The Role of Mitochondrial DNA (mtDNA) in the Development of Diabetic Retinopathy (DR): A Systematic Review

Diabetic Retinopathy (DR) is the most prevalent health problem, which is influenced by environmental and genetic factors with an increasing prevalence. The current systematic review is focused on mtDNA modification, including polymorphism and mutation/deletion, with a direct effect on DR. This systematic search was initially done through PubMed, Cochrane, EMBASE, SCOPUS, and Web of Science without a restriction on the years of publication. The terms searched included ‘‘mtDNA’’, ‘‘mitochondrial DNA’’, ‘‘diabetes’’, ‘‘diabetic’’, ‘‘retina’’, and ‘‘diabetic retinopathy’’. Animal, cohort, cross-sectional, and in vitro studies, as well as case series, case reports, review articles, and Letters to Editor were excluded from this research. From 1528 resulting searched articles, only 12 papers were finally chosen as the case-control studies considering  mtDNA gene and DR. Actually, of these 12 articles, 8 studies were concerned with mtDNA polymorphisms (UCP1, UCP2, ROMO-1, and Mn-SOD) and 4 articles were related to mtDNA mutation (A3243G mutation in tRNALeu(UUR) gene and mtDNA deletion (ΔmtDNA 4977)). Some conflicting results were found between the selected genetic modifications of mtDNA, such as Mn-SOD, UCP1, ΔmtDNA 4977, tRNALeu (UUR), and ROMO-1. Finally, A3243G mutation in the tRNALeu (UUR) gene and rs660339 and V16A polymorphisms of UCP2 and Mn-SOD genes were respectively considered as the most important factors in the pathogenesis of DR.Â

The Role of Mitochondrial DNA (mtDNA) in the Development of Diabetic Retinopathy (DR): A Systematic Review

Diabetic Retinopathy (DR) is the most prevalent health problem, which is influenced by environmental and genetic factors with an increasing prevalence. The current systematic review is focused on mtDNA modification, including polymorphism and mutation/deletion, with a direct effect on DR. This systematic search was initially done through PubMed, Cochrane, EMBASE, SCOPUS, and Web of Science without a restriction on the years of publication. The terms searched included ‘‘mtDNA’’, ‘‘mitochondrial DNA’’, ‘‘diabetes’’, ‘‘diabetic’’, ‘‘retina’’, and ‘‘diabetic retinopathy’’. Animal, cohort, cross-sectional, and in vitro studies, as well as case series, case reports, review articles, and Letters to Editor were excluded from this research. From 1528 resulting searched articles, only 12 papers were finally chosen as the case-control studies considering  mtDNA gene and DR. Actually, of these 12 articles, 8 studies were concerned with mtDNA polymorphisms (UCP1, UCP2, ROMO-1, and Mn-SOD) and 4 articles were related to mtDNA mutation (A3243G mutation in tRNALeu(UUR) gene and mtDNA deletion (ΔmtDNA 4977)). Some conflicting results were found between the selected genetic modifications of mtDNA, such as Mn-SOD, UCP1, ΔmtDNA 4977, tRNALeu (UUR), and ROMO-1. Finally, A3243G mutation in the tRNALeu (UUR) gene and rs660339 and V16A polymorphisms of UCP2 and Mn-SOD genes were respectively considered as the most important factors in the pathogenesis of DR.

Correlação entre os níveis de vitamina D e densidade mineral óssea em uma população iraniana saudável

ResumoObjetivosConsiderando os resultados controversos sobre a relação entre níveis de vitamina D e densidade mineral óssea em diferentes populações, o presente estudo foi desenhado para avaliar essa correlação em uma população iraniana saudável.MétodosCom uma amostra aleatória de homens e mulheres aparentemente saudáveis, este estudo transversal multicêntrico considerou 4.450 indivíduos que vivem na região urbana de cinco grandes cidades no Irã. Os valores da densidade mineral óssea (DMO) foram analisados em conjunto com os níveis séricos de 25(OH)D e PTH. Análise da variação (Anova) foi usada para estimar os principais efeitos por meio da comparação entre os valores médios desses marcadores e a condição da densidade mineral óssea de cada gênero nesta amostra de estudo.ResultadosNíveis de 25(OH)D foram inversamente proporcionais aos valores de DMO no nível do quadril (r=‐0,062 em homens e r=‐0,057 em mulheres) e da coluna vertebral (r=‐0,076 em homens e r=‐0,107 em mulheres). Após ajuste dos dados para idade, a correlação negativa não foi mais estatisticamente significante.ConclusãoNíveis séricos de 25(OH)D são inversamente correlacionados com os valores de massa óssea em ambos os gêneros.AbstractObjectivesConsidering the controversial results regarding the relationship between vitamin D levels and bone mineral density in different populations, the present study was designed to evaluate this correlation in a healthy Iranian population.MethodsUsing a random cluster sample of apparently healthy men and women, this multicenter cross‐sectional study was carried out among 4450 individuals living in urban areas of five major cities in Iran. Bone mineral density (BMD) values at different sites were analyzed along with the serum levels of 25(OH)D and PTH. Analysis of variance (Anova) was used to estimate the main effects, through comparing the mean values of these markers based on the bone mineral density status of the study group in each sex.Results25(OH)D levels were inversely correlated with BMD values at total hip (r=−0.062 in men and r=−0.057 in women) and spine (r=−0.076 in men and r=−0.107 in women). After adjusting the data for age, the inverse correlation was no longer statistically significant.ConclusionSerum 25(OH)D levels are inversely correlated with bone mass values in both sexes

Effectiveness of dry needling for improving pain and disability in adults with tension-type, cervicogenic, or migraine headaches: Protocol for a systematic review

Background: Headache is the most common neurological symptoms worldwide, as over 90% of people have noted at least one headache during their lifetime. Tension-type headaches, cervicogenic headaches, and migraines are common types of headache which can have a significant impact on social, physical, and occupational functioning. Therapeutic management of headaches mainly includes physical therapy and pharmacological interventions. Dry needling is a relatively new therapeutic approach that uses a thin filiform needle without injectate to penetrate the skin and stimulate underlying tissues for the management of neuromusculoskeletal pain and movement impairments. The main objective of this systematic review and meta-analysis is to evaluate the effectiveness of dry needling in comparison to other interventions on pain and disability in patients with tension-type headache, cervicogenic headache, and migraine. Methods/design: We will focus on clinical trials with concurrent control group(s) and comparative observational studies assessing the effect of dry needling in patients with tension-type headache, cervicogenic headache, and migraine. Electronic databases from relevant fields of research (PubMed/ Medline, Scopus, Embase®, PEDro, Web of Science, Ovid, AMED, CENTRAL, and Google Scholar) will be searched from inception to June 2019 using defined search terms. No restrictions for language of publication or geographic location will be applied. Moreover, grey literature, citation tracking, and reference lists scanning of the selected studies will be searched manually. Primary outcomes of this study are pain intensity and disability, and secondary outcomes are cervical spine ROM, frequency of headaches, health-related quality of life, and TrPs tenderness. Studies will be selected by three independent reviewers based on prespecified eligibility criteria. Three reviewers will independently extract data in each eligible study using a pre-piloted Microsoft Excel data extraction form. The assessment of risk of bias will be implemented using the Cochrane Back and Neck Review Group 13-item criteria and NOS. Direct meta-analysis will be performed using a fixed or random effects model to estimate effect size such as standardized mean difference (Morris's d ppc ) and 95% confidence intervals. Statistical heterogeneity will also be evaluated using the I 2 statistic and the χ2 test. All meta-analyses will be performed using Stata V.11 and V.14 softwares. The overall quality of the evidence for the primary outcomes will be assessed using GRADE. Discussion: All analyses in this study will be based on the previous published papers. Therefore, ethical approval and patient consent are not required. The findings of this study will provide important information on the value of dry needling for the management of tension-type headache, cervicogenic headache, and migraine

The Viewpoints of Paramedics Employed in Golestan Province towards Continuing Education Programs

Introduction: Retraining is an important way for professional development of health staff and keeping them up to date, and evaluation is one of the essential principles for enhancing the efficiency of these trainings. The aim of this study was to determine the viewpoints of paramedics employed in Golestan province towards continuing education programs. Methods: In this descriptive study, 274 samples were selected out of 1016 paramedics employed in clinics of the province, through systematic random sampling. The data gathering tool was a questionnaire. Data was analyzed by SPSS software using descriptive statistics, Chi², and independent T-test. Results: Among the participants, 26.2%, 41.8%, 25.5% and 6.5% had very weak, weak, average, and desirable viewpoint towards the courses, respectively. As the motivation for participating in the courses, 55.5% mentioned achieving points for job promotion opportunities, 21.2% resorting and reviewing former information, 13.8% exchanging information and experiences with other colleagues, and 9.5% mentioned seeking solutions for their professional problems. Thirty one percent reported lack of equity and fairness in participating in the programs on behalf of their direct administrator and 33.9% stated that the planning for participation in these courses was not favorable. Conclusion: Participants had a weak or very weak viewpoint toward programs and regarded their motiva-tion for participation in these programs as achieving points for job promotion. It is necessary for admini-strators to plan for changing the staff's viewpoint toward participation in continuing education programs

Development and validation of osteoporosis prescreening model for Iranian postmenopausal women

BACKGROUND: Studies have indicated that the commonly used osteoporosis prescreening tools are not appropriate for use in every nation. This study was designed to develop and validate a prescreening model for bone mineral densitometry among Iranian postmenopausal women. METHODS: From 13613 individuals who were referred for bone mineral densitometry in Shariati hospital in Tehran, 8644 postmenopausal women were considered for the study after excluding men and premenopausal women. Questionnaires regarding the risk factors for osteoporosis were filled for each individual. Bone mineral density at the lumbar vertebrae (L2-L4), femoral neck and total femur was measured by dual X-ray absorptiometry. Using holdout validation, the study sample was divided into two parts; training set (5705) and test set (2939). Logistic regression analysis was performed on the training set. A scoring model was developed and tested in the test set. RESULTS: Based on the training set, a seven-variable model named OPMIP (Osteoporosis Prescreening Model for Iranian Postmenopausal women) was developed with C statistics (area under curve) of 0.72. Using a cut-off of -2.5 for the model, the sensitivity, specificity, positive predictive value and negative predictive value were 72%, 59.5%, 64% and 69% respectively. The model performance was tested in the test set. OPMIP correctly classified 67.10% of cases with a sensitivity and specificity of 73.2% and 61%. CONCLUSIONS: In order to appropriately refer patients for a bone mineral densitometry, OPMIP can be used as a prescreening tool in Iranian Postmenopausal women

Subtypes of Benign Breast Disease as a Risk Factor for Breast Cancer: A Systematic Review and Meta-Analysis Protocol

Breast cancer is a multifactorial disease. Benign breast disease (BBD) is one of the most important risk factors for breast cancer. The etiology of BBD is unknown. It is divided into nonproliferative and proliferative diseases. The selection of studies will be based on titles, abstract screening, inclusion and exclusion criteria, and quality assessment. Previous studies have shown that all types of BBD increase the risk of breast cancer, but the risk degree is different for each one. Accurate risk estimation of breast cancer in each category can be very important for proper clinical management. This systematic review and meta-analysis will be conducted on observational studies (traditional case control, nested case control, case cohort, and cohort) published in the Web of Science (ISI), PubMed (MEDLINE), Scopus, Google Scholar, and the key journals of this field such as Breast Cancer Research and Treatment and Cancer Research from January 2000 to June 2015. Reference lists and gray literature will be reviewed too. All the initial retrievals will be performed by 2 researchers independently. The data extraction form will consist of general information concerning the studies, study eligibility, method, risk of bias assessment, and results—including odds ratios, risk ratios, rate ratios, and hazard ratios. The PRISMA and MOOSE guidelines will be used to report our findings. Registration Details: PROSPERO-4201603524

The Role of IL-6 for Predicting Neonatal Sepsis: A Systematic Review and Meta-Analysis

Objective: Neonatal sepsis (NS) is a common and life-threatening disorder in infants. Previous studies showed that interleukin-6 (IL-6) may be a valid non-invasive and rapid method for diagnosis of NS. We conducted this review to assess the validity of IL-6 for predicting NS. Methods: This was a systematic review with meta-analysis. Embase, Medline and Web of Science databases were searched between January 1990 and December 2009. The search terms used were “cytokine”, “neonate”, “sepsis” and “interleukin-6". We used standard methods recommended for meta analyses of diagnostic test evaluations. The analysis was based on a summary ROC (SROC) curve. Meta-regression analysis was used to assess the effects of some confounding factors on the results of meta-analysis. Potential presence of publication bias was tested using funnel plots and the Egger test. Findings: Meta-analysis was performed on 13 publications including 353 infants with sepsis and 691 control infants. The pooled sensitivity and specificity of IL-6 was 0.79 and 0.84, respectively. The maximum joint sensitivity and specificity (i.e., the Q value) in SROC curve was 0.82 and the area under curve (AUC) was 0.89 (95% CI: 0.84-0.94). Meta-regression analysis showed that the diagnostic accuracy of IL-6 was not affected by confounding variables. The evaluation of publication bias showed that the Egger test was not significant (P=0.07). Conclusion: IL-6 seems to be a valid marker for predicting NS. It may be considered for early diagnosis of sepsis in neonatal care units

The impact of alendronate on bone mineral density of osteoporotic patients

The present study assessed the real life therapeutic effects of weekly doses of alendronate in treating a group of osteoporotic patients in Iran. The present historical cohort was conducted on patients who had undergone two or more bone mineral densitometry within an interval of 1.5-2 years in Shariati Hospital bone mineral density department between 2002 and 2010.patients were asked by phone about consumption of alendronate. The mean increase in the BMD values at different sites was calculated. There was a significant increase in the body mass index (BMI) values of both the individuals taking alendronate and the control group (P<0.001). Taking the weekly dosage of the drug was associated with a 7.67% increase in the BMD values at the femoral neck, 8.68% at the total hip, and 3.17% at the lumbar spine. Moreover, our results showed a significant difference between the height decline in the two groups (alendronate taking: 0.7±2.4 vs. control: -0.7±2.6, P<0.001). Comparing the results of the present study with that of previous ones revealed the drug is beneficial in improving bone mineral density in Iranians; as well alendronate is more effective in Iranian postmenopausal women when compared with the Americans