Publications by authors named "Mohammad Zare"

156 Publications

Decontamination potential of five native plants in Maharlu Wetland, Iran.

Int J Phytoremediation 2021 Mar 24:1-10. Epub 2021 Mar 24.

Department of Earth Sciences, Shiraz University, Shiraz, Iran.

This study investigates the level of toxic trace elements (TTE) in the rhizosphere soil and tissues of five native plants and their phytoextraction/phytostabilization potential growing in Maharlu Lake wetland, in Southern Iran. The study anticipated by determination of 11 potentially TTE concentrations (As, Cd, Co, Cr, Cu, Fe, Mn, Mo, Ni, Pb, and Zn) in the soil, soil extract, and the plants' dry matter (root and shoot). Pollution index (PI), pollution load index (PLI), bioconcentration factor (BCF), bioaccumulation coefficient (BAC), and translocation factor (TF) were applied in the study. Two main results were pointed out in this study. Firstly, the result of pollution indexing and total and phyto-availability concentrations of TTE showed that some of them in the rhizosphere soil are problematic in the Maharlu wetland, in particular for Mo, Pb, Zn, and As. Secondly, the result of the correlation coefficients and phytoremediation indexing revealed that TTE accumulation in the plant tissues, not only depends on the concentration in the soil extract but is also plant-specific. Moreover, the results suggested that . has the potential for phytoextraction of Cd and Mo in the contaminated wetlands. This manuscript addresses the toxic trace elements concentration in rhizosphere soil and tissues of five native plants and their phytoextraction/phytostabilization potential: Maharlu wetland in southern Iran.
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http://dx.doi.org/10.1080/15226514.2021.1900064DOI Listing
March 2021

Core-shell chitosan/PVA-based nanofibrous scaffolds loaded with Satureja mutica or Oliveria decumbens essential oils as enhanced antimicrobial wound dressing.

Int J Pharm 2021 Mar 26;597:120288. Epub 2021 Jan 26.

Department of Chemical Engineering, School of Chemical and Petroleum Engineering, Shiraz University, Shiraz, Iran. Electronic address:

Wounds are prone to bacterial infections, which cause a delayed healing process. Regarding the emergence of bacterial resistance to common antibiotics, using natural antimicrobial agents can be beneficial. Chitosan is a biological polymer, which has shown partial antioxidant and antimicrobial activities. In this study, core-shell nanofibrous scaffolds composed of chitosan (CS)/polyvinyl alcohol (PVA) as the core and polyvinylpyrrolidone (PVP)/ maltodextrin (MD) as the shell were developed. Satureja mutica (S. mutica) or Oliveria decumbens (O. decumbens) essential oil (EO) was encapsulated into the core of the produced scaffolds. The broth microdilution analysis showed significant antimicrobial activity of the EOs. The SEM analysis indicated that the unloaded and loaded core-shell scaffolds with S. mutica or O. decumbens EO had a uniform, beadless structure with fiber mean diameters of 210 ± 50, 250 ± 45, and 225 ± 46 nm, respectively. The CS/PVA-PVP/MD and CS/PVA/EO-PVP/MD scaffolds indicated suitable mechanical properties. The addition of the studied EOs enhanced the antioxidant activity of the scaffolds. The antimicrobial test of produced scaffolds showed that loading of 10% S. mutica or O. decumbens EO could broaden the microbicidal activity of the CS/PVA-PVP/MD scaffolds. These results revealed that the CS/PVA/EO-PVP/MD nanofibrous scaffolds are promising candidates for wound dressing.
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http://dx.doi.org/10.1016/j.ijpharm.2021.120288DOI Listing
March 2021

Procalcitonin Has Good Accuracy for Prognosis of Critical Condition and Mortality in COVID-19: A Diagnostic Test Accuracy Systematic Review and Meta-analysis.

Iran J Allergy Asthma Immunol 2020 Dec 19;19(6):557-569. Epub 2020 Dec 19.

Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University, School of Medicine, Hangzhou, China.

Several reports have determined that changes in white blood cell counts and inflammatory biomarkers are related to disease outcome of coronavirus disease 2019 (COVID-19) and they can be utilized as prognostic biomarkers. For introducing a factor as a diagnostic/prognostic biomarker, diagnostic test accuracy (DTA) systematic review and meta-analysis are recommended. For the first time, we aimed to determine the accuracies of white blood cell counts and inflammatory biomarkers for prognosis of COVID-19 patient's outcome by a DTA meta-analysis. Until August24, 2020, we searched Web of Sciences, Scopus, and MEDLINE/PubMed databases to achieve related papers. Summary points and lines of included studies were calculated from 2×2 tables by bivariate/hierarchical models. Critical condition and mortality were considered as outcomes. A total of 13387 patients from 28 studies were included in this study. Six biomarkers containing leukocytosis, neutrophilia, lymphopenia, increased level of C-reactive protein, procalcitonin (PCT), and ferritin met the inclusion criteria. Analysis of the area under the curve (AUCHSROC) indicated that the PCT was the only applicable prognostic biomarker for critical condition and mortality (AUCHSROC=0.80 for both conditions). Pooled-diagnostic odds ratios were 6.78 (95% CI, 3.65-12.61) for prognosis of critical condition and 13.21 (95% CI, 3.95-44.19) for mortality. Other biomarkers had insufficient accuracies for both conditions (AUCHSROC< 0.80). Among evaluated biomarkers, only PCT has good accuracy for the prognosis of both critical condition and mortality in COVID-19 and it can be considered as a single prognostic biomarker for poor outcomes. Also, PCT has more accuracy for the prognosis of mortality in comparison to critical condition.
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http://dx.doi.org/10.18502/ijaai.v19i6.4926DOI Listing
December 2020

How to assess and relieve that perplexing rashless itch.

J Fam Pract 2020 Nov;69(9):430-437

Department of Family and Community Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, USA.

Your patient's pruritus absent skin lesions might be self-limiting-or indicate systemic disease. Probing the nature of the symptom can point to targeted treatment.
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November 2020

Sulfur Mustard and Immunology; Trends of 20 Years Research in the Web of Science Core Collection: A Scientometric Review.

Iran J Public Health 2020 Jul;49(7):1202-1210

Ophthalmology Division, Taleghani Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Background: We aimed to use the scientometric approach to evaluate immunological studies on the subject of sulfur mustard over the past 20 years.

Methods: In this scientometric study, the Web of Science Core Collection was searched on the studies about sulfur mustard. The published papers related to the field of immunology were retrieved from these papers. HistCite software and VOSviewer were the applied software packages for bibliometric analysis, information visualization, and creating bibliometric networks.

Results: Over the past 20 years, 741 researchers from 22 countries have published 201 scientific papers in 95 journals. Iran and the United States with 93 and 68 published articles ranked at the top. The Journal of International Immunopharmacology, with 33 published papers, 439 Total Global Citation Score (TGCS), and 105 Total Local Citation Score (TLCS) was the most productive and most influential in this regard. The paper entitled "Biomonitoring of exposure to chemical warfare agents: A review" and another paper entitled "Sardasht-Iran Cohort Study of Chemical Warfare Victims: Design and Methods" were the most influential papers in this topic with 200 TGCS and 27 TLCS, respectively. The most productive and the most influential centers were "Immunoregulation Research Center of Shahed University" and "The Janbazan Medical and Engineering Research Center (JMERC)," respectively.

Conclusion: The result of our report as the unique scientometric evaluation of the research on sulfur mustard and Immunology can be used as a roadmap for authors, researchers, and policymakers to define the best ways to allocate their financial and executive resources.
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http://dx.doi.org/10.18502/ijph.v49i7.3573DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7548481PMC
July 2020

Translation and Psychometric Evaluation of the Mahoney Pain Scale Among Iranian Elderly With Dementia: A Methodological Study.

Eval Health Prof 2020 Sep 29:163278720961818. Epub 2020 Sep 29.

Department of Neurology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

Valid and reliable measurement tools are necessary for pain assessment among the elderly with dementia. This study aimed to translate the Mahoney Pain Scale (MPS) into Persian and evaluate its psychometric properties among Iranian elderly with dementia. In this methodological study, after translating and assessing the face and content validity of MPS, 100 elderly with dementia were selected via convenience sampling from nursing homes and clinics in Kashan in 2018-19; then, MPS was completed for them both at rest and during a movement pain protocol. MPS was assessed by exploratory factor analysis, known-group comparison, convergent validity, internal consistency, equivalence, and stability. The factor analysis revealed a one-factor structure, which explained 57.11% of the total variance. The Persian MPS differentiated patients with and without known painful conditions, as well as pain at rest and during the movement pain protocol (p < .0001). There was a significant positive correlation between the scores of MPS and PACSLAC-II (r = .87, p < .0001). The Cronbach's α, intraclass correlation coefficient and standard error of measurement of MPS were .91, .79, and ±1.37, respectively. As a valid and reliable tool, the Persian MPS can be used for pain assessment among Iranian elderly with dementia.
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http://dx.doi.org/10.1177/0163278720961818DOI Listing
September 2020

Magnetic particle targeting for diagnosis and therapy of lung cancers.

J Control Release 2020 12 11;328:776-791. Epub 2020 Sep 11.

Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, Alberta T2N 1N4, Canada; Center for Bioengineering Research and Education, University of Calgary, Calgary, Alberta T2N 1N4, Canada. Electronic address:

Over the past decade, the growing interest in targeted lung cancer therapy has guided researchers toward the cutting edge of controlled drug delivery, particularly magnetic particle targeting. Targeting of tissues by magnetic particles has tackled several limitations of traditional drug delivery methods for both cancer detection (e.g., using magnetic resonance imaging) and therapy. Delivery of magnetic particles offers the key advantage of high efficiency in the local deposition of drugs in the target tissue with the least harmful effect on other healthy tissues. This review first overviews clinical aspects of lung morphology and pathogenesis as well as clinical features of lung cancer. It is followed by reviewing the advances in using magnetic particles for diagnosis and therapy of lung cancers: (i) a combination of magnetic particle targeting with MRI imaging for diagnosis and screening of lung cancers, (ii) magnetic drug targeting (MDT) through either intravenous injection and pulmonary delivery for lung cancer therapy, and (iii) computational simulations that models new and effective approaches for magnetic particle drug delivery to the lung, all supporting improved lung cancer treatment. The review further discusses future opportunities to improve the clinical performance of MDT for diagnosis and treatment of lung cancer and highlights clinical therapy application of the MDT as a new horizon to cure with minimal side effects a wide variety of lung diseases and possibly other acute respiratory syndromes (COVID-19, MERS, and SARS).
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http://dx.doi.org/10.1016/j.jconrel.2020.09.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7484624PMC
December 2020

Association of Endothelial Nitric Oxide Synthase Gene Polymorphisms with Susceptibility to Prostate Cancer: a Comprehensive Systematic Review and Meta-Analysis.

Urol J 2020 06 24;17(4):329-337. Epub 2020 Jun 24.

Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Purpose: A variety of studies have evaluated the association of polymorphisms at endothelial nitric oxide synthase (eNOS) gene with risk of prostate cancer. However, the results remain inconclusive. This meta-analysis was performed to derive a more precise estimation between eNOS polymorphisms and prostate cancer risk.

Materials And Methods: A comprehensive literature search was conducted using PubMed, EMBASE, Wed of Science, Elsevier, Cochrane Library, SciELO, SID, WanFang, VIP, CBD and CNKI database up to March 20, 2020. Odds ratios with 95% confidence intervals were used to assess the strength of the associations.

Results: A total of 22 case-control studies including 12 studies with 4,464 cases and 4,347 controls on +894G>T, five studies with 589 cases and 789 controls on VNTR 4a/b, and five studies with 588 cases and 692 controls on -786T > C were selected. Overall, pooled data showed a significant association between eNOS 894G>T, VNTR 4a/b, and -786T > C polymorphisms and an increased risk of prostate cancer in the global population. When stratified by ethnicity, a significant association was found between eNOS +894G>T and -786T>C polymorphisms and risk of prostate cancer in Caucasians.

Conclusion: Our results indicated that eNOS 894G>T, VNTR 4a/b, and -786T>C polymorphisms were associated with risk of prostate cancer in the global population as well as Caucasian population.
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http://dx.doi.org/10.22037/uj.v0i0.5445DOI Listing
June 2020

The effect of human wharton's jelly-derived mesenchymal stem cells on MC4R, NPY, and LEPR gene expression levels in rats with streptozotocin-induced diabetes.

Iran J Basic Med Sci 2020 Feb;23(2):214-223

Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Objectives: Type 1 diabetes (T1D) is an autoimmune disease resulting from inflammatory destruction of islets β-cells. Nowadays, progress in cell therapy, especially mesenchymal stem cells (MSCs) proposes numerous potential remedies for T1D. We aimed to investigate the combination therapeutic effect of these cells with insulin and metformin on neuropeptide Y, melanocortin-4 receptor, and leptin receptor genes expression in TID.

Materials And Methods: One hundreds male rats were randomly divided into seven groups: the control, diabetes, insulin (Ins.), insulin+metformin (Ins.Met.), Wharton's Jelly-derived MSCs (WJ-MSCs), insulin+metformin+WJ-MSCs (Ins.Met.MSCs), and insulin+WJ-MSCs (Ins.MSCs). Treatment was performed from the first day after diagnosis as diabetes. Groups of the recipient WJ-MSCs were intraportally injected with 2× 10⁶ MSCs/kg at the 7th and 28th days of study. Fasting blood sugar was monitored and tissues and genes analysis were performed.

Results: The blood glucose levels were slightly decreased in all treatment groups within 20 and 45 days compared to the diabetic group. The C-peptide level enhanced in these groups compared to the diabetic group, but this increment in Ins.MSCs group on the 45th days was higher than other groups. The expression level of melanocortin-4 receptor and leptin receptor genes meaningfully up-regulated in the treatment groups, while the expression of neuropeptide Y significantly down-regulated in the treatment group on both times of study.

Conclusion: Our data exhibit that infusion of MSCs and its combination therapy with insulin might ameliorate diabetes signs by changing the amount of leptin and subsequent changes in the expression of neuropeptide Y and melanocortin-4 receptor.
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http://dx.doi.org/10.22038/IJBMS.2019.39582.9387DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211357PMC
February 2020

Psychometric evaluation of the Persian version of the Doloplus-2 (P-Doloplus-2) scale in elderly with dementia

Turk J Med Sci 2020 06 23;50(4):953-962. Epub 2020 Jun 23.

Department of Neurology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

Background/aim: A scale for behavioural pain assessment is useful for the detection and determination of pain in the elderly with dementia. This study aimed to translate and evaluate the psychometric properties of Doloplus-2 in the elderly with dementia in Iran.

Materials And Methods: In this methodological study, after translation and evaluating the face and content validity of Doloplus-2, 100 elderly people were selected by the convenience sampling method in Kashan, 2018–2019. Exploratory factor analysis, convergent validity, and known-groups comparison were applied to determine construct validity. Reliability was also assessed through internal consistency, equivalence, and stability methods were used. The ceiling and floor effects were also examined. Data were analyzed using the SPSS-v16 and via Mann-Whitney U test, Cronbach’s alpha, Spearman-Brown, and intraclass correlation coefficient (ICC).

Results: The scale’s content validity index was 0.95%, and the item impact of each item was above 1.5. Factor analysis identified 2 “social- functional” and “conventional subjective-objective” factors in scale that altogether were able to explain 76% of the total variance. The results revealed that P-Doloplus-2 could discriminate between the 2 groups of elderly with and without known chronic painful diseases (P < 0.0001). There was a significant positive correlation between P-Doloplus-2 and PACSLAC-II-IR scores (r = 0.878, P < 0.0001). Cronbach’s alpha, ICC, and standard error of measurement for the scale were 0.950, 0.864, and ± 1.759, respectively. The frequency of minimum and maximum possible score of scale was less than 15%.

Conclusion: The Persian version of Doloplus-2 can be considered as a valid and reliable scale for pain assessment in the elderly with dementia.
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http://dx.doi.org/10.3906/sag-2001-117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379415PMC
June 2020

Association of Transforming Growth Factor-β1 rs1982073 Polymorphism with Susceptibility to Acute Renal Rejection: a Systematic Review and Meta-Analysis.

Urol J 2020 Apr 18;18(1):1-10. Epub 2020 Apr 18.

Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Purpose: The association of rs1982073 (codon 10) polymorphism at Transforming Growth Factor- β1 (TGF-β1) gene with acute renal rejection (ARR) has been reported by several studies. However, the results were controversial. To derive a more precise estimation of this association, a meta-analysis was performed.

Methods: The eligible literatures were identified through PubMed, Scopus, Web of Science, EMBASE, SciELO, WanFang, and CNKI databases up to July 01, 2019. The pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to calculate the strength of the association.

Results: A total of 23 case-control studies with 795 ARR cases and 1,562 non-AR controls were selected. Pooled data revealed that there was no significant association between TGF-β1 codon 10 polymorphism and an increased risk of ARR in the overall population (C vs. T: OR=0.908, 95% CI 0.750-1.099, p = 0.322; CT vs. TT: OR=1.074, 95% CI 0.869-1.328, p = 0.507; CC vs.TT: OR=0.509, 95% CI=0.738-1.253, p = 0.770; CC+CT vs. TT: OR = 0.917, 95% CI 0.756-1.112, p = 0.376, and CC vs. CT+TT: OR=0.995, 95% CI 0.809-1.223, p = 0.959). Moreover, stratified analysis revealed no significant association between the TGF-β1 rs1982073 polymorphism and ARR risk by ethnicity and cases type (recipient and donor).

Conclusion: The current meta-analysis demonstrated that the TGF-β1 rs1982073 polymorphism was not significantly associated with increased risk of ARR. However, studies with a larger number of subjects among different ethnic groups are needed to further validate the results.
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http://dx.doi.org/10.22037/uj.v0i0.5437DOI Listing
April 2020

While Urine and Plasma Decorin Remain Unchanged in Prostate Cancer, Prostatic Tissue Decorin Has a Prognostic Value.

Iran Biomed J 2020 07 19;24(4):229-35. Epub 2020 Apr 19.

Department of Genetics and Molecular Medicine, School of Medicine, Zanjan University of Medical Sciences (ZUMS), Zanjan 45139-56111, Iran.

Background: Numerous studies confirmed that significant decrease in tissue decorin (DCN) expression is associated to tumor progression and metastasis in certain types of cancer including prostate cancer (PC). However, the potential prognostic value of tissue DCN in PC has not yet been investigated.

Methods: A total number of 40 PC and 42 patients with benign prostatic hyperplasia (BPH) were investigated for the expression levels of DCN in their prostatic tissues using real-time quantitative polymerase chain reaction and immunohistochemical analyses. Urinary and plasma DCN levels were also measured by ELISA.

Results: Despite no significant changes in the mean of urine and plasma DCN concentrations between the two study groups, tissue DCN mRNA was found to be 5.5fold lower in cancer than BPH (p = 0.0001). Similarly, the stained DCN levels appeared significantly lower in cancer patients with higher Gleason Scores (8 and 9, n = 6) than those with lower Gleason Scores (6 and 7, n = 26), with a p value of 0.049.

Conclusion: Here, we report, for the first time, that urine and plasma DCN does not seem to have a diagnostic value in PC, while tissue DCN could potentially be used as a prognostic marker in PC.
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http://dx.doi.org/10.29252/ibj.24.4.229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275814PMC
July 2020

Association of NAD (P) H Quinine Oxidoreductase 1 rs1800566 Polymorphism with Bladder and Prostate Cancers - a Systematic Review and Meta-Analysis.

Klin Onkol 2020 ;33(2):92-100

Background: Number of studies has been performed to investigate the association of NAD (P) H quinine oxidoreductase 1 (NQO1) rs1800566 polymorphism with risk of bladder and prostate cancers, but presented inconsistent results. Therefore, we performed a meta-analysis to provide a comprehensive data on the association of NQO1 rs1800566 polymorphism with bladder and prostate cancers.

Methods: All eligible studies were identified in PubMed, Google Scholar, EMBASE, and China National Knowledge Infrastructure databases before June 01, 2019.

Results: A total of 22 case-control studies including 15 studies with 4,413 cases and 4,275 controls on bladder cancer and 7 studies with 762 cases and 1,813 controls on prostate cancer were selected. Overall, pooled data showed that the NQO1 rs1800566 polymorphism was significantly associated with an increased risk of bladder cancer (T vs. C: OR 1.300; 95% CI 1.112-1.518; P = 0.001; TT vs. CC: OR 1.415; 95% CI 1.084-1.847; P = 0.011; TC vs. CC: OR 1.389; 95% CI 1.111-1.738; P = 0.004; TT + TC vs. CC: OR 1.428; 95% CI 1.145-1.782; P = 0.002) and prostate cancer (TC vs. CC: OR 1.276; 95% CI 1.047-1.555; P = 0.016; TT + TC vs. CC: OR 1.268; 95% CI 1.050-1.532; P = 0.014). The stratified analysis by ethnicity revealed an increased risk of bladder cancer among Caucasians and prostate cancer among Asians.

Conclusion: This meta-analysis suggested that the NQO1 rs1800566 polymorphism was significantly associated with increased risk of bladder and prostate cancers.
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http://dx.doi.org/10.14735/amko202092DOI Listing
January 2021

ASSOCIATION OF IL-8 -251T>A (RS4073) POLYMORPHISM WITH SUSCEPTIBILITY TO GASTRIC CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS BASED ON 33 CASE-CONTROL STUDIES.

Arq Gastroenterol 2020 Jan-Mar;57(1):91-99

Shahid Sadoughi University of Medical Sciences, Department of Medical Genetics, Yazd, Iran.

Background: The role of -251A>T polymorphism in the anti-inflammatory cytokine interleukin-8 (IL-8) gene in gastric cancer was intensively evaluated, but the results of these studies were inconsistent.

Objective: Therefore, we performed a meta-analysis to provide a comprehensive data on the association of IL-8 -251T>A polymorphism with gastric cancer.

Methods: All eligible studies were identified in PubMed, Web of Science, EMBASE, Wanfang and CNKI databases before September 01, 2019. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were derived from a fixed effect or random effect model.

Results: A total of 33 case-control studies with 6,192 cases and 9,567 controls were selected. Overall, pooled data showed that IL-8 -251T>A polymorphism was significantly associated with an increased risk of gastric cancer under all five genetic models, i.e., allele (A vs T: OR=1.189, 95% CI 1.027-1.378, P=0.021), homozygote (AA vs TT: OR=1.307, 95% CI 1.111-1.536, P=0.001), heterozygote (AT vs TT: OR=1.188, 95% CI 1.061-1.330, P=0.003), dominant (AA+AT vs TT: OR=1.337, 95% CI 1.115-1.602, P=0.002) and recessive (AA vs AT+TT: OR=1.241, 95% CI 1.045-1.474, P=0.014). The stratified analysis by ethnicity revealed an increased risk of gastric cancer in Asians and mixed populations, but not in Caucasians. Moreover, stratified by country found a significant association in Chinese, Korean and Brazilian, but not among Japanese.

Conclusion: This meta-analysis suggests that the IL-8 -251T>A polymorphism is associated with an increased risk of gastric cancer, especially by ethnicity (Asian and mixed populations) and country (Chinese, Korean and Brazilian).
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http://dx.doi.org/10.1590/S0004-2803.202000000-16DOI Listing
May 2020

Documented opioid use disorder and its treatment in primary care patients across six U.S. health systems.

J Subst Abuse Treat 2020 03;112S:41-48

Kaiser Permanente Washington Health Research Institute, United States of America.

Background: The United States is in the middle of an opioid overdose epidemic, and experts are calling for improved detection of opioid use disorders (OUDs) and treatment with buprenorphine or extended release (XR) injectable naltrexone, which can be prescribed in general medical settings. To better understand the magnitude of opportunities for treatment among primary care (PC) patients, we estimated the prevalence of documented OUD and medication treatment of OUD among PC patients.

Methods: This cross-sectional study included patients with ≥2 visits to PC clinics across 6 healthcare delivery systems who were ≥16 years of age during the study period (fiscal years 2014-2016). Diagnoses, prescriptions, and healthcare utilization were ascertained from electronic health records and insurance claims (5 systems that also offer health insurance). Documented OUDs were defined as ≥1 International Classification of Diseases code for OUDs (active or remission), and OUD treatment was defined as ≥1 prescription(s) for buprenorphine formulations indicated for OUD or naltrexone XR, during the 3-year study period. The prevalence of documented OUD and treatment (95% confidence intervals) across health systems were estimated, and characteristics of patients by treatment status were compared. Prevalence of OUD and OUD treatment were adjusted for age, gender, and race/ethnicity. Combined results were also adjusted for site.

Result: Among 1,403,327 eligible PC patients, 54-62% were female and mean age ranged from 46 to 51 years across health systems. The 3-year prevalence of documented OUD ranged from 0.7-1.4% across the health systems. Among patients with documented OUD, the prevalence of medication treatment (primarily buprenorphine) varied across health systems: 3%, 12%, 16%, 20%, 22%, and 36%.

Conclusion: The prevalence of documented OUD and OUD treatment among PC patients varied widely across health systems. The majority of PC patients with OUD did not have evidence of treatment with buprenorphine or naltrexone XR, highlighting opportunities for improved identification and treatment in medical settings. These results can inform initiatives aimed at improving treatment of OUD in PC. Future research should focus on why there is such variation and how much of the variation can be addressed by improving access to medication treatment.
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http://dx.doi.org/10.1016/j.jsat.2020.02.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7107675PMC
March 2020

Radiation dose and risk of exposure-induced death associated with common computed tomography procedures in Yazd Province.

Eur J Radiol 2020 May 3;126:108932. Epub 2020 Mar 3.

Shahid Sadoughi University of Medical Sciences, Medical Physics Department, Yazd, Iran. Electronic address:

Purpose: This survey was conducted to evaluate the radiation dose delivered to the patients through different CT procedures along with its corresponding risks in Yazd province.

Method: Data for the five most common procedures were collected from six institutions from September 2017. The effective dose for each patient was estimated by ImpactDose software. The risk of exposure-induced death (REID) was calculated by coupling the BEIR VII model and ICRP 103 data for the Asian population.

Results: The median effective doses for the five most common procedures, in descending order, were as follows: 5.19 mSv for abdomen-pelvis, 3.30 mSv for routine chest, 3.00 mSv for chest HRCT, 0.76 mSv for Brain and 0.47 mSv for sinus. Averaged over all the procedures, the ratio of maximum to minimum of effective dose was 90-fold. The highest associated risk was tied to high-resolution CT scans for women which was estimated to be 1 exposure-induced death related to 2096 scans performed on a 20-year old patient.

Conclusion: The estimated effective doses for all the procedures except sinus were comparably low, however, the variations among patient doses, even for a given procedure, were substantially high, indicating that further optimization processes need to be undertaken. Moreover, it was estimated that approximately 2000 scans of abdomen-pelvis performed on 20 year-old women could result in 1 radiation-induced cancer death, which in large scales may cause drastic health issues. In this regard, several approaches, one of which is the implementation of DRLs, can be suggested to reduce the collective dose from CT scans.
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http://dx.doi.org/10.1016/j.ejrad.2020.108932DOI Listing
May 2020

Investigating the relationship between synergistic effects and diversity of four widely used agricultural pesticides by using bacterial species in liquid culture medium.

Environ Monit Assess 2020 Feb 15;192(3):176. Epub 2020 Feb 15.

Department of Environmental Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

Interactive effects of mixtures of pesticides on bacteria are rarely investigated. The aim of this study was to investigate the cumulative, synergistic, and antagonistic effects of four widely used agricultural pesticides including deltamethrin, diazinon, chlorpyrifos, and 2,4-dichlorophenoxyacetic acid (2,4-D) on Pseudomonas, Aeromonas, and Bacillus bacteria. The reduction of alamar blue, as an indicator of bacterial activity, was measured using a spectrophotometer at 600-nm wavelength. Data were analyzed using SPSS 24.0 software. The binary mixtures of pesticides had mainly antagonistic and additive effects, but quadruple mixtures of pesticides had synergistic effects on all of the three bacterial species. In the mixtures of pesticides, increasing the number of compounds leads to more synergistic effects.
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http://dx.doi.org/10.1007/s10661-020-8125-5DOI Listing
February 2020

The Relationship between Aura and Postoperative Outcomes of Epilepsy Surgery in Patients with Mesial Temporal Sclerosis.

Adv Biomed Res 2020 21;9. Epub 2020 Jan 21.

Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: We conducted a study to evaluate the relationship between aura types and postoperative outcomes in patients with mesial temporal sclerosis (MTS) to predict the prognosis of patients, accordingly.

Materials And Methods: In this cross-sectional study, 99 patients with MTS-temporal lobe epilepsy were enrolled based on inclusion and exclusion criteria. The types of aura were evaluated, and the outcomes were categorized according to the Engel scale. Preoperative and postoperative results of patients were compared and analyzed with the Kruskal-Wallis test.

Results: About 73.7% of patients had seizure-free after their surgeries. The most of patients ( = 81) were in Class I of Evaluating Engel criteria. About 36.3% had not experienced any aura before their seizures, and among those with aura, the most prevalent aura was abdominal aura in 29 patients (29.3%) followed by other types of aura and affective aura. Most of the patients in Class I, II, III, and IV of Engel scale had an abdominal aura, without aura, effective aura, and abdominal aura, respectively, but this difference was not statistically significant ( = 0.691).

Conclusion: According to this study, the type of aura cannot predict postoperative outcomes in MTS patients. More studies are needed to evaluate this relation in better-planned studies with greater sample size.
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http://dx.doi.org/10.4103/abr.abr_25_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003553PMC
January 2020

Association of IL-6 -174 G>C Polymorphism with Susceptibility to Colorectal Cancer and Gastric Cancer: a Systematic Review and Meta-Analysis.

Acta Medica (Hradec Kralove) 2019 ;62(4):137-146

Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background: The -174G>C (rs1800795) polymorphism at interleukin 6 (IL-6) gene has been reported to be related with the occurrence of colorectal (CRC) and gastric (GC) cancers. However, the results had been conflicting and controversial. In order to give a comprehensive and precise result, we summarized available data to analyze the association of this polymorphism with CRC and GC risk.

Methods: A comprehensive literature search on PubMed, Elsevier Science Direct, and CNKI database was performed to identify all eligible studies up to May 15, 2019. The strength of association was assessed by odds ratios (ORs) with 95% confidence intervals (CI).

Results: A total of 29 case-control studies including 16 studies with 7,560 cases and 9,574 controls on CRC and 13 studies with 1,445 cases and 2,918 controls on GC were selected. Overall, pooled data showed that the IL-6 -174G>C polymorphism was not significantly associated with increased risk of CRC and GC in overall. When stratified by ethnicity, we found a statistically significant association between the IL-6 -174 G>C polymorphism and CRC risk in Asians (CC vs. GG: OR = 1.860, 95% CI 1.061-3.258, p = 0.030; and CC vs. CG+GG: OR = 1.941, 95% CI 1.131-3.331, p = 0.016).

Conclusion: The meta-analysis suggests that IL-6 -174G>C polymorphism was not significantly associated with the increased risk of CRC and GC in overall population. However, the results showed that IL-6 -174G>C polymorphism may be associated with risk of GC in Asians. Further studies including a larger sample size will be necessary to clarify these results.
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http://dx.doi.org/10.14712/18059694.2020.2DOI Listing
July 2020

Investigating the heavy metals' removal capacity of some native plant species from the wetland groundwater of Maharlu Lake in Fars province, Iran.

Int J Phytoremediation 2020 15;22(7):781-788. Epub 2020 Jan 15.

Department of Earth Sciences, Shiraz University, Shiraz, Iran.

Saline Maharlu Lake in southern Iran is the outlet of Shiraz-Sarvestan basin, an inland flat lake, which its surroundings appear as wetland environment. The groundwater of the wetland area is polluted with heavy metals from the lake, and the wetland native plants grown in this area potentially have the tendency of uptaking the heavy metals from their rhizosphere environments. The lake is in hydraulic connection with its wetland groundwater and reverse hydraulic gradient results in movement of pollutants into the aquifers. This study aims to realize the wetland native plants efficiency in phytoremediation of the heavy metal. Groundwater samples were collected for analysis from rhizosphere of Jancus sp., Tamarix sp., and Suaeda sp. and compared with those of wetland regions without plants. Depletion and bio-concentration factors were calculated to evaluate the plants capability in removing metals from the wetland and determining the more suitable plant for phytoremediation. Results showed depletion of metals in the plant areas in compare with the bare land regions. Among the plants, the most depletion is for Jancus sp. followed by Tamarix sp. and Suaeda sp. The results also highlighted the potential of Jancus sp. for enhancing phytoremediation of heavy metal contaminated wetland, especially for Pb.
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http://dx.doi.org/10.1080/15226514.2019.1710815DOI Listing
May 2020

Multi-walled carbon nanotubes-CoFe O nanoparticles as a reusable novel peroxymonosulfate activator for degradation of Reactive Black 5.

Water Environ Res 2020 Jul 26;92(7):969-974. Epub 2020 Jan 26.

Department of Health Education and Promotion, Faculty of Evaz Health, Larestan University of Medical Sciences, Larestan, Iran.

In this study, CoFe O nanoparticles supported on multi-walled carbon nanotubes (MWCNTs), as novel peroxymonosulfate (PMS) activator, were synthesized for degradation of Reactive Black 5 (RB5). The results showed that the maximum removal efficiencies of RB5 (100%), chemical oxygen demand (83.12%), and total organic carbon (65.5%) could happen at pH of 7, catalyst dosage of 100 mg/L, PMS dosage of 2 mM, RB5 concentration of 50 mg/L, and time of 30 min. The results of the temperature effect showed that the activation energy (E  = 20.92 kJ/mol) for the synthesized catalyst is much lower compared to other studies. The PMS/MWCNTs-CoFe O system had higher decolorization efficiency and kinetic rates compared to other adsorption and oxidation systems. Quenching experiments proved that RB5 was degraded by sulfate and hydroxyl radicals. The MWCNTs-CoFe O catalyst showed suitable stability and reusability even after five consecutive catalytic reactions. The continuous treatment of RB5 in real water resources was performed using catalyst packed in a column reactor, and its results showed the high efficiency of the column in the catalytic treatment of the dye at long reaction time. Based on the proposed degradation pathway, the azo bands and the naphthalene structure of RB5 are oxidized to compounds with low molecular weight. PRACTITIONER POINTS: MWCNTs-CoFe O was used as a novel recyclable catalyst for the activation of peroxymonosulfate and dye degradation. The rate of dye degradation and peroxymonosulfate activation by MWCNTs-CoFe O was much higher than that of the catalysts alone. Radical , with contribution percentage of 73.20%, was the main agent for degradation of Reactive Black 5 dye. MWCNTs-CoFe O in the dye degradation process showed excellent stability and reusability, lower activation energy, and easier separation. The dye degradation products were identified by gas chromatography and UV-vis spectrophotometric analyses, and their degradation pathway was suggested.
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http://dx.doi.org/10.1002/wer.1291DOI Listing
July 2020

European trends in radiology: investigating factors affecting the number of examinations and the effective dose.

Radiol Med 2020 Mar 16;125(3):296-305. Epub 2019 Dec 16.

Department of Radiotherapy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

The advances in technology have led to a growing trend in population exposure to radiation emerging from the invention of high-dose procedures. It is, for example, estimated that annually 1.2% of cancers are induced by radiological scans in Norway. This study aims to investigate and discuss the frequency and dose trends of radiological examinations in Europe. European Commission (EC) launched projects to gain information for medical exposures in 2004 and 2011. In this study, the European Commission Radiation Protection (RP) reports No. 154 and 180 have been reviewed. The RP 154 countries' data were extracted from both reports, and the average variation trend of the number of examinations and effective doses were studied. According to the results, plain radiography and fluoroscopy witnessed a reduction in the frequency and effective dose per examination. Nevertheless, European collective dose encountered an average increase of 23%, which resulted from a growing tendency for implementation of high-dose procedures such as CT scans and interventional examinations. It is worth noting that most of the CT procedures have undergone an increase in effective dose per examination. Although demand and dose per examination in some radiological procedures (such as intravenous urography (IVU) have been reduced, population collective dose is still rising due to the increasing demand for CT scan procedures. Even though the individual risks are not considerable, it can, in a large scale, threaten the health of the people at the present time. Due to this fact, better justification should be addressed so as to reduce population exposure.
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http://dx.doi.org/10.1007/s11547-019-01109-6DOI Listing
March 2020

ASSOCIATION OF MMP-7 -181A>G POLYMORPHISM WITH COLORECTAL CANCER AND GASTRIC CANCER SUSCEPTIBILITY: A SYSTEMATIC REVIEW AND META-ANALYSIS.

Arq Bras Cir Dig 2019 21;32(3):e1449. Epub 2019 Oct 21.

Sadoughi University of Medical Sciences, Medical Genetics; Yazd, Yazd, Iran.

Introduction: The matrix metalloproteinase-7 (MMP-7) gene -181A>G polymorphism has been reported to be associated with colorectal cancer (CRC) and gastric cancer (GC) susceptibility, yet the results of these previous results have been inconsistent or controversial.

Aim: To elaborate a meta-analysis to assess the association of -181A>G polymorphism of MMP-7 with CRC and GC risk.

Methods: Published literature evaluating the association from PubMed, Web of Science, Google Scholar and other databases were retrieved up to April 25, 2018. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using random- or fixed-effects model.

Results: A total of 19 case-control studies, which included eleven studies on CRC (2,169 CRC cases and 2,346 controls) and eight studies on GC (1,545 GC cases and 2,366 controls) were identified. There was a significant association between MMP-7 -181A>G polymorphism and GC risk under the homozygote model (GG vs. AA: OR=1.672, 95% CI 1.161-2.409, p=0.006) and the recessive model (GG vs. GA+AA: OR=1.672, 95% CI 1.319-2.554, p=0.001), but not with CRC. By subgroup analysis based on ethnicity, an increased risk of CRC and GC was found only among Asians.

Conclusions: This meta-analysis suggests that MMP-7 -181A>G polymorphisms is associated with GC risk, but not with CRC. However, our results clearly showed that the MMP-7 -181A>G polymorphism significantly increased the risk of CRC only in Asians.
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http://dx.doi.org/10.1590/0102-672020190001e1449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812146PMC
October 2019

Outcome of lesional epilepsy surgery: Report of the first comprehensive epilepsy program in Iran.

Neurol Clin Pract 2019 Aug;9(4):286-295

Kashani Comprehensive Epilepsy Center (JMH, MZ), Kashani Hospital, School of Medicine, Isfahan University of Medical Sciences; Departments of Neurology (JMH, SB, BZ, NM, MZ), Isfahan Neurosciences Research Center and Neurosurgery (HM), Department of Radiology (RB), Students' Research Center (SB, NM), and Department of Psychiatry (MB), Psychosomatic Research Center, School of Medicine, Isfahan University of Medical Sciences; Shefa Neuroscience Research Center (ER), Tehran, Iran; Students' Research Center (AMH), School of Medicine, Shahrekord University of Medical Sciences, Iran; Department of Neurology (PM), University of Tennessee Health Science Center, Memphis, TN; Department of Clinical Neurosciences (YA), University of Calgary, Calgary, Alberta, Canada; and Epilepsy Center (SA, SL), Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH.

Background: We investigated the utility of epilepsy surgery and postoperative outcome in patients with lesional epilepsy in Iran, a relatively resource-poor setting.

Methods: This prospective longitudinal study was conducted during 2007-2017 in Kashani Comprehensive Epilepsy Center, Isfahan, Iran. Patients with a diagnosis of intractable focal epilepsy, with MRI lesions, who underwent epilepsy surgery and were followed up ≥ 24 months, were included and evaluated for postoperative outcome.

Results: A total of 214 patients, with a mean age of 26.90 ± 9.82 years (59.8% men) were studied. Complex partial seizure was the most common type of seizure (85.9%), and 54.2% of the cases had auras. Temporal lobe lesions (75.2%) and mesial temporal sclerosis (48.1%) were the most frequent etiologies. With a mean follow-up of 62.17 ± 19.33 months, 81.8% of patients became seizure-free postoperatively. Anticonvulsants were reduced in 86% of the cases and discontinued in 40.7%. In keeping with previous studies, we found that seizure freedom rates were lower among patients with longer follow-up periods.

Conclusions: We found high rates of seizure freedom after surgery in lesional epilepsy patients despite limited facilities and infrastructure; antiepileptic medications were successfully tapered in almost half of the patients. Considering the favorable outcome of epilepsy surgery in our series, we believe that it is a major treatment option, even in less resource-intensive settings, and should be encouraged. Strategies to allow larger scale utility of epilepsy surgery in such settings in the developing world and dissemination of such knowledge may be considered an urgent clinical need, given the established mortality and morbidity in refractory epilepsy.
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http://dx.doi.org/10.1212/CPJ.0000000000000627DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6745744PMC
August 2019

Association of Promoter Region Polymorphisms of IL-10 Gene with Susceptibility to Lung Cancer: Systematic Review and Meta-Analysis.

Asian Pac J Cancer Prev 2019 07 1;20(7):1951-1957. Epub 2019 Jul 1.

Mother and New Born Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Objective: Epidemiological studies have suggested that the promoter region polymorphisms of interleukin-10 (IL-10) gene may be associated with an increased risk of lung cancer. However, those studies results are controversial. Thus, a comprehensive meta-analysis was performed to evaluate the association of promoter region polymorphisms of IL-10 gene with susceptibility to lung cancer. Methods: a comprehensive search of PubMed, EMBASE, and CNKI databases was performed to find all eligible studies up to September 15, 2018. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of such association. Results: A total number of 19 case-control studies with 4084 cases and 6,131 controls were selected. The overall meta-analysis results showed that the -592A>C polymorphism was significantly associated with lung cancer risk under four genetic models, i.e., allele (CT vs. TT: OR= 1.17, 95% CI 1.01-1.35, p=0.02), homozygote (CC vs. AA: OR= 1.64, 95% CI 1.29-2.02, p≤0.001), heterozygote (CA vs. AA: OR= 1.26, 95% CI 1.06-1.50, p≤0.001), and dominant (CC+CA vs. AA: OR= 1.31, 95% CI 1.11-1.54, p=0.001). However, there was no significant association between -819T>C and -1082A>G polymorphisms of IL-10 and lung cancer risk. Similarly, subgroup analyses by ethnicity detected significant association between IL-10 -592A>C and lung cancer among Asians and Caucasians. Conclusions: Our meta-analysis suggests that the IL-10 -592A>C polymorphism might be risk factor for lung cancer, especially among Asian and Caucasians. In contrast, the IL-10 -819T>C and -1082A>G polymorphisms are not significantly associated with increased risk of lung cancer.
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http://dx.doi.org/10.31557/APJCP.2019.20.7.1951DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6745207PMC
July 2019

The protective effect of bone marrow-derived mesenchymal stem cells in liver ischemia/reperfusion injury via down-regulation of miR-370.

Iran J Basic Med Sci 2019 Jun;22(6):683-689

Department of Pathology, University of Toronto, Toronto, Canada.

Objectives: Liver transplantation is the most important therapy for end-stage liver disease and ischemia reperfusion (I/R) injury is indeed a risk factor for hepatic failure after grafting. The role of miRNAs in I/R is not completely understood. The aim of this study was to investigate the potential protective role of the mesenchymal stem cells (MSCs) and ischemic preconditioning on miR-370 expression and tissue injury in hepatic I/R injury.

Materials And Methods: In this study, 24 BALB/c mice were divided into 4 groups, including sham, I/R, I/R mouse that received MSCs (I/R+MSC) and ischemia preconditioning (IPC) The expression levels of hepatic miR-370, Bcl2 and BAX in male BALB/c mice in different groups including hepatic I/R, hepatic I/R received MSCs, and hepatic I/R with IPC were assessed by quantitative real-time PCR. The effect of miR-370 on hepatic I/R was investigated by serum liver enzyme analysis and histological examination.

Results: The expression of miR-370 was significantly up-regulated in the mice subjected to hepatic I/R injury as compared with the sham operated mice. Injection of MSCs led to the down-regulation of the serum liver enzymes, expression of miR-370 and BAX, up-regulation of Bcl2 as well as the improvement of hepatic histological damage. IPC led to similar results, but the difference was not significant.

Conclusion: Our data suggest that miR-370 affected the Blc2/BAX pathway in hepatic I/R injury, and down- regulation of miR-370 by BM-MSCs efficiently attenuated the liver damage.
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http://dx.doi.org/10.22038/ijbms.2019.32670.7812DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570750PMC
June 2019

Antioxidant and toxicity studies of biosynthesized cerium oxide nanoparticles in rats.

Int J Nanomedicine 2019 26;14:2915-2926. Epub 2019 Apr 26.

Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,

Purpose: The purpose of this study was to investigate the acute toxic potential of cerium oxide nanoparticles (CNPs) synthesized by pullulan in adult male Wistar rats.

Patients And Methods: Thirty male Wistar rats randomly were divided into five experimental groups of six animals each. The animals were received 50, 100, 200, and 400 mg/kg CNPs for 14 consecutive days. At the end of the experiment, the rats were euthanized and histopathological evaluation of the liver and renal tissues, as well ass, the markers of serum oxidative stress including thiobarbituric acid reactive substances, total sulfhydryl content, and antioxidant capacity (using ferric reducing/antioxidant power assay) were assessed. Hematological parameters and the activity of liver function enzymes were also measured.

Results: The results of this study showed that CNPs caused no significant changes in the activity of liver enzymes, hepatic and renal histopathology and hematological parameters, while significantly improved serum redox status.

Conclusion: Acute administration of pullulan-mediated CNPs is safe and possess antioxidant activity.
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http://dx.doi.org/10.2147/IJN.S194192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6487897PMC
July 2019

Water use indicators at farm scale - An agro-hydrological software solution.

Sci Total Environ 2019 Aug 27;678:133-145. Epub 2019 Apr 27.

Department Technology Assessment and Substance Cycles, Leibniz Institute for Agricultural Engineering and Bioeconomy, Max-Eyth-Allee 100, 14469 Potsdam, Germany.

The challenge to sustainably intensify agricultural production in farming systems in face of the increasing variability in regional water resources requires concerted action from many stakeholders, locally, regionally and globally. Models, such as the AgroHyd Farmmodel presented here, can provide information on how farm management decisions affect local water resources at various scales for use in multiple assessment frameworks. It is a stand-alone web-based software that connects agricultural and water-related systems, including all water flows related to farming systems. Results from a case study of the production of 12 crops with rainfed and supplemental irrigation on a farm in northeastern Germany are described here. Indicators that relate the water use to plant production on the farm such as water intensity or water productivity are compared in detail for three consecutive years with greatly varying annual rainfall amounts (from 373 to 790 mm) to highlight the effect of local variability on water flows and indicator values. The discussion illustrates how information on the effect of management decisions, such as crop type, seeding date, crop rotation, cultivation and irrigation on water use can be processed into indicators to help farmers make more effective decisions.
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http://dx.doi.org/10.1016/j.scitotenv.2019.04.368DOI Listing
August 2019

The Impact of Increased Hydrocodone Regulation on Opioid Prescribing in an Urban Safety-Net Health Care System.

J Am Board Fam Med 2019 May-Jun;32(3):362-374

From the Department of Family and Community Medicine, University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Houston, TX (TFN, KC, YRV, MZ, ALS); Ambulatory Care Services, Grady Health System, Atlanta, GA (KC); Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, Houston, TX (RS, ALS).

Background: Hydrocodone-combination analgesics were changed from Schedule III to Schedule II to discourage the prescribing of these analgesics. Our primary aim was to explore the effect of hydrocodone rescheduling on opioid prescribing within an urban safety-net health care system.

Methods And Design: Data were extracted from electronic records of ambulatory patients (N = 82,432 patients) prescribed hydrocodone-combination, codeine-combination, or tramadol opioid analgesics (N = 200,675 prescriptions) between October 6, 2013 and October 6, 2015. Data analyses modeled predicted probabilities of hydrocodone-combination prescriptions (HCPs). Chronic opioid therapy (COT) for chronic pain (ie, ≥3 opioid prescriptions/12 months) and morphine milligram equivalency (MME) levels were also examined.

Results: The probability of providers writing HCPs decreased significantly from pre- to postrescheduling (0.525 vs 0.158, respectively, < .0001). However, this coincided with large probability increases in codeine-combination (0.064 vs 0.269) and tramadol prescriptions (0.412 vs 0.573). The probability of HCPs varied across physician specialty ( < .0001), patient diagnoses ( < .0001), COT versus non-COT patients ( < .0001), and patient characteristics (sex, race/ethnicity, and age; < .05). COT patients received significantly more opioid prescriptions in the postrescheduling period ( = 4.81 vs = 4.27; < .0001). Patients on <20 MME/day increased slightly from pre- to postrescheduling ( < .0001).

Discussion: Significant declines in HCPs occurred after rescheduling; however, one third of patients prescribed opioids remained on doses ≥20 MME/day. Codeine- and tramadol-prescription probabilities increased significantly and providers may have an increased perception of safety about these medications. Physicians and health care systems must reduce their overreliance on opioids in treating pain, especially chronic pain, as all opioids incur some level of risk.
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http://dx.doi.org/10.3122/jabfm.2019.03.180356DOI Listing
June 2020

High Glucose-reduced Apoptosis in Human Breast Cancer Cells Is Mediated by Activation of NF-κB.

Iran J Allergy Asthma Immunol 2019 Apr 1;18(2):153-162. Epub 2019 Apr 1.

Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Tumor cells rely on glycolysis for their energy supply with the production of lactate even in normoxia condition, which is named aerobic glycolysis or Warburg effect. Therefore, high glucose (HG) concentration provides a favorable condition for increasing proliferation, angiogenesis and decreasing apoptosis, but its molecular mechanisms are still unknown. The objective of this study is to investigate HG condition on tumor cells behavior including proliferation, apoptosis, and an angiogenesis mediator. In this study, MCF-7 derived from human breast adenocarcinoma, were cultured in DMEM with two different concentrations of glucose for 48 h (5.5 mM as normal glucose (NG) condition and 25 mM as HG condition). We used Zingiber officinale extraction for the inhibition of NF-κB. Cell proliferation assay was done by direct counting, cell viability by MTT method, bcl-2 by Immunocytochemistry, apoptosis by Hoechst/PI double staining and vascular endothelium growth factor (VEGF) by ELISA. Results showed that HG increased lactate production, significantly. HG increased cell proliferation, cell viability, VEGF secretion, and bcl-2 expression while it decreased apoptosis. However, when HG was combined with Zingiber officinale extraction, cell proliferation, cell viability, VEGF secretion and bcl-2 expression decreased and apoptosis increased significantly due to inhibition of NF-κB. Results revealed that HG increased cell proliferation, angiogenesis and decreased apoptosis due to activation of NF-κB pathway. Moreover, the probable mechanism of the activation of NF-κB in HG is increasing reactive oxygen species (ROS) in this condition that can activate NF-κB directly.
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April 2019