Exploring the decision-making process of female genital cosmetic procedures in Iranian women and constructing and validating a results-based logic model for a healthy public policy: a study protocol

BACKGROUND

Female genital cosmetic procedures have grown rapidly in most parts of the world. Professional organizations have issued warnings about the complications and long-term consequences of these practices. To be able to adopt the right health policies, it is necessary to know why women decide to perform these procedures. Therefore, the present study will be aim to discover the decision-making process involved in performing female genital cosmetic procedures for Iranian women and construct and validate a results-based logic model for healthy public policy.

METHODS

The present study was conducted in three phases. In the initial phase, a qualitative study will be conducted with the Corbin and Strauss ground theory approach. The participants in the study will be healthy women who desire or have undergone female genital cosmetic procedures without medical indications. In this phase, purposive and theoretical sampling will guide recruitment and data collection. The data will be collected via semi-structured interviews, field notes and observations of individual interactions. The data will be analysed using the approach of Corbin and Strauss (2015). MAXQDA 2007 software was used for managing the process of data analysis. In the second phase, the development of a results-based logic model for a healthy public policy is performed based on the findings of the first phase of the study, interviews with key informants and a review of the results of the literature in this field. Finally, validation of the designed program will be performed by the nominal group technique with the presence of a group of experts in the third phase.

DISCUSSION

The findings of this study, by identifying women's main concerns related to the studied phenomenon, the existing context, participants' reactions and the consequences of the adopted reactions, can be very important in designing a program that fits Iran's cultural characteristics. In this research, a program using a logical model will be presented that is suitable for policymakers, planners and healthcare service providers to be implemented in the social-cultural context of the study.

Effectiveness of Family-oriented Education on Self-care behaviors of Patients with Acute Myocardial Infarction: A Randomized Clinical Trial

Background

Proper self-care practices play a crucial role in the well being and longevity of patients with cardiovascular disease. To effectively engage in self-care, it is imperative for patients to receive adequate education and training on the self-care process. This study was conducted to determine the effect of family-oriented education (FOE) on the self-care behaviors of patients with acute myocardial infarction (AMI).

Methods

In this randomized clinical trial study, 70 patients hospitalized in two hospitals in Shiraz during November 2021-April 2022 participated after the first AMI. Patients were randomly assigned into control (N=35) and intervention groups (N=35) based on random allocation. In the intervention group, an educational program was conducted for patients and active family members during three sessions of 45 to 60 minutes. The control group received routine care. Demographic information form and Self-Care Agency scale was completed by the patients before the educational intervention, one month, and two months after the educational intervention. Data analysis was done through SPSS 22 using Chi-square test, independent t-test, Fisher's exact, and Friedman test. P˂0.05 was considered as the statistical significance level.

Results

There was no significant difference in self-care behaviors between the two groups before the intervention (P=0.71). The mean score of self-care behaviors in patients one month (P<0.001) and two months (P<0.001) after FOE in the intervention group showed a statistically significant difference with the control group. Also, the mean score of self-care behaviors two months after the education in the intervention group was significantly higher than before and one month after the intervention (P<0.001).

Conclusion

Given the positive effect of FOE on self-care behaviors of patients with AMI, it is recommended that educational interventions related to the treatment plan of these patients with the participation of families should be conducted.Trial Registration Number: IRCT20211116053078N.

Gender Differences in the Impact of the Informal Economy on the Labor Market: Evidence From Middle Eastern Countries

Although considerable discussion has been devoted to the macro determinants of labor market variables across genders, comparatively little attention has been given to the contribution of the informal economy to this market. This study was aimed at empirically investigating the impact of the size of the shadow or informal economy (IE) on labor market variables across genders in 12 Middle Eastern countries. The study used quarterly time series data on each country under investigation, covering 1991 to 2015. Phillips-Perron unit root tests were carried out to verify the stationarity of the examined economic series. An autoregressive distributed lag approach was adopted to conduct cointegration tests and estimate long-run regression coefficients and error correction terms. The results indicated that the IE served men and women differently across countries. Whereas this economy had a long-run positive relationship with men's employment rates in Bahrain, Iran, Qatar, and Turkey, this relationship existed among women only in Israel. IE activities matter in the employment of men and women in Middle Eastern countries. The sizes of IEs in the labor market are a significant factor that favors men's employment rather than that of women.

P53 IHC Result as a Prognostic Tool in MDS

Background & Objective

Some of the patients with myelodysplastic syndrome (MDS) are categorized as good prognosis based on the Revised International Prognostic Scoring System (IPSS-R). However, these patients may have poor clinical outcomes. It seems that the current diagnostic tools and IPSS-R cannot consider genetic factors for determining the prognosis of MDS patients.

Methods

This cross-sectional study included all adult MDS patients of both genders who were admitted from March 2015 to March 2020 to the Hematology wards of two educational tertiary hospitals in Iran (Namazi and Faghihi, affiliated with Shiraz University of medical sciences). Study data included relevant retrospective data from medical records and the results of immunohistochemical p53 staining on bone marrow biopsies.

Results

Of the 84 patients, 65 (77.4%) showed p53 expression in bone marrow. They had shorter median survival than those without p53 expression. Considering both variables of P53 IHC results and IPSS-R score, the patients who died with low-risk IPSS-R score presented high p53 expression.

Conclusion

This study shows that the investigation of p53 expression by IHC at the time of diagnosis is a valuable indicator of survival rate in MDS patients. These data suggest that the immunohistochemical analysis of p53 can be a prognostic tool for MDS and should be used as an adjunct test to make decisions on the best therapeutic choice.

Antibacterial and antibiofilm activity of Lactobacillus strains secretome and extraction against Escherichia coli isolated from urinary tract infection

The purpose of this study was to antibacterial, and antibiofilm activity of two Lactobacillus strains secretome and extraction against E. coli isolated from women with urinary tract infection (UTI). We isolated 100 E. coli samples from women with UTI. Lactobacillus acidophilus and Lactobacillus casei characteristics were evaluated, and their secretome and extraction were prepared. The antibacterial and antibiofilm activity of secretome and extraction of both Lactobacillus strains were evaluated against isolated E. coli samples. L. acidophilus and L. casei were able to tolerate pH 3, bile salts, and pancreatic enzymes. Both probiotics were not resistant to antibiotics and demonstrated an appropriate ability to adhere to the intestinal epithelial cells. Secretome and extraction of L. acidophilus and L. casei strains showed a good antibacterial and antibiofilm against E. coli isolates. Generally, present study suggested that the secretome and extraction of L. acidophilus and L. casei strains exhibits a good antimicrobial activity.

Evaluation of CT Scan Diagnostic Value in the Novel Coronavirus Disease and Presenting a Corona CT Severity Index

BACKGROUND

Several diagnostic methods have been proposed and evaluated for the COVID-19 disease. However, the published studies have reported different diagnostic values for these methods.

AIMS

The present study aimed to evaluate the diagnostic performance and accuracy of CT in the novel corona virus disease (COVID-19) and to develop and present a Corona CT severity index.

METHODS

The CT diagnostic performance was measured based on sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy, and RT-PCR was regarded as a standard. Patients' CT reports were evaluated by a radiologist, and scoring and calculating of the CT severity index were performed.

RESULTS

Of 208 patients, 82 showed positive and 126 showed negative RT-PCR results with a positive frequency of 39.4% (95% CI, 32.7-46.4). The chest CT scan related to 136 patients indicated COVID-19, whereas their initial RT-PCR assays of 56 patients were negative. Considering RT-PCR results as reference standard, the sensitivity, specificity, and accuracy of chest CT to indicate COVID-19 infection was 100%, 55.6% (95% CI 46.4-64.4%), and 72.8% (95% CI 66.2-78.8%), respectively. The severity of pulmonary involvement was assigned with different grades. For 60.7% of patients with severity grades of 2 to 6, who showed the involvement of at least one lung lobe in CT, PCR retrieved negative results.

CONCLUSION

CT scan represents an appropriate sensitivity as well as a consistently higher specificity to diagnose COVID-19 pneumonia than PCR. It can be regarded as a primary tool to detect the current COVID-19 in epidemic regions.

Procalcitonin as a prognostic factor in patients with COVID-19 in southwestern Iran

BACKGROUND

There is increasing evidence supporting a central role of the viral-induced hyper-inflammatory immune response in the pathogenesis of COVID-19. Serum procalcitonin (PCT) is an emerging prognostic marker in coronavirus disease 2019 (COVID-19). The aim of this study was to investigate the relationship between serum procalcitonin and clinical severity and outcomes in patients with coronavirus disease 2019 (COVID-19).

MATERIALS AND METHODS

Hematological and biochemical parameters were evaluated in patients with COVID-19 infection from February to April 2020 at Hajar Hospital in the Shahrekord University of Medical Science, Shahrekord, Iran.

RESULTS

The results showed that total lymphocyte counts, albumin, calcium, and creatinine levels were significant different between the two moderate and severe groups, and the mean of procalcitonin level in COVID-19 patients with severe disease was higher (0.36 ng/mL) compared with the patients with moderate disease, and its level was found to be >5 ng/mL in 14.2% of5 ng/mL in 14.2% of patients in the former group.

CONCLUSIONS

PCT may be a marker of disease severity in COVID-19 and may contribute to determine the severity of patients infected with SARS-CoV-2. Moreover, serial PCT measurements may be beneficial in predicting the prognosis.

Identification of a compound heterozygous missense mutation in LAMA2 gene from a patient with merosin-deficient congenital muscular dystrophy type 1A

Background

Merosin‐deficient congenital muscular dystrophy type 1A (MDC1A) is occurred by mutations in LAMA2 gene that encodes the laminin α2 chain (merosin). MDC1A is a predominant subtype of congenital muscular dystrophy. Herein, we identified two missense mutations in LAMA2 gene in compound heterozygous status in an Iranian patient with MDC1A using whole‐exome sequencing (WES).

Methods

In the present study, we evaluated genetic alterations in an Iranian 35‐month‐old boy with MDC1A and his healthy family using WES method. The identified mutations further confirmed by Sanger sequencing method. Finally, in silico analysis was conducted to further evaluation of molecular function of the identified genetic variants.

Results

We identified two potentially pathogenic missense mutations in compound heterozygous state (c.7681G>A p.Gly2561Ser and c.4840A>G p.Asn1614Asp) in LAMA2 gene as contributing to the MDC1A phenotype. The healthy parents of our proband are single heterozygous for identified mutations. These variants were found to be pathogenic by in silico analysis.

Conclusions

In general, we successfully identified LAMA2 gene mutations in an Iranian patient with MDC1A using WES. The identified mutations in LAMA2 gene can be useful in genetic counseling, prenatal diagnosis, and predicting prognosis of MDC1A.

Melatonin increases the anticancer potential of doxorubicin in Caco-2 colorectal cancer cells

Colorectal cancer (CC) is an important human malignancy with high cancer related death worldwide. The chemotherapy using doxorubicin hydrochloride is one of the most common cancer therapeutic methods. However, drug resistance lowers the treatment efficacy in CC patients. The combination therapies seem to be more promising by taking the advantage of synergistic effects. The present study aimed to evaluate a new strategy to enhance the anticancer activity of doxorubicin in Caco-2 CC cell line by co-administration of melatonin. The effects of doxorubicin, melatonin, and their combinations (Dox-Mel) were investigated on the proliferation and viability, morphological alterations, and tumor spheroid formation. Flow cytometry was employed to compare the apoptotic situation of the cells in study groups. Changes in metastatic potential of the cells were assessed by wound healing assay and trans-well migration assays. Moreover, expression of BAX, SMAC, BCL-2, SURVIVIN, MMP-2, and MMP-9 genes were evaluated by quantitative real time PCR and western blotting. Our study showed that doxorubicin, melatonin, and Dox-Mel significantly decreased the proliferation and viability, tumor spheroid formation, invasion, and migration. Furthermore, the changes were in a concentration and time dependent manner. There was an increase in apoptosis rate in the treatment groups. Expression of genes involved in apoptosis and cell motility were altered significantly. It was observed that anticancer activity of Dox-Mel combination was significantly more than doxorubicin and melatonin treatments alone. We showed an enhanced apoptotic and anticancer activity of doxorubicin and melatonin combination chemotherapy on CC cell line than doxorubicin or melatonin treatments alone. This combination could promote the treatment efficiency and alleviate the un-intended side effects by lowering the dose of doxorubicin prescription.

Enhanced anticancer potency of hydroxytyrosol and curcumin by PLGA-PAA nano-encapsulation on PANC-1 pancreatic cancer cell line

Many chemotherapeutic regimens have been investigated for advanced unresectable and metastatic pancreatic cancer (PC), but with only minimal improvement in survival and prognosis. Here, we investigated anti-cancer function of free and nano-encapsulated hydroxytyrosol (Hyd) and curcumin (Cur), and its combinations (Hyd-Cur) on PANC-1 cell line. The poly lactide-co-glycolide-co-polyacrylic acid (PLGA-co-PAA) nano-encapsulated Hyd and Cur were synthesized, and MTT assay was performed to evaluate cytotoxic effects of free and nano-encapsulated Hyd, Cur, and Hyd-Cur. Effects of free and nano-encapsulated Hyd, Cur, and Hyd-Cur were evaluated on viability, migration, morphological alterations, colony formation, and apoptosis on PANC-1 cells. We observed that free and nano-encapsulated Hyd, Cur, and Hyd-Cur significantly increased apoptosis rates as well as significantly decreased viability, migration, and colony formation in PANC-1 cells. According to our results, Hyd-Cur combination and nano-encapsulation therapy exerts more profound apoptotic and anti-proliferative effects on PANC-1 cells than free Hyd or Hyd monotherapy.

Hypocalcemia in Covid-19: A Prognostic Marker for Severe Disease

BACKGROUND & OBJECTIVE

Previous studies have addressed the electrolyte abnormalities such as hypocalcemia in COVID-19 patients. We aimed to compare the laboratory findings especially the electrolyte levels among COVID-19 patients and healthy controls and evaluate their prognostic values.

METHODS

This case-control study included 91 COVID-19 patients and 169 healthy individuals. Their laboratory parameters including electrolytes, albumin, liver enzymes, complete blood count, vitamin D, and parathyroid hormone (PTH) were compared. We also analyzed the association between these markers and the major outcomes including severity, mortality and hospitalization.

RESULTS

Among patients with COVID-19, 59.3% of the patients had hypocalcemia on admission while in control group only 32.5% had low calcium level (OR=3.02, 95% CI: 1.79-5.13, P<0.001). The rates of death and ICU admission were significantly higher among the patients in hypocalcemic group than those of eucalcemic group (85.7% vs 14.3% and 33.3% Vs 9.1%, respectively). However, there was no significant difference in the mean PTH and vitamin D levels between the two groups. In terms of the severity of the infection, 74.1% of patients in hypocalcemic group had a severe infection while 24.3% of the patients in eucalcemic group were diagnosed with severe infection (OR=8.89, 95% CI: 3.38-23.37, P<0.001).

CONCLUSION

Patients with COVID-19 may present with considerable laboratory abnormalities including hypocalcemia. The hypocalcemia would be also associated with worse major clinical outcome and higher mortality risk.

Exposure to heavy metals and the risk of osteopenia or osteoporosis: a systematic review and meta-analysis

The relationship between heavy metal exposure and risk of osteopenia or osteoporosis has biological plausibility, yet it remains inconclusive; therefore, we conducted a systematic review and meta-analysis to evaluate the associations between exposure to heavy metals (i.e., cadmium, lead, and mercury) and the risk of osteopenia or osteoporosis. Databases of MEDLINE, Embase, Scopus, and Web of Science were searched through November 2019, to identify studies that evaluated the relationship between exposure to cadmium, lead, and mercury and risk of osteopenia or osteoporosis in adults. Fourteen eligible studies were included. Effect sizes expressed as pooled odds ratios (OR) and 95% confidence intervals (CI) were estimated using weighted random-effect models. Exposure to cadmium (OR = 1.35; 95% CI: 1.17 to 1.56; P ≤ 0.001) and lead (OR = 1.15; 95% CI: 1.00 to 1.32; P = 0.05) was associated with an increased risk of osteopenia or osteoporosis, unlike mercury. Subgroup analyses showed cadmium exposure increased the risk of osteopenia or osteoporosis in older (> 65 yrs.; OR = 1.43; 95%CI: 1.08 to 1.88, P = 0.01) compared with younger (18-65 yrs.; OR = 1.24; 95% CI: 1.02 to 1.52, P = 0.03) adults. Also, lead exposure increased the risk in men (OR = 1.55; 95% CI: 1.15 to 2.09, P = 0.007) unlike in women. By contrast to urinary levels, blood (OR = 1.26; 95% CI: 1.08 to 1.47, P = 0.003) and dietary (OR = 1.46; 95% CI: 1.28 to 1.67, P < 0.001) levels of cadmium were associated with an increased risk of osteopenia or osteoporosis. Exposure to cadmium and lead may be associated with an increased risk of osteopenia or osteoporosis, although high heterogeneity was detected.

Inhibition of Colorectal Cancer Cell Line CaCo-2 by Essential Oil of Eucalyptus camaldulensis Through Induction of Apoptosis

Treatment of colorectal cancer is one of the important challenges due to the increase of resistance to chemotherapeutic drugs. Isolated natural compounds from medicinal plants and other sources often are used as novel drugs for treatment of various human cancer. The aim of this study was to investigate the antioxidant and anticancer activity of Eucalyptus camaldulensis essential oil on colorectal cancer cell line Caco-2. The antioxidant activity of extracted E. camaldulensis essential oil (1000, 800, 400, 200, 100, 50, 25, 12.5, 6, and 3 μg/mL) was evaluated by free radicals inactivation method. Moreover, MTT assay was used to examine the cytotoxic effects of E. camaldulensis essential oil on the Caco-2 cell line. The mRNA expression of BAX and BCL-2 genes was studied using quantitative Real-Time PCR method, in treated cancer cells compared to untreated cells. We indicated a significant, impressive antioxidant activity in 1000 μg/mL of E. camaldulensis essential oil, in a concentration-dependent manner. In addition, we found that this product exerted a cytotoxic effect on cancer cells when 100 μg/mL concentration was considered as half-maximal inhibitory concentration (IC50). Also, the expression of BAX and BCL-2 genes were significantly upregulated and downregulated, respectively, in the treated Caco-2 cells with E. camaldulensis essential oil. In conclusion, our study showed significant antioxidant and anticancer activity in E. camaldulensis essential oil in a concentration and time-dependent manner, which may be due to the reduction of free radicals and induction of apoptosis process in colorectal cancer cells.

Enhanced anticancer potency of doxorubicin in combination with curcumin in gastric adenocarcinoma

Gastric cancer (GC) is one of the prevalent human malignancies and the third most common cause of cancer-related death worldwide. The doxorubicin hydrochloride is one of the important chemotherapeutic anticancer agents, with a limited therapeutic efficacy for treatment of GC. Therefore, taking advantage of synergistic effects by strategies like combination therapy seems appropriate and promising in treatment of GC. The aim of this study was to investigate a novel method to enhance the therapeutic efficacy of doxorubicin (as a chemotherapeutic agent) by co-administration of curcumin (as a bioactive herbal compound) in GC treatment. In the present study, the effects of curcumin, doxorubicin, and their combinations (Dox-Cur) were evaluated on the viability, morphological features, tumor spheroid formation, migration, invasion, and apoptosis of gastric adenocarcinoma cell line (AGS). Moreover, expression levels of BAX, BCL-2, and CASP9 genes were assessed among AGS cells treated with curcumin, doxorubicin, and Dox-Cur. The obtained results showed that all of curcumin, doxorubicin, and Dox-Cur treatments significantly decreased the viability, tumor spheroid formation, migration, and invasion in the GC model cells. Furthermore, apoptosis rates in AGS cells were increased in a concentration- and time-dependent manner in all of the treatment groups. Moreover, the anticancer activity of the Dox-Cur combination was significantly more than curcumin and doxorubicin treatments alone. According to the results, Dox-Cur combination therapy exerts more profound apoptotic and anticancer effects on the AGS cell line than curcumin or doxorubicin monotherapy.

Axial pharmaceutical properties of liposome in cancer therapy: Recent advances and perspectives

Evaluation of axial properties including preparation, surface functionalization, and pharmacokinetics for delivery of pharmacologically active molecules and genes lead to pharmaceutical development of liposome in cancer therapy. Here, analysis of effects of the axial properties of liposome based on cancer treatment modalities as individually and coherently is vital and shows deserving further investigation for the future. In this review, recent progress in the analysis of preparation approaches, optimizing pharmacokinetic parameters, functionalization and targeting improvement and modulation of biological factors and components resulting in a better function of liposome in cancer for drug/gene delivery and immunotherapy are discussed. Here, recent developments on liposome with vaccines and immunoadjuvant carriers, and antigen-carrier system to cancer immunotherapy are introduced.

Comparison of Anxiolytic Effect of Aqueous Extract of Root of Valeriana officinalis with Buspirone in Mature Male Mice

Background: Anxiety is the most common psychiatric disorder which can be cured by herbal and chemical medicine. Herbal medicine and complementary medicine are widely used among people suffering from anxiety disorder. Valeriana officinalis known to cause anxiolytic and sedative effects to have a special place in traditional Chinese, Indian and Iranian medicine. Aims: This study aims to compare the anxiolytic effect of aqueous extract of root of V. officinalis root with Buspirone in mature male mice. Study Design: Study was conducted in the Islamic Azad University of Mashhad to an animal room of the Faculty of Basic Sciences, Azad University of Nishabur, under standard conditions. This experimental study has been demonstrated by control and experimental groups. The sample consisted of 30 mature male mice assigned into five groups of six: group A receiving distilled water (control group), group B, group C and group D receiving 100 mg/kg, 200 mg/kg and 300 mg/kg aqueous extract of V. officinalis, respectively, and group E receiving 30 mg/kg buspirone orally in drinking water. Anxiolytic effects were evaluated 10 days after receiving by using maze. One-way ANOVA and T-test were analyzed by using SPSS 19 software package. Results and Discussion: The results show that the aqueous extract of V. officinalis root causes a significant increase in the number of arrivals and elapsed time in open arms compared to Buspirone. Medicinal plants currently form an important part of traditional medicine in many countries and they have a special place in new therapeutic approaches. ANOVA and T-test results showed a significant (P<0.05) relationship between the anxiolytic effect of aqueous extract of V. officinalis root and Buspirone in mice. Conclusion: It can be concluded that V. officinalis are more effective in reducing anxiety compared to buspirone.

Diagnostic investigation of breast magnetic resonance imaging in malignant and benign mass lesions

INTRODUCTION

Breast magnetic resonance imaging (BMRI) has been identified as a valuable modality in the diagnosis of breast cancer and monitoring the response to chemotherapy. The aim of this study was to evaluate the relative importance of different descriptors of breast masses in contrast-enhanced breast MRI.

MATERIAL AND METHODS

In a database of pathologically proven breast lesions, in total 433 masses in 312 patients detected by contrast-enhanced breast MRI were selected. All images were assessed according to the MRI BI-RADS lexicon and those with significant positive MRI findings (BI-RADS categories 3, 4, 5) were enrolled in the study.

RESULTS

Mean age of patients was 45.09 ±10.5 years. The most frequent BI-RADS score was 4 (60.7%), followed by 3 (27%). Among the morphologic descriptors of the enhancing masses, the findings most strongly associated with malignancy included spiculated margin (60.6%) and irregular shape (38%). Considering the dynamic descriptors, a wash-out pattern in the time-intensity curve was the most powerful finding associated with malignancy (27.9%). Among all breast MRI descriptors, the best odds ratio (OR) in association with malignancy was noted for speculated margin (OR = 10.2) followed by wash-out or plateau curves (OR = 6.1), size greater than 1 cm (OR = 4.3) and irregular shape (OR = 3.1).

CONCLUSIONS

It seems that morphologic descriptors of MRI BI-RADS for enhancing masses are quite specific, while dynamic descriptors of the masses are highly sensitive. Appropriate consideration and combination of different BI-RADS findings could help in better characterization of enhancing masses on breast MRI, lowering the rate of false positive reports and avoiding unnecessary biopsies.

Proliferation inhibition of cisplatin-resistant ovarian cancer cells using drugs screened by integrating a metabolic model and transcriptomic data

OBJECTIVES

If screening to find effective drugs is possible, the inhibition of proliferation using existing drugs can be a practical strategy to control the drug resistance of cancer. Development of a system-oriented strategy to find effective drugs was the main aim of this research.

MATERIALS AND METHODS

An algorithm (transcriptional regulated flux balance analysis [TRFBA]) integrating a generic human metabolic model with transcriptomic data was used to identify genes affecting the growth of drug-resistant cancer cells. Drugs that inhibit activation of the target genes were found and their effect on the proliferation was experimentally evaluated.

RESULTS

Experimental assessments demonstrated that TRFBA improves the prediction of cancer cell growth in comparison with previous algorithms. The algorithm was then used to propose the system-oriented strategy to search drugs effective in limiting the growth rate of the cisplatin-resistant A2780 epithelial ovarian cancer cell. Experimental evaluations resulted in the selection of azathioprine, terbinafine, hydralazine and sodium valproate that appropriately inhibit the proliferation of resistant cancer cells while minimally affecting normal cells. Furthermore, experimental data indicate that the selected drugs are synergistic and can be used in combination therapies.

CONCLUSIONS

The proposed strategy was successful to identify drugs effective on the viability of resistant cancer cells. This strategy can enhance the potency of treatments for drug-resistant cancer cells and provides the possibility of using existing drugs.

Differential Expression of Hox and Notch Genes in Larval and Adult Stages of Echinococcus granulosus

This investigation aimed to evaluate the differential expression of HoxB7 and notch genes in different developmental stages of Echinococcus granulosus sensu stricto. The expression of HoxB7 gene was observed at all developmental stages. Nevertheless, significant fold differences in the expression level was documented in the juvenile worm with 3 or more proglottids, the germinal layer from infected sheep, and the adult worm from an experimentally infected dog. The notch gene was expressed at all developmental stages of E. granulosus; however, the fold difference was significantly increased at the microcysts in monophasic culture medium and the germinal layer of infected sheep in comparison with other stages. The findings demonstrated that the 2 aforementioned genes evaluated in the present study were differentially expressed at different developmental stages of the parasite and may contribute to some important biological processes of E. granulosus.

Comparison of ex vivo harvested and in vitro cultured materials from Echinococcus granulosus by measuring expression levels of five genes putatively involved in the development and maturation of adult worms

Parts of the natural life cycle of Echinococcus granulosus can be retraced in vitro such as the development of protoscoleces into semiadult worms with three or more proglottids, or the redifferentiation of in vitro cultured protoscoleces into metacestode-like cystic structures. Most in vitro generated samples share—at the microscopical level—high similarities with those naturally grown, but developmental differences have also been documented, such as missing egg production in in vitro grown adults or unusual bladder/vesicle formation in protoscoleces cultured into the metacestode direction. The aim of the present study was to explore how far different in vitro generated stage-specific materials/structures match the natural situation on the transcriptome level, based on testing five exemplarily chosen different genes: the frizzled receptor eg-fz4 (posterior marker), the FGF receptor-like factor eg-fgfrl (anterior association), the cell differentiation protein eg-rcd1 (part of the CCR4-NOT complex, a key regulator of eukaryotic gene expression), the rapidly accelerated fibrosarcoma serin/threonin kinase eg-braf (part of the MAPK pathway involved, e.g., in EGF signaling) and the co-smad eg-smadD (downstream factor of TGFβ/BMP2/activin signaling). These genes—tested via qPCR—were selected such as to allow a discussion on their potential role in the development of E. granulosus into the adult stage. Thus, testing took place with three ex vivo isolated samples, namely (i) egg-containing adult worms, (ii) invaginated protoscoleces, and (iii) protoscolex-free germinal layer tissue. Respective data were compared (a) with in vitro generated metacestode-like microcysts developed from protoscolices, and (b) different development stages of protoscoleces in vitro cultured toward adult maturation. As a finding, only eg-smadD and partially eg-fz4 showed high expression similarities between ex vivo harvested and in vitro cultured E. granulosus, thus suggesting a putative role in adult maturation. Conclusively, the fact of using “only” five genes did not allow answering the question if ex vivo and in vitro materials are similar on the transcriptome level. Another experimental restriction arises from different growth conditions of the in vitro cultured materials, and comparing these to the ex vivo harvested ones. Future experiments may solve the problems by using fully standardized E. granulosus sample collection and fully standardized culture conditions.

Magnetic Resonance Imaging Features of Adenosis in the Breast

Purpose

Adenosis lesions of the breast, including sclerosing adenosis and adenosis tumors, are a group of benign proliferative disorders that may mimic the features of malignancy on imaging. In this study, we aim to describe the features of breast adenosis lesions with suspicious or borderline findings on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

Methods

In our database, we identified 49 pathologically proven breast adenosis lesions for which the final assessment of the breast MRI report was classified as either category 4 (n=45) or category 5 (n=4), according to the Breast Imaging Reporting and Data System (BI-RADS) published by the American College of Radiology (ACR). The lesions had a final diagnosis of either pure adenosis (n=33, 67.3%) or mixed adenosis associated with other benign pathologies (n=16, 32.7%).

Results

Of the 49 adenosis lesions detected on DCE-MRI, 32 (65.3%) appeared as enhancing masses, 16 (32.7%) as nonmass enhancements, and one (2.1%) as a tiny enhancing focus. Analysis of the enhancing masses based on the ACR BI-RADS lexicon revealed that among the mass descriptors, the most common features were irregular shape in 12 (37.5%), noncircumscribed margin in 20 (62.5%), heterogeneous internal pattern in 16 (50.0%), rapid initial enhancement in 32 (100.0%), and wash-out delayed en-hancement pattern in 21 (65.6%). Of the 16 nonmass enhancing lesions, the most common descriptors included focal distribution in seven (43.8%), segmental distribution in six (37.5%), clumped internal pattern in nine (56.3%), rapid initial enhancement in 16 (100.0%), and wash-out delayed enhancement pattern in eight (50.0%).

Conclusion

Adenosis lesions of the breast may appear suspicious on breast MRI. Awareness of these suspi-cious-appearing features would be helpful in obviating unnecessary breast biopsies.

Vitamin D status of type 2 diabetic patients compared with healthy subjects in the Islamic Republic of Iran

An inverse relationship has been shown between vitamin D deficiency and type 2 diabetes mellitus (DM). In this cross-sectional study in Tehran, Islamic Republic of Iran, a country with a high prevalence of vitamin D deficiency, we determined the prevalence of vitamin D deficiency among 90 type 2 DM patients and 90 healthy subjects. Based on serum levels of 25-hydroxyvitamin D, the rates of deficiency (< 50 nmol/L) and insufficiency (50-75 nmol/L) were 59.0% and 27.0% respectively in patients with type 2 DM, and 47.0% and 24.0% respectively in healthy subjects. Using the national cut-offs for vitamin D deficiency, 64.0% women with DM and 47.4% of healthy women were suffering from different degrees of vitamin D deficiency. The prevalence of vitamin D deficiency in men with type 2 DM and healthy men were 42.7% and 22.2% respectively. None of the differences between the 2 groups was statistically significant.

Diagnostic accuracy of non-echo-planar diffusion-weighted MRI versus other MRI sequences in cholesteatoma

INTRODUCTION

Non-echo-planar imaging (EPI) MRI has been recently introduced to improve the detection of small-sized cholesteatoma and decrease different artefacts occurring in the EPI-diffusion-weighted (DW) technique. This technique is also time saving in comparison to delayed post-contrast imaging. We prospectively assessed the diagnostic accuracy of MRI including delayed post-contrast standard MRI, EPI and non-EPI-DW sequences in the detection of middle ear cholesteatoma.

METHODS

We evaluated 35 patients suspected of having cholesteatoma who underwent MRI including delayed post-contrast MRI, EPI and non-EPI-DW sequences prior to their planned surgery, and the MR findings were compared with surgical findings. Two experienced radiologists reported the images. Sensitivity, specificity and predictive values of MRI were estimated.

RESULTS

We detected 26 cases of cholesteatoma at surgery. Sensitivity and specificity of delayed post-contrast MRI, EPI DW and non-EPI DW were 73.1 and 77.8%, 61.5 and 88.9%, and 96.2 and 100%, respectively, as interpreted by the first radiologist. Sensitivity and specificity of delayed post-contrast MRI, EPI-DW sequence and non-EPI-DW sequence were 84.6 and 88.9%, 50 and 88.9%, and 92.3 and 100%, respectively, as interpreted by the second radiologist.

CONCLUSION

The non-EPI MRI technique is a more accurate method in detecting middle ear cholesteatoma in comparison to other conventional sequences.

Hair regrowth with topical triiodothyronine ointment in patients with alopecia areata: a double-blind, randomized pilot clinical trial of efficacy

BACKGROUND

Thyroid hormone receptors are expressed in hair follicles and it is known that thyroid hormones can have a positive effect on hair growth, i.e. process which is disrupted in alopecia areata.

OBJECTIVES

The aim of this study was to determine the efficacy of topical triiodothyronine in patients with patchy alopecia areata.

METHODS

Ten patients with patchy alopecia areata were treated with triiodothyronine and placebo applied twice daily to either of two bilaterally symmetrical patches for 12 weeks. The two sides were randomly assigned following simple randomization procedure to one of the two treatment groups. The patients and the investigator were blinded to the content of the tubes. Hair regrowth was evaluated every 4 weeks. Blood samples for measurements of complete blood count along with thyroid function (T3, T4 and TSH) and liver function tests were taken at the baseline and at the end of study.

RESULTS

After 12 weeks of treatment, there was no statistically significant difference between the outcome in terms of reduction of the patch size and hair regrowth. No adverse effects were noted.

CONCLUSION

Triiodothyronine in the studied dosage and formulation was safe but not more effective than placebo. However, newer thyroid hormone analogues might be more effective and evaluating their effects probably warrants further consideration.

Ethical and legal aspects of organ transplantation in Iran

The great advances in the technology of organ preservation, immunosuppression, and surgical procedures have resulted in success in saving lives. However, these advantages have raised major ethical, policy, and religious problems in organ transplantation. Extensive efforts have been made to address these problems in different communities. In this study the transplantation program and implementation of legislation in Iran is reviewed. The history of the organ transplantation "Act of Organ Transplantation and Brain Death," which allows controlled living unrelated donors access to renal transplantation, is discussed as the main subject.