Iranian Red Crescent Medical Journal
Volume:21 Issue: 7, Jul 2019

New-onset diabetes mellitus (DM) after the first attack of acute pancreatitis (AP) has not been fully elucidated. The study aimed to explore the incidence and time-course of pancreatic endocrine insufficiency in patients with new-onset prediabetes or DM after the first attack of AP.  A comprehensive literature review was conducted by searching four major biomedical journal databases (PubMed, Embase, Cochrane Library, and Web of Science).  We included all prospective clinical studies that investigated the change in the metabolization of glucose after hospital discharge following the first attack of AP.  After quality assessment, data were extracted according to a standard protocol. Because of between-study heterogeneity, data were analyzed by the random-effects method. The inclusion criteria were met by 12 clinical studies, including 766 patients with the first attack of AP. Prediabetes and/or DM was observed in 51% (95% CI: 55% to 63%) of the patients after the first attack of AP. The pooled incidence of prediabetes and DM after AP was 23% (95% CI: 16% to 30%) and 18% (95% CI: 11% to 26%), respectively. The risk of new-onset prediabetes and DM significantly increased in 1 - 3 years (relative risk (RR): 4.00 (95% CI: 1.68 - 9.53)) and 3 - 5 years (RR: 2.12 (95% CI: 1.9 - 3.8)), respectively. New-onset prediabetes and/or DM after the first attack of AP developed in 51% of the patients after hospital discharge and the risk of DM increased more than two folds over three years.

Microarray technology is an accurate method for recognition of disease association gene alterations. However, there still is not an effective approach for the evaluation of gene expression in ovarian cancer. A reliable approach is described to identify genes associated with ovarian cancer. Microarray gene expression data analysis was applied to correct systematic differences through four different normalization methods; LOESS, 3D LOESS, and neural network (NN3, NN4). Then, three different clustering methods of K-means, fuzzy C-means, and hierarchical methods were examined on corrected gene expression values. The proposed approach was tested on a reliable source of genes’ information, where the entropy of genes in samples and Euclidean distance were used for gene selection. Our findings revealed that a neural-network-based normalization method could better control the effects of non-biological variations from microarray data. Moreover, the hierarchical clustering was more effective compared to other methods, and resulted in the identification of three genes, including BC029410, DUSP2, and ILDR1, as candidates for disease-association genes. According to the finding of the present study, hierarchical clustering with nonlinear-based normalization could have the ability to prioritize genes for ovarian cancer

Non-alcoholic Fatty Liver Disease (NAFLD) has become the first liver disease worldwide. This study aimed to explore the prospective risk factors for NAFLD in a large sample of the Chinese population in a five-year follow-up. In a cohort study, 1,277 subjects, enrolled in the Second Hospital of Dalian Medical University, were screened initially in 2013 and followed up yearly until 2017. NAFLD was diagnosed based on the ultrasound criteria and the absence of excessive alcohol intake. The follow-up parameters, obtained for 1,165 subjects, included both clinical parameters (body mass index and blood pressure) and biological parameters (fasting plasma glucose (FPG), plasma lipid indices, liver function parameters, and hematological parameters). All statistical analyses were performed using SPSS v20.0 software, and the logistic regression analysis was used to evaluate the risks for incidental and sustained NAFLD. Individuals with NAFLD at the baseline were more frequently male, old, obese, hypertensive, and diabetic, with hyperuricemia, dyslipidemia, higher liver enzymes, and higher hematological parameters (all P < 0.001). Logistic regression analysis showed that BMI and dyslipidemia were the independent predictors of NAFLD (OR = 1.2, 0.1, 5.2, 10.6, and 16.7 for BMI, TC, TG, LDL-C, and HDL-C, respectively, all P < 0.05). Moreover, increased systolic and diastolic blood pressure, and the serum transaminases (OR of 0.97, 1.04, and 1.02) were independently associated with sustained NAFLD (all P < 0.001). The present study indicated that increased BMI and dyslipidemia are the potential predictors of NAFLD development and that hypertension and hypertransaminasemia could be the risk factors for NAFLD maintenance. These findings may have practical therapeutic implications.

Cryptorchidism is a common gonadal disease in neonates that promotes oxidative stress and reactive oxygen spices production following the presence of testicles in ectopic places. Nuclear factor erythroid 2-related factor 2 (Nrf2) signaling could prevent oxidative stress damage through the Nrf2-driven antioxidants.

The current study aimed at evaluating the pattern of gene expressions related to this pathway in testis and epididymis of mice experimentally subjected to cryptorchidism.

The current experimental study was conducted on 48 male mice randomly divided into six groups at Arak University of Medical Sciences, Arak, Iran, 2018. Cryptorchidism was induced in the left testis of mice in five experimental groups by removing the testis from the scrotum and suturing it to the muscles of the abdominal wall. One group remained intact as the control group. Sperm parameters were analyzed one day, as well as one, two, four, and eight weeks after the operation. The expression of Nrf2, NQO1, HO1, and Keap1 genes in testis and epididymis was assessed using quantitative reverse transcriptase- polymerase chain reaction.

Sperm analysis showed a significant decrease in sperm number, viability, normal morphology (except in the one day group), and motility in all experimental groups compared to the control group (P ≤ 0.05). The expression level of Nrf2 (in testis tissue), Keap1 (in both testis and epididymis), and HO1 (in testis tissue) showed no changes over the time (P > 0.05), while the expression of other genes decreased remarkably (P ≤ 0.05) in both testis tissue and epididymis in a time-dependent manner.

The current study findings showed that the expression of genes involved in NRF2 systems decreased in the epididymis of cryptorchid mice more than testis and it suggested that treatment with Nrf2 inducer could decrease destructive effects of cryptorchidism on the reproductive system.

Evidence shows that chemical fertilizers used for agricultural purposes have high levels of nitrate. These agricultural products consumed by livestock are the most important sources of nitrate. Type-IV collagen, found primarily in the base membrane, is significantly vital for the performance of glomerular base membrane in the kidney. The present study aimed to investigate the effect of nitrate and vitamin C on the expression of type-IV collagen in rat kidney. This empirical research was conducted on 49 Wistar rats in Iran from 2017 to 2018. The sample size was determined using Morgan Table Samples were randomly divided into seven groups: (1) no nitrate (control), (2) nitrate at 10 mg/L, (3) nitrate at 45 mg/L, (4) nitrate at 200 mg/L, (5) nitrate (10 mg/L) + vitamin C (20 mg per 100 g of body weight), (6) nitrate (45 mg/L) + vitamin C (similar amount), and (7) nitrate (200 mg/L) + vitamin C (similar amount). After 91 days, the content of type-IV collagen in the kidney tissue was determined using the immunohistochemistry (IHC) protocol. The expression of type-IV collagen gene was detected by real-time polymerase chain reaction (RT-PCR) in all groups. There was no significant difference among the groups of 1-3 (4.55 ± 0.51, 4.7 ± 0.47, 3.6 ± 0.5, P > 0.05) in terms of type-IV collagen. However, the obtained results of group 4 indicated a significant reduction in the content of type-IV collagen (1.25 ± 0.44), compared to the control group (4.55 ± 0.51, P = 0.000). In terms of vitamin C consumption, the groups of 5 (3.45 ± 0.51) and 6 (3.4 ± 0.5) did not differ significantly from the control group (4.55 ± 0.51, P > 0.05). Nonetheless, the severity of response to anti-type-IV collagen antibody significantly increased in group 7 (3.55 ± 0.6) compared to group 4 (1.25 ± 0.44, P < 0.05). The investigated doses of nitrate in drinking water (up to 45 mg/L) had no significant effect on the content of type-IV collagen. On the other hand, the excessive concentrations of nitrate limited the distribution of type-IV collagen and led to potential side effects on the glomerular base membrane. Moreover, vitamin C had no significant effect on 10 and 45 mg/L doses of nitrate. Nevertheless, 200 mg/L dose of nitrate improved the destructive effects of type-IV collagen on the kidney.

Hemodilution anemia, due to the use of crystalloid liquids during the preparation of cardiopulmonary bypass (CPB) circuits, results in the increased number of RBC, which may lead to hemolysis, acute pulmonary injury, allergic reactions, metabolic and coagulative abnormalities, volume overload, alloimmunization, immunosuppression, graft versus host reaction, and a remarkable increase in hospitalization costs. The present study aimed to evaluate the effects of shortened cardiopulmonary bypass circuits on the blood salvage process in patients undergoing cardiac surgery with cardiopulmonary bypass and determine the cutoff BSA value for effectiveness. A retrospective cohort study was performed in a private hospital, Ankara, Turkey, between January 2011 and November 2015 to assess 235 patients having a CPB with shortened circuits. The control group comprised 240 patients who underwent cardiac surgery utilizing a standard extracorporeal circulation circuit at our institution. In the case group, to achieve a low-priming volume, the CPB circuit was shortened and CPB console was positioned as close as possible to the operative field. The arterial line (3/8”) and the venous line (1/2) were 80 cm and 90 cm, respectively, shorter in the case group than in the control group. Patient data were collected by retrospective medical chart review. Intraoperative red blood cell (RBC) transfusion amount was 465 ± 141.5 mL in the case group and 722.5 ± 285.4 mL in the control group (P < 0.001). Postoperative RBC transfusion was 418.7 ± 198.1 mL in the case group and 628.7 ± 452.3 mL in the control group (P < 0.001). The total amount of RBC transfusion was 742.4 ± 228.7 mL in the case group and 1012.3 ± 625.5 mL in the control group (P < 0.001). ROC analysis showed that shortening the CPB circuits was effective in patients with a BSA of < 1.67 (AUC = 0.84; P < 0.001) Shortening of the CPB circuit could be helpful to avoid severe hemodilution and to reduce RBC use in small adult patients (with BSA < 1.67) undergoing cardiac surgery with cardiopulmonary bypass.

Adenosine deaminase (ADA) is involved in recurrent spontaneous abortion (RSA) while normal pregnancy is defined by suppressed cell-mediated immunity. This study aimed to determine the connection between single nucleotide polymorphism (SNP) G22A and protection against RSA. In this analytical case-control study, the allele frequency of ADA G22A gene polymorphism was determined in 113 participants including 50 women with RSA and 63 healthy pregnant women using RFLP-PCR to determine if there is a statistically significant difference in the frequency of ADA genotypes between the patient group and the control group. The frequency of ADA2/ADA2 (AA) genotype was significantly different between RSA patients and controls (P = 0.004) while no significant differences were identified in the genotype frequency of ADA1/ADA1 (GG) (OR = 0.678; P = 0.228) and ADA1/ADA2 (GA) (OR = 0.976; P = 0.943). SNP G22A in the ADA gene was associated with the protection against RSA. The frequency of ADA alleles in RSA patients was compared between the age groups, and the results indicated that the ADA2 (A) allele was associated with protection against RSA in patients aged 35 years or younger (P < 0.0001). The findings showed that women carrying the ADA*2 allele are protected against RSA.

Atopic dermatitis (AD) is a chronic inflammatory skin disease with a specific immune and inflammatory mechanism. This study investigates inflammatory biomarkers and their correlation with disease severity. The aim of this study is to determine the relationship between platelet parameters [(mean platelet volume (MPV), platelet distribution width (PDW)], the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and AD severity in children. In this retrospective study, we reviewed patients diagnosed with AD and a healthy control group at the department of pediatrics at Health Sciences in a university-affiliated hospital in Istanbul, Turkey, between January 2015 and December 2016. The study included 79 children with AD and 75 healthy controls. AD severity was graded using the Scoring Atopic Dermatitis (SCORAD) index. Complete blood count was measured, and NLR and PLR were calculated. NLR, PLR, MPV, PDW were compared between AD patients and healthy controls, and the correlations between these indexes and clinical characteristics were analyzed. No significant difference was observed between patients and controls for MPV, NLR, and PLR (P = 0.708, P = 0.340, P = 0.179, respectively). In the AD group, PDW was lower than controls (17.39 ± 1.45, 18.04 ± 1.65, P = 0.006). In the severe AD group, MPV was higher (7.62 ± 1.81, 6.64 ± 1.16, P = 0.035) and PDW was lower than in the mild AD group (16.52 ± 1.49, 17.93 ± 1.44, P = 0.0001). Mean MPV and PDW levels are correlated with atopic dermatitis severity in children.

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. There is no definitive treatment for this, and prevention and treatment via diet and weight loss have been recommended. This study aimed to investigate the effect of Dava Al-Balgham, as one of the traditional medicine products, in patients with NAFLD. The study was a randomized, double-blinded, placebo-controlled trial performed among 76 patients with NAFLD in a university-affiliated hospital, Qom, Iran, in 2017. The individuals were assigned into two groups of intervention (receiving Dava Al-Balgham; n = 37) and placebo (n = 39), using the randomized block allocation method. Both groups maintained the same diet and lifestyle. In the intervention group, two tablets of Dava Al-Balgham (a combination of Nigella sativa, Zataria multiflora, Pistacia lentiscus, and Trachyspermum ammi) were consumed with each meal for three months. In the other group, placebo tablets were used in the same manner. Pre- and post-intervention weight, waist circumference, and liver enzyme levels were measured. Chi-square, t-test, and analysis of covariance were used for comparing the two groups. The levels of liver enzymes, weight, and waist circumference decreased in both groups. The mean reduction in alanine transaminase (ALT) in the intervention group was 22.80, while it was 1.59 in the placebo group (P = 0.008). The mean weight loss in the intervention and placebo groups was 2.69 kg and 0.9 kg, respectively (P = 0.003). Moreover, the mean reduction in waist circumference in the intervention and placebo groups was 3.43 cm and 0.33 cm, respectively (P = 0.001). Dava Al-Balgham tablets with the weight loss and hypolipidemic effect of its components can be used to help the prevention and treatment of NAFLD.

Breast carcinosarcoma is an extremely rare breast tumor comprising two distinct components, a carcinomatous component and a non-epithelial component of mesenchymal origin. It is a subtype of metaplastic carcinoma with a difficult preoperative diagnosis. We present the case of a 68-year-old postmenopausal woman with squamous metaplasia coexisting with adenocarcinoma in the epithelial component of a breast carcinosarcoma. She has been admitted in Department of Breast Surgery, The First Hospital of Jilin University, Changchun, China, in 2017, with a left breast mass. Preoperative assessment and histopathological examination of biopsy samples did not confirm the diagnosis of breast carcinosarcoma. The evaluation of tissue removed during surgery showed three components: high-grade fibrosarcoma (70%), squamous cell carcinoma (25%), and adenocarcinoma (5%), which were consistent with the diagnosis of breast carcinosarcoma. Immunohistochemistry showed that the epithelial component was positive for cytokeratin (CK) 5/6, CK7, CK-pan, and P40, and the sarcomatous component was positive for vimentin and smooth muscle actin (SMA). The estrogen and progesterone receptors (ER, PR) were negative but HER-2/neu was positive (2+) in adenocarcinoma. Case studies describing the clinical characteristics, diagnosis, and treatment of breast carcinosarcoma are required to raise the awareness of the heterogeneous nature of this tumor among clinicians. Large prospective studies should be conducted to identify the most beneficial therapeutic protocol.