Metformin protects against radiation-induced pneumonitis and fibrosis and attenuates upregulation of dual oxidase genes expression

Purpose: Lung tissue is one of the most sensitive organs to ionizing radiation (IR). Early and late side effects of exposure to IR can limit the radiation doses delivered to tumors that are within or adjacent to this organ. Pneumonitis and fibrosis are the main side effects of radiotherapy for this organ. IL-4 and IL-13 have a key role in the development of pneumonitis and fibrosis. Metformin is a potent anti-fibrosis and redox modulatory agent that has shown radioprotective effects. In this study, we aimed to evaluate possible upregulation of these cytokines and subsequent cascades such as IL4-R1, IL-13R1, Dual oxidase 1 (DUOX1) and DUOX2. In addition, we examined the potential protective effect of metformin in these cytokines and genes, as well as histopathological changes in rat�s lung tissues. Methods: 20 rats were divided into 4 groups: control; metformin treated; radiation + metformin; and radiation. Irradiation was performed with a 60 Co source delivering 15 Gray (Gy) to the chest area. After 10 weeks, rats were sacrificed and their lung tissues were removed for histopathological, real-time PCR and ELISA assays. Results: Irradiation of lung was associated with an increase in IL-4 cytokine level, as well as the expression of IL-4 receptor-a1 (IL4ra1) and DUOX2 genes. However, there was no change in the level of IL-13 and its downstream gene including IL-13 receptor-a2 (IL13ra2). Moreover, histopathological evaluations showed significant infiltration of lymphocytes and macrophages, fibrosis, as well as vascular and alveolar damages. Treatment with metformin caused suppression of upregulated genes and IL-4 cytokine level, associated with amelioration of pathological changes. Conclusion: Results of this study showed remarkable pathological damages, an increase in the levels of IL-4, IL4Ra1 and Duox2, while that of IL-13 decreased. Treatment with metformin showed ability to attenuate upregulation of IL-4�DUOX2 pathway and other pathological damages to the lung after exposure to a high dose of IR. © 2018 The Authors. This is an Open Access article distributed under the terms of the Creative Commons Attribution (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, as long as the original authors and source are cited. No permission is required from the authors or the publishers

Contrast Agents and Observing Patient Safety Programs in Radiology Departments in Kermanshah Province Hospitals in West of Iran

Introduction: Contrast agents play an important role in increasing the efficiency of diagnostic imaging techniques in the evaluation of vascular lesions, infections and tumors. Annually more than 70 million radiology tests performed using contrast agent materials in the world. Side effects of contrast agent can belief-threaten, so that observing safety guideline prescribed a key role in the patient's health. Aim: The aim of this study was evaluation of compliance with the instructions in the use of contrast agent materials in Kermanshah province Hospitals, West in Iran. Methods: In this cross-sectional study, five centers that were active in the administration of contrast agents were studied. The data collection tool, a checklist containing 49 safety principle of contrast agent material was administered that after confirming its validity and reliability were used. Data were analyzed using SPSS16 software and findings were presented using descriptive and analytical statistics. Findings: Results showed that the average age of the participants in this study 33.66 years.54 was male. 81.8 in the Radiology department and 18.2 were working in CT scan centers. 20.5 of prescribers the contrast agent assistant radiologist, and 79.5 was radiographer, respectively. 25 of them had passed training courses dealing with the acute effects of contrast agent. There was not a guideline to identify patients at high risk for adverse events and prevention and management of adverse reactions due to the side effects prescribing of contrast material in the imaging centers. This study showed that the overall safety of contrast agents in radiology departments only 2.3 appropriate and in 97.7 moderate. Conclusion: The results showed that the Safety observance of the use of contrast agents is not acceptable in many cases. Pregnancy and lactation control, sterile techniques during catheterization in non-inject able contrast agent was not acceptable. Monitoring the patients, use safety box in case of emergency and skilled use of defibrillator; observe this safety issues was rarely taken into consideration by prescribers of inject able contrast agents. The centers survey shows that there isn't a standard guideline to identify patients at high risk and management of side effects of prescribed contrast agent

Physicians’ Knowledge about Radiation Dose in Radiological Investigation in Iran

Background: Although ionizing radiation is very important in diagnostic and treatment of many diseases, the hazards of this radiation are considerable and irrefutable. One of the main stages in radiation protection is knowledge about radiation dose in radiological investigation. The aim of this study was to determine the physicians’ knowledge in radiological examinations. Material and Methods: The data collected by questionnaire were designed and the most commonly requested radiological investigations were listed. The questionnaire was distributed among 106 consultant physicians. The survey was conducted on the awareness about the radiation dose and risks among health professionals in Iran. Results: The results indicated that the majority of physicians did not know about ionizing radiation and evaluation of absorbed dose in patients. Many of these physicians were not aware of radiations risks and the most important aspects of radiation protection; although, they have passed some courses in radiobiology and medical physics. Conclusion: Since radiological examinations play an indispensable role in medicine, knowledge about radiation doses and hazards is very important. Generally, this study showed that knowledge of radiation doses is inadequate among physicians