فهرست مطالب

Journal of Research in Medical Sciences
Volume:23 Issue: 7, July 2018

  • تاریخ انتشار: 1397/04/24
  • تعداد عناوین: 10
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  • Zohreh Manoochehri, Nader Salari, Mansour Rezaei, Habibolah Khazaie, Sara Manoochehri, Behnam Khaledi Pavah Page 1
    Background
    Diagnosing of obstructive sleep apnea (OSA) is an important subject in medicine. Tis study aimed to compare the performance of two data mining techniques, support vector machine (SVM), and logistic regression (LR), in diagnosing OSA. Te best?ft model was used as a substitute for polysomnography (PSG), which is the gold standard for diagnosing this disease.
    Materials And Methods
    A total of 250 patients with sleep problems complaints and whose disease had been diagnosed by PSG and referred to the Sleep Disorders Research Center of Farabi Hospital, Kermanshah, between 2012 and 2015 were recruited in this study. To ft the best LR model, a model was frst ftted with all variables and then compared with a model made from the signifcant variables using Akaike’s information criterion (AIC). Te SVM model and radial basis function (RBF) kernel, whose parameters had been optimized by genetic algorithm, were used to diagnose OSA.
    Results
    Based on AIC, the best LR model obtained from this study was a model ftted with all variables. Te performance of fnal LR model was compared with SVM model, revealing the accuracy 0.797 versus 0.729, sensitivity 0.714 versus 0.777, and specifcity 0.847 vs. 0.702, respectively.
    Conclusion
    Both models were found to have an appropriate performance. However, considering accuracy as an important criterion for comparing the performance of models in this domain, it can be argued that SVM could have a better efciency than LR in diagnosing OSA in patients.
    Keywords: Genetic algorithms, logistic regression, obstructive sleep apnea, polysomnography, supp
  • Supakanya Lasom, Nantarat Komanasin, Nongnuch Settasatian, Chatri Settasatian, Upa Kukongviriyapan, Pongsak Intharapetch Page 2
    Background
    Te imbalance of von Willebrand factor (vWF) and a disintegrin and metalloproteinase with a thrombospondin type 1
    motif member 13 (ADAMTS13) has been associated with atherosclerosis progression. A high level of vWF which regulates thrombus formation is associated with diabetes mellitus (DM), and some ADAMTS13 and vWF polymorphisms have e?ects on their levels. Terefore, this study aimed to evaluate the associations of ADAMTS13 and vWF polymorphisms and their levels with DM and severity of coronary stenosis. Materials and
    Methods
    Eighty?seven DM and 84 control individuals were recruited. vWF and ADAMTS13 activities as well as vWF antigen were measured by collagen?binding assay (CBA), residual?CBA, and in?house enzyme?linked
    immunosorbent assay, respectively. ADAMTS13 and vWF polymorphisms were determined by polymerase chain reaction?restriction fragment length polymorphism.
    Results
    Te E and G alleles and AA genotype of ADAMTS13 Q448E, rs2073932, and rs652600, respectively, were independently associated with DM (odds ratio [OR] [95% confdence interval (CI)] = 2.5 [1.1, 5.6], 2.3 [1.0, 5.2], and 4.7 [1.2, 18.6], respectively). Moreover, E allele and AA genotype of Q448E and rs652600 were also signifcantly associated with multi?vessel disease (OR [95% CI] = 2.2 [1.0, 4.8] and 3.2 [1.0, 10.0], respectively), while the E and G allele of Q448E and rs2073932 were associated with high Gensini score (OR [95% CI] = 2.3 [1.1, 4.9] and 2.3 [1.1, 5.1], respectively).
    Conclusion
    Association ofADAMTS13 polymorphisms with DM, number of vessel stenosis, and Gensini score may indicate the possible contribution of ADAMTS13 polymorphisms to atherosclerosis progression and severity of coronary stenosis in DM.
    Keywords: A disintegrin_metalloproteinase with a thrombospondin type 1 motif member 13_coronary stenosis_diabetes mellitus_polymorphism
  • RalucaAna Rusu, Dana SÎrbu, Daniela Cureu, Bogdana Nsui, Mdlina Sava, Tefan Cristian Vesa, Anca Bojan, Cosmin Lisencu, Monica Popa Page 3
    Background
    Te objective of the present study was to determine the association between chemotherapy and infectious complications in patients diagnosed with Hematologic malignancies (HMs).
    Materials And Methods
    Te study included 463 patients diagnosed with HMs multiple myeloma (MM), Hodgkin’s lymphoma (HL), non?HL (NHL), acute myeloid leukemia (AML), acute lymphocytic leukemia, chronic lymphocytic leukemia, and chronic myeloid leukemia, between January 2014 and June 2015. Te patients were followed for 1 year after inclusion, to record the infectious complications. Te collected data included age, sex, type of chemotherapy
    regimen, and several blood tests at admission. All patients received prophylactic treatment with antibiotics and antifungal agents. For each infection, we recorded the microbiological diagnosis and the day of occurrence since HMs diagnosis.
    Results
    In patients with MM, we found that the treatment with growth factors (hazard ratio [HR] 2.2; confdence interval [CI] 95%: 1–4.6; P = 0.03) was associated with a higher chance of infectious complications. In patients with non?Hodgkin lymhoma (LNH), the following drugs were associated with a higher infectious incidence: cytarabine (HR: 2.3; CI 95%: 1–5; P = 0.03), methotrexate (HR: 2.1; CI 95%: 1.8–4; P = 0.01), dexamethasone (HR: 1.7; CI 95%: 0.9–3; P = 0.06), growth factors (HR: 1.7; CI 95%: 0.9–3.2; P = 0.001), and etoposide (HR: 2.5; CI 95%: 1.5–4.2; P = 0.002). Cytarabine (induction) (HR: 2; CI 95%: 1.1–3.7; P = 0.01), cytarabine (consolidation) (HR: 2.1; CI 95%: 1.3–3.5; P = 0.01), and growth factors (HR: 2.1; CI 95%: 1.3–3.5; P = 0.002) were often on the therapeutic plan of patients with AML, which developed infections.
    Conclusion
    Regarding the chemotherapy regimen, the highest incidences of infectious complications were observed for growth factors and cytarabine.
    Keywords: Chemotherapy, hematologic malignancies, infectious complications
  • Kaan Gokcen, Gokce Dundar, Halil Gulbahar, Gokhan Gokce, Emin Yener Gultekin Page 4
    Background
    Te purpose of this study was to assess the diagnostic role of preoperative hematological parameters, especially neutrophil?to?lymphocyte ratio (NLR), platelet?to?lymphocyte ratio (PLR), and mean platelet volume (MPV) in germ cell testicular malignancies and their prediagnostic role in staging of testicular cancer.
    Materials And Methods
    In this cross?sectional retrospective study, we analyzed 39 patients who underwent radical orchiectomy due to a testicular cancer (Group 1) and 82 patients on whom varicocelectomy procedure was performed as control group (Group 2) between January 2006 and January 2016 in our clinic. Evaluation of the preoperative hematological parameters in both groups and also the subgroups in malignancy group according to histopathological stages was conducted in this study.
    Results
    When the hematological parameters were compared, a statistically signifcant di?erence was found between the two groups in terms of neutrophil counts, NLR, PLR, and MPV. NLR and PLR were signifcantly higher and MPV was signifcantly lower in testicular cancer group compared to the control group. NLR was 3.1 ± 1.4 and 2.0 ± 1.5, PLR was 141.3 ± 53.2 and 115.7 ± 44.8, and MPV was 8.9 ± 1.0 and 9.3 ± 1.1 for testicular cancer and control groups, respectively (P
    Conclusion
    In accordance with these fndings, NLR, PLR, and MPV may be helpful for prediagnosis of testicular malignancies. Hematological parameters will become important in the preoperative assessment for those patients.
    Keywords: Hematological parameters, neutrophil?to?lymphocyte ratio, testicular cancer
  • Feyzi Gokosmanoglu, Attila Onmez Page 5
    Background
    In this study, we aimed to retrospectively evaluate treatment outcomes and treatment methods in acromegaly patients.
    Materials And Methods
    Te study included 65 acromegaly patients followed in Sakarya University Faculty of Medicine Department of Endocrinology in Turkey between 2004 and 2013. Clinical, biochemical, and radiological data were obtained retrospectively from the medical fles of the patients. All cases have been discussed in the endocrinology and pituitary surgery council, and a multidisciplinary treatment approach had been chosen in management.
    Results
    Sixty?fve patients were included in the study. Of the patients, 57% were female. Mean age was 45.3 ± 9.2 years old. Of the cases, 12.3% were microadenomas (n = 8, tumor diameter
    Conclusion
    Pituitary surgery is the frst treatment option for acromegaly. In patients who could not be remissioned after the frst operation, remission can be achieved by combined therapy consist of reoperation, medical treatment, and conventional or stereotactic radiotherapy.
    Keywords: Acromegaly, pituitary gland, treatment
  • Farhad Vahid, Samaneh Rashvand, Mahya Sadeghi, Azita Hekmatdoost Page 6
    Background
    Ulcerative colitis (UC) is a chronic in?ammatory bowel disease. Recent studies have shown that dietary factors play an important role in the development of UC. Index of Nutritional Quality (INQ) is a suitable method that analyzes quantitatively and qualitatively single foods, meals, and diets. Te aim of this study was to determine the association between INQ and UC.
    Materials And Methods
    Overall, 62 newly diagnosed cases with UC and 124 healthy age? and sex?matched controls were studiedin a referral hospital in Tabriz, Iran. INQ scores were calculated based on information on the usual diet that was measured by a valid and reliable Food Frequency Questionnaire consisting of 168 food items. Logistic regression analysis adjusting for age, gender, body mass index, education, smoking, Helicobacter pylori, family history of UC, appendectomy, alcohol, and total energy intake was used to estimate multivariable odds ratios (ORs).
    Results
    After controlling for several covariates, we found inverse associations between UC risk and INQs of Vitamin C (OR = 0.34 [0.16–0.73]) and folate (OR = 0.11 [0.01–0.99]). In crude model of analysis, cases had a higher intake of total energy, protein, carbohydrate, total fat, saturated fatty acid, monounsaturated fatty acid, polyunsaturated fatty acid, niacin, Vitamin B6, Vitamin B12, magnesium, zinc, copper, selenium, and iron compared to controls, whereas controls had higher intakes of Vitamin C, Vitamin D, folate, and biotin compared to cases.
    Conclusion
    Our results indicate that enoughconsumption of Vitamin C and folate was associated with lower risk of UC.
    Keywords: Folate, Index of Nutritional Quality, in?ammatory bowel disease, nutritional assessment, ulcerative colitis, Vitamin C
  • Bita Moudi, Zahra Heidari, Hamidreza MahmoudzadehSagheb, Parisa Farrokh Page 7
    Background
    Lamnin has important effects on human immunity system. The current study aimed to assess the role of L?leucine?7?amido?4?methyl coumarin 1 gene polymorphisms on hepatitis B virus (HBV) susceptibility.
    Materials And Methods
    Te rs20558, rs20563, rs10911193, rs10911251, and rs1413390 polymorphisms were analyzed using polymerase chain reaction (PCR) and PCR?reaction–restriction fragment?length polymorphism and amplifcation?refractory mutation system?PCR using three di?erent groups including chronic HBV?infected patients, HBV patients who were resolved their infection spontaneously and healthy volunteers. Laminin concentrations were also measured in the blood of these individuals.
    Results
    People with rs20558C, rs20563G, and rs10911193T alleles have an increased risk of HBV infection. Moreover, we found that CGTAT haplotype was more frequent in chronically infected people who could a?ect the mechanism of disease. Furthermore, there was a signifcant relationship between laminin concentration and rs20558, rs20563, and rs10911193 genotypes in patients.
    Conclusion
    According to the statistical analysis, rs20558, rs20563, rs10911193 polymorphisms probably, related to the chronic HBV infection. In addition, no association of the rs10911251, rs1413390 single nucleotide polymorphisms with the disease was found.
    Keywords: Hepatitis B virus_laminin_single nucleotide polymorphism
  • Sahar Vahdat Page 8
    Kidney diseases are categorized as the highest prevalent ones with worldwide noticeable incidence. Tey cause accelerated cardiovascular diseases and noticeable mortalities. Adipose tissue and its messengers, adipokines, are reported to have the highest relationship with end?stage renal diseases or chronic kidney diseases. Over recent years, with shifting of scientists’ mindset from a simple overview of adipose tissue as a fat store to the complex paradigm of this issue as a multipotential secretory organ, the importance of studies on this tissue has emerged.
    Keywords: Adipokines, adipose tissue, kidney diseases
  • Ciamak Ghazaei Page 9
    Mycobacterium tuberculosis is a causative agent of tuberculosis that causes deaths across the world. Te pathogen apart from causing disease manifestations can also enter into a phase of latency to re?emerge later. Among the various factors associated with the virulence of pathogen, the lipids composing the cell wall of the bacillus have drawn much interest among. Te unique composition of the cell wall composed of mycolic acid, glycolipids such as diacyltrehaloses, polyacyltrehalose, lipomannan, lipoarabinomannan (LAM), mannose?capped?LAM, sulfolipids, and trehalose?6,6’?dimycolate, all have been implicated in providing the pathogen an advantage in the host. Te pathogen also alters its metabolism of fatty acids to survive the conditions in the host that is re?ected in an altered cell wall composition in terms of lipids. In addition, the lipid profle of the cell wall has been shown to modulate the immune
    responses launched by the host, especially in the suppression, or roduction of in?ammatory factors, cytokines, and phagocytic cells, such as dendritic cells and macrophages. Apart from M. tuberculosis, the paper also brie?y looks at the role of Mycobacterium bovis and its role in tuberculosis in humans along with its lipid profle of its cell wall. Tis review aims to summarize the various lipids of the cell wall of M. tuberculosis along with their roles in enabling the pathogen to maintain its virulence to infect further humans and its persistence inside the host.
    Keywords: Cell wall lipids of Mycobacterium bovis, glycolipids, pathogenicity, lipids of cell wall, Mycobacterium tuberculosis, persistence, role of lipids in virulence
  • Farzad Gheshlaghi, Nastaran EizadiMood, Shayan Gheshlaghi Page 10