Imaging techniques for ocular neoplasia

Background: Novel ocular imaging modalities have greatly impacted the diagnosis and management of different types of ocular neoplasia. In this narrative review, we summarize the practical features of popular and novel imaging modalities for ocular tumors. Methods: Four databases, including PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar, were searched from January 1, 2000 to August 31, 2022. Articles reporting different imaging modalities for diagnosing or monitoring treatment responses of ocular tumors were extracted using various combinations of the following keywords: ocular neoplasia, positron emission tomography or PET, single-photon emission computed tomography or SPECT, optical coherence tomography or OCT, OCT angiography or OCTA, computed tomography or CT, ultrasonography or US, ultrasound biomicroscopy or UBM, and magnetic resonance imaging or MRI. Results: Various ocular imaging modalities had different accuracies as adjunctive tools for detecting or managing ocular tumors. Anterior ultra-high-resolution optical coherence tomography (OCT) could be used to evaluate images with < 5-µm resolution. OCT angiography provided deeper insight into retinal vascular changes associated with the malignant transformation of choroidal melanoma. OCT in children altered the diagnosis of suspicious retinoblastoma in 3% of the cases and treatment plan in 11% of the cases. While positron-emission tomography (PET)/computed tomography (CT) allowed the detection of metastatic lesions of choroidal melanoma by full-body scanning, single-photon emission CT was more sensitive compared to PET in detecting choroidal melanoma. Ultrasound biomicroscopy, with an accuracy exceeding 92.5%, could detect retinal calcification in lesions measuring 2–3 mm. Magnetic resonance imaging (MRI) had better contrast compared to ultrasound biomicroscopy and higher sensitivity compared to CT in detecting post-laminar optic nerve invasion. However, MRI had a lower spatial resolution compared to OCT. Further development of imaging modalities and their application in drug development would improve the treatment of ocular tumors. Conclusions: Although diagnosing ocular tumors depend on clinical characteristics, innovations in ocular imaging have enabled early diagnosis and timely, appropriate management of ocular neoplasia, which are conducive to favorable visual outcomes and increased life expectancy. Further systematic reviews and meta-analyses of primary studies focusing on a specific imaging modality in ocular neoplasia could precisely determine the diagnostic accuracy of each imaging modality to better guide eye practitioners with efficient diagnostic or therapeutic approaches for these sight- or life-threatening entities. Imaging modalities may play a major role in drug development in the future

The knowledge, attitude, and action of Northern Iranian women about cervical cancer and screening

Background: Cervical cancer is one of the most prevalent cancers in the world among women which its early diagnosis plays an important role in the prognosis. There are many factors that contribute to the participation in the screening programs, most notably the level of knowledge and attitude of people towards cancer. Understanding the level of these factors in the female population and its association with participation in screening programs is important. Therefore, the aim of this study was to determine the knowledge, attitude and practice of women in the north of Iran to compare these factors between two groups with different baseline knowledge.Methods: This cross-sectional study was carried out among female medical clients and healthcare staff in a healthcare center in the north of Iran. All the eligible patients were interviewed and were asked to fill a questionnaire containing the demographic data, knowledge, attitude, and action about cervical cancer and screening. The data were analyzed by SPSS v24.Results: A total of 283 females entered our study of which 156(55.1%) were clients of the healthcare center and 127(44.9%) were non-physician healthcare staff. Ninety (60.8%) of clients and 39(56.5%) of the staff have performed pap smear at least once (p=0.556). The levels of knowledge and attitude were significantly lower in the clients (p < 0.001 and p=0.003, respectively). There were no significant differences regarding the level of knowledge and attitude between those who performed pap smear and those who did not (0.621 and 0.788, respectively).Conclusions: Increasing awareness, especially improving attitudes in the female population, should be the focus of the health care system to encourage more women to participate in screening programs

Epigenetic Diabetic Vascular Complications

Diabetic vascular complications (DVC) influence several vital organ systems including cardiovascular, renal, ocular and nervous systems making it a major public health problem. Although extensive researches were performed in this field, the exact mechanisms responsible for these organ damages in diabetes remain obscure. Several metabolic disturbances have been involved in its complication and change in genes associated with these pathways occurred. Gene expression to produce a biologically active protein can be controlled by transcriptional and translational alteration on the head of genes without change in nucleotide composition. These epigenetic adjustments are steady, but possibly reversible and can be transmitted to future generation. Gene expression can be regulated by three epigenetic mechanisms including DNA methylation, histone modifications and noncoding microRNAs (miRNAs) activity. Epigenetic studies must be directed to better realize the role of epigenetic changes to the etiology of DVC and knowledge of epigenetic would play a pivotal role in the application of individualized medicine. Application and development of high technology sequencing combined with more sensitive and advanced methodologies for epigenome studying help to determine specific epigenetic events that stimulate gene responses in patients with diabetes mellitus

Epigenetic Diabetic Vascular Complications

Diabetic vascular complications (DVC) influence several vital organ systems including cardiovascular, renal, ocular and nervous systems making it a major public health problem. Although extensive researches were performed in this field, the exact mechanisms responsible for these organ damages in diabetes remain obscure. Several metabolic disturbances have been involved in its complication and change in genes associated with these pathways occurred. Gene expression to produce a biologically active protein can be controlled by transcriptional and translational alteration on the head of genes without change in nucleotide composition. These epigenetic adjustments are steady, but possibly reversible and can be transmitted to future generation. Gene expression can be regulated by three epigenetic mechanisms including DNA methylation, histone modifications and noncoding microRNAs (miRNAs) activity. Epigenetic studies must be directed to better realize the role of epigenetic changes to the etiology of DVC and knowledge of epigenetic would play a pivotal role in the application of individualized medicine. Application and development of high technology sequencing combined with more sensitive and advanced methodologies for epigenome studying help to determine specific epigenetic events that stimulate gene responses in patients with diabetes mellitus

Adding a back care package to the primary healthcare; a community-based cluster-randomized trial

Introduction: The clinical course of LBP is complex and chronicity is more frequent than once thought. Moreover, insufficient evidence was found in support of any specific approach at the level of the general population. Research question: This study aimed to evaluate the effectiveness of providing a back care package through the primary healthcare system in decreasing the rate of CLBP in the community. Material and methods: Clusters were primary healthcare units with the covered population as participants. The intervention package comprised both exercise and educational content in the form of booklets. Data regarding LBP were collected at baseline, 3 and 9-month follow-ups. The LBP prevalence and the incidence of CLBP in the intervention group compared to the control group were analyzed using logistic regression through GEE. Results: Eleven clusters were randomized including 3521 enrolled subjects. At 9 months, the intervention group showed a statistically significant decrease in both the prevalence and the incidence of CLBP, compared to the control group (OR ​= ​0.44; 95% CI ​= ​0.30–0.65; P ​< ​0.001 and OR ​= ​0.48; 95% CI ​= ​0.31–0.74; P ​< ​0.001, respectively). Discussion and conclusion: The population-based intervention was effective in reducing the LBP prevalence and CLBP incidence. Our results suggest that preventing CLBP through a primary healthcare package including exercise and educational content is achievable

The quality of care index for low back pain: a systematic analysis of the global burden of disease study 1990–2017

Abstract Background . Low back pain is one of the major causes of morbidity worldwide. Studies on low back pain quality of care are limited. This study aimed to evaluate the quality of care of low back pain worldwide and compare gender, age, and socioeconomic groups. Methods . This study used GBD data from 1990 to 2017 from the Institute for Health Metrics and Evaluation (IHME) website. Extracted data included low back pain incidence, prevalence, disability-adjusted life years (DALYs), and years lived with disability (YLDs). DALYs to prevalence ratio and prevalence to incidence ratio were calculated and used in the principal component analysis (PCA) to make a proxy of the quality-of-care index (QCI). Age groups, genders, and countries with different socioeconomic statuses regarding low back pain care quality from 1990 to 2017 were compared. Results The proxy of QCI showed a slight decrease from 36.44 in 1990 to 35.20 in 2017. High- and upper-middle-income countries showed a decrease in the quality of care from 43.17 to 41.57 and from 36.37 to 36.00, respectively, from 1990 to 2017. On the other hand, low and low-middle-income countries improved, from a proxy of QCI of 20.99 to 27.89 and 27.74 to 29.36, respectively. Conclusion . Despite improvements in the quality of care for low back pain in low and lower-middle-income countries between 1990 and 2017, there is still a large gap between these countries and higher-income countries. Continued steps must be taken to reduce healthcare barriers in these countries

Biomimetic amniotic/silicone-based bilayer membrane for corneal tissue engineering

Amniotic membrane (AM) is an effective and widely used dressing in ocular injuries to reconstruct the cornea. Due to its low mechanical strength, high biodegradation rate, and difficult handling, its usage in medical interventions remains challenging. In this study, decellularized AM was covered with an ultrathin layer of Polydimethylsiloxane (PDMS) through a spinning method, which in turn resulted in an ultrathin (less than 80 µm in thickness) bilayer corneal wound dressing membrane with improved mechanical behavior and transparency. The biomechanical, biological, and antibacterial properties of the bilayer membranes were measured both in vitro and in vivo. The optimized microsized membrane was applied on a corneal defect wound created in a rabbit model to evaluate the corneal healing. The results demonstrated a significant decrease in degradation rate, improved mechanical properties, and AM/PDMS transparency compared with AM. The corneal transparency improved until 21 days post-surgery in AM/PDMS group. Histological evaluations revealed that AM/PDMS had better epithelial delaminated cell morphology. The results of the RT-PCR showed a significant increase in MMP9, a significant decrease in Col1A1, TGF-β1, TNF-α and IL-6 in both AM and AM/PDMS compared with control wounds. This study suggessts AM/PDMS membrane as an excellent corneal wound dressing