1
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Li W, Takahashi T, Sehatbakhsh S, Parikh MA, Garcia-Garcia HM, Fearon WF, Kobayashi Y. Diagnostic performances of Nonhyperemic Pressure Ratios and Coronary Angiography-Based Fractional Flow Reserve against conventional Wire-Based Fractional Flow Reserve. Coron Artery Dis 2024; 35:83-91. [PMID: 38088790 DOI: 10.1097/mca.0000000000001309] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
BACKGROUND Nonhyperemic pressure ratios (NHPRs) have been proposed as alternatives to fractional flow reserve (FFR) without induction of hyperemia. More recently, imaging based-FFR estimation, especially coronary angiography-derived FFR (Angio-FFR) measurement, is proposed to estimate wire-based FFR. However, little is known about the diagnostic performance of these indices against conventional FFR. AIMS We aimed to assess and compare the diagnostic performance of both NHPRs and coronary Angio-FFR against wire-based conventional FFR. METHODS PubMed and Embase databases were systematically searched for peer-reviewed original articles up to 08/2022. The primary outcomes were the pooled sensitivity and specificity as well as the area under the curve (AUC) of the summary receiver-operating characteristic curve of those indices. RESULTS A total of 6693 records were identified after a literature search, including 37 reports for NHPRs and 34 for Angio-FFR. Overall, NHPRs have a lower diagnostic performance in estimating wire-based FFR with an AUC of 0.85 (0.81, 0.88) when compared with Angio-FFR of 0.95 (0.93, 0.97). When all four modalities of NHPRs (iFR, Pd/Pa, DPR, RFR) were compared, those had overlapping AUCs without major differences among each other. Similarly, when the two most commonly used Angio-FFR (QFR, FFR angio ) were compared, those had overlapping AUCs without major differences among each other. CONCLUSION Angio-FFR may offer a better estimation of wire-based FFR than NHPRs. Our results support a wider use of Angio-FFR in the cardiac catheterization laboratory to streamline our workflow for coronary physiologic assessment. CLASSIFICATIONS FFR,, stable ischemic disease and non-ST elevation acute coronary syndrome.
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Affiliation(s)
- Weijia Li
- Heart, Lung and Vascular Institute, AdventHealth Orlando, Orlando, Florida
| | - Tatsunori Takahashi
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Samineh Sehatbakhsh
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Manish A Parikh
- Division of Cardiology, New York-Presbyterian Brooklyn Methodist Hospital, Weill Cornell Medical College, Brooklyn, New York
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia
- MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, Washington, District of Columbia
| | - William F Fearon
- Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, California, USA
| | - Yuhei Kobayashi
- Division of Cardiology, New York-Presbyterian Brooklyn Methodist Hospital, Weill Cornell Medical College, Brooklyn, New York
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2
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Sehatbakhsh S, Li W, Takahashi T, Takahashi K, Parikh MA, Kobayashi Y. Nonhyperemic Pressure Ratios-All the Same or Nuanced Differences? Cardiol Clin 2024; 42:13-19. [PMID: 37949534 DOI: 10.1016/j.ccl.2023.07.011] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Fractional flow reserve (FFR) has become the gold standard for invasively assessing the functional significance of coronary artery disease (CAD) to guide revascularization. The amount of evidence supporting the role of FFR in the cardiac catheterization laboratory is large and still growing. However, FFR uptake in the daily practice is limited by a variety of factors such as invasive instrumentation of the coronary artery that requires extra time and need for vasodilator medications for hyperemia. In this review, we describe the details of wire-based alternatives to FFR, providing insights as to their development, clinical evidence, and limitations.
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Affiliation(s)
- Samineh Sehatbakhsh
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 210th Street, Bronx, NY 10467, USA
| | - Weijia Li
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, The Bronx, NY 10461, USA
| | - Tatsunori Takahashi
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, The Bronx, NY 10461, USA
| | - Kayo Takahashi
- Department of Cardiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Manish A Parikh
- Division of Cardiology, New York-Presbyterian Brooklyn Methodist Hospital, Weill Cornell Medical College, 506 6th Street, Brooklyn, NY 11215, USA
| | - Yuhei Kobayashi
- Division of Cardiology, New York-Presbyterian Brooklyn Methodist Hospital, Weill Cornell Medical College, 506 6th Street, Brooklyn, NY 11215, USA.
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3
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Sehatbakhsh S, Mignatti A, Murthy S, Latib A. A novel therapy in microvascular obstruction in ST-elevation myocardial infarction: pressure-controlled intermittent coronary sinus occlusion therapy. Future Cardiol 2023; 19:615-623. [PMID: 37933690 DOI: 10.2217/fca-2023-0002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Abstract
Percutaneous coronary intervention has transformed the management of ST-elevation myocardial infarction (STEMI) due to a reduction in early mortality and need for repeat revascularization. However, the conventional revascularization strategy, combined with state-of-the-art anti-thrombotic and antiplatelet therapies, can still be associated with poor clinical outcome in some patients, because of reperfusion injury and microvascular obstruction contributing to the infarct size. To address this important therapeutic need, a broad-range of device-based treatments have been introduced. This is an overview of the pressure-controlled intermittent coronary sinus occlusion (PiCSO) device (Miracor Medical SA) which has been proposed for STEMI patients. PiCSO therapy could lead to an improved perfusion, decrease microvascular dysfunction, and thus potentially reduce infarct size.
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Affiliation(s)
| | - Andrea Mignatti
- Division of Cardiology, Montefiore Medical Center, New York, 10467 NY, USA
| | - Sandhya Murthy
- Division of Cardiology, Montefiore Medical Center, New York, 10467 NY, USA
| | - Azeem Latib
- Division of Cardiology, Montefiore Medical Center, New York, 10467 NY, USA
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4
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Leone PP, Scotti A, Ludwig S, Sehatbakhsh S, Assafin M, Chau M, Spring A, Montesino J, Doolittle J, Granada JF, Latib A. Predictable Deployment of Suture-Based Vascular Closure Device Before Transfemoral Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv 2023; 16:485-486. [PMID: 36669982 DOI: 10.1016/j.jcin.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/07/2022] [Accepted: 11/15/2022] [Indexed: 01/20/2023]
Affiliation(s)
- Pier Pasquale Leone
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy; Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Andrea Scotti
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA
| | - Sebastian Ludwig
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA; Department of Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Samineh Sehatbakhsh
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Manaf Assafin
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Mei Chau
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Alexander Spring
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Jesus Montesino
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - James Doolittle
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Juan F Granada
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA
| | - Azeem Latib
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
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Sehatbakhsh S, Li W, Takahashi T, Takahashi K, Parikh MA, Kobayashi Y. Nonhyperemic Pressure Ratios-All the Same or Nuanced Differences? Interv Cardiol Clin 2023; 12:13-19. [PMID: 36372456 DOI: 10.1016/j.iccl.2022.09.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Fractional flow reserve (FFR) has become the gold standard for invasively assessing the functional significance of coronary artery disease (CAD) to guide revascularization. The amount of evidence supporting the role of FFR in the cardiac catheterization laboratory is large and still growing. However, FFR uptake in the daily practice is limited by a variety of factors such as invasive instrumentation of the coronary artery that requires extra time and need for vasodilator medications for hyperemia. In this review, we describe the details of wire-based alternatives to FFR, providing insights as to their development, clinical evidence, and limitations.
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Affiliation(s)
- Samineh Sehatbakhsh
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 210th Street, Bronx, NY 10467, USA
| | - Weijia Li
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, The Bronx, NY 10461, USA
| | - Tatsunori Takahashi
- Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, The Bronx, NY 10461, USA
| | - Kayo Takahashi
- Department of Cardiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Manish A Parikh
- Division of Cardiology, New York-Presbyterian Brooklyn Methodist Hospital, Weill Cornell Medical College, 506 6th Street, Brooklyn, NY 11215, USA
| | - Yuhei Kobayashi
- Division of Cardiology, New York-Presbyterian Brooklyn Methodist Hospital, Weill Cornell Medical College, 506 6th Street, Brooklyn, NY 11215, USA.
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Li W, Takahashi T, Sehatbakhsh S, Parikh M, Fearon W, Kobayashi Y. TCT-241 Comparison of Fractional Flow Reserve Alternatives: Non-Hyperemic Pressure Ratios and Imaging-Based Approach. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.733] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Ramos-Tuarez F, Pino JE, Nieves J, Sabates A, Sehatbakhsh S, Pradeep D, Torres P, Abbasi BA, Saona J, Abdallah A, Kale K, Pava D, Chomko TA, Ghumman W, Borzak S, Chait R. Non-invasive Evaluation of Cardiac Time Intervals By The HemotagTm Recording Device To Tailor Treatment of Acutely Decompensated Heart Failure. J Card Fail 2020. [DOI: 10.1016/j.cardfail.2020.09.148] [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: 11/25/2022]
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8
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Chen K, Pino JE, Ceka E, Ramos F, Saona J, Grajeda J, Al Abbasi B, Chacon A, Torres P, De Diego G, Bornmann R, Sehatbakhsh S, Chait R. The Impact of Fluid Management in Patients with Sepsis and Heart Failure. J Card Fail 2019. [DOI: 10.1016/j.cardfail.2019.07.286] [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: 10/26/2022]
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9
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Sehatbakhsh S, Kushnir A, Donath E, Chait R. Left Ventricular Global Longitudinal Strain as a Marker of Left Ventricular Dysfunction after Mitral Valve Surgery in Organic Mitral Regurgitation. J Card Fail 2018. [DOI: 10.1016/j.cardfail.2018.07.108] [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: 12/01/2022]
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10
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Sehatbakhsh S, Hakimian S, Jobanputra Y, Jimmy R, Chait R, Showronski M, Kale K, Borzak S. Assessment of LV systolic function using cardiac time intervals with an acoustic array approach. J Card Fail 2018. [DOI: 10.1016/j.cardfail.2018.07.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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11
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Sehatbakhsh S, Kushnir A, Kabach M, Kolek M, Chait R, Ghumman W. A case of electromagnetic interference between HeartMate 3 LVAD and implantable cardioverter defibrillator. Pacing Clin Electrophysiol 2017; 41:218-220. [PMID: 28976004 DOI: 10.1111/pace.13210] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 09/12/2017] [Accepted: 09/22/2017] [Indexed: 12/14/2022]
Abstract
Implantable cardioverter defibrillators (ICDs) have been shown to have a significant benefit in reducing sudden cardiac death (SCD) in patients with systolic heart failure. Additionally, cardiac devices as a bridge to transplant or destination therapy are often used in patients with end-stage systolic heart failure. As a result, most patients with left ventricular assist devices (LVADs) also have an ICD. Here, we present an electromagnetic interference (EMI) between HeartMate 3 LVAD and ICD. This issue might be critical for both electrophysiologists and advanced heart failure cardiologists to understand prior to implantation of ICD/LVADs in these patients.
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12
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Hakimian S, Sehatbakhsh S, Esfahanian M, Kale K, Donath E, Chait R, Borzak S. Systolic Time Ratios via Hemotag and 2D Echocardiography: Correlations with Ejection Fraction and Implications for Clinical Practice. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.07.135] [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: 11/25/2022]
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13
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Furlan S, Donath E, Sehatbakhsh S, Chait R. GLOBAL LONGITUDINAL STRAIN AS A PREDICTOR OF SURVIVAL IN SEPSIS-INDUCED MYOCARDIAL DYSFUNCTION: A META-ANALYSIS. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34919-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Salehi M, Bakhshaee M, Ashtiani S, Hossainzadeh M, Sehatbakhsh S, Najafi M. Allergic rhinitis and dental caries in preschool children. Dent Res J (Isfahan) 2017; 14:376-381. [PMID: 29238375 PMCID: PMC5713060 DOI: 10.4103/1735-3327.218560] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Allergic rhinitis (AR) may be overdocumented in cases of dental caries because of controversies in the literature This study was conducted to investigate the potential relationship between AR and dental caries in children. Materials and Methods: A total of 296 children were included in this cross-sectional study. Participants were evaluated using the decay-missing-filled (DMF) index, and their AR status was evaluated by physical examination and through a standard questionnaire. Baseline demographics and clinical characteristics were compared among groups using Student's t-test or the Mann–Whitney U-test, the Chi-square test, and/or Fisher's exact test as appropriate. A level of P < 0.05 was regarded as statistically significant. Results: Evidence of AR was found in 77 (35.1%) participants. There was no significant difference in the rate of tooth decay or DMF between participants with or without AR (P = 0.07), but a significant difference was observed in the number of missing and filled teeth between those with and without AR (P < 0.05). There were no significant differences in educational level, family income, milk intake, use of pacifier, use of a toothbrush, saliva secretion, or body mass index (P > 0.05 in all cases) between AR-positive and AR-negative patients. Fluoride therapy and oral breathing were identified as confounding factors and controlled using log-linear analysis. The mean rate of DMF in patients who also had AR was 20% greater than in the AR-negative group (odds ratio [OR] = 1.21, confidence interval [CI]: 1.05–1.35) and 15% greater in among children who breathed orally than those who did not (OR = 1.15 CI: 1.02–1.31). Conclusion: AR and oral breathing may have an effect on oral health and dental condition, leading to an increased rate of tooth loss, oral fillings, and development of dental caries.
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Salehi M, Bakhshaee M, Ashtiani SJ, Najafi M, Sehatbakhsh S, Hossainzadeh M. Parental smoking and allergic rhinitis in children. Int Forum Allergy Rhinol 2014; 4:357-60. [PMID: 24477987 DOI: 10.1002/alr.21286] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Revised: 11/22/2013] [Accepted: 12/07/2013] [Indexed: 11/06/2022]
Abstract
BACKGROUND Parental smoking is one of the controversial risk factors associated with allergic rhinitis. The aim of this study was to investigate the relationship between parental smoking and allergic rhinitis; considering confounding factors. METHODS A cross-sectional study was conducted on 671 children aged 2 to 7 years. Random cluster sampling was used to select the participants. The signs and symptoms of allergic rhinitis in children were assessed through standard questionnaires and physical examinations. RESULTS In the multivariate analysis, parental smoking (odds ratio [OR] 1.07; 95% confidence interval [CI], 0.48-2.41) was not a significant risk factor for allergic rhinitis; positive family history of allergy was the only significant factor among other factors (OR 23.64; 95% CI, 11.63-48.04). Sex (OR 1.16; 95% CI, 0.60-2.24), family size (OR 1.06; 95% CI, 0.22-5.05), family income (OR 0.60; 95% CI, 0.24-1.47), and parents' education (OR 1.79; 95% CI, 0.61-5.20) were not statistically significant. CONCLUSION The findings suggest that there is no significant relationship between parental smoking and allergic rhinitis.
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Affiliation(s)
- Maryam Salehi
- Immunology Research Center, Mashhad University of Medical Sciences and Assistant Professor of Community Medicine, Community Medicine Department, Faculty of Medicine, Mashhad, Iran
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Ghaderi R, Sehatbakhsh S, Bakhshaee M, Sharifzadeh GR. Urinary melatonin levels and skin malignancy. Iran J Med Sci 2014; 39:64-7. [PMID: 24453396 PMCID: PMC3895897] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 06/01/2013] [Accepted: 07/28/2013] [Indexed: 11/10/2022]
Abstract
Melatonin inhibits tumor genesis in a variety of in vivo and in vitro experimental models of neoplasia. In industrialized societies, light at night, by suppressing melatonin production, poses a new risk for the development of a variety of cancers such as breast cancer. This effect on skin has been previously studied only in animals and not in humans. Our goal was to examine the relationship between 24-hour 6-sulphatoxymelatonin levels and skin cancer in a case-control study of 70 patients with skin cancer and 70 healthy individuals. The level of 6-sulfatoxymelatonin was measured in 24-hour urine by the ELISA method. In the case group, 55 (78%) patients had basal cell carcinoma and 15 (22%) had squamous cell carcinoma. The mean level of 24-hour urine 6-sulfatoxymelatonin was significantly higher in the control group (P<0.001). Also, sleep duration had a significant difference between the two groups (P=0.001). It seems that a low level of 24-hour urinary 6-sulfatoxymelatonin renders human beings prone to skin cancer. This association, however, requires further investigation.
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Affiliation(s)
- Reza Ghaderi
- Department of Dermatology, Birjand University of Medical Sciences, Birjand, Iran;
| | - Samineh Sehatbakhsh
- The Sinus and Endoscopic Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Mashhad, Iran;
| | - Mehdi Bakhshaee
- The Sinus and Endoscopic Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Mashhad, Iran;
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