Caspian Journal of Internal Medicine最新文献

Background: With the improvement of cancer treatment methods and increased life expectancy of patients, the prevalence of second primary cancers has gradually increased.

Case presentation: In the present study, the case was a 58-year-old man diagnosed with rectal adenocarcinoma and underwent chemotherapy and neoadjuvant radiotherapy 10 years ago. After 5 years, he underwent a lobectomy due to lung metastasis. At the research time, he presented with itching; in ERCP, a 16-millimeter hypoechoic lesion was detected, and an FNA biopsy was performed, indicating malignancy. The patient underwent Whipple surgery, and pathology revealed a well-differentiated neuroendocrine tumor. He was discharged in good general condition.

Conclusion: This article emphasized the necessity of early detection and diagnosis of second primary cancer, as well as acting as if it was primary cancer to treat.

Background: The prevalence and mortality of CVD in women increase over time. We conducted this research to evaluate the severity of coronary artery disease with the number of live births and breastfeeding duration.

Methods: Patients aged 30-50 years old with positive exercise tests or evidence of cardiac ischemia who were candidates for coronary angiography were included. All the participants had at least one child. Syntax score was used to evaluate the severity of coronary arteries.

Results: Mean number of children was 3.72±1.85, in those patients with <2 live births no one had a syntax score≥1, but in the>5 live births group most patients had a syntax score≥1. In patients with zero syntax score, it was estimated as 4.91±39.7; in patients with 1≤ syntax score, it was 4.48±7.29 (P =0.76). Among patients with > 5 birth lives, those with higher syntax scores had older ages (P=0.497). After adjusting age, the association between live births and syntax score became non-significant (P=0.850).

Conclusion: By increasing the number of live births >5, the severity of coronary artery disease, increases. However, this association was not significant after adjusting the age of patients.

Background: The unique role of eosinophil in coronavirus disease 2019 (COVID-19) patients has been shown in several studies, but its role in end-stage kidney disease (ESKD) patients who contracted COVID-19 is less reported. This study investigated eosinopenia's predictive value as a mortality marker in ESKD patients with COVID-19.

Methods: It is a retrospective study of ESKD patients who contracted COVID-19 between May 2020 and October 2021 in West Nusa Tenggara General Hospital, Indonesia. Comparative analysis was carried out between the death dan survival group. Logistic regression analysis was done to investigate the role of eosinopenia on the outcome after controlling other significant variables.

Results: The analyses included one hundred fifteen confirmed COVID-19 in ESKD patients. The average age was 50, 53% of patients were males, 41% were newly diagnosed with ESKD, and the mortality rate was 25.2%. This study's prevalence of eosinopenia, high neutrophil-to-lymphocyte ratio (NLR), and high C-reactive protein (CRP) in the nonsurvivors was 51.4%, 39.3%, and 30.8%, respectively. Diastolic blood pressure <90 mmHg (P=0.004), respiratory rate >22 x/minutes (P=0.011), oxygen saturation <93% (P=0.008), NLR >6 (p<0.001), eosinophil count <0.01 x10³/uL (p<0.001), CRP >20 mg/L (P=0.047), and isolation hemodialysis (HD) therapy (p<0.001) were independently associated with mortality of COVID-19 in ESKD patients. However, on multivariate logistic regression analysis, eosinopenia (P=0.019) and HD (P=0.001) were risk factors that remained significant prognostic mortality factors.

Conclusion: Eosinopenia was common in ESKD patients with COVID-19, particularly in the death group. Eosinopenia at admission and HD during hospitalization were risk factors for COVID-19 mortality in ESKD patients.

Background: Despite the numerous articles discussing the relationship between diabetes mellitus type 2 (DMT2) and chronic Helicobacter pylori (H. pylori) infection the results have been inconsistent, necessitating further research. This study investigated the coexistence of Helicobacter pylori infection and DMT2.

Methods: We conducted a study in selected laboratories in Tehran, measuring the H.Pylori stool antigen (HpSA) in individuals referred by physicians for a glycosylated hemoglobin A1c (HbA1c) test.

Results: Out of the 2500 patients who were referred to randomly selected laboratories, a total of 2025 (81%) patients had serum HbA1c levels above 6.5%. of 2025 patients with HbA1c levels above 6.5%, 1321 (52.84%) had HpSA in their stool. No significant gender difference was observed, with a mean age ± SD, 48.65 ± 7.55. HpSA was positive in 52.84% of the DM group, while in the non-DM group, HpSA was positive in 37.36% of cases. Fecal antigen titers are not related to gender (P = 0.274) but are related to age (r = 0.213, P=0.034).

Conclusion: Long-term infection with Helicobacter pylori may be significantly associated with elevated HgA1c.Testing for H. pylori infection, regular monitoring of blood sugar and HbA1c levels in high-risk people can prevent DMT2.

Background: Because migraine is a common headache, finding ways to approach it better would be useful. So, studying the relation of dimensions of general health and personality types and pain severity in patients with migraine will be useful for fulfilling this aim.

Methods: In this cross-sectional study, the number of patients with migraine headache studied in this study was 170. The checklists used in this study were migraine disability assessment (MIDAS), visual analog scale (VAS), Neuroticism-Extraversion-Openness (NEO FFI), and General Health Questionnaire (GHQ-28).

Results: The average scores of general health dimensions in migraine sufferers with aura were higher than in migraine patients without aura. But this difference was significant only in the index of physical symptoms (P=0.02). There was a negative correlation between pain intensity and general health dimensions but it was not statistically significan. A positive correlation was observed between headache intensity and extroversion, which was significant (r=0.18 and P=0.01). The score of physical symptoms increases significantly with the increase of disability severity (P=0.007).

Conclusion: According to the results, the severity of migraine disability, general health dimensions, and personality types in patients with and without Aura was not different. Also, general health dimensions and personality types were not associated with pain intensity and the severity of migraine disability.

Background: Besides being commonly used to treat high blood pressure, beta blockers are a family of drugs that are primarily used to regulate irregular cardiac rhythms. Nebivolol is a third generation of beta blockers, which is highly cardioselective, about three times as selective as bisoprolol. In this study, we aimed to evaluate Nebivolol's effectiveness and safety in comparison to other beta blockers.

Methods: We searched the online databases PubMed, ScienceDirect, and Cochrane Library for relevant RCTs evaluating Nebivolol's effect on hypertension management. Relative risk (WRR) and weighted mean difference (WMD), with a 95% confidence interval (CI) were utilized to quantify the impact of nebivolol medication in the treatment of hypertension using a random effects model.

Results: Twelve RCTs are included in the study, the patient numbers in every attempt ranged from 42-273 and 1456 patients in all were included in this review. Nebivolol does not significantly reduce SBP, DBP and HR compared to other beta blockers (WMD -0.57 mmHg, 95% CI [-1.55; 0.42 mmHg] p=0.12; WMD -0.27 mmHg, 95% CI [-1.36; 0.82 mmHg] p=0.63 ; WMD 0.10 BPM, 95% CI [-4.11;1.31 BPM] p=0.96, respectively). Patients treated with Nebivolol has significantly lower LDL-C (WMD -8.88 mg/dL, 95% CI [-15.28; -2.48 mg/dL] p=0.007) and significantly higher HDL-C (WMD 2.30 mg/dL, 95% CI [0.75; 3.84 mg/dL] p=0.004.

Conclusions: According to this study's findings, nebivolol is well tolerated and decreases LDL-C. And higher HDL-C than other beta blocker agents. This review does not recommend nebivolol as first-line treatment in hypertension as Nebivolol does not significantly reduce blood pressure and HR of patients.

Background: The MUC1 gene encodes glycoproteins attached to cell membrane that play a protective role in gastric cancer and protect epithelial surfaces against external factors such as Helicobacter pylori. H. pylori infection can induce a cascade of innate and acquired immune responses in gastric mucosa. Relationship between rs4072037G>A polymorphism of MUC1 gene and increased susceptibility to H. pylori infection aimed to investigate in patients with gastric cancer in Mazandaran, northern Iran.

Methods: A case-control study was conducted on 99 patients with gastric cancer (H. pylori positive and negative) and 98 controls (H. pylori positive and negative) without gastric cancer (confirmed by pathological biopsy samples obtained during endoscopy). H. pylori infection was diagnosed by histological examination using Giemsa staining. Genomic DNA extracted from peripheral blood was analyzed by PCR-RFLP technique.

Results: Analysis of all genetic models showed no significant relationship between rs4072037G>A polymorphism and risk of gastric cancer (GC). The relationship between H. pylori infection and rs4072037G>A polymorphism showed an increased susceptibility to gastric cancer in both positive and negative H. pylori groups (including case and control groups). The genetic model of GA/GG and H. pylori- positive versus GA/GG and H. pylori-negative showed a significantly increased susceptibility to gastric cancer (OR=0.251, CI: 0.128-0.493, P=0.000).

Conclusion: These findings indicate that rs4072037G>A polymorphism may interact with H. pylori infection to increase the risk of GC.

Background: Diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE) is challenging due to nonspecific biomarkers. High serum levels of neurofilament protein light subunit (NFL), high mobility group box 1 (HMGB1), Matrix metalloproteinase-9 (MMP-9) and have been reported in several autoimmune diseases. The aim of this study was to examine whether their plasma levels could serve as a diagnostic or prognostic biomarker for NPSLE.

Methods: There were 90 SLE patients enrolled in this cross-sectional study (87.8% women and 12.2% men with a mean age of 41.67±11.05 years). We assessed the mental status of patients, also we measured the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and Systemic Lupus International Collaborating Clinics/ACR (SLICC/ ACR) Damage Index or SDI scores. Serum levels of NFL, HMGB1, MMP9, and ds-DNA were investigated to find a role in the pathophysiology of NPSLE.

Results: Among the 90 patients with SLE, 63 (70%) met the criteria of NPSLE syndrome. Our results have shown a notable difference concerning SEDIAC-2k score, SDI score, PANS, MoCA, and Beck anxiety depression, between the two groups (p < 0.05). Although serum level of all measured serum biomarkers (NFL, MMP-9, HMGB1, dsDNA) were higher in patients with NPSLE, the difference was not statistically significant. Interestingly, our results showed that the serum level of NFL was correlated with the serum level of HMGB-1 and MMP-9. (r: 0.411, P=0.003).

Conclusion: Serum level of NFL, HMGB-1 and MMP-9 may be used to detect abnormal mental status in patients with SLE.

Background: This study aimed to investigate the integration of the health belief model (HBM) and the theory of intention to plan preventive behavior for COVID-19 during the pandemic.

Methods: In a cross-sectional study, a sample of 480 adult participants from different outpatient clinics were recruited in the study. The participant responded by self-report; the health belief model (HBM) scale, preventive behavior scale, subjective norms scale, the intention of planned behavior scale, and perceived control behavior scale were measured. The hypothesized causal path models were examined using SEM analysis.

Results: The HBM had significant effects on perceived behavior control (β=0.60, P=0.001), the intended preventive behavior (β=0.32, P=0.001), and subjective norm (β=0.53, P=0.001). Subsequently, the intention of preventive behavior (β==0.39, P=0.001) and subjective norms (β=0.27, P=0.001) significantly affected the performance of preventive behaviors. The estimated fitting criteria showed that the hypothesized model fits relatively well.

Conclusion: The health belief model with the integration of subjective norms, perceived control behavior and mediation by the intention of planned behavior in a pathway relationship explains well the preventive behavior of COVID-19. The findings present a deeper understanding of how integrating HBM and intended planned behavior enhances people's preventive behavior against COVID-19.