Prognosis and complete remission rate of diffuse large B-cell lymphoma patients in standard R-CHOP with reduction of vincristine: A retrospective study.

Background and Aims: The effect of stopping or reducing the dose of vincristine in diffuse large B-cell lymphoma (DLBCL) on the outcome and prognosis of the disease is still in doubt. The present study aimed to investigate and compare the prognosis and complete remission of two R-CHOP treatment regimens with and without vincristine reduction in DLBCL patients. Methods: This retrospective study was conducted on newly diagnosed DLBCL patients during 2018-2021. The patients were over 18 years of age, had been histologically confirmed by a pathologist, and were under treatment with R-CHOP regimen. The clinical information of the subjects as well as the number of treatment courses were extracted from their medical records and then compared. Results: Overall, 269 patients with DLBCL were included in this study, 15.99% of whom (n = 43) had vincristine reduction. There was no significant difference between the studied factors regarding the reduction of vincristine and the complete R-CHOP regimen (p > 0.05). Besides, no difference was observed in the 1-year overall survival (OS) and progression-free survival (PFS) of the patients in the two groups treated with R-CHOP regimen with and without vincristine reduction (p > 0.05). The complete remission rates of the patients treated with R-CHOP regimen with and without vincristine (p > 0.05) were not different either. The results of the Cox multivariate regression showed that reducing the dose of vincristine from the R-CHOP treatment regimen had no relationship with the 1-year OS and PFS of the DLBCL patients (hazard ratio [HR]OS = 1.59, 95% confidence interval [CI]: 3.67-0.690, HRPFS = 1.67, 95% CI: 0.798-3.82). Conclusion: The results of this study showed that the reduction of vincristine from the R-CHOP regimen in the DLBCL patients was not likely to make a difference in the 1-year OS and PFS of the patients. However, further studies are needed on the issue.

Pairwise association of upper extremity musculoskeletal conditions: large population investigation from PERSIAN cohort study.

BACKGROUND: People with one area of upper extremity musculoskeletal conditions (UEMSCs) may have other. We aim to determine how frequent is the ipsilateral coexistence of common UEMSCs apparent on interview and examination. METHODS: This is a large population cross-sectional study conducted as part of the PERSIAN cohort study int Mashhad University of Medical Sciences (MUMS). The study aimed to evaluate individuals for symptoms and signs of the following conditions: carpal tunnel syndrome (CTS), lateral epicondylitis (LE), trapeziometacarpal osteoarthritis (TMC OA), DeQuervain's tendinopathy, trigger digit (TD), ganglion cyst, and rotator cuff tendinopathy (RCT). The primary outcomes of the study are (1) to determine the side-specific relative risk of each UEMSC coexisting with the second condition, and (2) to identify predictive factors of each UEMSC using side-specific multivariate logistic regression analysis. RESULTS: We conducted a study involving 4737 individuals from the staff of MUMS and found significant pairwise associations among UEMSCs on a side-specific basis. Women had more chance of having DeQuervain's disease (ß = 6.3), CTS (ß = 3.5), ganglion cyst (ß = 2.5), TMC OA (ß = 2.3), and RCT (ß = 2.0). Each condition (dependent variable) was associated with others (predictors) as follows: CTS: RCT (ß = 5.9), TMC OA (ß = 4.7), TD (ß = 2.9), and LE (ß = 2.5). TMC OA: LE (ß = 6.4), TD (ß = 5.4), RCT (ß = 4.3), and CTS (ß = 4.1). LE: RCT (ß = 8.1), TMC OA (ß = 6.4), and CTS (ß = 2.5). DeQuervain's disease: TD (ß = 13.6), RCT (ß = 4.5), and LE (ß = 3.8). TD: CTS (ß = 8.8), ganglion cyst (ß = 7.6), DeQuervain's disease (ß = 5.7), and TMC OA (ß = 4.3). RCT: LE (ß = 5.8), TMC OA (ß = 5.5), CTS (ß = 5.2), and DeQuervain's disease (ß = 4.3). Ganglion cyst: TD (ß = 4.8). CONCLUSION: Our study reports significant increased frequency of the UEMSCs among patients who already have one of the diseases, in a large sample size study. Level of Evidence Level II (Differential Diagnosis/Symptom Prevalence Study).

Accuracy of prognostic and predictive markers in core needle breast biopsies compared with excisional specimens.

BACKGROUND: Core needle biopsy (CNB) is widely accepted for preoperative diagnosis of breast cancer and sometimes can be the only way of providing a suitable specimen for prognostic and predictive marker studies prior to neoadjuvant treatment. The purpose of this study was to evaluate the accuracy of CNB by comparing histological tumor type and grade as well as estrogen receptor (ER), progesterone receptor (PR), p53, and HER2/ neu status by immunohistochemistry in CNB and excisional surgical specimens. PATIENTS AND METHODS: During a 2.5-year study period, we identified 30 patients with breast cancer, who underwent CNB and definitive surgery. To evaluate the accuracy of CNB, tumor grade, ER, PR, HER2, and p53 status were immunohistochemically determined in both the CNB and the surgical specimens, and concordance of results between the 2 specimens was assessed. RESULTS: The concordance rate was 100% for histological type, 66.6% for histological grade, and 96.7, 90, 76.7 and 93.3% for ER, PR, p53 and HER2/neu, respectively. CONCLUSION: Our study showed that CNB has an excellent accuracy for tumor type, ER, and HER2/ neu; however, it should be used cautiously for tumor grade, PR, and p53 status. Thus, excisional biopsy is recommended for the determination of these factors.

Shear bond strength and antibacterial effects of orthodontic composite containing TiO2 nanoparticles.

Nanofillers can reduce enamel demineralization without compromising physical properties of the composite. The aim of this study was to evaluate shear bond strength (SBS) and antibacterial effects of an orthodontic composite after adding titanium oxide (TiO2) nanoparticles. Light cure orthodontic composite paste (Transbond XT) was blended with TiO2 nanoparticles. A total of 30 extracted premolars were randomly allocated into two groups of 15. In order to bond brackets, Transbond XT adhesive and nanocomposite were used in each group, respectively. SBS of two groups were determined, and the adhesive remnant index (ARI) scores were assessed. A total of 45 composite discs specimen were prepared. Of the 45 discs, 30 discs were made from nanocomposite and tested for antibacterial properties immediately and 30 days after curing by direct contact test. The antibacterial properties of the remaining 15 discs that were made from the conventional composite were tested immediately after curing as control group. Student's t-test and chi-square tests were used to analyse the data with the significance level of 0.05. No significant difference was found between SBS of conventional and nanocomposites, 24 hours after curing (P = 0.58). Chi-square test showed that ARI scores of two groups were not significantly different after debonding (P = 0.69). Comparison of antibacterial effects between conventional and nanocomposite demonstrated significant difference between two groups, with nanocomposites having a higher antibacterial activity (P = 0.03). Colony count revealed no significant difference in bacterial growth immediately and 30 days after curing in nanocomposite group. Adding TiO2 nanoparticles to orthodontic composite enhances its antibacterial effects without compromising the SBS.

Effect of prenatal selenium supplementation on cord blood selenium and lipid profile.

BACKGROUND: Selenium is an essential trace element and as a component of selenoproteins it plays a key role as an antioxidant. We aimed to evaluate the effect of selenium supplementation during pregnancy on cord blood selenium content and lipid profile. METHODS: This trial was performed on 166 eligible women who were randomized to receive 100 µg of selenium, as selenium-yeast (Se group) or a placebo-yeast tablet (placebo group). Umbilical cord blood samples were collected at the time of delivery and selenium concentration and lipid profile were measured. RESULTS: Triglyceride levels were found to be significantly higher in the Se group than in the placebo group (p=0.01). However, no significant difference in cord blood selenium was observed between the groups nor were there any significant correlations between cord blood selenium and lipid profile parameters. CONCLUSION: Our findings suggest that selenium supplementation in pregnant women may be associated with an increased cord-blood triglyceride level, although total cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol levels did not change significantly. The clinical significance of the increased cord triglyceride concentration needs to be evaluated.

Prevalence of oral mucosal lesions in institutionalized elderly people in Mashhad, Northeast Iran.

OBJECTIVE: The aim of this study was to determine the prevalence of oral mucosal lesions in institutionalized elderly people in Mashhad, northeast of Iran. BACKGROUND: This study was conducted to assess the prevalence of oral lesions in the institutionalized elderly. METHODS: In this survey, we studied all of the nursing homes in Mashhad; a total of five encompassing 237 residents. The subjects were examined and lesions recorded in a designed checklist. T-test, chi-square and Fisher's exact tests were used for the analysis. RESULTS: The mean age of the patients was 79.59 ± 8.88. Ninety-eight per cent of cases had at least one oral mucosal lesion. The most common lesions were fissured tongue (66.5%), atrophic glossitis (48.8%), sublingual varicosity (42%) and xerostomia (38%). There was no significant difference in the prevalence of denture-related lesions (DRLs) between men and women (p > 0.05). Xerostomia was more prevalent in 70-79-year-old than in 60-69-year-old subjects. No case of oral malignant lesion was detected. DISCUSSION: These findings revealed a higher prevalence of oral mucosal lesions in Mashhad city compared with other studies conducted in other major cities in Iran and abroad. The results emphasise the necessity of national programmes towards oral health promotion.

Effect of supplementation with selenium on postpartum depression: a randomized double-blind placebo-controlled trial.

OBJECTIVE: Postpartum depression is a common complication of childbirth, and its prevention is an important public-health issue because of its negative effects on mother, infant, and family. The present randomized, double-blind, placebo-controlled trial was conducted to examine the effect of prenatal selenium supplementation on the postpartum depression level in Iranian women. DESIGN: A total of 166 primigravid pregnant women in the first trimester of pregnancy, were randomized to receive 100 µg of selenium (n = 83) or a placebo (n = 83) per day until delivery. The symptoms of postpartum depression were evaluated during the eight weeks following delivery by means of the Edinburgh Postnatal Depression Scale (EPDS). Serum selenium concentrations were measured at baseline and at the end of study. RESULTS: There was no significant difference in demographic characteristics and perceived social support between the selenium and control groups at baseline (p > 0.05). There were 22 drop-outs in the selenium-supplemented group and 19 in the placebo group. Forty-four women in the selenium group and 41 women in the placebo group completed the trial and the EPDS questionnaire. Selenium supplementation was associated with a significant increase in mean serum selenium concentration at term (p < 0.001) but remained unchanged in the control group. The mean EPDS score in the selenium group was significantly lower than that of the control group (p < 0.05). CONCLUSION: These findings suggest that supplementation with selenium during pregnancy might be an effective approach for the prevention of postpartum depression.

Electrophysiological changes in patients with acute organophosphorous pesticide poisoning.

Organophosphorous pesticides (OP) are widely used in agriculture without proper control in the Islamic Republic of Iran and thus OP poisonings are common in this country. Epidemiological and management aspects of OP have been studied in detail, but there have been very few reports on peripheral polyneuropathy, particularly electrophysiological changes related to this poisoning. Thus, we aimed to study electrophysiological changes including electromyography (EMG) and nerve conduction velocity (NCV) in patients with OP poisoning. The patients with acute moderate to severe OP poisonings who revealed clinical symptoms and signs of peripheral polyneuropathy after recovery of the acute phase of intoxication were investigated from 2005 to 2006 in Mashhad, Iran. These patients lacked previous neurological problems and had not been chronically exposed to OP. EMG and NCV were performed using MEDELEC MS92 & TOENNIES Multiliner E. Statistical analyses including Student's t-test and Pearson's test were applied using SPSS (Version 11.5). Of 342 hospitalized patients, eight patients (four females and four males) aged 13-59 years were investigated. Intervals between the onset of OP poisoning and electrodiagnostic tests varied between 10 and 210 days. On EMG, there was a sensory-motor peripheral polyneuropathy, which was predominantly a distal sensory deficit. Sensory nerve dysfunction (84.4%) was significantly higher (p < 0.001) than motor dysfunctions (18.7%). The lower extremities, particularly tibial and peroneal nerves, were more affected than the upper extremities (p < 0.0001). Sensory nerve dysfunction of the lower extremities was more common than motor nerves, which was predominantly a distal sensory deficit.

Association between angiotensin II type 1 receptor gene polymorphism and metabolic syndrome in a young female Iranian population.

BACKGROUND AND AIMS: The overall prevalence of obesity and metabolic syndrome (MetS) is increasing among children and adolescents and can predispose to type II diabetes mellitus and cardiovascular disease. There are reported associations between an angiotensin II type I receptor gene polymorphism (AT(1)R/A1166C) with hypertension, myocardial infarction, insulin resistance and cardiovascular disease risk. In the present study, we aimed to investigate whether the AT(1)R/A1166C polymorphism was associated with MetS among adolescent Iranian girls. METHODS: A total of 350 adolescent girls aged 15-17 years from high schools and different educational zones of Mashhad city participated in this population-based, genetic association study. Of these individuals, 101 patients had MetS (defined by the NCEP-ATP III criteria); the remaining 249 age-matched girls were considered as the control group. All subjects were genotyped for the AT(1)R/A1166C polymorphism using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. RESULTS: Frequencies of the AA, AC and CC genotypes were 164 (65.9%), 80 (32.1%) and 5 (2.0%) in the control group and 79 (78.2%), 20 (19.8%) and 2 (2.0%) in patients, which were not consistent with the Hardy-Weinberg equilibrium (p <0.05 and p <0.001, respectively). Frequency of the AT(1)R C allele was found to be significantly lower in patients compared with controls (p <0.05). CONCLUSIONS: Our findings suggested that the 1166C allele of AT(1)R gene may be associated with a decreased risk of MetS in adolescent Iranian females.

Selenium supplementation and the incidence of preeclampsia in pregnant Iranian women: a randomized, double-blind, placebo-controlled pilot trial.

OBJECTIVE: Recent studies have reported that antioxidant status, including serum selenium concentrations, is altered in women who develop preeclampsia. We wished to examine the effects of selenium supplementation in the prevention of preeclampsia in high-risk pregnant women. DESIGN: We carried out a randomized, double-blind, placebo-controlled pilot trial. A total of 166 primigravid pregnant women, who were in the first trimester of pregnancy, were randomized to receive 100 microg of selenium (n = 83; dropouts, n = 22) or a placebo (n = 83; dropouts, n = 19) per day until delivery. The incidence of preeclampsia, serum selenium concentrations, lipid profile and high-sensitivity C-reactive protein status were evaluated at baseline and at the end of the study. RESULTS: Supplementation with selenium was not associated with any reported major side effects and was associated with a significant increase in mean serum selenium concentrations at term (p < 0.001). In contrast, mean serum selenium concentrations remained unchanged in the control group (p = 0.63). The incidence of preeclampsia was lower in the selenium group (n = 0) than in the control group (n = 3), although this was not statistically significant (p > 0.05). After treatment, systolic and diastolic blood pressure, serum total cholesterol, triglycerides, low-density and high-density lipoprotein cholesterol, and high-sensitivity C-reactive protein were significantly increased in both groups compared with pretreatment levels (p < 0.05). CONCLUSION: Our findings indicate that selenium supplementation in pregnant women may be associated with a lower frequency of preeclampsia.

Prooxidant-antioxidant balance in pregnancy: a randomized double-blind placebo-controlled trial of selenium supplementation.

OBJECTIVE: We assessed the impact of selenium, a trace element with antioxidant properties on a simple measure of oxidative stress in pregnant women. STUDY DESIGN: A novel assay of prooxidant-antioxidant balance (PAB) was applied in a double-blind, placebo-controlled study of selenium supplementation in pregnancy. We measured the prooxidant burden and the antioxidant capacity simultaneously in one assay, thereby calculating a redox index. A total of 166 primigravid pregnant women in the first trimester of pregnancy, were randomized to receive 100 microg of selenium (n=83) or placebo (n=83) per day until delivery. PAB values and serum selenium concentrations were measured at baseline and at the end of study. RESULTS: Pretreatment demographic data and biochemical indices including serum selenium concentrations did not differ significantly between the groups. The drop-out rates for the groups were 22/83 and 19/83 for the selenium and placebo groups, respectively. Supplementation with selenium was associated with a significant increase in mean serum selenium concentration (P<0.001) but without significant change in mean PAB value. In contrast, mean serum selenium concentration remained unchanged and mean PAB values increased significantly (P<0.05 in the control group). CONCLUSION: Our findings suggest that selenium supplementation may reduce oxidative stress associated with pregnancy.

Histological changes in human dental pulp following application of intrusive and extrusive orthodontic forces.

The aim of this study was to compare the effects of orthodontic extrusive and intrusive forces on histological changes of the human dental pulp. In this clinical trial, 52 sound upper first premolars from 26 patients scheduled for extraction for orthodontic reasons were selected. They were divided into 2 groups, based on the time intervals for histological evaluation (3 days and 3 weeks). In each group, 10 teeth received orthodontic extrusive forces, 10 teeth underwent intrusive forces, and 6 teeth served as controls. After each period, teeth were extracted and prepared for histological examination under light microscopy and some histological parameters were evaluated. The data were statistically analyzed by Kruskall-Wallis and Mann Whitney tests. Of the parameters evaluated, just vacuolization and disruption of the odontoblastic layer showed statistically significant differences between the control group and both of the experimental groups in each test period (P < 0.05). Additionally, there was no significant difference between 3-day and 3-week intervals in each experimental group, except for fibrosis in the extrusive group which significantly increased after 3 weeks of force application (P = 0.001). Histological pulp changes following extrusive and intrusive force applications for 3 days and 3 weeks show no difference from each other.

The effect of fresh frozen plasma in severe closed head injury.

OBJECTIVE: Traumatic brain injury (TBI) is one of the most common causes of morbidity and mortality. Coagulopathy, commonly occurring after severe TBI, is associated with poor outcome and secondary complications, especially delayed traumatic intracerebral hematoma (DTICH). In this study we evaluated the effect of fresh frozen plasma (FFP) on the reduction in the incidence of DTICH in severe closed head injury victims. METHODS: This study was carried out as a double-blind randomized clinical trial. Ninety patients were entered in two parallel groups taking either FFP or normal saline (N/S). Patients' selection criteria for both groups were: severe closed head injury (Glasgow coma scale < or =8), no mass lesion required evacuation and no history of coagulopathy. The clinical findings, laboratory data, computed tomography (CT) scans and Glasgow outcome scale after 1 month were assessed and compared in two groups. RESULTS: Out of 90 patients, 44 received FFP and 46 received N/S. The development of new intracerebral hematoma in follow-up CT scans were more common in the FFP group than the N/S group (p=0.012). Both groups showed similar frequency of poor outcome (p=0.343). The mortality was significantly more common in the FFP group than in the N/S group (63% versus 35%, p=0.006). CONCLUSION: The result of this study revealed that early empirical infusion of FFP in patients with severe head injury may lead to adverse effects, such as an increase in the frequency of DTICH and an increase in the mortality.

Evaluation of the effect of castor oil on initiating labor in term pregnancy.

OBJECTIVE: To determine the effect of castor oil on initiating labor in term pregnant women. METHODS: We conducted this randomized control clinical trial on 47 pregnant women from August 2003 to March 2004 in Mashhad University of Medical Sciences, Iran. RESULTS: There was a significant increase in labor initiation ratio in the castor oil group compared with the control group (54.2% compared with 4.3%, p<0.001). Also, the mean bishop score in the castor oil group increased from 2.50 +/- 1.29 to 6.79 +/- 3.20 (p<0.001). CONCLUSION: The probability of labor initiation increases during the first 24 hours after using castor oil, however, further studies are recommended to improve its efficacy and safety.