data were searched within the time period of 1966 through may 2007. Result Eight randomized placebo-controlled clinical trials met our criteria and were included in the analysis. Seven determined clinical relapse and three evaluated endoscopic relapse among patients with CD received probiotics for maintenance of remission. Pooling of seven trials for the outcome of clinical relapse yielded an odds ratio of 0.92 (95% confidence interval of 0.52–1.62, P = 0.8853), a nonsignificant odds ratio. The odds ratio for three studies for the outcome of endoscopic relapse was 0.97 (95% confidence interval of 0.54–1.78, P = 0.93), a nonsignificant odds ratio. Conclusion This meta-analysis fails to demonstrate the efficacy of probiotics in maintaining remission and preventing clinical and endoscopic recurrence in CD. It is suggested to use probiotic preparations containing a mixture of lactobacillus with E. coli or Saccharomyces.

Journal ArticleDOI
TL;DR: The agreement obtained with the MAS was not good, which questions the validity of the measurements, and the Modified Ashworth Scale had moderate reliability.
Abstract: The Modified Ashworth Scale (MAS) is a clinical scale used to assess muscle spasticity. While the evidence indicates that the reliability of the MAS is better in the upper limb and in certain distal muscle groups, no investigation has compared the effect of limbs and muscle groups on the MAS reliability. This study aimed to evaluate the effect of limb and muscle group on the reliability of the MAS in patients with spastic hemiplegia. Thirty subjects with upper and lower limb muscle spasticity were recruited for this trial. Two female experienced physiotherapists participated in this examination of reliability, and rated each patient in a randomized order in a single session. For the intrarater reliability, the second rater repeated the test 1 week later. Shoulder adductor, elbow flexor, wrist flexor, hip adductor, knee extensor, and ankle plantar flexor were tested on the hemiplegic side. Results demonstrated moderate inter (kappa=0.514, SE=0.046, p < 0.001) and intrarater (kappa=0.590, SE=0.051, p<0.001) reliability. For the inter and intrarater reliability, the agreement obtained for the upper and lower limb was similar. In the upper limb, the agreement between raters on the distal wrist flexor was significantly higher than the agreement on the proximal shoulder adductor. In the lower limb, there was a similar agreement between raters on the distal ankle plantar flexor and proximal hip adductor. For within rater, the agreement on the proximal and distal muscles of both limbs was not statistically significant. The Modified Ashworth Scale had moderate reliability. The limbs had no effect on the reliability. The agreement on distal wrist flexor in the upper limb was significantly higher between rater than in the proximal shoulder adductor. The agreement obtained with the MAS was not good, which questions the validity of the measurements.

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TL;DR: Key themes for the implementation of guidelines' prescribing recommendations in primary care are explored, including credibility of content, credibility of source, presentation, influential people, organisational factors, disease characteristics, and dissemination strategy.

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TL;DR: This preliminary report shows that autologous Schwann cell transplantation is generally safe for the selected number of SCI patients but it does not prove beneficial effects and further safety and outcome studies are recommended.

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TL;DR: The prevalence of hypertension and prehypertension is high, and the rates of awareness, treatment, and control are unacceptably low, underscore the urgent need to develop national strategies to improve prevention, detection, and treatment of hypertension in Iran.

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TL;DR: Whole body vibration training improved proprioception and balance in athletes with reconstructed ACL.
Abstract: Objective: To compare the effect of a whole body vibration training (WBVT) programme with a conventional training (CT) programme on knee proprioception and postural stability after anterior cruciate ligament (ACL) reconstruction. Methods: Twenty athletes with unilateral ACL reconstruction were randomly assigned to the WBVT or CT group; all participants received 12 sessions of WBVT or conventional training. Absolute error in joint repositioning for two target angles (30° and 60°) was measured with the Biodex dynamometer; bilateral dynamic postural stability (anteroposterior, mediolateral and overall stability indices) was measured with the Biodex Stability System pre-intervention and post-intervention. Results: The improvement in postural stability in the WBVT group was significantly greater than that in the CT group (p⩽0.05). The p values of the changing scores of open overall, open anteroposterior, open mediolateral, closed overall, closed anteroposterior and closed mediolateral stability indices were 0.002, 0.010, 0.0001, 0.001, 0.0001 and 0.046, respectively. In addition, there were significant differences in all averages of absolute angular error at 60° and 30° between the WBVT and CT groups in both knees (p = 0.001 in healthy knees and p = 0.001 and p = 0.0001 in reconstructed knees), apart from the healthy knees at the 30° target position, which was not significant (p = 0.131). Conclusions: Whole body vibration training improved proprioception and balance in athletes with reconstructed ACL.

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TL;DR: Three consecutive intravitreal injections of bevacizumab had a beneficial effect on refractory DME in terms of CMT reduction and BCVA improvement and addition of triamcinolone in the first injection seemed to induce earlier visual improvement.
Abstract: Purpose To evaluate the effect of three intravitreal injections of bevacizumab (IVB) alone or combined with triamcinolone (IVT) in the first injection for treatment of refractory diabetic macular edema (DME).

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TL;DR: Probiotics may improve symptoms of irritable bowel syndrome and can be used as supplement to standard therapy and could be used in combination with standard therapy.
Abstract: This study was designed to evaluate whether probiotics improve symptoms in patients with irritable bowel syndrome. PubMed, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials were searched for studies that investigated the efficacy of probiotics in the management of irritable bowel syndrome. Clinical improvement was the key outcome of interest. Data were searched within the time period of 1966 through September 2007. Eight randomized, placebo-controlled, clinical trials met our criteria and were included in the analysis. Pooling of eight trials for the outcome of clinical improvement yielded a significant relative risk of 1.22 (95 percent confidence interval, 1.07–1.4; P = 0.0042). Probiotics may improve symptoms of irritable bowel syndrome and can be used as supplement to standard therapy.

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TL;DR: Ex vivo investigations revealed better insulin transport across the colon membrane of rats for nanoparticles made with quaternized derivatives than those made of chitosan, and enhanced colon absorption of insulin by using these nanoparticles compared to free insulin in diabetic rats.

Journal Article
TL;DR: The role of ROS in immunopathogenesis of Rheumatoid arthritis is clarified and it is shown that oxygen radicals might also be important in controlling disease severity and reducing joint inflammation and connective tissue damage.
Abstract: Rheumatoid arthritis is a disease associated with painful joints that affects approximately 1% of the population worldwide, and for which no effective cure is available. It is characterized by chronic joint inflammation and variable degrees of bone and cartilage erosion. Oxygen metabolism has an important role in the pathogenesis of rheumatoid arthritis. Reactive oxygen species (ROS) are produced in many normal and abnormal processes in humans, including atheroma, asthma, joint diseases, aging, and cancer. TNF-α overproduction is thought to be the main contributor to increased ROS release in patients with RA. Increased ROS production leads to tissue damage associated with inflammation. The prevailing hypothesis that ROS promote inflammation was recently challenged when polymorphisms in Neutrophil cytosolic factor 1(Ncf1), that decrease oxidative burst, were shown to increase disease severity in mouse and rat arthritis models. It has been shown that oxygen radicals might also be important in controlling disease severity and reducing joint inflammation and connective tissue damage. In this review article, our aim is to clarify the role of ROS in immunopathogenesis of Rheumatoid arthritis.