Low Level Laser Therapy (LLLT) Combined with Physical Exercise, A More Effective Treatment in Low Back Pain

INTRODUCTION: Low back pain is one of the most common musculoskeletal disorders,which is prevalent among the public population. Depending on the severity of the patients’ pain, different treatments are selected for them. Few studies have addressed, so far, the therapeutic effects of laser in such pains and different results have been published in this regard. The aim of this study is to investigate the therapeutic effect of low intensity laser therapy (LILT) on these diseases.METHODS: Sixty patients are randomly divided into three groups, one received low intensity laser therapy (LILT), the second group the low intensity laser and physical exercises simultaneously and the other the laser placebo and physical exercises simultaneously. Laser therapy was performed for 6 weeks, two sessions per week.Pain and disability were measured and compared, at 0, 6 and 12 weeks after the treatment in the three groups.RESULTS: Patient’s disability in groups 1 and 2 at week 6 showed a significant improvement compared to the beginning of the study. (Group I, P=0.02, P=0.012, group II, P=0.031, P=0.042, respectively).The rate of pain and disability at the week 12 improved significantly compared to the week 6 of the study in each group of 1 and 2. (Group I, P=0.002, P=0.02, group II, P=0.043, P=0.02, respectively). In the comparison of the groups at week 12, the values of pain (P=0.02) and disability (P=0.03) had improved in group I (laser therapy accompanied with physical exercise).CONCLUSION: Our Results revealed that laser therapy accompanied with physical exercise can be the most effective way for improving the chronic back pains including pain relief and reduction of disability in the patients

Częstość występowania incydentaloma tarczycy w Isfahanie, Iran - badanie populacyjne

Introduction: Thyroid nodules not detected in palpation but diagnosed following a radiological procedure or during surgery are called thyroid incidentalomas. We designed this study to investigate the prevalence of sonographic thyroid incidentaloma in Isfahan, Iran, for the first time. Material and methods: By a multistage cluster sampling method, 2523 adults were selected randomly. From this group, 2045 had normal thyroid examination. 234 out of the 2045 were selected randomly for thyroid sonography. Thyroid stimulating hormone (TSH), urinary iodine concentrations (UIC) and antithyroid antibodies were measured. Results: The prevalence of thyroid incidentaloma was 13.2% [Confidence interval (CI) 95% = 8–18]. The average age of subjects with and without incidentaloma was 46.1 (12.4) and 38.4 (12.1), respectively (P = 0.002). It was more prevalent in females than in males (19% vs. 10%) [Odds ratio (OR) = 2.59, CI 95% = 1.17–5.76, P value (P) = 0.01]. Median UIC in the incidentaloma group (14 μg/dl) was significantly lower than in the group of subjects without nodules (20 μg/dl) (OR = 0.9, CI 95% = 0.91–0.99, P = 0.02). There was no difference in the levels of TSH and antithyroid antibodies between the two groups (P > 0.05). Mean diameter of nodules was 8.14 (3.43) mm. Conclusions: The prevalence of thyroid incidentaloma was 13.2% in Isfahan. It was higher in females than males and increased with age.Wstęp: Incidentalona to guzki tarczycy niewykrywalne palpacyjnie, lecz zdiagnozowane przypadkowo podczas badania obrazowego lub zabiegu chirurgicznego. Celem badania było określenie po raz pierwszy częstości incidentaloma wykrywanych w badaniu sonograficznym w populacji irackiego miasta Isfahan. Materiał i metody: Metodą wielostopniowego losowania zespołowego wybrano grupę 2523 dorosłych osób. Spośród 2045 osób, u których nie stwierdzono zmian w badaniu palpacyjnym, wytypowano losowo 234 osoby do badania sonograficznego tarczycy. Oznaczono u nich również stężenie hormonu tyreotropowego (TSH, thyroid stimulating hormone), stężenie jodu w moczu (UIC, urinary iodine concentration) oraz przeciwciała przeciwtarczycowe. Wyniki: Incidentaloma tarczycy wykryto u 13,2% badanych (95% przedział ufności [CI] = 8–11). Średni wiek osób, u których wykazano obecność guzków wynosił 46,1 (± 12,4) lat, natomiast osób bez guzków - 38,4 (± 12,1) lat (p = 0,002). Incidentaloma występowały częściej u kobiet niż u mężczyzn (19 vs. 10%; iloraz szans [OR] = 2,59; 95% CI = 1,17–5,76; p = 0,01). Obie grupy nie różniły się pod względem stężeń TSH i przeciwciał przeciwtarczycowych (p > 0,05). Średnica guzków wynosiła średnio 8,14 (± 3,43) mm. Wnioski: Częstość incidentaloma tarczycy w populacji Isfahanu wynosiła 13,2%; była większa u kobiet niż u mężczyzn i wzrastała z wiekiem

International Consortium on Mammographic Density:methodology and population diversity captured across 22 countries

Mammographic density (MD) is a quantitative trait, measurable in all women, and is among the strongest markers of breast cancer risk. The population-based epidemiology of MD has revealed genetic, lifestyle and societal/environmental determinants, but studies have largely been conducted in women with similar westernized lifestyles living in countries with high breast cancer incidence rates. To benefit from the heterogeneity in risk factors and their combinations worldwide, we created an International Consortium on Mammographic Density (ICMD) to pool individual-level epidemiological and MD data from general population studies worldwide. ICMD aims to characterize determinants of MD more precisely, and to evaluate whether they are consistent across populations worldwide. We included 11755 women, from 27 studies in 22 countries, on whom individual-level risk factor data were pooled and original mammographic images were re-read for ICMD to obtain standardized comparable MD data. In the present article, we present (i) the rationale for this consortium; (ii) characteristics of the studies and women included; and (iii) study methodology to obtain comparable MD data from original re-read films. We also highlight the risk factor heterogeneity captured by such an effort and, thus, the unique insight the pooled study promises to offer through wider exposure ranges, different confounding structures and enhanced power for sub-group analyses

Mammographic density and ageing:A collaborative pooled analysis of cross-sectional data from 22 countries worldwide

BACKGROUND: Mammographic density (MD) is one of the strongest breast cancer risk factors. Its age-related characteristics have been studied in women in western countries, but whether these associations apply to women worldwide is not known. METHODS AND FINDINGS: We examined cross-sectional differences in MD by age and menopausal status in over 11,000 breast-cancer-free women aged 35-85 years, from 40 ethnicity- and location-specific population groups across 22 countries in the International Consortium on Mammographic Density (ICMD). MD was read centrally using a quantitative method (Cumulus) and its square-root metrics were analysed using meta-analysis of group-level estimates and linear regression models of pooled data, adjusted for body mass index, reproductive factors, mammogram view, image type, and reader. In all, 4,534 women were premenopausal, and 6,481 postmenopausal, at the time of mammography. A large age-adjusted difference in percent MD (PD) between post- and premenopausal women was apparent (-0.46 cm [95% CI: -0.53, -0.39]) and appeared greater in women with lower breast cancer risk profiles; variation across population groups due to heterogeneity (I2) was 16.5%. Among premenopausal women, the √PD difference per 10-year increase in age was -0.24 cm (95% CI: -0.34, -0.14; I2 = 30%), reflecting a compositional change (lower dense area and higher non-dense area, with no difference in breast area). In postmenopausal women, the corresponding difference in √PD (-0.38 cm [95% CI: -0.44, -0.33]; I2 = 30%) was additionally driven by increasing breast area. The study is limited by different mammography systems and its cross-sectional rather than longitudinal nature. CONCLUSIONS: Declines in MD with increasing age are present premenopausally, continue postmenopausally, and are most pronounced over the menopausal transition. These effects were highly consistent across diverse groups of women worldwide, suggesting that they result from an intrinsic biological, likely hormonal, mechanism common to women. If cumulative breast density is a key determinant of breast cancer risk, younger ages may be the more critical periods for lifestyle modifications aimed at breast density and breast cancer risk reduction

Investigation of Frequency Distribution of Breast Imaging Reporting and Data System (BIRADS) Classification and Epidemiological Factors Related to Breast Cancer in Iran: A 7-year Study (2010–2016)

Background: The first cause of women mortality due to cancer is breast cancer. Mammography plays a central part in early detection of breast cancers. The screening methods can play a major role to reduce the morbidity and mortality rate due to this malignancy. We sought the basic data in this study on our population because knowing about the baseline data is apt and vital. Materials and Methods: In this study, data were collected from a questionnaire, contained baseline bio data information, and mammographic imaging of the patients came during 7 years. Breast imaging reporting and data system (BIRADS) score, breast composition, presence of axillary lymph nodes, microcalcifications, and other incidental positive findings were determined by a radiologist and analysis was performed by SPSS package. Results: The most common indication for mammography was annual screening. The mean age of participants to the study was 55 ± 7.9 years. The majority (80%) of the patients with known breast cancer (BIRADS 6) had the extremely dense breast. The most common incidental findings in mammogram studies were focal asymmetry, architectural distortion, intramammary lymph node and accessory breasts, respectively. Conclusion: The frequency distribution of BIRADS classification in our society was clarified. It seems that the breast cancer risk is higher in women with dense breasts. Architectural distortion was also correlated to BIRADS score

A case report of Gorlin–Goltz syndrome as a rare hereditary disorder

Gorlin–Goltz syndrome is an autosomal dominant and a rare hereditary disease. Diagnosis of this syndrome is based on major and minor criteria. We report a Gorlin–Goltz syndrome in a 25-year-old male who was presented with progressive pain of maxilla and mandible over 5 years. The pain was diffuse and compatible with expansile cyst in alveolar ridges on panoramic radiography. In physical examination, he had coarse face and prognathism. Computer tomography of face revealed two expansile maxillary and one mandibular cyst. Calcification of entire length in falx and tentorium were detected in bone window

A Rare Presentation of Childhood Burkitt`s Lymphoma With Tense Ascites, Massive Pleural Effusion and Abdominal Mass

Burkitts lymphoma is a lymphatic tumor classified as non-Hodgkin lymphoma with small non cleaved cells. The disease has an incidence of two cases per million patients in North America, and usually present with an intra-abdominal tumor, or enlarged cervical lymph nodes. Massive amounts of peritoneal and plural fluid is rarely seen in these patients. A three year-old girl presented with massive pleural effusion, ascites, mesenteric infiltration, and intraperitoneal mass is discussed in this report. Burkitts lymphoma is a highly aggressive tumor with a very rapid growth and a variety of different presentations. It is potentially curable, if highly intensive multidrug chemotherapy is used with aggressive central nervous system prophylaxis

Contrast Enhancement of Mammograms for Rapid Detection of Microcalcification Clusters

Introduction Breast cancer is one of the most common types of cancer among women.  Early detection of breast cancer is the key to reducing the associated mortality rate. The presence of microcalcifications clusters (MCCs) is one of the earliest signs of breast cancer. Due to poor imaging contrast of mammograms and noise contamination, radiologists may overlook some diagnostic signs, specially the presence of MCCs. In order to improve cancer detection, image enhancement methods are often used to aid radiologists. In this paper, a new enhancement method was presented for the accurate and early detection of MCCs in mammograms. Materials and Methods The proposed system consisted of four main steps including: 1) image scaling;2) breast region segmentation;3) noise cancellation using a filter, which is sensitive to MCCs; and 4) contrast enhancement of mammograms using Contrast-Limited Adaptive Histogram Equalization (CLAHE) and wavelet transform. To evaluate this method, 120 clinical mammograms were used. Results To evaluate the performance of the image enhancement algorithm, contrast improvement index (CII) was used. The proposed enhancement method in this research achieved the highest CII in comparison with other methods applied in this study. The Validity of the results was confirmed by an expert radiologist through visual inspection. Conclusion Detection of MCCs significantly improved in contrast-enhanced mammograms. The proposed method could be helpful for radiologists to easily detect MCCs; it could also decrease the number of biopsies and reduce the frequency of clinical misdiagnosis. Moreover, it could be useful prior to segmentation or classification stages