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آخرین عناوین :   
منو اصلی
آمار بازدید
 بازدید این صفحه : 77
 بازدید امروز : 95
 کل بازدید : 622720
 بازدیدکنندگان آنلاين : 1
 زمان بازدید : 3.20
 
 

Impact of enhanced optical techniques at time of TURBT with or without single immediate intravesical chemotherapy on recurrence rate of NMIBC, a systematic review and network meta-analysis of randomized trials

Abstract

Introduction: The novel optical techniques such as blue light cystoscopy (BLC) during transurethral resection of bladder tumor (TURBT) has been shown to improve the tumor detection rate and recurrence rate. Whether a single immediate intravesical chemotherapy (SIIC) still has an additive therapeutic effect in the setting of these novel optical techniques (e.g., photodynamic diagnosis (PDD) and narrow band imaging (NBI)) remains unclear. The main aim of this systematic review and network meta-analysis was to assess whether SIIC still adds value to bladder tumor management in combination with optical techniques- enhanced TURBT. Methods: A systematic search was performed using PubMed and Web of Science databases in September 2020 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) extension statement for network meta-analysis. Studies that compared recurrence rates between intervention groups (TURBT by PDD ± SIIC, NBI ± SIIC, or WLC + SIIC) and control group (TURBT by WLC alone) were included. We used the Bayesian approach in the network meta-analysis. Results: Twenty-two studies (n= 4,519) met our eligibility criteria. Out of six different interventions including three different optical techniques, compared to WLC alone, BLC plus SIIC (odds ratio (OR): 0.349, 95% credible interval (CrI):0.196-0.601) and BLC alone (OR: 0.668, 95% CrI:0.459-0.931) were associated with a significantly lower likelihood of 12-month recurrence rate. In the sensitivity analysis, out of eight different interventions compared to WLC alone, PDD by 5-aminolevulinic plus SIIC (OR: 0.327, 95% CrI:0.159-0.646) and by hexaminolevulinic acid plus SIIC (OR: 0.376, 95% CrI:0.172-0.783) were both associated with a significantly lower likelihood of 12-month recurrence rate. NBI with and without SIIC were not associated with a significantly lower likelihood of 12-month recurrence rate (OR: 0.385, 95% CrI:0.105-1.29 and OR: 0.653, 95% CrI:0.343-1.15). Conclusion: BLC during TURBT with concomitant SIIC seems to yieled superior recurrence outcomes in patients with non-muscle invasive bladder cancer. The Use of PDD was able to reduce the 12-month recurrence rate; moreover, a concomitant SIIC increased this risk benefit by 32% additional reduction of odds ratio. Although using PDD could reduce the recurrence rate, SIIC remains necessary. Moreover, the ranking analysis showed that both PDD and NBI, plus SIIC were better than these techniques alone.

Keywords: blue light cystoscopy; hexaminolevulinic acid; narrow band imaging; non-muscle invasive urolthelial carcinoma; photodynamic diagnosis; single immediate intravesical chemotherapy.

DOI: 10.1111/bju.15383 


Pyrvinium pamoate induces in-vitro suppression of IL-6 and IL-8 produced by human endometriotic stromal cells

 

Abstract

Endometriosis, a chronic inflammatory disease, is identified by the presence of endometrial tissue outside the uterus. The prevalence of this disease among reproductive-age women is almost 10-15%. High levels of IL-6 and IL-8 have been found in the peritoneal fluid (PF) of women with endometriosis and are involved in its pathogenesis. Isolated stromal cells from 12 ectopic and eutopic endometrial biopsies of women with ovarian endometrioma and also 12 endometrial biopsies of nonendometriotic controls were treated with 1.1 µM pyrvinium pamoate, a Wnt/β-catenin signaling pathway inhibitor, for 72 hrs. Before treatment, mRNA gene expression and secretion of IL-6 and IL-8 were significantly higher in ectopic (EESCs) than eutopic (EuESCs) and control (CESCs) endometrial stromal cells. After treatment, mRNA gene expression and also secretion of IL-6 and IL-8 were significantly reduced. Our Findings showed that pyrvinium pamoate suppresses the mRNA gene expression and secretion of IL-6 and IL-8 in human endometriotic stromal cells. Additional investigations on this compound are required before clinical application.
 
Keywords: Endometriosis; Wnt signaling pathway; interleukin-6; interleukin-8; pyrvinium pamoate; stromal cells.
 
 

Photobiomodulation preconditioned human semen protects sperm cells against detrimental effects of cryopreservation

 

Abstract

The biological consequences of semen samples preconditioning with photobiomodulation (PBM) were studied on human sperm cells post cryopreservation. Donated semen samples were collected from 22 married men with normal sperm parameters according to World Health Organization (WHO) criteria. Included samples were divided into control and PBM-preconditioning (one session, 810 nm, diode laser, and 0.6 J/cm2) groups before cryopreservation procedure. Progressive sperm motility (PSM), morphology, viability, sperm mitochondrial membrane potential(MMP), intracellular reactive oxygen species (ROS) and lipid peroxidation of sperm cells were assessed post thawing. PBM preconditioning of cryopreserved semen samples most prominently increased the PSM percentage 30 min post thawing (p = 0.000).Application of PBM before cryopreservation significantly increased the number of viable spermatozoa (p = 0.000), increased significantly the number of spermatozoa with high MMP (p = 0.004) and decreased significantly the number of spermatozoa with low MMP post-thawing(P = 0. 007)compared to control group. Cryopreserved human sperm cells with PBM preconditioning showed significant decrease in the levels of intracellular ROS (47.66 ± 2.14 versus 60.42 ± 3.16, p = 0.002) and lipid peroxidation (3.06 ± 0.13 versus 3.68 ± 0.27, p = 0.05)compared to control group.
 
Our findings, as the first evidence, indicated that PBM-preconditioning of human semen before cryopreservation provides a real and substantial advantage. This might lead to a novel strategy in improving PBM application in the procedures of assisted reproductive technologies.
 
Keywords: SpermSemen analysisPhotobiomodulationCryopreservation procedureSperm motilitySperm viabilityMitochondrial membrane potentialIntracellular reactive oxygen speciesLipid peroxidation
 
 

Expression of T helper 1-associated lncRNAs in breast cancer

Abstract

Interferon gamma (IFN-gamma)-associated genes participate in the pathobiology of cancer and response of patients to immunotherapeutic modalities. This cytokine is regarded as a hallmark of T helper 1 type responses. In the current study, we estimated expression of this gene and a number of genes/ long non-coding RNAs (IFNG.AS001 and IFNG.AS003, AC007278.2 and AC007278.3 and IL18R1) which are encoded from proximal genomic regions to IFNG in a larger cohort of Iranian patients with breast cancer. Both IFNG.AS001 and IFNG.AS003 were up-regulated in breast cancer tissues compared with nearby non-cancerous tissues (Ratios of Mean Expressions = 5.62 and 5.88, P values = 1.28E-03 and 1.47E-03, respectively). Finally, IL18R1 was over-expressed in breast cancer tissues compared with nearby non-cancerous tissues (Ratio of Mean Expressions = 9.43, P values = 3.14E-03). Expression of AC007278.3 was associated with breast feeding duration (P value = 2.65E-02). Positive significant correlations were detected between expression levels of all genes in both sets of samples. The most robust correlation in the nearby non-cancerous tissues was detected between IFNG-AS003 and AC007278.2 (r = 088, P value = 5.19E-23). In the tumoral tissues, the strongest correlation was found between IFNG-AS001 and IL18R1 (r = 0.86, P value = 3.79E-15). AC007278.3 had the best diagnostic power among the assessed genes (AUC = 0.82). Both AC007278.2 and AC007278.3 were reported to be specific markers for differentiation of tumor tissues from nearby non-cancerous tissues. Combination of expression levels of genes increased specificity, sensitivity and AUC values to 0.97, 0.89 and 0.95, respectively. The current study accentuates the role of IFNG-associated genes in the pathogenesis of breast cancer.

Keywords: IFNGIFNG.AS001IFNG.AS003AC007278.2AC007278.3IL18R1Breast cancer
 
 

Penile Rehabilitation Strategy after Nerve Sparing Radical Prostatectomy: A Systematic Review and Network Meta-Analysis of Randomized Trials

 

Abstract

Purpose: Despite the advances in nerve sparing and minimally invasive radical prostatectomy, erectile dysfunction remains an important adverse event after radical prostatectomy. Penile rehabilitation strategies have been developed to expedite and improve erectile function recovery. However, the differential efficacy and the best penile rehabilitation strategy are unclear as yet. We conducted a systematic review and network meta-analysis to investigate and compare the efficacy of different penile rehabilitation strategies.
 
Materials and methods: A systematic search was performed in May 2020 using PubMed® and Web of Science™ databases according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension statement for network meta-analysis. Studies that compared the erectile function recovery rate and adverse events between penile rehabilitation treatment groups (eg medications, devices and actions) and control group were included. We used the Bayesian approach in the network meta-analysis.
 
Results: A total of 22 studies (2,711 patients) met our eligibility criteria. Out of 16 different penile rehabilitation strategies and schedules vs placebo, only pelvic floor muscle training (OR 5.21, 95% CrI 1.24-29.8) and 100 mg sildenafil regular doses, ie once daily or nightly (OR 4.00, 95% CrI 1.40-13.4) were associated with a significantly higher likelihood of erectile function recovery. The certainty of results for 100 mg sildenafil regular dose was moderate, while pelvic floor muscle training had low certainty. The sensitivity analysis confirmed that the regular high dose of phosphodiesterase-5 inhibitors regardless of type vs placebo (OR 2.09, 95% CrI 1.06-4.17) was associated with a significantly higher likelihood of erectile function recovery with a moderate certainty. The on-demand doses of phosphodiesterase-5 inhibitors were not proven to be more beneficial than placebo. Secondary outcomes such as adverse events were not analyzed due to incomplete data in the literature. However, no serious adverse events were reported in any of the studies.
 
Conclusions: Sildenafil 100 mg regular dose is the best penile rehabilitation strategy to improve erectile function recovery rates after radical prostatectomy. Although pelvic floor muscle training has been shown to be effective in increasing the erectile function recovery rate, well designed randomized controlled trials with larger sample sizes are needed to confirm the presented early results. The on-demand dose of phosphodiesterase-5 inhibitors should not be considered as a penile rehabilitation strategy.
 

 

Keywords: erectile dysfunction; penis; prostatectomy; prostatic neoplasms; urogenital surgical procedures.
 
 

The effects of vitamin E on colistin-induced nephrotoxicity in treatment of drug-resistant gram-negative bacterial infections: A randomized clinical trial

Abstract

Introduction: Nephrotoxicity remains a major long-standing concern for colistin, and it is critical to find agents that can prevent it. The present study aims to investigate the effect of vitamin E on the prevention of colistin-induced nephrotoxicity based on its antioxidant and free radical scavenging properties.
 
Methods: A randomized clinical trial was designed for 52 patients taking colistin. These patients were categorized into two groups of equal size, receiving colistin or colistin plus vitamin E (α-Tocopherol). Vitamin E with doses of 400 units was administrated daily either orally or by a nasogastric tube if needed. The incidence of Acute Kidney Injury (AKI) and its duration was recorded based on RIFLE criteria.
 
Results: The Incidence of AKI based on RIFLE criteria was 42.3% and 46.2% in intervention and control groups, respectively. The analysis showed no significant difference in the prevalence of AKI for the two groups (P = 0.78). There was no significant difference in the duration of AKI neither (P = 0.83).
 
Conclusion: Although vitamin E is a powerful biological antioxidant, the effects of Vitamin E prophylaxis on colistin-induced nephrotoxicity was not taken into consideration in this study.
 

 

Keywords: Acute kidney injury; Colistin; Nephrotoxicity; Prophylaxis; Vitamin E.
 
 

 

 

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آدرس (Affiliation) مرکز در مقالات فارسی :
 
مرکز تحقیقات سلامت مردان و بهداشت باروری ،
دانشگاه علوم پزشکی شهید بهشتی، تهران ، ایران
 
آدرس (Affiliation) مرکز در مقالات لاتین :
 
Men's Health and Reproductive Health
Research Center, Shahid Beheshti
University of Medical Sciences,
Tehran, Iran
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