Role of adipose-derived mesenchymal stem cells in the regeneration of cardiac tissue and improvement of cardiac function: A narrative review

Recent efforts have made in order to novel therapeutic approaches to reduce the heavy cardiovascular burden. The use of cell therapy and applying stem cell-based therapies has received much attention; of particular interest are adipose-derived mesenchymal stem cells (ADSCs). The present review aimed to review the studies which examined and researched various aspects of ADSCs to improve cardiac function. A comprehensive review of all articles assessed and discussed the application of ADSCs in the improvement of cardiac tissue renewing and cardiomyocytes regeneration was planned and conducted by the two reviewers. The initial literature search revealed a total of 153 articles that, of those, 34 were considered eligible. From the perspective of heart tissue regeneration, the inductive role of ADSCs in sensing mechanical stimulation and produce collagen and elastin scaffolds, vascularizing cardiac tissue, and exosomes (vesicles derived from ADSCs) in ADSCsmediated myocardial protection has indicated. In the process of ADSCs differentiation to cardiomyocyte-like cells, the role of various targeted pathways have been identified that can be influenced by different elements such as TGF-beta1, phorbol myristate acetate, Angiotensin II, Rhoassociated kinases, 5-Azaytidine, Sodium valproate, fibrin scaffold and trichostatin A have been highlighted. In the final, from a therapeutic point of view, the effectiveness of ADMSCs differentiation to cardiomyocytes as improving left ventricular functional state has been discussed. Summarizing the studies confirms a significant improvement in cardiac function following direct application of ADSCs or their transformation to cardiomyocytes by stimulating or inhibiting various cellular pathways leading reducing oxidative stress and inflammatory bed, reducing cardiomyocyte apoptosis, attenuating cardiac fibrosis, reducing the infiltration of immune cells and collagen deposition, and enhancing angiogenesis. © 2020 by the authors

Evaluation of Judet view radiographs accuracy in classification of acetabular fractures compared with three-dimensional computerized tomographic scan: A retrospective study

Background: In the current diagnostic procedure, generally, both plain radiographs and 3D-CT scans are used for the diagnosis of acetabular fractures. There is no consensus regarding the value of a three-dimensional computerized tomographic (3D-CT) scan alone in the classification of acetabular fractures. In this study, we compared the accuracy of 3D-CT scan and plain radiography through the evaluation of their agreement with the intraoperative surgeon's classification. Method: In a retrospective study, patients who were referred to our center with an acetabular fracture and underwent surgical treatment were included. The classification of acetabular fractures was performed once using Judet view plain radiographs and once using a 3D-CT scan by the corresponding one Experienced musculoskeletal radiologist one independent trauma fellowship-trained orthopaedic who routinely treat acetabular fractures and based on Letournel and Judet classification (17 and 23 years of experience respectively). Cohen's kappa value was used for the assessment agreement between the two imaging modalities, as well as between the imaging modalities and intraoperative classification. Results: Medical files of 152 patients with acetabular fracture were retrospectively reviewed. A kappa value of 0.236 was obtained as the agreement level between radiographs and intraoperative findings (p < 0.001). A kappa value of 0.943 was obtained as the agreement level between 3D-CT and intraoperative classification (p < 0.001). An agreement level of 0.264 was found between the Judet radiographs and 3D-CT scans (p < 0.001). Conclusions: 3D-CT scans are reliable enough in the classification of acetabular fractures, and plain radiographs could be omitted to avoid radiation exposure as well as to reduce the cost for patients who sustain acetabular fractures. © 2020 The Author(s)

Dysplasia epiphysealis hemimelica of the radial head: a rare case report

Background: Dysplasia epiphysealis hemimelica (DEH) is a rare benign overgrowth generally affecting the epiphyses and short bones of the lower limbs. DEH in the elbow joint is extremely rare, and to date, only three cases of DEH have been reported in the radial head. Case presentation: In this study, we report a case of DEH located in the radial head of the right elbow of a 10-year-old boy, which was presented with elbow pain and limited range of motion. In clinical examination, an asymmetrical enlargement was observed over the elbow. The lesion was resected surgically, and the patient�s symptoms resolved afterward. The histologic analysis of the lesion confirmed the diagnosis of DEH. Conclusion: This report highlights the role of DEH in the differential diagnosis of elbow pathologies, particularly its differentiation from osteochondroma. © 2021, The Author(s)

Evaluation of health-related quality of life after total hip arthroplasty: A case-control study in the Iranian population

Background: As the total hip arthroplasty (THA) mainly aims to improve the quality of life of the patients, study of health-related quality of life (HRQoL) after THA has attracted much attention. Yet, the results considerably vary between studies. Here, we evaluate the HRQoL of the patient after THA, for the first time in the Iranian population. Methods: In a case-control study, HRQoL was assessed in 217 patients after THA and compared with a matched reference population. The 36-item short-form health survey (SF-36) was used for the evaluation of HRQoL. A multiple linear regression model was used to investigate the influence of sociodemographic and clinical characteristics of the patients on the HRQOL. Results: The mean follow-up of the patients was 27 ± 18 months. The mean total SF-36 score was 41.4 ± 22.2 in the case and 67.3 ± 26.6 in the control group (p = 0.001). The mean physical component score, but not the mental component score, was significantly lower in the patient group (p = 0.001). Except for the vitality and emotional role, all other SF-36 subscales were significantly lower in the case group. Male sex (B = 4.52, p = 0.023), number of comorbidities (B = - 4.82, p = 0.011), body mass index (B = - 1.18, p = 0.044), number of post-operative complications (B = - 6.57, p = 0.001), and adherence to physiotherapy protocol (B = 2.09, p = 0.014) were associated with HRQoL after THA. Conclusion: Although THA is considered as one of the most successful orthopedic practices, it is associated with remarkable reduced HRQoL in Iranian population when compared with the reference population. A variety of patients-associated factors influence the HRQoL after THA. © 2019 The Author(s)

Comparison of hepatitis C virus risk factors in genotypes 1a and 3a

Background: One of the most important causes of chronic liver disease is hepatitis C virus (HCV), which causes liver cirrhosis and hepatocellular carcinoma. To control the prevalence of the disease, knowledge and information in risk factor of HCV are required. The aim of this study was to compare the risk factors of infection between HCV patients with genotypes 1a and 3a. Methods: This is an observational analytical study. HCV patients who referred to the clinic of hepatology, Rasoul-e-Akram University Hospital from July 2015 to July 2017, were assigned to the genotype 1a and 3a. Demographic (age, sex, family history), clinical (cirrhosis, hepatocellular carcinoma) and laboratory data, history of intravenous drug and alcohol usage, and history of imprisonment were gathered and compared between two groups. All the patients completed the informed consent form. Data analysis was performed by SPSS software, version 22 (IBM SPSS, Armonk, NY, USA). P value less than 0.05 was considered statistically significant. Results: Overall, 97 HCV patients were included in this study. Mean age was 45±12 years and 78 (80) of patients were male. Among them, 58 (60) and 39 (40) had genotype 1a and 3a. respectively. History of injection drug usage was recorded in 34/39 (87) of patients with genotype 3a, and significantly higher in genotype 3a as compared to genotype 1a OR adj: 3.1, CI (1.3-6.2). Also, in this study, genotype 3a was significantly recorded in younger patients OR adj: 1.7, CI (1.2-4.1). However, cirrhosis and hepatocellular carcinoma was more common in patients with genotype 1a as compared to genotype 3a OR adj: 2.05, CI (1.6-5.4) and OR adj: 2.8, CI (1.3-5.7) respectively. Conclusion: According to the results of this study, hepatitis C virus transmission risk factors differed in genotypes 3a and 1a. Genotype 3a is found among young patients with a history of intravenous drug usage and genotype 1a in patients with cirrhosis and hepatocellular carcinoma. © 2018, Tehran University of Medical Sciences. All rights reserved

Comparison of hepatitis C virus risk factors in genotypes 1a and 3a

Background: One of the most important causes of chronic liver disease is hepatitis C virus (HCV), which causes liver cirrhosis and hepatocellular carcinoma. To control the prevalence of the disease, knowledge and information in risk factor of HCV are required. The aim of this study was to compare the risk factors of infection between HCV patients with genotypes 1a and 3a. Methods: This is an observational analytical study. HCV patients who referred to the clinic of hepatology, Rasoul-e-Akram University Hospital from July 2015 to July 2017, were assigned to the genotype 1a and 3a. Demographic (age, sex, family history), clinical (cirrhosis, hepatocellular carcinoma) and laboratory data, history of intravenous drug and alcohol usage, and history of imprisonment were gathered and compared between two groups. All the patients completed the informed consent form. Data analysis was performed by SPSS software, version 22 (IBM SPSS, Armonk, NY, USA). P value less than 0.05 was considered statistically significant. Results: Overall, 97 HCV patients were included in this study. Mean age was 45±12 years and 78 (80) of patients were male. Among them, 58 (60) and 39 (40) had genotype 1a and 3a. respectively. History of injection drug usage was recorded in 34/39 (87) of patients with genotype 3a, and significantly higher in genotype 3a as compared to genotype 1a OR adj: 3.1, CI (1.3-6.2). Also, in this study, genotype 3a was significantly recorded in younger patients OR adj: 1.7, CI (1.2-4.1). However, cirrhosis and hepatocellular carcinoma was more common in patients with genotype 1a as compared to genotype 3a OR adj: 2.05, CI (1.6-5.4) and OR adj: 2.8, CI (1.3-5.7) respectively. Conclusion: According to the results of this study, hepatitis C virus transmission risk factors differed in genotypes 3a and 1a. Genotype 3a is found among young patients with a history of intravenous drug usage and genotype 1a in patients with cirrhosis and hepatocellular carcinoma. © 2018, Tehran University of Medical Sciences. All rights reserved

Predictors for the severe coronavirus disease 2019 (COVID-19) infection in patients with underlying liver disease: a retrospective analytical study in Iran

Risk factors for clinical outcomes of COVID-19 pneumonia have not yet been well established in patients with underlying liver diseases. Our study aimed to describe the clinical characteristics and outcomes of COVID-19 infection among patients with underlying liver diseases and determine the risk factors for severe COVID-19 among them. In a retrospective analytical study, 1002 patients with confirmed COVID-19 pneumonia were divided into two groups: patients with and without underlying liver diseases. The admission period was from 5 March to 14 May 2020. The prevalence of underlying conditions, Demographic data, clinical parameters, laboratory data, and participants' outcomes were evaluated. Logistic regression was used to estimate the predictive factors. Eighty-one (8) of patients had underlying liver diseases. The frequencies of gastrointestinal symptoms such as diarrhea and vomiting were significantly higher among patients with liver diseases (48 vs. 25 and 46.1 vs. 30 respectively, both P &lt; 0.05). Moreover, ALT and AST were significantly higher among patients with liver diseases (54.5 ± 45.6 vs. 37.1 ± 28.4, P = 0.013 and 41.4 ± 27.2 vs. 29.2 ± 24.3, P = 0.028, respectively). Additionally, the mortality rate was significantly high in patients with liver disease (12.4 vs. 7, P = 0.018). We also observed that the parameters such as neutrophil to leukocyte ratio Odds Ratio Adjusted (ORAdj) 1.81, 95% CI 1.21�3.11, P = 0.011 and blood group A (ORAdj 1.59, 95% CI 1.15�2.11, P = 0.001) were associated with progression of symptoms of COVID-19. The presence of underlying liver diseases should be considered one of the poor prognostic factors for worse outcomes in patients with COVID-19. © 2021, The Author(s)

Survival analysis in gastric cancer: A multi-center study among Iranian patients

Background: Gastric cancer (GC) has been considered as the 5th most common type of cancer and the third leading cause of cancer-associated death worldwide. The aim of this historical cohort study was to evaluate the survival predictors for all patients with GC using the Cox proportional hazards, extended Cox, and gamma-frailty models. Methods: This historical cohort study was performed according to documents of 1695 individuals having GC referred to three medical centers in Iran from 2001 to 2018. First, most significant prognostic risk factors on survival were selected, Cox proportional hazards, extended Cox, gamma-frailty models were applied to evaluate the effects of the risk factors, and then these models were compared with the Akaike information criterion. Results: The age of patients, body mass index (BMI), tumor size, type of treatment and grade of the tumor increased the hazard rate (HR) of GC patients in both the Cox and frailty models (P < 0.05). Also, the size of the tumor and BMI were considered as time-varying variables in the extended Cox model. Moreover, the frailty model showed that there is at least an unknown factor, genetic or environmental factors, in the model that is not measured (P < 0.05). Conclusions: Some prognostic factors, including age, tumor size, the grade of the tumor, type of treatment and BMI, were regarded as indispensable predictors in patients of GC. Frailty model revealed that there are unknown or latent factors, genetic and environmental factors, resulting in the biased estimates of the regression coefficients. © 2020 The Author(s)

How adding the abdominal massage to polyethylene glycol can improve symptom and quality of life in patients with functional constipation in comparison with each one of the treatment modalities alone: A randomized clinical trial

Background: A variety of medical and non-medical treatments have been introduced for functional constipation relief. Here, we aimed to compare the efficacy of a combination of polyethylene glycol (PEG) and abdominal massage with each one of the treatments alone. Materials and methods: Patients with functional constipation based on Rome IV criteria were randomly assigned into the three treatment groups: group A (abdominal massage for 15 min daily), group B (PEG 20 g daily), and group C (PEG 20 g plus abdominal massage for 15 min daily) for 14 days. PAC-QOL questionnaire, Bristol stool scale were evaluated at baseline and two weeks after treatment. Constipation-associated symptom scores were recorded at baseline, two weeks and four weeks after treatment beginning. Descriptive statistics were provided as the mean ± standard deviation or number and percentage. P-value<0.05 was considered statistically significant. Results: Forty eight, 47 and 48 patients in group A, B, and C completed the study, respectively. PAC-QOL, Bristol and Constipation-associated symptom scores showed a significant improvement in all study groups two weeks after the treatment compared to the baseline. At the end of treatment, the rate of straining, incomplete evacuation sensation, finger evacuation and the number of defecation was significantly lower in the group C (P < 0.04). Bristol score were significantly improved in group B (P = 0.029) in compare to other groups. The total quality of life score was also significantly improved in the group C (P = 0.028). Conclusion: A combination of abdominal massage and PEG is safe, tolerable and more effective than each one of the treatments alone. © 2020 Elsevier Lt

The effects of helicobacter pylori eradication on modification of metabolic syndrome parameters in patients with functional dyspepsia

Background Helicobactor pylori (H. pylori) have the potential role in the pathogenesis of various extra-gastric disorders such as metabolic disorders. But, it is now questioned about whether H. pylori eradication reduces or induces the risk for metabolic disorders especially in patients with dyspepsia. Hence, the present study aimed to assess the effects of H. pylori eradication on criteria of metabolic syndrome. Methods H. pylori infected patients with dyspepsia were included. The patients were treated with omeprazole (20 mg, q12 h), amoxicillin (1 g, q12 h), and clarithromycin (500 mg, q12 h) for two weeks, then H. pylori eradication was evaluated by C14 Breathing test (UBT) 6 weeks after the end of the treatment. Demographic data, clinical manifestation and metabolic parameters were recorded before and three months after completing treatment regimen. The data was analyzed by SPSS version 16.0. Results Of 110 patients were initially enrolled, 91 patients completed the study. Overall eradication rate was 61.5. Significant differences in the serum level of total cholesterol(180.7 ± 34 vs. 172.1 ± 28, p = 0.001), LDL(107.0 ± 25 vs. 100.8 ± 20, p &lt; 0.001), HDL(46.2 ± 8.7 vs. 48.9 ± 8.6, p &lt; 0.001), fasting blood sugar (93.7 ± 12 vs. 90.9 ± 10, p = 0.001), hemoglobin A1c(5.37 ± 0.52 vs 5.25 ± 0.53, p = 0.006), and as well as for waist circumference(92.2 ± 14 vs. 91.4 ± 13.9, p = 0.03) was found after treatment. Data for body weight, systolic and diastolic blood pressure and triglyceride level remained without any significant changes. Conclusion H. pylori eradication could relatively reduce the risk of metabolic syndrome criteria such as fasting blood sugar, hemoglobin A1c, lipid profile and waist circumference. © 2017 Diabetes Indi