Physiological response of the retinal pigmented epithelium to 3-ns pulse laser application, in vitro and in vivo.

BACKGROUND: To treat healthy retinal pigmented epithelium (RPE) with the 3-ns retinal rejuvenation therapy (2RT) laser and to investigate the subsequent wound-healing response of these cells. METHODS: Primary rat RPE cells were treated with the 2RT laser at a range of energy settings. Treated cells were fixed up to 7 days post-irradiation and assessed for expression of proteins associated with wound-healing. For in vivo treatments, eyes of Dark Agouti rats were exposed to laser and tissues collected up to 7 days post-irradiation. Isolated wholemount RPE preparations were examined for structural and protein expression changes. RESULTS: Cultured RPE cells were ablated by 2RT laser in an energy-dependent manner. In all cases, the RPE cell layer repopulated completely within 7 days. Replenishment of RPE cells was associated with expression of the heat shock protein, Hsp27, the intermediate filament proteins, vimentin and nestin, and the cell cycle-associated protein, cyclin D1. Cellular tight junctions were lost in lased regions but re-expressed when cell replenishment was complete. In vivo, 2RT treatment gave rise to both an energy-dependent localised denudation of the RPE and the subsequent repopulation of lesion sites. Cell replenishment was associated with the increased expression of cyclin D1, vimentin and the heat shock proteins Hsp27 and αB-crystallin. CONCLUSIONS: The 2RT laser was able to target the RPE both in vitro and in vivo, causing debridement of the cells and the consequent stimulation of a wound-healing response leading to layer reformation.

Gastric phytobezoars as a very unusual cause of gastric outlet obstruction.

Bezoars are collections of indigestible foreign material found in the gastrointestinal tract. Phytobezoars are the most common among the types of bezoars. Treatment of phytobezoars is categorized into four types: chemical dissolution, endoscopic removal, adjuvant prokinetics, and surgery. Complications from phytobezoars can include gastric outlet obstruction (GOO), ileus, ulcerations, gastrointestinal bleeding, and perforation. Herein, we present an 86-year-old woman with refractory postprandial vomiting. Then, exploratory laparotomy was performed and the diagnosis was gastric phytobezoar. Phytobezoars-induced GOO is rare and its diagnosis is still a challenge.

Ginger intervention on body weight and body composition in adults: a GRADE-assessed systematic review and dose-response meta-analysis of 27 randomized controlled trials.

CONTEXT: Ginger consumption may have an inverse relationship with obesity and metabolic syndrome parameters; however, clinical trials have reported contradictory results. OBJECTIVE: To systematically review and analyze randomized controlled trials (RCTs) assessing the effects of ginger on body weight and body composition parameters. METHODS: Databases were searched for appropriate articles up to August 20, 2022. All selected RCTs investigated the impact of ginger on glycemic indices in adults. A random effects model was used to conduct a meta-analysis, and heterogeneity was assessed using the I2 statistic. Net changes in body weight, body mass index (BMI), waist circumference (WC), and percent body fat were used to calculate the effect size, which was reported as a weighted mean difference (WMD) and 95% confidence intervals (CIs). The risk of bias was assessed. RESULTS: A total of 27 RCTs involving 1309 participants were included. The certainty in the evidence was very low for WC and BMI, and low for body weight and percent body fat as assessed by the GRADE evidence profiles. The meta-analysis showed a significant association between ginger supplementation and a reduction in body weight (WMD, -1.52 kg; 95%CI, -2.37, -0.66; P < 0.001), BMI (WMD, -0.58 kg/m2; 95%CI, -0.87, -0.30; P < 0.001), WC (WMD, -1.04 cm; 95%CI: -1.93, -0.15; P = 0.021), and percent body fat consumption (WMD, -0.87%; 95%CI, -1.71, -0.03; P = 0.042). The results of the nonlinear dose-response analysis showed a significant association between the ginger dose with body weight (Pnonlinearity = 0.019) and WC (Pnonlinearity = 0.042). The effective dose of ginger intervention for body mass reduction was determined to be 2 g/d in dose-response analysis. The duration of ginger intervention had a significant nonlinear relationship with body weight (Pnonlinearity = 0.028) with an effective duration of longer than 8 weeks. CONCLUSIONS: Our findings provide evidence that ginger consumption may significantly affect body composition parameters nonlinearly. More, well-constructed RCTs are needed.

Effect of vitamin D supplementation on inflammatory markers and total antioxidant capacity in breast cancer women using a machine learning technique.

Aim: This study aimed to establish a learning system using an artificial neural network (ANN) to predict the effects of vitamin D supplementation on the serum levels of vitamin D, inflammatory factors, and total antioxidant capacity (TAC) in women with breast cancer. Methods: The data set of the current project was created from women with breast cancer who were referred to the Shafa State Hospital of Patients with Cancers in Ahvaz city, Iran. Modeling was implemented using the data set at the serum levels of vitamin D, tumor necrosis factor-α (TNF-α), transforming growth factor ß (TGF-ß), and TAC, before and after vitamin D3 supplement therapy. A prediction ANN model was designed to detect the effects of vitamin D3 supplementation on the serum level changes of vitamin D, inflammatory factors and TAC. Results: The results showed that the ANN model could predict the effect of vitamin D3 supplementation on the serum level changes of vitamin D, TNF-α, TGF-ß1, and TAC with an accuracy average of 85%, 40%, 89.5%, and 88.1%, respectively. Conclusions: According to the findings of the study, the ANN method could accurately predict the effect of vitamin D3 supplementation on the serum levels of vitamin D, TNF-α, TGF-ß1, and TAC. The results showed that the proposed ANN method can help specialists to improve the treatment process more confidently in terms of time and accuracy of predicting the influence of vitamin D supplementation on the factors affecting the progression of breast cancer (https://www.irct.ir/ identifier: IRCT2015090623924N1).

Adaptation of Clinical Practice Guideline for Colorectal Cancer Screening in People with Average Risk in Isfahan Province.

Background: Colorectal cancer (CRC) is the third most common cancer among adults in Iran. The aim of colorectal cancer screening is to reduce the cancer burden in the population by diagnosing the disease in its early stages. Methods: We adapted this guideline for the moderate CRC risk population for Isfahan to determine how to screen them and when to start and end the CRC screening. This guideline was developed by clinical appraisal and review of the evidence, available clinical guidelines, and in consultation with members of the Isfahan Chamber of Iranian association of gastroenterology and hepatology. Results: In screening people with average risk for CRC who use personal resources and personally pay all the costs, colonoscopy is recommended as the first choice to be done every 10 years. In case of negative colonoscopy, we recommend FIT test to prevention of interval cancer every 5 years. In screening of people with average risk of CRC, FIT is suggested to be done every 2 years as a first-choice method test for those who use public resources and do not pay for this service personally. In screening individuals with average risk for CRC, g-FOBT is not recommended as the first method of choice. Repeating positive guaiac test is not recommended and if positive, colonoscopy is suggested.

The educational role of clinical informationist on improving clinical education among medical students: Based on Kirkpatrick model.

INTRODUCTION: Due to time constraints and a significant increase in medical information, one of the ways to keep physicians and medical teams up to date is to use evidence-based medicine. The current research focused on the effects of the educational role of clinical informationist (CI) on improving clinical education among medical students based on the Kirkpatrick (KP) model. METHODS: The method was semiexperimental research in two group designed with pretest and posttest. The research population included thirty medical students for each group that was selected by the convenience time-based sequential sampling method. The study data were collected using a researcher-made two questionnaires and a checklist. Data were analyzed by the descriptive statistics and inferential statistics using SPSS version 20 software. RESULTS: Based on the first level of the KP model, the total mean of medical students' satisfaction in the experimental group was 4.06 from 5. Based on the second, third, and fourth levels of the model, the independent t-test showed that before the intervention, the mean scores of attitude, knowledge, information-seeking skills and behaviors, and also clinical skills were not significantly different in both the intervention and control groups (P > 0.05). After the intervention, the results of covariance test showed that attitude, knowledge, information-seeking skills and behaviors, and also clinical skills of the intervention group are significantly better than that of the control group (P < 0.001). CONCLUSION: Training and the presence of the CIs in the clinical round had resulted in the improved satisfaction, attitude, knowledge, and information-seeking skills while also improving information-seeking behaviors and clinical skills of medical students.

Evaluation of the Prevalence of Shielding in Patients Undergoing Conventional Radiological Procedures (1 Work Shift-1 X-ray Room).

OBJECTIVES: This study aimed to evaluate the prevalence of shielding in patients undergoing conventional radiological procedures (1 work shift-1 x-ray room).The increased number of patients undergoing x-ray examinations has created a global concern due to the stochastic and nonstochastic association with x-ray exposure. Shielding is an efficient method of protecting radiosensitive organs when performing radiological examinations. MATERIALS AND METHODS: Thirty radiography students were sent to conventional radiology departments to act as observers in the control booth of an x-ray room when a radiological procedure was being performed. RESULTS: Of the 30 hospitals evaluated, 13% regarded shielding of radiosensitive organs. The prevalence of shielding in the hospitals where shielding of radiosensitive organs was implemented varied from 5.2% to 14%. CONCLUSION: The results of this study showed that shielding of radiosensitive organs was not performed in the majority of hospitals. More studies are needed to establish the potential causes of low shielding prevalence.If these findings, which were obtained over 1 work shift and in 1 x-ray room, are representative of a large number of medical imaging centers, this raises global concerns regarding shielding of radiosensitive organs, in particular gonad shielding.