Duloxetine for the Prevention of Oxaliplatin Induced Peripheral Neuropathy: A Randomized, Placebo-Controlled, Double-blind Clinical Trial.

PURPOSE: Peripheral neuropathy is a dose-limiting adverse effect of oxaliplatin. The aim of this study was to evaluate the efficacy and safety of duloxetine in the prevention of oxaliplatin-induced peripheral neuropathy (OIPN). METHOD: Cancer patients receiving oxaliplatin based chemotherapy were randomized into two arms. Duloxetine 60 mg capsule was given in the first 14 days of each chemotherapy cycle to one arm and placebo was similarly given to another. We compared the two arms based on the incidence of neuropathy and the results of the nerve conduction study (NCS). Grade of complained neuropathy was recorded according to Common Terminology Criteria for Adverse Events (CTCAE). RESULTS: Thirty-two patients mostly rectal cancer (90.6%) were randomized to duloxetine and placebo arms. Highest grade of neuropathy in each cycle was not significantly different between the two groups. Six weeks after treatment incidence of neuropathy of any grade was 52.9 in duloxetine arm compared to 76.9% in placebo arm (P: 0.26). Patients in the duloxetine arm had a lower percentage of chemotherapy cycles (mean) in which they reported distal paresthesia (51% vs. 84%, P = 0.01) and throat discomfort (37% vs. 69%, P = 0.01). Results of NCS were mostly comparable between the two arms except for the velocity in two of the examined nerve which was significantly higher in duloxetine group. Duloxetine was safe and well-tolerated. CONCLUSION: Although a definite conclusion might be difficult to draw but administering duloxetine for 14 days in each chemotherapy cycle could not decrease the incidence of acute OIPN based on CTCAE grading system.

Effect of Virtual Reality Exercises on the Cognitive Status and Dual Motor Task Performance of the Aging Population.

Aging is a global phenomenon affecting numerous developed and developing countries. During this process, the functional state of the body, especially the cognitive state, declines. This research investigated the impact of virtual reality exercises on the cognitive status and dual-task performance in the elderly of Tabriz city, Iran. Forty men with a mean age of 71.5 were selected and assigned to either the experimental (n = 20) or control groups (n = 20). Both groups completed the Mini-Mental State Examination for cognitive status. The pre-test was performed through the Timed Up and Go test (TUG) along with a countdown of numbers. Then, the experimental group practiced virtual driving for six weeks, while the control group received no treatment. After the treatment, both groups completed the post-test. At each stage, the test was performed as a dual motor task as well. Data were analyzed using the paired t-test and the independent sample t-test to show the intra-group and inter-group differences, respectively. The results showed a significant improvement in the cognitive status and dual-task performance of the elderly men after the six-week training period, which was also significant compared to the control group. Virtual reality driving can be used to improve the cognitive status and dual task performance of elderly men.

A case of multiple primary malignancies including peritoneal mesothelioma surviving over 11 years.

Multiple primary malignancies are exceedingly rare, but they may occur sequentially in a patient, so in the follow-up of patients with a history of malignancy, always pay attention to second and third primary malignancies as well.

The global status and genetic characterization of hydatidosis in camels (Camelus dromedarius): a systematic literature review with meta-analysis based on published papers.

Hydatidosis is a potential zoonotic helminthic disease affecting a broad spectrum of mammals, including humans, worldwide. The current review was conducted to investigate the genotypic status and prevalence of hydatid disease in camels across the world. For the purpose of the study, the articles addressing the worldwide prevalence of hydatidosis in camels were searched in several English language databases. The search process resulted in the inclusion of 122 papers. Based on the data presented in the reviewed articles, the pooled prevalence of hydatid disease in camels across the world was measured at 23.75% (95% CI 20.15-27.55). Moreover, the subgroup analysis demonstrated significant differences in the overall prevalence of hydatidosis among camels based on year, geographic area, climate parameters, camel population, gender, infected organ, fertility rate of the cyst and laboratory diagnostic technique. Furthermore, the Echinococcus granulosus genotypes identified in camels with hydatidosis included G1, G2, G3, G1-G3, G5, G6, G7, G6-G7 and G6-G10, with G6 being the most common genotype throughout the world. The data obtained from the current study are central to the better conceptualization of the biological and epidemiological characteristics of E. granulosus s.l. genotypes around the world, which can be helpful in the planning and adoption of more comprehensive control strategies.

Current situation and future prospects of Echinococcus granulosus vaccine candidates: A systematic review.

Cystic echinococcosis is a worldwide zoonotic disease, represents a threat for livestock and humans, manifests as a quiescent, subclinical and chronic hydatid cyst infection. The disease imposes high expenditures and economic losses in medical and veterinary. Prophylactic vaccination would be one of the effective preventive health care against echinococcosis. During the last decades, many studies have characterized the protective antigens of Echinococcus granulosus and their role in immunization of various animal host species. Herein, we aimed to systematically evaluate and represent the best antigens as possible vaccine candidates for cystic echinococcosis. Data were systematically searched from five databases including ProQuest, PubMed, Scopus, ScienceDirect and Web of Science, up to 1 February 2020. Two reviewers independently screened and assessed data extraction and quality assessment. A total of 47 articles were eligible for inclusion criteria in the current study. The most common antigens used for vaccination against E. granulosus were EG95 and antigen B. Freund's adjuvant and Quil A have been predominantly utilized. In addition, regarding the antigen delivery, animal models, measurement of immune responses and reduction in hydatid cyst have been discussed in the text. The data demonstrated that DNA vaccines with antigen B and recombinant protein vaccines based on EG95 antigen have the best results and elicited protective immune responses.

Assessment of the Effects of Inspiratory Muscle Training (IMT) and Aerobic Training on the Quality of Life of Patients with Chronic Obstructive Pulmonary Disease.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. The aim of this study was to investigate the effects of inspiratory muscle training (IMT) and aerobic exercise on health-related quality of life of patients with COPD. MATERIALS AND METHODS: This randomized controlled clinical trial was conducted on 60 patients with moderate to severe COPD, who were referred to Imam Hossein Hospital of Tehran, Iran in 2016. The patients were randomly assigned to four groups and treated for eight weeks. Group 1 (n=16) participated in 16 sessions of IMT (15 minutes per session), group 2 (n=14) performed aerobic exercises twice a week (40 minutes per session), group 3 (n=15) performed IMT and aerobic exercises, and group 4 (n=15) received no intervention, except for routine treatments (control). Quality of life was evaluated based on the Saint George's Respiratory Questionnaire (SGRQ) at baseline, week 4, and week 8 after the intervention. RESULTS: After eight weeks, all four groups experienced a significant improvement in their quality of life (P<0.05), and group 3 (IMT and aerobic exercise) showed the greatest improvement. However, quality of life improvement in group 4 (control) was less than the other three groups (P<0.05). CONCLUSION: Aerobic exercise and IMT were more effective than routine protocols in improving the quality of life of COPD patients. Furthermore, short-term IMT plus aerobic exercise had the greatest impact on improving the health-related quality of life of COPD patients and could be used in the management of these patients.

Nonlocal Intuition: Replication and Paired-subjects Enhancement Effects.

This article reports the results of a study of repeat entrepreneurs in Tehran, Iran, in which nonlocal intuition was investigated in a replication and extension of experiment using measures of heart rate variability (HRV). Nonlocal intuition is the perception of information about a distant or future event by the body's psychophysiological systems, which is not based on reason or memories of prior experience. This study follows up on the McCraty, Radin, and Bradley studies, which found evidence of nonlocal intuition. We used Radin's experimental protocol, with the addition of HRV measures as in the McCraty studies involving computer administration of a random sequence of calm and emotional pictures as the stimulus, and conducted two experiments on mutually exclusive samples-the first on a group of single participants (N=15) and the second on a group of co-participant pairs (N=30)-to investigate the question of the "amplification" of intuition effects by social connection. Each experiment was conducted over 45 trials while heart rate rhythm activity was recorded continuously. Results, using random permutation analysis, a statistically conservative procedure, show significant pre-stimulus results-that is, for the period before the computer had randomly selected the picture stimulus-for both experiments. Moreover, while significant separation between the emotional and calm HRV curves was observed in the single-participant experiment, an even larger separation was apparent for the experiment on co-participant pairs; the difference between the two groups was also significant. Overall, the results of the single-participant experiment confirm previous finding: that electrophysiological measures, especially changes in the heart rhythm, can detect intuitive foreknowledge. This result is notable because it constitutes cross-cultural corroboration in a non-Western context-namely, Iran. In addition, the results for co-participant pairs offer new evidence on the amplification of the nonlocal intuition signal.

The pharmacokinetics of Hemiscorpius lepturus scorpion venom and Razi antivenom following intramuscular administration in rat.

Hemiscorpius lepturus (H. lepturus) is one of the most dangerous scorpions in Iran. Intramuscular administration (IM) of available Razi antivenom to H. lepturus venom is used by many of Iranian clinicians. The purpose of the current study was to investigate the efficiency of IM route for treatment of envenomed patients by H. lepturus. We compared the pharmacokinetics parameters of venom and antivenom via subcutaneous (SC) and IM administration, respectively. The blood samples were taken at various predetermined time intervals, i.e., 10, 40, 60, 180, 210, 360 and 400min following 5µg (131)I-labeled venom and 5, 10, 40, 120 and 360min following 0.2ml of (131)I-labeled antivenom administration. The radio-iodination was carried out using the chloramin-T method. The results showed that pharmacokinetic parameters of the venom were T(elimination half-life) = 103.25min; Vd/F (apparent volume of distribution) = 14.9ml/kg; Cl/F (total blood clearance) = 0.04ml/kg/min; mean resident residual time (MRT) = 244.3min, and for the antivenom T(1/2) = 628.59min, Vd = 666.66ml/kg, Cl = 0.13ml/kg/min and MRT = 1292min. A comparison of pharmacokinetic profiles indicated that the intramuscular administration was helpful in the referral less than 2hr to clinical centers but not those exceeding 3hr. Overall, the data showed that immunotherapy against H. lepturus stings was likely to be more effective through intravenous administration.