Factors influencing the time of sentinel node visualization in breast cancer patients using intradermal injection of the radiotracer

Background

The objective of our study was to determine the important factors that have influence on the time of sentinel node visualization using intradermal injection of ^99mTc-antimony sulfide colloid.

Methods

Two hundred fifty consecutive patients with the diagnosis of early-stage breast cancer were evaluated. Anterior and lateral views were acquired in various intervals after intradermal injection of the tracer until 180 minutes or visualization of the sentinel node. The effect of several variables on the time of sentinel node visualization was evaluated by univariate and multivariate analyses.

Results

The time of sentinel node visualization was significantly correlated with age, body mass index (BMI), and interval between biopsy and sentinel node mapping. Standardized beta values for these variables were .1, .3, -.55 respectively.

Conclusions

Older age and higher BMI can result in slow sentinel node visualization. Longer interval between biopsy and sentinel node mapping can be associated with rapid sentinel node detection.     

The effect of short message service (SMS) on knowledge and preventive behaviors of diabetic foot ulcer in patients with diabetes type 2

ObjectiveThe present study aimed at evaluating the effectiveness of an educational intervention via mobile cells on foot care knowledge and foot care practices in patients with type 2 diabetes.Material and methodsThis is an interventional quasi-experimental study carried out in 4 community health centers in Andimeshk City in Iran in 2017. Of 160 patients 80 cases were randomly assigned as intervention group and 80 patients as the control one. A three-section questionnaire completed by a face-to-face interviewing used for data collection before and after the intervention and three months after the education. Fasting Blood Sugar (FBS) and Hemoglobin A1C (HbA1c) tests were done for both groups in a single laboratory before and three months after training.ResultsThe mean age of patients in intervention group was 48.11 ± 9.7 and control group was 47.3 ± 7.9 years. The awareness of the patients related to diabetes foot care, in the intervention group after the training significantly improved (P < 0.001). The mean scores of preventive behaviors of diabetic foot significantly increased in the intervention group (P < 0.001).ConclusionThe findings indicate that educational intervention based on short message service (SMS), resulting in improve foot care knowledge, foot care practices and metabolic control in patients with diabetes type 2.     

Health literacy among Iranian patients with type 2 diabetes: A systematic review and meta-analysis

Health literacy is one of the most important determinants of health. Limited health literacy can leads to reduced adherence to treatment, repeated hospitalizations, and increased diseases complications. Several studies on health literacy among Iranian patients with type 2 diabetes have reported different prevalences of health literacy. The present study is aimed to determine through a systematic review and meta-analysis the prevalence of adequate health literacy in the Iranian population. A total of 8 articles that met the inclusion criteria, published from inception until December 2018, were collected. Articles were searched using the following keywords and their possible combinations: Health Literacy, Illiteracy, Functional Health Literacy, Diabetes, Diabetes Mellitus, and Iran. The data were analyzed using meta-analysis and the random-effects model was used to obtain a pooled prevalence estimate along with its 95% confidence interval. Heterogeneity among the studies was assessed using the I² statistic. Analyses were performed using STATA software, version 12. The overall prevalences of inadequate and borderline health literacy among Iranian patients with type 2 diabetes were 43.47% (95% CI: 31–55.95) and 26.34% (95% CI: 19.49–33.19), respectively. In addition, the prevalence of adequate health literacy among patients with type 2 diabetes was 29.72% (95% CI: 22.79–36.64). There was no significant relationship between health literacy with year of publication, sample size, and patients’ age. Inadequate health literacy is high (43.5%) among Iranian patients with type 2 diabetes. This makes it necessary to provide interventions aimed at improving their heath literacy which will reduce hospitalizations and diseases complications.     

The association of LRP5 (rs556442) polymorphism with body composition and obesity in postmenopausal women

AimThe main of this study was to investigate the association between the rs566442 (V1119V) coding polymorphism of Low-density lipoprotein receptor-related protein 5 (LRP5) with obesity and basal metabolic rate in Iranian postmenopausal women.MethodsThis cross-sectional study was performed on 350 postmenopausal women with a mean age of 57.8 years (SD ± 6.14). Body composition was analyzed by bioelectrical impedance analysis (BIA) resistance. Obesity was defined based on Body mass index (BMI) ≥30 kg/m2. To determine the genotype of SNP (rs556442), PCR-RFLP assay was performed and confirmed by sequencing. DNA samples from participants were genotyped using the RFLP-PCR method.ResultsAmong the study population 37.1% (130) were obese. G allele had minor-allele frequency of 0.38% in our population. The frequency of genotypes in our study population was 12.9% (45 person) GG, 35.7% (125 person) AA and 51.4% (180) GA. After adjusting age and menopausal age, only basal metabolic rate showed significantly higher in GG group compare to other groups (p = 0.02). Our data showed basal metabolic rate was higher in obese women with GG genotype in comparison to obese women with AG and AA genotypes.DiscussionThe findings of this study suggest that the GG genotype of SNP (rs556442) could protective role in obese women through the association with BMR.     

Prevalence of metabolic syndrome among Iranian women with polycystic ovary syndrome: A systematic review and meta-analysis

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is associated with an increased the risk of metabolic syndrome (MetS) and hence increased cardiovascular diseases in women. This systematic review and meta-analysis aimed at examining the prevalence of MetS in Iranian women with PCOS. This was a systematic review and meta-analysis of English and Persian studies, using the following keywords: Polycystic Ovary Syndrome, Hyperandrogenism, Metabolic Syndrome,“MetSyn”, X Syndrome, and Iran in several national and international databases (Scientific Information Database (SID), Magiran, Web of Science, Google Scholar, PubMed, and Scopus from inception to February 2019. Heterogeneity among the studies was assessed using the Cochran's Q test. The random effects model was then used to estimate the overall prevalence of MetS. ALL the analyses were performed using STATA, version 12. Overall, 10 studies were included in the study. The overall prevalence of MetS among Iranian women with PCOS was 26.6% (95% CI: 16.60–31.70). In addition, the mean body mass index (BMI) was 27.47 (95% CI: 25.46–29.48) and the mean waist circumference was 87.94 (95% CI: 84.28–91.60). According the meta-regression results, there were no significant associations between the prevalence of MetS and sample size, year of publication, waist circumference, BMI, and age. One-fourth of Iranian women with PCOS have MetS. Given the overlap between anthropometric and metabolic abnormalities in PCOS and the features of MetS, accurate identification of patients with MetS is important to ensure early diagnosis and subsequent interventions to effectively manage the condition.     

Tioxolone niosomes exert antileishmanial effects on Leishmania tropica by promoting promastigote apoptosis and immunomodulation

Objective: To explore the antileishmanial effect of tioxolone and its niosomal form against Leishmania tropica. Methods: Tioxolone niosomes were prepared by the hydration method and were evaluated for morphology, size, release study, and encapsulation efficiency. The cytotoxicity of tioxolone and its niosomal form was measured by MTT assay, leishmanicidal activity against promastigote and amastigote by MTT assay, apoptosis by flow cytometry, IL-12, IL-10 and metacaspase gene expression levels by q-PCR. Results: Span/Tween 40 and Span/Tween 60 niosomes had good physical stability as depicted in their size distribution curves and high encapsulation efficiency(99%). The release profile of the entrapped compounds showed Fickian's model of tioxolone delivery based on diffusion through lipid bilayers. With the IC50 value for amastigote as(24.5±2.1) μg/mL and selectivity index as 10.5, the Span/Tween 60 niosome(NT2) had a superior effect to other drugs. The CC50 value and IC50 of promastigote value for NT2 were(257.5±24.5) μg/mL and(164.8±20.6) μg/mL, respectively. The flow cytometric analysis showed that tioxolone and niosomal forms induced apoptosis of Leishmania tropica promastigotes in a dose-dependent manner. NT2 increased the expression level of IL-12 and metacaspase genes and decreased the expression level of the IL-10 gene.Conclusions: Niosomes of tioxolone play an immunomodulatory role in increasing Th1 cytokine profile and inhibiting the Th2 cytokine profile. It could be used for treatment of anthroponotic cutaneous leishmaniasis.     

Resistance status of main malaria vector,Liston (Diptera:Culicidae) to insecticides in a malaria Endemic Area,Southern Iran

Objective: To evaluate the susceptibility of Anopheles stephensi(An. stephensi) Liston, the main malaria vector in southern Iran, to WHO recommended insecticides. Methods: Larvae of An. stephensi were collected from three different larval habitats in both urban and rural area of Bandar Abbas city and one rural area in Rudan county southern Iran. WHO standard method was used for evaluation of adult and larval mosquito susceptibility. Bendiocarb, permethrin, lambda-cyhalothrin, deltamethrin as insecticide and temephos and chlorpyriphos as larvicide were used at the diagnostic dosages recommended by WHO. Results: Findings of this study showed all larval populations of An. stephensi were completely susceptible to temephos and candidate for resistance to chlorpyriphos. Adult mosquitoes in rural areas of Bandar Abbas city were resistant to pyrethroid and carbamate insecticides. Conclusion: Comparison of the results of this survey with previous studies indicates that the resistance to pyrethroids and carbamates in this malaria endemic region is increasing. Wide use of pesticides in agriculture is certainly effective in increasing resistance. The inter-sectoral coordination and collaboration in health and agriculture seem to be necessary to manage insecticide resistance in malaria vectors.     

Protective effect of hawthorn extract against genotoxicity induced by methyl methanesulfonate in human lymphocytes

The preventive effect of hawthorn (Crataegus microphylla) fruit extract against genotoxicity induced by methyl methanesulfonate (MMS) has been investigated in human cultured blood lymphocytes. Peripheral blood samples were collected from human volunteers at 0 (10 minutes before), and at 1 and 2 hours after a single oral ingestion of 1 g hawthorn powder extract. At each time point, the whole blood was treated in vitro with MMS (200 μmol) at 24 hours after cell culture, and then the lymphocytes were cultured with mitogenic stimulation to determine the micronuclei in cytokinesis-blocked binucleated cells. The lymphocytes treated with hawthorn and MMS to exhibit a significant decreasing in the incidence of micronucleated binucleated cells, as compared with similarly MMS-treated lymphocytes from blood samples collected at 0 hour. The maximum protection and decreasing in frequency of micronuclei (36%) was observed at 1 hour after ingestion of hawthorn extract. The high performance liquid chromatography (HPLC) analysis showed that hawthorn contained chlorogenic acid, epicatechin and hyperoside. It is obvious that hawthorn, particularly flavonoids constituents with antioxidative activity, reduced the oxidative stress and genotoxicity induced by toxic compounds. This set of data may have an important application for the protection of human lymphocyte from the genetic damage and side effects induced by chemicals hazardous in people.