فهرست مطالب

Govaresh - Volume:22 Issue: 1, 2017

Govaresh
Volume:22 Issue: 1, 2017

  • تاریخ انتشار: 1396/02/07
  • تعداد عناوین: 8
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  • Amir Sadeghi, Mohammad Javad Ehsani Ardakani, Negyn Jamshidfar, Mohammad Rostami Nejad, Mohammad Reza Zali Pages 7-16
    Celiac disease as an autoimmune disease is predisposes in genetically susceptible subjects due to the consumption of wheat and other grains containing gluten and as a result of immunological responses, villous atrophy, mucosal hyperplasia, and lymphocytic infiltration will be occurred. The only treatment is a lifelong gluten-free diet.
    Most patients with celiac disease respond to gluten-free diet (GFD). But in a small percentage of patients, despite full compliance with gluten-free diet, symptoms and mucosal atrophy are remains. When other causes of mucosal atrophy are rejected, the diagnosis of refractory celiac disease (RCD) is suggested. Based on the abnormality in population of intraepithelial lymphocytes (IEL), RCD is divided into two types 1; (RCD I) and type 2 (RCDII). Prognosis, clinical symptoms and endoscopic findings of RCD I are better and milder than the RCD II. Treatment of RCD I is based on immunosuppressive therapy and RCD II is mostly based on nutritional support and chemotherapeutic agents. In this review the clinical characteristics, diagnostic and treatment approach of RCD will be reviewed.
    Keywords: Refractory celiac disease, Treatment, Diagnosis, Clinical manifestation
  • Zeinab Ghorbani, Azita Hekmatdoost, Hossein Poustchi, Akram Pourshams, Akbar Fazeltabar Malekshah, Maryam Sharafkhah, Reza Malekzadeh* Pages 17-27
    Background
    Pancreatic cancer (PC) is classed as the 7th leading cause of cancer-related death in the world. Previous evidence indicates that hyperglycemia, insulin resistance, diabetes, and obesity are implicated in pancreatic carcinogenesis. Thus, evaluation of the dietary intakes in the etiology of PC can be useful to identify the risk factors of the disease.
    Methods and Materials: We examined the association between total intake of fruits, vegetables, and dietary fiber and the risk of PC in 50,045 participants aged 40-75 years within the Golestan Cohort Study. Dietary data were collected using a validated semi-quantitative food-frequency questionnaire, which was administered at baseline. Cox proportional hazards models were used to estimate multivariate hazard ratio with 95% confidence interval.
    Results
    During 383,630 person-years of follow-up and after excluding the participants with incomplete baseline information, a total of 48,676 adults were evaluated. Until October 30, 2014, 54 cases of PC were confirmed based on the exact cause of death using ICD10 criteria. After considering all potential confounding factors, there was only a statistically significant inverse association between the risk of PC for the highest tertile of daily fiber intake compared with the lowest tertile (HR=0.41; 95% CI= 0.15-1.05; P for trend= 0.05). However, the relationship between fruits and vegetables and PC risk was not statistically significant.
    Conclusion
    In summary, based on the findings of this study, increased dietary fiber may reduce the risk of PC. This result highlights the importance of a diet rich in fiber in order to prevent PC progression. Finally, given the limited number of studies in this field and inconclusive results, there is still a need for new prospective studies with long follow-up.
    Keywords: Cohort studies, Pancreatic cancer, Nutrition, Fruits, Vegetables, Fiber
  • Sepehr Mohajerani, Sayed Abbas Haghayegh*, Peiman Adibi Pages 28-38
    Background
    The quality of life is an important target variable in determining the impact of the illness on the life of patients with ulcerative colitis. The present study aimed to investigate the role of alexithymia, illness perception, and resilience in the quality of life of patients with ulcerative colitis.
    Materials And Method
    This study is descriptive and correlational. 58 patients (34 females, 24 males) who suffered from ulcerative colitis and had referred to gastrointestinal clinics of Isfahan from March to May 2016 were selected. They were examined by using available sampling methods. The data were collected by three
    Methods
    1. Demographic forms concerning the subjects. 2. Clinical interview done by gastroenterologists based on the evidence of endoscopic, pathological, and colonoscopic findings. 3. Questionnaires that measured the variables alexithymia (Bagby, Taylor, & Parker, 1994), illness perception (Brad Benet, and his colleagues, 2006), resilience (Conner & Davidson, 2003), and quality of life (standardized by Gholamrezaei, and his colleagues).
    Results
    Based on regression results, there is a relationship between illness perception and the quality of life of the patients with ulcerative colitis. In addition, the results of correlation have shown that there is a significant relationship between alexithymia, illness perception, and resilience with the quality of life of the patients (p
    Conclusions
    It can be concluded that among the variables, illness perception is the most relevant to the quality of life.
    Keywords: Alexithymia, Illness perception, Resilience, Quality of life, Ulcerative colitis
  • Mohsen Saleh Jazi, Saber Zahri, Saeid Latifi Navid, Ardeshir Talebi Pages 39-46
    Background
    Colorectal cancer (CRC) is one of the most common gastrointestinal cancers worldwide. KRAS mutations are found in 20-30% of the cases and are associated with poor response to anti-EGFR therapies. Mutations in the KRAS gene induce the constitutive protein activity by eliminating the GTPase activity in the signal transduction pathway. Somatic mutations of KRAS are located up to 90% in codons 12 and 13 of exon 2. Therefore, this study evaluated the association between KRAS mutations and clinicopathological features of patients with CRC in Isfahan.
    Materials And Methods
    This study was performed on 52 patients with CRC referred to Al-Zahra Hospital in Isfahan. Total DNA was extracted from fresh tumor and normal tissues. The exon 2 of KRAS gene was amplified and sequenced for detection of the point mutations. After mutation analysis, the clinical and pathological associations of mutant genes were assessed.
    Results
    The prevalence of KRAS gene mutation was 15/4% (8 out of the 52 cases). Six mutations found in codon 12 (75%), were G12D and G12A, and two mutations found in codon 13 (25%) were G13D. Common tumor sites were rectum and rectosigmoid. The mean age of the patients was 61/2±13/9 years (range: 31-87 years). There was no significant relationship between the mutations and clinicopathological features of patients with CRC (p>0.05).
    Conclusions
    This paper presents new results on the frequency of KRAS mutations in patients with CRC. KRAS mutations could be used as molecular biomarkers to predict the lack of response to anti-EGFR monoclonal antibodies.
    Keywords: Colorectal cancer, KRAS, Mutation, Anti-EGFR
  • Mahmud Baghbanian, Hasan Salmanroghani, Mohsen Borhanimoghadam, Mohammad Zolfaghari Pages 50-56
    Background
    Providing ways for long-term feeding is essential for those who are not able to ingest. Percutaneous endoscopic gastrostomy (PEG) is a type of enteral feeding methods. The aim of this study was to evaluate the complications, indications, and one-year survival of this method in patients who underwent PEG.
    Materials And Methods
    The cross-sectional study was carried out on 97 patients (census sampling) who had referred to Shahid Sadoughi Hospital in Yazd (Iran) for PEG tube placement in the period of March 2014 to March 2016. Data were collected using a researcher-made questionnaire and were analyzed using SPSS software version 18.
    Results
    Cerebrovascular accident (CVA) was the most reason to refer to the hospital (52 cases, [%53.6]) followed by head and neck trauma (32 cases [33%]), head and neck tumors (6 cases, [6.2%]), ischemic encephalopathy (5 cases, [5.2%]), and burning (head trauma) (2 cases [1.2%]). Wound infection was observed in eight cases (8.2%), aspiration in three cases (1.3%), bleeding in three cases (3.1%), external leakage in two cases (2.1%), unplanned removal in two cases (2.1%), subcutaneous abscess in one patient (1%), and recurrent vomiting in one patient (1%). One year survival was measured 83.5%.
    Conclusions
    PEG tube is a very convenient feeding method. Its complications are limited compared with its benefits and it is useful for patients who have trouble in ingestion for a long time. Early discharge from the hospital, especially the intensive care units, reduces costs and length of hospital stay.
    Keywords: Enteral nutrition, Gastrostomy, Endoscopy, PEG tube, Complication
  • Abbas Esmaeilzadeh, Ladan Goshayeshi *, Ali Bahari, Azita Ganji, Hooman Mosannen Mozaffari Pages 57-63
    Background
    Hepatitis delta virus (HDV) is an RNA virus that causes hepatitis. Since HDV is dependent on hepatitis B virus (HBV) for its pathogenesis, two major types of HDV and HBV infection is coinfection with HBV in anti-HBs negative individuals, or superinfection in chronic HBV carriers. Therefore, the prevalence of HDV depends on the frequency of HBV infection in various populations. In this study, we aimed to systematically review the prevalence of HDV in Iran.
    Materials And Methods
    A systematic literature search was performed in August 2016 in PubMed, Scopus, and Iran Medex using the following keywords (((hepatitis delta virus OR HDV)) AND (prevalence OR frequency OR distribution OR epidemiology)) AND Iran to investigate the prevalence of HDV in Iran. After literature search and selection of appropriate documents, the desired data were extracted and described.
    Results
    A total of 14 articles with overall 6300 study population with HDV infection were collected. The results of this study showed that the prevalence of HDV varied from zero in the north to 19.7% in the south of Iran (in HIV infected patients).
    Conclusions
    The prevalence of HDV was relatively high among Iranian patients with chronic HBV infection. Furthermore, the results of this study showed that the prevalence of HBV/HDV coinfection has increased during the last decade in Iran.
    Keywords: Hepatitis D virus_HDV antigen_Coinfection_Superinfection
  • Ramak Ghavam, Marjan Mokhtare, Ali Zaremirzaie, Alireza Aziz Ahari, Amirhosein Faghihi, Alireza Hejrati Pages 64-67
    A 48-year-old man was found to have elevated liver enzymes and clinical manifestations of icter, itching, nausea, and vomiting. He had developed a severe hepatotoxic reaction, liver fibrosis, and cirrhosis after treatment with acitretin 25 mg daily (oral retinoid, which is the derivative of etretinate). Elevated serum aminotransferase levels, which are usually reversible, have been reported during treatment with acitretin, however; the present study indicates a warning message that severe hepatotoxic injury may follow such a treatment.
    Keywords: Acitretin, Hepatictoxicity, Cirrhosis
  • Rezvan Mirzaei, Bahar Mahjoubi, Ali Reza Negahi * Pages 68-72
    Lower gastrointestinal bleeding refers to bleeding within the lumen of the gastrointestinal tract located below the ligament of Treitz. In this study, we present a case with bleeding from massive anorectal varices, caused by a congenital high pressure Portosystemic
    shunt. A 31-year-old man with a prolonged history of painless rectal bleeding was referred to our center. The onset of symptoms was at the age of two years. Finally, he underwent semi-elective surgery due to severe bleeding and a diagnosis of portosystemic shunt was made intraoperatively.
    Keywords: Gastrointestinal Bleeding, Congenital, Porto systemic shunt