Publications by authors named "Gholamreza Esmaeeli Djavid"

39 Publications

Network Analysis of Common Genes and Transcriptional Factors between Celiac Disease and Inflammatory Bowel Diseases.

Middle East J Dig Dis 2020 Oct;12(4):257-264

Department of Photo Healing and Regeneration, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran.

BACKGROUND Understanding the associations among different disorders remarkably improves their diagnosis and treatments. Celiac disease is the most complicated and prevalent form of immune-mediated diseases. On the other hand, inflammatory bowel diseases lead to inflammation of the intestine with an unknown cause. Although inflammatory bowel diseases have been often thought of as an autoimmune disorder, they can be triggered by whatever that can lead to the inflammation in the whole bowel. Henceforth, both aforementioned diseases are related to autoimmune attacks and cause a sort of inflammatory event, which exploring trade-off among them supposedly will lead to discovering important genes and, in turn, to the possible common therapeutic protocols. In the current study, we aimed to determine the correlation between the common genes in celiac disease and inflammatory bowel diseases. METHODS 314 and 851 genes correlated with celiac disease and inflammatory bowel diseases respectively extracted from DisGeNET were subjected to an in-silico data analysis framework to mine prognosticates genes and the associated pathways. RESULTS 149 shared genes between these diseases regulated by highlighted transcription factors NFKB1, IRF1, STAT1, HSF1, GATA3 were characterized as discriminating molecules, which by further screening were enriched in pathways mostly involved in apoptosis, T cell activation, and cytokine, chemokine, and interleukin signaling. CONCLUSION We observed that the identified common genes were associated with a wide range of pathogenic mechanisms underlying these diseases.
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http://dx.doi.org/10.34172/mejdd.2020.191DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7859603PMC
October 2020

An in vitro model for investigation of vitamin A effects on wound healing.

Int J Vitam Nutr Res 2021 Jan 4:1-6. Epub 2021 Jan 4.

Department of Photo Healing and Regeneration, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran.

Wound healing consists of a series of highly orderly overlapping processes characterized by hemostasis, inflammation, proliferation, and remodeling. Prolongation or interruption in each phase can lead to delayed wound healing or a non-healing chronic wound. Vitamin A is a crucial nutrient that is most beneficial for the health of the skin. The present study was undertaken to determine the effect of vitamin A on regeneration, angiogenesis, and inflammation characteristics in an in vitro model system during wound healing. For this purpose, mouse skin normal fibroblast (L929), human umbilical vein endothelial cell (HUVEC), and monocyte/macrophage-like cell line (RAW 264.7) were considered to evaluate proliferation, angiogenesis, and anti-inflammatory responses, respectively. Vitamin A (0.1-5 μM) increased cellular proliferation of L929 and HUVEC (p < 0.05). Similarly, it stimulated angiogenesis by promoting endothelial cell migration up to approximately 4 fold and interestingly tube formation up to 8.5 fold (p < 0.01). Furthermore, vitamin A treatment was shown to decrease the level of nitric oxide production in a dose-dependent effect (p < 0.05), exhibiting the anti-inflammatory property of vitamin A in accelerating wound healing. These results may reveal the therapeutic potential of vitamin A in diabetic wound healing by stimulating regeneration, angiogenesis, and anti-inflammation responses.
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http://dx.doi.org/10.1024/0300-9831/a000692DOI Listing
January 2021

Application of a collagen matrix dressing on a neuropathic diabetic foot ulcer: a randomised control trial.

J Wound Care 2020 Mar;29(Sup3):S13-S18

4 Teba Zist Polymer Company (Treetta), Technology and Innovation Development Management, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran.

Objective: Diabetic foot ulcers (DFU) are often hard-to-heal, despite standard care. With such a complicated healing process, any advanced wound care to aid healing is recommended. Chitosan/collagen composite hydrogel materials have the potential to promote the regenerative process. In this study, the efficacy of a new collagen matrix dressing including chitosan/collagen hydrogel was compared with a standard dressing of saline-moistened gauze for wound healing in patients with a hard-to-heal neuropathic DFU.

Method: This is an open labelled, randomised clinical trial. After conventional therapy consisting of debridement, infection control and offloading, patients were randomly allocated to receive either a collagen matrix dressing (the study group, receiving Tebaderm manufacturer) or a saline-moistened gauze dressing (control group) for wound care. The reduction in DFU size and the number of patients with complete healing were measured throughout the treatment and in follow-up.

Results: A total of 61 patients with a neuropathic DFU were recruited. Average percentage reduction in DFU size at four weeks was greater in the study group compared with the control group (54.5% versus 38.8%, respectively). Rate of complete healing rate at 20-weeks' follow-up was significantly better in the study group than the control group (60% versus 35.5%, respectively).

Conclusion: The collagen matrix dressing used in this study accelerated the healing process of patients with a hard-to-heal DFU. Further research may suggest the used of this dressing to shorten the length of time to achieve complete healing.
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http://dx.doi.org/10.12968/jowc.2020.29.Sup3.S13DOI Listing
March 2020

Modulation of cardiac optogenetics by vitamin A.

Biofactors 2019 Nov 11;45(6):983-990. Epub 2019 Sep 11.

Department of Medicine I, Comprehensive Cancer Center Vienna, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria.

Cardiac optogenetics is an emergent research area and refers to the delivery of light-activated proteins to excitable heart tissue and the subsequent use of light for controlling the electrical function with high spatial and temporal resolution. Channelrhodopsin-2 (ChR2) is a light-sensitive ion channel with the chromophore, all trans retinal, derived from vitamin A (all-trans-retinol; retinol). In this study, we explored whether exogenous vitamin A can be a limiting factor in the light responsiveness of cardiomyocytes-expressing ChR2. We showed that in cardiomyocytes virally transduced with ChR2 (H134R)-enhanced yellow fluorescent protein, vitamin A supplements lower than 10 μM significantly increased ChR2 expression. Adding 1 μM vitamin A changed light-induced transmembrane potential difference significantly, whereas 5 μM dramatically induced membrane depolarization and triggered intracellular calcium elevation. We concluded that vitamin A supplementation can modulate the efficiency of ChR2 and provide a complementary strategy for improving the performance of optogenetic tools.
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http://dx.doi.org/10.1002/biof.1564DOI Listing
November 2019

Efficacy of Maggot Therapy on Staphylococcus aureus and Pseudomonas aeruginosa in Diabetic Foot Ulcers: A Randomized Controlled Trial.

J Wound Ostomy Continence Nurs 2019 Jan/Feb;46(1):25-29

Azam Malekiam, MSc, Maggot Debridement Therapy Clinic, Iranian Center for Wound Healing, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran; and Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Esmaeeli Djavid, MD, Maggot Debridement Therapy Clinic, Iranian Center for Wound Healing, ACECR, Tehran, Iran; and Medical Laser Research Center, ACECR, Tehran, Iran. Kamran Akbarzadeh, PhD, Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Soltandallal, PhD, Department of Medical Pathology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Yavar Rassi, PhD, Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Javad Rafinejad, PhD, Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Abbas Rahimi Forooshani, PhD, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Amirreza Farhoud, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Ronak Bakhtiary, Department of Medical Pathology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Purpose: This study was conducted to evaluate the antimicrobial effects of medicinal maggots of Lucilia sericata on Staphylococcus aureus and Pseudomonas aeruginosa on diabetic foot ulcers (DFUs).

Design: Randomized controlled trial.

Subjects And Setting: The sample comprised 50 adult patients from the clinic of the Academic Center for Education, Culture and Research of Tehran University of Medical Sciences, Iran. All participants who had at least 1 DFU present for at least 12 weeks, an arterial brachial index value of more than 0.6, and a hemoglobin A1c value of less than 8% were included in this study.

Methods: Subjects were randomly selected for the maggot-treated (treatment) or conventional treatment (control) group. Conventional treatments such as antibiotic therapy, debridement, and offloading were done for both groups, but maggot therapy (MT) was added to the protocol of the treatment group. Bacterial burden was monitored and compared for both groups using cultures collected using swab technique. Wound secretions were measured and compared in both groups.

Results: The number of infected cases with S aureus in the treatment group was significantly reduced after 48 hours in comparison with the control group (P = .047). The number of infected cases with P aeruginosa was significantly reduced after 96 hours (P = .002). We also found that wound secretions in the treatment group were significantly higher than in the control group (P < .00).

Conclusions: Our findings indicate that MT is a safe and efficacious treatment of DFUs.
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http://dx.doi.org/10.1097/WON.0000000000000496DOI Listing
April 2019

Association of the gene expression variation of tumor necrosis factor-α and expressions changes of dopamine receptor genes in progression of diabetic severe foot ulcers.

Iran J Basic Med Sci 2017 Nov;20(11):1213-1219

Photo Healing and Regeneration Research Group, Medical Laser Research Center, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.

Objectives: Regulation of pro-inflammatory factors such as TNF-α which are secreted by the immune cells through induction of their several receptors including dopamine receptors (especially DRD2 and DRD3) is one of the noticeable problems in diabetic severe foot ulcer healing. This study was conducted to evaluate the alteration of TNF-αin plasma as well as DRD2 and DRD3 changes in PBMCs of diabetics with severe foot ulcers.

Materials And Methods: Peripheral blood samples were collected from 31 subjects with ulcers, 29 without ulcers, and 25 healthy individuals. Total mRNA was extracted from PBMCs for the study of DRD2, DRD3, and TNF-α gene expression variations. Expression patterns of these genes were evaluated by real-time PCR. Consequently, concentration of TNF-α was investigated in plasma.

Results: Significant decrease in gene expression and plasma concentration of TNF-α in PBMCs was observed in both patient groups at <0.05. These diminutions are correlated to the decrease in the expression of both DRD2 and DRD3 in PBMCs of both patient groups. Also, the same relationship is present between expressions of two new DRD3 transcripts with TNF-α downturn.

Conclusion: We concluded that DRD2 and DRD3 expression alteration and presence of new DRD3 transcripts can be effective in reduction of TNF-α expression as a pro-inflammatory factor. Performing complementary studies, may explain that variations in DRD2 and DRD3 are prognostic and effective markers attributed to the development of diabetes severe foot ulcers.
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http://dx.doi.org/10.22038/IJBMS.2017.9475DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749355PMC
November 2017

A Comparative Study of 660 nm Low-Level Laser and Light Emitted Diode in Proliferative Effects of Fibroblast Cells.

J Lasers Med Sci 2017 29;8(Suppl 1):S46-S50. Epub 2017 Aug 29.

Aerospace Research Institute, Ministry of Science Research and Technology, Tehran, Iran.

In recent years, low-power lasers have been widely used in medicine. With the introduction of affordable light emitted diode (LED), clinical application of LED light has become more and more popular. However, some researchers believe that due to lack of coherence of the LED light, it can be different in terms of biological effects, in comparison with laser. In this study, the biological effects of low-level laser (LLL) to those of LED light are compared and discussed. Human skin fibroblast cell line Hu02 was irradiated with LLL and LED light with a wavelength of 660 nm, power output of 35 mW and in continuous mode and the control group was not irradiated. The biological effects were compared through analysis of cell proliferation, production of reactive oxygen species (ROS) within the cell and rate of cell division. Our findings showed that production of ROS within the cell was linearly increased both in the LED and laser light irradiated cells. However, laser light is more incremental in comparison to LED light. The MTT results showed that laser light at low energy density (less than 5 J/cm) increased the rate of cell proliferation after 24 hours. Although, the rate of cell division was increased in energy density of 1 J/cm compared to the control group, this increase was not statistically significant. The findings indicated that the coherence properties of laser light provided more energy for the cells, and in a constant energy density, laser light created more oxidative stresses in comparison with LED light.
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http://dx.doi.org/10.15171/jlms.2017.s9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642178PMC
August 2017

Assessing the Efficacy of Second-Line Antiretroviral Treatment for HIV Patients Failing First-Line Antiretroviral Therapy in Iran: A Cohort Study.

Acta Med Iran 2017 Apr;55(4):233-240

Academic Member of Academic Center for Education, Culture and Research, Tehran, Iran.

There are limited documents about HIV patients switched to second-line antiretroviral therapy (ART) in resource-limited countries. We aimed to assess the efficacy of second-line ART for HIV patients following first-line ART failure. This was a cohort study of HIV/AIDS patients with first-line ART treatment failure switched to second-line ART between January 2004 and March 2014, who followed for at least 12 months after switching. Fifty of studied patients (85%) were treated with regimens containing lopinavir/ritonavir (Kaletra) and nine of them (15%) treated with other regimes. Seven patients were experienced opportunistic infections in accordance with stage III and IV WHO classification. In this way, 11.8% of patients had aclinicalfailure, and 37 of them (62%) had immunological responses. Weight gain was evident in these patients, and there was a significant correlation between theincrease in CD4 and weight gain (P=0.007). Only 13 patients achieved HIV viral load testing that 6 of them had avirological response after 12 months on second-line ART. No significant associations were found between virological or immunological response and gender, age, and lopinavir/ritonavir regimens (P>0.05).With counselling and supporting in those failing first-line ART, inessential switching to more costly second-line ART can be prevented in the majority of patients. However, patients' need to second-line ART drugs has increased, for which national ART programmes and regular follow-up should be organized. The high cost of these drugs and limited access to viral load testing are main barriers to proper management of patients switched to second-line ART regimens.
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April 2017

Photobiomodulation leads to enhanced radiosensitivity through induction of apoptosis and autophagy in human cervical cancer cells.

J Biophotonics 2017 Dec 2;10(12):1732-1742. Epub 2017 May 2.

Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA.

The radiomodulatory effect of photobiomodulation (PBM) has recently been studied in cancer cells. The aim of this study was to investigate cellular mechanisms involved in the X-ray radiosensitivity of HeLa cells pre-exposed to PBM. HeLa cells were irradiated with 685 nm laser at different energy densities prior to X-ray ionizing radiation. After irradiation, clonogenic cell survival, cell death due to apoptosis and autophagy were determined. Levels of intracellular reactive oxygen species (ROS), DNA damage and, cell cycle distribution after PBM were measured. PBM at different energy densities (5-20 J/cm ) was not cytotoxic. However, HeLa cells pre-exposed to 20 J/cm showed enhanced inhibition of colony formation following ionizing radiation. Enhanced radiosensitivity was due to increased oxidative stress, DNA damage, and radiation-induced apoptosis and autophagy. These results suggest that 685 nm PBM at a higher energy density could possibly be a promising radiosensitizing agent in cervical cancer, to decrease the radiation dose delivered, and therefore prevent the side-effects that are associated with cancer radiotherapy.
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http://dx.doi.org/10.1002/jbio.201700004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5668202PMC
December 2017

HIV, HCV, HBV, HSV, and syphilis prevalence among female sex workers in Tehran, Iran, by using respondent-driven sampling.

AIDS Care 2016 13;28(4):487-90. Epub 2015 Nov 13.

a Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors , Tehran University of Medical Sciences , Tehran , Iran.

To find out the prevalence of HIV, HCV, HBV, HSV, and syphilis infections among female sex workers (FSWs) in Tehran, a cross-sectional study by using respondent-driven sampling (RDS) method was conducted. From December 2012 to April 2013 FSWs in Tehran were recruited. Inclusion criteria consisted of trading sex during the 12 months prior to this study and selling sex for at least 6 months in participants' lifetime. Among 161 consenting participants, 5% were infected with HIV. Moreover, 8.1% of FSWs were HCV positive, 37.9% were of HSV type1/type2, 1.2% of participants were infected with HBV, and none of the participants were infected with syphilis. HIV-positive participants were significantly more likely to be co-infected with HSV type1/type2, be younger, have more sexual partners and especially more clients during seven days prior to this study and report more history of having at least one of sexually transmitted infections symptoms in 12 months prior the study. In the multiple logistic regression analysis, being infected with HSV and also being under 25 years of age were found to be independently associated with HIV infection. Compared with the prevalence of HIV among general population of Tehran, relatively high prevalence of HIV and other viral infections among FSWs should be considered. All in all, it is critical to commence effective counter-measures for this high-risk group if the aim is to prevent spreading of these viruses to general population.
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http://dx.doi.org/10.1080/09540121.2015.1109582DOI Listing
September 2016

Analysis of Radiomodulatory Effect of Low-Level Laser Irradiation by Clonogenic Survival Assay.

Photomed Laser Surg 2015 Sep;33(9):452-9

2 Radiotherapy Department, Firoozgar Hospital, Iran University of Medical Sciences . Tehran, Iran .

Objective: The aim of this study was to investigate the radiomoulatory effects of low-level laser irradiation (LLLI) in normal and cancer cells exposed to ionizing X-ray radiation on clonogenic survival assay.

Background Data: LLLI does have radioprotective effects on normal tissue. LLLI can reduce the incidence of mucocutaneous complications of ionizing radiation. Few in vitro studies reported adaptive responses for LLLI to ionizing radiation in normal and cancer cells, particularly with respect to clonogenic cell survival assay.

Methods: Normal NIH 3T3 cells and cancer HeLa cells were irradiated with 685 and 830 nm LLLI at different energy densities prior to ionizing X-ray radiation. The survival fraction was determined after ionizing radiation (0, 2, 4, and 6 Gy). The values of the linear (α) and quadratic (β) parameters were calculated based on the clonogenic survival curves.

Results: Clonogenic radiation survival assay showed that the application of LLLI at 685 nm prior to ionizing radiation could significantly inhibit clonogenic growth of HeLa cells compared with unirradiated HeLa cells. LLLI could also significantly increase the α parameter of the linear quadratic (LQ) model. In contrast, application of LLLI at 830 nm could significantly protect NIH 3T3 cells against radiation and decreased α parameter.

Conclusions: This study suggests that various physical parameters of LLLI can be diverse adaptive responses to ionizing radiation on normal and cancer cells.
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http://dx.doi.org/10.1089/pho.2015.3893DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560855PMC
September 2015

Phototoxic effect of hypericin alone and in combination with acetylcysteine on Staphylococcus aureus biofilms.

Photodiagnosis Photodyn Ther 2015 Jun 17;12(2):186-92. Epub 2015 Apr 17.

Iranian Research Center for Medical Lasers, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran. Electronic address:

Background: Resistance of bacteria against antibiotics and antimicrobials is arising worldwide and there is an urgent need for strategies that are capable of inactivating biofilm-state pathogens with less potential of developing resistance in pathogens. A promising approach could be photodynamic inactivation (PDI) which uses light in combination with a photosensitizer to induce a phototoxic reaction. In this study, we evaluated the in vitro phototoxic effect of hypericin (HYP) alone and in combination with acetylcysteine (AC) on Staphylococcus aureus biofilms. AC, a mucolytic agent, reduces the production of extracellular polysaccharide matrix while promoting the disruption of mature biofilm.

Methods: In vitro phototoxic effect of HYP alone (0.5 μg/ml, light dose: 16 J/cm(2)), and in combination with AC (10 mg/ml) on ten clinical S. aureus isolates and S. aureus (ATCC 25923) biofilms was studied. Effect of HYP concentration (0.5 μg/ml) and light dose (8 J/cm(2)) on PDI of all eleven S. aureus strains in planktonic forms was also investigated.

Results: HYP-PDI did not result in a reduction in viable count for each of the strains when grown in biofilms. However, HYP-PDI applied on biofilms treated with AC was able to disrupt pre-formed biofilms (viable count reduction ranging from 5.2 to 6.3 log10-unit in comparison to controls in all tested strains). A 6.5 log killing was obtained for S. aureus (ATCC 25923) planktonic cells treated with 0.5 μg/ml at 8 J/cm(2). For this set of PDI parameters, ten clinical S. aureus isolates showed 5.5-6.7 log killing.

Conclusion: HYP-PDI in combination with AC had significant ability to eradicate the pre-formed mature biofilms of S. aureus strains.
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http://dx.doi.org/10.1016/j.pdpdt.2015.04.001DOI Listing
June 2015

The efficacy of Radachlorin-mediated photodynamic therapy in human hepatocellular carcinoma cells.

J Photochem Photobiol B 2015 Jan 9;142:86-91. Epub 2014 Dec 9.

Radiotherapy and Oncology Department, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Photodynamic therapy (PDT) is a relatively novel modality for the treatment of cancer and some non-malignant lesions. PDT uses a photosensitive drug and light to destroy malignant cells. The aim of this study was to determine in vitro efficacy of Radachlorin-based PDT (Radachlorin-PDT) on human hepatocellular carcinoma (HCC).

Methods: The study used human liver cancer cells (HepG2) and normal liver cells (HFLF-PI4) to evaluate cell viability using the standard 2-(4, 5-dimethyl-2-thiazolyl)-3,5-diphenyl-2H-tetrazolium bromide (MTT) assay. The mechanism of cell death following Radachlorin-PDT was determined by DNA agarose gel electrophoresis and flow cytometry.

Results: Radachlorin without light irradiation had no toxic effect on HepG2 and HFLF-PI4 cells. Cell survival of HepG2 and HFLF-PI4 cells were decreased following PDT in a concentration-dependent manner. However, HepG2 cells were much more sensitive to Radachlorin-PDT than HFLF-PI4 cells. Radachlorin LD50 on HepG2 cells was 30μg/ml and 20μg/ml, 24h after exposure to doses of 5J/cm(2) and 15, or 25J/cm(2), respectively. Optimal Radachlorin and light dose to kill HepG2 cells with minimal effects on normal HFLF-PI4 cells were 100μg/ml and 15J/cm(2), respectively. Our results also showed that apoptosis is induced in HepG2 cells following Radachlorin-PDT.

Conclusion: Our in vitro data suggest that the use of PDT with Radachlorin can be effective in the treatment of HCC.
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http://dx.doi.org/10.1016/j.jphotobiol.2014.11.007DOI Listing
January 2015

Effects of low-level laser irradiation on the pathogenicity of Candida albicans: in vitro and in vivo study.

Photomed Laser Surg 2014 Jun;32(6):322-9

1 Department of Medical Microbiology , Radboudumc, Nijmegen, The Netherlands .

Objective: The purpose of this study was to evaluate the effects of low-level laser irradiation (LLLI) on the in vitro growth characteristics and in vivo pathogenicity of Candida albicans in a murine model in the absence of a photosensitizer.

Background Data: C. albicans is an opportunistic commensal organism that causes a wide variety of diseases in human beings, ranging from superficial infections to life-threatening invasive candidiasis. The incidence of C. albicans infection is increasing, because of the greater frequency of acquired immunodeficiency conditions. A high recurrence rate has been reported for vulvovaginal and oral candidiasis, despite the best available treatments. Therefore, the search for new treatment modalities seems quite rational.

Methods: Candida culture plates were exposed to common clinical energies of LLLI: 3, 5, 10, and 20 J at 685 nm (BTL Laser 5000, Medicinos Projektai, Czech Republic, Prague, max power output 50 mW) and 3, 5, 10, 30, and 50 J at 830 nm (BTL Laser 5000, Medicinos Projektai, Czech Republic, Prague, max power output 400 mW).

Results: Following LLLI with energies >10 J at both 685 and 830 nm wavelengths, statistically significant effects were observed in vitro on the turbidimetric growth kinetics of C. albicans and in vivo on the survival rate of infected mice (p value ≤ 0.05). Therefore, this energy could be considered a threshold for clinical investigation.

Conclusions: Translating our data into the clinical setting, it can be proposed that a direct laser-based approach without using a photosensitizing dye can significantly reduce the pathogenicity of Candida albicans. It can also be concluded that laser light at specific wavelengths could be a possible promising novel treatment for superficial and mucocutaneous C. albicans infections.
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http://dx.doi.org/10.1089/pho.2012.3387DOI Listing
June 2014

Determination of the accuracy and optimal cut-off point for ELISA test in diagnosis of human brucellosis in Iran.

Acta Med Iran 2013 ;51(10):687-92

Department of Infectious Diseases, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

In endemic area the most challenging problem for brucellosis is to find a reliable diagnostic method. In this case-control study, we investigated the accuracy of ELISA test for diagnosis of human brucellosis and determined the optimal cut-off value for ELISA results in Iran. The laboratory diagnosis of brucellosis was performed by blood isolation of Brucella organism with a BACTEC 9240 system and/or detection of Brucella antibodies by standard agglutination test (titer ≥ 1:160). Serum level of ELISA IgG and ELISA IgM from 56 confirmed cases of brucellosis and 126 controls were compared with each other by Box plot graph and Receiver Operating Characteristic (ROC) curve. Box plot graphs showed the high degree of dispersion for IgG and IgM data in patients compared with all controls. We observed partially overlapping for IgM data (not for IgG) between cases and controls in graphs. The area under ROC curve for distinguishing between cases and controls was larger for IgG compared to IgM. Based on results of this study, ELISA IgG test was more reliable than ELISA IgM test in diagnosis of human brucellosis in Iran. Using a cut-off of 10 IU/ml and 50 IU/ml had most sensitivity (92.9%) and most specificity (100%) for ELISA IgG test, respectively.
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July 2014

Photodynamic effect of hypericin on the microorganisms and primary human fibroblasts.

Photodiagnosis Photodyn Ther 2013 May 11;10(2):150-5. Epub 2012 Dec 11.

Department of Microbiology, School of Biology, College of Science, University of Tehran, Tehran, Iran.

Background: Hypericin (HYP) is a natural photosensitizer considered for the new generation of photodynamic therapy (PDT) drugs. The aim of this study was to evaluate the in vitro bactericidal effect of HYP-PDT on four bacterial species, assessing its photocytotoxicity to primary human fibroblasts to determine possible side effects.

Methods: Effect of photosensitizer concentration (0.1, 0.3, 0.6, and 1 μg/ml) and light irradiation time (3, 5, 10 min) on photodynamic inactivation of microorganisms and primary human fibroblasts was investigated.

Results: A 6.3 log killing was obtained for Staphylococcus aureus (ATCC 25923) treated with 1 μg/ml at 48 J/cm². For this set of PDT parameters, Enterococcus faecalis (ATCC 11700) showed 6.5 log killing, Escherichia coli (ATCC 25922) 6.2 log killing, and Pseudomonas aeruginosa (ATCC 27853) 0.7 log killing. Fibroblasts can be preserved by keeping the HYP concentration below 0.6 μg/ml and the light dose below 48 J/cm².

Conclusion: S. aureus, E. faecalis, and E. coli appear to be suitable for treatment with HYP-PDT without significant damage to fibroblasts.
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http://dx.doi.org/10.1016/j.pdpdt.2012.11.007DOI Listing
May 2013

Photodynamic inactivation of primary human fibroblasts by methylene blue and toluidine blue O.

Photodiagnosis Photodyn Ther 2012 Dec 26;9(4):355-8. Epub 2012 Jun 26.

Department of Microbiology, School of Biology, College of Science, University of Tehran, Tehran, Iran.

Background: An important determinant of the clinical applicability and value of antimicrobial photodynamic inactivation (PDI) is the cytotoxicity of the treatment to human cells. We evaluated the in vitro cytotoxicity of PDI to primary human fibroblasts using methylene blue (MB) and toluidine blue O (TBO) as the photosensitizers.

Methods: The primary human fibroblasts were exposed to PDI regimes that were used for the inactivation of methicillin-resistant Staphylococcus aureus (MRSA) and multi-drug resistant Escherichia coli (MDR E. coli). Mitochondrial activity subsequent to exposure was evaluated after 24h using the methylthiazoletetrazolium assay and compared to pretreatment values.

Results: Mitochondrial activity of primary human fibroblasts was reduced by 27% after exposure to light (163.8 J/cm(2)) and MB (50 μg/ml). At a TBO concentration previously demonstrated to induce 99.91% and 83.2% reduction in a viable count for MRSA and MDR E. coli, respectively, 39.6% of the fibroblasts were photo-inactivated.

Conclusion: Our findings showed that MB/TBO-PDI did not induce significant cytotoxic effects on human fibroblasts in culture.
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http://dx.doi.org/10.1016/j.pdpdt.2012.05.001DOI Listing
December 2012

Promoting wound healing in minor recurrent aphthous stomatitis by non-thermal, non-ablative CO(2) laser therapy: a pilot study.

Photomed Laser Surg 2012 Dec 31;30(12):719-23. Epub 2012 Oct 31.

Medical Laser Research Center, Iranian Center for Medical Laser (ICML), Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.

Background And Objective: This randomized controlled clinical trial (RCT) was designed to evaluate the effects of non-thermal, non-ablative CO(2) laser therapy (NACLT) to promote wound healing in minor recurrent aphthous stomatitis (miRAS).

Study Design/materials And Methods: Ten patients with 20 minor aphthous ulcers completed this study. Each patient had two discrete aphthous ulcers that had developed within 72 h before enrollment. One of the ulcers was randomly allocated to be treated with NACLT and the other one served as placebo. Before laser irradiation, a layer of transparent, non-anesthetic oral gel with high water content was placed on the laser and placebo lesions both. The CO(2) laser device was operated using 1 W power in defocused continuous mode, scanning rapidly over the lesion. The placebo lesion was irradiated with the same laser, but with an inactive probe. The healing times of the lesions were recorded by a blinded physician.

Results: The healing period was significantly shorter in ulcers treated by NACLT than in those treated with placebo (p=0.02). The process was not painful and anesthesia was not required. There were no visible side effects after NACLT and during follow-up periods.

Conclusions: The results of this RCT suggest that single session of NACLT could be used to promote wound healing in minor aphthous ulcers, with no visible side effects.
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http://dx.doi.org/10.1089/pho.2012.3301DOI Listing
December 2012

Randomized controlled trial of mindfulness-based stress reduction delivered to human immunodeficiency virus-positive patients in Iran: effects on CD4⁺ T lymphocyte count and medical and psychological symptoms.

Psychosom Med 2012 Jul-Aug;74(6):620-7. Epub 2012 Jun 28.

Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran.

Objective: To evaluate the immediate and long-term effectiveness of mindfulness-based stress reduction (MBSR) on biological and symptomatological markers of health among human immunodeficiency virus-positive (HIV+) patients in Tehran, Iran.

Methods: Using a randomized controlled trial design, data from 173 HIV+ patients (CD4 count > 250) not yet receiving antiretroviral therapy, who participated in either an 8-week MBSR (n = 87) or a brief education and support condition (n = 86) at the Imam Khomeini Hospital, were analyzed. Assessments included CD4 count, Symptom Checklist-90-Revised (SCL-90R), and Medical Symptom Checklist (MSCL) at baseline, immediate post-treatment, and at the 3-, 6-, 9-, and 12-month follow-up periods.

Results: The treatment-adherent sample had a mean (standard deviation) age of 35.1 (6.5) years and 69% were male. Linear mixed-model estimates indicated that, in the MBSR condition, the mean CD4 count increased from baseline up to 9 months after treatment and then returned to baseline level at 12 months. Improvements in mean SCL-90R (up to 6 months) and MSCL (up to 12 months) scores were observed for the MBSR condition, whereas education and support condition scores remained the same over time; however, only MSCL improvements significantly differed between groups and these changes lasted up to the final assessment.

Conclusions: Findings suggest that among treatment-adherent Iranian HIV+ patients not yet receiving antiretroviral drug treatment, MBSR seems to have the strongest potential to improve self-reported medical symptoms.

Trial Registration: Iranian Registry of Clinical Trials: IRCT201106084076N2.
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http://dx.doi.org/10.1097/PSY.0b013e31825abfaaDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392542PMC
November 2012

Thermal damage patterns of diode hair-removal lasers according to various skin types and hair densities and colors: a simulation study.

Photomed Laser Surg 2012 Jul 1;30(7):374-80. Epub 2012 Jun 1.

Research Center for Science and Technology in Medicine (RCSTIM), Tehran University of Medical Sciences, Tehran, Iran.

Background And Objective: It is important to prevent unwanted side effects of diode hair-removal lasers especially in dark skin tones. This study simulates the thermal damage patterns caused by diode hair-removal lasers in different skin types, hair colors, and hair densities.

Materials And Methods: LITCIT software has been used with the tissue modeled as two components, the skin and the hair. The absorption coefficients of various skin types (f(mel)=5%, 10%, 15%, and 20%), laser parameters, and optothermal properties of tissue were inputs.

Results: For all skin types there was a significant unwanted thermal damage to the epidermis as a result of fluence increase. Using longer pulse durations is accompanied by effective thermal damage to the hair follicle, while preserving the epidermis in skin types II and III, an effect not achieved in darker skins. Regardless of pulse duration, when the distance between hair follicles is ≤ 0.5 mm, there is a significant increase in thermal damage to interfollicular epidermis with high fluences compared with lower hair densities (interfollicular space ≥ 1 mm). In lighter hairs, while using longer pulse durations, higher fluences are needed in order to obtain the same level of thermal damage in the hair follicle as shorter pulse widths.

Conclusions: In lighter skin types, lengthening the pulse duration of diode lasers (up to 400 ms) increases efficacy while preserving epidermis from unwanted thermal damage. However, it is necessary to use lower fluences while using longer pulse duration to avoid irreversible thermal damage to epidermis in darker tones, as is also true for locations with higher hair densities.
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http://dx.doi.org/10.1089/pho.2011.3152DOI Listing
July 2012

Comparison of Red and Infrared Low-level Laser Therapy in the Treatment of Acne Vulgaris.

Indian J Dermatol 2012 Mar;57(2):128-30

Department of Dermatology, Hazrat-e Rasool University Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background/purpose: Acne vulgaris is a very prevalent skin disorder and remains a main problem in practice. Recently, phototherapy with various light spectrums for acne has been used. There are some evidences that low-level laser therapy (LLLT) has beneficial effect in the treatment of acne lesions. In this study, two different wavelengths of LLLT (630 and 890 nm) were evaluated in treatment of acne vulgaris.

Materials And Methods: This study was a single-blind randomized clinical trial. Patients with mild to moderate acne vulgaris and age above 18 years and included were treated with red LLLT (630 nm) and infrared LLLT (890 nm) on the right and left sides of the face respectively, twice in a week for 12 sessions, and clinically assessed at baseline and weeks 2, 4, 6, and 8.

Results: Twenty-eight patients were participated in this study. Ten weeks after treatment acne lesion were significantly decreased in the side treated by 630 nm LLLT (27.7±12.7 to 6.3±1.9) (P<0.001), but this decrease was not significant in the site treated by 890 nm LLLT (26.9±12.4 to 22.2±8.5) (P>0.05).

Conclusion: Red wavelength is safe and effective to be used to treat acne vulgaris by LLLT compared to infrared wavelength.
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http://dx.doi.org/10.4103/0019-5154.94283DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352636PMC
March 2012

Phototoxicity of phenothiazinium dyes against methicillin-resistant Staphylococcus aureus and multi-drug resistant Escherichia coli.

Photodiagnosis Photodyn Ther 2012 Mar 16;9(1):11-5. Epub 2011 Dec 16.

Department of Microbiology, School of Biology, College of Science, University of Tehran, Tehran, Iran.

Background: Photodynamic inactivation (PDI) has been investigated to cope with the increasing incidence of multidrug-resistant (MDR) pathogens. Here we studied the PDI mediated by methylene blue (MB) and toluidine blue O (TBO) in clinical methicillin-resistant Staphylococcus aureus and MDR Escherichia coli, together with their corresponding American Type Culture Collection (ATCC) strains.

Methods: Effect of photosensitizer concentration (12.5, 25, 50 μg/ml) and laser irradiation time (10, 20 and 30 min) on lethal photosensitization was investigated.

Results: TBO was more effective. TBO at 50 μg/ml, 46.8 J cm⁻², exhibited 0.7 log killing for MDR E. coli and 1.7 log killing for E. coli (ATCC 25922); 3.1 log killing for MRSA, and 4.2 log killing for S. aureus (ATCC 25923). MB at 50 μg/ml, 163.8 J cm⁻², only exhibited 2.2 log killing in MRSA and 3.1 log killing in S. aureus (ATCC 25923). MB (50 μg/ml, 163.8 J cm⁻²) induced 0.2 log killing for MDR E. coli and 0.3 log killing for E. coli (ATCC 25922). After TBO-PDI, MDR isolates were more susceptible to some antibiotics than control groups.

Conclusion: Our studied clinical isolates were more resistant to PDI-mediated killing than their ATCC reference strains. Thus, TBO/MB-mediated PDI in other MDR isolates deserves further investigation.
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http://dx.doi.org/10.1016/j.pdpdt.2011.11.004DOI Listing
March 2012

Quality of Life among Persons with HIV/AIDS in Iran: Internal Reliability and Validity of an International Instrument and Associated Factors.

AIDS Res Treat 2012 12;2012:849406. Epub 2012 Jan 12.

Department of Medicine, University of Southern California, CA, USA.

The purpose of this cross-sectional study on 191 HIV/AIDS patient was to prepare the first Persian translation of complete WHOQOL-HIV instrument, evaluate its reliability and validity, and apply it to determine quality of life and its associated factors in Tehran, Iran. Student's t-test was used to compare quality of life between groups. Mean Cronbach's α of facets in all six domains of instrument were more than 0.6 indicating good reliability. Item/total corrected correlations coefficients had a lower limit of more than 0.5 in all facets except for association between energy and fatigue facet and physical domain. Compared to younger participants, patients older than 35 years had significantly lower scores in overall quality of life (P = 0.003), social relationships (P = 0.021), and spirituality/religion/personal beliefs (P = 0.024). Unemployed patients had significantly lower scores in overall quality of life (P = 0.01), level of independence (P = 0.004), and environment (P = 0.001) compared to employed participants. This study demonstrated that the standard, complete WHOQOL-HIV 120 instrument translated into Farsi and evaluated among Iranian participants provides a reliable and valid basis for future research on quality of life for HIV and other patients in Iran.
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http://dx.doi.org/10.1155/2012/849406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265053PMC
August 2012

Assessing the prevalence of HIV among Afghan immigrants in Iran through rapid HIV testing in the field.

Acta Med Iran 2011 ;49(7):478-9

Iranian Research Center for HIV/AIDS, Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran.

Throughout the world, many migrant and mobile populations are at elevated risk for HIV. Iran has a large immigrant population from neighboring Afghanistan; however, few data exist on the prevalence of HIV in this community. In 2008, we conducted a study to assess the presence of HIV infection among 477 immigrants in a town to the northeast of Tehran using a rapid test in the field. HIV prevalence was 0.2% (95% CI 0.005-1.2) with one person HIV-positive. We recommend periodic HIV sero-surveillance with detailed behavioral measures for this population in the future.
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January 2012

Frequency of HIV Infection among Sailors in South of Iran by Rapid HIV Test.

AIDS Res Treat 2011 10;2011:612475. Epub 2011 Apr 10.

Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, Iran.

Information on the prevalence and risk factors for HIV infection among sailors is scarce. The aim of this seroprevalence study was to evaluate the frequency of HIV infection among sailors in south of Iran using rapid HIV test. The study included 400 consecutive participants in Lengeh, Shahid Rajaie, and Shahid Bahonar ports in south of Iran in May 2010. We observed only one case (0.25%) of HIV infection in this sample of sailors. While prevalence appears low at present, we recommend periodic HIV serosurveillance with detailed behavioral measures for this population in the future.
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http://dx.doi.org/10.1155/2011/612475DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085304PMC
July 2011

Simulation of heat distribution and thermal damage patterns of diode hair-removal lasers: an applicable method for optimizing treatment parameters.

Photomed Laser Surg 2011 Jul 21;29(7):509-15. Epub 2011 Mar 21.

Iranian Center for Medical Lasers, Academic Center for Education, Culture and Research, Tehran.

Objective: We simulated the heat distribution and thermal damage patterns of diode hair-removal lasers for different spot sizes, pulse durations, and fluences as a guide for optimization.

Background: Recently, the concept of thermal damage time as a reference for pulse duration has become a subject of debate.

Methods: Laser-Induced-Temperature-Calculation-In-Tissue (LITCIT) was used for the simulations. Skin was modeled as two homogenous layers of epidermis/dermis and two coaxial cylinders as the hair shaft/ follicle. Opto-thermal coefficients of the components and the radiant parameters of the laser (diode, 810 nm) were defined.

Results: At constant fluences and pulse durations, the damage occurred deeper when larger spot sizes were used. At constant pulse duration, high fluences caused significant damage to the hair follicle and epidermis. By using longer pulse durations (≤ 400 ms) at constant fluences, there was more effective damage to the hair follicle while sparing the adjacent epidermis and dermis. Because of the time-dependent temperature profiles, an increased pulse duration creates a moderate, gradual rise in the target's temperature. Pulse durations > 400 ms are accompanied by unwanted dermis damage.

Conclusions: Our results show that using very long pulse durations near the tissue damage time (≤ 400 ms) creates better efficacy in treating unwanted hairs while avoiding unwanted damage.
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http://dx.doi.org/10.1089/pho.2010.2895DOI Listing
July 2011

Bilirubin/Albumin Ratio for Predicting Acute Bilirubin-induced Neurologic Dysfunction.

Iran J Pediatr 2011 Mar;21(1):28-32

Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran ; Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran.

Objective: The aim of this study was to evaluate the bilirubin albumin (B/A) ratio in comparison with total serum bilirubin (TSB) for predicting acute bilirubin-induced neurologic dysfunction (BIND).

Methods: Fifty two term and near term neonates requiring phototherapy and exchange transfusion for severe hyperbilirubinemia in Children's Medical Center, Tehran, Iran, during September 2007 to September 2008, were evaluated. Serum albumin and bilirubin were measured at admission. All neonates were evaluated for acute BIND based on clinical findings.

Findings: Acute BIND developed in 5 (3.8%) neonates. B/A ratio in patients with BIND was significantly higher than in patients without BIND (P<0.001). Receiver operation characteristics (ROC) analysis identified a TSB cut off value of 25 mg/dL [area under the curve (AUC) 0.945] with a sensitivity of 100% and specificity of 85%. Also, according to the ROC curve, B/A ratio cut off value for predicting acute BIND was 8 (bil mg/al g) (AUC 0.957) with sensitivity of 100% and specificity of 94%.

Conclusion: Based on our results, we suggest using B/A ratio in conjunction with TSB. This can improve the specificity and prevent unnecessary invasive therapy such as exchange transfusion in icteric neonates.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3446111PMC
March 2011

A randomized clinical trial on the effect of low-level laser therapy on chronic diabetic foot wound healing: a preliminary report.

Photomed Laser Surg 2011 Feb 9;29(2):109-14. Epub 2011 Jan 9.

Department of Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background And Objectives: Low-level laser therapy (LLLT) has been shown to promote chronic wound healing in conditions of reduced microcirculation. In this preliminary study, we report the results of using LLLT to heal foot ulcers in patients with diabetes mellitus.

Materials And Methods: Twenty-three patients with a diabetic foot wound for at least 3 months were included in this double-blind randomized clinical trial. Patients were randomized to receive placebo treatment (n = 10) or LLLT (n = 13) (685 nm, energy density 10 J/cm(2)) in addition to conventional therapy. Patients were followed for 20 weeks. Ulcer size reduction and the number of patients with complete healing were compared between the LLLT and placebo groups.

Results: There were no significant differences in baseline characteristics of patients and foot ulcers receiving LLLT and placebo treatment. At week 4, the size of ulcers decreased significantly in the LLLT group (p = 0.04). After 20 weeks, in the LLLT group, eight patients had complete healing and in the placebo group only three patients experienced complete wound healing. The mean time of complete healing in LLLT patients (11 weeks) was less than that in placebo patients (14 weeks) though the difference was not statistically significant.

Conclusions: The study provides evidence that LLLT can accelerate the healing process of chronic diabetic foot ulcers, and it can be presumed that LLLT may shorten the time period needed to achieve complete healing.
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http://dx.doi.org/10.1089/pho.2009.2680DOI Listing
February 2011

Respiratory Complications in Iranian Hospitalized Patients with HIV/AIDS.

Tanaffos 2011 ;10(3):49-54

CAPS and the Institute for Global Health, University of California, San Francisco, USA.

Background: The respiratory tract has been the most commonly affected site of illness in HIV-infected patients. The current study was done to identify the frequency of respiratory complications in a consecutive case series of HIV-positive patients in Iran.

Materials And Methods: This study was a retrospective analysis at the national academic reference medical center of Imam-Khomeini Hospital, in Tehran, Iran. The study included 199 new admissions for 177 HIV-infected patients between 2000 and 2005. Demographic characteristics, risk factors for HIV infection, respiratory complications, and CD4+ lymphocyte counts were evaluated in these patients.

Results: All patients were males. The mean age was 35 years (age range: 15 to 63 years). Among 34 cases with available CD4+ lymphocyte count results, 70.6% had results <200 cells/mm(3). Nearly half the patients (47.7%) had respiratory symptoms. The most common pulmonary complications were cough (86.3%), sputum (71.6%), dyspnea (54.7%), and hemoptysis (10.5%). The most common diagnosis was pulmonary tuberculosis (27.1%), followed by other bacterial pneumonias (16.6%) and pneumocystis carinii pneumonia (4.5%). Intravenous drug users who had history of incarceration had the highest risk factors for Mycobacterium tuberculosis infection (59%), and other bacterial pneumonias (52%).

Conclusion: Our study demonstrates that respiratory complications are highly frequent in HIV patients in Iran and that pulmonary tuberculosis is still a common complication in HIV infected patients, despite the availability of effective treatment. Results suggest the need for more effective preventive and prophylactic measures, wider use of antiretroviral treatment and effective chemotherapy for Iranian patients with HIV/AIDS.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4153161PMC
September 2014

Taxane-based regimens as a risk factor for chemotherapy-induced amenorrhea.

Menopause 2011 Feb;18(2):208-12

Medical Oncology and Hematology, Iranian Center for Breast Cancer (ICBC), Academic Center for Education, Culture and Research (ACECR), Tehran, Iran.

Objective: The objective of our study was to show the impact of different chemotherapy regimens on the incidence of amenorrhea (chemotherapy-induced amenorrhea [CIA]) in premenopausal women of various ages with breast cancer.

Methods: This is a follow-up study of 226 premenopausal women with breast cancer who had received one of three chemotherapy regimens: conventional (cyclophosphamide/methotrexate/5-fluorouracil), anthracycline based, and anthracycline-taxane based. They were evaluated for the incidence of CIA in the follow-up clinic of the Iranian Center for Breast Cancer. A statistical analysis using SPSS software was performed, and logistic regression and Cox regression model were used to determine the risk factors for CIA.

Results: Of the 226 women with a median age of 40 years (range, 26-56 y) who participated in this study, 154 (68.1%) developed CIA. In 101 (65.6%) of these women, CIA was established. CIA was present in 52.5% of the women who had been treated with conventional regimens (cyclophosphamide/methotrexate/5-fluorouracil), 66.7% of the women who had been treated with anthracycline, and 78.7% of the women who had been treated with anthracycline-taxane. Therefore, the frequency of CIA was significantly higher in the taxane-based chemotherapy group than in the other groups (P = 0.015). Although a slightly higher incidence of CIA in women with hormone-insensitive tumors (estrogen receptor negative and progesterone receptor negative) versus hormone-sensitive tumors (estrogen receptor positive and progesterone receptor positive) who had been treated with combination regimens was observed, no statistically significant difference was found (P = 0.629). Of all of the risk factors that were evaluated in the study, anthracycline-taxane-based regimens (odds ratio, 4.059; 95% CI, 1.6-9.8) and age older than 40 years (odds ratio, 3.5; 95% CI, 1.9-6.6) were the most important factors in the development of CIA.

Conclusions: The type of chemotherapy and the age of the woman at the onset of breast cancer are the most important risk factors in CIA. Taxane-based regimens induced more CIA than did other regimens.
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http://dx.doi.org/10.1097/gme.0b013e3181f3e6e7DOI Listing
February 2011