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Reviews in Clinical Medicine - Volume:3 Issue: 4, Autumn 2016

Reviews in Clinical Medicine
Volume:3 Issue: 4, Autumn 2016

  • تاریخ انتشار: 1395/10/11
  • تعداد عناوین: 8
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  • Farzad Khademi *, Mohammad Derakhshan, Ramin Sadeghi Pages 133-140
    Introduction
    Susceptibility to tuberculosis (TB) infection varies in individuals and is linked to genetic variations in the toll-like receptors (TLRs) genes. The current study employed a systematic literature review and meta-analysis to describe the most prevalent single nucleotide polymorphisms (SNPs) from various TLRs and to assess the association between these polymorphisms and tuberculosis susceptibility.
    Methods
    The PubMed, Google Scholar, Scopus, and ISI Web of Knowledge databases were searched for all articles published before May 25, 2015, that contained the target keywords. Following the application of the inclusion and exclusion criteria, a total of 37 relevant articles were identified that examined the association between the TLRs gene polymorphism and susceptibility to tuberculosis.
    Result
    A meta-analyses approach to the research determined that there is a statistically significant association between TLR1 rs4833095, TLR6 rs5743810, and TLR8 rs3788935 in the allelic model and also TLR1 rs4833095, TLR1 rs5743018, TLR2 rs5743708, TLR6 rs5743810, and TLR8 rs3761624 in the co-dominant model with increased or decreased susceptibility to tuberculosis. No associations were observed between the other TLRs polymorphisms and tuberculosis risk.
    Discussion
    Several studies have found that host genetic factors, such as SNPs in TLRs gene, may increase an individual’s susceptibility to tuberculosis. Therefore, the identification of these SNPs is important to investigate immune responses to TB.
    Conclusion
    The present study concluded that there is an association between some polymorphisms of TLRs and tuberculosis risk. Thus, for a better understanding about the role of SNPs to TB susceptibility, additional studies on alternative TLRs SNPs are needed.
    Keywords: Mycobacterium tuberculosis, Polymorphism, Toll, Like Receptor
  • Kamran Aryana, Abolghasem Allahyari, Ramin Sadeghi, Farrokh Silanian Tousi, Mohammad Mahdi Kooshyar, Seyed Hosein Hashemipour, Hamideh Sadra * Pages 141-147
    Introduction
    This systematic review studies the prognostic value of two conventional imaging tools, sestamibi and gallium scans, for predicting how patients with Hodgkin lymphoma will respond to treatment.
    Methods
    The PubMed database was searched for English-language articles that contained the following search terms: (Hodgkin AND [mibi OR sestamibi OR gallium OR spect] AND response). All articles that were identified during this search were included in the study, regardless of date published. The inclusion criteria were as follows: articles that described studies that were limited to Hodgkin patients and that reported the predictive value of conventional imaging tools. Articles about other types of lymphoma and/or those that focused on the diagnostic and staging accuracy of mibi and gallium scans were excluded.
    Result
    In total, 14 articles were retrieved. Of these, the majority met the inclusion criteria of the systematic review with the exception of two, which were limited to an examination of the reliability of performing sestamibi scans to predict the response to treatment. All remaining 12 articles considered both the sestamibi scans and the gallium scintigraphy.
    The results of the systematic review indicate that positive gallium scan results can be proposed as a poor prognostic factor that is associated with partial or full recurrence of Hodgkin disease, a reduction in overall survival rate, and progression-free survival compared with patients with a negative scan.
    Discussion
    Both sestamibi and gallium scans revealed high sensitivity and specificity in predicting the response to treatment including complete remission, partial remission, and recurrence of the disease.
    Conclusion
    These imaging tools can appropriately assess how Hodgkin patients will respond to chemotherapy. As such, clinicians can use these tools to devise appropriate treatment strategies.
    Keywords: Hodgkin lymphoma, Gallium scintigraphy, Sestamibi
  • Mohammad Mardani, Mohammad Javad Saeedi Borujeni, Ebrahim Esfandiary* Pages 148-153
    Congenital fusion of cervical vertebrae is a rare anomaly. In this condition, two fused vertebrae appear structurally and functionally as one. This anomaly may be symptomatic or asymptomatic. Myelopathy, limitation in neck movement, muscular atrophy and regional sensory loss are examples of probable morbidity associated with this anomaly. Combination of genetic and environmental factors are involved in pathogenesis of this anomaly. Malformation of notochord, poor performance of retinoids, decreased local blood supply of spine and alteration in genes expression, especially members of Hox and Pax family genes are some of the proposed reasons of congenital fusion of cervical vertebrae. Diagnosis of this congenital anomaly in childhood seems to have an important role in prevention of probable secondary disorders in adulthood. We offer to clinicians that after performing careful physical tests and noticing the presence of signs and symptoms that mentioned in this paper, if a patient suspected to have congenital fusion of cervical vertebrae, genetic tests ought to be performed.
    Keywords: Cervical vertebrae fusion, Developmental anomalies, Embryology
  • Atooshe Rohani * Pages 154-157
    One in five adults has patent foramen ovale (PFO), which is typically without symptoms. Because of the low pressure in both atria and the anatomical position of the septum secundum, there is no left-to-right shunting and little right-to-left shunting in the general condition; however, when the right atrial pressure increases, this slit-like flap separates and allows right-to-left shunting. According to the Johnson criteria, simultaneous occurrences of arterial emboli, such as those caused by cerebrovascular accident or pulmonary embolism, demonstrate the presence of paradoxical embolism through a PFO. When a patient presents with multivascular arterial embolism, the clinician should perform a contrast transthoracic echo, a transesophageal (TEE), a real-time three-dimensional TEE, and even an intracardiac echocardiography (ICE) in order to differentiate between PFO, flat atrial septal defect (ASD) and hybrid defects. The randomized trials that have assessed therapeutic interventions for paradoxical embolism have not produced any clear guidelines as to how best to treat this condition. The classic treatment is surgical embolectomy with exploration of the right chambers and the pulmonary arteries under full cardiopulmonary bypass. Patients with a history of ≥1 paradoxical embolism may be indicated for device PFO closure.
    Keywords: Echocardiography, Paradoxical embolism, Patent foramen ovale
  • Jalil Tavakol Afshari, Mahdi Yousefi, Roshanak Salari * Pages 158-162
    Atopic dermatitis is an inflammatory skin disease that starts in the early life and usually persists by the end of life in 20% of cases. The disease shows multiple periods of relapse, and significantly affects the patient’s quality of life. The etiology of this disease is unknown, yet recent studies have reported incidence of immunological disorders and mutation in the filaggrin gene as the major causes. In some cases, concurrent incidence of infection with these inflammatory lesions reinforces the significance of treatment. Various methods of treatment such as emollients, corticosteroids, and calcineurin inhibitors are applied to manage this disorder. Traditional and complementary approaches may also help to control the disease. This disease is not usually easily controllable, thus requires full awareness of physicians on the underlying prospects of this disease. This review paper deals with the important aspects of the clinical perspectives and presents an integrative therapeutic approach for treating atopic dermatitis.
    Keywords: Atopic dermatitis, Immunological disorder, Treatment
  • Niaz Mohammad Jafari Chokan*, Hamidreza Reihani, Elham Pishbin Pages 163-165
    Anterior shoulder dislocation is the most common joint dislocation in human body. Many methods are traditionally described for reduction of shoulder dislocation. Most of these techniques are painful to patients and may be associated with further injury. An ideal method should be easy, effective, and less painful, not associated with iatrogenic complications and should be easy to teach and learn. Among different methods of reduction, external rotation and Milch methods are more popular. Both methods are found to be atraumatic, relatively painless and can be performed without anesthesia. In this article, we aimed to review the literatures regarding these two methods of reduction and comparing their success rate and outcome. We reviewed the literature to find articles related to reduction of anterior shoulder dislocations applying one of two techniques described above. We searched PubMed and Google Scholar. In total, 46 articles were found, of them 17 articles -which mainly focused on anterior shoulder dislocation reduction by means of two above methods-were included in this review. The results showed that both techniques were effective, safe, relatively painless, and were well tolerated with no complications, but the external rotation method was superior.
    Keywords: Shoulder, Shoulder dislocation, Shoulder joint
  • Mohammad Derakhshan* Pages 166-170
    Type A influenza viruses causes infections in human and animals, especially in birds. Wild aquatic birds are the natural hosts for all known influenza type A viruses. Avian type viruses are divided into two groups: highly pathogenic avian influenza (HPAI) and low pathogenic avian influenza (LPAI). HPAI virus is very dangerous, but LPAI virus is much weaker. Two forms of mutations including drift and shift have been recognized for antigenic changes in influenza viruses. Antigenic shift is responsible for producing re-assortment viruses with a potentiality to be transmissible to human and possibly resulting in pandemic. Emerging new species of viruses, the loss of previous immunity in human population and the transmission from human to human are the three major conditions that result in the occurrence of influenza pandemic in human. When pandemic happens, public health is a major concern due to probability of high fatality rate and other socioeconomic consequences.
    Keywords: Human_Influenza A virus_Pandemics
  • Raheleh Mirsadraee, Saba Vakili, Mohammad Reza Abbaszadegan, Rahim Vakili * Pages 171-174
    Fragile X syndrome (FXS) is the most common known genetic cause of male intellectual disability. A wide variety of medical problems has been reported in FXS syndrome including seizures, facial abnormalities, macroorchidism, and autistic disorders. Here we reported a 9-year-old boy with fragile X syndrome that was confirmed through karyotyping and mental retardation. Initially, he was diagnosed as hypothyroidism when he was 15 months old. However, due to unusual clinical presentation, we re-evaluated the patient according to his history and clinical findings. Subsequently, targeted laboratory tests were performed and the results were indicative for thyroxin-binding globulin (TBG) deficiency in our patient. Therefore, levothyroxine was discontinued and one month later, laboratory tests were repeated and his diagnosis confirmed. As inherited TBG deficiency might also be X-linked, FXS and TBG deficiency may be coincidental findings in the patient.
    Keywords: Fragile X syndromes_Hypothyroidisms_TBG deficiency_Thyroid function test