The survey of family history of diabetes in patients with type 2 diabetes in Chaharmahal va Bakhteyari province, Iran, 2008

چکیده: زمینه و هدف: دیابت از گروه بیماری های متابولیک و یک اختلال چند عاملی است که با افزایش مزمن قند خون مشخص می شود. از آنجایی که در زمینه اپیدمیولوژی ژنتیک دیابت نوع 2 در کشور ما، مطالعات اندکی انجام شده و هنوز بطور قطعی مشخص نیست که توارث دیابت نوع 2 بیشتر از طرف کدام یک از والدین (پدر یا مادر) به فرزندان منتقل می شود، این مطالعه با هدف بررسی زمینه ژنتیکی بیماران دیابتی نوع 2 استان چهارمحال و بختیاری طراحی و اجرا گردید. روش بررسی: این بررسی یک مطالعه اپیدمیولوژیک از نوع توصیفی-تحلیلی است که جامعه پژوهش آن افراد مبتلا به دیابت نوع 2 در استان چهارمحال و بختیاری در سال 1387 بود. تعداد 254 نفر به روش تصادفی دو مرحله ای انتخاب و مورد بررسی قرار گرفتند. داده ها بوسیله مصاحبه و با تکمیل فرمی، جمع آوری و با نرم افزار STATA9 و آزمون مجذور کا مورد تجزیه و تحلیل قرار گرفت. یافته ها: از254 نفر بررسی شده 150 نفر (59) مونث و 104 نفر(41) مذکر بودند. متوسط سن آنها 6/8±8/54 سال و متوسط مدت زمان ابتلا به دیابت در آنها 8/5±4/7 سال بود. 116 نفر (7/45) از آنها دارای سابقه خانوادگی مثبت دیابت بودند که از این میان، 4/61 مادر دیابتی، 8/19 پدر دیابتی، 9/62 خواهر دیابتی، 1/18 برادر دیابتی، 5/40 دختر دیابتی و 1/18 پسر دیابتی داشتند. سابقه خانوادگی دیابت در مادر بیشتر از پدر، در خواهر بیشتر از برادر و در دختران بیشتر از پسران بود (001/0>P). نتیجه گیری: نسبت شانس ابتلا به دیابت برای کسانی که سابقه خانوادگی مثبت دیابت در مادر دارند بیشتر و مهم تر از پدر بوده و می توان اظهار نمود که به احتمال قوی، توارث دیابت نوع 2 بیشتر از طریق مادر به فرزندان منتقل می شود.

An integrated clinical-MR radiomics model to estimate survival time in patients with endometrial cancer

Background: Determination of survival time in women with endometrial cancer using clinical features remains imprecise. Features from MRI may improve the survival estimation allowing improved treatment planning. Purpose: To identify clinical features and imaging signatures on T2-weighted MRI that can be used in an integrated model to estimate survival time for endometrial cancer subjects. Study Type: Retrospective. Population: Four hundred thirteen patients with endometrial cancer as training (N = 330, 66.41 ± 11.42 years) and validation (N = 83, 67.60 ± 11.89 years) data and an independent set of 82 subjects as testing data (63.26 ± 12.38 years). Field Strength/Sequence: 1.5-T and 3-T scanners with sagittal T2-weighted spin echo sequence. Assessment: Tumor regions were manually segmented on T2-weighted images. Features were extracted from segmented masks, and clinical variables including age, cancer histologic grade and risk score were included in a Cox proportional hazards (CPH) model. A group least absolute shrinkage and selection operator method was implemented to determine the model from the training and validation datasets. Statistical Tests: A likelihood-ratio test and decision curve analysis were applied to compare the models. Concordance index (CI) and area under the receiver operating characteristic curves (AUCs) were calculated to assess the model. Results: Three radiomic features (two image intensity and volume features) and two clinical variables (age and cancer grade) were selected as predictors in the integrated model. The CI was 0.797 for the clinical model (includes clinical variables only) and 0.818 for the integrated model using training and validation datasets, the associated mean AUC value was 0.805 and 0.853. Using the testing dataset, the CI was 0.792 and 0.882, significantly different and the mean AUC was 0.624 and 0.727 for the clinical model and integrated model, respectively. Data Conclusion: The proposed CPH model with radiomic signatures may serve as a tool to improve estimated survival time in women with endometrial cancer

Canola Oil Could Affect PUFA and MUFA Content of Abdominal Fat of Azerbaijan Native Turkey?

Abstract: This research was performed to investigate effect of dietary Canola oil on abdominal fat PUFA and MUFA percentage. Ninety male Iranian native turkeys were randomly distributed into three experimental treatments and each treatment in three replicate. These diets were isonitrogenous and isoenergetic were given to broiler chickens throughout a 20 week growth period. Fatty acids profiles with Gas Chromatography (GC) technique were measured. Data was analyzed with one way ANOVA and means compared with Duncan test. Result show that PUFA content were increased and MUFA were decreased with usage of canola oil and approximately no difference between levels of canola oil, thus we can suggest 2.5% of canola oil could improve abdominal fat quality

Association between social capital, health-related quality of life, and mental health: A structural-equation modeling approach

Aim To explore the association(s) between demographic factors, socioeconomic status (SES), social capital, healthrelated quality of life (HRQoL), and mental health among residents of Tehran, Iran. Methods The pooled data (n = 31 519) were extracted from a population-based survey Urban Health Equity Assessment and Response Tool-2 (Urban HEART-2) conducted in Tehran in 2011. Mental health, social capital, and HRQoL were assessed using the 28-item General Health Questionnaire (GHQ-28), social capital questionnaire, and Short-Form Health Survey (SF-12), respectively. The study used a multistage sampling method. Social capital, HRQoL, and SES were considered as latent variables. The association between these latent variables, demographic factors, and mental health was determined by structural-equation modeling (SEM). Results The mean age and mental health score were 44.48 ± 15.87 years and 23.33 ± 11.10 (range, 0-84), respectively. The prevalence of mental disorders was 41.76 (95 confidence interval 41.21-42.30). The SEM model showed that age was directly associated with social capital (P = 0.016) and mental health (P = 0.001). Sex was indirectly related to mental health through social capital (P = 0.018). SES, HRQoL, and social capital were associated both directly and indirectly with mental health status. Conclusion This study suggests that changes in social capital and SES can lead to positive changes in mental health status and that individual and contextual determinants influence HRQoL and mental health

Epithelial ovarian carcinoma diagnosis by desorption electrospray ionization mass spectrometry imaging

Ovarian cancer is highly prevalent among European women, and is the leading cause of gynaecological cancer death. Current histopathological diagnoses of tumour severity are based on interpretation of, for example, immunohistochemical staining. Desorption electrospray mass spectrometry imaging (DESI-MSI) generates spatially resolved metabolic profiles of tissues and supports an objective investigation of tumour biology. In this study, various ovarian tissue types were analysed by DESI-MSI and co-registered with their corresponding haematoxylin and eosin (H&E) stained images. The mass spectral data reveal tissue type-dependent lipid profiles which are consistent across the n = 110 samples (n = 107 patients) used in this study. Multivariate statistical methods were used to classify samples and identify molecular features discriminating between tissue types. Three main groups of samples (epithelial ovarian carcinoma, borderline ovarian tumours, normal ovarian stroma) were compared as were the carcinoma histotypes (serous, endometrioid, clear cell). Classification rates >84% were achieved for all analyses, and variables differing statistically between groups were determined and putatively identified. The changes noted in various lipid types help to provide a context in terms of tumour biochemistry. The classification of unseen samples demonstrates the capability of DESI-MSI to characterise ovarian samples and to overcome existing limitations in classical histopathology

The intelligent-Knife (i-Knife) and its intraoperative diagnostic advantage for the treatment of cervical disease

Clearance of surgical margins in cervical cancer prevents the need for adjuvant chemoradiation and allows fertility preservation. In this study, we determined the capacity of the rapid evaporative ionization mass spectrometry (REIMS), also known as intelligent knife (iKnife), to discriminate between healthy, preinvasive, and invasive cervical tissue. Cervical tissue samples were collected from women with healthy, human papilloma virus (HPV) ± cervical intraepithelial neoplasia (CIN), or cervical cancer. A handheld diathermy device generated surgical aerosol, which was transferred into a mass spectrometer for subsequent chemical analysis. Combination of principal component and linear discriminant analysis and least absolute shrinkage and selection operator was employed to study the spectral differences between groups. Significance of discriminatory m/z features was tested using univariate statistics and tandem MS performed to elucidate the structure of the significant peaks allowing separation of the two classes. We analyzed 87 samples (normal = 16, HPV ± CIN = 50, cancer = 21 patients). The iKnife discriminated with 100% accuracy normal (100%) vs. HPV ± CIN (100%) vs. cancer (100%) when compared to histology as the gold standard. When comparing normal vs. cancer samples, the accuracy was 100% with a sensitivity of 100% (95% CI 83.9 to 100) and specificity 100% (79.4 to 100). Univariate analysis revealed significant MS peaks in the cancer-to-normal separation belonging to various classes of complex lipids. The iKnife discriminates healthy from premalignant and invasive cervical lesions with high accuracy and can improve oncological outcomes and fertility preservation of women treated surgically for cervical cancer. Larger in vivo research cohorts are required to validate these findings

Use of Laser Speckle Contrast Analysis during pelvic surgery in a uterine transplantation model

Aim: Uterine transplantation (UTx) is proposed for treatment of uterine factor infertility. Our aim was to assess whether Endoscopic Laser Speckle Contrast Analysis (eLASCA) could evaluate pelvic blood flow at anastomotic sites required for sheep and rabbit UTx. Results/methodology: eLASCA detected blood flow in rabbit UTx #7 and #9. In sheep UTx #2, #3 and #5, the results allowed us to conclude that blood flow was present in the uterine graft following transplantation; and post-UTx, the animal had heart and respiratory rates, and oxygen saturation compatible with a normal hemodynamic status. Conclusion: These preliminary results establish the potential of Laser Speckle Contrast Analysis as noncontact and real-time tool for observation of spatially-resolved blood flow from which other parameters can be derived

Diagnostic accuracy of FET-PET/CT, FDG-PET/CT and diffusion-weighted MRI in detection of nodal metastases in surgically treated endometrial and cervical carcinoma

PURPOSE:Pre-operative nodal staging is important for planning treatment in cervical cancer (CC) and endometrial cancer (EC) but remains challenging. We compare nodal staging accuracy of {18}^F-ethyl-choline-(FEC)-PET/CT, {18}^F-Fluoro-deoxy-glucose-(FDG)-PET/CT and diffusion-weighted-MRI (DW-MRI) with conventional morphological MRI. Experimental Design: A prospective, multicentre observational study of diagnostic accuracy for nodal metastases was undertaken in 5 gyne-oncology centres. FEC-PET/CT, FDG-PET/CT and DW-MRI were compared to nodal size and morphology on MRI. Reference standard was strictly correlated nodal histology. Eligibility included operable CC stage=>1B1 or EC (grade 3 any stage with myometrial invasion or grade 1-2 stage=>II). RESULTS: Among 162 consenting participants, 136 underwent study DW-MRI and FDG-PET/CT, and 60 underwent FEC-PET/CT. 267 nodal regions in 118 women were strictly correlated at histology (nodal positivity rate 25%). Sensitivity per-patient (n=118) for nodal size, morphology, DW-MRI, FDG- and FEC-PET/CT were 40%*, 53%, 53%, 63%* and 67% for all cases (*p=0.016); 10%, 10%, 20%, 30% and 25% in CC (n=40); 65%, 75%, 70%, 80% and 88% in EC (n=78). FDG-PET/CT outperformed nodal size (p=0.006) and size ratio (p=0.04) for per-region sensitivity. False positive rates were all <10%. CONCLUSIONS: All imaging techniques had low sensitivity for detection of nodal metastases and cannot replace surgical nodal staging. The performance of FEC-PET/CT was not statistically different to other techniques that are more widely available. FDG-PET/CT had higher sensitivity than size in detecting nodal metastases. False positive rates were low across all methods. The low false positive rate demonstrated by FDG-PET/CT may be helpful in arbitration of challenging surgical planning decisions

Point-of-care diagnosis of endometrial cancer using the surgical intelligent knife (iknife)-a prospective pilot study of diagnostic accuracy

Introduction: Delays in the diagnosis and treatment of endometrial cancer negatively impact patient survival. The aim of this study was to establish whether rapid evaporative ionisation mass spectrometry using the iKnife can accurately distinguish between normal and malignant endometrial biopsy tissue samples in real time, enabling point-of-care (POC) diagnoses. Methods: Pipelle biopsy samples were obtained from consecutive women needing biopsies for clinical reasons. A Waters G2-XS Xevo Q-Tof mass spectrometer was used in conjunction with a modified handheld diathermy (collectively called the ‘iKnife’). Each tissue sample was processed with diathermy, and the resultant surgical aerosol containing ionic lipid species was then analysed, producing spectra. Principal component analyses and linear discriminant analyses were performed to determine variance in spectral signatures. Leave-one-patient-out cross-validation was used to test the diagnostic accuracy. Results: One hundred and fifty patients provided Pipelle biopsy samples (85 normal, 59 malignant, 4 hyperplasia and 2 insufficient), yielding 453 spectra. The iKnife differentiated between normal and malignant endometrial tissues on the basis of differential phospholipid spectra. Cross-validation revealed a diagnostic accuracy of 89% with sensitivity, specificity, positive predictive value and negative predictive value of 85%, 93%, 94% and 85%, respectively. Conclusions: This study is the first to use the iKnife to identify cancer in endometrial Pipelle biopsy samples. These results are highly encouraging and suggest that the iKnife could be used in the clinic to provide a POC diagnosis