Pre-operative laparoscopic staging of gastric cancer in patients who are candidates for neo-adjuvant chemotherapy: A Cross Sectional Study.

Objective The aim of this study is to evaluate the laparoscopic method in gastric cancer staging before surgery in patients undergoing Neo-adjuvant chemotherapy. Methods This was a cross-sectional study on patients with T3-T4 and node positive non-metastatic gastric adenocarcinoma who was candidates for neo-adjuvant chemotherapy. The patients were excluded from the study when they were not in the condition to continue the study. All eligible patients underwent metastases work up by abdominal, pelvic and chest CT scans and then received neo-adjuvant chemotherapy. Pre-operative laparoscopy was performed before definitive surgery. The collected data was analyzed using SPSS software. The statistical significance, sensitivity, specificity and predictive values were calculated from this data. Results In this study, out of 50 patients, 26 (52%) were male. The mean age of the patients was 62.44 ± 12.136 years. Most tumors were located in one-third distal of stomach (21 patients, 42%). The accuracy of the laparoscopic method, to determine the degree of involvement of the lymph nodes, revealed that the method had a sensitivity of 84%, a specificity of 47.62%, a positive likelihood ratio (PLR) of 1.6, a negative likelihood ratio (NLR) of 0.33%, a positive predictive value of 65.62% and a negative predictive value of 71.43%. The accuracy of the laparoscopic method, regarding determining the presence or absence of metastasis, revealed that the method had a sensitivity, specificity, positive predictive value, and a negative predictive value of 100%. Conclusion Based on the evidence of this study, and other studies in this field, it seems that the use of a step-by-step combination methods in gastric cancer staging would be logical. Alone, no singular method would be sufficient in providing the physician with sufficient information to successfully stage the tumor and thus determine the appropriate treatment. Therefore, the combination of methods should be used which, in view of the economic constraints of health systems, would be recommended for high-risk patients for metastasis (N+/ T3-T4), diagnostic pre-operative laparoscopy.

Effects of Spirulina platensis microalgae on antioxidant and anti-inflammatory factors in diabetic rats.

OBJECTIVES: Lipid peroxidation and hyperglycemia are common signs for diabetes. Natural antioxidants such as Spirulina platensis microalgae (SPM) may prevent lipid peroxidation and hyperglycemia. This study aimed to evaluate the effects of SPM on antioxidant and anti-inflammatory in diabetic rats. MATERIALS AND METHODS: Sixty-four rats were divided into eight groups (n=8) and orally treated with 0, 10, 20 and 30 mg/kg body weight of SPM extract. Experimental groups included diabetic rats fed with 0 (DC), 10, 20 and 30 mg/kg SPM. Healthy rats were treated with 0 mg/kg SPM (HC), 10 mg/kg SPM, 20 mg/kg SPM and 30 mg/kg SPM. At the end of the trial, blood samples were collected and the plasma concentrations of trace minerals (TMs), biochemical parameters, and antioxidant enzymes in liver were evaluated. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), TNF-α (tumor necrosis factor-alpha) and IL-6 (interleukin-6) were evaluated. RESULTS: Our findings showed that diabetes significantly lowered the plasma concentration of TMs and antioxidant enzymes in liver and also increased the levels of malondialdehyde, glucose, lipid profile, AST, ALT, TNF-α and IL-6 (DC vs HC). However, an oral supplement of SPM (20 and 30 mg/kg body weight) lowered levels of malondialdehyde level, glucose, lipid parameters, AST, ALT, TNF-α and IL-6. The same levels increased the plasma contents of zinc, iron, copper and selenium and activity of antioxidant enzymes (P<0.05). CONCLUSION: It can be concluded that diabetes decreases TM concentration and antioxidant enzymes and also increases lipid profile, glucose, AST, ALT, TNF-α and IL-6 concentrations. Inclusion of SPM supplementing (20 and 30 mg/kg body weight) increased some TMs and antioxidant enzymes. SPM may provide TMs for synthesis of antioxidant enzymes which subsequently reduce lipid profile, glucose concentration and anti-inflammatory responses.

Functional foods and their role in cancer prevention and health promotion: a comprehensive review.

Following cardiovascular disease, cancer is the second leading cause of death in most affluent countries. The 13.3 million new cases of cancer in 2010 were predicted to cost US$ 290 billion, but the total costs were expected to increases to US$ 458 billion in the year 2030 on basis of World Economic Forum in 2011. More than half of all cancer cases and deaths worldwide are consider being preventable. From its inception, the disease control priorities series has focused attention on delivering efficacious health interventions that can result in dramatic reductions in mortality and disability at relatively modest cost. The approach has been multidisciplinary, and the recommendations have been evidence-based, scalable, and adaptable in multiple settings. Better and more equitable health care is the shared responsibility of governments and international agencies, public and private sectors, and societies and individuals, and all of these partners have been involved in the development of the series. Functional foods are foods and food components that supply health benefits beyond basic nutrition. It's-believed these functional foods do more than simply provide nutrients because they help to maintaining health and thereby reducing the risk of disease. There are some reported evidences showing association between functional foods and cancer. For example, S-ally cysteine of garlic and lycopene from tomatoes in combination form suppressed the development of chemically induced gastric cancer by modulation of apoptosis-associated proteins (reduced Bcl-2/Bax ratio and up-regulation of Bim and caspases 8 and 3) at considerably lower intakes than when these substances were given in isolation. Similarly, vitamin D3 with genistein in combination form precipitated a growth inhibition of prostate cancer cells at much lower concentration than when these substances were provided individually. There are very few studies conducted worldwide to see the effects of functional foods on health or cancer or related states. This review, presents the complex patterns of cancer incidence and death around the world and evidence on effective and cost-effective ways to control cancers. The evaluation of cancer will indicate where cancer treatment is ineffective and wasteful, and offer alternative cancer care packages that are cost-effective and suited to low-resource settings. In the present paper, cancer prevention by functional foods is reviewed and the possible mechanisms of action are described.

Modelling the regional vulnerability to Echinococcosis based on environmental factors using fuzzy inference system: A case study of Lorestan Province, west of Iran.

BACKGROUND AND AIM: Echinococcosis as a zoonosis disease is one of the most important parasitic helminth that is affected by many risk factors such as the environmental factors. Thus, we predicted the regional vulnerability to Echinococcosis based on environmental factors using a fuzzy inference system (FIS) in Lorestan Province. METHODS: Our study was cross-sectional study on 200 patients from Lorestan Province (west of Iran) who underwent surgery for hydatidosis between October 2005 and November 2014. In order to model the vulnerability to Echinococcosis, first we determined the effective environmental variables. In the next step, the FIS was designed and implemented using MATLAB v.2012 software. Thus, definition and determination of linguistic variables, linguistic values, and their range were performed based on expert knowledge. Then, the membership functions of inputs (environmental variables) and output (vulnerability to Echinococcosis) were defined. A fuzzy rules base was formed. Also, the defuzzification of output was done using a centroid defuzzification function. To test the accuracy of the predictive model, we calculated the AUC (to this purpose, we used four different thresholds, 5%, 10%, 15%, and 20%) using IDRISI Selva v.17.0 software. RESULTS: Based on the results of this study, Aligoudarz and Koohdasht counties were identified as a highest and lowest risk area in Lorestan, respectively. The results showed that a predictive model was more efficient than a random model (AUC>0.5). Also, potential vulnerable areas cover 78.29% at threshold of 5%, 60.72% at threshold of 10%, 43.54% at threshold of 15%, and 39.82% at threshold of 20% of the study area. CONCLUSION: According to the success of this research, we emphasized the necessity of attention to fuzzy approach to model vulnerability to hydatidosis. This approach can provide a practical economic basis for making informed preventive services decisions and the allocation of health resources.

Characteristics of Colorectal Cancer in Khorramabad, Iran during 2013.

BACKGROUND Colorectal cancer is a common, deadly disease with different incidence rates in different parts of the world. The present study aims to investigate the clinical presentations, colonoscopic findings, and family history of colorectal cancer in the city of Khorramabad, Iran. METHODS This cross-sectional study, conducted in 2013, included 112 patients diagnosed with colorectal cancer by colonoscopy with pathological confirmation in addition to 112 individuals matched with patients for age and gender. Controls were chosen from the outpatients admitted to the Skin and Eye Clinics of ShohadaAshayer Hospital in Khorramabad who had no gastrointestinal diseases. A self-generated questionnaire was used to assess family history of smoking and gastrointestinal cancer history in immediate relatives of subjects from both groups. Fisher's exact test and odds ratios (OR) were used to analyze the data. RESULTS Based on the findings of this study, the most common clinical presentation in the patients was abdominal pain (67.9%). The sigmoid colon (40%) was the most common anatomical site of the tumor in men; the rectum (34.6%) and sigmoid colon (34.6%) were the most common sites in women, which was not statistically significant (p=0.21). There were 11 (19.6%) patients and 2 (3.6%) individuals in the control group who reported a history of colorectal cancer in their immediate relatives, which was statistically significant (p=0.008). CONCLUSION In this study, left-sided colon cancer was more common. Subjects with colon cancer had more positive FHx. This indicated that genetic factors, in addition to environmental factors, could increase the incidence of colorectal cancer in a community. A better identification of these factors would result in better control and management of this disease.

Upper Gastrointestinal Bleeding in Khorramabad City in 2011A Single Referral Center Experience.

BACKGROUND: Acute upper gastrointestinal bleeding (UGIB) is a common medical emergencyand is known as one of the main causes of mortality and morbidity. Thisresearch was conducted to study the causes and risk factors for UGIB, in areferral center. METHODS: In this cross sectional study, carried out in a one year period, all patientswith acute UGIB living in Khorramabad city and surrounding area, entered thestudy. A control group with age and sex matched was selected from outpatientvisits and their relatives who had referred to hospital clinics. Data collectingtool was a self-made questionnaire, demographic, clinical manifestations andendoscopic findings. The data was analyzed using chi-square test, Fisher exacttest and Odds ratio estimation. RESULTS: Sixty-two patients with acute UGIB were studied, 67.7% of them weremales. The mean age of patients was 54.5±12.1. The most common causesof acute UGIB were peptic (42.7%), erosive gastritis (19.8%) and esophagealvarices (19.8%). 29%, and 9.7% of patients, and control group had a history ofregular consumption of Non Steroidal Anti-Inflammatory Drugs ( Odd' s ratio3.8, CI: 1.3-4.8). 35.5% of episodes of acute UGIB were in age more than 60years. CONCLUSION: Peptic ulcer disease is the most common cause of acute UGIB in our region.Episodes of acute UGIB were correlated with regular NSAIDs use, but notwith alcohol consumption, smoking, and gender. Identifying people who are atrisk and providing preventive strategies can reduce the rate of this disease andits complications.