Serum hyaluronate as a non-invasive marker of hepatic fibrosis and inflammation in HBeAg-negative chronic hepatitis B

Background: HBV infection is a serious global heath problem. It is crucial to monitor this disease more closely with a non-invasive marker in clinical trials. We aimed to evaluate the predictive value of serum hyaluronate for the presence of extensive liver fibrosis and inflammation. Methods: 28 healthy volunteers and 65 patients with HBeAg negative chronic hepatitis B were enrolled. Liver biopsies scored according to Ishak system. Association of serum hyaloronate with liver fibrosis and inflammation were assessed, and cut off points for serum hyaluronate levels were identified by receiver operating characteristics (ROC) curves and their values for prediction of fibrosis and inflammation were assessed. Results: In patients with CHB serum hyaluronate had the most significant correlation and predictive values for the liver fibrosis and inflammation comparing to the other variables. At the cut off point of 126.4 ngm/ml it could discriminate extensive fibrosis from milder ones with sensitivity of 90.9% and specificity of 98.1%. With the same value it could discriminate extensive inflammation from their milder counterparts with sensitivity of 63.6% and specificity of 92.6%. Conclusion: Serum hyaluronate was the best predictor of extensive liver fibrosis and inflammation and it could discriminate subgroups of patients with chronic hepatitis B. It could be used as a non-invasive test to monitor these patients more closely with developing anti viral agents in clinical trials

Estimating the dynamics and dependencies of accumulating mutations with applications to HIV drug resistance

We introduce a new model called the observed time conjunctive Bayesian network (OT-CBN) that describes the accumulation of genetic events (mutations) under partial temporal ordering constraints. Unlike other CBN models, the OT-CBN model uses sampling time points of genotypes in addition to genotypes themselves to estimate model parameters. We developed an expectation-maximization algorithm to obtain approximate maximum likelihood estimates by accounting for this additional information. In a simulation study, we show that the OT-CBN model outperforms the continuous time CBN (CT-CBN) (Beerenwinkel and Sullivant, 2009. Markov models for accumulating mutations. Biometrika 96(3), 645-661), which does not take into account individual sampling times for parameter estimation. We also show superiority of the OT-CBN model on several datasets of HIV drug resistance mutations extracted from the Swiss HIV Cohort Study databas

Influence of B cells in liver fibrosis associated with hepatitis B virus harboring basal core promoter mutations

The development of the liver disease in chronic hepatitis B with common viral variants can be determined through the interaction between the virus and the host immune response. B cells constitute half of the intrahepatic lymphocyte population with an impact on fibrosis. A proliferation-inducing ligand (APRIL) has been shown to have a co-stimulatory activity on B cells. For this study HBV DNA was amplified and then sequenced to show the presence of the basal core promoter (BCP) mutations in the serum from 57 patients with chronic hepatitis B. The range of IgD-positive B cells was detected by immunohistochemistry in liver biopsies; and patients serum was assayed for APRIL levels by enzyme immunoassay. Twenty-seven patients (47.4) harbored the A1762T-G1764A BCP mutations. Coefficients of logistic regression showed that the effect of increasing IgD-positive B cells in rising odds of the liver disease is the same in the patients with BCP mutation A1762T-G1764A and in the patients without mutation, nevertheless the effect of APRIL is not similar in these two groups of patients. Logistic regression in patients with BCP A1762T-G1764A mutations demonstrated that increasing one score of APRIL decreased the odds of fibrosis stage about 8. These results suggest that in infection with viral variants of hepatitis B virus, the population of IgD-positive B cells may play a decisive role in later stages of the liver disease which is reduced by APRIL in chronic hepatitis patients with BCP mutations. J. Med. Virol. 84:18891896, 2012. (c) 2012 Wiley Periodicals, Inc

Assessing breast cancer risk among Iranian women using the gail model

Background: Breast cancer risk assessment is a helpful method for estimating development of breast cancer at the population level. Materials and Methods: In this cross-sectional study, participants consisted of a group of 3,847 volunteers (mean ± SD age: 463 ± 7.59 years) in a convenience sample of women referred to health centers affiliated to Tehran University of Medical Sciences in Tehran, Iran. The risk of breast cancer was estimated by applying the National Cancer Institute's online version of the Gail Risk Assessment Tool. Results: Some 24.9 of women reported having one first-degree female relative with breast cancer, with 8.05 of them having two or more first-degree relatives with breast cancer. The mean five-year risk of breast cancer for all participants was 1.61±0.73, and 9.36 of them had a five-year risk of breast cancer > 1.66. The mean lifetime risk of breast cancer was 11.7±3.91. Conclusions: The Gail model is useful for assessing probability of breast cancer in Iranian women. Based on the their breast cancer risk, women may decide to accept further screening services

Health-related quality of life in infertile couples receiving IVF or ICSI treatment

<p>Abstract</p> <p>Background</p> <p>Infertile couples might experience psychological distress and suffer from impaired health-related quality of life. This study aimed to examine health-related quality of life in infertile couples receiving either in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment.</p> <p>Methods</p> <p>This was a cross-sectional study of quality of life in infertile couples attending to Vali-e-Asr Reproductive Health Research Center or Royan Institute for either IVF or ICSI treatment in Tehran, Iran. Health-related quality of life was assessed using the Short Form Health Survey (SF-36). Patients' demographic and clinical characteristics were also recorded. Data were analyzed to compare quality of life in infertile women and men and to indicate what variables predict quality of life in infertile couples.</p> <p>Results</p> <p>In all 514 women and 514 men (n = 1028) were studied. There were significant differences between women and men indicating that male patients had a better health-related quality of life. Also health-related quality of life was found to be better in infertility due to male factor. Performing logistic regression analysis it was found that female gender, and lower educational level were significant predictors of poorer physical health-related quality of life. For mental health-related quality of life in addition to female gender and lower educational level, younger age also was found to be a significant predictor of poorer condition. No significant results were observed for infertility duration or causes of infertility either for physical or mental health-related quality of life.</p> <p>Conclusion</p> <p>The findings suggest that infertility duration or causes of infertility do not have significant effects on health-related quality of life in infertile couples. However, infertile couples, especially less educated younger women, are at risk of a sub-optimal health-related quality of life and they should be provided help and support in order to improve their health-related quality of life.</p

The Evaluation of the Anatomical Variations of Osteomeatal Complex in Cone Beam Computed Tomography Images

BACKGROUND AND OBJECTIVE: Anatomical variations of ostiomeatal complex have an imperative role in pathologies of sinonasal complex, ventilation obstruction and success of surgical treatments. The purpose of this study was to evaluate the anatomical variations of osteomeatal complex in cone beam computed tomography images in North of Iran. METHODS: In this cross-sectional retrospective study, 159 CBCT images were analyzed. Anatomical variations evaluated included Concha bullosa, Paradoxical middle turbinate, Uncinate process hypertrophy and pneumatization, hypertrophied Bulla ethmoidalis, Agger nasi cell, Maxilo-ethmoidal cell (Haller's cell) which were assessed based on the frequency, gender, unilateral/bilateral appearance and the involved side in unilateral cases (left/right). Also, two observers evaluated the data simultaneously and the result of final agreement was recorded on the checklists.The data were analyzed descriptively and analytically. FINDINGS: From among 159 subjects, 76 (47.8%) were female and 83 (52.2%) were male. The patients were 18-80 years old (mean: 34.96±14.50 years). Agger nasi cell and concha bullosa which were observed in 143 (98.9%) and 151 (95%) cases, respectively, were the most common findings and often appeared bilaterally. The least frequency belonged to hypertrophied bulla ethmoidalis which was 9 (5.7%) and uncinate process hypertrophy which was 12 (7.5%). Paradoxical middle turbinate, uncinate process pneumatization, and Haller's cell were observed in 28 (17.6%), 57 (35.8%), and 61 (38.4%) cases, respectively. No significant relationship was found between gender and the anatomical variations. (p>0.05) CONCLUSION: In the present study, Concha Bullosa and Agger Nasi Cell were the most common anatomical variations in CBCT images of paranasal sinuses, which were reported bilaterall

Quality of life in patients with breast cancer before and after diagnosis: an eighteen months follow-up study

<p>Abstract</p> <p>Background</p> <p>Measuring quality of life in breast cancer patients is of importance in assessing treatment outcomes. This study examined the impact of breast cancer diagnosis and its treatment on quality of life of women with breast cancer.</p> <p>Methods</p> <p>This was a prospective study of quality of life in breast cancer patients. Quality of life was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast cancer supplementary measure (QLQ-BR23) at three points in time: baseline (pre diagnosis), three months after initial treatment and one year after completion of treatment (in all 18 months follow-up). At baseline the questionnaires were administered to all suspected identified patients while both patients and the interviewer were blind to the final diagnosis. Socio-demographic and clinical data included: age, education, marital status, disease stage and initial treatment. Repeated measure analysis was performed to compare quality of life differences over the time.</p> <p>Results</p> <p>In all, 167 patients diagnosed with breast cancer. The mean age of breast cancer patients was 47.2 (SD = 13.5) years and the vast majority (82.6%) underwent mastectomy. At eighteen months follow-up data for 99 patients were available for analysis. The results showed there were significant differences in patients' functioning and global quality of life at three points in time (P < 0.001). Although there were deteriorations in patients' scores for body image and sexual functioning, there were significant improvements for breast symptoms, systematic therapy side effects and patients' future perspective (P < 0.05).</p> <p>Conclusion</p> <p>The findings suggest that overall breast cancer patients perceived benefit from their cancer treatment in long-term. However, patients reported problems with global quality of life, pain, arm symptoms and body image even after 18 months following their treatments. In addition, most of the functional scores did not improve.</p