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1.
Daru ; 32(1): 443-447, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38151679

ABSTRACT

INTRODUCTION: Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory lesion of the breast that mimics breast cancer or infection. Immunological pathogenesis is strongly suggested for the disease. REASON FOR THE REPORT: The treatment remains controversial, comprising a spectrum from observation or NSAIDs to immunosuppressive agents and surgery. Intractable cases are not uncommon and represent a major treatment challenge. Therefore in this study, we examine the effect of a topical immunomodulator agent, imiquimod, on refractory IGM. Patient 1 had IGM for 9 months and had not responded to the existing treatments. She responded to a 7-week course of imiquimod. In patient 2, the disease had begun 4 months sooner and had been resistant to all treatments; it responded to imiquimod after 4 weeks. Ulcers appeared on the skin of both patients but resolved safely. OUTCOME: Both patients were very satisfied with the results. Imiquimod can be an appropriate local treatment with limited adverse effects in refractory IGM. We propose similar studies to assess the efficacy of imiquimod in IGM further, paying attention to the possibility of developing skin wounds.


Subject(s)
Granulomatous Mastitis , Imiquimod , Humans , Imiquimod/administration & dosage , Imiquimod/therapeutic use , Female , Granulomatous Mastitis/drug therapy , Adult , Treatment Outcome , Adjuvants, Immunologic/therapeutic use , Adjuvants, Immunologic/administration & dosage , Aminoquinolines/therapeutic use , Aminoquinolines/administration & dosage
2.
Arch Iran Med ; 26(11): 618-622, 2023 Nov 01.
Article in English | MEDLINE | ID: mdl-38310421

ABSTRACT

BACKGROUND: Sentinel lymph node biopsy (SLNB) with injection of radiopharmaceuticals is now the standard of care for staging the axilla in patients with breast cancer. Sulfur or antimony colloids labeled with 99mTechnetium (Tc) are used globally for the procedure, with a detection rate of 94%. However, in Iran, Tc phytate has been used because it is more easily producible in the country. The detection rate with Tc phytate has not been well determined in large-scale studies. Objective: We performed this study to report the detection rate of SLNB with Tc phytate, its advantages and disadvantages using large multicentric data. METHODS: This is a retrospective cross-sectional multicenter study. Participants were breast cancer patients without previous history of axillary surgery, who underwent sentinel node biopsy using Tc phytate on the morning of surgery or the day before. The detection rate was calculated as the number of patients with histologically positive sentinel nodes to all patients with histologically positive lymph nodes; we compared those injected on the day of surgery and those injected on the day before. RESULTS: Overall, 2663 women aged 50.2±11.6 years were included. The detection rate was 91.8% (806 out of 878). The false negative rate was 8.2% overall, and statistically similar for injections on the day or the day before surgery (2.9 vs 2.1; P=0.32). CONCLUSION: Tc phytate has a good detection rate for breast radio-guided SLNB with similar result for injections on the surgery day or the day before it.


Subject(s)
Breast Neoplasms , Organotechnetium Compounds , Sentinel Lymph Node , Female , Humans , Sentinel Lymph Node/pathology , Phytic Acid , Lymph Nodes/pathology , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Retrospective Studies , Cross-Sectional Studies , Radionuclide Imaging , Sentinel Lymph Node Biopsy/methods
3.
Psychosom Med ; 77(9): 993-1005, 2015.
Article in English | MEDLINE | ID: mdl-26461854

ABSTRACT

OBJECTIVES: Major life stressors, including major surgeries, are often followed by psychiatric symptoms and disorders. Prior retrospective work found abdominal aortic aneurysm (AAA) repair is followed by increased psychiatric morbidity, which may adversely influence physical and functional recovery. Identifying risk factors before surgery, such as dysregulation in stress response systems, might be useful in improving preventative intervention. METHODS: Two hundred sixteen patients receiving open AAA or aortofemoral bypass surgeries, endovascular AAA repair, or nonsurgical AAA treatment were recruited from two vascular surgery services. Psychiatric symptoms and salivary cortisol measures (waking, 4 PM, and 11 PM, before and after low-dose dexamethasone) were obtained at intake and 3- and 9-month follow-ups. RESULTS: After open surgeries, 18% of patients had new psychiatric disorders, compared with 4% of patients receiving endovascular AAA repair or nonsurgical treatment (odds ratio = 6.0, 95% confidence interval = 1.6-22.1, p = .007). Having a history of major depression predicted the onset of new disorders in surgical patients. Presurgical cortisol levels were associated with both baseline (r = 0.23, p < .05) and 9-month (r = 0.32, p < .01) psychiatric symptoms (cortisol B = 1.0, standard error = 0.48, p < .05, in repeated-measures mixed model). CONCLUSIONS: Open AAA repair surgery is prospectively linked to the development of psychiatric morbidity, and history of depression elevates risk. Cortisol measures before surgery are associated with current and future psychological functioning, suggesting potential neurobiological mechanisms that may contribute to vulnerability. These results can help identify surgical patients at risk and point to potential targets for risk reduction interventions.


Subject(s)
Anxiety Disorders/etiology , Aorta, Abdominal/surgery , Aortic Aneurysm, Abdominal/psychology , Depressive Disorder/complications , Femoral Artery/surgery , Hydrocortisone/analysis , Peripheral Arterial Disease/psychology , Postoperative Complications/epidemiology , Stress Disorders, Post-Traumatic/etiology , Vascular Surgical Procedures/psychology , Aged , Anastomosis, Surgical/psychology , Aortic Aneurysm, Abdominal/complications , Aortic Aneurysm, Abdominal/surgery , Depressive Disorder/blood , Dexamethasone/pharmacology , Disease Progression , Disease Susceptibility , Female , Follow-Up Studies , Humans , Hydrocortisone/metabolism , Hypothalamo-Hypophyseal System/physiopathology , Interview, Psychological , Male , Middle Aged , Peripheral Arterial Disease/complications , Peripheral Arterial Disease/surgery , Pituitary-Adrenal System/physiopathology , Postoperative Complications/psychology , Preoperative Care , Prospective Studies , Risk , Risk Factors , Saliva/chemistry , Self Report , Severity of Illness Index
4.
J Gastroenterol Hepatol ; 17(10): 1092-7, 2002 Oct.
Article in English | MEDLINE | ID: mdl-12201870

ABSTRACT

BACKGROUND: In order to evaluate some possible risk factors for the spread of hepatitis C infection a case-control study was undertaken. METHODS: The study population consisted of first time blood donors referred to the Iranian Blood Transfusion Organization. Enzyme-linked immunosorbent assay and recombinant immunoblot assay anti-hepatitis C virus (HCV) tests were performed for all samples. Risk factors were evaluated using a questionnaire. A stepwise forward logistic regression analysis was used. RESULTS: The case group consisted of 193 HCV-positive donors, and 196 HCV-negative donors comprised the control group. Transfusion, undergoing endoscopy, extramarital sexual activities, non-intravenous (i.v.) drug abuse, i.v. drug abuse, and receiving wounds at war were found to be independent risk factors of being HCV-positive (Odds ratio: 17, 4, 42.2, 34.4, 52.8 and 5.2, respectively). No apparent risk factors could be demonstrated in 24.5% of the positive cases. CONCLUSION: This study could be of particular interest because of the low seroprevalence of hepatitis C and the religious culture of the study population. There are certain medical procedures, lifestyle patterns, and customs and cultural matters in Iran that predispose people to a number of HCV risk factors.


Subject(s)
Blood Donors , Hepacivirus/isolation & purification , Hepatitis C/diagnosis , Adult , Case-Control Studies , Enzyme-Linked Immunosorbent Assay , Female , Hepatitis C/epidemiology , Humans , Iran/epidemiology , Male , Middle Aged , Risk Factors , Seroepidemiologic Studies , Sexual Behavior , Substance Abuse, Intravenous , Surveys and Questionnaires , Tattooing
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