Vinorelbine and docetaxel combination as the first line treatment in patients with metastatic breast cancer: results of a multi-centric phase ii trial in Iran

Introduction: We conducted a multi-centric phase II study to evaluate the tumor response and safety of the combination of vinorelbin and docetaxel in treatment of metastatic breast cancer patients

Patients and methods: Forty one metastatic breast cancer patients, who had at least one measurable lesion and had not been treated for metastasis before, were enrolled from March 2006 to June 2009. Treatment contained vinorelbine 25mg/m2 IV and docetaxel 30mg/m2 at day 1 and 8. Cycles were repeated every 21 days for 6 cycles. We evaluated response to chemotherapy every three weeks and toxicity every week

Results: The mean age of patients was 50.4 years [range 30-81]. Twenty eight patients [68.2%] had received prior neoadjuvant anthracycline based chemotherapy. No patient had received adjuvant chemotherapy within the last 3 months. Twenty four patients [58.3%] had two or more metastatic sites. Thirty six patients were evaluable for their response. An objective tumor response [either complete response or partial response] was achieved in 32 [88.8%] and complete response was seen in 9 [25%] patients. Thirteen patients [31.6%] developed grade 3-4 neutropenia and neutropenic fever was reported in 11 [26.8%]. Grade 3 anemia was observed in 1 patient [2.4%]. No grade 4 non-hematological toxicity was noted and the most frequent grade 3 non-hematological toxicities were hair loss [39%], stomatitis [7.3%] and diarrhea [4.8%]. Median time to progression was 7 months and median overall survival was 11 months

Conclusion: Vinorelbine-docetaxel combination shows a considerable tumor response and manageable toxicity as the first line treatment for metastatic breast cancer. It seems logical to conduct phase III trials to further evaluate this regimen

Estimating total economic value of coral reefs of Kish Island [Persian Gulf]

This paper is concerned with the economic valuation of the coral reef within Kish Island in Persian Gulf of Iran. For calculating this value, all components of use and non-use values are estimated and then according to each of them, suitable method has applied. Many different evaluation tools such as contingent valuation method, zonal travel cost method, replacement cost, avoided cost method, value at risk method are used. The semi non parametric distribution free estimator for calculating the contingent valuation method is applied. The probability of willingness to pay the same as the probability of accepting bids is estimated by using data based on questioners approach using stated preference method. The result indicates that the total economic value of this unique ecosystem in Kish Island is at least 14.6 million dollar per year, showing the importance of conservation value of the ecosystem. Its largest component of total economic value is about 62 percent attributed to the recreational value. This is followed by conservation value which is about 23 percent of the economic value. Since coastal protection and waste assimilation functions of coral reef are 10 percent, it is also suitable factor in illustrating total economic value. The economic value for each hectare of this ecosystem in Kish Island is US$ 237,000 in 2009

[ degree of agreement of quantiferon TB gold test and tuberculin skin test in nurses]

Tuberculin skin test [TST] is the standard method for diagnosis of latent tuberculous infection. Positive results of TST [significant induration] may be seen in persons with latent M.tuberculosis infection and negative results of this test may be seen in patients with active tuberculosis. After performing TST false positive reactions may be seen with nontuberculous mycobacterial infections or false negative results may be encountered in anergic patients with tuberculosis disease. Quantiferon TB Gold test [QFT] is a new diagnostic test which assays the amount of released interferon gamma from peripheral blood lymphocytes in response to M.tuberculosis antigens. The purpose of this study was to determine the degree TST and QFT correlation. This descriptive study carried out on 72 nurses of two internal medicine and infectious diseases wards of Imam Reza and Imam Khomeini hospitals in Kermanshah located in West of Iran, during 2009. 58 of nurses were vaccinated with BCG vaccine and none of them had any immune compromising condition. TST was performed by intradermal injection of 0.1 ml of standard tuberculin test [5 TU] and QFT was performed 48 hours then after using peripheral whole blood. The amount of released interferon gamma from lymphocytes in response to antigens were measured by ELISA method. Three of nurses excluded and this study was done on 69 nurses. Overall the degree of agreement of TST and QFT was 63.7% [P=0.69 and Kappa=0.139]. The degree of discordance between these tests in PPD negative but QFT positive persons was 15.94% and in PPD positive but QFT negative persons was 20.3%. The sensitivity and specificity of QFT was 41.67% and 75.56% respectively. The degree of agreement of TST and QFT in vaccinated and unvaccinated nurses was 63.8% [Kappa=0.143] and 66.67% [Kappa=0.54] respectively. There was no significant difference between QFT and TST in diagnosing latent tuberculous infection

[Diagnostic validity of BCL-2 in ganglion cell staining and its application in Hirschprung's disease diagnosis]

Hirschsprung's disease is a congenital disorder, characterized by the absence of ganglion cells in the intramural and submucosal plexus in distal parts of large bowel. Diagnosis is based on the histopathologic examination of hematoxilin and eosin stained sections. Due to diagnosis limitation by Hematoxylin and Eosin staining [H and E], this study was done to identify the ganglion cells by BCL-2 immunoreactivity and compared it with H and E staining. In this laboratory study, paraffin blocks of 36 specimens demonstrating ganglion cells on original H and E stained sections and 35 specimens lacking ganglion cells on H and E staining, were selected. Recuts were stained by H and E and BCL-2 methods. Ganglion cells were observed in 36 cases by H and E staining but in BCL-2 staining ganglion cells were detected in 29 cases. In 35 cases reported negative for ganglion cells on H and E staining, ganglion cells were detected in 5 cases by BCL-2 method. Sensitivity, spesificity, positive and negative predictive values for BCL-2 method for diagnosis of hirshsprung's disease were 81%, 86%, 85% and 86% respectively.discordancy [positive BCL-2, negative H and E] was 14%. Immunohistochemistry method using BCL-2 improve the accuracy of diagnosis in hirschsprung's disease, when accompanied with H and E staining, particulary for negative slides

[Effects of hydroalcoholic extract of carthamus tinctorius on activity of hepatic transaminases in alloxan-induced diabetic rats]

Safflower [Carthamus tinctorius L.] flowers, mostly used for coloring and flavoring food, are attributed with anti-rheumatic and anti-diabetic effects in traditional medicine. The purpose of this research was to experimentally assess the effect of hydroalcoholic extract of Carthamus tinctorius on the level of AST and ALT in alloxan-induced diabetic rats. In the present study, 18 male Wistar rats, of body wt. 180-220 g were randomly allocated into three groups with six rats per group: first group, non-diabetic rats; second group, diabetic rats; third group, diabetic rats treated with hydroalcoholic extract of Carthamus tinctorius [200 mgkg [-1] BW, i.p.]. Rats were fasted for 16h and then fasting blood samples were collected in heparinated tubes. Sampling was performed from the orbital sinus. ANOVA was used for data analysis. Our results indicated a significant difference in AST and ALT levels in the diabetic group compared with the other groups [P<0.05]. Histomorphological studies of the liver of these animals, demonstrated the same results. Hydroalcoholic extract of Carthamus tinctorius can inhibit liver failure-induced by diabetes and is suggested as an antidiabetic drug. Further biochemical and pharmacological investigations should be performed to elucidate its mechanism of action in detail

[Diagnostic value of immunohistochemical markers in uterine smooth muscle tumors]

Uterine smooth muscle tumors are the most common human neoplasms. They are divided clinically as benign and malignant but there is another group of lesions which is difficult to place in these two categories, so-called [STUMP] and differentiation of these tumors on the basis of H and E staining is impossible. The aim of this study was to find a set of distinguishing objective biomarkers and a survey of immunohistochemical [IHC] markers comparing these three groups of tumors. Twenty one [21] cases in each group of the above mentioned tumors were randomly selected [63 cases in total] from pathobiology laboratories of Kermanshah and Shiraz cities and studied by IHC for expression of ER, PR, C-kit, Bcl-2, P16, and P53. The frequency of IHC markers expression in leiomyosarcoma [LMS] were as follow: ER [5.26%], PR [15.52%], P53 [26.31%], Bcl-2 [15.78%], C-kit [15.52%] and P16 [15.42%]. In the STUMP cases: PR [23.80%], Bcl-2 [4.76%] and P16 [9.52%], ER, C-kit and P53 were not expressed. In Leiomyoma group, only Bcl-2 was expressed [14.28%] and the others had no expression. P53 and P16 expression between the two groups of Leiomyoma and LMS, and also STUMP and LMS were significantly different [P<0.05]. P53 and P16 are reliable markers for differentiation between STUMP and LMS and also Leiomyoma from LMS and have a high diagnostic specificity. STUMP is used to identify cases in which clinicopathologic findings for final diagnosis as benign or malignant is not adequate. In this study a high similarity of STUMP group of immunohistochemical profile with benign cases was seen

Hypocholesterolemic and antiatherosclerotic effect of Artemisia aucheri in hypercholesterolemic rabbits

Atherosclerosis which results from gradual deposition of lipids in arteries is a leading cause of mortality worldwide. Diet is one of the most important factors underlying atherosclerosis. High-cholesterol diets enhance atherosclerosis and vegetarian diets are known to slow down the process. Artemisia aucheri is a herb of the Composite family. Many species of Artemisia have proven hypolipidemic and antioxidant properties. This study determine the effects of Artemisia aucheri on lipoproteins and atherosclerosis in hypercholesterolemic rabbits. Fifteen male rabbits were randomly divided into three groups. Normal diet group, high-cholesterol diet group [1% cholesterol] and Artemisia aucheri group [1% cholesterol diet supplemented with 100 mg/kg body weight the Artemisi aucheri every other day]. Biochemical factors were measured at the start, end of the first and second months of the study. At the end of the study, the aorta were removed for assessment of atherosclerotic plaques. The results indicate that Artemisia aucheri significantly reduced the level of total cholesterol, LDL cholesterol and triglycerids and increased HDL cholesterol. The degree of atherosclerotic thickness was significantly reduced in the treated group. Therefore, Artemisia aucheri is one of the useful herbal medicine for preventation of atherosclerosis and more studies in this regard is recommended

Effect of artemisia aucheri on regression of atherosclerotic plaque in rabbits

Atherosclerosis which is the most common risk factor for CHD is caused by a gradual deposition of lipids in large and small arteries. Nowadays regression and suppression of atherosclerotic lesion is one of the candidate approach for prevention of atherosclerotic complication. Whereas large majority of people use herbal medicine for treatment, this study was designed to evaluate the effects of A. aucheri on regression of atherosclerosis in atherosclerotic rabbits. Twenty rabbits were randomly divided into four groups of five each and treated 3-months as follows: 1: normal diet for 3- month, 2, 3 and 4: Hypercholesterolemic diet [HCD] for 2- month. One group [2] killed after this period and two groups [3 and 4] received normal dietand normal diet + A. aucheri [100 mg. kg-1 .day-1] respectively for an additional 1 - month [regression period]. Biochemical factors [total cholesterol, LDL-cholesterol, HDL- cholesterol and triglycerides] were measured at first, end of second and third month. At the end of the study, animals killed and aortas were removed for assessment of atherosclerotic plaques. Normal diet in regression period improved lipid profile but the animals in this group showed no regression but rather progression of atherosclerosis. Whereas extract of A. aucheri significantly decreased atherosclerotic area in the aorta. These findings suggest that control diet without additional treatment cannot stop the progression of atherosclerosis. To use A. aucheri with control diet can stop progression of atherosclerosis and is effective for regression of atherosclerotic lesion

Senior nursing students skills in patients health assessment in Zanjan university of medical sciences

Assessing patients' health is the base of nursing process. Also finding patients' problems is necessary for designing care plan by nurses and nursing students. This study was performed to determine the proficiency level of senior nursing students in assessing patients' health in Zanjan University of Medical Sciences in the year 2005. In this descriptive cross-sectional study, all senior nursing students of Zanjan University of Medical Sciences [44 students] were studied. The data gathering tools included a questionnaire consisted of demographic data, which was filled by the samples and an observational checklist which was completed by researchers while observing students' performance in assessing patients' health status. Data was analyzed using descriptive statistics methods, independent t-test, and one-way AN OVA by SPSS software. Twenty point four percent of students had a poor performance in assessing patients' health, 68.2% of them achieved moderate score, and only 11.4% were proficient in assessing patients' health. Most senior nursing students were not skillful enough in assessing health status. The collaboration of administrators of nursing in ministry of health and medical education, hospitals, nursing schools and instructors in order to make appropriate planning for this problem seems necessary

Bone marrow-mesenchymal stem cells as a suitable model for assessment of environmental pollution

Stem cells are considered as ideal model for assessment of environmental toxins on proliferation, multipotency and differentiation. The aim of this study was to investigate the effect of lead as harmaful environmental pollutant on proliferation and neural differentiation of murine bone marrow-MSCs. In this experimental study, MSC cells were exposed to different concentrations of lead [0 to 100 micro M] for 24h, and the level of cell proliferation was determined by 3-[4, 5-dimethyl-2-thiazolyl]-2, 5-dipheny-2H-tetrazolium bromide [MTT] reduction assay. In addition, DNA fragmentation was evaluated with comet assay at a single cell level. To induce the neural phenotype, MSCs were cultured for 2 days in the presence of 50 micro Pb[2+] for 48 h. At the end of this period, the medium was replaced by fresh medium supplemented with 1 mM beta-ME for 24 hr and then fresh medium supplemented with 7 mM beta-ME for 4 hours respectively. The expression of neural marker such as nestin, MAP2, and tau was assessed by immunocytochemistry, while the expression of neuronal specific genes such as Neur-1, Nestin, and beta-tubulin III was determined by RT-PCR analysis. Exposure to lead reduced the level of cell proliferation in a dose-dependent manner. The comet assay of cells exposed to lead showed varying degrees of DNA damaged. Change in cell morphology was observed 1 to 4 hr post neural exposure. The percentage of the MAP2 positive cells was reduced significantly at greater than 40 micro M lead concentration. This observation was further verified by assessment of the expression of neural markers. This study clearly indicated lead is highly cytotoxic to MSCs and these cells appear to be an excellent choice for establishment of guidelines for environmental hazards and drugs on cell proliferation and differentiation

[ effect of hydroalcoholic extracts of Hypericum perforatum and Amaranthus caudatus on rabbits with hypercholesterolemia]

Atherosclerosis is one of the most common causes of death throughout the world. In this study, anti-atherosclerotic effect of combination extracts of Hypericum and Amaranth on hypercholesterolemic rabbits was compared with that of lovastatin. Twenty adult male Newzeland rabbits were randomly divided into four groups of five and were fed for 60 days as follows: basic diet, high cholesterol, high cholesterol along with combination Hypericum and Amaranth [HA] extract [75 mg/kg] and high cholesterol along with lovastatin [10 mg/kg]. Blood samples were taken at the beginning, one month later and at the end of the study in order to measure their serum factors. Data were analyzed using ANOVA and Danken tests. The extract and lovastatin decreased the levels malondialdehyde [MDA] and apolipoprotein B [apoB], apoB/apoA and increased the levels apolipoprotein A [apoA] in rabbits compared to high cholesterol group [P<0.05]. The extract by decreasing cardiovascular risk factors especially apoB that is one of the most important risk factors of cardiovascular diseases, prevent progression of atherosclerosis. The extract is more effective in decreasing the level of cardiovascular risk factors than Lovastatin in hypercholesterolemic rabbits

Effect of Artemisia aucheri extract on atherogenic lipids and atherogenesis in hypercholesterolemic rabbits

Atherosclerosis that is caused a gradual deposition of lipids in muscular arteries remain a major cause of mortality worldwide. Dietary is one of the most important environmental factors associated with the incidence of these diseases. Diets high in cholesterol have been shown to promote atherosclerosis. Inversly diets high in vegetables have been shown to reduce development this disease. In many species of Artemisia evaluated antioxidative properties. The objective of this study was evaluating the effect of Artemisia aucheri extract on blood lipids and development of atherosclerosis in rabbits fed by a high cholesterol diet. Fifteen male rabbits were randomly divided in three experimental groups [normal diet group, hypercholesterolemic diet [HCD] group and the group that fed by HCD + supplemented with 100 mg/kg body weight Artemisia aucheri extract every other day]. Total cholesterol [TC], LDL cholesterol, triglycerides [TG] and HDL cholesterol were measured before and after 1 and 2 months of experimental period. At the end of the experimental period the aorta was removed for assessment of atherosclerotic plaques. Artemisia aucheri significantly reduced the levels of TC, LDL, TG and significantly increased the level of HDL. Degree of atherosclerotic plaque significantly reduced in this group. Results of this study indicate that Artemisia aucheri extract inhibits the development of atherosclerosis. This may be related to the effect of Artemisia aucheri on plasma lipoproteins in addition to its antioxidant and anti-inflammatory properties

[Investigation of oral and dental-care procedures in high school students of Zanjan province - 2005]

Regarding the high prevalence of dental caries and its individual complications and the reports concerning the effects of healthy behavior on oral and dental hygiene, this study was carried out with the aim of investigation of different oral and dental-care procedures among adolescent population of Zanjan province during the academic year 2004-2005. This descriptive study was performed on 1500 high school students through multi-stage cluster random sampling. The study tool was researcher-made questionnaire whose validity and reliability had been confirmed through content validity and repeated test respectively. Descriptive statistics and chi [2] test were used to determine the difference among groups [based on a number of demographic features]. The most common dental-care procedure among the students was brushing [89.7%] and statistical tests showed a significant difference in terms of gender [P=0.001], different educational levels [P=0.04], different schools [P=0.02] and different school areas [P=0.001]. The only common dental-care procedure used by the province adolescents was brushing. Hence, planning for various oral and dental-care procedures in adolescent population is highly recommended

Reproductive characteristics and the risk of breast cancer: a case-control study

Breast cancer is a common malignancy in women in many parts of the world. The Incidence of breast cancer in Iranian women is growing. Iranian patients are relatively younger than their western counterparts. We conducted a case-control study to determine roles of reproductive factors for breast cancer among women in Iran. A hospital based case-control study was conducted in 2004 at a teaching hospital in Tehran, Iran. A total of 303 cases of breast cancer and 303 healthy controls were interviewed. Cases were identified through the oncology department of a university hospital and controls were recruited from other wards or out-patients clinics at the same hospital. Controls were matched to cases on age. Demographic and reproductive data were ascertained by personal interview using a structured questionnaire. Informed consent was obtained from cases and controls. Odds ratios and 95% confidence intervals for breast cancer were derived using logistic regression analysis. Mean +/- SD age of cases and controls was 48.8 +/- 9.8 and 50.2 +/- 11.1 years, respectively [range 24-84]. The final model constructed after multivariate analysis indicated that factors such as never being married, menopause, older age at first live birth, parity, use of oral contraceptives, and history of chest X-ray between adolescence and the age of 30 yrs were significantly associated with breast cancer. Variables such as higher education, early age at menarche, abortion, breast feeding and its duration did not constitute significant risk factors. Marital status, history of chest X-ray between adolescence end the age of 30, number of live births, and age at first live birth, menopause, and oral contraceptive use seem to increase the risk of developing breast cancer among women in Iran

Hepatoprotective effect of silybum marianum [L] gaertn and glycyrrhiza glabra L. in the rats

One of the major role of liver is metabolism of xenobiotics and detoxification. But sometimes during metabolism of xenobiotics produce active and more toxic agents which cause liver damage and disease. Use of nature products from vegetables. In the treatment of diseases and liver diseases have a long history, especially in Eastern medicine in this study we have investigate the protective effects of polyphenolic extracts of Silybum marianum and Cichorium intybus. Liver damage induced with hepatotoxin, thioacethamide. Extracts was injected every day for a duration of 3 days, to rats, at a doses of 25 mmg/kg body weight together with thioacetamide at a doses of 50 mg/kg body weight. In order to investigate the hepatoprotective effect of extracts against thioacetamide activities of serum aminotrasferases [SGOT and SGPT], alkalline Pbosphatase bilirubin, Na[+] and K[+] were measured.Activities of serum aminotrasferases [SGOT and SGPT], alkaline phosphatase and bilirubin were decreased significantly to rats treated with extracts compared to thioacetamide group. The results showed potent protective effects of these extracts against the thioacetamide induced hepatotoxicity that are due to antioxidant effect of polyphenolic compound