Journal of Research in Medical Sciences最新文献

Despite significant advancements in the diagnosis and treatment of acute myeloid leukemia (AML), patients still face poor diagnosis with unsatisfactory survival, so it is imperative to explore novel diagnostic biomarkers to improve early detection and treatment outcomes. Thus, here, the potential role of circular RNAs (circRNAs) in AML diagnosis is reviewed. PubMed, Scopus, WOS, ProQuest databases, and Google Scholar search engines were searched for studies published through March 2023. The results were assessed using the modified method of GRADE assessment. The sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curve (AUC) were combined to investigate the diagnostic role of circRNAs in AML. The number of studies included in this systematic review and meta-analysis was 18. For the diagnostic value of circRNAs in AML, the pooled SEN, SPE, PLR, and NLR were 0.85 (95% confidence interval [CI]: 0.80-0.89), 0.85 (95% CI: 0.82-0.88), 5.74 (95% CI: 4.49-7.33), and 0.18 (95% CI: 0.13-0.24), respectively. Furthermore, the pooled DOR and AUC were 32.71 (95% CI: 20.09-53.24) and 0.91 (95% CI: 0.88-0.93), respectively. Furthermore, through subgroup analysis, it is better to have a sample size above 120 and a control/patient ratio above 50%. In addition, Deek's funnel plot demonstrated nonconsiderable publication bias (P = 0.65). Finally, according to the GRADE assessment for diagnostic tests, the certainty of evidence regarding sensitivity and specificity was moderate. Our systematic review and meta-analysis suggest the analysis of circRNAs expression as promising and valuable biomarkers related to the diagnosis of AML and also can be helpful in the diagnosis of AML patients as a noninvasive and low-cost method.

Background: This study aimed to evaluate the impact of mobile health (mHealth) intervention on colorectal cancer (CRC) screening.

Materials and methods: This semiexperimental study collected data from individuals aged 50-70 years who had no history of CRC screening. Participants (n = 350) were randomly assigned to one control and five intervention groups. The data were collected by theory-based CRC screening questionnaire before and after the mHealth intervention.

Results: The results indicated a significant improvement in screening rates when utilizing mHealth interventions, which included text messages, videos, and telephone calls from health workers, showing a rate of 68.6% (P < 0.001) compared to 5.7% of individuals in the routine care group. Logistic regression analysis revealed that "perceived severity" and "perceived benefits" were significantly associated with increased screening uptake, compared to the routine care group.

Conclusion: The current study indicates that mobile phone technology significantly impacts the outreach efforts for encouraging the covered population to participate in screening.

Background: Previous research has indicated that chronic inflammation plays a significant role in the development of coronary artery ectasia (CAE). However, there is limited data on the role of plasma fibrinogen-to-albumin ratio (PFAR) in CAE patients. Our study aimed to explore the connection between PFAR and the presence of CAE.

Materials and methods: This research used a case-control methodology. We included a total of 108 consecutive patients who had CAE without any stenosis. Among them, there were 65 males and 43 females, with a mean age of 58.2 ± 8.5 years. The control group included 102 consecutive participants with angiographically normal coronary arteries, consisting of 62 males and 40 women, with a mean age of 57.3 ± 8.6 years. Statistical analyses were conducted using Student's-t-test, Mann-Whitney U-test, Chi-square test, linear regression, logistic regression, and receiver operating characteristic (ROC) curve analysis.

Results: PFAR in the CAE group was significantly higher compared to the controls (84.8 ± 7.4 vs. 70.1 ± 9.5, P < 0.001). Using multiple logistic regression showed a strong link between PFAR and CAE, with an odds ratio for PFAR of 1.818 (95% confidence interval [CI] 1.092-6.201; P = 0.005). PFAR was exceeded 72.6, the sensitivity and specificity were 80.2% and 72.6%, respectively. The area under the ROC curve (area under the curve) was 0.731 (95% CI: 0.659-0.803, P = 0.028).

Conclusion: In our study, we found that PFAR levels were notably higher in the CAE group compared to the control group, and we observed a significant correlation between PFAR and CAE.

Background: Opium use disorder (OUD) is prevalent worldwide. Despite its traditional use, recent studies suggest that OUD may exacerbate atherosclerosis and ischemic stroke. This study investigates the effect of OUD on internal carotid artery sonographic findings using B-mode Doppler sonography.

Materials and methods: A case-control study was conducted in Isfahan, Iran, from 2021 to 2023. A total of 295 patients, including 95 with OUD and 200 without, were evaluated through medical records and B-mode Doppler sonography to assess atherosclerotic plaques, vulnerability of plaques, carotid artery stenosis, and carotid artery intima-media thickness (CIMT). Data on age, sex, smoking, and medical history were also collected.

Results: The OUD group had a higher prevalence of tobacco smoking (56% vs. 18%; P < 0.001). Atherosclerotic plaques were more common in OUD patients (83% vs. 65%; P = 0.001). Vulnerable plaques were more frequent in OUD patients (19% vs. 9%; P = 0.039). OUD patients were three times more likely to have carotid artery stenosis (85% vs. 65%; P < 0.001) and had a higher incidence of more than 70% stenosis (33.8% vs. 16%; P = 0.003). CIMT was significantly higher in the OUD group (0.95 mm vs. 0.87 mm; P < 0.001). Logistic regression analysis revealed that OUD was independently associated with atherosclerotic plaque, carotid stenosis, stenosis of more than 70%, and CIMT (P < 0.05).

Conclusion: This study highlights a significant association between OUD and sonographic markers of carotid atherosclerosis, including increased intima-media thickness, higher prevalence of atherosclerotic plaques, and stenosis of more than 70%. We suggest OUD as a potential risk factor for carotid artery atherosclerosis.

Background: This study aims to evaluate the nutritional condition of individuals undergoing hemodialysis (HD) in Isfahan, Iran.

Materials and methods: This cross-sectional study involved 201 HD patients. The modified quantitative subjective global assessment was employed to evaluate nutritional status, along with the collection of sociodemographic data, anthropometric measurements, and biochemical tests.

Results: The participants had a mean age of 60.2 ± 16.24 years, with 70 (34.83%) being female. The prevalence of malnutrition was 63.18%, with 60.2% classified as mild-moderately malnutrition and 2.98% identified as severely malnutrition. The participants had a mean body mass index (BMI) of 24.6 ± 5.0 (kg/m²), while 7.96% of patients had a BMI below the normal range. Compared to patients who underwent HD for <5 years, patients who had been on dialysis for >5 years demonstrated 2.5 times higher odds of malnutrition (odds ratio: 2.47, 95% confidence interval: 1.25-4.9). Age, mid-arm circumference, education level, and comorbid diabetes mellitus were significantly associated with malnutrition. In addition, malnourished patients showed lower levels of serum albumin (Alb) (P < 0.001) and serum creatinine (Cr) (P < 0.001). Multivariate logistic regression demonstrated age, dialysis duration, upper diploma educational level, lower serum Alb, and lower serum Cr may independently be associated with malnutrition in HD patients.

Conclusion: Malnutrition is prevalent among HD patients. Regular assessment of nutritional status may enhance nutritional outcomes and overall well-being in this patient population.

Background: To evaluate the safety of propofol and sevoflurane for general anesthesia in elderly.

Materials and methods: All studies on sevoflurane, propofol, and hyperamylasemia from the establishment of Embase, Ovid, Cochrane Library, and Google Scholar from database establishment to December 2024 were searched. Literatures were screened, and data were extracted on the grounds of inclusion and exclusion criteria. Review Manager (RevMan) (Version 5.4. The Cochrane Collaboration.) was used for statistical analysis. Outcomes assessed included time to spontaneous eye opening, extubation time, incidence rate of postoperative cognitive dysfunction (POCD), postoperative delirium, agitation, nausea and vomiting.

Results: Fourteen trials were identified and included in this meta-analysis. The results showed no significant difference in time to spontaneous eye opening (P = 0.54), the incidence of POCD (P = 0.07), postoperative delirium (P = 0.37), and postoperative nausea and vomiting (P = 0.8) between the sevoflurane and propofol groups. Compared with propofol groups, extubation time (P < 0.0001) was significantly shortened by sevoflurane groups. Conversely, compared with sevoflurane, the incidence of postoperative agitation in the propofol group was significantly reduced (P = 0.04).

Conclusion: There was no difference in time to spontaneous eye-opening, the incidence of POCD, postoperative delirium, postoperative nausea, and vomiting between the sevoflurane and propofol groups. However, compared with propofol, sevoflurane can significantly shorten intubation time. The incidence of postoperative agitation (P = 0.04) was significantly lower in the propofol group compared with sevoflurane.

Nonmelanoma skin cancer (NMSC), including basal cell carcinoma and squamous cell carcinoma, is the most prevalent type of skin cancer. While generally less aggressive than melanoma, early detection and treatment are crucial to prevent the complications. Artificial intelligence (AI) systems show promise in enhancing the accuracy, efficiency, and accessibility of NMSC diagnosis and management. These systems can facilitate early interventions, reduce unnecessary procedures, and promote collaboration among healthcare providers. Despite AI algorithms demonstrating moderate-to-high performance in diagnosing NMSC, several challenges remain. Ensuring the robustness, explainability, and generalizability of these models is vital. Collaborative efforts focusing on data diversity, image quality standards, and ethical considerations are necessary to address these issues. Building patient trust is also essential for the successful implementation of AI in the clinical settings. AI algorithms may outperform experts in controlled environments but can fall short in the real-world clinical applications, indicating a need for more prospective studies to evaluate their effectiveness in the practical scenarios. Continued research and development are essential to fully realize AI's potential in improving NMSC diagnosis and management by overcoming the existing challenges and conducting comprehensive studies.

Background: The objective of this study was to systematically review the use of diffusion tensor imaging (DTI) biomarkers in the early detection of radiation-induced white matter (WM) changes.

Materials and methods: The PubMed and Scopus databases were searched for peer-reviewed articles published in English up to November 28, 2022, according to the PRISMA guidelines to identify studies that related to changes in DTI parameters after radiotherapy.

Results: After reviewing the literature, eight studies met the inclusion criteria. The results indicated that changes in the late delay phase were completely related to changes in the acute phase. There was a difference in the sensitivity of the biomarkers between studies. Still, there was substantial evidence for the early detection of changes by axial diffusivity (AD), radial diffusivity (RD), and fractional anisotropy (FA). However, further research is still necessary on the potential of mean diffusivity (MD) sensitivity for detecting early changes. The majority of the included studies demonstrated progressive changes in DTI parameters over time and with dose.

Conclusion: There is significant potential for DTI biomarkers to predict WM changes caused by radiation after brain radiation therapy by having significant predictive power.