Medical Journal of the Islamic Republic of Iran最新文献

Background: Continuous care for patients with post-war stress disorder can affect the psychological health of caregivers. Recognizing the available and credible interventions for enhancing the psychological well-being of caregivers is one of the goals of healthcare providers. Therefore, the present scoping review was conducted with the aim of identifying the types of interventions aiming at enhancing the psychological health and well-being of the family caregivers of individuals suffering from war-induced post-traumatic stress disorder.

Methods: In this scoping review, studies conducted on healthcare interventions aimed at improving the psychological health of family caregivers of individuals with war-induced PTSD, with any study design published in both Persian and English languages, within the timeframe of 2000-2023, were searched in the following databases: PubMed (Medline), Google Scholar, Scopus, ProQuest, Science Direct, Web Of Science,Cochrane , SID, IranDoc, IranMedex, and Magiran. The search utilized the following keywords in English as well as their Persian equivalents: posttraumatic stress disorder, combat veteran, military veteran, psychological intervention, program, therapy, family caregiver, family member, partner, spouse, wife, and veterans' families.

Results: Out of a total of 22,500 articles initially found, ultimately, 11 articles were found to be eligible for this study. A review of the studies revealed that interventions conducted to enhance the psychological well-being of family caregivers of individuals with war-induced post-traumatic stress disorder were broadly categorized into three intervention groups. These interventions groups included the second wave of behavioral therapies (such as cognitive-behavioral strategy training, stress inoculation training, group therapy, and cognitive-based couples therapy), a third wave of behavioral therapy (acceptance and commitment-based therapies, mindfulness-based cognitive therapy, and mindfulness-based family therapy), and fourth wave of behavioral therapy (spiritual-religious interventions, hope therapy, logotherapy, internet-based interventions, and online education).

Conclusion: Based on the findings, it can be stated that the third wave of behavioral interventions, where behavioral strategies take precedence over traditional cognitive strategies, may prove beneficial in reducing psychological symptomatology and enhancing the psychological well-being of family caregivers of individuals with war-induced PTSD, compared to interventions in other categories. However, the clear lack of data underscores the need for further research into the psychological well-being of caregivers of individuals with war-induced PTSD.

Background: Considering the importance of early diagnosis of coronary artery disease (CAD) in reducing subsequent complications, non-invasive tests, especially myocardial perfusion imaging (MPI) and coronary CT angiography (CCTA) play a pivotal role in this regard. Therefore, a study was conducted to compare the diagnostic results of these two methods.

Methods: A cross-sectional study was conducted on 51 patients who underwent MPI and CCTA and 18 patients whose noninvasive test was positive and high risk underwent invasive coronary angiography (ICA) at Farshchian Heart Center, Hamadan, Iran, during one year (2019-2020). The data including demographic characteristics as well as the histories of dyslipidemia, smoking, positive family history, hypertension, and diabetes, was collected using a checklist. Descriptive statistics, independent samples t-tests, and chi-square tests and Sensitivity, Specificity and Positive predictive value, Negative predictive value and Roc Curve were applied for data analysis. For data analysis, the SPSS software version 21 was used. P values less than 0.05 were considered.

Results: The mean age of the patients, including 29 males (56.9%) and 22 females (43.1%), was 60.11±8.99 years. No significant correlation was found between the results of MPI and CCTA compared to ICA. CCTA demonstrated higher sensitivity (100% versus 88%), higher specificity (33% versus 0%), and higher accuracy (66% versus 44%) than MPI. Furthermore, CCTA performed better in terms of positive predictive value (60% versus 47%) than MPI. The overall diagnostic accuracy of MPI when CCTA is considered as a reference, according to the area under the Rock's curve, which is equal to 0.691, is relatively good. Based on the calculated optimal Yoden index, the appropriate cut point is SSS≥8. on the other hand, MPI can be useful in functional evaluation and has important rules in moderate stenosis.

Conclusion: Considering the high sensitivity and accuracy of CCTA compared to MPI, CTCA, and MPI provide differing information for CAD from respective angles. The correlation between CTCA and MPI is supplemental rather than substitutional.

Background: We conducted a systematic review of all published epidemiological research related to the relationship between occupational silica exposure and the rates of silicosis incidence and mortality.

Methods: We searched Scopus, PubMed, and Web of Sciences up to 11/07/2023, for original in any language. The search start date was not limited Observational studies, including cohort, case-control, and cross-sectional that have reported risk estimates for the association between silica exposure and silicosis mortality and incidence rates were considered. The methodological quality of the included articles was assessed using the Newcastle-Ottawa scale. Pooled estimates were calculated using the random effects model. Dose-response relations were explored through a two-stage random-effects model with "drmeta" command in Stata software version 14.

Results: Nineteen observational studies were included in the present systematic review and meta-analysis. Based on the linear dose-response analysis, with each mg/m3 increase in daily occupational exposure to silica, the mortality risk of silicosis, the odds and risk of silicosis occurrence significantly increased by 10.19%, 360.02%, and 4.43 × 108%, respectively.

Conclusion: This review revealed that there is a linear dose-response relationship between occupational exposure to silica and incidence and mortality from silicosis. Our findings could have practical applications for occupational and public health. Considering the direct relationship between occupational silica exposure and high incidence and mortality rates of silicosis, the level of silica dust should be decreased in different industries.

Background: The Sjogren syndrome (SS) is the least well-known rheumatic condition. We aim to gradually resolve it by standardizing the process of SS care in our country, at first for primary Sjogren syndrome cases, through developing Iran Primary Sjogren Syndrome Registry (IRAPSS) which will create a representative and comparable data bank.

Methods: Guilan Primary Sjogren Syndrome Registry (GUIRAPSS) is a pilot phase of IRAPSS, which is a prospective cohort. Care of its patients is done based on EULAR Sjögren's syndrome disease activity index (ESSDAI) recommendations. Other IRAPSS outcome measurements are EULAR Sjogren syndrome patient reported index (ESSPRI) and Sjögren's syndrome disease damage index (SSDDI) for detecting disease damage.

Results: Female-male ratio was 17.5. The age at expert diagnosis was 46.97 ± 11.93 years old. The most common comorbidity was hypothyroidism (28.38%), followed by musculoskeletal conditions (27.02%). 28.38% had fatigue. Active disease existed based on the clinical form of ESSDAI and ESSDAI, 31.8% and 81.8% respectively. The most involved organs during disease activity based on ESSDAI were biological 68.12% following pulmonary (12.16%) and respiratory (10.81%) system. Hydroxychloroquine was the most prescribed drug (72.97%), followed by prednisolone (28.38%).

Conclusion: Disease registries provide an ideal opportunity for gathering standardized and comparable data which provides needed items for creating, updating, or adapting pSS classification criteria/diagnosis, outcome measurements and or treatment guidelines.

Background: Testosterone replacement therapy (TRT) is pivotal in addressing male hypogonadism, yet uncertainties persist regarding its optimal use and long-term ramifications. This study aims to explore the knowledge map of TRT.

Methods: In this bibliometric study, we searched Scopus for relevant keywords from the beginning to 2023. Our inclusion criteria were original articles and reviews and our exclusion criteria were non-English and non-related articles and document types other than original articles and reviews. Excel, VOS viewer, and Science of Science (Sci2) software were used for data synthesis.

Results: From 6712 retrieved articles, 5325 articles were included for analysis. The most productivity belonged to the USA (n=2,570 documents), the United Kingdom (n=476), and Italy (n=339). "Journal of Clinical Endocrinology and Metabolism" (n=168) had the highest participation in publishing. Also, "Journal of Clinical Endocrinology and Metabolism" and the "Journal of Sexual Medicine" exhibited significant bibliographic coupling with other journals in the TRT field. The research topics of interest were mainly related to hypogonadism, prostate cancer, and erectile dysfunction. Bursting analysis of the title and abstract revealed the TRT research prior to the year 2000 was mainly focused on castration, gonadectomy, growth, and aplastic anemia, while the focus of recent research moved towards libido, cardiovascular events, HIV, geriatric issues, diabetes, bipolar disorder, cancer, transmasculine, and transgender individuals.

Conclusion: This study highlights the growing trend of TRT research over time, with most focus on hypogonadism, prostate cancer, and erectile dysfunction. Insights gleaned from this analysis inform research priorities and resource allocation, facilitating enhanced patient care in androgen deficiency management.

Background: While the coronavirus disease 2019 (COVID-19) pandemic devastated the healthcare systems, its consequences have been particularly severe for senior citizens. They have been at higher risk of being physically affected and faced more social and mental problems in the COVID-19 era. During the pandemic, they, more than other age groups, reported a feeling of loneliness, symptoms of depression, and anxiety, and, more than ever, faced ageism, discrimination, and elder abuse. Although many people can overcome social isolation in the light of social media and the internet, the elderly are not digitally literate and welcoming to technology like younger generations. Recognizing the unique needs of older adults must be considered in making health policies.

Methods: In this systematized review, we collected all studies originally written in English and containing relative information regarding the social problems of older adults during the pandemic in PubMed, Medline, Embase, Scopus, and Web of Science (n = 25).

Results: Findings were categorized into 3 main components: (1) body function and body structure, (2) activities and participation, and (3) environmental factors.

Conclusion: Social isolation has proven more debilitating for older adults, as they often lack equal access to the internet, nor are they equally welcoming to social media and the internet as younger generations. This negative impact is worse for those with chronic conditions, especially cognitive impairments.

Background: Diffuse large B-cell lymphoma (DLBL) and systemic lupus erythematosus (SLE) are complex autoimmune disorders that present unique clinical challenges. These conditions may share underlying genetic and signaling pathways despite their distinct manifestations. Uncovering these commonalities could offer invaluable insights into disease pathogenesis, paving the way for more targeted and effective therapeutic interventions. This study embarks on a comprehensive investigation of the common genes and signaling pathways between SLE and DLBL.

Methods: The researchers scoured the Gene Expression Omnibus database, meticulously gathering microarray datasets for SLE (GSE61635) and DLBL (GSE56315). Differential expression analysis was performed, allowing the team to identify the genes that were commonly dysregulated across these 2 autoimmune conditions. To delve deeper into the biological significance of these shared genes, the researchers conducted functional enrichment analysis, network analysis, and core gene identification. Notably, the diagnostic potential of the identified hub genes was assessed using a cutting-edge neural network model.

Results: The data analysis revealed a remarkable 146 genes that were shared between SLE and DLBL, of which 111 were upregulated and 45 downregulated. Functional enrichment analysis unveiled the involvement of these shared genes in vital immune system-related processes-such as defense response to viruses, interferon signaling, and broader immune system pathways. Network analysis pinpointed 5 hub genes (IFIT3, IFIT1, DDX58, CCL2, and OASL) that emerged as central players, exhibiting a high degree of centrality and predicted to hold crucial roles in the underlying molecular mechanisms. Remarkably, the neural network model demonstrated exceptional diagnostic accuracy in distinguishing between the disease states (DLBL and SLE) based solely on the expression patterns of these hub genes.

Conclusion: The identified hub genes and their associated pathways hold immense potential as diagnostic biomarkers and may serve as valuable targets for future therapeutic explorations.

Background: Coronary artery disease (CAD) is one of the heart diseases that causes the death of many patients in the world. Many genes and molecular pathways are involved in the regulation of inflammation. However, some genes have a regulatory role and control immune responses. In recent studies, few studies have been done regarding the role of TLRs and PPARs in CAD. Hence, the present study aimed to determine and compare the mRNA expression of PPAR-α and PPAR-γ genes and genes of the innate immune system messenger pathway, including TLR2and TLR4, in CAD patients in comparison to normal individuals.

Methods: This study (case-control) was conducted on 12 patients with coronary arteries and 10 healthy individuals as healthy controls. RNA extraction was performed, cDNA was produced, and then the mRNA expression levels of TLR2, TLR4, PPAR-α, and PPAR-γ genes were examined using Syber green Real-Time PCR. The t-test sample and the related non-parametric tests were used to investigate the relationship between the quantitative variables. The significance level in all tests was considered as less than 0.05.

Results: The results of data analysis showed that the expression level of TLR2 and TLR4 genes was significantly increased in the patient group compared to the controls (P=0.001). However, although PPAR-α and PPAR-γ genes were up-regulated in patients' samples, the comparison of gene expression levels did not significantly differ between the case and control groups.

Conclusion: we found meaningful results to the significant role of 2 and TLR4 in the pathogenesis of CAD and emphasize the hypothesis that TLR2 and TLR4 can be considered therapeutic options.