Sex and smoking differences in the association between gastroesophageal reflux and risk of esophageal squamous cell carcinoma in a high-incidence area: Golestan Cohort Study

Prior studies have conflicting findings regarding the association between gastroesophageal reflux disease (GERD) and esophageal squamous cell carcinoma (ESCC). We examined this relationship in a prospective cohort in a region of high ESCC incidence. Baseline exposure data were collected from 50 045 individuals using in-person interviews at the time of cohort entry. Participants were followed until they developed cancer, died, or were lost to follow up. Participants with GERD symptoms were categorized into any GERD (heartburn or regurgitation), mixed symptoms, or heartburn alone. Multivariable Cox regression was used to assess the relationship between GERD symptom group and histologically confirmed ESCC. The model was adjusted for known risk factors for GERD and ESCC. 49 559 individuals were included in this study, of which 9005 had GERD symptoms. Over 13.0 years of median follow up, 290 individuals were diagnosed with ESCC. We found no association between any GERD and risk of ESCC (aHR 0.90, 95% CI: 0.66-1.24, P = .54). Similar findings were observed for the GERD symptom subtypes. Significant interactions between any GERD and sex (P = .013) as well as tobacco smoking (P = .028) were observed. In post-hoc analyses, GERD was associated with a decreased risk of ESCC in men (aHR 0.51, 95% CI: 0.27-0.98 P = .04) and in smokers (aHR 0.26, 95% CI: 0.08-0.83 P = .02). While there was little evidence for an overall association between GERD symptoms and ESCC risk, significant interactions with sex and smoking were observed. Men and smokers with GERD symptoms had a lower risk of ESCC development.     

Sexual compatibility among Iranian couples: a qualitative study

Sexual compatibility increases the stability of marriage and partners’ relationships and decreases sexually transmitted diseases. This qualitative study using a content analysis approach was conducted with 36 married men and women. Interviews were conducted for data collection. As the main theme of this study, “couple's sexual companionship” emerged as the main theme of sexual compatibility, that means couples’ participation for fulfilling each other sexual needs and solving problems arising from sexual discrepancies based on sexual understandings, sexual agreements and interests for continuing the sexual relationship with the aim of mutual sexual satisfaction. Sexual compatibility did not necessarily mean similarities, as during the marital life sexual discrepancies were inevitable. However, compatible couples encountered such a situation based on understandings, agreement and love. Active participation in sexual relationships, forgiveness and consideration, no huffing, mutual respect, flexibility and an occasional use of non-penetrative sexual relationships, sexual conversation with spouses, patience and development of the sexual relationship were the prominent feature of sexually compatible couples.     

Cognitive rehabilitation for individuals with opioid use disorder: A randomized controlled trial*

Aim: To examine the efficacy of cognitive rehabilitation treatment (CRT) for people with opioid use disorder who were recruited into a methadone maintenance treatment (MMT) programme.

Method: 120 male subjects were randomly assigned to (1) MMT plus CRT in two months or (2) MMT plus a control intervention. Subjects were assessed at the beginning, mid-point and post-intervention as well as at 1-, 3- and 6-month follow-up time points.

Results: Analysis with repeated measure ANOVA showed that the CRT group performed significantly better in tests of learning, switching, processing speed, working memory and memory span. Moreover, the CRT group had significantly lower opiate use over the control group during 3-months follow-up. Analysis including only those with a history of methamphetamine use showed that the CRT group had significantly lower amphetamine use. No group differences were observed for treatment retention.

Conclusions: Our findings provide evidence that adding CRT as an adjunct intervention to MMT can improve cognitive performance as well as abstinence from both opiates and stimulants.     

Effects of Pistacia atlantica on Oxidative Stress Markers and Antioxidant Enzymes Expression in Diabetic Rats

Introduction: Diabetes mellitus (DM) affects many patients all over the world. It involves different parts of the body, such as brain, eyes, kidneys, vessels, and so on. The lack of balance between free radicals and antioxidants is a possible mechanism involved in the pathogenesis of diabetes. Antioxidant treatment, especially natural forms, can be a beneficial solution. Therefore, we evaluated the effects of Pistacia atlantica oleoresin (PAO) on oxidative stress markers and antioxidant enzymes expression in diabetic rats.

Method: Fifty adult male Wistar rats were allotted randomly into five groups as follow: control group, diabetic control group, glibenclamide control group, diabetic glibenclamide group, diabetic treated group with 200?mg/kg PAO. Then PAO was prepared and analyzed by gas chromatography/mass spectroscopy (GC/MS). LD50 was also estimated for essential oil. Oxidative stress markers and antioxidant enzyme including malondialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD) were also measured. The expression of GPx, CAT, and SOD genes was investigated using real-time polymerase chain reaction (PCR).

Results: The main constituents of essential oil gum were beta-pinene (29.38%), followed by alpha-pinene (18.15%), myrcene (7.36%), trans-pinocarveol (7.15%), and camphene (4.12%). Diabetes induced an increased level of MDA (69.92?±?3.92 vs. 43.76?±?3.73) and decreased levels of GSH (2.57?±?0.40 vs. 7.05?±?1.59), GPx (11.66?±?2.2 vs. 16.38?±?2.1), CAT (12.17?±?3.38 vs. 18.7?±?2.66), and SOD (0.78?±?0.67 vs. 2.41?±?0.46). In contrast, PAO treatment significantly decreased MDA (54.59?±?12.54 vs. 69.92?±?3.92) and increased GSH (4.5?±?0.89 vs. 2.57?±?0.40), GPx (25.86?±?5.37 vs. 11.66?±?2.2), CAT (22.69?±?0.36 vs. 12.17?±?3.38), and SOD (3.65?±?1.08 vs. 0.78?±?0.67) (p?<?0.05). Moreover, our results indicated that both GPx and CAT mRNA levels significantly increased approximately 4.46 and 6.23 times in rats fed with 200?mg/kg of PAO, more than that of the healthy control group, respectively (p?<?0.01 and p?<?0.001, respectively). Also, the average expression level of SOD was also significantly 1.57 higher in rats fed with 200?mg/kg of PAO in comparison to the diabetic control group (p?<?0.05).

Conclusion: The results indicated that PAO could be propose as an agent that protects the body against diseases that are associated with oxidative stress.     

Protective effects of silymarin on testis histopathology,oxidative stress indicators,antioxidant defence enzymes and serum testosterone in cadmium‐treated mice

Cadmium is known as an oxidative stress‐inducing factor. Silymarin extracted from Silybum marianum is regarded as a potent antioxidant. The present study investigated the preventing effects of silymarin on cadmium chloride‐induced toxicity in terms of testis histopathology and serum testosterone level as well as oxidative stress indicators in mice. In addition, the activities of antioxidant defence enzymes was evaluated. Adult male mice were divided into four groups (n = 6 in each group): (a) control; (b) cadmium chloride; (c) silymarin + cadmium chloride and (d) Silymarin. In this study, cadmium chloride significantly decreased the diameter and wall thickness of the seminiferous tubule, diameter of the spermatogonia nucleus and serum testosterone levels compared to the control group. Furthermore, in mice treated with this pollutant, a significant increase in malondialdehyde was observed while ferric reducing antioxidant power level, and the activity of catalase, superoxide dismutase and glutathione peroxidase were significantly reduced in the testis. In the silymarin + cadmium chloride group, silymarin could significantly reverse the toxic effects of cadmium chloride. The findings of this study showed that silymarin, as a potent antioxidant, can compensate the adverse effects of cadmium chloride on testis histopathology, testosterone level, oxidative stress indicators and antioxidant defence enzymes in mice.     

Social Workers in Pediatric Oncology: A Qualitative Study in Iranian Context

Background: As professionals, social workers have a special position in relation to considering the needs ofchildren with cancer and their families. Hence, it is important to recognize the experiences and challenges of socialworkers to improve care of their clients. Method: This study was a qualitative content analysis that aimed to determinea comprehensive understanding of pediatric oncology social workers’ experiences in Iran. In total, 19 social workersparticipated in the study. A purposeful sampling method was applied until reaching data saturation. Data were collectedusing semi-structured interviews and field observations. Then, the gathered data were analyzed through face contentanalysis. The study lasted from 2015 to 2017. Finding: Concepts extracted from social workers’ experiences consistedof the nature of oncology work, lack of professional competence, low organizational support and professional inferioritythat were related to main concept of “exhausting and stressful service”. The results indicated that social workers’involvement in stressful and emotionally demanding situations and facing with professional and organizationalchallenges caused personal exhaustion. Conclusion: In addition to explaining the social workers’ experiences andrelated factors, the results emphasize the importance of taking care of service providers to prevent them becomingstressed and exhausted. It is also important to protect patients from the consequences of stressed and exhausted careproviders so further research is recommended to develop specific intervention.     

GLI inhibitors overcome Erlotinib resistance in human pancreatic cancer cells by modulating E-cadherin

Inhibition of hedgehog (Hh) signalling pathway, including its end effector GLI1, can reverse epithelial-to-mesenchymal transition (EMT) which plays an important role in drug resistance of pancreatic cancer cells to Erlotinib (ETB). This study investigated the effect of GLI inhibitors Forskolin (FSK), GANT-61 (GNT), and Arsenic trioxide (ATX) on suppressing the resistance of pancreatic cancer cells to ETB. The effect of GLI inhibitors was evaluated by measuring mRNA expression levels of EMT factors using quantitative RT-PCR. Immunocytochemistry and flow cytometry were used to assess E-cadherin (E-Cad) and GLI1 protein levels. MTT and apoptosis assays were used to evaluate the synergistic effects for the combination treatment of each GLI inhibitor with ETB. Pancreatic cancer cells PANC-1 treated by GNT showed the highest significant reduction in mRNA levels of GLI1 and other EMT pathway genes. Moreover, GNT was able to upregulate E-Cad and downregulate GLI1 proteins, more than FSK, while ATX had no effect. Apoptosis levels of PANC-1 cells following treatment with LD30 concentrations of FSK, GNT, or ATX, showed 57%, 62% and 67%, respectively, in comparison to ETB (～48%). Importantly, combination treatments of ETB with either FSK, GNT, or ATX demonstrated a significant increase in apoptotic cells reaching 61% (ETB?+?FSK), 80% (ETB?+?GNT) or 88% (ETB?+?ATX). FSK did not have much effect on the drug resistance of PANC-1 cells to ETB. However, GNT, but more effectively ATX, were able to reduce the drug resistance of this cell line to ETB.