فهرست مطالب
Journal of Research in Medical Sciences
Volume:27 Issue: 6, Jun 2022
- تاریخ انتشار: 1401/04/18
- تعداد عناوین: 6
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Page 43Background
Since December 2019, the world is struggling with an outbreak of coronavirus disease?2019 (COVID?19) infection mostly represented as an acute respiratory distress syndrome and has turned into the most critical health issue worldwide. Limited information is available about the association between dynamic changes in the naso/oropharyngeal viral shedding in infected patients and biomarkers, aiming to be assessed in the current study.
Materials and MethodsThis quasi?cohort study was conducted on 31 patients with moderate severity of COVID?19 anifestations, whose real?time polymerase chain reaction (RT?PCR) test waspositive for severe acute respiratory syndrome?coronavirus?2 (SARS?CoV?2) RNA at baseline. RT?PCR was rechecked for patients every 3–4 days until achieving two negative ones. In parallel, biomarkers, including lymphocyte count, lactate dehydrogenase (LDH), and C?reactive protein (CRP), were assessed every other day, as well. Viral shedding also was assessed.
ResultsSpearman’s correlation test revealed a significant direct correlation between the viral shedding from the symptom onset and the time, in whichCRP (P = 0.0015, r = 0.54) and LDH (P = 0.001, r = 0.6207) return to normal levels after symptom onset, but not for lymphocyte count (P = 0.068, r = 0.34).
ConclusionBased on the current study’s findings, the duration of SARS?CoV?2 RNA shedding was directly correlated with the required time for LDH and CRP return to normal levels. Therefore, these factors can be considered the determinants for patients’ discharge, isolation, and return to social activities; however, further investigations are required to generalize the outcomes.
Keywords: COVID‑19, C‑reactive protein, lymphocyte count, real‑time polymerase chain reaction, virus shedding -
Page 44Background
Despite the availability of iron chelators, toxicity due to increased iron load is the leading cause of death in thalassemia major patients, especially in Iran. This study was performed to determine the association between cardiovascular magnetic resonance using T2?weighted sequences (CMR T2*) and diagnostic value of echocardiographic arterial elasticity in major beta?thalassemia patients without cardiac symptoms in Isfahan, Iran, in 2019 and 2021.
Materials and MethodsThis cross?sectional study assessed the association between CMR T2*, advanced echocardiographic arterial elasticity criteria, and serum ferritin in 67 patients with major beta?thalassemia patients without cardiac symptoms at Chamran Cardiovascular, Medical, and Research Center in Isfahan, Iran, in 2019–2021. Data analysis was performed among the 67 patients using SPSS, version 24.0 (StatisticalProcedures for Social Sciences, Chicago, Illinois, USA). Spearman’s rank test was used to assess the correlation between T2*CMR, echocardiographic arterial elasticity criteria, and ferritin. All parameters are presented as mean ± standard deviation. The results were considered statistically significant at P < 0.05.
ResultsThere was a positive correlation between CMR T2* and arterial elastance index (P = 0.035, r = 0.258), according to the Spearman test. In addition, CMR T2* was not correlated with the erum ferritin (P = 0.158, r = 0.201).
ConclusionTotally, according to the obtained results, it may be concluded that the arterial elastance index from echocardiography and the CMR T2* may be indicators of myocardial iron overload in patients with major beta?thalassemia patients without cardiac symptoms.
Keywords: Arterial elasticity, echocardiography, ferritin, major thalassemia, T2*CMR -
Page 45Background
Plaque instability is a leading cause of morbidity and mortality in coronary artery disease (CAD) patients. Numerous efforts have been made to figure out and manage unstable plaques prior to major cardiovascular events incidence. The current study aims to assess the values of the atherogenic index of plasma (AIP) to detect unstable plaques.
Materials and MethodsThe current case?control study was conducted on 435 patients who underwent percutaneous coronary intervention due to chronic stable angina (stable plaques, n = 145) or acute coronary syndrome (unstable plaques, n = 290). The demographic, comorbidities, chronic edications, biochemical and hematological characteristics of the patients were entered into the study checklist. The baseline AIP was measuredaccording to the formula of triglycerides/high?density lipoprotein logarithm. Binary logistic regression was applied to investigate the standalone association of AIP with plaque instability. Receiver operating curve (ROC) was depicted to determine a cut?off, specificity, and sensitivity of AIP in unstable plaques diagnosis.
ResultsAIP was an independent predictor for atherogenic plaque unstability in both crude (odds ratio [OR]: 3.677, 95% confidence interval [CI]: 1.521–8.890; P = 0.004) and full?adjusted models (OR: 15, 95% CI:2.77–81.157; P = 0.002). According to ROC curve, at cut?point level of 0.62, AIP had sensitivity and specificity of 89.70% and 34% to detect unstable plaques, respectively (area under the curve: 0.648, 95% CI: 0.601–0.692, P < 0.001).
ConclusionAccording to this study, at the threshold of 0.62, AIP as an independent biomarker associated with plaque instability can be considered a screening tool for patients at increased risk for adverse events due to unstable atherosclerotic plaques.
Keywords: Arezoo Khosravi, Masoumeh Sadeghi, Ehsan Shirvani Farsani, Manizheh Danesh, Kiyan Heshmat?Ghahdarijani, Hamidreza Roohafza, Ali Safaei -
Page 46Background
This study aimed to determine changes in microvascular endothelial function with upper arm arteriovenous fistula (AVF) creation and maturation in patients with chronic kidney disease (CKD).
Materials and MethodsThis prospective cross?sectional study was performed at Hospital Universiti Sains Malaysia, a tertiary hospital in Malaysia. Forty CKD patients (stage 4–5) who were scheduled for elective AVF creation over the upper extremity for maintenance hemodialysis were recruited using conveniencesampling method. Microvascular endothelial?dependent vasodilation was measured using laser Doppler flowmetry and the process of iontophoresis preoperatively and postoperatively at weeks 2 and 6. Fistula maturation was assessed at week 6.
ResultsThirty?two patients had successful AVF maturation. Endothelial?dependent vasodilation (acetylcholine (Ach)%) was higher (246.48 [standard deviation (SD) 209.38] vs. 104.95 [SD 43.29], P = 0.001) while systolic blood pressure was lower (142.25 [SD 21.50] vs. 162.25 [SD 13.26], P = 0.017) in this group as compared to unsuccessful AVF group. No significant changes were seen in overall microvascular endothelial?dependent vasodilation during the 6?week study period (day 0, 246.48 [SD 209.38]; week 2, 201.14 [SD 198.19]; and week 6, 203.53 [SD 145.89]).
ConclusionUpper arm AVF creation does not affect microvascular endothelial function up to 6 weeks post operation and may not contribute to the success of AVF maturation. However, the lower microvascular endothelial?dependent vasodilation and higher systolic blood pressure in unsuccessful AVF subjects need to be further studied.
Keywords: Arteriovenous fistula, chronic kidney disease, hemodialysis, microcirculation, vascular access -
Page 47Background
Streptococcus mutans involved in caries pathogenesis is classified into four serotypes, namely serotypes c, e, f, and k. Candida albicans can be found in the plaque of children with early childhood caries (ECC).
AimsThe aim of this study was to analyze the quantity of the antigens of S. mutans serotype e and C. albicans and its correlation with the salivary flow rate in ECC.
Materials and MethodsThe antigen quantities of caries plaque samples and caries?free were determined using an enzyme?linked immunoassay with 450?nm optical density.
ResultsThere was a significant difference between the quantity of S. mutans serotype e and C. albicans antigens in each salivary flow rate category (P < 0.05). The relationship between the antigen quantity of S. mutans serotype e and C. albicans was r = 0.624 (P > 0.05) for caries plaque samples and r = 0.628 (P > 0.05) for caries?free samples.
Conclusionthe antigen quantities of S. mutans serotype e and C. albicans and the salivary flow rate might correlate to the pathogenesis of ECC.
Keywords: Endang Winiati Bachtiar, Vanya A Kusuma, Ferry P Gultom, Retno D Soejoedono -
Page 48Background
Available data suggest that obesity is related to changes in the several adipocyte?derived proteins levels, which are involved in cancer recurrence. The purpose of this work was to investigate the correlation etween obesity with metalloproteinase?9 (MMP?9), adiponectin and adiponectin and AMP?activated protein kinase (AMPK) levels by comparing serum levels of MMP?9, AMPK in normal weight and obese breast cancer survivors.
Materials and MethodsIn this cross?sectional study, 30 normal weight breast cancer survivors (body mass index [BMI] 18.5?25 kg/m2) and 30 obese breast cancer survivors (BMI ?30 kg/m2) were investigated.Anthropometric parameters and serum levels of MMP?9, adiponectin, and AMPK were compared between the two groups.
ResultsNo differences were detected in the serum levels of MMP?9, adiponectin, and AMPK in obese patients and normal weight patients (P > 0.05). There were no correlations between MMP?9, adiponectin, and AMPK levels with anthropometric measurements in two groups (P > 0.05).
ConclusionWe found that there was a lack of correlation between obesity measures and serum levels of MMP?9, adiponectin, and AMPK. In breast cancer survivors, it seems that circulating levels of adiponectin, AMPK, and MMP?9 do not change in obesity state.
Keywords: Zeinab Babaei, Hadi Parsian, Bahare Korani, Amrollah Mostafazadeh, Dariush Moslemi