Resuming Breast Imaging Services in the Aftermath of the COVID-19 Pandemic: Safety and Beyond

As the Coronavirus disease 2019 (COVID-19) epidemic begins to stabilize, different medical imaging facilities not directly involved in the COVID-19 epidemic face the dilemma of how to return to regular operation. We hereby discuss various fields of concern in resuming breast imaging services. We examine the concerns for resuming functions of breast imaging services in 2 broad categories, including safety aspects of operating a breast clinic and addressing potential modifications needed in managing common clinical scenarios in the COVID-19 aftermath. Using a stepwise approach in harmony with the relative states of the epidemic, health care system capacity, and the current state of performing breast surgeries (and in compliance with the recommended surgical guidelines) can ensure avoiding pointless procedures and ensure a smooth transition to a fully operational breast imaging facility.     

RAR‐related orphan receptor A: One gene with multiple functions related to migraine

AimsRAR‐related orphan receptor (RORA) involves in regulation of several biological processes including inflammation and circadian rhythm that probably are involved in migraine pathophysiology. In the current study, the association between RORA rs11639084 and rs4774388 variants and susceptibility to migraine were investigated in a sample of Iranian migraine patients for the first time.MethodsIn a case‐control study including 400 participants, 200 migraineurs and 200 healthy controls, genotyping of RORA rs4774388 and rs11639084 polymorphisms was performed using tetra‐primer amplification refractory mutation system–polymerase chain reaction (TP‐ARMS‐PCR).ResultsThe distribution of rs4774388 C/T and T/T genotypes differed significantly between the studied groups. Moreover, an association was observed between rs4774388 and migraine under the recessive mode of inheritance (P = 0.002; OR = 1.89.; CI = 1.25‐2.87). The distribution of rs11639084 alleles and genotypes was not significantly different between migraineurs and healthy controls.ConclusionCurrent results suggest RORA, as a molecular link, may explain inflammation and circadian rhythm dysfunction in migraine. Further studies in different ethnicities are required to confirm the function of RORA in migraine development.     

Potential Cardioprotective Effects of Sumac Capsule in Patients With Hyperlipidemia: A Triple-Blind Randomized,Placebo-Controlled Crossover Trial

Objective: Alternative medicine and herbal drugs have been taken into account for managing cardiovascular risk factors. Sumac (Rhus coriaria L.) is rich in biologically active ingredients known to improve cardiovascular health. We investigated the effect of sumac on systolic (SBP) and diastolic (DBP) blood pressure, flow-mediated dilation (FMD), body mass index (BMI), and serum concentrations of lipids and fasting blood sugar (FBS) in participants with hyperlipidemia in a triple-blind randomized placebo- controlled crossover trial.

Methods: Thirty adults with dyslipidemia (mild to moderate elevation of plasma total cholesterol and/or triglycerides [TG; total cholesterol ≥ 6.0 mmol/L or TG ≥ 1.7 mmol/L and TG ≤ 5.0 mmol/L]) were assigned randomly to a sumac or a placebo group. Participants in the sumac group received sumac capsules (500 mg/twice daily) for the first 4 weeks, followed by 2 weeks’ washout period; the patients were then switched to a 4-week interval and received placebo for 4 weeks in the second period. The placebo group received these treatments in reverse order. FMD, BMI, SBP, DBP, lipids, and FBS were measured at baseline and after each period.

Results: Differences between placebo group and sumac group (placebo-sumac) were significantly decreased for BMI (0.21 ± 0.075 kg/m²), SBP (1.87 ± 0.83 mm Hg), DBP (1.32 ± 0.46 mm Hg), and total cholesterol (14.42 ± 4.95 mmol/L) and significantly increased for FMD (?0.23% ± 0.065%). Plasma level of TG did not change significantly across the treatment.

Conclusion: Sumac consumption may decrease cardiovascular risk factors in persons with mild to moderate hyperlipidemia.     

Structural characterization of polysaccharide‐coated iron oxide nanoparticles produced by Staphylococcus warneri,isolated from a thermal spring

The biocompatible‐coated iron oxide nanoparticles (IONs) have attracted a great interest because of their various applications in biological science and medicine. In most cases, the toxic effect of naked iron oxide nanoparticles is completely cleared by adding a biocompatible coating, such as polysaccharides, polyethylene glycol (PEG), or biosynthesis of biocompatible‐coated IONs using microorganisms such as bacteria. In the present study, polysaccharide‐coated iron oxide nanoparticles were produced by a strain of Staphylococcus warneri isolated from a thermal spring. For identification of the isolated bacterium, 16S rRNA gene sequencing was done. Characterization of the nanoparticles was performed for the first time, using transmission electron microscopy (TEM), dynamic light scattering (DLS), thermogravimetric analysis (TGA), X‐ray crystallography (XRD), Fourier‐transform infrared (FTIR) spectroscopy, vibrating sample magnetometer (VSM), and 3‐(4,5‐dimethylthiazol‐2‐yl)?2,5‐diphenyltetrazolium bromide (MTT) assay. Results indicated that the spherical iron oxide nanoparticles were coated by a polysaccharide (13.6%), which provided a large negative charge of ?91 mV and very low saturation magnetization of around 0.28 emu/g. The result of MTT assay on MOLT‐4 cell lines showed that the percentage of viability was between 95.6% and 68.9% in the 10–100 µM of nanoparticle concentrations with a high IC ₅₀ value, which makes it appropriate for biomedical applications such as cancer therapy.     

Effects of one-year storage in water on bond strength of self-etching adhesives to enamel and dentin

The aim of this study was to compare the bond strengths of three self-etching materials during one year of storage. Clearfil SE Bond (SE), Clearfil Protect Bond (PB), and Clearfil Tri-S Bond (TS) were used for bonding to dentin and enamel according to manufacturer's instructions. Microshear bond strength values were measured after 24 hours, six months, and one year. Two-way ANOVA showed that the interaction of material type and storage time was significant for dentin. At baseline, SE had the highest bond strength to dentin. There were no significant changes in bond strength for each material during the storage period, except for PB which showed increased bond strength to dentin after one year. All materials performed reliably after one year. However, the antibacterial and fluoride-releasing effects of PB would further contribute to the long-term clinical benefits of this material.     

Bilateral tibial lengthening over the nail: our experience of 143 cases

Introduction

Using lengthening over an intramedullary nail as a technique for cosmetic purposes improves the individuals’ quality of life and provides more satisfactory results due to less external fixator period.

Methods

This study reports a case series of 143 individuals who underwent bilateral tibial lengthening over an intramedullary nail for cosmetic purposes together with the review of parameters related to the surgery and complications. Level of satisfaction was measured with the standard visual analog scale at least 1 year after removal of external fixator.

Results

In this study, mean (SD) age of patients was 26.6 (7.26) years. 85 (59.4 %) participants were male and 58 (40.6 %) were female. Mean end lengthening of all individuals was 6.65 cm. The mean external fixator period was 93.7 days. Complication rate was 0.74 per segment but it decreased to 0.45 when pin-tract infection was excluded. Complications were categorized based on Paley et al.’s classification as 129 problems, 85 obstacles and no sequelae. Interestingly, 44 (30.8 %) individuals had no problem and obstacle.

Conclusions

Lengthening over an intramedullary nail provides bone formation in equal quality to that obtained by the conventional Ilizarov method, along with lower rate of complications. The large number of individuals involved in our study is a remarkable benefit which could be used as an appropriate sample to compare results for outcomes and complications.     

Magnesium Sulfate Mediates Morphine Administration Reduction in Varicocelectomy Surgery

Aims: Varicocelectomy is the most common operation carried out by doctors for male infertility treatment. The aim of varicocele treatment is to hinder the refluxing venous drainage to the testis, retaining arterial inflow, and lymphatic drainage. A lot of pain is generated after this surgery, and the use of opium should be reduced to nearest minimum, as all drugs are toxins. Thus the aim of the present study is to facilitate morphine usage reduction after varicocelectomy surgery. Material and Methods: One-hundred (100) patients who were varicocelectomy candidate were randomized into two groups: experimental group contain 50 patients and control group contain 50 patients as well. In experimental group, 2 mL magnesium sulfate in 2 mL normal saline was injected into patient immediately after surgery. The control group received only 4 mL normal saline. Morphine dosage administered, and severity of pain monitoring was accessed and recorded with a visual analogue scale (VAS). Result: Result indicated that administration of morphine dosage in the test group 0.21 ± 0.64 mg was significantly lower as compared to the control group 0.75 ± 1.30 mg during the first 24-hour after surgery (p = 0.01). Average VAS scores in the experimental and control groups in the first 4-hour interval were 0.91 ± 1.30 and 2.9 ± 2.50 (p = 0.02) respectively. We observed a significant difference in the VAS score for pain severity and the dosages of morphine administered. Conclusions: The experimental group with magnesium sulfate in its drug formulation showed better pain control compared to the control group which received only normal saline, whose pain manifested after every few hours. This can be used for the formulation of opium for this surgery in a large scale.