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Knee Arthroplasty without Metal Augmentations in Patients with Major Tibial Defects: A Retrospective Study. 胫骨主要缺损患者的无金属增量膝关节置换术:回顾性研究
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 DOI: 10.30476/ijms.2024.100363.3265
Gholam Hossain Shahcheraghi, Mahzad Javid, Alireza Tavakoli, Elahe Nirooei, Elham Momtahan

Background: Knee arthroplasty procedures improve pain, function, stability, and appearance of the limb. Total knee arthroplasty (TKA) in severe, long-standing osteoarthritis (OA) with large medial tibial defects could be a challenge. This paper looks at TKA outcomes when large tibial defects are managed without metal wedges or stems.

Methods: TKA cases done for OA with tibial defects of 15-25 mm, without any metal wedge or stem from 2004 to 2017 by a single surgeon in Shiraz, Iran, were clinically and radiographically evaluated. The preoperative questionnaires of SF36, WOMAC, KSS, and radiographs were compared with the follow-up assessments of the same parameters. Data were analyzed by R programming language using student t test, ANOVA, and Kruskal-Wallis. P<0.05 was considered significant.

Results: 91 knees in 72 patients at 65.99±8.66 years of age and 8.28±2.58 years follow-up were studied. The tibial defects were managed with extra tibial cuts and adjustment of tibial component position in all, and the addition of structural autograft in 14 knees. 89 (98%) knees survived with a knee society score (KSS) of 79.4±17.6 and were significantly functioning well (P<0.001). Two knees required revision surgery. Significant improvement in outcome measurements was seen in all cases (P<0.001). No radiographic loosening, alignment change, or clinical instability was detected. The tibial plateau reconstruction without bone grafting and the ones that had autologous bone grafting had similar functional results and radiographic outcomes.

Conclusion: TKA with tibial defects of 15-25 mm treated with a semi-constrained posterior-cruciate ligament (PCL) sacrificing condylar prosthesis without any metal wedges or stem extensions with or without additional autogenous bone graft obtained very good functional and radiographic outcome and 97% survival in 6-17 years follow-up.

背景:膝关节置换术可改善疼痛、功能、稳定性和肢体外观。对于胫骨内侧大面积缺损的严重、长期骨关节炎(OA)患者,全膝关节置换术(TKA)可能是一项挑战。本文探讨了在不使用金属楔或金属柄的情况下处理巨大胫骨缺损的 TKA 结果:2004年至2017年期间,伊朗设拉子市的一名外科医生在未使用任何金属楔或金属柄的情况下,为胫骨缺损15-25毫米的OA患者实施了TKA手术,并对这些病例进行了临床和影像学评估。将术前的 SF36、WOMAC、KSS 问卷和射线照片与相同参数的随访评估进行了比较。数据分析采用 R 编程语言,使用学生 t 检验、方差分析和 Kruskal-Wallis 分析。结果研究了 72 名患者的 91 个膝关节,年龄(65.99±8.66)岁,随访时间(8.28±2.58)年。所有患者的胫骨缺损均通过胫骨外切口和调整胫骨组件位置进行了处理,14 个膝关节增加了结构性自体移植。89个(98%)膝关节存活,膝关节社会评分(KSS)为79.4±17.6,功能明显良好(PC结论:胫骨缺损为15-25毫米的TKA采用半约束后交叉韧带(PCL)牺牲髁假体治疗,不使用任何金属楔或骨干延长部分,无论是否进行额外的自体骨移植,均获得了非常好的功能和影像学结果,在6-17年的随访中,97%的患者存活。
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引用次数: 0
Clustering the Economic Status via Partitioning around Medoid and Its Association with Common Non-communicable Diseases. 通过围绕 Medoid 的划分对经济状况进行聚类及其与常见非传染性疾病的关联。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 DOI: 10.30476/ijms.2023.100513.3275
Elaheh Sanjari, Ali Ahmadi, Hadi Raeisi Shahraki

Background: During the last decades, the role of economic status and wealth-related variables in relation to the mortality and incidence of a wide range of diseases have received increased attention. This study focused on clustering the economic status of a population-based study using partitioning around the medoid (PAM) and then investigating the association between the obtained economic clusters and the incidence of non-communicable diseases (NCDs).

Methods: The present study was based on data from Shahrekord Cohort Study (SCS). This study considered nine NCDs, including cardiac disease, myocardial infarction, diabetes, hypertension, stroke, all types of malignancies, chronic lung disease, depression, and obesity, among 7034 participants aged 35 and 70 from the urban population of Sharekord (IRAN) in 2022. Four quantitative and four qualitative variables were used to cluster the economic status. The NbClust package was used to determine the optimal number of clusters, and the K-med package in R software (version 4.2.1) was used for PAM clustering. Descriptive statistics were reported as frequency (%) or median (IQR), and statistical analysis was performed using the Chi square test and Mann-Whitney test in SPSS software (version 19.0). P<0.05 was considered statistically significant.

Results: The estimated optimal number of clusters was two. The first cluster contained individuals with good economic status, while the second cluster contained those with a moderate economic status. The findings indicated that individuals with a good economic status had significantly higher rates of cardiac disease (7.2% versus 5.3%, P<0.001), stroke (1.3% versus 0.6%, P<0.001), diabetes (12.8% versus 9.1%, P<0.001), hypertension (21.6% versus 15.6%, P<0.001), depression (P<0.001), and obesity (P=0.03).

Conclusion: The findings of the present study showed that economic status was significantly associated with the majority of NCDs.

背景:在过去的几十年中,经济状况和财富相关变量在各种疾病的死亡率和发病率中的作用受到越来越多的关注。本研究的重点是利用中值附近划分法(PAM)对一项基于人口的研究的经济状况进行聚类,然后调查所获得的经济聚类与非传染性疾病(NCDs)发病率之间的关联:本研究基于沙勒科德队列研究(SCS)的数据。该研究考虑了 2022 年 Sharekord(伊朗)城市人口中年龄在 35 岁至 70 岁之间的 7034 名参与者的九种非传染性疾病,包括心脏病、心肌梗塞、糖尿病、高血压、中风、各种恶性肿瘤、慢性肺病、抑郁症和肥胖症。研究使用了四个定量变量和四个定性变量对经济状况进行聚类。NbClust 软件包用于确定最佳聚类数量,R 软件(4.2.1 版)中的 K-med 软件包用于 PAM 聚类。描述性统计以频率(%)或中位数(IQR)的形式报告,统计分析采用 SPSS 软件(19.0 版)中的卡方检验和曼-惠特尼检验。结果估计最佳聚类数为两个。第一个聚类包含经济状况良好的个人,第二个聚类包含经济状况中等的个人。研究结果表明,经济状况良好的人患心脏病的比例明显更高(7.2% 对 5.3%):本研究的结果表明,经济状况与大多数非传染性疾病有显著相关性。
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引用次数: 0
Foramen Ovale Pulsatility Index as an Early Affected Doppler Study among Abnormal Growth Fetuses: A Recent Insight for Practice Based on a Prospective Study. 将卵圆孔搏动指数作为发育异常胎儿的早期受影响多普勒研究:基于前瞻性研究的最新实践启示。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 DOI: 10.30476/ijms.2024.100177.3231
Azam Faraji, Fereshteh Gharibpour, Niloofar Namazi, Ali Mohammad Shakiba, Maryam Kasraeian, Nasrin Asadi, Homeira Vafaei, Marjan Zare, Khadijeh Bazrafshan, Zahra Oveisi

Background: Routine Doppler study is a common tool for early diagnosis of Fetal Growth Restriction (FGR) and Small for Gestational Age (SGA) patients. It aimed to determine the role of the Foramen Ovale Pulsatility Index (FOPI) study beside routine Doppler study among patients with FGR and SGA fetuses.

Methods: This prospective study was conducted on 35 FGR, 32 SGA, and 33 Appropriate for Gestational Age (AGA) fetuses. Demographic data, amniotic fluid index, neonatal outcome, and Doppler velocimetry, including Umbilical Artery Pulsatility Index (UMAPI), Uterine Artery Pulsatility Index (UTAPI), Middle Cerebral Artery Pulsatility Index (MCAPI), Ductus Venosus Pulsatility Index (DVPI), and FOPI were documented. Kolmogorov-Smirnov normality test, one-way ANOVA, Mann-Whitney U, Kruskal-Wallis, non-parametric pairwise comparisons adjusted for Bonferroni correction, Pearson correlation test, Chi square, Fisher's exact test, and Receiver Operating Characteristic Curve (ROC) analysis with Youden's Index (sensitivity+specificity-1) to estimate cut-off point were used to analyze the data at significance level <0.05 for all tests.

Results: FOPI cut-off points were 2.24 (sensitivity=77%, specificity=94%) and 1.15 (sensitivity=90%, specificity=20%) to predict FGR and SGA, respectively. FOPI showed a positive correlation with UMAPI and UTAPI (r=0.52 and r=0.30, P<0.001 and P=0.006, respectively), but not with MCAPI and DVPI (r=0.08 and r=0.12, P=0.50 and P=0.30, respectively). Besides, UMAPI, UTAPI, and FOPI were altered among patients with stages I and II FGR. Umbilical cord potential hydrogen (umbilical cord pH), 1- and 5-min Apgar score significantly increased by Birth weight centile; however, UMAPI, FOPI, and UTAPI significantly decreased.

Conclusion: UMAPI is recommended to predict short-term neonatal morbidities and demonstrate the early or late onset FGR. Besides, FOPI is suggested as the first-line Doppler study to detect abnormal growth velocity. More studies are warranted, especially considering long-term neonatal morbidities.

背景:常规多普勒检查是早期诊断胎儿生长受限(FGR)和小于胎龄(SGA)患者的常用工具。该研究旨在确定卵圆孔脉动指数(FOPI)研究在 FGR 和 SGA 胎儿患者常规多普勒检查中的作用:这项前瞻性研究针对 35 名 FGR 胎儿、32 名 SGA 胎儿和 33 名适合妊娠年龄(AGA)胎儿。研究记录了人口统计学数据、羊水指数、新生儿结局以及多普勒速度测量,包括脐动脉脉动指数(UMAPI)、子宫动脉脉动指数(UTAPI)、大脑中动脉脉动指数(MCAPI)、静脉导管脉动指数(DVPI)和FOPI。采用 Kolmogorov-Smirnov 正态性检验、单因素方差分析、Mann-Whitney U、Kruskal-Wallis、经 Bonferroni 校正的非参数配对比较、Pearson 相关性检验、Chi 平方、费雪精确检验和用 Youden 指数(敏感性+特异性-1)估计临界点的接收者工作特征曲线(ROC)分析对数据进行显著性水平分析 结果:预测 FGR 和 SGA 的 FOPI 临界点分别为 2.24(灵敏度=77%,特异度=94%)和 1.15(灵敏度=90%,特异度=20%)。FOPI 与 UMAPI 和 UTAPI 呈正相关(r=0.52 和 r=0.30):建议使用 UMAPI 预测新生儿短期内的发病情况,并显示 FGR 发病的早晚。此外,建议将 FOPI 作为检测生长速度异常的一线多普勒检查。还需要进行更多的研究,尤其是考虑到新生儿的长期发病率。
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引用次数: 0
Letter to the Editor regarding "Comparison of High-intensity Laser Therapy with Extracorporeal Shock Wave Therapy in the Treatment of Patients with Plantar Fasciitis: A Double-blind Randomized Clinical Trial". 致编辑的信,内容涉及 "高强度激光疗法与体外冲击波疗法在治疗足底筋膜炎患者方面的比较:双盲随机临床试验"。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 DOI: 10.30476/ijms.2024.103196.3637
Yuhan Gong, Xinjie Wang
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引用次数: 0
Evaluation of Antioxidant Effects of Coenzyme Q10 against Hyperglycemia-Mediated Oxidative Stress by Focusing on Nrf2/Keap1/HO-1 Signaling Pathway in the Liver of Diabetic Rats. 通过关注糖尿病大鼠肝脏中的Nrf2/Keap1/HO-1信号通路评估辅酶Q10对高血糖引起的氧化应激的抗氧化作用
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 DOI: 10.30476/ijms.2023.100078.3222
Fatemeh Samimi, Maryam Baazm, Zahra Nadi, Sanaz Dastghaib, Mehri Rezaei, Farideh Jalali-Mashayekhi

Background: Hyperglycemia-induced oxidative stress can damage the liver and lead to diabetes complications. Coenzyme Q10 (CoQ-10) reduces diabetes-related oxidative stress. However, its molecular mechanisms are still unclear. This study aimed to examine CoQ-10's antioxidant capabilities against hyperglycemia-induced oxidative stress in the livers of diabetic rats, specifically targeting the Nrf2/Keap1/ARE signaling pathway.

Methods: This study was conducted between 2020-2021 at Arak University of Medical Sciences. A total of 30 male adult Wistar rats (8 weeks old) weighing 220-250 g were randomly assigned to five groups (n=6 in each group): control healthy, sesame oil (CoQ-10 solvent), CoQ-10 (10 mg/Kg), diabetic, and diabetic+CoQ-10. Liver oxidative stress indicators, including malondialdehyde, catalase, glutathione peroxidase, and glutathione, were estimated using the spectrophotometry method. Nrf2, Keap1, HO-1, and NQO1 gene expressions were measured using real-time PCR tests in the liver tissue. All treatments were conducted for 6 weeks. Statistical analysis was performed using SPSS software. One-way ANOVA followed by LSD's or Tukey's post hoc tests were used to compare the results of different groups. P<0.05 was considered statistically significant.

Results: The findings showed that induction of diabetes significantly increased Keap1 expression (2.1±0.9 folds, P=0.01), and significantly inhibited the mRNA expression of Nrf2 (0.38±0.2 folds, P=0.009), HO-1 (0.27±0.1 folds, P=0.02), and NQO1 (0.26±0.1 folds P=0.01), compared with the healthy group. In the diabetic group, the activity of glutathione peroxidase, catalase enzymes, and glutathione levels was decreased with an increase in malondialdehyde level. CoQ-10 supplementation significantly up-regulated the expressions of Nrf2 (0.85±0.3, P=0.04), HO-1 (0.94±0.2, P=0.04), NQO1 (0.88±0.5, P=0.03) genes, and inhibited Keap1 expression (1.1±0.6, P=0.02). Furthermore, as compared to control diabetic rats, CoQ-10 ameliorated oxidative stress by decreasing malondialdehyde levels and increasing catalase, glutathione peroxidase activities, and glutathione levels in the liver tissues of the treated rats in the treatment group.

Conclusion: The findings of this study revealed that CoQ-10 could increase the antioxidant capacity of the liver tissue in diabetic rats by modulating the Nrf2/Keap1/HO-1/NQO1 signaling pathway.

背景:高血糖引起的氧化应激可损害肝脏,导致糖尿病并发症。辅酶 Q10(CoQ-10)可降低与糖尿病相关的氧化应激。然而,其分子机制仍不清楚。本研究旨在研究辅酶Q10对高血糖诱导的糖尿病大鼠肝脏氧化应激的抗氧化能力,特别是针对Nrf2/Keap1/ARE信号通路:本研究于 2020-2021 年在阿拉克医科大学进行。将 30 只体重 220-250 克的雄性成年 Wistar 大鼠(8 周大)随机分为 5 组(每组 6 只):健康对照组、芝麻油(CoQ-10 溶剂)组、CoQ-10(10 毫克/千克)组、糖尿病组和糖尿病+CoQ-10 组。采用分光光度法估算肝脏氧化应激指标,包括丙二醛、过氧化氢酶、谷胱甘肽过氧化物酶和谷胱甘肽。采用实时 PCR 检测肝组织中 Nrf2、Keap1、HO-1 和 NQO1 基因的表达。所有治疗均持续 6 周。使用 SPSS 软件进行统计分析。采用单因素方差分析和 LSD 或 Tukey 后检验来比较不同组的结果。结果研究结果表明,与健康组相比,糖尿病诱导明显增加了 Keap1 的表达(2.1±0.9 倍,P=0.01),并显著抑制了 Nrf2(0.38±0.2 倍,P=0.009)、HO-1(0.27±0.1 倍,P=0.02)和 NQO1(0.26±0.1 倍,P=0.01)的 mRNA 表达。在糖尿病组中,谷胱甘肽过氧化物酶、过氧化氢酶的活性和谷胱甘肽水平降低,丙二醛水平升高。补充 CoQ-10 能明显上调 Nrf2(0.85±0.3,P=0.04)、HO-1(0.94±0.2,P=0.04)、NQO1(0.88±0.5,P=0.03)基因的表达,抑制 Keap1 的表达(1.1±0.6,P=0.02)。此外,与对照组糖尿病大鼠相比,CoQ-10能降低丙二醛水平,提高过氧化氢酶、谷胱甘肽过氧化物酶活性和治疗组大鼠肝组织中谷胱甘肽水平,从而改善氧化应激:本研究结果表明,CoQ-10 可通过调节 Nrf2/Keap1/HO-1/NQO1 信号通路提高糖尿病大鼠肝组织的抗氧化能力。
{"title":"Evaluation of Antioxidant Effects of Coenzyme Q10 against Hyperglycemia-Mediated Oxidative Stress by Focusing on Nrf2/Keap1/HO-1 Signaling Pathway in the Liver of Diabetic Rats.","authors":"Fatemeh Samimi, Maryam Baazm, Zahra Nadi, Sanaz Dastghaib, Mehri Rezaei, Farideh Jalali-Mashayekhi","doi":"10.30476/ijms.2023.100078.3222","DOIUrl":"10.30476/ijms.2023.100078.3222","url":null,"abstract":"<p><strong>Background: </strong>Hyperglycemia-induced oxidative stress can damage the liver and lead to diabetes complications. Coenzyme Q10 (CoQ-10) reduces diabetes-related oxidative stress. However, its molecular mechanisms are still unclear. This study aimed to examine CoQ-10's antioxidant capabilities against hyperglycemia-induced oxidative stress in the livers of diabetic rats, specifically targeting the Nrf2/Keap1/ARE signaling pathway.</p><p><strong>Methods: </strong>This study was conducted between 2020-2021 at Arak University of Medical Sciences. A total of 30 male adult Wistar rats (8 weeks old) weighing 220-250 g were randomly assigned to five groups (n=6 in each group): control healthy, sesame oil (CoQ-10 solvent), CoQ-10 (10 mg/Kg), diabetic, and diabetic+CoQ-10. Liver oxidative stress indicators, including malondialdehyde, catalase, glutathione peroxidase, and glutathione, were estimated using the spectrophotometry method. Nrf2, Keap1, HO-1, and NQO1 gene expressions were measured using real-time PCR tests in the liver tissue. All treatments were conducted for 6 weeks. Statistical analysis was performed using SPSS software. One-way ANOVA followed by LSD's or Tukey's <i>post hoc</i> tests were used to compare the results of different groups. P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>The findings showed that induction of diabetes significantly increased Keap1 expression (2.1±0.9 folds, P=0.01), and significantly inhibited the mRNA expression of Nrf2 (0.38±0.2 folds, P=0.009), HO-1 (0.27±0.1 folds, P=0.02), and NQO1 (0.26±0.1 folds P=0.01), compared with the healthy group. In the diabetic group, the activity of glutathione peroxidase, catalase enzymes, and glutathione levels was decreased with an increase in malondialdehyde level. CoQ-10 supplementation significantly up-regulated the expressions of Nrf2 (0.85±0.3, P=0.04), HO-1 (0.94±0.2, P=0.04), NQO1 (0.88±0.5, P=0.03) genes, and inhibited Keap1 expression (1.1±0.6, P=0.02). Furthermore, as compared to control diabetic rats, CoQ-10 ameliorated oxidative stress by decreasing malondialdehyde levels and increasing catalase, glutathione peroxidase activities, and glutathione levels in the liver tissues of the treated rats in the treatment group.</p><p><strong>Conclusion: </strong>The findings of this study revealed that CoQ-10 could increase the antioxidant capacity of the liver tissue in diabetic rats by modulating the Nrf2/Keap1/HO-1/NQO1 signaling pathway.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 10","pages":"661-670"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigating the Effect of High-Dose Vitamin D3 Administration on Inflammatory Biomarkers in Patients with Moderate to Severe Traumatic Brain Injury: A Randomized Clinical Trial. 研究大剂量维生素 D3 对中重度脑外伤患者炎症生物标志物的影响:随机临床试验。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 DOI: 10.30476/ijms.2023.99465.3156
Farnoosh Masbough, Mehran Kouchek, Mohsen Koosha, Sara Salarian, Mirmohammad Miri, Masoomeh Raoufi, Niloufar Taherpour, Saied Amniati, Mohammad Sistanizad

Background: Traumatic brain injury (TBI) is one of the most common neurological disorders worldwide. We aimed to investigate the efficacy of high-dose vitamin D3 on inflammatory biomarkers in patients with moderate to severe TBI.

Methods: Thirty-five moderate to severe TBI patients were randomly assigned to intervention and control groups. Patients in the intervention group received a single intramuscular (IM) dose of 300,000 IU vitamin D. The primary endpoints were interleukin levels (IL-1β and IL-6), and the secondary endpoints were changes in neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), Glasgow Coma scale (GCS), and Glasgow Outcome Scale-Extended (GOS-E) scores compared between intervention and control arms of the study. The linear Generalized Estimating Equations were used for trend analysis and evaluating the association of independent factors to each outcome.

Results: The results revealed a significant decrease in IL-1β levels (-2.71±3.02, in the intervention group: P=0.001 vs. -0.14±3.70, in the control group: P=0.876) and IL-6 (-88.05±148.45, in the intervention group: P=0.0001 vs. -35.54±175.79, in the control groupL P=0.325) 3 days after the intervention. The improvement in the GCS score (P=0.001), reduction in NLR (P=0.001) and PLR (P=0.002), and improvement in the GOS-E score (P=0.039) was found to be greater in the vitamin D3 arm of the study than the control group.

Conclusion: Administration of high-dose vitamin D3 in the acute phase of TBI could be effective in lowering the inflammatory markers and improving the level of consciousness and long-term performance outcomes.Trial Registration Number: IRCT20180522039777N2.

背景:创伤性脑损伤(TBI)是全球最常见的神经系统疾病之一。我们旨在研究大剂量维生素 D3 对中重度创伤性脑损伤患者炎症生物标志物的疗效:35名中重度创伤性脑损伤患者被随机分配到干预组和对照组。主要终点是白细胞介素水平(IL-1β和IL-6),次要终点是中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、格拉斯哥昏迷量表(GCS)和格拉斯哥结果量表扩展版(GOS-E)评分的变化。采用线性广义估计方程进行趋势分析,并评估独立因素与各项结果的关联:结果显示,干预组的 IL-1β 水平明显下降(-2.71±3.02,P=0.001 vs. -2.71±3.02,P=0.001 vs. -2.71±3.02):P=0.001 vs. -0.14±3.70, in the control group:P=0.876)和 IL-6 水平(干预组为 -88.05±148.45,对照组为 -0.14±3.70,P=0.0001):P=0.0001;对照组-35.54±175.79,P=0.325)。研究发现,维生素 D3 组的 GCS 评分改善(P=0.001)、NLR 降低(P=0.001)和 PLR 降低(P=0.002)以及 GOS-E 评分改善(P=0.039)均高于对照组:试验注册号:IRCT20180522039777N2。
{"title":"Investigating the Effect of High-Dose Vitamin D3 Administration on Inflammatory Biomarkers in Patients with Moderate to Severe Traumatic Brain Injury: A Randomized Clinical Trial.","authors":"Farnoosh Masbough, Mehran Kouchek, Mohsen Koosha, Sara Salarian, Mirmohammad Miri, Masoomeh Raoufi, Niloufar Taherpour, Saied Amniati, Mohammad Sistanizad","doi":"10.30476/ijms.2023.99465.3156","DOIUrl":"10.30476/ijms.2023.99465.3156","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is one of the most common neurological disorders worldwide. We aimed to investigate the efficacy of high-dose vitamin D3 on inflammatory biomarkers in patients with moderate to severe TBI.</p><p><strong>Methods: </strong>Thirty-five moderate to severe TBI patients were randomly assigned to intervention and control groups. Patients in the intervention group received a single intramuscular (IM) dose of 300,000 IU vitamin D. The primary endpoints were interleukin levels (IL-1β and IL-6), and the secondary endpoints were changes in neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), Glasgow Coma scale (GCS), and Glasgow Outcome Scale-Extended (GOS-E) scores compared between intervention and control arms of the study. The linear Generalized Estimating Equations were used for trend analysis and evaluating the association of independent factors to each outcome.</p><p><strong>Results: </strong>The results revealed a significant decrease in IL-1β levels (-2.71±3.02, in the intervention group: P=0.001 vs. -0.14±3.70, in the control group: P=0.876) and IL-6 (-88.05±148.45, in the intervention group: P=0.0001 vs. -35.54±175.79, in the control groupL P=0.325) 3 days after the intervention. The improvement in the GCS score (P=0.001), reduction in NLR (P=0.001) and PLR (P=0.002), and improvement in the GOS-E score (P=0.039) was found to be greater in the vitamin D3 arm of the study than the control group.</p><p><strong>Conclusion: </strong>Administration of high-dose vitamin D3 in the acute phase of TBI could be effective in lowering the inflammatory markers and improving the level of consciousness and long-term performance outcomes.<b>Trial Registration Number:</b> IRCT20180522039777N2.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 10","pages":"643-651"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring Differentially Expressed Genes and Immune Modulation in Diffuse Large B-Cell Lymphoma through RNA Sequencing Analysis. 通过 RNA 测序分析探索弥漫大 B 细胞淋巴瘤中的差异表达基因和免疫调节。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 DOI: 10.30476/IJMS.2023.100149.3234
Nor Adzimah Johdi, Amanda Seng, Wei-Kang Lee, Hanif Zulkhairi Mohamad Said, Wan Fariza Wan Jamaluddin

Background: Diffuse large B-cell lymphoma (DLBCL) is globally recognized as the most prevalent and aggressive subtype of non-Hodgkin lymphoma. While conventional treatments are effective initially, the disease can become resistant or relapse over time. This study aimed to examine the differentially expressed genes at the transcriptome level and molecular pathways in DLBCL patients.

Methods: This investigation utilized RNA sequencing analysis to compare differentially expressed gene samples from five diffuse large B-cell lymphoma patients with two healthy volunteers. These participants were admitted to UKM Medical Center, Kuala Lumpur between 2019 and 2020. The differentially expressed genes were identified using the DESeq2 R package (version 1.10.1) using a negative binomial distribution model. The obtained P values were corrected with the Benjamin and Hochberg method and identified using a False Discovery Rate threshold of <0.05, with log2 fold change (FC) of ≥2 or ≤-2.

Results: Results showed 73 differentially expressed genes between the two groups, among which 70 genes were downregulated, and three genes were upregulated. The differentially expressed genes analyzed with the Reactome pathway were significantly associated with the downregulation of antimicrobial humoral response (P<0.001), neutrophil degranulation (P<0.001), chemokine receptors bind chemokines (P=0.028), defensins (P=0.028) and metabolism of angiotensinogen (P=0.040).

Conclusion: These findings suggest that the identified pathways may contribute to cancer progression and weaken the immune response in diffuse large B-cell lymphoma patients. This study offers fresh insights into previously undiscovered downstream targets and pathways modulated by diffuse large B-cell lymphoma.

背景:弥漫大 B 细胞淋巴瘤(DLBCL)是全球公认的非霍奇金淋巴瘤中发病率最高、侵袭性最强的亚型。虽然常规治疗最初有效,但随着时间的推移,该病可能会出现耐药性或复发。本研究旨在检测DLBCL患者转录组水平的差异表达基因和分子通路:本研究利用 RNA 测序分析比较了五名弥漫大 B 细胞淋巴瘤患者和两名健康志愿者的差异表达基因样本。这些参与者于2019年至2020年期间入住吉隆坡UKM医疗中心。采用负二项分布模型,使用 DESeq2 R 软件包(1.10.1 版)确定了差异表达基因。获得的 P 值用本杰明和霍赫伯格方法进行校正,并使用≥2 或≤-2 的 2 倍变化(FC)的假发现率阈值进行识别:结果显示,两组之间存在73个差异表达基因,其中70个基因下调,3个基因上调。用 Reactome 通路分析的差异表达基因与抗微生物体液反应(PC)的下调显著相关:这些研究结果表明,所发现的通路可能会导致弥漫大B细胞淋巴瘤患者的癌症进展并削弱其免疫反应。这项研究为弥漫大 B 细胞淋巴瘤调节以前未被发现的下游靶点和通路提供了新的见解。
{"title":"Exploring Differentially Expressed Genes and Immune Modulation in Diffuse Large B-Cell Lymphoma through RNA Sequencing Analysis.","authors":"Nor Adzimah Johdi, Amanda Seng, Wei-Kang Lee, Hanif Zulkhairi Mohamad Said, Wan Fariza Wan Jamaluddin","doi":"10.30476/IJMS.2023.100149.3234","DOIUrl":"https://doi.org/10.30476/IJMS.2023.100149.3234","url":null,"abstract":"<p><strong>Background: </strong>Diffuse large B-cell lymphoma (DLBCL) is globally recognized as the most prevalent and aggressive subtype of non-Hodgkin lymphoma. While conventional treatments are effective initially, the disease can become resistant or relapse over time. This study aimed to examine the differentially expressed genes at the transcriptome level and molecular pathways in DLBCL patients.</p><p><strong>Methods: </strong>This investigation utilized RNA sequencing analysis to compare differentially expressed gene samples from five diffuse large B-cell lymphoma patients with two healthy volunteers. These participants were admitted to UKM Medical Center, Kuala Lumpur between 2019 and 2020. The differentially expressed genes were identified using the DESeq2 R package (version 1.10.1) using a negative binomial distribution model. The obtained P values were corrected with the Benjamin and Hochberg method and identified using a False Discovery Rate threshold of <0.05, with log<sub>2</sub> fold change (FC) of ≥2 or ≤-2.</p><p><strong>Results: </strong>Results showed 73 differentially expressed genes between the two groups, among which 70 genes were downregulated, and three genes were upregulated. The differentially expressed genes analyzed with the Reactome pathway were significantly associated with the downregulation of antimicrobial humoral response (P<0.001), neutrophil degranulation (P<0.001), chemokine receptors bind chemokines (P=0.028), defensins (P=0.028) and metabolism of angiotensinogen (P=0.040).</p><p><strong>Conclusion: </strong>These findings suggest that the identified pathways may contribute to cancer progression and weaken the immune response in diffuse large B-cell lymphoma patients. This study offers fresh insights into previously undiscovered downstream targets and pathways modulated by diffuse large B-cell lymphoma.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 10","pages":"652-660"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence, Incidence, and Risk Factors of Hypothyroidism in Adult Residents of Yazd Greater Area, 2015-2021: Results of Yazd Health Study. 2015-2021 年亚兹德大区成年居民甲状腺功能减退症的患病率、发病率和风险因素:亚兹德健康研究结果
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 DOI: 10.30476/ijms.2023.99865.3208
Masoumeh Khosravi, Reyhaneh Azizi, Hossein Fallahzadeh, Masoud Mirzaei

Background: Any abnormal change in thyroid hormone levels leads to thyroid disorders, including hyperthyroidism, hypothyroidism, goiter, and so on. Recent studies have reported an increasing prevalence and incidence of thyroid disorders worldwide. This study aims to determine the hypothyroid prevalence, incidence, and risk factors related to this disorder.

Methods: Data from a comprehensive prospective cohort study, collected from a population of 10,000 Yazd (Iran) individuals over a period of 6 years (2015-2021) was analyzed. Physicians diagnosed hypothyroidism and reported it. Data processing and preparation were performed using SQL18 and Excel, while STATA17 and SPSS22 software were employed for data analysis. Descriptive statistics, logistic regression, and Chi-square tests were conducted at a significance level of 0.05.

Results: The prevalence of hypothyroidism was found to be 93/1000, and the incidence was 15/1000 of the population, respectively. Women had five folds more chance of hypothyroidism (adjusted OR=5.31, 95% CI=3.06-9.19 vs. unadjusted OR=6.28, 95% CI=3.90-10.12), and they usually developed it between the ages of 30 and 39. Eating less (iodized) salt also increased the risk of hypothyroidism (unadjusted OR=1.47, 95% CI=1.02-2.11). Iron supplementation (unadjusted OR=2.09, 95% CI=1.26-3.48) was identified as one of the significant risk factors. Based on our findings in the unadjusted model, tooth brushing once or twice a day increases the chance of hypothyroidism (OR=1.89, P=0.008, and OR=2.12, P=0.016, respectively). Tobacco smoking (unadjusted OR=0.29, 95% CI=0.107-0.786) was also among the factors that need further investigation.

Conclusion: The increasing trend of hypothyroidism is concerning in our population. The high prevalence, particularly among women of childbearing age, is notable.

背景:甲状腺激素水平的任何异常变化都会导致甲状腺疾病,包括甲状腺功能亢进症、甲状腺功能减退症、甲状腺肿等。最近的研究报告显示,甲状腺疾病在全球的流行率和发病率不断上升。本研究旨在确定甲状腺功能减退症的患病率、发病率以及与这种疾病相关的风险因素:本研究分析了一项综合性前瞻性队列研究的数据,该研究收集了亚兹德(伊朗)10,000 人在 6 年内(2015-2021 年)的数据。医生诊断并报告甲状腺功能减退症。数据处理和准备使用 SQL18 和 Excel,数据分析使用 STATA17 和 SPSS22 软件。在 0.05 的显著性水平下进行了描述性统计、逻辑回归和卡方检验:甲状腺功能减退症的患病率为 93/1000,发病率为 15/1000。女性患甲状腺功能减退症的几率是男性的五倍(调整后的OR=5.31,95% CI=3.06-9.19;未调整的OR=6.28,95% CI=3.90-10.12),她们通常在30至39岁之间发病。少吃(加碘)盐也会增加甲状腺功能减退症的风险(未调整OR=1.47,95% CI=1.02-2.11)。铁补充剂(未调整 OR=2.09,95% CI=1.26-3.48)被认为是重要的风险因素之一。根据我们在未调整模型中的发现,每天刷牙一次或两次会增加患甲状腺功能减退症的几率(OR=1.89,P=0.008;OR=2.12,P=0.016)。吸烟(未经调整的OR=0.29,95% CI=0.107-0.786)也是需要进一步调查的因素之一:甲状腺功能减退症在我国人口中的增长趋势令人担忧。结论:甲状腺功能减退症在我国人口中的增长趋势令人担忧,尤其是在育龄妇女中的高发病率值得注意。
{"title":"Prevalence, Incidence, and Risk Factors of Hypothyroidism in Adult Residents of Yazd Greater Area, 2015-2021: Results of Yazd Health Study.","authors":"Masoumeh Khosravi, Reyhaneh Azizi, Hossein Fallahzadeh, Masoud Mirzaei","doi":"10.30476/ijms.2023.99865.3208","DOIUrl":"https://doi.org/10.30476/ijms.2023.99865.3208","url":null,"abstract":"<p><strong>Background: </strong>Any abnormal change in thyroid hormone levels leads to thyroid disorders, including hyperthyroidism, hypothyroidism, goiter, and so on. Recent studies have reported an increasing prevalence and incidence of thyroid disorders worldwide. This study aims to determine the hypothyroid prevalence, incidence, and risk factors related to this disorder.</p><p><strong>Methods: </strong>Data from a comprehensive prospective cohort study, collected from a population of 10,000 Yazd (Iran) individuals over a period of 6 years (2015-2021) was analyzed. Physicians diagnosed hypothyroidism and reported it. Data processing and preparation were performed using SQL18 and Excel, while STATA17 and SPSS22 software were employed for data analysis. Descriptive statistics, logistic regression, and Chi-square tests were conducted at a significance level of 0.05.</p><p><strong>Results: </strong>The prevalence of hypothyroidism was found to be 93/1000, and the incidence was 15/1000 of the population, respectively. Women had five folds more chance of hypothyroidism (adjusted OR=5.31, 95% CI=3.06-9.19 vs. unadjusted OR=6.28, 95% CI=3.90-10.12), and they usually developed it between the ages of 30 and 39. Eating less (iodized) salt also increased the risk of hypothyroidism (unadjusted OR=1.47, 95% CI=1.02-2.11). Iron supplementation (unadjusted OR=2.09, 95% CI=1.26-3.48) was identified as one of the significant risk factors. Based on our findings in the unadjusted model, tooth brushing once or twice a day increases the chance of hypothyroidism (OR=1.89, P=0.008, and OR=2.12, P=0.016, respectively). Tobacco smoking (unadjusted OR=0.29, 95% CI=0.107-0.786) was also among the factors that need further investigation.</p><p><strong>Conclusion: </strong>The increasing trend of hypothyroidism is concerning in our population. The high prevalence, particularly among women of childbearing age, is notable.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 10","pages":"623-631"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative Analysis of Surgical Outcomes in Hybrid and Open Esophagectomy for Esophageal Cancer: A Regional Russian Cancer Centre Experience. 混合式与开放式食管癌切除术的手术效果对比分析:俄罗斯地区癌症中心的经验
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 DOI: 10.30476/ijms.2024.101493.3419
Evgeny Toneev, Oleg Aleksandrov, Oleg Pikin, Lyudmila Danilova, Oleg Midlenko, Vladimir Midlenko, Andrey Chavga

Surgery is pivotal in treating esophageal cancer; hybrid esophagectomy, which combines minimally invasive and open techniques, shows promising outcomes. This historical cohort study compared the surgical outcomes of standard open esophagectomy with hybrid esophagectomy. Overall, 58 patients who underwent either hybrid or open esophagectomy at the Ulyanovsk Regional Clinical Oncology Clinic, Russia, from January 2015 to December 2023 were included. Data on demographics, surgical details, and postoperative outcomes were analyzed. The primary measures were overall complications and anastomotic leakage rates. Statistical analysis was performed using Pearson's Chi square test and t test via StatTech software (version 2.8.8). The number of removed lymph nodes was higher in the hybrid group (24±9) than in the open group (15±7) (P<0.001). In addition, the hybrid esophagectomy group showed significant reductions in operational time and blood loss (P<0.001 and P=0.014, respectively). The need for blood transfusion was higher in the open esophagectomy group (P=0.043). The postoperative length of stay in the hospital did not differ significantly between the two groups (open=20±8 days, hybrid=17±7 days, P=0.178). Cardiac complications were more frequent after an open esophagectomy (P=0.044). Hybrid esophagectomy reduced postoperative cardiac complications and other adverse events while maintaining satisfactory oncological outcomes. It had advantages over standard open esophagectomy in terms of lymphadenectomy, operative time, blood loss, and transfusion requirements, suggesting its efficacy for esophageal cancer patients.

手术是治疗食管癌的关键;结合了微创和开放技术的混合食管切除术显示出良好的疗效。这项历史性队列研究比较了标准开放式食管切除术和混合式食管切除术的手术效果。研究共纳入了 2015 年 1 月至 2023 年 12 月期间在俄罗斯乌里扬诺夫斯克地区临床肿瘤诊所接受混合或开放式食管切除术的 58 名患者。对人口统计学、手术细节和术后结果等数据进行了分析。主要衡量指标为总体并发症和吻合口漏率。统计分析通过 StatTech 软件(2.8.8 版)使用皮尔逊卡方检验和 t 检验进行。杂交组切除的淋巴结数量(24±9)个高于开放组(15±7)个(P
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引用次数: 0
Efficacy of ColonFlag as a Complete Blood Count-Based Machine Learning Algorithm for Early Detection of Colorectal Cancer: A Systematic Review. ColonFlag作为基于全血细胞计数的机器学习算法对早期检测结直肠癌的功效:系统回顾
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 DOI: 10.30476/ijms.2024.101219.3400
Raeni Dwi Putri, Syifa Alfiah Sujana, Nadhira Nizza Hanifa, Tiffanie Almas Santoso, Murdani Abdullah

Background: Colorectal cancer (CRC) screening is essential to reduce incidence and mortality rates. However, participation in screening remains suboptimal. ColonFlag, a machine learning algorithm using complete blood count (CBC), identifies individuals at high CRC risk using routinely performed tests. This study aims to review the existing literature assessing the efficacy of ColonFlag across diverse populations in multiple countries.

Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) were followed in reporting this systematic review. Searches were conducted on PubMed, Cochrane, ScienceDirect, and Google Scholar for English articles, using keywords related to CBC, machine learning, ColonFlag, and CRC, covering the first development study from 2016 to August 2023. The Cochrane Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to assess the risk of bias.

Results: A total of 949 articles were identified during the literature search. Ten studies were found to be eligible. ColonFlag yielded Area Under the Curve (AUC) values ranging from 0.736 to 0.82. The sensitivity and specificity ranged from 3.91% to 35.4% and 82.73% to 94%, respectively. The positive predictive values ranged between 2.6% and 9.1%, while the negative predictive values ranged from 97.6% to 99.9%. ColonFlag performed better in shorter time windows, tumors located more proximally, in advanced stages, and in cases of CRC compared to adenoma.

Conclusion: While ColonFlag exhibits low sensitivity compared to established screening methods such as the fecal immunochemical test (FIT) or colonoscopy, its potential to detect CRC before clinical diagnosis suggests an opportunity for identifying more cases than regular screening alone.

背景:大肠癌(CRC)筛查对于降低发病率和死亡率至关重要。然而,参与筛查的情况仍不理想。ColonFlag是一种使用全血细胞计数(CBC)的机器学习算法,它能通过常规检测确定CRC高危人群。本研究旨在回顾现有文献,评估ColonFlag在多个国家不同人群中的疗效:方法:在报告本系统性综述时,遵循了系统性综述和元分析的首选报告项目(PRISMA)。使用与 CBC、机器学习、ColonFlag 和 CRC 相关的关键词,在 PubMed、Cochrane、ScienceDirect 和 Google Scholar 上检索英文文章,涵盖 2016 年至 2023 年 8 月的首次开发研究。使用 Cochrane 预测模型偏倚风险评估工具(PROBAST)评估偏倚风险:在文献检索过程中,共发现了 949 篇文章。发现有 10 项研究符合条件。ColonFlag的曲线下面积(AUC)值从0.736到0.82不等。灵敏度和特异性分别为 3.91% 至 35.4% 和 82.73% 至 94%。阳性预测值介于 2.6% 和 9.1% 之间,阴性预测值介于 97.6% 和 99.9% 之间。与腺瘤相比,ColonFlag 在时间窗口较短、肿瘤位置较近、晚期以及 CRC 病例中的表现更好:尽管与粪便免疫化学检验(FIT)或结肠镜检查等成熟的筛查方法相比,ColonFlag 的灵敏度较低,但它在临床诊断前检测出 CRC 的潜力表明,它有机会比单纯的常规筛查发现更多的病例。
{"title":"Efficacy of ColonFlag as a Complete Blood Count-Based Machine Learning Algorithm for Early Detection of Colorectal Cancer: A Systematic Review.","authors":"Raeni Dwi Putri, Syifa Alfiah Sujana, Nadhira Nizza Hanifa, Tiffanie Almas Santoso, Murdani Abdullah","doi":"10.30476/ijms.2024.101219.3400","DOIUrl":"10.30476/ijms.2024.101219.3400","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) screening is essential to reduce incidence and mortality rates. However, participation in screening remains suboptimal. ColonFlag, a machine learning algorithm using complete blood count (CBC), identifies individuals at high CRC risk using routinely performed tests. This study aims to review the existing literature assessing the efficacy of ColonFlag across diverse populations in multiple countries.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) were followed in reporting this systematic review. Searches were conducted on PubMed, Cochrane, ScienceDirect, and Google Scholar for English articles, using keywords related to CBC, machine learning, ColonFlag, and CRC, covering the first development study from 2016 to August 2023. The Cochrane Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to assess the risk of bias.</p><p><strong>Results: </strong>A total of 949 articles were identified during the literature search. Ten studies were found to be eligible. ColonFlag yielded Area Under the Curve (AUC) values ranging from 0.736 to 0.82. The sensitivity and specificity ranged from 3.91% to 35.4% and 82.73% to 94%, respectively. The positive predictive values ranged between 2.6% and 9.1%, while the negative predictive values ranged from 97.6% to 99.9%. ColonFlag performed better in shorter time windows, tumors located more proximally, in advanced stages, and in cases of CRC compared to adenoma.</p><p><strong>Conclusion: </strong>While ColonFlag exhibits low sensitivity compared to established screening methods such as the fecal immunochemical test (FIT) or colonoscopy, its potential to detect CRC before clinical diagnosis suggests an opportunity for identifying more cases than regular screening alone.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 10","pages":"610-622"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Iranian Journal of Medical Sciences
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