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1.
Ther Adv Chronic Dis ; 15: 20406223241257342, 2024.
Article En | MEDLINE | ID: mdl-38827348

Hidradenitis suppurativa (HS) is an inflammatory skin condition with an underlying inflammatory process. Due to the limited efficacy of available treatments, HS remains a therapeutic challenge. The safety and efficacy of tumor necrosis factor-α (TNF-α) inhibitors, adalimumab, infliximab, and etanercept, are well studied in this patient population, and in some cases, HS was unresponsive to them. In recent years, evidence has been growing regarding the application of other anti-TNFs, including certolizumab pegol (CPZ) and golimumab. We sought to evaluate the overall safety and efficacy of golimumab and CPZ in the management of HS. A comprehensive search was performed on the PubMed, Scopus, Web of Science, and Ovid Embase databases, as well as the Google Scholar search engine from initiation to 31 August 2023. A total of nine and four studies used CPZ and golimumab to treat HS, respectively. Individuals with concomitant inflammatory immune-mediated diseases, pregnant females, and patients who were refractory to previous treatments achieved a Hidradenitis Suppurativa Clinical Response following CPZ administration. Also, golimumab showed promise in treating recalcitrant HS after the failure of other treatments, such as adalimumab and anti-interleukin-1. CPZ and golimumab can be efficacious treatment options for moderate-to-severe HS, especially in patients who are unresponsive to other TNF inhibitors, such as adalimumab.

2.
Aesthetic Plast Surg ; 2024 Jun 17.
Article En | MEDLINE | ID: mdl-38886198

BACKGROUND: The prominence of minimally invasive aesthetic approaches has become increasingly pivotal. The endo-lift laser method is an intralesional 1470 nm diode laser connected to a fiber that serves both therapeutic and aesthetic properties. We sought to evaluate the efficacy and safety of the endo-lift laser method for dermatological aesthetic applications. METHODS: PubMed, Ovid-Embase, and Web of Science were systematically searched up to November 5th, 2023. A citation search was also performed. The National Institute of Health (NIH) Quality Assessment Tool was used to evaluate the quality of the studies. RESULTS: Out of 339 articles, twenty-three relevant studies were included in the current review. Applying the endo-lift laser method for rejuvenation, including face and neck lifting, enhancing skin laxity, and disappearing wrinkles, folds, and lines, demonstrated favorable efficacy and safety profile. Moreover, most studies have shown that the endo-lift laser method is promising in eliminating the adipose tissue in the jowl, abdomen, thighs, and arms. The endo-lift laser technique was also efficacious in nose remodeling and blepharoplastic procedures, including treating eyelid and eyebrow ptosis, eye bag, eyebrow position, and eyelid laxity. Patients who suffer from several diseases, such as hidradenitis suppurativa, progressive lipodystrophy, acne vulgaris, scars, and keloids, benefit from procedural treatment with the endo-lift laser technique. Across all studies, the adverse events were mild and self-limiting. Investigating the endo-lift laser method in all aesthetic and therapeutic indications resulted in high patient satisfaction rates. CONCLUSION: The endo-lift laser technique has therapeutic effects and is recommended for various dermatological aesthetic indications. Further clinical studies with control groups and larger sample sizes are needed to acquire more reliable evidence. LEVELS OF EVIDENCE III AND IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

3.
Neurotoxicol Teratol ; 104: 107367, 2024 Jun 10.
Article En | MEDLINE | ID: mdl-38866258

Alcohol use, which alters the epigenome, increases the probability that it could affect subsequent generations, even if they were never directly exposed to ethanol or even in utero. We explored the effects of parental ethanol exposure before conception on behavioral changes in the offspring. Considering the role of Monoamine oxidase-B (MAO-B) in dopamine turnover in the prefrontal cortex (PFC) and its influence on behavior, and taking into account that ethanol exposure could alter MAO-B, we assessed the protein levels in the offspring. Male and female rats were exposed to ethanol for 30 days and then allowed ten days of abstinence. Afterward, they were mated with either control or ethanol-exposed rats. The F1 and F2 male offspring underwent tests to assess behavioral changes. Additionally, the levels of MAO-B in the PFC were evaluated. Results revealed that in the F1, anxiety increased only in the bi-parental ethanol-exposed male offspring in the elevated plus maze test (p < 0.05), while depressive-like behavior rose only in maternal and bi-parental ethanol-exposed offspring (p < 0.01). However, compulsive-like behavior increased in all ethanol-exposed offspring (p < 0.01). No significant phenotypic changes were observed in the F2. The levels of MAO-B in the PFC increased in the maternal (p < 0.05) and bi-parental ethanol-exposed offspring (p < 0.01). Our study demonstrates that parental ethanol exposure, even in the days preceding mating, adversely affects behaviors and induces molecular changes in the brain. Given these findings, it becomes imperative to monitor children exposed to parental (especially maternal) ethanol for the prevention of mental disorders.

4.
Skin Res Technol ; 30(5): e13723, 2024 May.
Article En | MEDLINE | ID: mdl-38696233

BACKGROUND: Notalgia paresthetica (NP) is a rare condition characterized by localized pain and pruritus of the upper back, associated with a distinct area of hyperpigmentation. Given the lack of standardized treatment and the uncertain efficacy of available options, applying procedural methods is of growing interest in treating NP. AIMS: We sought to comprehensively evaluate the role of procedural treatments for NP. METHODS: We systematically searched PubMed/Medline, Ovid Embase, and Web of Science until November 14th, 2023. We also performed a citation search to detect all relevant studies. Original clinical studies published in the English language were included. RESULTS: Out of 243 articles, sixteen studies have reported various procedural modalities, with or without pharmacological components, in treating NP. Pharmacological procedures, including injections of botulinum toxin, lidocaine, and corticosteroids, led to a level of improvement in case reports and case series. However, botulinum toxin did not show acceptable results in a clinical trial. Moreover, non-pharmacological procedures were as follows: physical therapy, exercise therapy, kinesiotherapy, acupuncture and dry needling, electrical muscle stimulation, surgical decompression, and phototherapy. These treatments result in significant symptom control in refractory cases. Physical therapy can be considered a first-line choice or an alternative in refractory cases. CONCLUSION: Procedural modalities are critical in the multidisciplinary approach to NP, especially for patients who are refractory to topical and oral treatments. Procedural modalities include a spectrum of options that can be applied based on the disease's symptoms and severity.


Pruritus , Humans , Pruritus/therapy , Lidocaine/administration & dosage , Lidocaine/therapeutic use , Paresthesia/therapy , Paresthesia/physiopathology , Hyperpigmentation/therapy , Physical Therapy Modalities , Acupuncture Therapy/methods , Botulinum Toxins/administration & dosage , Botulinum Toxins/therapeutic use , Anesthetics, Local/administration & dosage , Exercise Therapy/methods , Adrenal Cortex Hormones/therapeutic use , Adrenal Cortex Hormones/administration & dosage , Dry Needling/methods
5.
Lasers Med Sci ; 39(1): 139, 2024 May 25.
Article En | MEDLINE | ID: mdl-38795173

BACKGROUND AND AIMS: Hidradenitis suppurativa (HS) is an inflammatory skin disease affecting apocrine gland-bearing sites of the body. Radiofrequency (RF) is a minimally invasive method that acts by minimizing thermal damage to the dermis, resulting in collagen synthesis and scar improvement. We systematically reviewed the efficacy and safety of RF in treating HS. METHODS: A systematic search was performed up to November 18th, 2023, in PubMed/Medline, Ovid Embase, and Web of Science. Clinical studies with English full texts were included. The National Institute of Health (NIH) Quality Assessment Tool for clinical trials and Methodological quality and synthesis of case series and case reports by Murad et al. were utilized for critical appraisal. RESULTS: Out of 55 identified studies, 11 met our inclusion criteria with 167 subjects who underwent RF therapy alone or combined with an intense pulsed laser (IPL), known as LAight®. LAight® significantly improved clinical outcomes in mild-to-moderate HS patients based on the Dermatology Life Quality Index (DLQI), International Hidradenitis Suppurativa Score System (IHS4), Pain-Numerical Rating Scale (NRS), and Hidradenitis Suppurativa Clinical Response (HiSCR). Moreover, RF therapy alone significantly alleviated the clinical manifestations in patients with mild-to-moderate HS. Additionally, fractional microneedling RF significantly decreased HS-associated inflammatory markers. RF was found to be safe with limited adverse events. However, in moderate-to-severe HS, RF has failed to yield satisfactory results. CONCLUSION: RF is a safe energy-based method with promising outcomes, especially for long-term application in mild-to-moderate HS. In moderate-to-severe cases, RF should be combined with a systemic medication for further beneficial impacts.


Hidradenitis Suppurativa , Radiofrequency Therapy , Hidradenitis Suppurativa/radiotherapy , Hidradenitis Suppurativa/surgery , Hidradenitis Suppurativa/therapy , Humans , Radiofrequency Therapy/methods , Treatment Outcome , Quality of Life
7.
Alcohol ; 117: 27-41, 2024 Jun.
Article En | MEDLINE | ID: mdl-38508286

While DNA serves as the fundamental genetic blueprint for an organism, it is not a static entity. Gene expression, the process by which genetic information is utilized to create functional products like proteins, can be modulated by a diverse range of environmental factors. Epigenetic mechanisms, including DNA methylation, histone modification, and microRNAs, play a pivotal role in mediating the intricate interplay between the environment and gene expression. Intriguingly, alterations in the epigenome have the potential to be inherited across generations. Alcohol use disorder (AUD) poses significant health issues worldwide. Alcohol has the capability to induce changes in the epigenome, which can be inherited by offspring, thus impacting them even in the absence of direct alcohol exposure. This review delves into the impact of alcohol on the epigenome, examining how its effects vary based on factors such as the age of exposure (adolescence or adulthood), the duration of exposure (chronic or acute), and the specific sample collected (brain, blood, or sperm). The literature underscores that alcohol exposure can elicit diverse effects on the epigenome during different life stages. Furthermore, compelling evidence from human and animal studies demonstrates that alcohol induces alterations in epigenome content, affecting both the brain and blood. Notably, rodent studies suggest that these epigenetic changes can result in lasting phenotype alterations that extend across at least two generations. In conclusion, the comprehensive literature analysis supports the notion that alcohol exposure induces lasting epigenetic alterations, influencing the behavior and health of future generations. This knowledge emphasizes the significance of addressing the potential transgenerational effects of alcohol and highlights the importance of preventive measures to minimize the adverse impact on offspring.


Alcoholism , Epigenome , Animals , Female , Humans , Male , Alcohol Drinking/genetics , Alcohol Drinking/adverse effects , Alcoholism/genetics , Brain/drug effects , Brain/metabolism , DNA Methylation/drug effects , Epigenesis, Genetic/drug effects , Epigenome/drug effects , Ethanol/pharmacology , MicroRNAs/genetics
8.
Int Immunopharmacol ; 131: 111827, 2024 Apr 20.
Article En | MEDLINE | ID: mdl-38460303

Immune thrombocytopenia (ITP) is an autoimmune-driven disease characterized by increased destruction and impaired platelet production resulting in an enhanced risk of bleeding. Immunosuppressant agents are the most common treatment strategies for ITP. Despite their efficacy, these medications often cause unpredictable side effects. Recent investigations revealed that patients with ITP exhibit elevated B-cell activating factor (BAFF) levels in both their spleens and serum. Belimumab, a BAFF inhibitor, illustrated a promising therapeutic avenue for managing ITP by interfering with BAFF activity and long-lived plasma cell production. Both clinical and experimental studies have yielded positive outcomes when combining rituximab with an anti-BAFF monoclonal antibody in treating ITP. In addition, ianalumab, a monoclonal antibody with a dual mechanism that targets BAFF-R and deletes peripheral BAFF-R+ B cells, is currently being used for ITP treatment [NCT05885555]. The upcoming results from novel BAFF inhibitors, such as ianalumab, could offer clinicians an additional therapeutic option for treating ITP.


Purpura, Thrombocytopenic, Idiopathic , Thrombocytopenia , Humans , B-Cell Activating Factor , Interleukin-4 , Antibodies, Monoclonal/therapeutic use
9.
BMC Psychiatry ; 24(1): 132, 2024 Feb 16.
Article En | MEDLINE | ID: mdl-38365633

BACKGROUND: The prevalence and burden of substance and opium use have increased worldwide over the past decades. In light of rapid population changes in Tehran, we aimed to evaluate the prevalence of opium and other substance use among adult residents in Tehran, Iran. METHOD: From March 2016 to March 2019, we utilized data from 8 296 participants in the Tehran Cohort Study recruitment phase (TeCS). We calculated the age-sex-weighted prevalence of substance use and the geographic distribution of substance use in Tehran. We also used logistic regression analysis to determine possible determinants of opium use. RESULT: We analyzed data from 8 259 eligible participants with complete substance use data and the average age of participants was 53.7 ± 12.75 years. The prevalence of substance use was 5.6% (95% confidence interval [CI]: 4.6- 7.1%). Substance use was more common in males than females (Prevalence: 10.5% [95% CI: 8.6- 12.6%] vs. 0.5% [95% CI: 0.2- 1.2%], respectively). The age-sex weighted prevalence of substance use was 5.4% (95% CI: 4.6-7.1%). Moreover, opium was the most frequently used substance by 95.8% of substance users. Additionally, we found that male gender (Odds ratio [OR]: 12.1, P < 0.001), alcohol intake (OR: 1.3, P = 0.016), and smoking (OR: 8.5, P < 0.001) were independently associated with opium use. CONCLUSIONS: We found that the prevalence of substance use in Tehran was 5.6%, and opium was the most frequently used substance. In addition, male gender, lower levels of education, alcohol, and tobacco consumption are the main risk factors for substance use in Tehran. Healthcare providers and policymakers can utilize our results to implement preventive strategies to minimize substance use in Tehran.


Opium Dependence , Substance-Related Disorders , Adult , Female , Humans , Male , Middle Aged , Aged , Opium Dependence/epidemiology , Cohort Studies , Opium/adverse effects , Iran/epidemiology , Risk Factors , Substance-Related Disorders/epidemiology
10.
Inflammopharmacology ; 32(2): 991-1003, 2024 Apr.
Article En | MEDLINE | ID: mdl-38332383

BACKGROUND: Prurigo nodularis (PN) is a neuroimmunological skin disease. Severe itching is the most challenging symptom which affects patients' quality of life. T helper 2-derived cytokines, such as interleukin-31 and oncostatin M (OSM), play a crucial role in PN pathogenesis. Nemolizumab and vixarelimab are two biologics acting as IL-31 inhibitors. Vixarelimab also suppresses the OSM activity. This systematic review evaluates the efficacy and safety of nemolizumab and vixarelimab in PN management. METHODS: A systematic search was conducted in PubMed/Medline, Ovid Embase, and Web of Science up to September 17th, 2023. Clinical trials and cohort studies published in English were included. RESULTS: Among a total of 96 relevant records, five were included. The results of four studies with 452 patients using nemolizumab showed that a significantly higher percentage of patients treated with nemolizumab demonstrated a reduction in peak pruritus numerical rating scale (PP-NRS) and investigator's global assessment along with improved sleep disturbance (SD) and quality of life than the placebo group. Moreover, one study administered vixarelimab to 49 PN patients, and their finding illustrated a higher rate of subjects who received vixarelimab experienced ≥ 4-point diminution in worst itch NRS, visual analog scale, healing of representative lesions, and SD quality compared to the placebo group. CONCLUSIONS: IL-31 inhibitors suggest distinct advantages in improving pruritus, sleep quality, and overall quality of life in subjects with moderate-to-severe PN. Further clinical studies are recommended to compare the effectiveness of these biologics to other therapeutic choices.


Biological Products , Interleukin Inhibitors , Interleukins , Prurigo , Humans , Biological Products/therapeutic use , Interleukin Inhibitors/therapeutic use , Prurigo/drug therapy , Prurigo/complications , Prurigo/diagnosis , Pruritus/drug therapy , Pruritus/etiology , Quality of Life , Interleukins/antagonists & inhibitors
11.
PLoS One ; 19(2): e0293433, 2024.
Article En | MEDLINE | ID: mdl-38335182

BACKGROUND: Cicatricial alopecia (CA) refers to various conditions that result in permanent hair loss. Treatment of CA has always been challenging. Regarding immune-mediated pathophysiology for many CA subtypes, the administration of Janus kinase (JAK) and tumor necrosis factor (TNF) inhibitors have potentiated the treatments of CA. METHODS: After a thorough systematic search in PubMed/Medline, Embase, Web of Science, Scopus, Google Scholar, ClinicalTrials.gov, and WHO ICTRP, a total of 3,532 relevant records were retrieved and screened. Accordingly, 56 studies met the eligibility criteria and entered the review. RESULTS: Among JAK inhibitors, oral tofacitinib was the most frequently reported and the most effective treatment in improving signs and symptoms of CA with minimal adverse effects (AEs). Baricitinib was another JAK inhibitor with sustained improvement while causing mild AEs. As a TNF inhibitor, adalimumab induced a rapid and stable improvement in signs and symptoms in most patients with rare, tolerable AEs. Thalidomide was the other frequently reported yet controversial TNF inhibitor, which caused a rapid and significant improvement in the condition. However, it may result in mild to severe AEs, particularly neuropathies. Infliximab is a TNF inhibitor with mostly favorable results, albeit in a few patients caused treatable dermatological AEs. Apremilast and certolizumab pegol caused an incomplete amelioration of signs and symptoms with no AEs. Lenalidomide is another TNF inhibitor that can induce temporary improvement in CA with probable AEs. It is noteworthy that utilizing adalimumab, infliximab, etanercept, golimumab, and an anonymous TNF inhibitor has induced paradoxical CA and other A.E.s in some patients. CONCLUSION: Recent studies have recommended JAK and TNF inhibitors, especially oral tofacitinib and adalimumab, as a new modality or adjuvant therapy to previous medications for primary CA. Nonetheless, monitoring AEs on a regular basis is suggested, and further extensive studies are required before definitive recommendations.


Janus Kinase Inhibitors , Humans , Adalimumab/therapeutic use , Janus Kinase Inhibitors/adverse effects , Tumor Necrosis Factor Inhibitors , Infliximab , Antibodies, Monoclonal, Humanized/therapeutic use , Alopecia/drug therapy , Tumor Necrosis Factor-alpha
12.
Lasers Med Sci ; 39(1): 44, 2024 Jan 23.
Article En | MEDLINE | ID: mdl-38253899

Acanthosis nigricans (AN) is a cutaneous disorder identified by well-defined pigmented plaques mostly detected on skin folds. Timely diagnosis and treatment of AN is essential as it could be an early manifestation of an underlying condition. The treatment of choice for AN has not been determined yet. Our study aimed to compare the efficacy and safety of various lasers with topical medications, including cream and peel. PubMed, Scopus, and Web of Science databases, as well as the Google Scholar search engine, were thoroughly searched until May 1st, 2023. Study selection was restricted to clinical trials published in English language comparing lasers with topical treatments. This study followed the PRISMA guidelines for systematic reviews and meta-analyses. Out of 1748 studies, Six clinical trials met our inclusion criteria, with 133 patients. We examined laser therapies, including fractional CO2 laser, 1550-nm erbium fiber laser, and long-pulsed alexandrite laser, while the topical treatments comprised glycolic acid (GA) peel, retinoic acid peel, trichloroacetic acid (TCA) peel, and tretinoin cream. In two studies, GA peel demonstrated favorable results compared to fractional CO2 laser. Besides, fractional CO2 laser exhibited efficacy, surpassing TCA peel in AN management. Additionally, a fractional 1550-nm erbium fiber laser displayed superiority over tretinoin cream in reducing average roughness. Similarly, a long-pulsed alexandrite laser demonstrated its effectiveness in axillary AN treatment compared to the combination of tretinoin and ammonium lactate. Overall, the findings revealed that laser therapy was associated with superior results. Moreover, topical treatments are safe and efficacious in AN management.


Acanthosis Nigricans , Glycolates , Humans , Acanthosis Nigricans/therapy , Erbium , Lasers , Tretinoin
13.
Int Immunopharmacol ; 127: 111435, 2024 Jan 25.
Article En | MEDLINE | ID: mdl-38150881

BACKGROUNDS AND AIMS: Hidradenitis suppurativa (HS) is a challenging skin disease with an underlying inflammatory process. Substantial progress has been made in our understanding of HS over the last few years, with the advancement of novel treatment approaches. The current systematic review aims to evaluate the safety and efficacy of Janus kinase (JAK) inhibitors and spleen tyrosine kinase (Syk) inhibitors in treating HS. METHOD: A thorough systematic search was performed on PubMed/Medline, Web of Science, and Ovid Embase databases up to September 23th, 2023. Clinical studies published in English were included. RESULTS: Our search yielded ten articles with a total of 165 patients treated with four types of JAK inhibitors (upadacitinib, povorcitinib, tofacitinib, and baricitinib) and one Syk inhibitor (fostamatinib). Upadacitinib, povorcitinib, and tofacitinib improved clinical outcomes, with a significant reduction in hidradenitis suppurativa clinical response (HiSCR) and abscess and inflammatory nodule count (AN count) during the treatment period. Also, these drugs are well tolerated in most HS patients with minimal adverse events (AEs). Moreover, baricitinib depicted an amelioration in signs and symptoms of HS in one case report. Also, fostamatinib exhibited favorable tolerability throughout a 12-week in moderate-to-severe HS patients. The remarkable clinical improvement, as assessed through HiSCR and hidradenitis suppurativa severity (IHS4), corresponded closely with serological indicators of inflammation following fostamatinib administration was achieved. CONCLUSION: JAK and Syk inhibitors are potentially efficacious in managing moderate-to-severe HS since the proinflammatory cytokines are mediated by JAK and Syk signaling pathways. However, further research with a more rigorous examination is mandatory to evaluate such medication's long-term safety and efficacy.


Aminopyridines , Azetidines , Hidradenitis Suppurativa , Janus Kinase Inhibitors , Morpholines , Purines , Pyrazoles , Pyrimidines , Sulfonamides , Humans , Hidradenitis Suppurativa/drug therapy , Hidradenitis Suppurativa/diagnosis , Adalimumab/therapeutic use , Janus Kinase Inhibitors/therapeutic use , Spleen , Syk Kinase , Treatment Outcome , Severity of Illness Index
14.
Heliyon ; 9(12): e22912, 2023 Dec.
Article En | MEDLINE | ID: mdl-38125430

Bruton's tyrosine kinase (BTK) is a protein involved in B-cell-receptor signaling and B-cell proliferation. The pathophysiology of several autoimmune diseases, such as pemphigus disorder, relies on the BTK signaling pathway. Therefore, BTK inhibitors were found to be beneficial alternatives to conventional treatmentsThe current study aimed to assess the efficacy and safety of BTK inhibitors in treating pemphigus. A complete search was performed on databases including PubMed/MedLine, Scopus, Web of Science, as well as Google Scholar search engine for studies published by September 20th, 2023. The current review indicates that BTK inhibitors alone or in combination with conventional treatments are promising options in the management of pemphigus. The overall safety profile of BTK inhibitors has been acceptable, and the reported adverse reactions were not severe or life-threatening.

15.
Health Sci Rep ; 6(9): e1576, 2023 Sep.
Article En | MEDLINE | ID: mdl-37752973

Background and Aim: Metabolic syndrome (MetS) is a well-known noncommunicable disease that plays a significant role in emerging other chronic disorders and following complications. MetS is also involved in the pathophysiology of numerous dermatological diseases. We aim to evaluate the association of MetS with the most prevalent dermatological diseases. Methods: A systematic search was carried out on PubMed, Science Direct, Web of Science, Cochrane, as well as the Google Scholar search engine. Only English case-control studies regarding MetS and any skin disease from the beginning of 2010 up to November 15, 2022, were selected. The study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Results: A total of 37 studies (13,830 participants) met the inclusion criteria. According to our result, patients with psoriasis, hidradenitis suppurativa (HS), vitiligo, androgenetic alopecia (AGA), and lichen planus (LP) have a higher chance of having MetS compared to the general population. Furthermore, people with seborrheic dermatitis (SED) and rosacea are more prone to insulin resistance, high blood pressure (BP), and higher blood lipids. After pooling data, the meta-analysis revealed a significant association between MetS and skin diseases (pooled odds ratio [OR]: 3.28, 95% confidence interval: 2.62-4.10). Concerning the type of disease, MetS has been correlated with AGA (OR: 11.86), HS (OR: 4.46), LP (OR: 3.79), and SED (OR: 2.45). Psoriasis also showed a significant association but with high heterogeneity (OR: 2.89). Moreover, skin diseases and MetS are strongly associated in Spain (OR: 5.25) and Thailand (OR: 11.86). Regarding the metaregression model, the effect size was reduced with increasing age (OR: 0.965), while the size increased with AGA (OR: 3.064). Conclusions: MetS is closely associated with skin complications. Dermatologists and other multidisciplinary teams should be cautious while treating these patients to prevent severe complications resulting from MetS.

16.
Health Sci Rep ; 6(7): e1432, 2023 Jul.
Article En | MEDLINE | ID: mdl-37492274

Background and aims: Implantable cardioverter-defibrillators (ICDs) are frequently used to prevent sudden cardiac death in patients with high-risk arrhythmias. However, the use of ICD therapy in elderly patients beyond the predicted age of life expectancy is still controversial. We aimed to evaluate the predictors of mortality and clinical outcomes following ICD implantation in elderly patients. Methods: We conducted a retrospective analysis of 145 elderly patients aged 72 years and older who received ICD implantation between January 2010 and August 2015. We collected and analyzed baseline data, including clinical, demographic, and medical history, the reason for ICD therapy, procedural data, and echocardiography results. Follow-up data included the development of complications and mortality. The predictors of mortality were identified using the univariate and multivariable Cox regression models. Results: During the median follow-up duration of 30.5 [18.0-48.0] months, 141 cases completed follow-up (mean age = 76.0 ± 3.7 years). Forty-four patients experienced at least one episode of ICD therapy. Inappropriate shock, recurrent shock, and device-related infection were the most frequent complications observed in our study. Of the 145 patients, 42 died during the follow-up period, with an average survival time of 22.4 months after ICD implantation. Among these patients, 11 received ICD for primary prevention, and 31 received it for secondary prevention. Cardiovascular problems were the leading cause of death. We found that a low baseline ejection fraction (EF) was an independent predictor of mortality (hazard ratio = 0.93, 95% confidence interval: 0.90-0.98; p = 0.008). Conclusion: Our study suggests that ICD therapy is a valuable treatment option for elderly patients beyond their predicted age of life expectancy. The study highlights the importance of baseline EF as a significant predictor of mortality in these patients.

17.
Behav Pharmacol ; 34(5): 243-250, 2023 08 01.
Article En | MEDLINE | ID: mdl-37401401

The role of the lateral habenula (LHb) as a hub for receiving and relaying signals from the limbic system to serotonergic, dopaminergic, and norepinephrinergic regions in the brainstem makes this area a critical region in the control of reward and addiction. Behavioral evidence reveals the vital role of the LHb in negative symptoms during withdrawal. In this investigation, we study the role of the LHb N-Methyl D-Aspartate receptor (NMDAR) in the modulation of tramadol reward. Male adult Wistar rats were used in this study. The effect of intra-LHb micro-injection of NMDAR agonist (NMDA, 0.1, 0.5, 2 µg/rat) and antagonist (D-AP5, 0.1, 0.5, 1 µg/rat) was evaluated in conditioned place preference (CPP) paradigm. The obtained results showed that intra-LHb administration of NMDA induced place aversion dose-dependently, while blockade of NMDAR in the LHb using D-AP5 micro-injection led to an increased preference score in the CPP task. Co-administration of NMDA (0.5 µg/rat) with tramadol (4 mg/kg) reduced preference score, while co-administration of D-AP5 (0.5 µg/rat) with a non-effective dose of tramadol (1 mg/kg) potentiate the rewarding effect of tramadol. LHb receives inputs from the limbic system and projects to the monoaminergic nuclei in the brainstem. It has been declared that NMDAR is expressed in LHb, and as obtained data revealed, these receptors could modulate the rewarding effect of tramadol. Therefore, NMDA receptors in the LHb might be a new target for modulating tramadol abuse.


Habenula , Tramadol , Rats , Male , Animals , Receptors, N-Methyl-D-Aspartate , Tramadol/pharmacology , Rats, Wistar , N-Methylaspartate/pharmacology , Habenula/metabolism
18.
Small ; 19(40): e2207626, 2023 10.
Article En | MEDLINE | ID: mdl-37309299

Nanoparticles (NPs) based therapies for Alzheimer's disease (AD) attract interest due to their ability to pass across or bypass the blood-brain barrier. Chitosan (CS) NPs or graphene quantum dots (GQDs) are promising drug carriers with excellent physicochemical and electrical properties. The current study proposes the combination of CS and GQDs in ultrasmall NP form not as drug carriers but as theranostic agents for AD. The microfluidic-based synthesis of the CS/GQD NPs with optimized characteristics makes them ideal for transcellular transfer and brain targeting after intranasal (IN) delivery. The NPs have the ability to enter the cytoplasm of C6 glioma cells in vitro and show dose and time-dependent effects on the viability of the cells. IN administration of the NPs to streptozotocin (STZ) induced AD-like models lead to a significant number of entrances of the treated rats to the target arm in the radial arm water maze (RAWM) test. It shows the positive effect of the NPs on the memory recovery of the treated rats. The NPs are detectable in the brain via in vivo bioimaging due to GQDs as diagnostic markers. The noncytotoxic NPs localize in the myelinated axons of hippocampal neurons. They do not affect the clearance of amyloid ß (Aß) plaques at intercellular space. Moreover, they showed no positive impact on the enhancement of MAP2 and NeuN expression as markers of neural regeneration. The memory improvement in treated AD rats may be due to neuroprotection via the anti-inflammation effect and regulation of the brain tissue microenvironment that needs to be studied.


Alzheimer Disease , Chitosan , Graphite , Nanoparticles , Quantum Dots , Rats , Animals , Alzheimer Disease/metabolism , Chitosan/chemistry , Graphite/therapeutic use , Amyloid beta-Peptides , Microfluidics , Drug Carriers/chemistry , Nanoparticles/chemistry
19.
J Tehran Heart Cent ; 18(1): 68-71, 2023 Jan.
Article En | MEDLINE | ID: mdl-37252220

Background: Coronary artery disease (CAD) is the leading cause of cardiovascular death globally, and the most severe form of CAD, ST-elevation myocardial infarction (STEMI), needs immediate treatment. This study aimed to report patient characteristics and the causes of door-to-balloon time (D2BT) delays in STEMI patients admitted to Tehran Heart Center with a D2BT exceeding 90 minutes. Methods: This cross-sectional study was conducted at Tehran Heart Center, Iran, from March 20th, 2020, through March 20th, 2022. Variables consisted of age, sex, diabetes mellitus, hypertension, dyslipidemia, smoking, opium, family history of CAD, in-hospital mortality, primary percutaneous coronary intervention results, culprit vessels, causes of delays, the ejection fraction, triglycerides, and low and high-density lipoprotein levels. Results: The study population was composed of 363 patients (272 males [74.9]) at a mean (SD) age of 60±11.47 years. The leading causes of D2BT delays were the catheterization lab used in 95 patients (26.2) and misdiagnosis in 90 (24.8). Other causes were ST-elevation less than 2 mm in electrocardiograms in 50 patients (13.8) and referral from other hospitals in 40 (11.0). Conclusion: The catheterization lab in use and misdiagnosis were the leading causes of D2BT delays. We recommend that high-volume centers allocate an additional catheterization lab with an on-call cardiologist. Improved resident training and supervision in hospitals with many residents are also necessary.

20.
BMC Public Health ; 23(1): 740, 2023 04 21.
Article En | MEDLINE | ID: mdl-37085856

INTRODUCTION: Tobacco use is a major health concern worldwide, especially in low/middle-income countries. We aimed to assess the prevalence of cigarette smoking, waterpipe, and pipe use in Tehran, Iran. METHODS: We used data from 8272 participants of the Tehran Cohort Study recruitment phase. Tobacco use was defined as a positive answer to using cigarettes, waterpipes, or pipes. Participants who did not report tobacco use during the interview but had a previous smoking history were categorized as former users. Age- and sex-weighted prevalence rates were calculated based on the national census data, and characteristics of current and former tobacco users were analyzed. RESULTS: Age- and sex-weighted prevalence of current tobacco users, cigarette smokers, waterpipe, and pipe users in Tehran was 19.8%, 14.9%, 6.1%, and 0.5%, respectively. Current tobacco use was higher in younger individuals (35-45 years: 23.4% vs. ≥ 75 years: 10.4%, P < 0.001) and men compared to women (32.9% vs. 7.7% P < 0.001). The prevalence of tobacco use increased with more years of education (> 12 years: 19.3% vs. illiterate: 9.7%, P < 0.001), lower body mass index (< 20 kg/m2: 31.3% vs. ≥ 35 kg/m2: 13.8%, P < 0.001), higher physical activity (high: 23.0% vs. low: 16.4%, P < 0.001), opium (user: 66.6% vs. non-user: 16.5%, P < 0.001), and alcohol use (drinker: 57.5% vs. non-drinker: 15.4%, P < 0.001). Waterpipe users were younger (46.1 vs. 53.2 years) and had a narrower gender gap in prevalence than cigarette smokers (male/female ratio in waterpipe users: 2.39 vs. cigarette smokers: 5.47). Opium (OR = 5.557, P < 0.001) and alcohol consumption (OR = 4.737, P < 0.001) were strongly associated with tobacco use. Hypertension was negatively associated with tobacco use (OR = 0.774, P = 0.005). CONCLUSION: The concerning prevalence of tobacco use in Tehran and its large gender gap for cigarette and waterpipe use warrant tailored preventive policies.


Opium , Tobacco Products , Humans , Male , Female , Cohort Studies , Prevalence , Iran/epidemiology , Tobacco Use/epidemiology
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