Evaluation of patient outcome and satisfaction after surgical treatment of adolescent idiopathic scoliosis using scoliosis research society-30

Background: Adolescent idiopathic scoliosis (AIS) may lead to physical and mental problems. It also can adversely affect patient satisfaction and the quality of life. In this study, we assessed the outcomes and satisfaction rate after surgical treatment of AIS using scoliosis research society-30 questionnaire (SRS-30). Methods: We enrolled 135 patients with AIS undergoing corrective surgery. Patients were followed for at least 2 years. We compared pre- and post-operative x-rays in terms of Cobb's angles and coronal balance. At the last visit, patients completed the SRS-30 questionnaire. We then assessed the correlation between radiographic measures, SRS-30 total score, and patient satisfaction. Results: Cobb's angle and coronal balance improved significantly after surgery (P<0.001). The scores of functional activity, pain, self-image/cosmesis, mental health, and satisfaction were 27±4.3, 26±2.5, 33±5.2, 23±3.5, and 13±1.8, respectively. The total SRS-30 score was 127±13. Radiographic measures showed significant positive correlation with satisfaction and SRS-30 total scores. There was also a positive correlation between satisfaction and self-image/cosmesis domain scores. Conclusions: The greater the radiographic angles were corrected the higher the SRS-30 total score and patient satisfaction were. It is intuitive that the appearance and cosmesis is of most important factor associated with patient satisfaction. © 2015 BY THE ARCHIVES OF BONE AND JOINT SURGERY

The combination of retinoic acid and estrogen can increase germ cells genes expression in mouse embryonic stem cells derived primordial germ cells

A B S T R A C T Generation of germ cells from embryonic stem cells in vitro could have great application for treating infertility. The temporal expression profile of several genes was expressed at different stages of germ cell development and examined in differentiation the mouse embryonic stem cells. Cells were treated in three groups of control, with 10−8M of all-trans retinoic acid and the combination of 10−9M of 17β-Estradiol and retinoic acid for 7, 12, 17 or 22 days. Quantitative RT-PCR and Immunofluorescent were used to investigate the possible inductive effects of estrogen on mouse embryonic stem cell-derived primordial germ cells. mRNA expression of Oct4 and Dazl were downregulated in embryonic stem cells by the retinoic acid group, whereas Mvh transcription was reduced by retinoic acid and estrogen group in these cells compared to the control group. But, retinoic acid with estrogen group-treated cells exhibited increased mRNA expression of Stra8, Fragilis, Sycp3, GDF9, and Stella compared to untreated controls. The expression of Stella and Mvh proteins were remarkably increased in cell colonies. This study shows that estrogen affects the expression of specific markers of primordial germ cells. Also, estrogen and retinoic acid speed up and increase the level of expression of specific markers. Keywords: Gene expression profiling Immunofluorescent Mouse embryonic stem cells Primordial germ cells RT PC

The role of spinopelvic parameters in clinical outcomes of spinal osteotomies in patients with sagittal imbalance

Background: Sagittal imbalance is known as the main radiographic driver of disability in adult spinal deformity (ASD). In this study, the association of radiological spinopelvic parameters and clinical outcomes was evaluated following the corrective surgery of sagittal imbalance, in order to explore the predictive ability of each parameter. Methods: A total of 23 patients, who underwent corrective osteotomy for restoration of sagittal balance, were included in this study. The mean follow-up period of the patients was 15.5±2.1, ranging from 12 to 18 months. Pre- and postoperative radiological parameters including pelvic tilt (PT), sagittal vertical axis (SVA) and pelvic incidence minus lumbar lordosis (PI-LL) were assessed for each patient. Clinical outcomes were evaluated using Oswestry disability Index (ODI). Results: The mean ODI improved 32 following the corrective osteotomy of sagittal imbalance. Postoperative ODI was significantly correlated with all preoperative radiological parameters (r=0.608, P=0.002 for PI-LL; r=0.483, P=0.01 for PT; and r=0.464, P=0.02 for SVA). ODI improvement was significantly correlated with PI-LL and SVA change (r=536, P=0.008 and r=416, P=0.04, respectively), but not with PT change (r=247, P=0.25). The outcome was better in pedicle subtraction osteotomy (PSO) compared to Smith-Petersen Osteotomy (SPO). Conclusion: Surgical correction of sagittal imbalance could limit the amount of disability caused by this misalignment. According to our results, while all the spinopelvic parameters could be used in the prediction of the outcomes of corrective surgery of sagittal imbalance, PI-LL was the most informative parameter and more attention should be devoted to this parameter. © 2018 By The Archives of Bone and Joint Surgery

Differential expression of HSP90β in MDA-MB-231 and MCF-7 cell lines after treatment with doxorubicin

Breast cancer is a complex, heterogeneous disease and one of the most common malignancies in women worldwide. The efficacy of chemotherapy as an important breast cancer treatment option has been severely limited because of the inherent or acquired resistance of cancer cells. The molecular chaperone heat shock protein 90 (HSP90) upregulated in response to cellular stress is required for functions such as conformational maturation, activation and stability in more than 200 client proteins, mostly of the signaling type. In this study, the expression of HSP90 isoforms including HSP90α and HSP90β in breast cancer cell lines before and after treatment with doxorubicin (DOX) was assessed. Material and Methods: The cell cytotoxicity of DOX in MDA-MB-231 and MCF-7 cell lines was determined using the MTT assay. Immunofluorescence and western blotting techniques were used to determine the expression of HSP90β in the cell lines before and after DOX treatment. Immunofluorescence was also conducted to ascertain the expression of HSP90α. Results: The MTT assay results showed that the MDAMB- 231 cells (IC50=14.521 μM) were more sensitive than the MCF-7 cells (IC50=16.3315 μM) to DOX. The immunofluorescence results indicated that the expression of HSP90α in both cell lines decreased after exposure to DOX. The western blot and immunofluorescence analyses showed that HSP90β expression decreased in the MCF-7 cells but increased in the MDAMB- 231 cells after DOX treatment. Conclusion: The obtained results suggested that HSP90α and HSP90β expression levels were reduced in the MCF-7 cells after exposure to DOX. In the MDA-MB-231 cells, HSP90α expression was reduced while HSP90β was found to be overexpressed following DOX treatment. © 2019 Korean Pharmacopuncture Institute

Drug-related mutational patterns in hepatitis B virus (HBV) reverse transcriptase proteins from Iranian treatment-Naïve chronic HBV patients

Background: Immunomodulators and Nucleotide analogues have been used globally for the dealing of chronic hepatitis B virus (HBV) infection. However, the development of drug resistance is a major limitation to their long-term effectiveness. Objectives: The aim of this study was to characterize the hepatitis B virus reverse transcriptase (RT) protein variations among Iranian chronic HBV carriers who did not receive any antiviral treatments. Materials and Methods: Hepatitis B virus partial RT genes from 325 chronic in active carrier patients were amplified and directly sequenced. Nucleotide/amino acid substitutions were identified compared to the sequences obtained from the database. Results: All strains belonging to genotype D.365 amino-acid substitutions were found. Mutations related to lamivudine, adefovir, telbivudine, and entecavir occurred in (YMDD) 4% (n = 13), (SVQ) 17.23% (n = 56), (M204I/V + L180M) 2.45% (n = 8) and (M204I) 2.76% (n = 9) of patients, respectively. Conclusions: RT mutants do occur naturally and could be found in HBV carriers who have never received antiviral therapy. However, mutations related to drug resistance in Iranian treatment-naïve chronic HBV patients were found to be higher than other studies published formerly. Chronic HBV patients should be monitored closely prior the commencement of therapy to achieve the best regimen option. © 2013, KOWSAR Corp

Short-term efficacy of epidural injection of triamcinolone through translaminar approach for the treatment of lumbar canal stenosis

Background: Epidural steroid injection is a non-operative minimally invasive procedure for pain relief in spinal canal stenosis. However, there is no significant consensus regarding its efficacy. Objectives: In this study, we aimed to evaluate the effectiveness of translaminar injection of triamcinolone in lumbar canal stenosis. Methods: In a retrospective study, we included 111 patients with MRI-confirmed spinal canal stenosis who were irresponsive to 12 weeks of conservative treatment and underwent epidural injection of triamcinolone through the translaminar approach. Outcome measures were routinely checked before the intervention and four weeks after the intervention, which included the Visual Analog scale (VAS) for low back pain, VAS for lower-limb pain, and Oswestry Disability index (ODI). Results: The study population included 32 (28.8) males and 79 (71.2) females with the mean age of 61 ± 13.4 years. The mean ODI, VAS for low back pain, and VAS for lower-limb pain significantly improved at the final evaluation session (P < 0.001, P = 0.001, and P < 0.001, respectively). The levels of improvement in ODI, VAS for low back pain, and VAS for lower-limb pain were considerably more in patients with single-level involvement (P < 0.001, P = 0.04, and P < 0.001, respectively). Improvement of lower-limb VAS was negatively correlated with age (r =-0.400, P < 0.001) and BMI (r =-0.525, P < 0.001). The ODI improvement was also negatively correlated with BMI (r =-0.569, P < 0.001). Conclusions: Epidural injection of triamcinolone through the translaminar approach could be regarded as an efficacious method for the alleviation of pain and disability in patients with spinal canal stenosis. © 2020, Anesthesiology and Pain Medicine

Studies on combination of oxaliplatin and dendrosomal nanocurcumin on proliferation, apoptosis induction, and long non-coding RNA expression in ovarian cancer cells

Drug resistance remains a major challenge in the treatment of patients with ovarian cancer. Therefore, the development of new anticancer drugs is a clinical priority to develop more effective therapies. New approaches to improve clinical outcomes and limit the toxicity of anticancer drugs focus on chemoprevention. The aim of this study was to determine the effects of dendrosomal nanocurcumin (DNC) and oxaliplatin (Oxa) and their combination on cell death and apoptosis induction in human ovarian carcinoma cell lines analyzed by MTT assay and flow cytometry, respectively. The synergism effect of Oxa and DNC was analyzed using the equation derived from Chou and Talalay. In addition, real-time PCR was used to measure the effect of this combination on the expression levels of long non-coding RNAs with different expression in ovarian cancer and normal ovaries. Our data showed that the effect of DNC on cell death is more than curcumin alone in the same concentration. The greatest cell death effect was observed in combination of Oxa with DNC, while Oxa was added first, followed by DNC at 4 h interval (0/4 h). The findings indicated that DNC induced apoptosis significantly in both cell lines as compared to control groups; however, combination of both agents had no significant effect in apoptosis induction. In addition, combination of both agents significantly affects the relative expression of long non-coding RNAs investigated in the study as compared with mono therapy. © 2018, Springer Nature B.V

Hepatitis B virus genotype D is the only genotype circulating in Iranian chronic carriers, the unique pattern of genotypic homogeneity

Aim: To characterize the hepatitis B virus surface protein genotypes and sequence variations among HBsAg positive chronic Iranian patients from different ethnic groups. Method: The surface genes from 312 patients were amplified and directly sequenced. Results: All strains (100) belonged to genotype D and subtypes ayw2. The average nucleotide mutation frequency was 0.91 (dN/dS < 1.0), indicated negative selection. There was no significant correlation between HBV DNA and ALT levels and the occurrence of amino acid substitutions. However, in terms of HBeAg/Anti-HBe status, the association between both groups for silent nucleotide mutation was strong, indicating selection bias on missense mutations. A higher number of amino acid mutations was found in anti-HBe positive versus HBeAg positive patients.Conclusion: The uniqueness pattern of HBV genetics hemogeniety together with the low mutational frequency indicated that HBV has introduced to Iran recently and isolation of people in the absence of intermixing with other genotypes led to a homologous pattern. © 2014 ACT

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

Background: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagonlike peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. Methods: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallelgroup, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. Results: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m2, and duration of T2DM was 9.3±8.2 years. The qualifying ACS wasamyocardial infarctionin83% and unstableangina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. Conclusion: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk. © 2015 Elsevier Inc. All rights reserved