Exposure to polycyclic aromatic hydrocarbon-induced oxidative stress in Shiraz, Iran: urinary levels, health risk assessment and mediation effect of MDA on the risk of metabolic syndromes.

PURPOSE: Polycyclic Aromatic Hydrocarbons (PAHs) have been identified as carcinogenic and endocrine disrupter compounds that cause Metabolic Syndrome (MetS). Oxidative stress can lead to carcinogenesis and MetS in exposed people. Therefore, the relationship between urinary metabolite of PAH (OH-PAHs) level and the oxidative stress biomarker (Malondialdehyde) effect as the mediator in increasing the risk of MetS due to PAH exposure and risk assessment was investigated in Shiraz, Iran. METHODS: The first morning void urinary and blood samples were obtained from participants and analyzed. Physical examinations and anthropometric measurements were performed on the day of sampling. An automatic biochemistry analyzer was used to measure the blood cells. The participants' socio-demographic information was gathered using a questionnaire and direct interviews with participants. RESULTS: The MetS prevalence was 26%. Malondialdehyde could act as a mediator between exposure to 1-HydroxyPyrene and increase in fast blood sugar, exposure to 2-HydroxyNaphthalene and increase in systolic blood pressure and exposure to 2-HydroxyFluorene and increase in SBP. Hazard quotients varied from 0.009 to 14.92 in women, and from 0.005 to 8.43 for Fluorene and Naphthalene in men, respectively. The Hazard Indexes were greater than one meaning that the non-cancer health risk related to the PAH exposure could be identified in the participants. CONCLUSION: Although oxidative stress has been suggested to lead to MetS and the high HI levels obtained in the current study, future researches are essential to achieve more reliable findings and monitoring the environmental influencing factors in PAH exposure.

Detection of Human Papillomavirus in Papillary Thyroid Carcinoma and its Association with Tumor Staging and Pathologic Features.

Background: The role of human papillomavirus (HPV), as a common infection, has been evaluated in many cancers such as the cervix and squamous cell carcinoma of the head and neck. To the best of our knowledge, for the first time, the association of HPV with papillary thyroid carcinoma (PTC) and its pathologic features are investigated. Methods: A retrospective cross-sectional study was conducted from May 2014 to January 2018 in several hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Thyroid tissue specimens of patients diagnosed with PTC (n=82) and benign thyroid nodules (n=77) were collected using the consecutive sampling method. The presence of HPV in PTC, adjacent normal tissue, and benign thyroid nodules was evaluated using the polymerase chain reaction (PCR) method. The frequency of HPV positivity in PTC tissues was compared with benign thyroid nodules and adjacent normal tissue. Association of pathologic features of PTC with HPV positivity was also investigated. Data were analyzed using SPSS version 21.0, and P values less than 0.05 were considered statistically significant. Results: HPV PCR positivity was observed in 3.8% of benign thyroid nodules and 13.4% of PTC samples but in none of the adjacent normal tissues. After adjustment for age and sex, the prevalence of HPV PCR positivity in the PTC tissues was significantly more than the benign thyroid nodules (P=0.015). The prevalence was also significantly higher than the adjacent normal tissues (P<0.001). Conclusion: There was a significant association between PTC and HPV positivity. Further studies are required to determine the cause and effect of the association between these two conditions.

Seventeen Alpha-Hydroxylase Deficiency Associated with Absent Gonads and Myelolipoma: A Case Report and Review of Literature.

Congenital adrenal hyperplasia comprises a group of disorders resulting from defects in enzymes required for the synthesis of cortisol. The clinical presentation depends on the specific enzyme defect. We report a rare case of congenital adrenal hyperplasia due to 17 alpha-hydroxylase deficiency. A 26-year-old female patient referred with hypertension and hypokalemia. She also had primary amenorrhea and lack of sexual development. The karyotype was 46, XY. Hormonal evaluation showed low serum levels of all steroid hormones, requiring alpha-hydroxylation, which included cortisol, 17 alpha-hydroxy progesterone, dehydroepiandrosterone sulfate, estradiol, and testosterone. The levels of adrenocorticotropic, follicle-stimulating, and luteinizing hormones were high. Radiological and surgical investigations failed to show a gonad. She also had a large myelolipoma. Treatment was commenced with low-dose dexamethasone and conjugated estrogen. Her hypertension and hypokalemia were resolved. The myelolipoma was removed by laparoscopy due to pain and sensation of heaviness. Our review of literature revealed that a combination of this disorder with either agonadism or myelolipoma is very rare and that only 2 previous cases have been reported for each entity.

Immune Rebound: Multiple Sclerosis after Treatment of Cushing's Disease.

High cortisol level in endogenous Cushing's syndrome suppresses the immune system and after treatment there may be an over activity of immune reaction leading to autoimmune diseases mostly thyroid and rheumatologic disorders. This is the second reported case of multiple sclerosis developing after treatment of Cushing's syndrome. A 42-year old man is reported who presented with bone fracture and osteoporosis and diagnosed with Cushing's disease. Six months after surgical treatment of his pituitary adenoma, he developed progressive multiple sclerosis. We conclude that after treatment of endogenous Cushing's syndrome, the patients should be watched for development of autoimmune disorders including those affecting the central nervous system.

The effect of iodine prophylaxis on the frequency of thyroiditis and thyroid tumors in Southwest, Iran.

OBJECTIVE: To investigate the effect of the salt iodization program, which was initiated in 1989 on frequencies of thyroiditis and papillary carcinoma in Fars province of Iran, which was previously an iodine deficient area. METHODS: Four hundred and eighty-two thyroidectomy specimens belonging to the pre-iodization period from 1983 to 1988, and 466 post iodization specimens from 1998 to 2003 were re-examined for presence of lymphocytic infiltration and types of thyroid tumors. This study was carried out in Shiraz University of Medical Sciences, Iran. RESULTS: The frequency of lymphocytic infiltration in non-neoplastic specimens increased from 30-60.5% after salt iodization (p<0.001). Background of lymphocytic infiltration in neoplastic specimens also increased from 18.5-61% after iodine prophylaxis (p<0.001). The frequency of papillary carcinoma in neoplastic specimens increased from 15-43% (p=0.01) and that of follicular adenoma decreased from 69-32.5% (p<0.0001). CONCLUSION: Salt iodization is associated with an increased occurrence of histologic thyroiditis and papillary carcinoma.