Polymorphic CA repeat length in insulin-like growth factor 1 and risk of breast cancer in Iranian women

To evaluate the association between breast cancer and cytosine–adenine (CA) dinucleotide repeat length polymorphisms in the promoter region of the Insulin-like Growth Factor 1 (IGF-1) gene, a case–control study of 215 breast cancer patients and 224 controls was conducted in Iranian women. The most common allele and genotype in both controls and patients were an allele length of 19 and a homozygous genotype of (CA)₁₉/(CA)₁₉. Women with two alleles longer than 19 were found to be at a higher risk of breast cancer with an odds ratio of 4.1 (P = 0.0002). In contrast, women with two alleles shorter than 20 were at lower risk of breast cancer. These results suggest a novel association between CA repeat length in IGF-1 and risk of breast cancer.     

Non-alcoholic steatohepatitis and influence of age and gender on histopathologic findings

AIM:To characterize the histopathologic specifications of non-alcoholic steatohepatitis(NASH)according to age and gender.METHODS:An analytical cross-sectional study was conducted in two private gastroenterology clinics on biopsy proven patients suffering from NASH.Biopsy histopathologic findings as well as demographic and laboratory data of the patients at the time of biopsy were gathered retrospectively from clinical records.The grading and staging of histopathologic findings were performed according to th...     

A randomized, double-blind, placebo-controlled trial of concomitant pilocarpine with head and neck irradiation for prevention of radiation-induced xerostomia.

BACKGROUND: Xerostomia is one of the disturbing side-effects of radiotherapy to the head and neck region. Pilocarpine has been approved for the treatment of this condition in the chronic phase, but its use concurrent with radiation could also be beneficial for prevention or reduction of the subsequent radiation-induced xerostomia. We undertook to test this hypothesis in a clinical trial. METHODS: At the start of radiotherapy, randomization was performed to either pilocarpine 5 mg three times daily or placebo in a double-blind setting. The drug was started with irradiation and continued until 3 months after the end of radiotherapy. Xerostomia was evaluated 6 months after the end of radiation by a subjective visual analog scale questionnaire. Also the objective grade of xerostomia was recorded by two separate observers. RESULTS: A total number of 60 patients were randomized into the trial, but unfortunately only 39 patients were finally evaluated for xerostomia, 18 in the pilocarpine and 21 in the placebo group. Mean age was 42 years, and mean parotid dose was 58 Gy. Mean subjective xerostomia was 40.3 mm in the pilocarpine group and 57 mm in the placebo group (P = 0.02). Also mean objective xerostomia grade was 2.2 in the pilocarpine group and 2.6 in the placebo group (P = 0.01). Subjective and objective xerostomia results were positively correlated (P = 0.01). Age and the parotid dose did not have a significant effect on xerostomia. CONCLUSIONS: Compared to placebo, pilocarpine used with radiotherapy could lead to a significant diminishment of subsequent radiation-induced xerostomia.     

Semaphorin 3A在局灶性脑缺血大鼠脑组织中的表达特征及通络救脑注射液的保护作用

目的:观察局灶性脑缺血损伤后大鼠脑组织中Semaphorin 3A(Sema 3A)蛋白表达水平,以及通络救脑注射液对该因子表达的影响.方法:以线拴法制作大鼠大脑中动脉缺血模型(MCAO),设正常组、模型组及通络救脑注射液组,分别在造模后12h、24h、3d、7d,共4个时间点采取动物脑组织,测定脑梗死体积及脑组织中GAP43的表达水平,及Sema 3A的表达部位和蛋白表达水平.结果:通络救脑注射液能够减少脑缺血动物脑梗死体积,与模型组相比均有显著差异.结论:大鼠脑缺血损伤后Sema 3A表达增加与神经元的坏死有相关性,通络救脑注射液能够降低其表达水平,对缺血损伤的脑组织发挥保护作用.     

Computerized tomographic simulation compared with clinical mark-up in palliative radiotherapy: a prospective study

PURPOSE: To evaluate the impact of computed tomographic (CT) planning in comparison to clinical mark-up (CM) for palliative radiation of chest wall metastases. METHODS AND MATERIALS: In patients treated with CM for chest wall bone metastases (without conventional simulation/fluoroscopy), two consecutive planning CT scans were acquired with and without an external marker to delineate the CM treatment field. The two sets of scans were fused for evaluation of clinical tumor volume (CTV) coverage by the CM technique. Under-coverage was defined as the proportion of CTV not covered by the CM 80% isodose. RESULTS: Twenty-one treatments (ribs 17, sternum 2, and scapula 2) formed the basis of our study. Due to technical reasons, comparable data between CM and CT plans were available for 19 treatments only. CM resulted in a mean CTV under-coverage of 36%. Eleven sites (58%) had an under-coverage of >20%. Mean volume of normal tissues receiving >/=80% of the dose was 5.4% in CM and 9.3% in CT plans (p = 0.017). Based on dose-volume histogram comparisons, CT planning resulted in a change of treatment technique from direct apposition to a tangential pair in 7 of 19 cases. CONCLUSIONS: CT planning demonstrated a 36% under-coverage of CTV with CM of ribs and chest wall metastases.     

Impact of preload changes on positive and negative left ventricular dP/dt and systolic time intervals: preload changes on left ventricular function

AIM/OBJECTIVES: Previous work has shown that the electromechanical activation time (EMAT) is prolonged in patients with abnormally low left ventricular (LV) dP/dt. In the present study, we investigated whether EMAT was responsive to rapid changes in LV systolic function induced by abrupt increases in LV preload. METHODS AND RESULTS: A total of 116 patients were assessed before and after LV angiography with a bolus injection of 40 mL of non-ionic contrast dye. Left ventricular end-diastolic pressure (LVEDP) increased from 18 ± 7 mmHg to 20 ± 8 mmHg (P < 0.01). In patients with a baseline dP/dt < 1500 mmHg/sec, dP/dt increased from 1098 ± 213 mmHg/sec to 1146 ±306 mmHg/sec (P=0.02) and EMAT decreased from 106 ± 29 ms to 103 ±18 ms (P=0.02). In patients with a baseline dP/dt > 1500 mmHg/sec, dP/dt decreased from 1894 ± 368 mmHg/sec to 1762 ± 403 mmHg/sec (P=0.01) and EMAT increased from 88 ± 13 ms to 93 ± 16 ms (P=0.02). Changes in negative dP/dt were similar to changes in dP/dt. CONCLUSION: Electromechanical activation time is a non-invasively measured parameter that allows accurate and rapid detection of changes in LV contractility.     

Incidence,Risk Factors for and Outcomes of Transplant-Associated Thrombotic Microangiopathy

Transplant-associated thrombotic microangiopathy (TA-TMA) is a complication of allogeneic transplantation (allo-HCT). The incidence and risk factors associated with TA-TMA are not well known. A retrospective analysis from the Center for International Blood and Marrow Transplant Research (CIBMTR) was conducted including patients receiving allo-HCT between 2008 and 2016, with the primary objective of evaluating the incidence of TA-TMA. Secondary objectives included identification of risk factors associated with TA-TMA, and the impact of TA-TMA on overall survival and the need for renal replacement therapy (RRT). Among 23,665 allo-HCT recipients, the 3-year cumulative incidence of TA-TMA was 3%. Variables independently-associated with increased incidence of TA-TMA included female sex, prior autologous transplant, primary disease (acute lymphoblastic leukaemia and severe aplastic anaemia), donor type (mismatched or unrelated donor), conditioning intensity (myeloablative), GVHD prophylaxis (sirolimus + calcineurin inhibitor), pre-transplant kidney dysfunction and acute GVHD (time-varying effect). TA-TMA was associated with higher mortality (HR = 3·1, 95% Confidence Interval [CI] = 2·8–16·3) and RRT requirement (HR = 7·1, 95% CI = 5·7–311·6). This study provides epidemiologic data on TA-TMA and its impact on transplant outcomes. Increased awareness of the risk factors will enable providers to be vigilant of this uncommon but serious transplant complication. The results will also provide benchmarking for future study designs and comparisons.