Virginity and Virginity Testing: Then and Now

Background: Despite the increasing progresses in medicine and health in the 21st century especially in the area of reproductive health, myths related to “virginity” and “virginity testing” still figure out life and death in some communities after centuries. Overall, aim of this study was to investigate the myths and objective facts associated with virginity and virginity testing.Methods: This review conducted by SID, Ovid, Science Direct, Pub Med, Pro Quest, Iran Medex, Google Scholar, Cochrane library, EBSCO, and United Nations Population Fund, WHO from 1980 to 2015. Keywords for search included virginity, virginity testing, hymen, sexual abstinence.Results: The undeniable value of virginity, female virginity worth versus the shame of virginity for male, the idea to preserve virginity despite oral and anal sex and indicators to assess the intact hymen and wedding night bleeding to prove virginity are misconceptions that besides perceived premarital sex as signs of civilization and conflicts of gender inequality and violence against women lead to fail most of approaches against increasing of premarital sex.Conclusion: Although programs such as "virginity pledge", "Silver Ring" and "Sexual abstinence education" are running in some countries, in order to expand virginity as a practical approach in controlling sexual transmitted diseases and teen pregnancy, the role of undeniable myths in advance to such approaches, the use of cultural, social and religious potentials of different societies to cope with the misconceptions and teaching of related objective facts seems necessary

Denosumab in patients with giant cell tumor and its recurrence: A systematic review

Recent studies suggest that Denosumab reduces tumor size, therefore, makes the surgery easier with lower morbidity. However, some studies have reported several complications for this drug. So, this systematic review was performed to determine the effectiveness and safety of Denosumab in reducing bone destructions activity of giant cell tumor and skeletal-related events (SRE) in affected patients with giant cell tumor of bone (GCTB) and its recurrence. We explored studies in PubMed, and Cochrane Library. For this purpose, articles of various levels were retrieved until October 22, 2016. Two reviewers assessed the articles independently based on predefined criteria to extract the relevant data. Primary outcomes associated with skeletal-related event, overall survival, and secondary outcomes such as pain, quality of life and adverse events were evaluated and analyzed. The total population of this meta-analysis consisted of 686 patients. Of this population, 55 had primary GCTB and 45 had giant cell tumor recurrence, with 2 experiencing secondary recurrence. The results showed the effectiveness of Denosumab in reducing the tumor size due to inhibiting the Osteoclastogenesis. Denosumab didnot show any effect on reducing tumor recurrence, but, in cases where complete tumor surgery is not possible and tumor residuals may remain, Denosumab can be helpful. Also, the clinicians should consider the risk benefit of Denosumab. © 2018 By The Archives of Bone and Joint Surgery

Reducing the risk of nerve injury during Bernese periacetabular osteotomy: A cadaveric study

The modified Smith-Petersen and Kocher-Langenbeck approaches were used to expose the lateral cutaneous nerve of the thigh and the femoral, obturator and sciatic nerves in order to study the risk of injury to these structures during the dissection, osteotomy, and acetabular reorientation stages of a Bernese peri-acetabular osteotomy. Injury of the lateral cutaneous nerve of thigh was less likely to occur if an osteotomy of the anterior superior iliac spine had been carried out before exposing the hip. The obturator nerve was likely to be injured during unprotected osteotomy of the pubis if the far cortex was penetrated by > 5 mm. This could be avoided by inclining the osteotome 45° medially and performing the osteotomy at least 2 cm medial to the iliopectineal eminence. The sciatic nerve could be injured during the first and last stages of the osteotomy if the osteotome perforated the lateral cortex of ischium and the ilio-ischial junction by > 10 mm. The femoral nerve could be stretched or entrapped during osteotomy of the pubis if there was significant rotational or linear displacement of the acetabulum. Anterior or medial displacement of < 2 cm and lateral tilt (retroversion) of < 30° were safe margins. The combination of retroversion and anterior displacement could increase tension on the nerve. Strict observation of anatomical details, proper handling of the osteotomes and careful manipulation of the acetabular fragment reduce the neurological complications of Bernese peri-acetabular osteotomy. © 2015 The British Editorial Society of Bone & Joint Surgery

Morphology of asterion and its proximity to deep vein sinuses in Iranian adult skull

Background: The asterion is located at the posterior lateral side of the skull at the junction of the parietal, temporal and occipital bones. Methods: We examined the morphology of the asterion, its association with deep vein elements, the mastoid apex and inion in 105 adult cadavas (210 hemicraniums) including 146 males and 64 females at the anatomy lab of the Legal Medicine Organization. Results: Two types of asterion were observed. Type I was found in 14.7, and type II in 85.3 of cases. In 70 of cases, the asterion was at or above the venous sinus. The distance between the asterion and the mastoid appendage on the right side was 47.03 mm and on the left side was 46.5 mm. The distance between the asterion and the inion at the right side was 70.55 mm and on the left side was 70.2 mm. Conclusion: The asterion in 70 of cases was at or above the level of the transverse sinus. For this reason, in posterior fossa surgical approaches, the first burr hole is preferred to start in the lower parts of the asterion. © 2019, © 2019 The Neurosurgical Foundation

Elevated Fasting Glucose and C-Reactive Protein Levels Predict Increased All-Cause Mortality after Elective Transcatheter Aortic Valve Implantation

Surgical aortic valve replacement in the elderly is now being supplanted by transcatheter aortic valve implantation (TAVI). Scoring systems to predict survival after catheter-based procedures are understudied. Both diabetes (DM) and underlying inflammatory conditions are common in patients undergoing TAVI, but their impact remains understudied in this patient group. We examined 560 consecutive TAVI procedures and identified eight pre-procedural factors: age, body mass index (BMI), DM, fasting blood glucose (BG), left-ventricular ejection fraction (EF), aortic valve (AV) mean gradient, C-reactive protein levels, and serum creatinine levels and studied their impact on survival. The overall mortality rate at 30 days, 1 year and 2 years were 5.2%, 16.6%, and 34.3%, respectively. All-cause mortality was higher in patients with DM (at 30 days: 8.9% vs. 3.1%, p = 0.008; at 1 year: 19.7% vs. 14.9%, p = 0.323; at 2 years: 37.9% vs. 32.2%, p = 0.304). The presence of DM was independently associated with increased 30-day mortality (hazard ratio [HR] 5.38, 95% confidence interval [CI], 1.24–23.25, p = 0.024). BG levels within 7–11, 1 mmol/L portended an increased risk for 30-day and 2-year mortality compared to normal BG (p = 0.001 and p = 0.027). For each 1 mmol/L increase in BG 30-day mortality increased (HR 1.21, 95% CI, 1.04–1.41, p = 0.015). Reduced EF and elevated CRP were each associated with increased 2-year mortality (p = 0.042 and p = 0.003). DM, elevated BG, reduced EF, and elevated baseline CRP levels each are independent predictors of short- and long-term mortality following TAVI. These easily accessible screening parameters should be integrated into risk-assessment tools for catheter-based aortic valve replacement candidates

Induced Human Regulatory T Cells Express the Glucagon-like Peptide-1 Receptor

The glucagon-like peptide-1 receptor (GLP-1R) plays a key role in metabolism and is an important therapeutic target in diabetes and obesity. Recent studies in experimental animals have shown that certain subsets of T cells express functional GLP-1R, indicating an immune regulatory role of GLP-1. In contrast, less is known about the expression and function of the GLP-1R in human T cells. Here, we provide evidence that activated human T cells express GLP-1R. The expressed GLP-1R was functional, as stimulation with a GLP-1R agonist triggered an increase in intracellular cAMP, which was abrogated by a GLP-1R antagonist. Analysis of CD4+ T cells activated under T helper (Th) 1, Th2, Th17 and regulatory T (Treg) cell differentiation conditions indicated that GLP-1R expression was most pronounced in induced Treg (iTreg) cells. Through multimodal single-cell CITE- and TCR-sequencing, we detected GLP-1R expression in 29&ndash;34% of the FoxP3+CD25+CD127- iTreg cells. GLP-1R+ cells showed no difference in their TCR-gene usage nor CDR3 lengths. Finally, we demonstrated the presence of GLP-1R+CD4+ T cells in skin from patients with allergic contact dermatitis. Taken together, the present data demonstrate that T cell activation triggers the expression of functional GLP-1R in human CD4+ T cells. Given the high induction of GLP-1R in human iTreg cells, we hypothesize that GLP-1R+ iTreg cells play a key role in the anti-inflammatory effects ascribed to GLP-1R agonists in humans