Physiological and molecular changes of onion (Allium cepa L.) seeds under different aging conditions.

BACKGROUND: Onion seeds have limited storage capacity compared to other vegetable seeds. It is crucial to identify the mechanisms that induce tolerance to storage conditions and reduce seed deterioration. To address this goal, an experiment was conducted to evaluate changes in germination, biochemical, physiological, and molecular characteristics of onion seed landraces (Horand, Kazerun landraces and Zargan cultivar) at different aging levels (control, three-days and six-days accelerated aging, and natural aging for one year). RESULTS: The findings suggest that there was an increase in glucose, fructose, total sugar, and electrolyte leakage in the Horand (HOR), Kazerun (KAZ) landraces, and Zarghan (ZAR) cultivar, with Kazerun exhibiting the greatest increase. The percentage and rate of germination of Kazerun decreased by 54% and 33%, respectively, in six-day accelerated aging compared to the control, while it decreased by 12% and 14%, respectively, in Horand. Protein content decreased with increasing levels of aging, with a decrease of 26% in Kazerun landrace at six days of aging, while it was 16% in Horand landrace. The antioxidant activities of catalase, superoxide dismutase, and glutathione peroxidase decreased more intensively in Kazerun. The expression of AMY1, BMY1, CTR1, and NPR1 genes were lower in Kazerun landraces than in Horand and Zargan at different aging levels. CONCLUSIONS: The AMY1, BMY1, CTR1, and NPR1 genes play a pivotal role in onion seed germination, and their downregulation under stressful conditions has been shown to decrease germination rates. In addition, the activity of CAT, SOD, and GPx enzymes decreased by seed aging, and the amount of glucose, fructose, total sugar and electrolyte leakage increased, which ultimately led to seed deterioration. Based on the results of this experiment, it is recommended to conduct further studies into the molecular aspects involved in onion seed deterioration. More research on the genes related to this process is suggested, as well as investigating the impact of different priming treatments on the genes expression involved in the onion seed aging process.

A drug utilization study of thiocolchicoside-containing medicinal products for systemic use in France and Italy: A cross-sectional electronic medical records database study.

PURPOSE: The risk minimization measures (RMM) for systemic use of thiocolchicoside (TCC) was implemented across Europe during 2014-2016. RMM included restriction of use in age <16 years, maximum dose and duration, chronic conditions, contraindication in pregnancy, lactation or in women of childbearing potential [WOCBP] without appropriate contraception. The current Drug Utilization Study was aimed to describe the prescribing practices of TCC in France and Italy. METHOD: The study analyzed data (demographic, prescription, diagnosis, and concomitant treatment) from electronic medical record databases. It compares drug utilization during pre-implementation (baseline: year 2013) and post-implementation (years 1, 2, and 3) of RMM. This study included panels of general practitioners (FGP) and rheumatologists (FRH) in France and Italy (IGP). RESULTS: TCC was largely prescribed as adjuvant therapy in both pre-implementation (FGP: 93.5%, FRH: 88.8%, IGP: 86.6%) and post-implementation (FGP: 92.3%, FRH: 89.5%, IGP: 89.0%) periods. Prescribing patterns were different in France and Italy, with FGP and FRH mainly prescribing oral formulation (>95% and >80%, respectively), while IGP prescribing intramuscular formulation (>70%). Prescriptions to patients aged ≥16 years were >99% in all panels during both periods. An improvement was observed in compliance with treatment duration for oral formulation in the FGP panel post-implementation versus pre-implementation (66.2% vs. 46.7%; p < 0.001). There was no change in prescription rate post RMM implementation in pregnant (FGP: 0.5%, IGP: 4.7%) and in WOCBP without appropriate contraception (FGP: 89.3%, IGP: 93.4%). CONCLUSION: These results highlighted changes in prescribing practices of TCC after RMM implementation, which varied across panels and measures.

DELAY OF GERMINATION 1 (DOG1) regulates dormancy in dimorphic seeds of Xanthium strumarium.

Seed dormancy ensures plant survival but many mechanisms remain unclear. A high-throughput RNA-seq analysis investigated the mechanisms involved in the establishment of dormancy in dimorphic seeds of Xanthium strumarium (L.) developing in one single burr. Results showed that DOG1 , the main dormancy gene in Arabidopsis thaliana L., was over-represented in the dormant seed leading to the formation of two seeds with different cell wall properties. Less expression of DME /EMB1649 , UBP26 , EMF2, MOM, SNL2, and AGO4 in the non-dormant seed was observed, which function in the chromatin remodelling of dormancy-associated genes through DNA methylation. However, higher levels of ATXR7 /SDG25, ELF6 , and JMJ16/PKDM7D in the non-dormant seed that act at the level of histone demethylation and activate germination were found. Dramatically lower expression in the splicing factors SUA, PWI , and FY in non-dormant seed may indicate that variation in RNA splicing for ABA sensitivity and transcriptional elongation control of DOG1 is of importance for inducing seed dormancy. Seed size and germination may be influenced by respiratory factors, and alterations in ABA content and auxin distribution and responses. TOR (a serine/threonine-protein kinase) is likely at the centre of a regulatory hub controlling seed metabolism, maturation, and germination. Over-representation of the respiration-associated genes (ACO3 , PEPC3 , and D2HGDH ) was detected in non-dormant seed, suggesting differential energy supplies in the two seeds. Degradation of ABA biosynthesis and/or proper auxin signalling in the large seed may control germinability, and suppression of endoreduplication in the small seed may be a mechanism for cell differentiation and cell size determination.

Profiling "Success": Demographic and Personality Predictors of Effective Peer Leaders in a Diabetes Self-management Intervention.

BACKGROUND: The sociodemographic and personality profiles of effective peer leaders in the context of diabetes self-management interventions are poorly understood. In this study, we explored the demographic and personality characteristics of peer leaders participating in a 12-month, telephone-based type 2 diabetes self-management intervention. METHODS: We used a sequential explanatory mixed-methods research design and recruited 52 peer leaders. Thirty-seven peer leaders had at least 1 participant complete both the baseline and the 12-month assessments. Eligible peer leader candidates were English-speaking adults (≥21 years of age) with diabetes and a self-reported glycated hemoglobin (A1C) level of ≤8% who had access to a phone and transportation and were willing to attend a 30-hour training program. Peer leaders completed a self-report survey assessing sociodemographic characteristics and a Mini-International Personality Item Pool scale measuring the "Big 5" personality traits. After the intervention, 17 peer leaders participated in semistructured interviews on their program experience. We categorized peer leaders as effective if their participants sustained or improved their A1C and diabetes distress (DD) scores from baseline to 12 months, and as ineffective if their participants worsened on any of these parameters. RESULTS: Our cohort scored highest on agreeableness and lowest on neuroticism. Twenty peer leaders were considered effective, most of whom were male, married, employed and educated. They also had significantly lower mean DD levels (p=0.02) and a higher extroversion score (p=0.03) at baseline. CONCLUSIONS: Extroversion emerged as the best personality predictor of peer leader effectiveness. These results, in combination with interview responses, were used to produce a peer leader selection model.

Bioavailability of rectal acetaminophen in children following anorectal surgery.

BACKGROUND: Acetaminophen is widely used as an analgesic and antipyretic agent in pediatrics. Although bioavailability of rectal acetaminophen is unpredictable, rectal route is a usual and acceptable method of prescription. Major anorectal surgery may alter the normal structure of the surgical site, especially the vascular elements and the normal connections between port and systemic vessels. As a result the pharmacokinetics of rectal medications might also be altered. Based on this hypothesis, we decided to study acetaminophen plasma concentration among children who underwent these types of surgeries to determine the pharmacokinetic of absorption, plasma concentration, safety, and efficacy of rectal acetaminophen. MATERIALS AND METHODS: The study included 20 cases with previous history of pull-through procedure owing to Hirschsprung's disease (HD), 20 cases with imperforate anus (IA) reconstructive surgeries who were admitted for colostomy closure, and 20 otherwise healthy cases of inguinal herniotomy. Venus blood sampling was done 4, 8 and 12 hrs after a single loading dose of rectal acetaminophen (40 mg/kg), and plasma acetaminophen concentration was compared between groups. RESULTS: Mean serum acetaminophen levels of the HD group were significantly higher than those of the herniotomy group (36.3 ±â€¯6.79, 27.4 ±â€¯8.42, 16.8 ±â€¯7.62 versus 25.9 ±â€¯9.12, 16.7 ±â€¯6.74, 8.1 ±â€¯5.79 (µg/ml) at 4, 8 and 12 hrs after drug administration and P < 0.05). The IA group had higher concentrations of plasma acetaminophen compared to the herniotomy group; however, the p values were not statistically significant. (31.4 ±â€¯10.39, 21.5 ±â€¯9.12, 13.3 ±â€¯6.79 versus 25.9 ±â€¯9.12, 16.7 ±â€¯6.74, 8.1 ±â€¯5.79 (µg/ml) at 4, 8 and 12 hrs after drug administration). Serum concentrations of acetaminophen in IA and HD patients were above the therapeutic range four hours after administering the loading dose (31.4 ±â€¯10.39 and 36.3 ±â€¯6.79 versus 5-20 µg/ml). CONCLUSION: Bioavailability of rectal acetaminophen might get altered after major anorectal surgery in children. Rectal acetaminophen should be administered with special caution among infants with history of anorectal operations. Repeated dose of rectal acetaminophen may cause the drug blood concentration to reach toxic levels in these patients. TYPE OF STUDY: Prospective comparative study. LEVEL OF EVIDENCE: Level II.

Mercury from crematoriums: human health risk assessment and estimate of total emissions in British Columbia.

OBJECTIVES: Mercury occurs in the environment as a result of natural processes and human activities, including when individuals with amalgam dental fillings are cremated. This work aimed to estimate the quantity of mercury emitted to the atmosphere from crematoriums in British Columbia (BC) and assess the human health risk. METHODS: A BC-specific emissions factor for mercury from crematoriums was developed and applied to an estimate of the quantity of mercury released annually to the atmosphere from crematoriums. The maximum ground-level mercury vapour concentrations resulting from crematorium emissions were estimated. RESULTS: In BC, it is estimated that approximately 1.20 g of mercury is emitted to the atmosphere per body cremated and about 30,000 cremations were conducted in the province in 2016. It is estimated that almost 36 kg of elemental mercury was released to the atmosphere as a result. The maximum estimated peak short-term and long-term average ground-level mercury vapour concentrations associated with crematorium emissions were 0.31 µg/m3 and 7.9 × 10-3 µg/m3 respectively, which are far lower than the reference concentration (hazard quotient of less than 1). CONCLUSION: Mercury from crematoriums accounts for more than 7% of total mercury emissions to the atmosphere in BC, but risk assessment found no indication that ground-level exposures to elemental mercury vapour from crematoriums poses a significant risk to human health. If the number of cremations increases, it might reach considerable levels, highlighting the need for developing a national plan similar to other countries.

RéSUMé: OBJECTIVES: Le mercure est présent dans l'environnement à la suite de processus naturels et d'activités humaines, notamment lors de la crémation d'individus porteurs d'amalgames. Ce travail visait à estimer la quantité de mercure rejetée dans l'atmosphère par les crématoriums en Colombie-Britannique et à évaluer le risque pour la santé humaine. MéTHODES: Un facteur d'émissions spécifique à la Colombie-Britannique pour le mercure des crématoriums a été élaboré et appliqué à une estimation de la quantité de mercure rejetée chaque année dans l'atmosphère par les crématoriums. Les concentrations maximales de vapeur de mercure au niveau du sol résultant des émissions de crématorium ont été estimées. RéSULTATS: En Colombie-Britannique, on estime qu'environ 1,20 g de mercure est émis dans l'atmosphère par corps incinéré et environ 30 000 incinérations ont eu lieu dans la province en 2016. On estime que près de 36 kg de mercure élémentaire ont ainsi été rejetés dans l'atmosphère. Les concentrations maximales moyennes estimées de vapeurs de mercure au niveau du sol associées aux émissions de crématorium étaient de 0,31 µg/m3 et 7,9 x 10−3 µg/m3, respectivement, valeurs nettement inférieures à la concentration de référence (quotient de danger inférieur à 1). CONCLUSION: Le mercure provenant des crématoriums représente plus de 7 % des émissions totales de mercure dans l'atmosphère en Colombie-Britannique, mais l'évaluation des risques n'a révélé aucune indication selon laquelle l'exposition au niveau du sol aux vapeurs de mercure élémentaire provenant de crématorium pose un risque important pour la santé humaine. Si le nombre de crémations augmente, il pourrait atteindre des niveaux considérables, soulignant la nécessité d'élaborer un plan national similaire à celui d'autres pays.

Very low dose naltrexone in opioid detoxification: a double-blind, randomized clinical trial of efficacy and safety.

Withdrawal syndrome is one of the initial focuses of opioid detoxification. Very low dose naltrexone (VLNTX) has been found to reduce opioid tolerance and dependence in animal and human clinical studies. The aim of this study was to determine the safety and efficacy of VLNTX during early stages of detoxification. In a multi-arm parallel, double-blind, randomized controlled trial, 63 opioid-dependent male participants referring to Imam Reza Rehabilitation Center were allocated to three equal groups using block randomization method. They received 0.125 mg, 0.250 mg of VLNTX or placebo daily for 10 days, together with the routine clonidine-based protocol. Self-reported and observer ratings of withdrawal severity and adverse events were measured on the 1st, 4th and 10th day of treatment. Runny eyes (p = 0.006), anxiety (p = 0.031) and dehydration (p = 0.014) were reduced during the whole 10 days in the 0.125 mg VLNTX-treated group compared to placebo. Only drowsiness (p = 0.043) and dysphoric mood (p < 0.001) were reduced in the 0.250 mg VLNTX-treated group. Results of 1st, 4th, and 10th-day assessment showed that most symptoms reductions were for the 0.125 mg VLNTX and the placebo group in the 1st and 4th days, respectively. On the 10th day, there was not any significant difference between 0.250 mg VLNTX-treated group and placebo group. No adverse effect was observed. In the starting days of detoxification, VLNTX can reduce the withdrawal symptoms, but the efficacy declined by passing time. Further studies are needed to test the utility of this new therapeutic approach.

Mercury and Atherosclerosis: Cell Biology, Pathophysiology, and Epidemiological Studies.

Today atherosclerosis is considered as a main cause of death in the worldwide. There is a significant association between heavy metal exposure and atherosclerosis. In this study, we discussed the scientific literature about the effect of mercury on the pathogenesis of atherosclerosis. We also considered the epidemiological studies on mercury as a risk factor for atherosclerosis. Web of Science, Google Scholar, Medline, PubMed, and Scopus were searched by using the following keywords to 2019: (cardiovascular diseases OR atherosclerosis OR endothelial dysfunction) AND (mercury). Mercury has the potential to act as one of the novel risk factors for atherosclerosis development. The findings have indicated the role of mercury in the pathogenesis of atherosclerosis, vascular endothelial dysfunction, oxidative stress, inflammation, and dyslipidemia. Mercury can induce atherosclerosis indirectly via increasing the total cholesterol, triglycerides, and LDL-C levels as well as decreasing the HDL-C level. Mercury can be considered as a risk factor in the atherosclerosis progression. However, more studies are required to find the exact mechanisms involved in the pathogenesis of atherosclerosis induced by mercury.

Oil pipelines and food sovereignty: threat to health equity for Indigenous communities.

Energy projects may profoundly impact Indigenous peoples. We consider effects of Canada's proposed Trans Mountain oil pipeline expansion on the health and food sovereignty of the Tsleil-Waututh Nation (TWN) through contamination and impeded access to uncontaminated traditional foods. Federal monitoring and TWN documentation show elevated shellfish biotoxin levels in TWN's traditional territory near the terminus where crude oil is piped. Although TWN restoration work has re-opened some shellfish-harvesting sites, pipeline expansion stands to increase health risk directly through rising bioaccumulating chemical toxins as well as through increased hazardous biotoxins. Climate change from increased fossil fuel use, expected via pipeline expansion, also threatens to increase algae blooms through higher temperature and nutrient loading. As the environmental impact assessment process failed to effectively consider these local health concerns in addition to larger impacts of climate change, new assessment is needed attending to linked issues of equity, sustainability and Indigenous food sovereignty.

Analysis of effectiveness of Iranian snake antivenom on Viper venom induced effects including analysis of immunologic biomarkers in the Echis carinatus sochureki envenomed victims.

Snakebite is an important toxicologic emergency with the potential of triggering local and systemic inflammation. Antivenom has remained the mainstay of treatment for snakebite envenomation. In this study we sought to investigate the effectiveness of Iranian antivenom in a series of 44 viper envenomed patients through analysis of changes in clinical severity and the levels of inflammatory markers. Clinical envenomation severity assessed by snakebite severity score (SSS) and laboratory exams of the patients were recorded before (baseline visit) and after antivenom therapy. During 12-h antivenom therapy, the median (range) score of SSS significantly decreased from 3.5 (2-10) on admission to 1 (0-5) in the last visit (P < 0.001). Moreover, a significant decrease in prothrombin time and international normalized ratio was found (P = 0.006 and 0.008; respectively). Plasma concentrations of interleukin (IL) 1-ß, IL-6, IL-8, tumor necrosis factor α (TNF-α), complement hemolytic activity (CH50) were also measured in 10 severely Echis carinatus sochureki envenomed victims and 10 age and gender-matched healthy controls. Except IL-8, the baseline levels of IL-1ß, IL-6 and TNF-α in victims were significantly higher than healthy controls (P = 0.005, <0.001 and < 0.001, respectively). Moreover, the baseline level of CH50 was significantly lower in the patients compared to healthy controls (P < 0.001). After 12-h antivenom therapy, the plasma levels of IL-1ß, IL-6 and TNF-α significantly decreased (P = 0.032, 0.006 and 0.003, respectively), the levels of IL-8 remained relatively unchanged and the CH50 significantly increased (P = 0.011). Iranian snake antivenom was effective in treating viper bite envenomation as it reversed clinical venom effects and restored near normal underlying inflammatory status. This study is the first to ascertain and report the effectiveness of this antivenom in human subjects.

Measurement of Methanol and Ethanol Contents in Most Commonly Used Herbal Distillates Produced by Three Famous Brands.

BACKGROUND: Herbal distillates have been used for many centuries as herbal medicines in Traditional Persian medicine. The main purpose of this study was to determine methanol and ethanol contents in commonly-used industrial herbal distillates produced by three famous factories in Khorasan Razavi, Mashhad, Iran (2014-2015). METHODS: Ninety herbal waters of ten types of most commonly used herbal distillates including Willow (Salix alba), Ajava seeds (Carum copticum), Fennel (Foeniculum vulgare), Poleigamander (Teucrium polium), Forty plants, Peppermint (Mentha piperita), Camel thorn (Alhagi camelorum), Chicory (Cichorium intybus), Fumitory (Fumaria officinalis) and Rose water (Rosa damascene) of three famous company in Mashhad were randomly bought from market. Methanol and ethanol contents of each sample were measured by Gas chromatography according to the standard method. Collected data were analyzed by SPSS using appropriate descriptive statistical tests. RESULTS: The highest average amount of methanol of all tested distillates is for forty plants (46.06 mg/dl) and M. piperita (46.72 mg/dl) and the lowest for ajava seed (8.46 mg/dl). The maximum and minimum ethanol level was reported for rose water (0.39 mg/dl) and ajava seed (0.15 mg/dl), respectively. CONCLUSION: High methanol and ethanol concentrations may induce toxicity in people taking these products regularly for a long time. Therefore, considering the harmful effects of methanol and ethanol on human health, further studies are required for determining permitted levels of methanol and ethanol in herbal distillates.

Superior adaptation of aerobic rice under drought stress in Iran and validation test of linked SSR markers to major QTLs by MLM analysis across two years.

Drought is one of the biggest challenges for rice (Oryza sativa L.) production in rainfed areas. Developing "aerobic rice" cultivars could be a valuable alternative to irrigated/rainfed areas. During 2010-2013, 115 rice genotypes, including non-local cultivars and aerobic rice genotypes, were evaluated and 31 rice genotypes were screened, while 21 Iranian lowland rice cultivars (52 genotypes) were investigated under non-stress and drought conditions at the University of Guilan, Rasht, Iran, in 2014 and 2017. The results revealed the superiority of high yielding genotypes, namely Neda (6.202 t ha- 1), IR82639-B-B-140-1 (6.020 t ha- 1), and IR82635-B-B-82-2 (5.75 t ha- 1) under non-stress, Panda (4.512 t ha- 1), and IR82639-B-B-140-1 (4.08 t ha- 1), under drought stress conditions. Based on the molecular markers evaluation using identified SSR markers linked to major QTLs different important traits specially drought stress, IR 82639-B-B-140-1 showed the highest genetic distance with high-quality Iranian lowland cultivars, which could be considered as a donor for the development of new cultivars. Moreover, the assignment of rice genotypes based on Jaccard distance clustering was in agreement with the grouping of structure analysis. The validation test using MLM analysis in this natural population revealed the most important significant associations that were identified under drought conditions. These are: the associations between RM306, RM319, RM511, RM28166, and RM11943 with different grain yield (GY)-related traits simultaneously and stable across both years. These markers, which were verified in a natural population across 2 years, could be considered as the potential markers for use in marker-assisted breeding and to improve the grain yield of rice.

Qualitative thallium urinary assays are almost as valuable as quantitative tests: implication for outpatient settings in low and middle income countries.

BACKGROUND: Thallium (Tl), lead and steroid exposures were reported as a result of street drug consumption such as heroin and cocaine. OBJECTIVE: This study aimed to compare the values of qualitative and quantitative assays for detecting Tl as an adulterant in opioid-like compound drug users. METHODS: This case-control study was conducted throughout a specified time bracket ranging from May 2015 to November 2015 in Imam Reza Hospital, Mashhad, Iran. In general, urine thallium samples for 100 opioid overdosed subjects with a history of chronic opioid use and 50 non-drug users were studied. Qualitative 24 hours-urinary-thallium-level (QL) and quantitative 24 hours-urinary-thallium-level (QT) were conducted in both groups. Independent-samples t-test and Spearman's Coefficient were applied for analytical purposes. SPSS software 16 was used to conduct statistical analyses with P values less than 0.05 regarded as significant. RESULTS: A total of 150 cases were studied. Raw opium users accounted for 66% of the cases followed by mixed (28%) and heroin users (6%). Mean (SD) QT level for QL was 26.8 (1) µg/L, while it was 2.3 µg/L (0.4 µg/L) for negative QL, which was far below QL positive cases (p=0.002). The qualitative test showed more accuracy at higher quantitative levels. In all cases, qualitative test was fully sensitive (100%), highly specific (89%) with a positive likelihood ratio (PLR) of 9.1 and a negative likelihood ratio (NLR) of 0. CONCLUSION: These results suggest that qualitative assays could be used with confidence in assessing Tl exposure in drug users. Physicians may easily and confidently use Tl qualitative tests in rehabilitation centers, where toxicology laboratories may not be available.

Mushroom Poisoning in the Northeast of Iran; a Retrospective 6-Year Epidemiologic Study.

INTRODUCTION: Toxic mushrooms are distributed across the globe with over 5000 species. Among them, 100 species are responsible for most of the cases of mushroom poisoning. This study aimed to evaluate the epidemiologic pattern of mushroom poisoning among patients referred to the main toxicology center of Mashhad province located in North-east of Iran. METHOD: This cross-sectional study was conducted on patients with final diagnosis of mushroom poisoning referred to the toxicology center of Mashhad, Iran, from February 2005 to 2011. Patients' demographic characteristics, clinical presentations, laboratory findings, outcomes, and therapeutic measures were collected using a predesigned checklist and searching patient's profile. RESULTS: 32 cases with the mean age of 24.6 ± 16.7 years were presented to the toxicology center following mushroom poisoning (59% female). Mushroom poisoning accounted for 0.1% of all admitted cases. The mean time elapsed from consumption to referral to poisoning department was 61.9 ± 49.4 hours. 19 (59%) cases were discharged with complete recovery, 7 (22%) expired, and 6 (19%) cases left hospital against medical advice. Mushroom poisoning mortality accounted for 1.5% of deceased cases in the studied center. There was significant relationship between mortality rate and higher values of INR (p = 0.035), PT (p = 0.011) and PTT (p = 0.003). Likewise, there was significant relationship between the need for mechanical ventilation and higher values of INR (p = 0.035), PT (p = 0.006) and PTT (p = 0.014). The relationships between the need for ICU admission, mechanical ventilation, and mortality rate with the rise of hepatic transaminases and serum bilirubin were not significant. CONCLUSION: Based on the findings, the prevalence of mushroom poisoning among patients referred to Mashhad toxicology center was very low (0.1%), but with a high mortality rate of 22%. Nausea and vomiting were the most common early symptoms of intoxication and higher values of coagulation profile were correlated with poor outcome.

Opium Addiction and Risk of Laryngeal and Esophageal Carcinoma.

INTRODUCTION: Cigarette smoking and alcohol consumption have a well-known effect on the development of upper aerodigestive tract carcinomas, but such a role for opium is questionable. This study was designed to assess the correlation between opium inhalation and cancer of the larynx and upper esophagus. MATERIALS AND METHODS: Fifty eight patients with laryngeal cancer, ninety eight patients with upper esophageal cancer and twenty seven healthy individuals with no evidence of head and neck or esophageal malignancies were selected from Otolaryngology and Radiation Oncology Department of Mashhad University of Medical Sciences. Duration and amount of cigarette smoking and opium consumption were recorded through comprehensive interviews. RESULTS: The crude odds ratio for laryngeal cancer was 5.58 (95% CI 2.05-15.15, P=0.000) in cigarette smokers relative to non-smokers and 9.09 (95% CI 3.21-25.64, P=0.000) in opium users relative to non-users. The crude odds ratio for esophageal cancer was 0.44 (95% CI 0.18-1.09, P=0.07) in cigarette smokers relative to non-smokers and 1.44 (95% CI 0.57-3.62, P=0.43) in opium users relative to non-users. After adjusting for smoking, the odds ratio for laryngeal cancer in opium users relative to non-users was 6.06 (95% CI 1.10-33.23, P=0.05). Laryngeal cancer was detected at a significantly lower age in opium users (54.54±10.93 vs 62.92±10.10 years, P=0.02) than in smokers. This effect was not observed in esophageal cancer. Although the duration (year 17.50±14.84 vs 21.91±14.03; P=0.34) and amount (pack/day 0.625 vs 0.978; P=0.06) of smoking were higher among those who were opium dependent, these differences were not statistically significant (P=0.34 and P=0.06, respectively). CONCLUSION: Opium addiction by snuffing is an independent risk factor for the development laryngeal cancer but not esophageal cancer. Cigarette smoking increases this risk. Opium dependency increases the likelihood of developing laryngeal cancer at a younger age.

Myocardial perfusion and left ventricular function indices assessed by gated myocardial perfusion SPECT in methamphetamine abusers.

OBJECTIVES: Methamphetamine (MA) is associated with alterations of cardiac structure and function, although it is less known. In this study, we assessed possible abnormality in myocardial perfusion and left ventricular function using gated myocardial perfusion SPECT. METHODS: Fifteen patients with MA abuse, on the basis of Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) MA dependency determined by Structured Clinical Interview for DSM-IV, underwent 2-day dipyridamole stress/rest Tc-sestamibi gated myocardial perfusion SPECT. RESULTS: An average daily dose of MA use was 0.91±1.1 (0.2-4) g. The duration of MA use was 3.4±2.1 (1-7) years. In visual and semiquantitative analyses, all patients had normal gated myocardial perfusion SPECT, with no perfusion defects. In all gated SPECT images, there was no abnormality in left ventricular wall motion and thickening. All summed stress scores and summed rest scores were below 3. Calculated left ventricular functional indices including the end-diastolic volume, end-systolic volume, and left ventricular ejection fraction were normal. CONCLUSION: Many cardiac findings because of MA mentioned in previous reports are less likely because of significant epicardial coronary artery stenosis.