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1. Sleep quality and glycemic control in adults with type 2 diabetes mellitus

Author: Shiva Borzouei, Asma Ahmadi, and Azar Pirdehghan
Subjects: blood glucose control, type 2 diabetes mellitus, sleep, Medicine
Abstract: Aim: Type 2 diabetes mellitus (T2DM) is a common disease that imposes a substantial burden on the healthcare system and patients. Lifestyle modification such as sleep hygiene plays a crucial role in glycemic control. Sleep disorders impact many aspects of health. In this study, we aimed to investigate the correlation between sleep quality and glycemic control in T2DM. Method: This cross-sectional study was performed on 163 T2DM patients, attending Shahid Beheshti Hospital in Hamadan, Iran from March 2020 to 2021. Besides recording the demographic data and HbA1c level of participants, they were asked the Pittsburgh Sleep Quality Index questionnaire for evaluating sleep quality. We employed SPSS ver. 21 for data analysis and considered 0.05 as a significant level Results: Among all participants, 62 (38%) were female and 30.7% were illiterate. The mean age was 56.67 ± 12.90 years, and HbA1c was 9.03 ± 1.92 mg/dL. Among sleep metrics, mean waking time was 8.74 ± 1.74 hours, and average sleep time was 12.90 ± 4.90 hours. Overall, 58.2% of the participants had poor glycemic control and 44.8% were suffering from poor sleep quality. We found that patients with poor glycemic control exhibited significantly higher levels of sleep disturbances compared to those with good glycemic control (P < 0.001). Conclusion: Sleep quality is associated with glycemic control in patients with T2DM. Sleep disorders are common among diabetic patients. Thus, healthcare providers need to consider sleep quality improvement in their holistic approach to diabetes management.
Published: 2024
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2. Investigation of Sleepiness and Obstructive Sleep Apnea in Type 2 Diabetic Patients Based on STOP-BANG Questionnaire and Epworth Sleepiness Scale and its Relationship with Hemoglobin A1c

Author: Mohammad Ishaq Soltaninia, Zohreh Kahramfar, Leili Tapak, and Shiva Borzouei
Subjects: diabetes mellitus type 2, hemoglobin a1c, obstructive sleep apnea, sleepiness, Medicine
Abstract: Background and Objective: Lack of sleep and insomnia are associated with an increase in the risk of diabetes. Sleep disorders in diabetic people are significantly higher than in healthy people. Moreover, sleep duration is related to blood sugar control in diabetes. This study was conducted with the purpose of investigating the level of sleepiness and obstructive sleep apnea in type 2 diabetic patients and its relationship with glycemic levels. Materials and Methods: This cross-sectional study was conducted on 200 patients with type 2 diabetes referred to Shahid Beheshti Hospital in Hamadan in 2023. Diabetes control status was evaluated by hemoglobin A1c, and the frequency of sleepiness and obstructive sleep apnea was assessed by the Epworth Sleepiness Scale and STOP-BANG questionnaires. Data analysis was done using SPSS 26 statistical software. Results: The mean age of the participants was 56.16 ± 9.77 years. A significant difference was observed between the frequency of daily sleepiness score with gender (P
Published: 2024

3. Evaluation of the Relationship Between Salivary Adipokine Levels With Appetite and Anthropometric Indices in Patients With Type 2 Diabetes

Author: Amir Reza Akbarzadeh, Shiva Borzouei, Salman Khazaei, and Mina Jazaeri
Subjects: adipokine, anthropometric indices, appetite, chemerin, interleukins, leptin, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: ABSTRACT Objective This study aimed to evaluate the association between salivary adipokine levels, including leptin, chemerin, resistin and interleukin‐6, with body mass index (BMI), waist and wrist circumference and appetite in patients with type 2 diabetes. Methods In this cross‐sectional study, 104 participants were divided into three groups: 35 diabetic patients, 35 pre‐diabetic individuals and 34 healthy controls. Unstimulated saliva samples were collected using the spitting method, and salivary levels of leptin, chemerin, resistin and interleukin‐6 were measured via ELISA. Appetite was assessed using a standard questionnaire, and BMI, waist and wrist circumferences were measured with a tape measure. Statistical analysis was performed using SPSS 26, with a significance threshold set at 0.01. Results Significant differences were found in the salivary levels of leptin, chemerin, and resistin among the three groups (p 0.01). Analysis also revealed significant differences in appetite traits among the groups, with the highest appetite trait observed in pre‐diabetic subjects (p = 0.0002). The salivary level of chemerin was significantly associated with appetite traits regardless of diabetic status (p = 0.009). Appetite was also significantly related to BMI (p = 0.002) and waist circumference (p = 0.001) in all subjects. However, no significant relationship was observed between appetite and fasting plasma glucose or HbA1c levels (p > 0.01). Conclusion The results of this study indicate that salivary levels of certain adipokines, such as leptin, chemerin and resistin, may be significantly higher in diabetic patients, although this is not true for all adipokines. While pre‐diabetic patients exhibited a higher level of appetite, no positive correlation was found between salivary adipokine levels (except chemerin) and appetite or anthropometric characteristics, irrespective of diabetic status.
Published: 2024
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4. Diabetic foot ulcers risk prediction in patients with type 2 diabetes using classifier based on associations rule mining

Author: Nasrin Piran, Maryam Farhadian, Ali Reza Soltanian, and Shiva Borzouei
Subjects: Medicine, Science
Abstract: Abstract Identifying diabetic patients at risk of developing foot ulcers, as one of the most significant complications of diabetes, is a crucial healthcare concern. This study aimed to develop an associative classification model (CBA) using the Apriori algorithm to predict diabetic foot ulcers (DFU). This retrospective cohort study included 666 patients with type 2 diabetes referred to Shahid Beheshti Hospital in Iran between April 2020 and August 2022, of which 279 (42%) had DFU. Data on 29 specific baseline features were collected, which were preprocessed by discretizing numerical variables based on medical cutoffs. The target variable was the occurrence of DFU, and the minimum support, confidence, and lift thresholds were set to 0.01, 0.7, and 1, respectively. After data preparation and cleaning, a CBA model was created using the Apriori algorithm, with 80% of the data used as a training set and 20% as a testing set. The accuracy and AUC (area under the roc curve) measure were used to evaluate the performance of the model. The CBA model discovered a total of 146 rules for two patient groups. Several factors, such as longer duration of diabetes over 10 years, insulin therapy, male sex, older age, smoking, addiction to other drugs, family history of diabetes, higher body mass index, physical inactivity, and diabetes complications such as proliferative and non-proliferative retinopathy and nephropathy, were identified as major risk factors contributing to the development of DFU. The CBA model achieved an overall accuracy of 96%. Also, the AUC value was 0.962 (95%CI 0.924, 1.000). The developed model has a high accuracy in predicting the risk of DFU in patients with type 2 diabetes. The creation of accurate predictive models for DFU has the potential to significantly reduce the burden of managing recurring ulcers and the need for amputation, which are significant health concerns associated with diabetes.
Published: 2024
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5. Investigation of Clinical Features and Surgical Results in Patients with Thyroid Nodules Referred to the Endocrinology Clinic in Hamadan City

Author: Fatemeh Yaghoubi, Ali Reza Soltanian, and Shiva Borzouei
Subjects: pathology, thyroid nodules, thyroid surgery, Medicine
Abstract: Background and Objective: Considering the high prevalence of thyroid nodules and the increased incidence of malignancy of this gland, the present study aimed to assess the clinical characteristics and pathology results following surgery in patients with nodular goiter and referred to the endocrinology clinic in Hamadan, Iran. Materials and Methods: This study was conducted as case series from 2011 to 2021. All patients diagnosed with thyroid nodules who underwent thyroidectomy according to the indication and whose pathology was benign or malignant were included in the study. The patients' information was collected by reviewing the files, which included demographic, clinical, and pathology results. The data was analyzed in SPSS software (version 26), and the significance level was considered less than 0.05. Results: Among the 507 patients studied, 88.2% were female, and 11.8% were male. The mean age of the patients was 41.93 years. Pathology result was malignant in 57% of cases and benign in 43% of subjects. Most patients with malignant pathology were under 35 years of age, and those with benign pathology were older (P
Published: 2023

6. Simultaneous onset of Crohn's disease and Psoriasis in a Multiple Sclerosis patient treated with Teriflunomide: A novel case report highlighting potential autoimmune interactions

Author: Masoud Ghiasian, Alireza Rastgoo Haghi, Shiva Borzouei, and Rashed Bawand
Subjects: Relapsing-remitting multiple sclerosis, Teriflunomide, Disease-modifying therapy, Crohn's disease, Inflammatory bowel disease, Psoriasis, Science (General), Q1-390, Social sciences (General), H1-99
Abstract: Teriflunomide (TFN) is an oral Disease-modifying therapy (DMT) widely used in the treatment of relapsing forms of Multiple Sclerosis (MS). Although TFN has demonstrated efficacy in reducing MS activity, recent evidence suggests a possible association between TFN and the onset of rare and severe medical conditions. We present a novel case report of a 47-year-old woman with a history of MS who developed concurrent Crohn's disease and Psoriasis following TFN treatment. This unique occurrence has not been previously documented in the literature. The patient experienced gastrointestinal symptoms and changes in nail color while on TFN. Colonoscopy and biopsy revealed crypt architectural distortion and lamina propria expansion, indicative of Crohn's disease, while dermatological evaluation suggested Psoriasis. Consequently, TFN was discontinued and switched to alternative therapy (Glatiramer acetate), and the patient underwent close observation and regular evaluations. Three months after stopping the TFN, the patient's nail lesions disappeared completely, her abdominal pain and diarrhea were resolved, and the follow-up colonoscopy was completely normal. In this regard, the association between MS, Inflammatory Bowel Disease (IBD), and Psoriasis has been reported in previous studies, with potential involvement of Th17 and IL-17 pathways. Although gastrointestinal side effects with TFN use are typically mild and transient, rare cases of TFN-induced IBD have been reported. Dermatological disorders, including Psoriasis, have also been linked to TFN use, with similarities to our case report. Further research and awareness are warranted to better understand the potential side effects and long-term implications of TFN in the management of MS.
Published: 2024
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7. Frequency of sleep disorders among patients with type 2 diabetes and contributing factors

Author: Mobina Riahi, Mohammad Ahmadpanah, Ali Reza Soltanian, and Shiva Borzouei
Subjects: Frequency, Type 2 diabetes, Sleep disorders, Factor, History of Africa, DT1-3415, Nursing, RT1-120
Abstract: Introduction: Sleep disorders represent a significant health concern among individuals diagnosed with type 2 diabetes. Identifying the prevalence and underlying factors contributing to these disorders is crucial for devising effective interventions to mitigate or resolve this issue. Methods: This cross-sectional study was undertaken, involving 320 patients diagnosed with type 2 diabetes, who were attendees of the Hamadan Diabetes Clinic in 2023. Data collection was done using the demographic information checklist and the Pittsburgh Sleep Quality Index. Furthermore, the study examined the associations between sleep quality and demographic parameters, hemoglobin A1C levels, body mass index, and duration of diabetes by the t-test, chi-square test and logistic regression analysis. Poor sleep quality was defined as a sleep quality score exceeding 5. Results: 70.3 % of participants exhibited poor sleep quality. Female gender, hemoglobin A1c levels exceeding 7.5 %, a body mass index exceeding 30 kg/m2, and advancing age were associated with an increased likelihood of poor sleep quality. Higher levels of education were correlated with a decreased likelihood of poor sleep quality (P
Published: 2024
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8. Comparison of clinical efficacy of antithyroid drugs, radioactive iodine, and thyroidectomy for treatment of patients with graves' disease, toxic thyroid adenoma, and toxic multinodular goiter

Author: Rashed Bawand, Shiva Borzouei, Seid Ahmadreza Salimbahrami, and Vida Sheikh
Subjects: graves' disease, methimazole and propylthiouracil, primary hyperthyroidism, radioactive iodine, surgery, thyrotoxicosis, toxic multinodular goiter, toxic thyroid adenoma, Biotechnology, TP248.13-248.65
Abstract: Background: The thyroid gland plays an important role in regulating the body's metabolism. On the other hand, primary hyperthyroidism is one of the most common disorders of the endocrine system. Therefore, we aimed to investigate the differences between outcomes of drug therapy with Methimazole & Propylthiouracil (PTU), radioactive Iodine therapy, and surgical procedures as the three most common therapeutic options for primary hyperthyroidism- in patients with Graves' disease, toxic thyroid adenoma, and Toxic Multi Nodular Goiter (TMNG). Methods: This observational study was performed prospectively, and after applying the exclusion criteria, 316 patients with a definite diagnosis of TNMG, toxic adenoma, or Graves' disease, remained in the study. For each patient, one of the therapeutic methods of administration of anti-thyroid drugs, the use of radioactive Iodine, or the use of thyroid surgery was chosen and applied, and during the study period, all patients were followed and evaluated. Results: In this study, 316 patients with primary hyperthyroidism were evaluated, of which 238 (75.31%) patients had Graves' disease, 23 (7.27%) patients had toxic adenoma, and 55 (17.40%) patients had TNMG. The symptoms of thyrotoxicosis syndrome were more common in Graves' disease than in other groups. In this study, 63.82% of drug takers, 20.90% of radioactive Iodine receivers, and 5.26% of patients who had gone under surgery became euthyroid. In addition, 83.27% of drug consumers did not have any side effects. Most patients receiving radioactive Iodine and surgical procedures developed hypothyroidism after treatment, while only 1.70% of those taking anti-thyroid drugs developed this complication. Nevertheless, the failure rate in the drug therapy was highest among all three methods by a percentage of 34.47%. Conclusion: This study suggests a prominent role of drug therapy in the treatment of patients with Graves' disease and TMNG, and in contrast, reduces the role of radioactive Iodine in the treatment of these diseases. However, it is difficult to comment on the treatment of toxic thyroid adenoma based on the findings of this study.
Published: 2022
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9. Evaluation of Medication Adherence and its Related Factors among Type 2 Diabetic Patients

Author: Sepideh Khanjani Movaghar, Salman Khazaei, and Shiva Borzouei
Subjects: diabetes mellitus type 2, medication adherence, self-care, Medicine
Abstract: Background and Objective: Diabetes is the most common chronic metabolic disease in the world and one of its control principles is the patient's adherence to the physician's treatment recommendations. This study aimed to determine the adherence to medication treatment and related factors in type 2 diabetic patients referring to the Diabetes Clinic of Shahid Beheshti Hospital, Hamadan, Iran, in 2020. Materials and Methods: The present cross-sectional study was conducted on 284 patients with type 2 diabetes referring to the Diabetes Clinic of Shahid Beheshti Hospital. The data collection tool was a researcher-made questionnaire whose validity and reliability were confirmed in a pilot study. Data were analyzed in Stata software (version 11) at the significance level of 0.05. Results: Most of the patients were women (64.08%) and urban dwellers (79.08%). The mean age of the patients was obtained at 54.78 years, and 47.89% of the patients had poor medication adherence. Patients' medication adherence showed a statistically significant relationship with gender, marital status, education, physician's respectful behavior, respect for patient privacy, physician skill, the satisfaction of the physician, a history of other diseases, and a history of hypertension (P
Published: 2021

10. Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran

Author: Mahdi Mahdavi, Mahboubeh Parsaeian, Shiva Borzouei, and Reza Majdzadeh
Subjects: Type 2 diabetes, Quality of life, Satisfaction with healthcare, Satisfaction with health status, Patient experience, Healthcare structure, Public aspects of medicine, RA1-1270
Abstract: Abstract Background Facing limited health resources, healthcare providers need to rely on health service delivery models that produce the best clinical outcomes and patient experience. We aimed to contribute to developing a patient experience-based type 2 diabetes service delivery model by identifying operational structures and processes of care that were associated with clinical outcome, health experience, and service experience. Methods We conducted a cross-sectional survey of type 2 diabetes patients between January 2019 to February 2020. Having adjusted for demand variables, we examined relationships between independent variables (behaviours, services/processes, and structures) and three categories of dependent variables; clinical outcomes (HbA1c and fasting blood glucose), health experience (EuroQol quality of life (EQ-5D), evaluation of quality of life (visual analgene scale of EQ-5D), and satisfaction with overall health status), and service experience (evaluation of diabetes services in comparison with worst and best imaginable diabetes services and satisfaction with diabetes services). We analysed data using multivariate linear regression models using Stata software. Results After adjusting for demand variables; structures, diabetes-specific health behaviours, and processes explained up to 22, 12, and 9% of the variance in the outcomes, respectively. Based on significant associations between the diabetes service operations and outcomes, the components of an experience-based service delivery model included the structural elements (continuity of care, redistribution of task to low-cost resources, and improved access to provider), behaviours (improved patient awareness and adherence), and process elements (reduced variation in service utilization, increased responsiveness, caring, comprehensiveness of care, and shared decision-making). Conclusions Based on the extent of explained variance and identified significant variables, health services operational factors that determine patient-reported outcomes for patients with type 2 diabetes in Iran were identified, which focus on improving continuity of care and access to providers at the first place, improving adherence to care at the second, and various operational process variables at the third place.
Published: 2021
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11. Evaluation of the Effect of Empagliflozin Therapy on T Helper 22 Cell-Related Factors in Patients with Type 2 Diabetes Mellitus

Author: Hamid Moghimi, Shiva Borzouei, Alireza Zamani, and Mahdi Behzad
Subjects: diabetes mellitus type 2, empagliflozin, interleukin 22, t helper 22 cell, Medicine
Abstract: Background and Objective:The increased response of T helper (Th) 22cells might be involved in thepathogenesis ofType 2 Diabetes Mellitus (T2DM). The present study aimed to investigate the transcription factor of Th22 cells (aryl hydrocarbon receptor [AHR]) and interleukin 22 (IL-22) in CD4+ T cells as well as the impact of oral empagliflozin treatment. The correlation between the aforementioned factors and clinical parameters was also determined among the patients. Materials and Methods:In this case-control study, 50 patients under the treatment of metformin and gliclazide were divided into two equal groups, including the patients receiving empagliflozin (EMPA+) and not receiving empagliflozin (EMPA, as the control group). The peripheral blood CD4+ T cells were isolated on the initiation day of the study and after 6 months of therapy, and the gene expression levels of AHR and IL-22 were evaluated by real-time polymerase chain reaction. In addition, the production of IL-22 after activation was measured using enzyme-linked immunosorbent assay. Results:The levels of fasting plasma glucose and hemoglobin A1c diminished in the EMPA+ group after empagliflozin therapy, compared to those reported at the baseline (initiation day; P
Published: 2021

12. The positive effect of short-term nano-curcumin therapy on insulin resistance and serum levels of afamin in patients with metabolic syndrome

Author: Nejat Kheiripour, Zahra Khodamoradi, Akram Ranjbar, and Shiva Borzouei
Subjects: nano-curcumin, metabolic syndrome, insulin resistance, afamin, Therapeutics. Pharmacology, RM1-950
Abstract: Objective: Metabolic syndrome (MS) is a cluster of cardio-metabolic risk factors. MS is known as a highly prevalent disease worldwide. According to the existing evidence, consuming curcumin has positive effects on lipids profile, glucose, and body weight. This study aimed to evaluate the effects of nano-curcumin therapy on insulin resistance and serum level of afamin in patients with MS. Materials and Methods: Thirty MS patients (15 males and 15 females) received 80 mg/daily nano-curcumin for two months. The samples of fasting blood were collected from the participants at the beginning and 60 days after initiation of the intervention to measure biomarkers. Results: Comparing pre- and post-treatment with nano-curcumin values revealed a significant decrease in fasting plasma glucose (FPG) (p=0.017), insulin, homeostatic model assessment of insulin resistance (HOMA-IR) (p=0.006), and afamin (p=0.047). Moreover, there was a significantly negative relationship between afamin and high-density lipoprotein cholesterol (HDL-C) (p=0.044), as well as a significantly positive relationship between afamin and systolic (SBP) (p
Published: 2021
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13. Health literacy and diabetes control in pregnant women

Author: Azar Pirdehghan, Mohammad Eslahchi, Farzaneh Esna-Ashari, and Shiva Borzouei
Subjects: gestational diabetes, health literacy, pregnancy complications, Medicine
Abstract: Background: Low health literacy (HL) is associated with an extensive range of health outcomes. Objective: The present study was performed to inquire about the relationship between HL and glycemic control in gestational diabetes in order to design interventional future preventing programs. Methods: This cross-sectional study was performed on 104 Iranian pregnant women with gestational diabetes mellitus (GDM) referred from urban and rural areas to endocrinology clinic of Hamadan Beheshti Hospital, in 2017. Iranian Health Literacy Questionnaire (IHLQ) and a sociodemographic checklist were distributed among women. Correlation between HL and glycemic control was examined using SPSS. The significance level was set at P < 0.05. Results: Among women, 48.1% (50) were affected by uncontrolled diabetes and only 22% (11) had an adequate level of HL. An adequate level of HL were 50% and 22% in glycemic controlled and uncontrolled women, respectively. In univariate analysis, there was a significant relationship between diabetes control and adequate HL. So, problematic HL could increase the chance of uncontrolled diabetes more than three times (odds ratio: 3.5; CI: 1.5–8.3; P value: 0.004). Among all related variables, education and being housewife were considered as protective and risk factors for problematic HL, respectively. Conclusion: In conclusion, this study has provided evidence of limited HL and its relationship with low glycemic control in pregnant women with GDM. The problem was more serious in low educated, rural, housekeepers, and older-aged women. This deficit needs to be addressed by health planners and policymakers who are responsible for promoting the health of people and decreasing health inequalities community.
Published: 2020
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14. Diagnosing thyroid disorders: Comparison of logistic regression and neural network models

Author: Shiva Borzouei, Hossein Mahjub, Negar Asaad Sajadi, and Maryam Farhadian
Subjects: classification, multinomial logistic model, neural networks, thyroid disorder, Medicine
Abstract: Background: The main goal of this study was to diagnose the two most common thyroid disorders, namely, hyperthyroidism and hypothyroidism, based on multinomial logistic regression and neural network models. In addition, the study evaluated the predictive ability of laboratory tests against the individual clinical symptoms score. Materials and Methods: In this study, the data from patients with thyroid dysfunction who referred to Imam Khomeini Clinic and Shahid Beheshti Hospital in Hamadan were collected. The data contained 310 subjects in one of three classes—euthyroid, hyperthyroidism, and hypothyroidism. Collected variables included demographics and symptoms of hypothyroidism and hyperthyroidism, as well as laboratory tests. To compare the predictive ability of the clinical signs and laboratory tests, different multinomial logistic regression and neural network models were fitted to the data. These models were compared in terms of the mean of the accuracy and area under the curve (AUC). Results: The results showed better performance of neural network model than multinomial logistic regression in all cases. The best predictive performance for logistic regression (with a mean accuracy of 91.4%) and neural network models (with a mean accuracy of 96.3%) was when all variables were included in the model. In addition, the predictive performance of two models based on symptomatic variables was superior to laboratory variables. Conclusions: Both neural network and logistic regression models have a high predictive ability to diagnose thyroid disorder, although neural network performance is better than logistic regression. In addition, as achieving less error prediction model has always been a matter of concern for researchers in the field of disease diagnosis, predictive nonparametric techniques, such as neural networks, provide new opportunities to obtain more accurate predictions in the field of medical research.
Published: 2020
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15. Adrenal Mass in a 70-Year-Old Woman

Author: Kiana Karimi, Mohsen Nikzad, Sohrab Kulivand, and Shiva Borzouei
Subjects: Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: Introduction. Adrenocortical carcinoma is a rare endocrine malignancy with a bimodal age distribution pattern that affects women more than men. More than half of the patients present with hormone excess manifestations such as Cushing’s syndrome and virilization. Non-functional tumors usually are diagnosed incidentally following imaging studies due to a mass effect or metastatic disease. Surgical resection is considered the best curative treatment for these tumors. Case Presentation. A 70-year-old woman presented with a 3-month history of diffuse intermittent abdominal discomfort, weight loss, and additional hair growth. Imaging investigations revealed a large 187 × 85 × 140 mm mass between the liver and upper pole of the right kidney which has displaced the adjacent structures. Hormonal evaluations detected high levels of cortisol and adrenal androgens. She underwent open adrenalectomy and right nephrectomy due to severe adhesion of the mass. Histopathological evaluations revealed adrenocortical carcinoma and the patient received adjuvant radiotherapy. Conclusion. Precise physical examination, hormonal evaluation, and imaging studies play a key role in differentiating malignant adrenal masses in all patients, especially in those with vague symptoms. Radical excision of the mass and appropriate adjuvant chemotherapy or radiotherapy improve the outcome for patients.
Published: 2022
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16. Hypothyroidism evaluation after radiotherapy of breast and supraclavicular in patients with breast cancer

Author: Mohammad R Karimijavid, Abdolazim S Pashaki, Shiva Borzouei, Elham Khanlarzadeh, Mohammad H Gholami, and Safoora Nikzad
Subjects: breast cancer, radiotherapy, hypothyroidism, thyroid hormones, Medicine, Biology (General), QH301-705.5
Abstract: Background: This study aims to evaluate the risk of hypothyroidism (HT) after radiotherapy (RT) of breast and supraclavicular in patients with breast cancer (BC). Materials and Methods: In a historical cohort study, the records of all patients with BC who had been referred to the Mahdieh radiotherapy Center of Hamadan from 2017 to 2019 were reviewed. Demographic characteristics, clinical information, previous and current used treatment methods (surgery, radiotherapy, chemotherapy), number of RT sessions and doses, and HT (TSH >5 mIU/L) were extracted from the patient's documents. Data were analyzed using SPSS software version 16. Results: Out of 304 patients referred to the Center, 266 patients were investigated. The mean TSH was 6.3 ± 7.9 ml/L (1.5 to 65.4). Approximately half of the patients were in Stage 2 of the disease. 37 (16.4%) patients were diagnosed with HT, of which 8.8% were clinical, and 7.5% were subclinical. The mean total dose of HT patients (5621.62 ± 491.67) was significantly higher than other patients (5304.76 ± 937.98). 21 patients (56.8%) in Stage 3 and 4 and 16 (43.2%) patients in Stages 1 and 2 had HT (P = 0.006). Spearman correlation coefficient showed that there was a significant relationship between total dose and TSH hormone (r = 0.624), the number of RT sessions with TSH hormone (r = 0.237), and total dose with T4 hormone (r = -0.232). Conclusion: The findings of this study showed that the risk of HT increases significantly in patients with BC who undergo RT of breast and supraclavicular. Patients with higher stage, more radiation, and more RT sessions are at higher risk of HT.
Published: 2023
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17. Adherence and related factors in pregnant women with gestational diabetes

Author: shiva Borzouei, Mohammad Eslahchi, farzaneh Esna-Ashari, and azar pirdehghan
Subjects: key, Medicine (General), R5-920
Abstract: Background: Gestational diabetes is a metabolic disease that can have multiple maternal and fetal complications. Therapeutic adherence can help controlling blood sugar and reducing its complications. This study investigates the medication adherence among pregnant women and effective factors on it. Materials and methods: This cross-sectional study was conducted on 104 pregnant women with gestational diabetes who referred to endocrinology clinic of Shahid Beheshti hospital in Hamadan, Iran, in 2018. Input criteria were those over 18 years of age and output criteria included heart, kidney and thyroid disorders. Medication adherence was evaluated using the Morisky's 6-question questionnaire (MMAS-6). Analyzes were conducted using SPSS version 21 at the significance level of less than 0.05. Findings: Based on the results, 77.9% of the women lived in the city, 65.4% had a college education and 73.1% were housewives. 58.7% of them had good medication adherence. There was the significance relationship between adherence and glycemic control. Address and level of education had a significant relationship with medication adherence. People with higher levels of health literacy had significantly higher medication adherence. Conclusion: Low education level, rural residence and low health literacy level are determinants of poor medication adherence in pregnant women with gestational diabetes, which indicate the need for more training to these people.
Published: 2021

18. Comparison of Cytologic Reports of Fine-Needle Aspiration of Thyroid Nodules with Pathologic Results of Thyroid Surgery

Author: Akbar Jafari, Arash Dehghan, Farzaneh Esna-Ashari, and Shiva Borzouei
Subjects: fine-needle aspiration, thyroid nodules, thyroid surgery, Medicine
Abstract: Background and Objective: Thyroid nodules are among the most common clinical problems and the application of an inexpensive and accurate diagnostic method prevents performing inessential surgeries. In this regard, the aim of this study was to compare the cytologic report of fine-needle aspiration (FNA) of thyroid nodules with the results of thyroid surgery. Materials and Methods: In this cross-sectional study, all the patients who had referred to the clinic of Beheshti Hospital of Hamedan, Iran, due to thyroid nodule in 2017 underwent FNA. The samples were then sent to the pathology laboratory, and the cytology results were recorded in a checklist. Based on the cytology results, a portion of these cases was referred to undergo surgery. Following that, the sensitivity and specificity of cytology results of thyroid nodules were calculated in comparison to pathology results of the surgery sample. Results: Out of 115 studied patients, 18 (15.65%) and 97 (84.35%) subjects were male and female, respectively. The mean age of the subjects was 40.14±12.34 years. Most cases were in the form of the right-side unilateral nodule (46.1%). The number of benign and malignant cases diagnosed by the pathologist was 73 (63.48%) and 42 (36.52%), respectively. The specificity, sensitivity, as well as positive and negative predictive values obtained from the FNA of thyroid nodules by the pathologist, were reported as 82.98%, 95.56%, 89.04, and 92.68%, respectively. It is necessary to mention that the diagnostics accuracy of the pathologist associated with the results of surgery pathology was 90.43%. Conclusion: Performing FNA enjoys a relatively high specificity and sensitivity as an inexpensive, low-risk, and simple method in the differentiation of benign and malignant cases if it is performed precisely from the site of the nodule with adequate biopsy and properly examined pathologically.
Published: 2019

19. The Prevalence of Thyroid Disorders in Pregnant Women of Hamadan

Author: Shiva Borzouei, Mohammad Taghi Goodarzi, Mansooreh Biglari, Fathollah Nazari, and Zahra Shivapour
Subjects: pregnancy, thyroid disorders, risk factor, Nursing, RT1-120
Abstract: Introduction: Different studies have demonstrated that maternal thyroid dysfunction during pregnancy is associated with adverse obstetrics and fetal outcomes. There is no international consensus regarding to use a guidelines for screening in high risk women. The aim of the present study was to determine prevalence of thyroid disorders in high and low risk pregnant women. Methods: In a cross-sectional study during 2015-2016, from all pregnant women who had referred to Hamadan health center Lab for their first visit, a sample of 852 pregnant women were selected and assigned to low risk and high risk group. Thyroid tests and Anti TPO tests were carried out. Results: Of 852 pregnant women, 26.5% had Subclinical hypothyroidism, 1.2% had overt hypothyroidism, 0.5% had overt hyperthyroidism and 0.2% had subclinical hyperthyroidism. 25.6% were in the high risk group and 74.4% in the low risk group and 37.4% of high risk group and 25% of the low risk population had thyroid disorders (P
Published: 2019

20. Effect of Sitagliptin and Vitamin D3 on Secretion of IL-6 and TNF-α Inflammatory Factors in Patients with Type 2 Diabetes

Author: Elham Mahabadi-Ashtiyani, Vida Sheikh, Shiva Borzouei, Iraj Salehi, and Mahdi Alahgholi-Hajibehzad
Subjects: diabetes mellitus type 2, sitagliptin, vitamin d3, Medicine
Abstract: Background and Objective: Diabetes mellitus is one of the most commonly reported diseases that is associated with insulin resistance and increased blood glucose levels. The aim of this study was to determine the probable anti-inflammatory effects of sitagliptin and vitamin D3 (VitD3) on pro-inflammatory IL-6 and TNF-α in patients with type 2 diabetes mellitus (T2DM). Materials and Methods: In this case-control study, 20 blood samples of patients with T2DM and healthy controls (HCs) were collected (n=20). Peripheral blood mononuclear cells (PBMCs) were isolated using the Ficoll-Paque method and cultured with Phytohemagglutinin (PHA) in the presence or absence of sitagliptin and VitD3 for 4 days. The enzyme-linked immunosorbent assay was used to analyze the levels of IL-6 and TNF-α produced by PBMCs. Results: After PHA stimulation, the production of IL-6 was increased significantly in T2DM patients compared to HCs (P=0.03) . Compared to PHA cultures, sitagliptin and VitD3 resulted in the reduction of IL-6 production in patients (P≤0.001, P≤0.001), and HCs (P=0.03, P=0.02), respectively. Moreover, with regard to the cultures with sitagliptin or VitD3, sitagliptin with VitD3 reduced the level of IL-6 in both groups of patients (P=0.02, P=0.002) and HCs (P=0.002, P=0.03). There was a significant reduction in the level of TNF-α by sitagliptin with VitD3 in patients (P=0.04, P=0.002) and HCs (P=0.04, P=0.03) , compared to cultures with sitagliptin or VitD3. Conclusion: According to the results, it can be concluded that the combined use of sitagliptin and VitD3 is more influential regarding the anti-inflammatory effects on patients. In addition, the reduction of sitagliptin dose may result in decreasing its possible side effects
Published: 2018

21. The Relationship between Gestational Diabetes and Risk Factors in Pregnant Women in Hamadan

Author: Shiva Borzouei, Soghra Rabiei, Farzaneh Esna Ashari, Zohreh Zareeighane, and Mansooreh Biglari
Subjects: gestational diabetes, prevalence, screening, Medicine, Medicine (General), R5-920, Psychology, BF1-990
Abstract: Background and Objective: Gestational diabetes is a health problem and is one of the most commonly occurring complications of pregnancy worldwide, which has many effects on the mother and the fetus. The present study was conducted to determine the prevalence of gestational diabetes and its risk factors in Hamadan city, Iran. Materials and Methods: In this cross-sectional study, the study population was 534 pregnant women who were referred to control pregnancy to Hamadan health center from April 2014 to December 2016. Results: The study participants were 534 with the age range of 15-42 years old with an average age of 26.8 and a standard deviation of 5.56. The gestational age was 4 to 29 weeks with an average of 8.32 weeks with a standard deviation of 2.68. Of the 534 participants in this study, 211 (39.5%) had gestational diabetes and there was a significant relationship between factors such as macrosomia and history of impaired glucose tolerance with the prevalence of gestational diabetes. Conclusion: Gestational diabetes has a relatively high prevalence in Hamadan, further information is needed in this area as well as studies based on new guidelines in different parts of the country.
Published: 2018

22. Public Awareness of Early and Late Complications of Type 2 Diabetes - Application of Latent Profile Analysis in Determining Questionnaire Cut-Off Points

Author: Nasrin Shirmohammadi, Ali Reza Soltanian, and Shiva Borzouei
Subjects: awareness, questionnaire, statistical model, Type 2 diabetes, Special situations and conditions, RC952-1245, Infectious and parasitic diseases, RC109-216
Abstract: Objectives A questionnaire was designed to determine public understanding of early and late complications of Type 2 diabetes mellitus (T2DM). Methods A cross-sectional study was performed in participants who were selected using a multi-stage sampling method and a standard questionnaire of 67 questions was proposed. An expert panel selected 53 closed-ended questions for content validity to be included in the questionnaire. The reliability of the questionnaire was tested using Cronbach’s alpha coefficient giving a score of 0.84. Results Of the 825 participants, 443 (57.6%) were male, and 322 (41.87%) were 40 years or more. The proportion of low-, moderate- and high- awareness about T2DM and its complications was 29.26%, 62.68%, and 8.06%, respectively. Friends (56.31%) and internet and social networks (20.55%) were the 2 major sources of awareness, respectively. The medical staff (e.g., physicians) had the lowest share in the level of public awareness (3.64%) compared to other sources. Conclusion These results present data that shows the general population awareness of T2DM is low. Healthcare policymakers need to be effective at raising awarenes of diabetes and it should be through improved education.
Published: 2018
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23. Malignant pheochromocytoma with negative biochemical markers: Is it time to reclassify pheochromocytomas?

Author: Shiva Borzouei, Seyed Habibollah Mousavi-bahar, Sayed Ahmadreza Salimbahrami, and Mher Sardari Masihi
Subjects: Diseases of the genitourinary system. Urology, RC870-923
Abstract: Pheochromocytomas are catecholamine producing tumors of adrenal gland generally diagnosed by presence of these markers in urine or plasma. However, a few may be marker-negative and challenging for clinicians. Several reports of these marker-negative pheochromocytomas may warrant necessity for a new classification of these tumors. Adrenergic blockade before surgery is one of the main reasons for recognition of these cases. We present a case of marker-negative pheochromocytoma which turned out to be malignant on its recurrence. To our knowledge, this is the only case of malignant marker-negative pheochromocytoma reported in literature so far. Keywords: Pheochromocytoma, Adrenal, Catecholamines, Hypertension
Published: 2019
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24. Application of an artificial neural network model for diagnosing type 2 diabetes mellitus and determining the relative importance of risk factors

Author: Shiva Borzouei and Ali Reza Soltanian
Subjects: Statistical model, Glycated hemoglobin A, Epidemiology, Iran, Medicine
Abstract: OBJECTIVES To identify the most important demographic risk factors for a diagnosis of type 2 diabetes mellitus (T2DM) using a neural network model. METHODS This study was conducted on a sample of 234 individuals, in whom T2DM was diagnosed using hemoglobin A1c levels. A multilayer perceptron artificial neural network was used to identify demographic risk factors for T2DM and their importance. The DeLong method was used to compare the models by fitting in sequential steps. RESULTS Variables found to be significant at a level of p
Published: 2018
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25. Evaluation of the Relationship between Serum 25-Hydroxy Vitamin D and Hypertension in Hamadan, Iran-A Case Control Study

Author: Behshad Naghshtabrizi, Shiva Borzouei, Pedram Bigvand, and Mohamad Ali Seifrabiei
Subjects: high blood pressure, risk factor, vitamin deficiency, Medicine
Abstract: Introduction: Hypertension or high blood pressure is one of the main reasons of fatality in the world. The role of vitamin D in developing hypertension has not been proved yet. Some studies have shown positive correlation between low serum vitamin D level and hypertension. Due to this fact, recognising hypertension risk factors such as potential impact of low serum vitamin D level seems to be required. Aim: This study was conducted to evaluate potential impact of serum vitamin D level on hypertension. Materials and Methods: This case-control study had 188 subjects including 55 cases suffering from hypertension and 133 controls with normal blood pressure in Hamadan, Iran. After taking the medical history and physical examination, 5 cc of their blood was taken to measure their serum 25-Hydroxyvitamin D [25(OH)D] level through ELISA test. Data analysis was done by version 16.0 of SPSS software and used independent sample t-test and Chi-square test for related comparisons. Results: Mean and standard deviation of serum 25(OH)D level in patients suffering from hypertension was 13.10±9.7 ng/ml and in control group was 20.87±10.34 ng/ml. This variance was statistically significant (p0.05). Conclusion: According to this study, reverse relationship between serum 25(OH)D and blood pressure levels was seen.
Published: 2017
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26. A Case Report of Multiple Endocrine Neoplasia Type IIa Associated with Cushing Syndrome

Author: Shiva Borzouei, Vida Sheikh, Seyyed Habib Allah Mosavi Bahar, Ali Yousefian, and Radin Maheronnaghsh
Subjects: medullary thyroid carcinoma, multiple endocrine neoplasia type 2a, pheochromocytoma, Medicine
Abstract: Introduction: Multiple endocrine neoplasia type IIa (MEN IIa) is an autosomal dominant syndrome characterized bypheochromocytoma ,medullary thyroid carcinoma and hyperparathyroidism. Pheochromocytoma approximately occurs in 50% of patients with MEN IIa. This tumor has the capacity to produce ACTH ectopically and becomes manifest like Cushing syndrome,although it is very rare. Case Report: We report a 26-year-old woman patient with severe muscle weakness, skin lesions in extremity, hypertension, new onset diabetes and in the laboratory data hypokalemia, metabolic alkalosis, high serum level of cortisol, metanephrine, normetanephrine, calcitonin and bilateral adrenal mass in computed tomography as the first clinical manifestations of an ACTH-secreting pheochromocytoma. Conclusion: In the patients with hypertension, new onset diabetes and hypokalemia Cushing syndrome and pheochromocytoma should always be ruled out.
Published: 2013

27. A Case Report of Adrenocortical Carcinoma with Hypercortisolism and Heart Failure

Author: Shiva Borzouei, Seyyed Ahmadreza Salim Bahrami, Niloofar Hemati, and Hamidreza Ghadimipour
Subjects: adrenal cortex neoplasms, heart failure, hypercortisolism, Medicine
Abstract: Introduction: Adrenocortical carcinoma is a rare and severe malignant tumor that in 60% of cases are functional and the most common clinical manifestation is Cushing's syndrome with a progressive course. The only treatment is surgical removal of the entire tumor and effec-tiveness of medical treatments, including mitotane and chemotherapy for survival is still questionable.Case Report: A 36-year-old man with progressive muscle weakness, high blood pressure, and sudden heart failure is presented. In laboratory tests, hypokalemia, hyperglycemia, increased cortisol, increased serum estradiol and DHEAS were observed. There were an adrenal mass and multiple lung and liver metastases on imaging studies and CT-guided biopsy confirmed adrenal tumor. Conclusion: High serum concentrations of estradiol and cortisol appear to be effective on heart involvement and acute onset of diabetes, hypertension, and severe heart failure require more evaluations in young adults.
Published: 2013

28. The Relationship between Serum 25-Hydroxyvitamin D Levels and Metabolic Syndrome

Author: Shiva Borzouei, Farzaneh Esna Ashari, Seyyed Javad Kiani, Mohammad Reza Kaveh, Mohammad Taghi Goodarzi, and Seyywd Ahmad Salim Bahrami
Subjects: metabolic syndrome, risk factors, vitamin d, Medicine
Abstract: Introduction & Objective: Metabolic syndrome is one of the main health problems raised around the world and vitamin D deficiency is a possible new risk factor. The aim of this study was to understand this relationship in the Iranian population. Materials & Methods: This case-control study was done on 186 subjects over 20 years referred to endocrine clinic in the spring and summer of 2011. Clinical and laboratory data were col-lected using questionnaires . After determining the subjects with metabolic syndrome accord-ing to ATP III criteria and the control group ,blood samples of all participants were taken to measure 25-hydroxyvitamin D levels and sent to the laboratory. The collected data were ana-lyzed with statistical software SPSS v.16.0 and Pearson's chi square test. Results: Comparing vitamin D levels between the healthy individuals and the patients showed significant differences between the two groups (32.6± 16.5 in the control group vs.17.3± 10.7 in the case group). In the patients, those with vitamin D deficiency compared with those with normal levels of vitamin D, had higher levels of BMI and triglycerides and lower levels of HDL cholesterol. Conclusion: It seems that vitamin D-deficient individuals have a greater chance of having metabolic syndrome. However, prospective studies are needed to prove this relationship.
Published: 2013

29. COVID-19 Preventive Behaviors and Related Beliefs Among Diabetics: The Use of Protection Motivation Theory

Author: Mohadese Sadri, Majid Barati, Shiva Borzouei, Saeed Bashirian, Salman Khazaei, Ensiyeh Jenabi, and Sepideh Zareian
Subjects: Health (social science), Health Informatics, Education
Abstract: Background: Recent data from coronavirus disease 2019 (COVID-19) confirm that diabetes, along with advanced age, is an important risk factor for adverse prognosis. Therefore, the present study aimed to determine the status of COVID-19 prevention behaviors and related beliefs among diabetic patients in Hamadan province using protection motivation theory (PMT). Methods: This cross-sectional descriptive study was conducted from April to September 2020. The research population included all diabetics, of whom 355 patients, who referred to an adult endocrinologist in Hamadan, were selected using the convenience sampling method. The data collection tool was a researcher-made questionnaire with demographic variables and PMT constructs. Data were analyzed by SPSS 22 using descriptive statistics, correlation, and logistic regression. Results: According to the result, the PMT construct explained 15% of the variance in the frequency of the intention to perform preventive behaviors. Perceived sensitivity (β=-0.128), perceived response efficiency (β=0.140), and perceived response cost (β=0.386) were the best significant predictors of behavior (P
Published: 2022
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30. Impact of interleukin-32α on T helper cell-related cytokines, transcription factors, and proliferation in patients with type 2 diabetes mellitus

Author: Shiva Borzouei, Mahdi Behzad, and Mohammad Gholamian-Hamadan
Subjects: Pharmacology, Immunology, Immunology and Allergy, General Medicine, Toxicology
Abstract: The ability of interleukin (IL)-32α to induce T helper (Th) 1, Th17, and Treg cytokines (interferon gamma [IFN-γ], IL-17, and IL-10, respectively), and transcription factors ([signal transducer and activator of transcription (Serum levels of IL-32α in 31 patients and 31 healthy controls (HCs) were determined by ELISA assay. CD4The patients showed significant increase in IL-32α levels compared with HCs and its levels were positively correlated with fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c). rIL-32α enhanced IL-17 and IL-2 production, increasedAberrant IL-32α levels are participated in T2DM pathogenesis. IL-32α potently induces Th17-related factors and amplifies the proliferative function of T cells.HighlightsEnhanced serum levels of IL-32α in T2DM patients was correlated with FPG and HbA1c.IL-32α increases
Published: 2022
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31. Health system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019

Author: Farshad Farzadfar, Mohsen Naghavi, Sadaf G Sepanlou, Sahar Saeedi Moghaddam, William James Dangel, Nicole Davis Weaver, Arya Aminorroaya, Sina Azadnajafabad, Sogol Koolaji, Esmaeil Mohammadi, Negar Rezaei, Jaffar Abbas, Behzad Abbasi, Mitra Abbasifard, Mohsen Abbasi-Kangevari, Zeinab Abbasi-Kangevari, Hedayat Abbastabar, Amir Abdoli, Mohammad Abdollahi, Sina Abdollahzade, Hassan Abolhassani, Zahra Abrehdari-Tafreshi, Soodabeh Aghababaei, Bahman Ahadinezhad, Ali Ahmadi, Sepideh Ahmadi, Hamid Ahmadieh, Mohammad Esmaeil Akbari, Yousef Alimohamadi, Vahid Alipour, Hesam Alizade, Saba Alvand, Saeed Amini, Sohrab Amiri, Ali Arash Anoushirvani, Fereshteh Ansari, Jalal Arabloo, Morteza Arab-Zozani, Zahra Aryan, Armin Aryannejad, Mehran Asadi-Aliabadi, Ali A Asadi-Pooya, Zatollah Asemi, Samaneh Asgari, Saeed Asgary, Babak Asghari, Mohammad Asghari Jafarabadi, Elham Ashrafi, Zahra Atafar, Seyyed Shamsadin Athari, Abolfazl Avan, Abbas Azadmehr, Hiva Azami, Mohammadreza Azangou-Khyavy, Samad Azari, Amirhossein Azari Jafari, Ghasem Azarian, Alireza Badirzadeh, Elham Bahrami, Mohammad Amin Bahrami, Nastaran Barati, Mohsen Bayati, Gholamreza Bazmandegan, Masoud Behzadifar, Ali Bijani, Somayeh Bohlouli, Shiva Borzouei, Parnaz Daneshpajouhnejad, Abdollah Dargahi, Ahmad Daryani, Jalal Davoodi Lahijan, Mojtaba Didehdar, Shirin Djalalinia, Saeid Doaei, Fariba Dorostkar, Leila Doshmangir, Mohammadreza Edraki, Amir Emami, Babak Eshrati, Sharareh Eskandarieh, Firooz Esmaeilzadeh, Shahriar Faghani, Mahdi Fakhar, Hamid Reza Farpour, Hossein Farrokhpour, Majid Fasihi Harandi, Mohammad Fereidouni, Masoud Foroutan, Mansour Ghafourifard, Azin Ghamari, Seyyed-Hadi Ghamari, Ahmad Ghashghaee, Fariba Ghassemi, Ali Gholami, Asadollah Gholamian, Abdolmajid Gholizadeh, Salime Goharinezhad, Pouya Goleij, Mostafa Hadei, Nima Hafezi-Nejad, Sanam Hariri, Edris Hasanpoor, Hossein Hassanian-Moghaddam, Soheil Hassanipour, Hadi Hassankhani, Mohammad Heidari, Reza Heidari-Soureshjani, Mohammad Hoseini, Mohammad-Salar Hosseini, Mostafa Hosseini, Seyed Kianoosh Hosseini, Ali Hosseinzadeh, Mehdi Hosseinzadeh, Soodabeh Hoveidamanesh, Pooya Iranpour, Seyed Sina Naghibi Irvani, Jalil Jaafari, Roxana Jabbarinejad, Morteza Jafarinia, Hamed Jafari-Vayghan, Mohammad Ali Jahani, Nader Jahanmehr, Mahsa Jalili, Roksana Janghorban, Fatemeh Javanmardi, Farahnaz Joukar, Ali Kabir, Leila R Kalankesh, Rohollah Kalhor, Zahra Kamiab, Naser Kamyari, Behzad Karami Matin, Amirali Karimi, Salah Eddin Karimi, Ali Kazemi Karyani, Leila Keikavoosi-Arani, Maryam Keramati, Pedram Keshavarz, Mohammad Keykhaei, Ali Khaleghi, Mohammad Khammarnia, Javad Khanali, Maryam Khayamzadeh, Sajad Khosravi, Mina Khosravifar, Omid Khosravizadeh, Neda Kianipour, Ali-Asghar Kolahi, Amirhosein Maali, Mokhtar Mahdavi Mahdavi, Afshin Maleki, Mohammad-Reza Malekpour, Kamyar Mansori, Borhan Mansouri, Mohammad Ali Mansournia, Mohammad Reza Maracy, Abdoljalal Marjani, Sahar Masoudi, Seyedeh Zahra Masoumi, Hossein Masoumi-Asl, Mahsa Mayeli, Entezar Mehrabi Nasab, Fereshteh Mehri, Mohammad Miri, Seyyedmohammadsadeq Mirmoeeni, Hamed Mirzaei, Maryam Mirzaei, Roya Mirzaei, Ashraf Mohamadkhani, Heidar Mohammadi, Seyyede Momeneh Mohammadi, Shadieh Mohammadi, Abdollah Mohammadian-Hafshejani, Noushin Mohammadifard, Reza Mohammadpourhodki, Mohammad Mohseni, Amin Mokari, Sara Momtazmanesh, Abdolvahab Moradi, Masoud Moradi, Yousef Moradi, Mohammad Moradi-Joo, Farhad Moradpour, Maliheh Moradzadeh, Rahmatollah Moradzadeh, Abbas Mosapour, Shandiz Moslehi, Simin Mouodi, Mehdi Naderi, Homa Naderifar, Zhila Najafpour, Javad Nazari, Seyed Aria Nejadghaderi, Leila Nemati-Anaraki, Amin Reza Nikpoor, Marzieh Nojomi, Maryam Noori, Hasti Nouraei, Ali Nowroozi, Morteza Oladnabi, Fatemeh Pashazadeh Kan, Majid Pirestani, Meghdad Pirsaheb, Mohammadreza Pourahmadi, Hadis Pourchamani, Hadi Pourjafar, Akram Pourshams, Mohammad Rabiee, Navid Rabiee, Alireza Rafiei, Sima Rafiei, Fakher Rahim, Amir Masoud Rahmani, Sina Rashedi, Vahid Rashedi, Amirfarzan Rashidi, Mahsa Rashidi, Mohammad-Mahdi Rashidi, Ramin Ravangard, Reza Rawassizadeh, Iman Razeghian-Jahromi, Mohammad Sadegh Razeghinia, Sofia B Redford, Maryam Rezaei, Nazila Rezaei, Nima Rezaei, Saeid Rezaei, Hossein Rezaei Aliabadi, Mohsen Rezaeian, Mohammad Sadegh Rezai, Aziz Rezapour, Hossein Rezazadeh, Sahba Rezazadeh-Khadem, Morteza Rostamian, Ehsan Sadeghi, Erfan Sadeghi, Masoumeh Sadeghi, Reihaneh Sadeghian, Saeid Sadeghian, Hamid Safarpour, Mahdi Safdarian, Sare Safi, Maryam Sahebazzamani, Amirhossein Sahebkar, Mohammad Ali Sahraian, Sarvenaz Salahi, Payman Salamati, Hossein Samadi Kafil, Yaser Sarikhani, Maryam Sarkhosh, Arash Sarveazad, Maryam Seyed-Nezhad, Omid Shafaat, Zahra Shaghaghi, Saeed Shahabi, Sarvenaz Shahin, Elaheh Shaker, Saeed Shakiba, MohammadBagher Shamsi, Erfan Shamsoddin, Kiomars Sharafi, Sakineh Sharifian, Maryam Shaygan, Abbas Sheikhtaheri, Amir Shiani, Kiarash Shirbandi, Reza Shirkoohi, Parnian Shobeiri, Azad Shokri, Soraya Siabani, Ali Reza Sima, Ahmad Sofi-Mahmudi, Amin Soheili, Shahin Soltani, Mohammad Sadegh Soltani-Zangbar, Moslem Soofi, Seidamir Pasha Tabaeian, Mohammadreza Tabary, Alireza Tahamtan, Majid Taheri, Amir Taherkhani, Masih Tajdini, Hamed Tavolinejad, Arash Tehrani-Banihashemi, Amir Tiyuri, Seyed Abolfazl Tohidast, Alireza Vakilian, Sahel Valadan Tahbaz, Bay Vo, Seyed Hossein Yahyazadeh Jabbari, Vahid Yazdi-Feyzabadi, Zabihollah Yousefi, Taraneh Yousefinezhadi, Mazyar Zahir, Telma Zahirian Moghadam, Maryam Zamanian, Hamed Zandian, Alireza Zangeneh, Hadi Zarafshan, Fariba Zare, Ali Zare Dehnavi, Kourosh Zarea, Ahmad Zarei, Zahra Zareshahrabadi, Arash Ziapour, Sina Zoghi, Nizal Sarrafzadegan, Vafa Rahimi-Movaghar, Hamid Reza Jamshidi, Ali H Mokdad, Simon I Hay, Christopher J L Murray, Ardeshir Khosravi, Maziar Moradi-Lakeh, Mohsen Asadi-Lari, Reza Malekzadeh, and Bagher Larijani
Subjects: General Medicine
Published: 2022
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32. Comparison of Salivary Antioxidants and Oxidative Stress Status in Gestational Diabetes Mellitus and Healthy Pregnant Women

Author: Mohammad Taghi Goodarzi, Shiva Borzouei, Shima Fathi, Yasamin Barakian, Fatemeh Ahmadi-Motamayel, and Jalal Poorolajal
Subjects: Adult, Saliva, Antioxidant, endocrine system diseases, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Physiology, Iran, medicine.disease_cause, Antioxidants, Young Adult, chemistry.chemical_compound, Pregnancy, Malondialdehyde, Humans, Immunology and Allergy, Medicine, biology, business.industry, Significant difference, nutritional and metabolic diseases, Catalase, medicine.disease, Gestational diabetes, Diabetes, Gestational, Oxidative Stress, chemistry, Case-Control Studies, biology.protein, Uric acid, Female, business, Oxidation-Reduction, Biomarkers, Oxidative stress
Abstract: Background: One of the most common complications of pregnant women is gestational diabetes mellitus (GDM). Oxidative stress can play an important role in GDM. Objective: The aim of this study was to evaluate salivary antioxidants and oxidative stress markers in GDM. Methods: Twenty pregnant women with GDM and 20 healthy pregnant women with normal blood glucose test participated in this study. Five mL of unstimulated saliva samples were collected. Spectrophotometric assay was carried out for sialo-chemical analysis. Stata software was used for data analysis. Results: The GDM group exhibited no significant difference in salivary total antioxidant capacity and malondialdehyde compared to the healthy control group. All antioxidants markers, the uric acid, total antioxidant, peroxidase and catalase, decreased in GDM group that the difference of peroxidase and catalase was statistically significant. All of oxidative stress markers, the salivary malondialdehyde, total oxidative stress and total thiol, increased in GDM group. GDM group exhibited significantly higher salivary total oxidative stress levels. Conclusion: Catalase level was significantly lower and total oxidative stress was significantly higher. These two markers might have significant importance and might exhibit early changes compared to other factors in GDM. Some salivary antioxidants might have diagnostic, prognostic or therapeutic implications in GDM. Other studies with large sample size on salivary and blood samples need to be done to confirm these properties and salivary samples using instead of blood samples in GDM biomarkers changes.
Published: 2021
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33. Identifying associations between health services operational factors and health experience for patients with type 2 diabetes in Iran

Author: Mahboubeh Parsaeian, Reza Majdzadeh, Shiva Borzouei, and Mahdi Mahdavi
Subjects: Gerontology, Quality of life, Patient experience, medicine.medical_specialty, Service delivery framework, Satisfaction with health status, Iran, Health informatics, Health administration, Quality of life (healthcare), medicine, Humans, Service system, business.industry, Research, Health Policy, Public health, Nursing research, Type 2 diabetes, Health Services, Health services operations, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Satisfaction with healthcare, Healthcare structure, Public aspects of medicine, RA1-1270, business, Healthcare process
Abstract: Background Facing limited health resources, healthcare providers need to rely on health service delivery models that produce the best clinical outcomes and patient experience. We aimed to contribute to developing a patient experience-based type 2 diabetes service delivery model by identifying operational structures and processes of care that were associated with clinical outcome, health experience, and service experience. Methods We conducted a cross-sectional survey of type 2 diabetes patients between January 2019 to February 2020. Having adjusted for demand variables, we examined relationships between independent variables (behaviours, services/processes, and structures) and three categories of dependent variables; clinical outcomes (HbA1c and fasting blood glucose), health experience (EuroQol quality of life (EQ-5D), evaluation of quality of life (visual analgene scale of EQ-5D), and satisfaction with overall health status), and service experience (evaluation of diabetes services in comparison with worst and best imaginable diabetes services and satisfaction with diabetes services). We analysed data using multivariate linear regression models using Stata software. Results After adjusting for demand variables; structures, diabetes-specific health behaviours, and processes explained up to 22, 12, and 9% of the variance in the outcomes, respectively. Based on significant associations between the diabetes service operations and outcomes, the components of an experience-based service delivery model included the structural elements (continuity of care, redistribution of task to low-cost resources, and improved access to provider), behaviours (improved patient awareness and adherence), and process elements (reduced variation in service utilization, increased responsiveness, caring, comprehensiveness of care, and shared decision-making). Conclusions Based on the extent of explained variance and identified significant variables, health services operational factors that determine patient-reported outcomes for patients with type 2 diabetes in Iran were identified, which focus on improving continuity of care and access to providers at the first place, improving adherence to care at the second, and various operational process variables at the third place.
Published: 2021

34. Changes in T helper cell-related factors in patients with type 2 diabetes mellitus after empagliflozin therapy

Author: Hamid Moghimi, Alireza Zamani, Mahdi Behzad, and Shiva Borzouei
Subjects: Adult, Male, 0301 basic medicine, medicine.medical_specialty, medicine.medical_treatment, Immunology, Anti-Inflammatory Agents, chemical and pharmacologic phenomena, Flow cytometry, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Glucosides, Internal medicine, medicine, Empagliflozin, Humans, Immunology and Allergy, Gliclazide, Benzhydryl Compounds, Cells, Cultured, Cell Proliferation, medicine.diagnostic_test, business.industry, Type 2 Diabetes Mellitus, FOXP3, General Medicine, T helper cell, Middle Aged, Nuclear Receptor Subfamily 1, Group F, Member 3, Th1 Cells, Metformin, 030104 developmental biology, Cytokine, Endocrinology, medicine.anatomical_structure, Diabetes Mellitus, Type 2, Th17 Cells, Female, T-Box Domain Proteins, business, 030215 immunology, medicine.drug
Abstract: The immune factors related to T helper (Th) 1 (T-bet, STAT1, and IFN-γ), Th17 (ROR-γt, STAT3, and IL-17), and Treg (FOXP3, STAT5, and IL-10) cells, and SOCS1/3 and the proliferation of Th cells were investigated in type 2 diabetes mellitus patients before (baseline) and after empagliflozin therapy. A total of 56 patients on metformin and gliclazide were separated into two groups: Group 1 did not receive empagliflozin (EMPA−) and the Group 2 received 10 mg/day of empagliflozin for 6 months (EMPA+). The expressions of T-bet, ROR-γt, FOXP3, STAT1/3/5 and SOCS1/3 were evaluated in CD4+ T cells with real-time PCR. The production of IFN-γ, IL-17, and IL-10 from CD4+ T cells was measured using ELISA. The proliferation of Th cells was assessed with flow cytometry. Six months of empagliflozin therapy significantly reduced the expression of ROR-γt and increased FOXP3 and STAT5 expression, compared to baseline. Production of IL-17 decreased after empagliflozin treatment, while IL-10 was enhanced in the EMPA+ group. Oral administration of empagliflozin or the addition of empagliflozin to the cell cultures diminished the proliferation of Th cells. Empagliflozin showed anti-inflammatory effects on Th cells by decreasing Th17-related factors, reducing proliferation capacity, and increasing Treg cell properties.
Published: 2021
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35. Thyroid Dysfunction in Pregnant Women with Gestational Diabetes Mellitus

Author: Shahin Safian, Farzaneh Esna-Ashari, and Shiva Borzouei
Subjects: Adult, endocrine system, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Thyroid Function Tests, Autoantigens, Iodide Peroxidase, Autoimmune Diseases, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Hypothyroidism, Pregnancy, Thyroid peroxidase, Iron-Binding Proteins, Diabetes mellitus, medicine, Humans, Subclinical infection, Glucose tolerance test, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, biology, Obstetrics, business.industry, Thyroid, medicine.disease, Pregnancy Complications, Gestational diabetes, Diabetes, Gestational, medicine.anatomical_structure, biology.protein, Gestation, Female, Thyroid function, business
Abstract: Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.
Published: 2020
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36. Serum Interleukin-17, Carcinoembryonic Antigen, and Prostate-Specific Antigen in High Lipid Profile Individuals

Author: Behzad Pakrad, Shiva Borzouei, Mohammad Rafiee, Mohammad Yousef Alikhani, Alireza Zamani, and Sina Mohagheghi
Subjects: Adult, Male, endocrine system, Immunology, Systemic inflammation, Carcinoembryonic antigen, Virology, Biomarkers, Tumor, medicine, Humans, medicine.diagnostic_test, biology, business.industry, Interleukin-17, Cell Biology, Prostate-Specific Antigen, Lipids, Carcinoembryonic Antigen, Prostate-specific antigen, biology.protein, Female, Interleukin 17, medicine.symptom, business, Lipid profile
Abstract: [Figure: see text] It is assumed that high lipid profile (HLP) causes chronic systemic inflammation, which ultimately leads to inflammatory diseases and cancers. The aim of the study was to investigate the serum concentration of proinflammatory/tumor markers of interleukin-17 (IL-17), carcinoembryonic antigen (CEA), and prostate-specific antigen (PSA) in HLP. HLP cases [F/M: 11/17 triglyceride (TG)200 mg/dL, high-density lipoprotein (HDL)50 mg/dL for females and HDL40 mg/dL for males] and controls (F/M: 12/15, TG200 mg/dL) were included. The volunteers with diabetes, high blood pressure, infection, cancer, inflammation, smoking addiction, drug consumption, and pregnancy were excluded. Serum TG, cholesterol, HDL and low-density lipoprotein were measured by routine biochemical procedures. The serum levels of IL-17, CEA, and PSA (only in men) were determined by enzyme-linked immunosorbent assay (ELISA). Independent samples
Published: 2020
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37. Effect of sitagliptin on serum levels of TNF-α, IL-1β and IL-10 in patients with type 2 diabetes mellitus

Author: Mohammad Ali Amirzargar, Vida Sheikh, Zahra Telikani, Mahdi Alahgholi-Hajibehzad, Iraj Salehi, Alireza Zamani, and Shiva Borzouei
Subjects: medicine.medical_specialty, Interleukin 10, Endocrinology, business.industry, Internal medicine, Sitagliptin, Medicine, Type 2 Diabetes Mellitus, In patient, General Medicine, business, medicine.drug
Published: 2020
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38. Thyroid disorder diagnosis based on Mamdani fuzzy inference system classifier

Author: Negar Asaad Sajadi, Shiva Borzouei, Hossein Mahjub, and Maryam Farhadian
Subjects: Computer science, Fuzzy inference system, business.industry, Pattern recognition, General Medicine, Artificial intelligence, business, Classifier (UML), Fuzzy logic, Thyroid disorder
Published: 2020
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39. Adherence and related factors in pregnant women with gestational diabetes

Author: Azar Pirdehghan, Mohammad Eslahchi, Farzaneh Esna-Ashari, and Shiva Borzouei
Subjects: Related factors, Gestational diabetes, medicine.medical_specialty, Medicine (General), R5-920, key, business.industry, Obstetrics, Medicine, General Medicine, business, medicine.disease
Abstract: Background: Gestational diabetes is a metabolic disease that can have multiple maternal and fetal complications. Therapeutic adherence can help controlling blood sugar and reducing its complications. This study investigates the medication adherence among pregnant women and effective factors on it. Materials and methods: This cross-sectional study was conducted on 104 pregnant women with gestational diabetes who referred to endocrinology clinic of Shahid Beheshti hospital in Hamadan, Iran, in 2018. Input criteria were those over 18 years of age and output criteria included heart, kidney and thyroid disorders. Medication adherence was evaluated using the Morisky's 6-question questionnaire (MMAS-6). Analyzes were conducted using SPSS version 21 at the significance level of less than 0.05. Findings: Based on the results, 77.9% of the women lived in the city, 65.4% had a college education and 73.1% were housewives. 58.7% of them had good medication adherence. There was the significance relationship between adherence and glycemic control. Address and level of education had a significant relationship with medication adherence. People with higher levels of health literacy had significantly higher medication adherence. Conclusion: Low education level, rural residence and low health literacy level are determinants of poor medication adherence in pregnant women with gestational diabetes, which indicate the need for more training to these people.
Published: 2021

40. Survival rates and prognostic factors of thyroid cancer: A retrospective cohort study

Author: Ali Amri, Ali Reza Soltanian, and Shiva Borzouei
Abstract: Introduction: The most prevalent endocrine malignancy is thyroid carcinoma. Thyroid cancer is much more common than it was previously. The prognosis of people with this condition can be impacted by a number of factors. Objectives: The purpose of this study was to assess the prognosis and survival rates of thyroid cancer patients in western Iran. Patients and Methods: This retrospective cohort study was performed on all patients (n = 312) with diagnosing thyroid cancer based on pathology results between 2011 and 2021. Demographic and clinical information and disease staging of patients based on TNM (tumor, node, and metastasis) system were extracted from patients’ medical records. Kaplan-Meier method, log-rank test, and Cox regression were used for the analysis of the data. The obtained data were analyzed in SPSS version 22. Results: Our findings showed that the mean survival time for all participants in the study was 39.9 months. Additional analysis revealed that the mean survival time is significantly lower in people who residence in urban areas. Furthermore, men, people aged 50-80 years old, and those who were in the TNM stage I had the highest mean survival time. Based on the univariate analysis age, TNM stage are associated with risk of death in patient with thyroid cancer. Conclusion: Death from thyroid cancer is correlated with patients’ age, gender, and disease stage. Age is important risk of death. Additionally, overall survival of the patients decreases with increasing time.
Published: 2022
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41. Prevalence of increased intraocular pressure in patients with Graves’ ophthalmopathy and association with ophthalmic signs and symptoms in the north-west of Iran

Author: Shiva Seif, Fatemeh Eslami, Shiva Borzouei, and Elham Khanlarzadeh
Subjects: Intraocular pressure, medicine.medical_specialty, genetic structures, Lid lag, Population, Periorbital Edema, Disease, Graves' ophthalmopathy, 03 medical and health sciences, 0302 clinical medicine, Ophthalmology, medicine, In patient, intra ocular pressure, education, Original Research, education.field_of_study, business.industry, medicine.disease, eye diseases, 030221 ophthalmology & optometry, Population study, sense organs, business, 030217 neurology & neurosurgery
Abstract: Introduction: Graves’ ophthalmopathy (GO) is the most common extra-thyroidal manifestation of Graves' disease and is characterized by multiple ocular symptoms such as eyelid retraction, lid lag, proptosis, elevated intraocular pressure (IOP) and ultimately loss of vision. We aimed to investigate the prevalence of increased IOP in Graves' patients and association with ophthalmic signs and symptoms in north-west of Iran. Materials and methods: This descriptive cross-sectional study recruited 93 patients with GO who were diagnosed based on clinical and laboratory examinations. A complete ocular examination and IOP measurements on forward gaze were performed using Goldman applanation tonometer. Results: In this study, 93 patients with GO were evaluated from 2016 to 2017. Among these patients, 67 (72.05) were female and 27 (27.95) were male. The most common complaints of patients were lid retraction (62.36), puffy eyelids (58.06) and proptosis (46.23), respectively. The duration of disease was 0–24 months in most patients. Most subjects were at grade 3 according to NOSPECS classification. Nine patients (9.6) had an IOP greater than or equal to 21 mmHg. The mean IOP in subjects was 16.61±3.42 mmHg. The mean IOP in males and smokers was significantly higher than that of females and nonsmokers. The mean IOP increased significantly with a higher grade of disease, duration of disease, age and smoking. Conclusions: According to the results, females comprised the majority of the study population, while ocular complications were more prevalent among males. The highest IOP was seen in old cases of GO. The most prevalent ocular signs in patients were eyelid retraction and periorbital edema. The least prevalent sign was glaucomatous optic neuropathy. In this study, the prevalence of intra-ocular hypertension was higher than that of the general population, especially in males, old cases with a drug history of antithyroid medication and smokers. © 2019 Eslami et al.
Published: 2019
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42. Anti-Inflammatory Effect of Combined Sitagliptin and Vitamin D3 on Cytokines Profile in Patients with Type 2 Diabetes Mellitus

Author: Mohammad Ali Amirzargar, Vida Sheikh, Azadeh Mozayanimonfared, Zohre Zareighane, Iraj Salehi, Mahdi Alahgholi-Hajibehzad, Shiva Borzouei, Alireza Zamani, Morteza Ghasemi, and Zahra Telikani
Subjects: Adult, Male, 0301 basic medicine, Vitamin, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Immunology, Anti-Inflammatory Agents, Enzyme-Linked Immunosorbent Assay, Gastroenterology, Anti-inflammatory, Proinflammatory cytokine, Young Adult, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Interferon, Virology, Internal medicine, medicine, Humans, Diabetic Nephropathies, In patient, Cholecalciferol, business.industry, Sitagliptin Phosphate, Type 2 Diabetes Mellitus, Cell Biology, Middle Aged, Drug Combinations, 030104 developmental biology, Cytokine, Diabetes Mellitus, Type 2, chemistry, 030220 oncology & carcinogenesis, Sitagliptin, Cytokines, Female, business, medicine.drug
Abstract: Studies indicated that imbalance of proinflammatory and anti-inflammatory cytokines may contribute to development of type 2 diabetes mellitus (T2DM). We hypothesized that sitagliptin and VitD3 may exert more anti-inflammatory effects on the regulation of cytokine balance in T2DM. Nonnephropathic and nephropathic T2DM patients were divided into the subgroups, based on treatments. The effect of 8 months sitagliptin, alone or together with 2 months of VitD3, on serum IFN-γ, IL-4, IL-17, IL-6, IL-21, TGF-β, and IL-37 levels was determined using enzyme-linked immunosorbent assay. Increased levels of interferon (IFN)-γ and IL-17 in untreated (without sitagliptin and VitD3) nephropathic and nonnephropathic patients and decreased levels of IL-37 in untreated nephropathic patients were observed compared with healthy controls. Treatment with sitagliptin plus VitD3 reduced the levels of IFN-γ and IL-17 in both nonnephropathic and nephropathic patients compared with untreated patients. The level of IL-37 was enhanced in patients treated with sitagliptin or sitagliptin plus VitD3, compared with untreated patients. Sitagliptin plus VitD3 treatment increased the levels of IL-4 in nonnephropathic patients. These findings indicated that the sitagliptin plus VitD3 was more effective to reduce the increased proinflammatory IFN-γ and IL-17 cytokines in T2DM patients.
Published: 2019
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43. Palmitate-induced IL6 expression ameliorated by chicoric acid through AMPK and SIRT1-mediated pathway in the PBMCs of newly diagnosed type 2 diabetes patients and healthy subjects

Author: Zahra Arab Sadeghabadi, Roohollah Mohseni, Roghayeh Abbasalipourkabir, Shiva Borzouei, and Nasrin Ziamajidi
Subjects: Adult, Male, 0301 basic medicine, medicine.medical_specialty, endocrine system diseases, Neutrophils, Immunology, Anti-Inflammatory Agents, Palmitates, Inflammation, Type 2 diabetes, AMP-Activated Protein Kinases, Biochemistry, Peripheral blood mononuclear cell, 03 medical and health sciences, Caffeic Acids, 0302 clinical medicine, Insulin resistance, Sirtuin 1, Downregulation and upregulation, Internal medicine, Gene expression, medicine, Humans, Immunology and Allergy, Interleukin 6, Molecular Biology, biology, Interleukin-6, business.industry, AMPK, Succinates, Hematology, Middle Aged, medicine.disease, 030104 developmental biology, Endocrinology, Diabetes Mellitus, Type 2, 030220 oncology & carcinogenesis, biology.protein, Female, Insulin Resistance, medicine.symptom, business
Abstract: Inhibition of inflammation is one of the possible therapeutic approaches for Insulin resistance (IR) during type 2 diabetes mellitus (T2DM). In the current study we investigated the effects of palmitate and chicoric acid (CA) on inflammation in peripheral blood mononuclear cells (PBMCs) of newly diagnosed T2DM patients and healthy subjects and explored the mechanism by which palmitate and CA influence inflammation. 20 newly diagnosed T2DM patients and 20 healthy subjects were recruited in our study. Blood sample were collected and PBMCs were isolated. Interleukin 6 (IL6), silent information regulator type 1 (SIRT1), AMP-activated protein kinase (AMPK) and phospho-AMPK (pAMPK) were evaluated both in vivo and in vitro. PBMCs were treated with palmitate and CA to investigate their effects on inflammation. IL6 and SIRT1 genes expression were evaluated by real-time PCR. The levels of IL6 in culture medium were measured by ELISA. Proteins levels of AMPK and pAMPK in PBMCs were detected by western blotting. IL6 expression was higher and SIRT1 expression and pAMPK levels were lower in PBMCs of diabetic patients and obese subjects compared to healthy subjects and non-obese subjects, respectively. CA significantly prevented against increased IL6 levels as well as its gene expression in PBMCs induced by palmitate. Also, CA returned reduction in SIRT1 expression and pAMPK levels mediated via palmitate to near control level. These findings reveal that CA reduces inflammation in PBMCs probably through upregulation of SIRT1 and pAMPK. Therefore, CA would be suggested as a novel agent for the treatment of T2DM.
Published: 2019
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44. Effects of sitagliptin and vitamin D3 on T helper cell transcription factors and cytokine production in clinical subgroups of type 2 diabetes mellitus: highlights upregulation of FOXP3 and IL-37

Author: Zahra Telikani, Vida Sheikh, Shiva Borzouei, Mohammad Ali Amirzargar, Iraj Salehi, Alireza Zamani, and Mahdi Alahgholi-Hajibehzad
Subjects: Adult, Male, 0301 basic medicine, medicine.medical_treatment, Immunology, Pharmacology, Toxicology, 03 medical and health sciences, 0302 clinical medicine, Immune system, Downregulation and upregulation, RAR-related orphan receptor gamma, Humans, Immunology and Allergy, Medicine, Cholecalciferol, business.industry, Sitagliptin Phosphate, Type 2 Diabetes Mellitus, FOXP3, Forkhead Transcription Factors, T-Lymphocytes, Helper-Inducer, General Medicine, T helper cell, Middle Aged, Up-Regulation, 030104 developmental biology, medicine.anatomical_structure, Cytokine, Diabetes Mellitus, Type 2, 030220 oncology & carcinogenesis, Sitagliptin, Female, business, Interleukin-1, medicine.drug
Abstract: Objective: Gene expression level of T helper cell transcription factors and cytokines production in type-2 diabetes mellitus (T2DM) patients treated with mono- or combined sitagliptin and vitamin D3 (VitD3) were evaluated. Methods: Fifty-four nephropathic and 57 non-nephropathic T2DM patients were divided into the subgroups based on their treatment with/without sitagliptin and VitD3. The expression of T-bet, RORγt, BCL6, and FOXP3 was evaluated using real-time PCR. The levels of IFN-γ, IL-6, IL-17, IL-21, TGF-β, and IL-37 were assessed in PBMC supernatants using ELISA. Results: The production of IFN-γ and IL-17 was increased in untreated (without sitagliptin and VitD3) nephropathic and non-nephropathic T2DM patients compared with healthy controls, whereas FOXP3 expression was decreased. Treatment with sitagliptin alone or in combination with VitD3 reduced the production of IFN-γ in the patients. Production of IL-17 and IL-21 and the expression of RORγt and BCL6 was diminished in patients treated with combined sitagliptin and VitD3, whereas the production of IL-37 and FOXP3 expression were increased in the patients treated with sitagliptin or sitagliptin plus VitD3. Conclusion: These data demonstrate that sitagliptin in combination with VitD3 may accelerate the process of T2DM treatment by exerting synergic anti-inflammatory effects on immune system through upregulation of FOXP3 and IL-37, and downregulation of RORγt and BCL6 as well as IFN-γ, IL-17 and IL-21 production. Combined sitagliptin and VitD3 can be safely utilized to modulate the inflammatory conditions of T2DM.
Published: 2019
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45. Predictors of COVID-19 related death in diabetes patients: A case-control study in Iran

Author: Maryam Mohammadian-khoshnoud, Fatemeh Bahreini, Tahereh Omidi, Salman Khazaei, Saeid Bashirian, Rezvan Heidarimoghadam, and Shiva Borzouei
Subjects: 0301 basic medicine, Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Iran, Logistic regression, Article, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Diabetes mellitus, Internal medicine, Internal Medicine, Diabetes Mellitus, Medicine, Humans, 030212 general & internal medicine, Risk factor, media_common, Retrospective Studies, business.industry, SARS-CoV-2, Addiction, Medical record, Diabetes, Case-control study, Age Factors, COVID-19, General Medicine, Odds ratio, Middle Aged, medicine.disease, Prognosis, Death, Hospitalization, Survival Rate, 030104 developmental biology, Radiological weapon, Case-Control Studies, Female, business
Abstract: Background Identifying the predictors of COVID-19 related death in diabetes patients can assist physicians for detecting risk factors related to the worse outcome in these patients. In this study we investigated the predictors of the death in patients with diabetes compared with non-diabetic COVID-19 patients. Methods In the present case-control study, the case group were diabetic patients with COVID-19 and the control group included Non-diabetic COVID-19 patients. The data source regarding the demographic characteristics, clinical symptoms, laboratory, and radiological findings on admission as well as the complications, treatment, and outcomes during hospitalization were gathered from their medical record through two trained nurses. Adjusted and unadjusted odds ratios (OR) estimate were calculated using the simple and multiple logistic regression through backward model. Results The mean (SD) age of the case group was higher than that of the control group; [65.24 (12.40) years vs. 59.35 (17.34) years, respectively (P
Published: 2021

46. The relationship between satisfaction with treatment services and the quality of life in type II diabetic patients in Hamadan, Iran, 2021.

Author: Salman, Khazaei, Reza, Nowruzi Shadmani, Saman, Talebi Seyed, and Shiva, Borzouei
Subjects: CROSS-sectional method, MEDICAL care, PATIENT satisfaction, TYPE 2 diabetes, QUALITY of life, QUESTIONNAIRES, STATISTICAL sampling, DEMOGRAPHY, DATA analysis software, BODY mass index, SOCIODEMOGRAPHIC factors
Abstract: Introduction: The satisfaction of diabetic patients with the treatment and their cooperation in obtaining therapeutic results and increasing quality of life is very decisive. This study aimed to investigate the relationship between type II diabetes patients' satisfaction with medical services and their quality of life. Methods: This cross-sectional study was conducted on 198 type II diabetic patients referred to Hamadan Diabetes Clinic in 2021. The convenience sampling method was used to select the samples. The data were collected using a checklist of demographic characteristics and the quality of care, patient behavior, and quality of life researcher-made questionnaire. The obtained data were then analyzed in SPSS software at a significant level of 0.05. Results: According to the results, the majority of the participants were female (70.71%), and the mean age of the respondents was obtained at 59.65 ± 9.26 years. In addition, the mean score of quality of life was estimated at 84.7±12.6. The quality of life score showed a significant relationship with education level, marital status, employment status, and body mass index. The mean score of satisfaction with services was 92.78±19.8. The high level of education and lack of health insurance revealed a correlation with lower satisfaction with services. Finally, there was a direct and significant relationship between quality of life and satisfaction with the received services. Conclusion: A significant relationship was found between the quality of life and the level of satisfaction with the services received. Therefore, improving the quality of medical services for these patients in order to increase their satisfaction level with treatment can be effective in enhancing their quality of life. [ABSTRACT FROM AUTHOR]
Published: 2022

47. Reduced frequency and functional potency of CD49d

Author: Shiva, Borzouei, Mina, Mohamadtaheri, Alireza, Zamani, and Mahdi, Behzad
Subjects: Adult, Glycated Hemoglobin, Male, Integrin alpha4, Gene Expression, Forkhead Transcription Factors, Middle Aged, T-Lymphocytes, Regulatory, Coculture Techniques, Diabetes Mellitus, Type 2, Cytokines, Humans, Female, Cells, Cultured
Abstract: This study set out to check the quantitative and qualitative properties of peripheral CD4
Published: 2021

48. Evaluation of Thyroid Function in Patients with Type II Diabetes during 2019-2021.

Author: Nasim, Karimi, Saeed, Bashirian, Maryam, Esmaeelzadeh, and Shiva, Borzouei
Subjects: THYROID gland function tests, THYROID diseases, HYPOTHYROIDISM, CROSS-sectional method, HYPERTHYROIDISM, AGE distribution, TYPE 2 diabetes, SEX distribution, DESCRIPTIVE statistics, DISEASE prevalence, DATA analysis software, DISEASE risk factors
Abstract: Introduction: Today diabetes is one of the most common endocrine diseases today and a leading cause of death across the globe. There is evidence of thyroid dysfunction in people with type II diabetes, leading to a poorer prognosis in diabetics. The present study aimed to assess thyroid function in patients with type II diabetes. Methods: This cross-sectional study was conducted on 800 patients with type 2 diabetes in Hamada, Iran, during 2018-1400. All patients under treatment with type II diabetes confirmed by the census method were included in the study. A checklist with two sections of demographic and clinical information was used to collect data. After data collection, they were analyzed in SPSS software (version 22) using descriptive and analytical methods. Results: The patients included 36.6% males and 63.4% females with a mean age of 58.09±10.95 years. The result of the thyroid examination was abnormal in 10.5% of diabetic patients. Thyroid disorder was detected in 31.4% of patients, including clinical hypothyroidism (17.8%), subclinical hypothyroidism (10.5%), and hyperthyroid (3.1%). The prevalence of thyroid disorder in patients with type 2 diabetes in females and those over 35 years of age was significantly higher than in males and those under 35 years of age (P<0.05). Conclusion: About one-third of participants with diabetes had thyroid dysfunction. Both hypothyroidism and subclinical hypothyroidism were more common in type II diabetic patients. The findings of this study indicated that further research is needed in the future on measures to evaluate thyroid function in patients with type II diabetes. [ABSTRACT FROM AUTHOR]
Published: 2022

49. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Author: Soufiane Boufous, Yousef Veisani, Mehran Asadi-Aliabadi, Sharath Burugina Nagaraja, Maziar Moradi-Lakeh, Getachew Mullu Kassa, Edward J Mills, Dimas Ria Angga Pribadi, William James Dangel, Mohamad-Hani Temsah, Catherine O. Johnson, Gregory A. Roth, Giuseppe Gorini, Fariborz Mansour-Ghanaei, Alberto Ortiz, Samad Azari, Assefa Ayalew Ayalew Ayalew Gebreslassie, Salime Goharinezhad, Stephanie R. M. Zimsen, Peng Zheng, Michael Assmus, Elisabetta Pupillo, Bach Xuan Tran, Lal B. Rawal, Narayanaswamy Venketasubramanian, Noushin Mohammadifard, Stephen S Lim, Ata Rafiee, Maria Inês Schmidt, Vincent C. Iannucci, Suzanne Lyn Barker-Collo, Leah E. Cahill, Tauseef Ahmad, Platon D. Lopukhov, Kazumasa Yamagishi, Abdullah Al Mamun, Iqbal R. F. Elyazar, Giovanni Damiani, Mohammad Hossein Bakhshaei, Mehdi Fazlzadeh, Virginia Núñez-Samudio, Alyssa Pennini, Dietrich Plass, Atkilt Esaiyas Etisso, Gebre Teklemariam Demoz, Alexandrea Watson, Arvin Haj-Mirzaian, Paul S Briant, Frank B. Osei, Blair R. Bumgarner, Maciej Banach, Ravensara S. Travillian, Kai-Lan Chang, Shirin Djalalinia, Hasan Yusefzadeh, Silvano Gallus, Seyyed Meysam Mousavi, Bernhard T. Baune, Aaron van Donkelaar, Azeem Majeed, Hans Kromhout, Robert Ancuceanu, Blessing J. Akombi, Pushpendra Singh, Nayu Ikeda, William M. Gardner, Zahid A Butt, Mohammad Abdollahi, Temesgen Yihunie Akalu, Rahman Shiri, Benn Sartorius, Ai-Min Wu, Bing Fang Hwang, Flavia M. Cicuttini, Hiroyasu Iso, Luis Camera, Amin Soheili, Félix Carvalho, Yun Jin Kim, Caleb Mackay Salpeter Irvine, Mehdi Mirzaei-Alavijeh, Iman Halvaei, Saqib Ali, Giulio Castelpietra, Catalina Liliana Andrei, Ali Kazemi Karyani, Parkes J Kendrick, Hamidreza Haririan, Lucas Guimarães Abreu, Mukhammad David Naimzada, Jeff T. Zhao, Samiah Alam, Sorin Hostiuc, Shaun Wen Huey Lee, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Cyrus Alinia, Takahiro Tabuchi, Manu Raj Mathur, Søren Thorgaard Skou, Thomas Khaled Dwayne Classen, Reza Heidari-Soureshjani, Massimo Cirillo, Nikita Otstavnov, Mehdi Bohluli, Ruth W. Kimokoti, Animut Tagele Tamiru, Masoumeh Sadeghi, Mohammad Ali Jahani, Itamar S. Santos, Mekdes Tigistu Yilma, Lars Johansson, Arielle Wilder Eagan, Nevine El Nahas, Silvia Schiavolin, Kevin D. Shield, Dinh-Toi Chu, Shiva Borzouei, Paul S. F. Yip, Beatrix Haddock, Gianfranco Alicandro, Vasily Vlassov, Deanna Anderlini, Giuseppe Remuzzi, Khalid A Altirkawi, Farahnaz Joukar, Aso Mohammad Darwesh, Ratilal Lalloo, Panniyammakal Jeemon, Rohollah Kalhor, Daniel Youngwhan Cho, Weijia Fu, João Pedro Silva, Rodrigo Sarmiento-Suarez, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Jacob Olusegun Olusanya, José Neves, Gaorui Guo, Tomas Y. Yeheyis, John S. Ji, Charles D. H. Parry, Maryam Ghadimi, Seyed-Mohammad Fereshtehnejad, Serge Resnikoff, Anna E. Torre, Vinod C Nayak, Jamileh Shadid, Susanne Breitner, Mohammad Khammarnia, Mathilde Touvier, Ensiyeh Jenabi, Hosna Janjani, Floriane Ausloos, Irmina Maria Michalek, Alexandra S. Boon-Dooley, Jessica A. Cruz, Syed Mohamed Aljunid, Abiodun M. Adeoye, André Faro, Bartosz Miazgowski, Jobert Richie Nansseu, Erin C Mullany, Giannina Ferrara, Martin McKee, Emmanuel Peprah, Oommen John, Reza Saeedi, Yasser Vasseghian, Dragos Virgil Davitoiu, Sarah Wulf Hanson, Yingxi Zhao, Omid Shafaat, Ali Rajabpour-Sanati, Farid Najafi, Ana Maria Mantilla Herrera, Fatemeh Rajati, Tarun Gupta, Łukasz Szumowski, Mohammed Ibrahim Mohialdeen Gubari, Peter Njenga Keiyoro, Dharmesh Kumar Lal, Zhi Jiang Zhang, Osayomwanbo Osarenotor, Tanvir M. Huda, Perminder S. Sachdev, Farhad Ghamari, Era Upadhyay, Vivek Kumar, Guoqing Hu, Vinay Nangia, Vladimir Andreevich Korshunov, Saeed Shahabi, Golnaz Heidari, Ashraf Nabhan, Robert C. Reiner, Aziz Rezapour, Justin J. Lang, Rakhi Dandona, Josephine W. Ngunjiri, Anna-Karin Danielsson, André Karch, Filippo Ariani, Ahmed Abdelalim, Masih Tajdini, Stefanos Tyrovolas, Mohamed Hsairi, Jae Il Shin, Jasvinder A. Singh, Meghan D. Mooney, Fiona B. Bennitt, Hesam Alizade, Segun Emmanuel Ibitoye, Pradhum Ram, Soraya Siabani, Evanson Z. Sambala, Reza Malekzadeh, Falk Schwendicke, Lalit Dandona, Masoud Moradi, Molly R Nixon, Roya Mirzaei, Rachel Feldman, Hosni Salem, Alberto L. García-Basteiro, Lorainne Tudor Car, Sharareh Eskandarieh, Ramesh Holla, Ritesh G. Menezes, Taraneh Yousefinezhadi, Hai Quang Pham, Hamideh Salimzadeh, Luisa Sorio Flor, Priya Rathi, Ali Bijani, Harvey Whiteford, Shanshan Li, Aleksandr Y. Aravkin, Joshua A. Salomon, Franz Castro, Lisa M. Force, Abdilahi Yousuf Yousuf, Mina Anjomshoa, Ken Takahashi, Maigeng Zhou, Telma Zahirian Moghadam, Maseer Khan, Irina Filip, Santi Martini, Randah R. 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Mini, Christian Razo, Manuela L. Ferreira, Diego De Leo, Francesco Saverio Violante, Aristidis Tsatsakis, Zahra Sadat Dibaji Forooshani, Tea Lallukka, Dickson A. Amugsi, Anna Poznańska, Graeme J. Hankey, Kewal Krishan, Maryam Zamanian, Eirini Skiadaresi, Jai K Das, Felix Greaves, Tessa M. Pilz, Sameer Vali Gopalani, Mansour Ghafourifard, M. DeLang, Morteza Mahmoudi, Alton Lu, Brian J. Hall, Ravi Prakash Jha, David Edvardsson, Xiu Ju George Zhao, Farshad Farzadfar, Hadi Hassankhani, Samuel M. Ostroff, Gerhard Sulo, Keyghobad Ghadiri, Neeraj Bhala, Stefan Lorkowski, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Amirhossein Sahebkar, Rashid Abdi Guled, Abdallah M. Samy, Roman Topor-Madry, Michal Grivna, Afsaneh Arzani, Ayesha Humayun, Simin Liu, Maryam Khayamzadeh, Davoud Adham, Ahad Bakhtiari, Shafiu Mohammed, Paolo Lauriola, Abbas Mosapour, Sophia Emmons-Bell, Khurshid Alam, Rajat Das Gupta, Matilde Leonardi, Muktar Beshir Ahmed, Jeffrey V. Lazarus, Mohamed M. 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S. B., Caetano Dos Santos, F. L., Camera, L. A., Elyazar, I. R. F., Ayalew Gebreslassie, A. A. A., Ginindza, T. G., Matin, B. K., Morgado-Da-Costa, J., Khaneghah, A. M., Mahesh, P. A., Toroudi, H. P., Syed, Z. Q., Salem, M. R., Skou, S. T., Tovani-Palone, M. R., Tudor Car, L. T., and Moghadam, T. Z.
Subjects: Male, Nutritional Sciences, Specific risk, Contaminación del Aire Interior, 030204 cardiovascular system & hematology, Socioeconomic Factor, systematic analysis, Global Health, Body Mass Index, Global Burden of Disease, Health Risk Behavior, Health Risk Behaviors, Disease studies, 0302 clinical medicine, Risk Factors, METABOLIC RISKS, 030212 general & internal medicine, 11 Medical and Health Sciences, Factores de Riesgo, 2. Zero hunger, education.field_of_study, Public health, Injuries, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, GBD, risck factors, attributable burden of disease, 3142 Public health care science, environmental and occupational health, 3. Good health, Relative risk, Environmental health, Health, Hypertension, Global Burden of Diseases, Injuries, Risk Factors, A990 Medicine and Dentistry not elsewhere classified, Female, Leading risk factors, Global Health Metrics, Cohort study, Human, medicine.medical_specialty, Substance-Related Disorders, Population, UNITED-STATES, Risk Assessment, DIET, ITC-HYBRID, 03 medical and health sciences, Life Expectancy, MORTALITY, DISABILITY, POLLUTION, CLUSTERS, SDG 3 - Good Health and Well-being, General & Internal Medicine, medicine, Humans, Global Burden of Disease Study, Risk factor, education, Global burden, business.industry, Risk Factor, Malnutrition, Klinisk medicin, Global Burden of Diseases, Environmental Exposure, medicine.disease, Enfermedades, purl.org/pe-repo/ocde/ford#3.02.00 [https], Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Years of potential life lost, Socioeconomic Factors, Risk factors, Disease study, Hyperglycemia, ITC-ISI-JOURNAL-ARTICLE, NA, Clinical Medicine, business, RA
Abstract: Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk-outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk-outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk-outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10.8 million (95% uncertainty interval [UI] 9.51-12.1) deaths (19.2% [16.9-21.3] of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8.71 million (8.12-9.31) deaths (15.4% [14.6-16.2] of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253-350) DALYs (11.6% [10.3-13.1] of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0-9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10-24 years, alcohol use for those aged 25-49 years, and high systolic blood pressure for those aged 50-74 years and 75 years and older. Interpretation Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.
Published: 2020
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50. Von Hippel-Lindau; A 47-year-old woman with renal cell carcinoma and multiorgan involvement

Author: Aidin Tarokhian, Arash Dehghan, Sohrab Kulivand, and Shiva Borzouei
Abstract: Von Hippel-Lindau (VHL) is a rare autosomal dominant genetic disease. Affected individuals manifest clinically with tumors involving multiple organs including hemangioblastoma of the central nervous system and retina, cystic kidney disease, renal cell carcinoma (RCC), pheochromocytoma, and pancreatic neuroendocrine tumors. Its diagnosis is based on genetic testing and clinical criteria in suspected patients. Treatment principles are to save organs and periodic surveillance for in-time tumor detection and appropriate follow-ups. This case report presents a 47-year-old woman with five years history of abdominal pain alongside long-standing headaches and progressive hearing loss. On imaging, multiple suspicious tumors throughout her body were detected and she proceeded to surgical resection. She was finally diagnosed with RCC, central nervous system tumor hemangioblastoma, and pancreatic cyst. The patient underwent a right-sided nephrectomy and Sunitinib therapy. She is continuing therapy and currently does not have any sign of metastasis. Due to her constellation of tumors VHL disease was suspected. Although she did not have any positive family history, the VHL diagnosis was conducted based on clinical criteria. The case emphasized the importance of timely recognition and evaluation of suspected cases and evidence base surveillance. Physician familiarity with the underestimated disease is of paramount importance.
Published: 2022
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