Hadamard multiplexed fluorescence tomography

Depth-resolved three-dimensional (3D) reconstruction of fluorophore-tagged inclusions in fluorescence tomography (FT) poses a highly ill-conditioned problem as depth information must be extracted from boundary data. Due to the ill-posed nature of the FT inverse problem, noise and errors in the data can severely impair the accuracy of the 3D reconstructions. The signal-to-noise ratio (SNR) of the FT data strongly affects the quality of the reconstructions. Additionally, in FT scenarios where the fluorescent signal is weak, data acquisition requires lengthy integration times that result in excessive FT scan periods. Enhancing the SNR of FT data contributes to the robustness of the 3D reconstructions as well as the speed of FT scans. A major deciding factor in the SNR of the FT data is the power of the radiation illuminating the subject to excite the administered fluorescent reagents. In existing single-point illumination FT systems, the source power level is limited by the skin maximum radiation exposure levels. In this paper, we introduce and study the performance of a multiplexed fluorescence tomography system with orders-of-magnitude enhanced data SNR over existing systems. The proposed system allows for multi-point illumination of the subject without jeopardizing the information content of the FT measurements and results in highly robust reconstructions of fluorescent inclusions from noisy FT data. Improvements offered by the proposed system are validated by numerical and experimental studies.OCIS codes: (170.3880) Medical and biological imaging, (170.0110) Imaging systems, (170.6960) Tomography, (110.6955) Tomographic imaging     

Maternal and neonatal complications of substance abuse in Iranian pregnant women

There is an increased prevalence of maternal substance abuse during pregnancy in younger women in all socioeconomic classes and races. Our aim was to determine the prevalence and correlates of self-reported substance abuse among pregnant women and obstetric complications or neonatal outcomes in Iran. This retrospective cohort study is covering a five year period on medical records of pregnant women attending the maternity unit of four major hospitals (Mahdieh, Taleghani, Imam Hossein and Akbarabadi Hospitals). Women who reported using opium, heroin, crack, cannabis or methamphetamine were compared with women with no reported history of drug abuse for obstetric complications and prenatal morbidity and neonatal mortality. From 100,620 deliveries substance abuse was recorded for 519 women giving a prevalence of 0.5%. Opium was the most prevalent substance abused followed by crack (a mix of heroin and amphetamines). The exposed group had significantly more obstetric complications including preterm low birth weight and postpartum hemorrhage than the non-exposed group. The exposed group had significantly worse prenatal outcomes including more admissions to intensive care unit and higher infant mortality than the non-exposed group. None of the women in the exposed group was on methadone treatment at time of delivery. Risks of maternal and neonatal complications were increased in substance using pregnant women, especially preterm birth and low birth weight. We recommend a multidisciplinary team to provide methadone maintenance therapy for substance using pregnant women and urinary screen of all pregnant women presenting to hospital.     

The effect of combined exercise therapy on knee proprioception,pain intensity and quality of life in patients with hypermobility syndrome: A randomized clinical trial

Objective

Proprioception, the perception of limb movements and spatial orientation derived from body stimuli, plays a critical role in maintaining joint stability. This study aimed to investigate the effect of combined exercise therapy (closed kinetic chain exercises and proprioception exercises) on knee proprioception, pain intensity and quality of life in patients with hypermobility syndrome.

Ulcerated disseminated cutaneous leishmaniasis associated with vitiligo, hypothyroidism, and diabetes mellitus in a patient with Down syndrome

We report a 35-year-old man who was referred to our dermatology department with multiple, nodular, ulcerated, and crusted lesions disseminated on the face, trunk, and extremities. He has a known diagnosis of Down syndrome. The past medical history also included vitiligo (for 20 years), hypothyroidism (for 2 years), and type-II diabetes mellitus (for 3 months). Direct smear of an ulcer was positive for leishmania. Skin biopsy confirmed the diagnosis. A leishmanin skin test was negative. Polymerase chain reaction (PCR) from two separate skin biopsies demonstrated the presence of Leishmania major. To our knowledge, this is the first report of disseminated cutaneous leishmaniasis (DCL) caused by L. major in Iran, and also the first report of association between DCL with Down syndrome, vitiligo, hypothyroidism, and diabetes mellitus.     

Alteration in CD8+ T cell subsets in enterovirus-infected patients: An alarming factor for type 1 diabetes mellitus

Type 1 diabetes is a multi-factorial disease that can develop due to the combination of genetic and environmental factors. Viruses, particularly enteroviruses, are major environmental candidates in the pathogenesis of type 1 diabetes, even though the mechanisms of pathogenicity of these viruses and their effects on the immune system have not been understood very well yet. Previous studies show that any imbalance in the population of different lymphocyte subsets could develop autoimmune diseases. Our theory is that enteroviral infection causes an impairment in the distribution of lymphocyte subtypes and consequently results in the diabetes onset in some individuals. Therefore, in this project, we evaluated the distribution of T CD8+ lymphocytes and their subsets in type 1 diabetes patients. This study was conducted to investigate the relationship between enteroviral infection and type 1 diabetes mellitus in an Iranian population, and suggestion a predicting approach for susceptible subjects.     

Presentation and treatment of aggressive,Triple‐Negative carcinosarcoma of the breast

An extremely rare form of breast cancer, breast carcinosarcoma accounts for less than a percent of all breast malignancies and is highly aggressive. Composed of both cancerous epithelial and mesenchymal cell types, breast carcinosarcoma is associated with a poor prognosis compared to more common breast cancers, and typically lack the receptors typical of other breast carcinomas, which minimize potential targets for treatment. In this case report, we discuss a 56‐year‐old patient affected by carcinosarcoma of the breast at a T2N1 stage, and the decision‐making process that factored into her treatment plan.