Tobacco smoking influences the side effects of radiation therapy-managed patients with various malignancies: A systematic review.

BACKGROUND: Tobacco smoking may decrease the effectiveness of radiation therapy. This is because tobacco smoking can cause inflammation and damage to surrounding tissues, which may interfere with radiation delivery to the tumor. Our aim of this study is to investigate the effect of tobacco smoking use on complications in radiotherapy as a systematic review. METHOD: The articles searched from the MEDLINE, PubMed, EMBASE, and Web of Science databases. The search terms used were "radiotherapy", "outcome", "radiation therapy", "tobacco", "smoking", "complications", "side effects", "cancer", and "malignancy". PRISMA check list was used to assess the overall quality of evidence for each outcome. RESULT: The outcomes of radiotherapy-inducing tobacco smoking in smokers are more than non-smokers including; high SPC (second primary cancer), decreased median overall survival, higher infections during treatment, increased fatigue (p = 0.027), increased pain (p = 0.009), poorer cognitive function (0.041), affected mouth opening (0.049), more speech disturbances (p = 0.017), higher metastasis risk (p = 0.031 and 0.019), higher locoregional recurrence risk (p = 0.027), oral mucositis (p = 0.03), mucositis severity related to higher tobacco exposure (p = 0.008), severe acute radiation skin reactions, and myocardial infarction. DISCUSSION: Tobacco smoking appears to be the most significant modifiable factor influencing cancer treatment outcomes. As such, healthcare providers should take detailed notes on patients' smoking histories during both routine and future clinical studies. Beyond immediate cessation, cancer patients should undertake comprehensive smoking cessation programs. These programs can significantly boost the efficacy of radiotherapy and enhance overall patient outcomes.

Should Parents Allow Their Children Use Smartphones and Tablets? The Issue of Screen Time for Recreational Activities.

Previous research has shown that children are more vulnerable to the adverse effects of radiofrequency electromagnetic fields (RF-EMFs) and blue light emitted from digital screens compared to healthy adults. This paper presents the findings of a cross-sectional study conducted in Yasuj, Iran, to investigate the screen time habits of children and adolescents and its potential impact on their health. A total of 63 participants, including 44 boys and 19 girls, were randomly selected for the study. The results showed that the average daily screen time for the children was 87.38 minutes, with a standard deviation of 49.58. When examining the specific purposes of screen time, it was found that the children spent an average of 17.54 minutes per day on screens for school assignments, 70 minutes per day for recreational purposes, and 23.41 minutes per day for contacting family, friends, and relatives. Our study highlights that a significant portion of the children's screen time was allocated to recreational activities. We observed some differences in screen time between girls and boys. Boys had a slightly higher overall daily screen time, primarily driven by more recreational screen time. However, girls spent slightly more time on screens for school assignments. The screen time for social interactions was similar for both genders. Our findings on the cognitive performance of children with different levels of screen time will be published in a separate paper.

Inducing apoptosis by using microRNA in radio-resistant prostate cancer: an in-silico study with an in-vitro validation.

BACKGROUND: One of the problems with radiation therapy (RT) is that prostate tumor cells are often radio-resistant, which results in treatment failure. This study aimed to determine the procedure involved in radio-resistant prostate cancer apoptosis. For a deeper insight, we devoted a novel bioinformatics approach to analyze the targeting between microRNAs and radio-resistant prostate cancer genes. METHOD: This study uses the Tarbase, and the Mirtarbase databases as validated experimental databases and mirDIP as a predicted database to identify microRNAs that target radio-resistant anti-apoptotic genes. These genes are used to construct the radio-resistant prostate cancer genes network using the online tool STRING. The validation of causing apoptosis by using microRNA was confirmed with flow cytometry of Annexin V. RESULTS: The anti-apoptotic gene of radio-resistant prostate cancer included BCL-2, MCL1, XIAP, STAT3, NOTCH1, REL, REL B, BIRC3, and AKT1 genes. These genes were identified as anti-apoptotic genes for radio-resistant prostate cancer. The crucial microRNA that knockdown all of these genes was hsa-miR-7-5p. The highest rate of apoptotic cells in a cell transfected with hsa-miR-7-5p was (32.90 ± 1.49), plenti III (21.99 ± 3.72), and the control group (5.08 ± 0.88) in 0 Gy (P < 0.001); also, this rate was in miR-7-5p (47.01 ± 2.48), plenti III (33.79 ± 3.40), and the control group (16.98 ± 3.11) (P < 0.001) for 4 Gy. CONCLUSION: The use of this new treatment such as gene therapy to suppress genes involved in apoptosis can help to improve the treatment results and increase the quality of life of patients with prostate cancer.

The role of microRNA-induced apoptosis in diverse radioresistant cancers.

Resistance to cancer radiotherapy is one of the biggest concerns for success in treating and preventing recurrent disease. Malignant tumors may develop when they block genetic mutations associated with apoptosis or abnormal expression of apoptosis; Tumor treatment may induce the expression of apoptosis-related genes to promote tumor cell apoptosis. MicroRNAs have been shown to contribute to forecasting prognosis, distinguishing between cancer subtypes, and affecting treatment outcomes in cancer. Constraining these miRNAs may be an attractive treatment strategy to help overcome radiation resistance. The delivery of these future treatments is still challenging due to the excess downstream targets that each miRNA can control. Understanding the role of miRNAs brings us one step closer to attaining patient treatment and improving patient outcomes. This review summarized the current information on the role of microRNA-induced apoptosis in determining the radiosensitivity of various cancers.

Overview of the Effect of Herbal Medicines and Isoflavones on the Treatment of Cognitive Function.

OBJECTIVES: The current overview aimed to present the effect of herbal medicines on cognitive function among menopausal women. METHODS: Two separate authors performed systematic search of the 3 databases of (the MEDLINE Scopus and the Cochrane Central Register Trials) from inception to January 2018. Methodological quality of each study was assessed using the AMSTAR. RESULTS: According to 2 reviews, soy seems to be effective in enhancing summary cognitive function and visual memory. The effect of isoflavones on cognition was affected by treatment duration as six weeks of treatment improved some dimensions of cognitive parameters, including mental flexibility and planning, and longer treatment period (6 months) improved category digit span test, digit symbol test, and visual scanning test score. The effect of phytoestrogen on cognitive function of menopausal women might be altered age, gender, ethnicity, menopausal status, dosage, and length of treatment, types of cognitive test, location, types of soy, and types of phytoestrogen. Combination of Gingko with ginseng could not improve sustained attention, episode memory, category generation or frontal lobe function. Gingko biloba had no significant effect on planning, memory and sustained attention, except for its limited effect on mental flexibility in late menopause. In addition, other herbal medicines like black cohosh showed no effective beneficial. CONCLUSIONS: Phytoestrogen, soy and isoflavones might have a limited beneficial effect on some aspects of cognition. The phytoestrogens affecting cognition might be modified by age, gender, ethnicity, menopausal status, dosage, and length of treatment, types of cognitive test, location, types of soy, and types of phytoestrogen.

Effect of Aromatherapy on the Treatment of Psychological Symptoms in Postmenopausal and Elderly Women: A Systematic Review and Meta-analysis.

OBJECTIVES: To critically assess the effect of aromatherapy on the psychological symptoms as noted in the postmenopausal and elderly women. METHODS: Three following databases were systematically searched: MEDLINE, Scopus and Cochrane Library (Cochrane Central Register of Controlled Trials) from inception to January 2018. The search keywords included 'menopause' AND (aromatherapy), without language restrictions. RESULTS: In this study, 4 trials were included which fit into our systematic review. The findings demonstrated that the aromatherapy massage have significantly improved psychological symptoms in menopausal and elderly women as compared to the control group (standardized mean difference [SMD] = -1.24; 95% confidence interval, -0.188 to -0.606; P < 0.001 random effect model; 3 trials, moderate to high heterogeneity, I2 = 0.76; P = 0.028). According to 1 of the trials, the aromatherapy oil massage was no more effective than the untreated group regarding their experience of symptoms such as nervousness. CONCLUSIONS: The aromatherapy may be beneficial in attenuating the psychological symptoms that these women may experience, such as anxiety and depression, but it is not considered as an effective treatment to manage nervousness symptom among menopausal women. This finding should be observed in light of study limitations.

Influence of Radiofrequency Electromagnetic Fields on the Fertility System: Protocol for a Systematic Review and Meta-Analysis.

BACKGROUND: Due to the increased number of users of mobile phones, tablets, and other devices over the past few years, concerns about the potential impact of mobile phones on health are growing. The influence of mobile phone exposure on male fertility has been studied in recent years. Other research has shown that electromagnetic fields (EMFs) increase macrophages in the corpus luteum and growing follicles. Due to conflicting results among studies and since no systematic review has been performed to analyze the effects of radiofrequency EMF exposure from electronic devices on the fertility system in recent years, this evidence-based study is necessary. OBJECTIVE: The main objectives of this study are to determine the best evidence associated with the influence of radiofrequency EMFs on the fertility system and to provide insight into a potential mechanism using our observations. METHODS: In this systematic review, the databases and gray literature will be searched with no language and date limitation. The following databases will be searched: Cochrane Library, MEDLINE, PubMed, EMBASE, CINAHL, ProQuest, Scopus, Science Direct, Google Scholar, and other Persian databases. The combination of the Medical Subject Heading terms "radiofrequency electromagnetic" and "male reproductive system" or "female reproductive system" will be searched. Observational study designs will be included but case reports, case series, reviews, and letters to the editor will be excluded. Papers selected for retrieval will be evaluated by two independent referees for methodological validation before entering a review using the Newcastle-Ottawa Scale for nonrandomized studies and cohort studies. RESULTS: The results of this study will be submitted to a peer-reviewed journal for publication and also presented at PROSPERO. CONCLUSIONS: This systematic review will provide evidence-based data on the effect of radiofrequency EMFs on the fertility system. This article will also classify the harmful effect of radiofrequency waves on primary and secondary infertility. This study could be useful for decreasing infertility. This is important because the rate of infertility is growing, leading to negative outcomes for couples and the health care system. TRIAL REGISTRATION: PROSPERO CRD42017072462; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=72462 (Archived by WebCite at http://www.webcitation.org/6wjiE9R2q).

Mathematical formulation of 125I seed dosimetry parameters and heterogeneity correction in lung permanent implant brachytherapy.

OBJECTIVES: Precise determination of dose distribution around low-energy brachytherapy sources as well as considering tissue heterogeneity is crucial for optimized treatment planning. This study is aimed at determination and mathematically formulation of American Association of Physicists in Medicine Task Group No. 43 (AAPM TG-43) dosimetry parameters of 125I seed (model 6711) and calculation of dose difference caused by neglecting lung heterogeneity in permanent implant brachytherapy. MATERIALS AND METHODS: Using MCNPX 2.6.0 code, 125I seed (model 6711) was simulated in a cubic water environment, and its dosimetry parameters mentioned in AAPM TG-43 protocol were obtained. After benchmarking of parameters and comparison with prior studies, mathematical equations were fitted to the data, and a specific set of 125I seeds was simulated on a plane in simulated lung and water environments. Appropriate photon histories were considered to achieve data with maximum accuracy (max error 1%). In the end, isodose curves, profiles, depth dose, and dose difference between lung and water environments were obtained. RESULTS: For 125I seed (model 6711), radial dose function and anisotropy functions were obtained precisely with R2 > 0.99, all in good agreement with previous studies and protocol. In addition, percentage dose difference between inhomogeneous lung and homogenous water environments in a 5 cm distance was calculated and presented as D (r) function with R2 > 0.99. CONCLUSIONS: Considering practical difficulties in dose calculations, 125I seed dosimetry parameters and lung heterogeneity corrections can be obtained precisely by MCNPX. Equations presented in this study are recommended to be considered in future studies based on lung permanent implantation.

Hypoglycemic effects of Acacia nilotica in type II diabetes: a research proposal.

OBJECTIVE: Diabetes mellitus is a common metabolic disorder throughout the world which can negatively affect the function of various body organs. Due to their availability and few side effects, herbal medicines have been proposed as suitable alternatives in the management of diabetes. Previous studies have confirmed the anti diabetic properties of Acacia nilotica. The hypoglycemic effects of this plant have been attributed to its role in stimulating the islets of Langerhans to produce more insulin. The present paper describes a systematic review protocol for the assessment of the hypoglycemic effects of A. nilotica. MAIN TEXTS: Randomized and non-randomized placebo-controlled clinical trials, performed during 1999-2016 will be included. The outcomes will be measured through FBS, GCT, GTT, and OGTT in all of studies and in addition to these tests, will be measured 2HPP and HbA1c level in human study. Well-known databases will be searched for selected key terms A. nilotica, type II diabetes and hypoglycemia. The quality assessment of the selected papers will be evaluated based on SYRCLE and Cochrane Risk of Bias Tool. We believe that our findings will provide details about difficulties researchers face during the design of protocols or implementation of scientific studies. Ultimately, the publication of our findings will facilitate the development of effective treatment strategies to promote the health of people with type II DM. PROSPERO registration CRD42016053141.

Pregnancy Outcome of Abnormal Nuchal Translucency: A Systematic Review.

INTRODUCTION: Nuchal Translucency (NT) is the sonographic form of subcutaneous gathering of liquid behind the foetal neck in the first trimester of pregnancy. There is association of increased NT with chromosomal and non-chromosomal abnormalities. AIM: The purpose of this systemic review was to review the pregnancy outcome of abnormal nuchal translucency. MATERIALS AND METHODS: The present systematic review was conducted by searching English language articles from sources such as International Medical Sciences, Medline, Web of science, Scopus, Google Scholar, PubMed, Index Copernicus, DOAJ, EBSCO-CINAHL. Persian articles were searched from Iranmedex and SID sources. Related key words were "outcome", "pregnancy", "abnormal", and "Nuchal Translucency" (NT). All, randomized, descriptive, analytic-descriptive, case control study conducted during 1997-2015 were included. RESULTS: Including duplicate articles, 95 related articles were found. After reviewing article titles, 30 unrelated article and abstracts were removed, and 65 articles were evaluated of which 30 articles were duplicate. Finally 22 articles were selected for final analysis. Exclusion criteria were, case studies and reports and quasi experimental designs. This evaluation has optioned negative relationship between nuchal translucency and pregnancy result. Rate of cardiac, chromosomal and other defects are correlated with increased NT≥2.5mm. Cardiac disease which were associated to the increased NT are heart murmur, systolic organic murmur, Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), tricuspid valve insufficiency and pulmonary valve insufficiency, Inferior Vena Cava (IVC) and Patent Ductus Arteriosus (PDA). The most common problems that related with increased NT were allergic symptoms. CONCLUSION: According to this systematic review, increased NT is associated with various foetal defects. To verify the presence of malformations, birth defect consultations with a perinatologist and additional tests are required.

Alteration of Bacterial Antibiotic Sensitivity After Short-Term Exposure to Diagnostic Ultrasound.

BACKGROUND: Many pathogenic bacteria show different levels of antibiotic resistance. Furthermore, a lot of hospital-acquired infections are caused by highly resistant or multidrug-resistant Gram-negative bacteria. According to WHO, patients with drug-resistant infections have higher morbidity and mortality. Moreover, patients infected with bacteria that are resistant to antibiotics considerably consume more healthcare resources. OBJECTIVES: In this study, we explored a physical method of converting drug-resistant bacteria to drug-sensitive ones. MATERIALS AND METHODS: This is an in vitro case-control study, performed at the Ionizing and Non-ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences (SUMS), Shiraz, Iran in 2014. All experiments were carried out using Gram-negative bacteria Klebsiella pneumonia and E. coli and Gram-positive Staphylococcus aureus and Streptococcus group A, isolated from hospitalized patients. The bacterial strains were obtained from the Persian Type Culture Collection, IROST, Iran (Klebsiella pneumonia PTCC 1290) and Bacteriology Department of Shahid Faghihi Teaching Hospital, Shiraz, Iran (E. coli, Staphylococcus aureus, and Streptococcus group A). The bacteria in culture plates were exposed to diagnostic ultrasound using a MyLab70XVG sonography system for 5 minutes. Then, the bacteria were cultured on Mueller-Hinton agar and incubated at 35°C for 18 hours. Finally, antibiotic susceptibility test was performed and the inhibition zone in both control and exposed groups were measured. Three replicate agar plates were used for each test and the inhibition zones of the plates were recorded. RESULTS: Compared with the results obtained from unexposed bacteria, statistically significant variations of sensitivity to antibiotics were found in some strains after short-term exposure. In particular, we found major differences (making antibiotic-resistant bacteria susceptible or vice versa) in the diameters of inhibition zones in exposed and non-exposed samples of Klebsiella pneumonia and Streptococcus. CONCLUSIONS: This study clearly shows that short-term exposure of microorganisms to diagnostic ultrasonic waves can significantly alter their sensitivity to antibiotics. We believe that this physical method of making the antibiotic-resistant population susceptible can open new horizons in antibiotic therapy of a broad range of diseases, including tuberculosis.