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Saboori S, Jarvis M, Baker J, Seminara B, Vickers D, Pacicco T, Moshiree B. Hard to Swallow Results. Dysphagia 2021; 37:863-867. [PMID: 34297152 DOI: 10.1007/s00455-021-10344-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
The American Neurogastroenterology and Motility Society (ANMS) proposed quality measures (QMs) for performance and interpretation of esophageal manometry (EM). We implemented a quality improvement (QI) study at a large community hospital to assess and improve procedural adherence and interpretation of EM studies based on the ANMS QMs using the Chicago Classification 3.0 (CC) Guidelines. For pre-intervention, three motility independent reviewers reinterpreted 60 EM studies conducted by community gastroenterologists without Tier II-III motility training from October to December 2018 for compliance with pre-procedural, procedural, and data interpretation ANMS QMs. In December 2018, we developed a pre-procedural form, educated nurses on EM procedural compliance, and provided preliminary pre-intervention results to gastroenterologists along with literature utilizing the CC 3.0 Guidelines. For post-intervention, we reinterpreted 54 EM studies from January to August 2019 and investigated whether they met QMs for data interpretation with respect to the CC Guidelines and resulted in appropriate treatment. We found a statistically significant improvement in procedural compliance among nursing staff for 30 s of swallows (76% post-intervention versus 12% pre-intervention, p < 0.001) and 7 evaluable swallows (94% post-intervention versus 53% pre-intervention, p < 0.001). However, quality metrics within data interpretation by physicians post-intervention showed mixed results. An incorrect diagnosis was made in 50% (n = 27)) of studies with 72% (n = 39) having at least one missing item based on the CC. The most missed diagnosis was fragmented peristalsis (30%, n = 29). Among the 39% (n = 21) of surgery referrals, 24% (n = 5) were incorrectly referred. Our study shows poor data interpretation by community gastroenterologists without formal motility training despite adequate performance by nursing staff. This further supports the need for a national ANMS certification process for formal HRM education.
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Affiliation(s)
- S Saboori
- Department of Internal Medicine at Atrium Health's Carolinas Medical Center, 5th Floor Medical Education Building, 1000 Blythe Blvd, Charlotte, NC, 28203, USA.
| | - M Jarvis
- Department of Internal Medicine at Atrium Health's Carolinas Medical Center, Atrium Health Gastroenterology and Hepatology, Charlotte, USA
| | - J Baker
- Department of Internal Medicine and Surgery at Atrium Health's Carolinas Medical Center, Charlotte, USA
| | - B Seminara
- Atrium Health Gastroenterology and Hepatology, Charlotte, USA
| | - D Vickers
- Atrium Health Gastroenterology and Hepatology, Charlotte, USA
| | - T Pacicco
- Atrium Health Gastroenterology and Hepatology, Charlotte, USA
| | - B Moshiree
- UNC School of Medicine-Charlotte Campus, Atrium Health Gastroenterology and Hepatology, Charlotte, USA
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Saboori S, Falahi E, Eslampour E, Zeinali Khosroshahi M, Yousefi Rad E. Effects of alpha-lipoic acid supplementation on C-reactive protein level: A systematic review and meta-analysis of randomized controlled clinical trials. Nutr Metab Cardiovasc Dis 2018; 28:779-786. [PMID: 29753588 DOI: 10.1016/j.numecd.2018.04.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 04/03/2018] [Accepted: 04/09/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM The aim of this meta-analysis was to assess effects of alpha-lipoic acid supplementation on C-reactive protein (CRP) levels in clinical trial studies. METHODS AND RESULTS A systematic search was carried out on clinical trial studies published in PubMed, ISI Web of Science, Cochrane Library and Scopus databases completed by manual search on reference list of eligible studies accomplished by November 4, 2017. Of a total number of 508 studies found in the first step of literature search, only 11 were included with 264 participants in supplementation groups and 287 in control groups. Estimated pooled random effects size analysis showed a significant reducing effect of alpha-lipoic acid supplementation on CRP level (-0.72 mg/l, 95% CI; -1.4, -0.04; P = 0.03) with a significant heterogeneity between the selected studies. Sub-group analysis showed that alpha-lipoic acid supplementation could significantly reduce serum CRP level when the baseline CRP level was greater than 3 mg/l (-1.02 mg/l, 95% CI: -1.3, -0.73) and when trial duration was >8 weeks (-0.99 mg/l, 95% CI: -1.29, -0.70). Results of subgroup analysis also showed that alpha lipoic acid supplementation could decrease CRP level only in non-diabetic patients (-1.02 mg/l, 95% CI: -1.31, -0.74). CONCLUSIONS Results of the current meta-analysis study showed that alpha-lipoic acid supplementation could significantly decrease CRP level in patients with elevated levels of this inflammatory marker.
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Affiliation(s)
- S Saboori
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - E Falahi
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - E Eslampour
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - M Zeinali Khosroshahi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - E Yousefi Rad
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
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Saboori S, Koohdani F, Nematipour E, Yousefi Rad E, Saboor-Yaraghi AA, Javanbakht MH, Eshraghian MR, Ramezani A, Djalali M. Beneficial effects of omega-3 and vitamin E coadministration on gene expression of SIRT1 and PGC1α and serum antioxidant enzymes in patients with coronary artery disease. Nutr Metab Cardiovasc Dis 2016; 26:489-494. [PMID: 27033026 DOI: 10.1016/j.numecd.2015.11.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/26/2015] [Accepted: 11/26/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIM SIRT1 and PGC1α are two important genes, which play critical roles in regulating oxidative stress and inflammation processes. The study aimed assess the effects of coadministration of omega-3 and vitamin E supplements on SIRT1 and PGC1α gene expression and serum levels of antioxidant enzymes in coronary artery disease (CAD) patients. METHODS AND RESULTS Participants of this randomized controlled trial included 60 CAD male patients who were categorized into three groups: Group 1 received omega-3 (4 g/day) and vitamin E placebo (OP), group 2 omega-3 (4 g/day) and vitamin E (400 IU/day; OE), and group 3 omega-3 and vitamin E placebos (PP) for 2 months. Gene expression of SIRT1 and PGC1α in peripheral blood mononuclear cells (PBMCS) was assessed by reverse transcription polymerase chain reaction (RT-PCR). Furthermore, serum antioxidant enzyme and high-sensitivity C-reactive protein (hsCRP) levels were assessed at the beginning and end of the intervention. Gene expression of SIRT1 and PGC1α increased significantly in the OE group (P = 0.039 and P = 0.050, respectively). Catalase and hsCRP levels increased significantly in the OE and OP groups. However, glutathione peroxidase (GPX) and superoxide dismutase (SOD) levels did not statistically change in all groups. The total antioxidant capacity (TAC) increased significantly in the OE group (P = 0.009) but not in OP and PP groups. CONCLUSION Supplementation of omega-3 fatty acids in combination with vitamin E may have beneficial effects on CAD patients by increasing gene expression of SIRT1 and PGC1α and improving oxidative stress and inflammation in these patients.
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Affiliation(s)
- S Saboori
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, HojatDoost St, Tehran, Iran; Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - F Koohdani
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, HojatDoost St, Tehran, Iran
| | - E Nematipour
- Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - E Yousefi Rad
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - A A Saboor-Yaraghi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, HojatDoost St, Tehran, Iran
| | - M H Javanbakht
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, HojatDoost St, Tehran, Iran
| | - M R Eshraghian
- Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - A Ramezani
- Department of Basic sciences and Nutrition, Cardiovascular Research Center, School of public Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - M Djalali
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, HojatDoost St, Tehran, Iran.
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Saboori S, Noormohammadi Z, Zare-Karizi S. Genetic variation in vascular endothelial growth factor gene and its association with recurrent spontaneous abortion. ACTA ACUST UNITED AC 2016; 117:80-6. [PMID: 26830037 DOI: 10.4149/bll_2016_016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Vascular endothelial growth factor (VEGF) plays a main role in fetal and placental angiogenesis and is secreted by different cells of endometrium and placenta. OBJECTIVE In the present study we investigated the association of VEGF gene polymorphisms with recurrent spontaneous abortion (RSA). METHODS A case-control study of 100 women with at least two consecutive pregnancy losses before 20 weeks of gestational age and 100 fertile controls was performed to evaluate four VEGF gene polymorphisms including +936C/T (rs3025039), -154G>A (rs1570360), rs3025010 and +5092A/C (rs2146323). Genotyping was performed by PCR based restriction fragment length polymorphism (PCR-RFLP) analysis. Haplotype frequency was estimated for three SNPs' genotypes. Analysis of genetic STRUCTURE and K means clustering were performed to estimate genetic variation. RESULTS We found an association between -154G/A heterozygous genotype (GA) and RSA. The VEGF single nucleotide polymorphism (SNP) in intron region (rs3025010) in different inheritance models was also associated with RSA. Linkage disequilibrium analysis revealed that VEGF SNP in intron 5 (rs3025010) was linked to promoter region SNP (rs1570360). Cluster analysis including Neighbor Joining and K-means clustering supported genetic differentiation of women with RSA and controls. CONCLUSION Allelic polymorphisms in common VEGF SNPs was associated with RSA samples and haplotypes with at least one minor allele showing an association with RSA pathogenesis (Tab. 8, Fig. 2, Ref. 35).
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Saboori S, Hosseinzadeh-Attar MJ, Yousefi Rad E, Hosseini M, Mirzaei K, Ahmadivand Z. The comparison of serum vaspin and visfatin concentrations in obese and normal weight women. Diabetes Metab Syndr 2015; 9:320-323. [PMID: 25470626 DOI: 10.1016/j.dsx.2013.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES There is evidence based studies which show that plasma level of visfatin and vaspin in patients with type 2 diabetes mellitus elevate in comparison with healthy people. But there is no consistency in plasma visfatin and vaspin concentration between studies done on obese people. For this reason, the aim of this study is to investigate the serum level concentrations of visfatin and vaspin in obese women compared to normal weight women. MATERIALS AND METHODS The participants of this study consist of 43 women aged 20-50, and 43 healthy women with normal weight as a control group. They were matched for age and physical activity. 24h food recall was used to collect dietary information from subjects. Moreover, blood sampling was taken to measure the blood levels of sugar, lipid profile, vaspin and visfatin. RESULTS The mean serum level of visfatin was not statistically different between obese and normal weight women. But, the obese women had statistically higher mean serum level of vaspin than normal women (p=0.04). We found no relations between serum levels of vaspin with serum concentration of visfatin. Also, serum levels of these two adipokines were not related to the serum concentrations of fasting glucose, total cholesterol, low-density lipoprotein cholesterol and triglyserides and high-density lipoprotein cholesterol. Also, there was a significant positive relationship between carbohydrate intake and serum visfatin level in women participating to this study (p=0.018, r=0.257). CONCLUSION The results of this study demonstrated that the level of serum vaspin was significantly higher in obese women. But there were no differences in serum levels of visfatin in comparison to normal weight women. Meanwhile this study demonstrated a positive relationship between serum levels of visfatin with dietary intake of carbohydrate, but no relationship between serum level of visfatin and vaspin in women participating in this study.
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Affiliation(s)
- S Saboori
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Department of Nutrition and Biochemistry, school of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M J Hosseinzadeh-Attar
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Department of Nutrition and Biochemistry, school of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - E Yousefi Rad
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Department of Nutrition and Biochemistry, school of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M Hosseini
- Department of Statistics and Epidemiology, school of Public Heath, Tehran University of Medical Sciences, Tehran, Iran
| | - K Mirzaei
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Department of Nutrition and Biochemistry, school of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Z Ahmadivand
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Department of Nutrition and Biochemistry, school of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Saboori S, Shab-Bidar S, Speakman JR, Yousefi Rad E, Djafarian K. Effect of vitamin E supplementation on serum C-reactive protein level: a meta-analysis of randomized controlled trials. Eur J Clin Nutr 2015; 69:867-73. [DOI: 10.1038/ejcn.2014.296] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 11/22/2014] [Accepted: 12/06/2014] [Indexed: 01/07/2023]
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Hossein-Nezhad A, Mirzaei K, Keshavarz SA, Ansar H, Saboori S, Tootee A. Evidences of dual role of vitamin D through cellular energy homeostasis and inflammation pathway in risk of cancer in obese subjects. Minerva Med 2013; 104:295-307. [PMID: 23748283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM The underlying molecular mechanisms of the role obesity plays in increasing the risk of cancer are not well illuminated. Several mechanisms are proposed for vitamin D as an anti-cancer agent in various malignancies which may be attributed to both its both its anti-inflammatory characteristics as well as its mediatory role in cellular energy homeostasis. This study evaluates the expression of PBMCs' genes which are involved in cellular energy homeostasis such as VDR, PPARγ, PGC1a and UCP2. Moreover, considering the possible role of vitamin D in the inflammation mechanisms, we also aimed at measurement of some inflammatory mediators such as TNF-α, IL-1β, IL4, IL-6, IL10, IL13 and IL17 in inflammatory state in samples obtained from obese persons with and without positive family history of cancer. Moreover, to expand the study to a clinical context, we assessed the correlation of the resting metabolic rate with the evaluated gene. METHODS A total of 274 obese women were included in the current cross-sectional study. All of participants were class I obese. By constructing a pedigree that includes 3 generations, twenty-one subjects were at increased risk because of a positive family history of colorectal cancer. Accordingly, current study's analysis was based on positive and negative family history of colorectal cancer. RESULTS The concentration of Insulin and PTH were significantly high in group with positive history of cancer. 25 (OH) vitamin D, REE/kg and REE/FFM statuses in two groups; the level of mentioned terms were lower in group with positive history of cancer compared to group with negative history of cancer. We found significantly lower REE/kg in deficiency of vitamin D and higher REE/kg in sufficiency status. Our results demonstrated significant higher concentrations of IL1β, IL17, TNFα and IL6 in group with positive history of cancer compared to group with negative history of cancer. The concentrations of IL13, IL10 and IL4 were significantly lower in group with positive history of cancer compared to group with negative history of cancer. The relative expression of VDR, PGC1αand PPARγ gene was significantly lower in group with positive history of cancer. The relative expression of UCP2 was almost significantly lesser in group with positive history of cancer also. CONCLUSION The observed mutual alteration in the levels of inflammatory markers and relative expression of important gene in energy homeostasis may be caused by vitamin D deficiency among the obese subjects with positive history of colorectal cancer.
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Saboori S, Schmidt M, Mueller R, Mohammadi M. SU-E-T-58: Specific Patient Exit Dose Verification Base on Treatment Planning System and Experimental Data. Med Phys 2012. [DOI: 10.1118/1.4735114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Barhaghtalab MY, Saboori S, Damiri M, Ekrahi M. Prevalence of Viral Markers for Hepatitis B and C in Healthy Volunteer Blood Donors in Fasa Region, South Iran. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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