فهرست مطالب

  • Volume:13 Issue: 5, 2020
  • تاریخ انتشار: 1399/03/12
  • تعداد عناوین: 7
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  • Pedram Hashemian, Hossein Javid, Ayda Tadayyon Tabrizi, Seyed Isaac Hashemy* Page 1
    Context

     Tachykinins (TKs), an evolutionarily conserved family of peptide hormones, are widely distributed within the peripheral and central nervous systems. TKs exert their biological actions in many processes via three subtypes of transmembrane G-protein coupled receptors, which are NK1R, NK2R, and NK3R. Although the mechanisms that connect TKs peptide activity to physiological processes are currently precise, it has been shown that TKs over-activation is associated with the pathogenesis of many diseases, including pain, emesis, depression, stress, and inflammatory processes, as well as human tumors. Gastrointestinal (GI) cancers refer to malignant conditions of the GI tract, which are among the most prevalent diseases and are the leading cause of cancer-related death worldwide. Recent studies have shown that the binding of TKs to specific cellular receptors mediates a critical GI tumor proliferation pathway via initiation and activation of effector mechanisms, including protein synthesis and progression of the eukaryotic cell cycle.

    Evidence Acquisition

    This study reviewed the role of tachykinins in the initiation and progression of gastrointestinal cancers. In this regard we searched databases such as PubMed, Science Direct, Google Scholar, and Scopus databases by using these keywords “Tachykinins”, “Gastrointestinal cancer”, “Metastasis”, “G-protein coupled receptors”, and “pharmacological inhibitor” without any time limit. The relevance of studies was identified by reviewing the titles and the abstracts. A total of 100 English language articles including experimental, observational, molecular, and cellular studies were reviewed.

    Results

    The administration of the gastrointestinal cancer cells with Tk receptor antagonists induces apoptotic cell death through the tachykinin-mediated pathway. The findings showed that the pharmacological inhibition of TKRs with its selective antagonists has a promising prospect for the GI cancers treatment approach, either as a single agent or in combination with other chemotherapeutic agents.

    Conclusions

    In this review, we presented different facts regarding the role of TKs and TKRs in the pathogenesis of GI malignancies for a better understanding and hence better management of these cancers. Therefore, understanding the underlying mechanism of the TK/TKR system can help to have a more excellent clinical vision for the treatment of GI cancers.

    Keywords: Metastasis, Gastrointestinal Cancer, Tachykinins, G-Protein Coupled Receptors, Pharmacological Inhibitor
  • Alireza Mirkheshti, Elham Memary, Shahram Sayyadi, Majid Samsami *, Seyed Hassan Motevalli Page 2
    Background

    To decrease postoperative pain (PP) control, opioid requirement, and outcome improvement, regional anesthesia or preoperative analgesia is routinely performed as an alternative to general anesthesia. Thoracic wall nerve blocks, such as the pectoral nerves (PECS) block have recently become popular for preoperative pain control in patients undergoing breast cancer (BC) surgery.

    Objectives

    The current study was designed to evaluate the effect of PECS anesthesia on the fentanyl and propofol consumption, as well as time to the first request to analgesia in the patients with BC surgery.

    Methods

    A total of 22 women aged 20 to 75 years old with biopsy-proven BC were randomized to receive either propofol general anesthesia with PECS or total intravenous anesthesia without PECS in a randomized clinical trial. Total propofol and fentanyl dose and time to the first request for postoperative analgesia were assessed and compared in both groups.

    Results

    The obtained data showed no significant difference in the total dose of fentanyl and propofol between the two groups. However, the PECS group showed a significant increase in time to the first request for postoperative analgesia.

    Conclusions

    The PECS block in combination with general anesthesia for BC surgery significantly increased time to the first request to analgesia and was effective for reducing PP in the recovery room. PECS block combined with general anesthesia did not reduce the intraoperative use of fentanyl and propofol compared with the control group injected with normal saline.

    Keywords: Breast Cancer, Propofol, Fentanyl, PECS Block
  • Azim Adibmanesh, Mahdi Bijanzadeh, Ghorban Mohammadzadeh, Rahim Alidadi, Mojtaba Rashidi*, Abdolhassan Talaiezadeh Page 3
    Background

    The endothelial nitric oxide synthase (eNOS) gene encodes the eNOS enzyme in humans; it synthesizes nitric oxide (NO), which prevents or promotes colorectal cancer (CRC) progression. Polymorphisms of eNOS are correlated with the probability of cancer, but the findings are not consistent.

    Objectives

    The present study aimed at investigating the correlation of eNOS rs1799983 polymorphism with CRC compared to the control group.

    Methods

    The eNOS rs1799983 polymorphism (G894T) was assessed in 100 healthy control subjects and 100 patients with CRC. Polymerase chain reaction (PCR) and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were utilized to analyze the eNOS polymorphism.

    Results

    The risk of CRC in genotypes TT and GT of eNOS G894T polymorphism was significantly greater than genotype GG. The frequencies of genotypes TT and GT were 6% and 37% in the controls and 28% and 44% in the patients, respectively. The frequency of TT and GT genotypes showed a significant difference between patients with CRC (adjusted odds ratio (OR = 3.1, 95% confidence interval (95% CI) = 1.6 - 3.2; P = 0.001) and controls (adjusted OR = 1.8, 95% CI = 0.6 - 2.5; P = 0.005).

    Conclusions

    According to the results of the present study, allele T of eNOS G894T had a significant correlation with CRC even after adjusting for traditional risk factors.

    Keywords: Colorectal Cancer, Polymorphisms, Endothelial Nitric Oxide Synthase
  • Shervin Shokouhi, Ilad Alavi Darazam, Shiva Shabani*, Dina Jalalvand, Reyhaneh Jamily, Latif Gachkar Page 4
    Objectives

    The aim of this study was to evaluate the clinical significance of early screening of computerized tomography scan of paranasal sinuses (PNS CT) in hematologic malignancies before chemotherapy and evaluation of changes after chemotherapy and during neutropenia.

    Methods

    All 40 new cases of hematologic malignancies with febrile neutropenia in a teaching referral hospital between 2018 and 2019 were enrolled in this study. All of these patients underwent paranasal sinus (PNS) CT scan before chemotherapy, along with other preliminary investigations. Symptoms and signs indicating the infectious process were meticulously followed and monitored before and during chemotherapy as well as the occurrence of febrile neutropenia. All patients were clinically and radiologically evaluated regarding the presumptive diagnosis of invasive fungal sinusitis during prolonged febrile neutropenia (more than 4 days). PNS CTs before and after chemotherapy of all patients were compared by two radiologists and were evaluated based on histopathologic findings of nasal and or paranasal biopsies.

    Results

    Around 50% of patients with PNS CT scan abnormality suspected inflammatory process including microbial and fungal sinusitis during prolonged febrile neutropenia (more than 4 days) were confirmed that have had similar involvement before starting chemotherapy and these abnormalities have been stable with no significant changes after chemotherapy. The histopathologic examination of sinuses also showed no evidence of invasive fungal infection by endoscopic biopsy. Therefore, the abnormal findings including mucosal thickening in PNS CT during prolonged febrile neutropenia were not consistent with the confirmed invasive fungal infection. The rate of mortality was 2.5% without association with invasive fungal sinusitis.

    Conclusions

    A considerable number of patients with underlying hematologic malignancies have paranasal sinus involvement such as mucosal thickening that may be misdiagnosed as invasive fungal sinusitis during the hazardous phase of prolonging febrile neutropenia. Thus, performing PNS CT scan before initiation of chemotherapy even though in asymptomatic patients could be helpful to decrease the number of suspected and probable cases of fungal sinusitis based on abnormal findings in PNS CT scan followed by the number of cases undergoing sinus endoscopic surgery.

    Keywords: Neutropenia, Hematologic Malignancy, Invasive Fungal Sinusitis, Screen Paranasal CT Scan
  • Fazlollah Ghofranipour, Fatemeh Pourhaji *, MohammadHossein Delshad, Fahime Pourhaji Page 5
    Background

    Breast cancer is a major public health problem in both developed and developing countries. The mortality rates of this disease are due to the lack of awareness about screening methods and late detection of breast cancer, which is high in Iran.

    Objectives

    The aim of this study was to determine breast self-examination (BSE) behaviors applying protection motivation theory (PMT).

    Methods

    In this cross-sectional study, the multi-stage cluster sampling method was used to 410 women aged 40 - 65 years old in Tehran, Iran. The questionnaire was completed through self-reported for each of the participants. PMT theoretical variables and BSE behavior are the basis of the data collection procedure. All analyses were performed using SPSS 20 for the windows. One-way ANOVA, chi-Square test, Independent Samples t-test, logistic regression, and Pearson correlation coefficient were applied. We set 0.05 as a criterion for statistical significance.

    Results

    The results indicated there were significant and positive correlations between the knowledge about breast cancer and self-efficacy of practicing BSE (r = 0.43, P < 0.001), response efficacy (r = 0.20, P < 0.001), and protection motivation (r = 0.25, P = 0.003).

    Conclusions

    Healthcare providers may consider PMT as a framework for developing educational interventions aiming at improving women’s BSE behavior.

    Keywords: Breast Cancer, Breast Self-Examination, Protection Motivation Theory
  • Mohammad Mozaffar, Parima Safe, Tayebeh Rostami, Barmak Gholizadeh, Adel Zeinalpour * Page 6
    Introduction

    The autonomic nervous system, a derivative of neural crest cells, may undergo the neoplastic transformation and give rise to paragangliomas, which can arise either at intra-adrenal or extra-adrenal sites, commonly referred to as pheochromocytomas and paragangliomas, respectively. Although indistinguishable at the cellular level and usually identical in clinical manifestation, these two tumors differ in means of malignancy risk, genetic testing, and the probability of detecting an associated neoplasm, highlighting the importance of making a correct diagnosis to prevent additional complications.

    Case Presentation

    We report a 17-year-old female patient presented with sudden blurred vision and palpitation lasting for 1 week. The physical examination revealed tachycardia, hypertension, and a mildly tender mass on the left side of the umbilicus. A spiral abdominal and pelvic computed tomography (CT) scan was performed, which depicted a hypervascular retroperitoneal mass in the left infrarenal region. Mildly-elevated urine metanephrine and normetanephrine levels were suggestive of a paraganglioma (PGL). Iodine-131 metaiodobenzylguanidine (MIBG) scan was also in favor of PGL of the organ of Zuckerkandl. The mass was completely resected and the immunohistochemistry (IHC) study of the specimen confirmed the diagnosis.

    Conclusions

    The diversity of manifestations and rarity of PGL can delay the diagnosis, which may lead to potential complications. This makes it compelling to include PGLs in differential diagnoses in a clinical setting compatible with catecholamine hypersecretion.

    Keywords: Autonomic Nervous System, Neural Crest, Pheochromocytoma, Paraganglioma of Organ of Zuckerkandl
  • Seyed Amir Sheikholeslami, Seyed Saeid Noorani Yazdi, Meghdad Sedaghat *, Sara Sadeghipour Meybodi Page 7
    Background

    Pegylated granulocyte colony stimulating factor (PEG-G-CSF) is used as prophylaxis to reduce the risk of neutropenic fever, as a complication of chemotherapy. Bone pain is one of this drug complications. Although we do not have a standard treatment for controlling the secondary pain due to PEG-G-CSF, the combination of Naproxen and Loratadine has shown good results in several studies.

    Objectives

    The purpose of this study was to compare the non-inferiority of Acetaminophen-Loratadine combination due to its lower complications with the known Naproxen-Loratadine combination in patients with cancer.

    Methods

    Total of 200 patients with solid tumor and lymphoma were randomly assigned to the groups of A (Naproxen and Loratadine), and B (Acetaminophen and Loratadine), and the treatment were applied. During the chemotherapy weeks, after each chemotherapy session, pain scores were evaluated on a pain questionnaire according to the designed schedule. Finally both groups were compared.

    Results

    The median age of patients in the Acetaminophen group was significantly higher than the Naproxen group (P < 0.001). The mean pain score of patients before chemotherapy was 1.07 in the Naproxen group and 1.67 in the Acetaminophen group. There was a statistically significant difference in patients’ average pain between the two groups before the start of chemotherapy (P < 0.001). After controlling the effect of age, sex, and baseline pain, it was observed that the mean pain score in all courses in the Acetaminophen group was higher than the Naproxen group (P = 0.044).

    Conclusions

    By controlling the effects of age, sex, and baseline pain, Naproxen in the second and subsequent courses of treatment was significantly better than Acetaminophen in reducing pain.

    Keywords: Cancer, Bone Pain, PEG-G-CSF