فهرست مطالب

Medical Sciences - Volume:44 Issue: 5, 2019
  • Volume:44 Issue: 5, 2019
  • تاریخ انتشار: 1398/06/10
  • تعداد عناوین: 10
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  • Seyedeh Masomeh Derakhshandeh Rishehri, Ali Reza Rahbar *, Afshin Ostovar Pages 359-373
    Background

    C-reactive protein (CRP) and lipoprotein (a) (Lp[a]) play essential roles in cardiovascular disease incidence. This study aimed to review the association between the intake of conjugated linoleic acid (CLA) in the form of dietary supplement or enriched food with different treatment durations and the levels of Lp(a) and CRP in human studies.

    Methods

    All the articles published in Cochrane Library, ProQuest, Scopus, and Google Scholar from November 2014 to October 2015 were searched and the clinical trials on the effects of CLA on Lp(a) and CRP levels were assessed. Of the 2249 articles initially retrieved, 21 eligible randomized clinical trials were enrolled in this systematic review. The publication dates of the eligible articles ranged from 2005 to 2013. The mean difference and the standard deviation of changes in CRP and Lp(a) levels in intervention and control groups were used as effect-size measures for meta-analysis. The obtained data from the eligible randomized controlled trials were meta-analyzed using Stata, version 13.

    Results

    The intake of CLA as a dietary supplement led to a significant increase in CRP levels (standardized mean difference [SMD]=0.41, 95% CI: 0.28 to 0.54; P=0.001). Subgroup analysis based on the duration of CLA consumption showed that CLA consumption more than 24 weeks resulted in a significant increase in the levels of CRP (SMD=0.52, 95% CI: 0.36 to 0.68; P=0.001) and Lp(a) (SMD=0.24, 95% CI: 0.01 to 0.47; P=0.04).

    Conclusion

    The current systematic review and meta-analysis showed that the long-term consumption of CLA increases the levels of CRP and Lp(a).

    Keywords: Conjugated linoleic acid, C-reactive protein, Lipoprotein (a), Meta-analysis
  • Alireza Rajaei, Ali Amiri *, Faraneh Farsad, Pooneh Dehghan Pages 374-381
    Background
    Trabecular bone score (TBS) measures the underlying quality of bone texture using dual-energy X-ray absorptiometry (DXA) images. The present study aimed to investigate the correlation between lumbar spine bone mineral density (BMD) and TBS, and subsequently determine whether the association varies with the body mass index (BMI).
    Methods
    Data from 548 patients were collected and categorized into three groups according to the relationship between BMD and age. BMD of the lumbar spine (LS) using DXA and TBS from DXA images were measured. Pearson’s correlation coefficient (SPSS software, version 24.0) was used to investigate the association between LS-BMD and TBS, as well as the effect of BMI and age on these parameters. P
    Results
    The total mean TBS was 1.31±0.12. LS-BMD and TBS values significantly decreased with age in both sexes. A statistically significant correlation was found between TBS and LS-BMD (r=0.601). An increase in BMI was associated with a higher LS-BMD score and a lower TBS level. The correlation coefficient between LS-BMD and TBS reduced as the BMI increased. By comparing TBS with BMD, the majority of the patients with osteopenia and osteoporosis had fully degraded and partially degraded TBS, respectively.
    Conclusion
    TBS was positively correlated with LS-BMD and decreased with age. Moreover, the extent of the correlation varied with respect to BMI.
    Keywords: Bone Density, Osteoporosis, Cancellous bone, Body mass index
  • Zahra Jeddi, Younes Lotfi *, Abdollah Moossavi, Enayatollah Bakhshi, Seyed Basir Hashemi Pages 382-389
    Background

    Variability in speech performance is a major concern for children with cochlear implants (CIs). Spectral resolution is an important acoustic component in speech perception. Considerable variability and limitations of spectral resolution in children with CIs may lead to individual differences in speech performance. The aim of this study was to assess the correlation between auditory spectral resolution and speech perception in pediatric CI users.

    Methods

    This cross-sectional study was conducted in Shiraz, Iran, in 2017. The frequency discrimination threshold (FDT) and the spectral-temporal modulated ripple discrimination threshold (SMRT) were measured for 75 pre-lingual hearing-impaired children with CIs (age=8–12 y). Word recognition and sentence perception tests were completed to assess speech perception. The Pearson correlation analysis and multiple linear regression analysis were used to determine the correlation between the variables and to determine the predictive variables of speech perception, respectively.

    Results

    There was a significant correlation between the SMRT and word recognition (r=0.573 and P<0.001). The FDT was significantly correlated with word recognition (r=0.487 and P<0.001). Sentence perception had a significant correlation with the SMRT and the FDT. There was a significant correlation between chronological age and age at implantation with SMRT but not the FDT.

    Conclusion

    Auditory spectral resolution correlated well with speech perception among our children with CIs. Spectral resolution ability accounted for approximately 40% of the variance in speech perception among the children with CIs.

    Keywords: Child, Cochlear implant, Auditory threshold, Speech perception
  • Reza Salehi, Hossein Negahban, Najmeh Saghayezhian *, Maryam Saadat Pages 390-396
    Background

    Clinicians and researchers commonly use responsive outcome measures to interpret changes in a patient’s condition as a result of an intervention. This study was conducted to assess the ability of the Persian version of Neck Disability Index and Functional Rating Index to detect responsiveness in the patients with neck pain.

    Methods

    A diagnostic accuracy study was done in Ahvaz, Iran, 2016. A convenience sample of 57 Persian-speaking patients with non-specific chronic neck pain completed the Neck Disability Index and the Functional Rating Index at the beginning and after physiotherapy intervention. The responsiveness was investigated by the receiver operating characteristics method and the correlation analysis. Statistical analysis was done using SPSS (version 21), with a P<0.05 as the level of significance.

    Results

    The Functional Rating Index showed that the area under the curve was greater than 0.70 (range=0.651-0.942). The optimal cutoff points for the Functional Rating Index and the Neck Disability Index were 9.5 and 7.5, respectively. Gamma correlation between change scores of the Functional Rating Index and the Neck Disability Index and the Global Rating of Change Scores was 0.53 and 0.33, respectively.

    Conclusion

    The results indicated that the Persian version of the Functional Rating Index could detect clinical changes following physiotherapy intervention in a group of patients with chronic non-specific neck pain. Therefore, we recommend that this instrument be used as a responsive measure of neck pain disability in patients with neck pain.

    Keywords: Disability evaluation, Neck Pain, Patient health questionnaire, ROC curve
  • Asef Hormozi, Asadollah Zarifkar *, Bahar Rostami, Fakhraddin Naghibalhossaini Pages 397-405
    Background

    Intense stress can change pain perception and induce hyperalgesia; a phenomenon called stress-induced hyperalgesia (SIH). However, the neurobiological mechanism of this effect remains unclear. The present study aimed to investigate the effect of the spinal cord µ-opioid receptors (MOR) and α2-adrenergic receptors (α2-AR) on pain sensation in rats with SIH.

    Methods

    Eighteen Sprague-Dawley male rats, weighing 200- 250 g, were randomly divided into two groups (n=9 per group), namely the control and stress group. The stress group was evoked by random 1-hour daily foot-shock stress (0.8 mA for 10 seconds, 1 minute apart) for 3 weeks using a communication box. The tail-flick and formalin tests were performed in both groups on day 22. The real-time RT-PCR technique was used to observe MOR and α2-AR mRNA levels at the L4-L5 lumbar spinal cord. Statistical analysis was performed using the GraphPad Prism 5 software (San Diego, CA, USA). Student’s t test was applied for comparisons between the groups. P<0.05 was considered statistically significant.

    Results

    There was a significant (P=0.0014) decrease in tailflick latency in the stress group compared to the control group. Nociceptive behavioral responses to formalin-induced pain in the stress group were significantly increased in the acute (P=0.007) and chronic (P=0.001) phases of the formalin test compared to the control group. A significant reduction was also observed in MOR mRNA level of the stress group compared to the control group (P=0.003). There was no significant difference in α2-AR mRNA level between the stress and control group.

    Conclusion

    The results indicate that chronic stress can affect nociception and lead to hyperalgesia. The data suggest that decreased expression of spinal cord MOR causes hyperalgesia.

    Keywords: Stress, Hyperalgesia, Spinal cord, Receptors, opioid, mu, Adrenergic alpha-2 receptor antagonists
  • Naeimeh Dehghani, Mehdi Dianatpour *, Seyed Ebrahim Hosseini, Zahra Khodabandeh, Hamed Daneshpazhouh Pages 406-414
    Background
    Gamete cryopreservation is an inseparable part of assisted reproductive technology, and vitrification is an effective approach to the cryopreservation of oocytes. The aim of this study was to investigate vitrification effects on the expression levels of mitochondrial transcription factor A (Tfam) and mitochondrial-encoded cytochrome c oxidase subunit 1 (Cox1) in mouse metaphase II oocytes.
    Methods
    Oocytes were selected by simple random sampling and distributed amongst five experimental groups (control [n=126], docetaxel [n=132], docetaxel+cryoprotectant agent [CPA] [n=134], docetaxel+vitrification [n=132], and vitrification [n=123]). After the warming process, the oocytes were fertilized and cultured into a 2-cell stage. Then, the effects of vitrification on the expression of the Tfam and Cox1 genes were determined via real-time reverse transcriptase polymerase chain reaction. Each group was compared with the control group. The data were analyzed with ANOVA using GraphPad and SPSS, version 21.
    Results
    A significant decrease was observed in the fertilization rate of each group in comparison with the control group (P=0.001). The rate of 2-cell formation after in vitro fertilization was significantly lower in both vitrification groups (docetaxel+vitrification and vitrification) than in the non-vitrification groups (fresh control and docetaxel) and control group (P=0.001 and P=0.004). The expression level of Cox1 was significantly higher in the vitrification group than in the control group (P=0.01), while it was lower in the docetaxel group than that in the control group (P=0.04). The expression level of the Tfam gene was significantly high in the vitrification group (vitrification+docetaxel) and the non-vitrified group (docetaxel+CPA) in comparison with the control group (P=0.01).
    Conclusion
    This study indicated that the vitrification of mouse MII oocytes increased the expression of the Tfam and Cox1 genes.
    Keywords: Vitrification, Oocytes, Docetaxel, Mitochondrial transcription factor A
  • Chiquita Prahasanti *, Lieke Halim Subrata, Tania Saskianti, Ketut Suardita, Diah Savitri Ernawati Pages 415-421
    Background
    Tissue engineering using Stem cell from Human Exfoliated Deciduous Teeth (SHED) and a natural biomaterials biomaterial scaffold has become a promising therapy for the alveolar bone defect. The aim of this study was to analyze the Osteoprotegerin (OPG) and Receptor Activator of NF-Κb ligand (RANKL) expression after the application of Hydroxyapatite scaffold and SHED.
    Methods
    A laboratory experimental research with a post test-only control group. 14 male Wistar rats weighing from 260 to 280 g were used as the animal study. The animals were randomly assigned to an experimental group Hydroxyapatite scaffold (group I) and Hydroxyapatite scaffold combined with SHED (group II). The alveolar bone defect in the animal study model was affected by extracting anterior mandible teeth. Immunostaining was performed after 8 weeks in order to facilitate the examination of OPG and RANKL expression. Data were analyzed by independent t test. The correlation between OPG and RANKL expression were analyzed using Pearson’s correlation test (P<0.05). Statistical analysis was performed using R statistical software version 3.4.0.
    Results
    The independent t test showed that the differences were statistically significant. OPG expression in Group I (6.0±1.00) was lower than in Group II (11.6±1.14) (P=0.0004). The independent t test showed that the differences were statistically significant. RANKL expression for Group I (12.67±2.08) and Group II (4.80±1.304) showed a statistically significant difference (P=0.0005).
    Conclusion
    Hydroxyapatite scaffold and SHED increase Osteoprotegerin and decrease Receptor Activator of NF-κB Ligand expression with high potential as an effective agent in alveolar bone defect regeneration.
    Keywords: Mesenchymal stromal cells, Tissue engineering, Hydroxyapatites, Osteoprotegerin, RANK ligand
  • Nafiseh Saghafi, Asieh Maleki *, Sedigheh Ayati, Laya Shirinzadeh Pages 422-426
    Uterine rupture often occurs in the third trimester of pregnancy or during labor. Its occurrence in early pregnancy and in the absence of any predisposing factors is very rare. Untimely diagnosis and a low index of suspicion could be life-threatening. Here we report the case of a 29-year-old woman with a history of two previous cesarean sections. An ultrasound report revealed a dead fetus in the abdominal cavity at 14 weeks into the abdominal cavity due to a rupture at the site of the previous cesarean scar. Awareness of probable diagnosis of uterine rupture in a pregnant woman with abdominal pain could be important for timely diagnosis and proper management.
    Keywords: Uterine Rupture, Pregnancy Trimester, First, Cesarean Section
  • Maliheh Mahmoudinia, Masoumeh Mirteimoori *, Armin Attaranzadeh Pages 427-429

    Cervical adenomyomas of endocervical type (endocervical adenomyomas) are very rare benign lesions. Here we report the case of a 33-year-old woman who referred to the Perinatology Clinic of Ommolbanin Hospital (Mashhad, Iran) in September 2017. The patient was 8 weeks pregnant and complained of spotting and feeling a mass protruding from her vagina for 2 months. Physical examination revealed the presence of three masses of approximately 10 cm in the vagina, which were treated surgically. Histopathological examination of the excised specimen showed the presence of glands lined by a single layer of endocervical-type mucinous epithelium with smooth muscle fibers. Clinicians should be aware of such lesions in order to differentiate them from other malignancies and to individualize treatment.

    Keywords: Adenomyoma, Cervix uteri, Uterus, Vagina
  • Donya Farrokh, Reihane Mortazavi, Soroosh Dehghani, Farrokh Seilanian Toosi, Bita Abbasi * Pages 430-431