Serum Concentration of Thyroid Hormones Long-Term After Sulfur Mustard Exposure

Background: Despite several reports on the clinical manifestations of sulfur mustard (SM) intoxication, there is no study on serum concentrations of thyroid hormones long-term after SM exposure. In this study, the changes in thyroid functioning parameters 20 yr after SM exposure were evaluated. Methods: This study is a part of a larger historical cohort study conducted in 2007 following 20 years of the exposure to SM, called Sardasht–Iran cohort study (SICS). We (SICS) comprised an SM–exposed group from Sardasht City, West Azerbaijan Province, Iran (n=169 as hospitalized group and n=203 as non-hospitalized exposed group); and control participants were selected from Rabat, a town near Sardasht (n=126). Peripheral blood samples were taken in fasting state and then the sera were separated. T4, T3, TSH, antithyroglobulin (anti–Tg), and antithyroid peroxidase (anti–TPO) concentrations in the sera were measured by the ELISA method. Results: The mean of T3 concentration was significantly higher in the exposed than control group (0.88 ± 0.26 nmol/L vs 0.8 ± 0.25 nmol/L, P<0.001). The levels of TSH, T4, and T3up were not significantly different between the exposed and control groups. Thyroglobulin level was significantly higher in the exposed non-hospitalized group (56.07 ± 140.22 µg/L vs 17.66 ± 41.49 µg/L, P=0.004), but the level of anti–Tg and anti–TPO showed no significant differences between the two groups. Conclusion: More studies are needed on the alterations in thyroid hormones, their gene expressions, and mechanisms involved in SM exposure to clarify the causes of these alterations.

Download Full-text

Evaluation of the LTBP1 and Smad6 Genes Expression in Lung Tissue of Sulfur Mustard-exposed Individuals with Long-term Pulmonary Complications

Iranian Journal of Allergy Asthma and Immunology ◽

10.18502/ijaai.v18i5.1895 ◽

2019 ◽

Cited By ~ 1

Author(s):

Somayeh Mami ◽

Sara Ghaffarpour ◽

Soghrat Faghihzadeh ◽

Tooba Ghazanfari

Keyword(s):

Lung Tissue ◽

Negative Feedback ◽

Transforming Growth Factor Beta ◽

Transforming Growth Factor ◽

Sulfur Mustard ◽

Control Group ◽

Main Role ◽

Expression Levels ◽

And Control

Sulfur mustard (SM) exposure injures different organs such as the lungs and leads to short and long term complications Transforming growth factor beta (TGF-β) has the main role in altering fibroblast activities linked to airways remodeling. Latency TGF beta binding proteins 1 (LTBP1 facilitates localization of TGF-β in the extracellular matrix. Mothers against decapentaplegic homolog 6 (Smad6) negatively regulates TGF-β signaling, thus establishing a main negative feedback loop. In this study, we investigated the expression of LTBP1 and Smad6 in the lung tissues of SM-exposed and control individuals. Lung formalin-fixed paraffin-embedded (FFPE) blocks of SM-exposed (20 samples) and control groups (20 samples) were collected from archival pathology department of several general hospitals. The total mRNA of lung FFPE tissues was extracted. Quality of the extracted mRNA was evaluated by an Agilent Bio analyzer and RNA was quantified using a Nano Drop. LTBP1 and Smad6 expression levels were evaluated by real-time PCR. LTBP1 expression levels did not change between the two groups (p=0.626), howeverSmad6 expression levels were significantly higher (2.6 fold) in SM-exposed individuals compared to the control group (p=0.001). Our results revealed that Smad6 may be involved in lung tissue remodeling process in SM-exposed patients. Smad6 regulates fibrotic alterations in lung tissue and its function as negative feedback mechanisms in TGF-β.

Download Full-text

The Anti-PD-1/PD-L1 Immunotherapy for Gastric Esophageal Cancer: A Systematic Review and Meta-Analysis and Literature Review

Cancer Control ◽

10.1177/1073274821997430 ◽

2021 ◽

Vol 28 ◽

pp. 107327482199743

Author(s):

Ke Chen ◽

Xiao Wang ◽

Liu Yang ◽

Zheling Chen

Keyword(s):

Overall Survival ◽

Esophageal Cancer ◽

Survival Rate ◽

Meta Analysis ◽

Response Rates ◽

Control Group ◽

Term Survival ◽

Long Term Survival ◽

And Control

Background: Treatment options for advanced gastric esophageal cancer are quite limited. Chemotherapy is unavoidable at certain stages, and research on targeted therapies has mostly failed. The advent of immunotherapy has brought hope for the treatment of advanced gastric esophageal cancer. The aim of the study was to analyze the safety of anti-PD-1/PD-L1 immunotherapy and the long-term survival of patients who were diagnosed as gastric esophageal cancer and received anti-PD-1/PD-L1 immunotherapy. Method: Studies on anti-PD-1/PD-L1 immunotherapy of advanced gastric esophageal cancer published before February 1, 2020 were searched online. The survival (e.g. 6-month overall survival, 12-month overall survival (OS), progression-free survival (PFS), objective response rates (ORR)) and adverse effects of immunotherapy were compared to that of control therapy (physician’s choice of therapy). Results: After screening 185 studies, 4 comparative cohort studies which reported the long-term survival of patients receiving immunotherapy were included. Compared to control group, the 12-month survival (OR = 1.67, 95% CI: 1.31 to 2.12, P < 0.0001) and 18-month survival (OR = 1.98, 95% CI: 1.39 to 2.81, P = 0.0001) were significantly longer in immunotherapy group. The 3-month survival rate (OR = 1.05, 95% CI: 0.36 to 3.06, P = 0.92) and 18-month survival rate (OR = 1.44, 95% CI: 0.98 to 2.12, P = 0.07) were not significantly different between immunotherapy group and control group. The ORR were not significantly different between immunotherapy group and control group (OR = 1.54, 95% CI: 0.65 to 3.66, P = 0.01). Meta-analysis pointed out that in the PD-L1 CPS ≥10 sub group population, the immunotherapy could obviously benefit the patients in tumor response rates (OR = 3.80, 95% CI: 1.89 to 7.61, P = 0.0002). Conclusion: For the treatment of advanced gastric esophageal cancer, the therapeutic efficacy of anti-PD-1/PD-L1 immunotherapy was superior to that of chemotherapy or palliative care.

Download Full-text

The incidence of mental disorder increases after hip fracture in older people: a nationwide cohort study

BMC Geriatrics ◽

10.1186/s12877-021-02195-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ling-Yin Kuo ◽

Po-Ting Hsu ◽

Wen-Tien Wu ◽

Ru-Ping Lee ◽

Jen-Hung Wang ◽

...

Keyword(s):

Cohort Study ◽

Hip Fracture ◽

Geriatric Patients ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Control Group ◽

Research Database ◽

Fracture Group ◽

Related Risk ◽

And Control

Abstract Background People living with dementia seem to be more likely to experience delirium following hip fracture. The association between mental disorders (MD) and hip fracture remains controversial. We conducted a nationwide study to examine the prevalence of MD in geriatric patients with hip fractures undergoing surgery and conducted a related risk factor analysis. Material and methods This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012 and focused on people who were older than 60 years. Patients with hip fracture undergoing surgical intervention and without hip fracture were matched at a ratio of 1:1 for age, sex, comorbidities, and index year. The incidence and hazard ratios of age, sex, and multiple comorbidities related to MD and its subgroups were calculated using Cox proportional hazards regression models. Results A total of 1408 patients in the hip fracture group and a total of 1408 patients in the control group (no fracture) were included. The overall incidence of MD for the hip fracture and control groups per 100 person-years were 0.8 and 0.5, respectively. Among MD, the incidences of transient MD, depression, and dementia were significantly higher in the hip fracture group than in the control group. Conclusions The prevalence of newly developed MD, especially transient MD, depression, and dementia, was higher in the geriatric patients with hip fracture undergoing surgery than that in the control group. Prompt and aggressive prevention protocols and persistent follow-up of MD development is highly necessary in this aged society.

Download Full-text

Endo-sponge Assisted Early Surgical Closure of Ileal Pouch-anal Anastomotic Leakage Preserves Long-term Function: A Cohort Study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz093 ◽

2019 ◽

Vol 13 (12) ◽

pp. 1537-1545

Author(s):

Karin A Wasmann ◽

Maud A Reijntjes ◽

Merel E Stellingwerf ◽

Cyriel Y Ponsioen ◽

Christianne J Buskens ◽

...

Keyword(s):

Cohort Study ◽

Effective Treatment ◽

Anastomotic Leakage ◽

Ileal Pouch ◽

Pelvic Sepsis ◽

Surgical Closure ◽

Pouch Failure ◽

Pouch Function ◽

And Control

Abstract Background and Aims Endo-sponge [Braun Medical] assisted early surgical closure [ESC] is an effective treatment to control pelvic sepsis after ileal pouch-anal anastomosis [IPAA] leakage, and became standard treatment in our centre from 2010 onwards. The aim of this cohort study was to assess the long-term pouch function of ulcerative colitis [UC] patients treated with ESC or conventional management [CM] for anastomotic leakage after IPAA. Methods Consecutive patients who underwent an IPAA for UC between 2002 and 2017 were included. Patients treated with ESC [2010–2017] or CM [2002–2009] for anastomotic leakage were compared with control patients without anastomotic leakage of the corresponding time period. Main endpoints were long-term pouch function on a 3-point scale and pouch failure, as measured with the validated pouch dysfunction score questionnaire. Results Some 280 of 334 patients [84%] returned the pouch dysfunction questionnaire, of whom 18 were treated with ESC and 22 with CM for anastomotic leakage. Control cohorts included 133 [2010–2017] and 107 patients [2002–2009]. Between ESC-treated patients and control patients, pouch function [p = 0.647] and pouch failure rates [0/18 versus 5/133, p >0.99] were similar. CM resulted in worse pouch function [p = 0.016] and a higher pouch failure rate [5/22 versus 5/107, p = 0.013] compared with control patients. Conclusions ESC, in contrast to CM, for IPAA leakage in UC patients is associated with preservation of pouch function and preclusion of pouch failure, probably due to early and effective treatment of pelvic sepsis.

Download Full-text

Predictors of long-term mortality in left-sided infective endocarditis: an historical cohort study in 414 patients

European Journal of Internal Medicine ◽

10.1016/j.ejim.2021.08.011 ◽

2021 ◽

Author(s):

Emanuele Durante-Mangoni ◽

Giuseppe Giuffrè ◽

Maria Paola Ursi ◽

Domenico Iossa ◽

Lorenzo Bertolino ◽

...

Keyword(s):

Cohort Study ◽

Infective Endocarditis ◽

Historical Cohort ◽

Historical Cohort Study ◽

Long Term Mortality

Download Full-text

The Effect of Telerehabilitation on Quality of Life, Exercise Capacity, and Spirometry Indexes in Patients with Chronic Obstructive Pulmonary Disease in Masih Daneshvari Hospital

Journal of Iranian Medical Council ◽

10.18502/jimc.v4i3.7218 ◽

2021 ◽

Author(s):

Somayeh Ghadimi ◽

Atefeh Fakharian ◽

Mohsen Abedi ◽

Reyhaneh Zahiri ◽

Mahsan Norouz Afjeh ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

And Control

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to limited activity and reduced quality of life. Treatment of this disease is a long-term process that requires the cooperation of patients in monitoring and treatment. Methods: In the present study which was conducted from April 2019 to March 2021 in Masih Daneshvari Hospital, Tehran, Iran, 75 patients were randomly divided into telerehabilitation and control groups. Patients in the control group received pulmonary rehabilitation including respiratory, isometric, and aerobic exercises for 8 weeks, three times per week. In the second group, patients were given a lung rehabilitation booklet and asked to repeat the exercises three times a week for four weeks according to a specific schedule. In addition, patients installed Behzee care application on the mobile phone that recorded various indicators such as heart rate, SpO2, dyspnea, fatigue, and daily activities. This application reminded the patient of the program every day and at a specific time. Finally, the patients’ conditions were compared in the two groups after 8 weeks using CAT and mMRC questionnaires and 6-Minute Walk (6MW) exercise indices as well as spirometry tests. Results: In all four indicators (6MW, CAT, and mMRC questionnaires as well as spirometry), patients showed improvement after rehabilitation (p<0.001). This improvement was significantly higher in the telemedicine group compared to the other group (p<0.01). Conclusion: The use of telerehabilitation in COPD patients is effective in improving spirometry indices, quality of life, as well as activity and sports indices.

Download Full-text

What is the impact of methotrexate on liver in patients with juvenile idiopathic arthritis? Results of liver SWE performed in a single centre

Modern Rheumatology ◽

10.1093/mr/roab064 ◽

2021 ◽

Author(s):

Vildan Güngörer ◽

Mehmet Öztürk ◽

Mustafa Yasir Özlü ◽

Şükrü Arslan

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Shear Wave Elastography ◽

Term Therapy ◽

Control Group ◽

Significant Difference ◽

Group 2 ◽

Long Term Therapy ◽

And Control ◽

The Impact

ABSTRACT Objectives Long-term therapy with low-dose methotrexate (MTX) is widely used in treatment of rheumatic diseases, in children. The purpose of this study was to evaluate liver elasticity in patients with juvenile idiopathic arthritis (JIA) who received MTX and compare the results with control group. Methods Liver elasticity was evaluated with shear wave elastography (SWE) technique in 25 patients aged 3–17 years who were followed up with JIA and received MTX and compared with 25 healthy controls of the same age and weight. Factors that had an effect on liver elasticity were examined. Results The mean SWE value of patients was 2.64 ± 2.13 m/s and 24.10 ± 18.50 kPa, whereas 1.83 ± 0.16 m/s and 10.09 ± 1.83 kPa in control group. There was a significant difference in liver elasticity in the patient and control groups. When the patients were evaluated as Group 1 (< 1000 mg) and Group 2 (≥ 1000 mg) according to the cumulative MTX dose, no significant difference was obtained. There was positive correlation between liver elasticity and weekly MTX dose and age. Conclusions Our study revealed that liver elasticity significantly decreased in patients who received MTX when compared with the control group. The elastography technique will be understood better over time and used safely in many areas.

Download Full-text

EFFECT OF COMBINATION OF HYPNOBREASTFEEDING AND ACUPRESSURE ON ANXIETY AND WOUND PAIN IN POST-CAESAREAN MOTHERS

Belitung Nursing Journal ◽

10.33546/bnj.191 ◽

2017 ◽

Vol 3 (5) ◽

pp. 525-532

Author(s):

Diah Evawanna Anuhgera ◽

Tjahjono Kuncoro ◽

Sri Sumarni ◽

Mardiyono Mardiyono ◽

Ari Suwondo

Keyword(s):

Public Hospital ◽

Alternative Therapy ◽

Control Group ◽

P Value ◽

Control Group Design ◽

Group Data ◽

Before And After ◽

Wound Pain ◽

And Control

Background: Post-cesarean mothers often experience anxiety and discomfort due to long-term pain. The combination of hypnobreastfeeding and acupressure is considered to be effective in reducing anxiety and pain levels. Objective: This study aims to examine the effect of combination of hypnobreastfeeding and acupressure on anxiety and pain levels in post-caesarean mothers.Methods: This study was a true experiment with pretest-posttest control group design, conducted in the Ambarawa Public Hospital on 5 November to 9 December 2016. There were 36 participants selected using stratified random sampling, with 18 assigned in the experiment and control group. Data were analyzed using paired t-test and wilcoxon test.Results: There were statistically significant differences of anxiety and pain levels before and after intervention in the experiment and control group with p-value 0.001 (<0.05).Conclusion: The combination of hypnobreastfeeding and acupressure has a significant effect in reducing anxiety and pain levels in post-cesarean mothers. This intervention could be applied as an alternative therapy in treating post-caesarean mothers.

Download Full-text

Evaluating Hemato_4 (HCT), Hemato_5 (PLAT 1000), Hemato_9 (MCHC), and Biochem_20 (Alkaline Phosphatase) as biomarkers and possible mediators of the relationship between Xerosis and Sulfur Mustard

Biomedical Research and Therapy ◽

10.15419/bmrat.v5i6.452 ◽

2018 ◽

Vol 5 (6) ◽

Author(s):

Marjan Zare ◽

Zaher Khazaei ◽

Soghrat Faghihzadeh ◽

Shohreh Jalaie ◽

Malihe Sohrabivafa

Keyword(s):

Indirect Effects ◽

Sulfur Mustard ◽

Bootstrap Method ◽

Control Group ◽

Case Group ◽

Historical Cohort ◽

Causal Pathways ◽

The Relationship ◽

Causal Variables

Background: Estimating total, direct, and indirect effects of causal variables on outcome variables can be done through proposed mediator guides on causal pathways. This can improve the efficiency of diagnostic efforts done by clinicians. In this study, the relationship between Sulfur Mustard and Xerosis was investigated, specifically with respect to the role of Hemato_4, Hemato_5, Hemato_9, and Biochem_20 biomarkers as mediators. Methods and Results: This was a historical cohort study (in Sardasht, Iran) which consisted of 492 subjects; 129 subjects were not exposed to Mustard Gas (control group) and 363 subjects were exposed to it (case group). Mediation models along with bootstrap method were used to evaluate the mediator validity of Hemato_4, Hemato_5, Hemato_9, and Biochem_20 on the relationship between Sulfur Mustard and Xerosis. The direct effects of Sulfur Mustard, via Hemato_4 and Hemato_9, on Xerosis were also significant (P<0.05 for each). However, there was no significant effects mediated by Hemato_5 or Biochem_20 (P>0.05 for each). While there were non-significant indirect effects of Sulfur Mustard on Xerosis by these latter biomarkers (P>0.05 for each), the first two biomarkers were, indeed, partial mediators. Conclusion: Sulfur Mustard can affect Xerosis through several single immune biomarker. However, as an intervention, sulfur mustard should affect several biomarkers through various mechanisms. Therefore, effects through multiple mediators, instead of single ones, may be more rational in the treatment strategy for xerosis.

Download Full-text

The SPARKLE registry: protocol for an international prospective cohort study in patients with alpha-mannosidosis

10.21203/rs.2.19376/v2 ◽

2020 ◽

Author(s):

Julia Hennermann ◽

Nathalie Guffon ◽

Federica Cattaneo ◽

Ferdinando Ceravolo ◽

Line Borgwardt ◽

...

Keyword(s):

Cohort Study ◽

Natural History ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Clinical Care ◽

Clinical Manifestations ◽

Routine Clinical Care ◽

Safety Outcomes ◽

History Of

Abstract Background: Alpha-mannosidosis is a lysosomal storage disorder caused by reduced enzymatic activity of alpha-mannosidase. SPARKLE is an alpha-mannosidosis registry intended to obtain long-term safety and effectiveness data on the use of velmanase alfa during routine clinical care in patients with alpha-mannosidosis. It is a post-approval commitment to European marketing authorization for Velmanase alfa (Lamzede®), the first enzyme replacement therapy for the treatment of non-neurologic manifestations in patients with mild to moderate alpha-mannosidosis. In addition, SPARKLE will expand the current understanding of alpha-mannosidosis by collecting data on the clinical manifestations, progression, and natural history of the disease in treated and untreated patients, respectively.Results: The SPARKLE registry is designed as a multicenter, multinational, noninterventional, prospective cohort study of patients with alpha-mannosidosis, starting patient enrollment in 2020. Patients will be followed for up to 15 years. Safety and effectiveness as post-authorization outcomes under routine clinical care in patients with treatment will be evaluated. The primary safety outcomes are the rate of adverse events (anti-velmanase alfa-immunoglobulin G antibody development, infusion-related reactions, and hypersensitivity). Secondary safety outcomes include the evaluation of medical events, change in vital signs, laboratory tests, physical examination, and electrocardiogram results. The primary effectiveness outcome is a global treatment response rate, evaluated as the individual aggregate of single endpoints from pharmacodynamic, functional, and quality of life effectiveness outcomes; secondary effectiveness outcomes are to characterize the population of patients with alpha-mannosidosis with regard to clinical manifestation, progression, and natural history of the disease. Any patient in the European Union with a diagnosis of alpha-mannosidosis who is willing to participate will likely be eligible for inclusion in the registry. Publications to disseminate scientific insights from the registry are planned. Conclusion: This study will provide real-world data on the long-term safety and effectiveness of velmanase alfa in patients with alpha-mannosidosis during routine clinical care and increase the understanding of the natural course, clinical manifestations, and progression of this ultra-rare disease.

Download Full-text