BackgroundAnal sphincter injury leads to fecal incontinence. Based on the regenerative capability of laser and human adipose-derived stem cells (hADSCs), this study was designed to assess the effects of co-application of these therapies on anal sphincter recovery after injury.DesignMale rabbits were assigned to equal groups (n = 7) including control, sphincterotomy, sphincterotomy treated with laser (660 nm, 90 s, immediately after sphincterotomy, daily, 14 days), hADSCs (2 × 106 hADSCs injected into injured area of the sphincter immediately after sphincterotomy), and laser + hADSCs. Ninety days after sphincterotomy, manometry and electromyography were performed, sphincter collagen content was evaluated, and Ki67, myosin heavy chain (MHC), skeletal muscle alpha-actin (ACTA1), vascular endothelial growth factor A (VEGFA), and vimentin mRNA gene expression were assessed.ResultsThe laser + hADSCs group had a higher resting pressure compared with the sphincterotomy (p < 0.0001), laser (p < 0.0001), and hADSCs (p = 0.04) groups. Maximum squeeze pressure was improved in all treated animals compared with the sphincterotomized animals (p < 0.0001), without a significant difference between treatments (p > 0.05). In the laser + hADSCs group, motor unit numbers were higher than those in the laser group (p < 0.0001) but did not differ from the hADSCs group (p = 0.075). Sphincterotomy increased collagen content, but the muscle content (p = 0.36) and collagen content (p = 0.37) were not significantly different between the laser + hADSCs and control groups. Laser + hADSCs increased ACTA1 (p = 0.001) and MHC (p < 0.0001) gene expression compared with laser or hADSCs alone and was associated with increased VEGFA (p = 0.009) and Ki67 mRNA expression (p = 0.01) and decreased vimentin mRNA expression (p < 0.0001) compared with laser.ConclusionThe combination of laser and hADSCs appears more effective than either treatment alone for promoting myogenesis, angiogenesis, and functional recovery after anal sphincterotomy.
The present systematic review and meta-analysis aims to investigate the role of Posterior Tibial Nerve Stimulation (PTNS) in the control of Fecal Incontinence (FI). Methods: Two independent reviewers extensively searched in the electronic databases of Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, CINAHL, and Scopus for the studies published until the end of 2016. Only randomized clinical trials were included. The studied outcomes included FI episodes, FI score, resting pressure, squeezing pressure, and maximum tolerable pressure. The data were reported as Standardized Mean Differences (SMD) with 95% confidence interval. Results: Five articles were included in the present study (249 patients under treatment with PTNS and 239 in the sham group). Analyses showed that PTNS led to a significant decrease in the number of FI episodes (SMD=-0.38; 95%
Introduction: Currently breast (BC) cancer is a serious medical problem in all countries of the world. Survival depends on many factors. The present study focused on 5-year survival and its related factors in patients with BC in Iran. Material and methods. The present analytical retrospective study was performed (from March 2010 until March 2015) on patients with BC followed for at least 6 months. The main variables assessed were tumor size, grade of lymph node involvement, metastasis, stage, history, human epidermal growth factor receptor expression, and tumor origin. Analysis of survival was accomplished using the Kaplan- Meier method. Results: Some 351 (80.2%) of the total of 438 individuals had unilateral and 87(19.8%) had bilateral cancer, 28 (35.6%) of the latter being synchronous and 56(64.4%) metachronous. Mean duration of follow-up was 47.44±28.19 months, during which 61 (17.3%) patients with unilateral and 18 with bilateral cancer eventually died. The 5-year survival rate in patients with unilateral BC was significantly higher than those with bilateral BC (Log-rank Test chi2= 3.11, p=0.032). In addition, with metachronous cases, the survival rate was 64.2% in comparison with 51.6% for synchronous BCs. Survival rate was significantly (p value =0.038) higher with metachronous than with synchronous cancers (Log-rank Test chi2=3.54, p=0.038). The highest survival rate was reported for BCs originating from lobule tissue and the lowest rate examples of interstitial tissue origin (Log-rank Test chi2=11.54, p=0.0001). Patients with earl stage lesions (M1) survived longer than with other stages (Log-rank Test chi2= 9.55, p=0.001). Conclusion: In this study, most women with BC had a positive family history and were married. The 5-year survival rate was lower with advanced stages of cancer. According to our findings, survival rates might improve if patients undergo screening and diagnosis is made at an early stage of the disease.
Background: Avian schistosomes comprise a diverse and widespread group of trematodes known for their surprising ability to switch into new hosts and habitats. Their cercariae are the causative agents of the waterborne allergic disease cercarial dermatitis. There are 13 recognised genera of avian schistosomes with majority of the extant species with freshwater-based life-cycles. Despite the considerable research attention on avian schistosomes much less it is known about the diversity, geographical range and host associations of the marine representatives. Here, we provide novel data on the species diversity and host-parasite relationships of the marine schistosomes in respect to their intermediate gastropod host from the Persian Gulf. Methods: A total of 1,745 horn snails of Pirenella cingulata (Gmelin), were examined during a survey from December 2019 to February 2020 from eight distinct locations along the coast of Iran. Partial sequences of the mitochondrial cytochrome c oxidase subunit 1 (cox1) and the nuclear 28S rRNA gene were generated for the schistosome isolates recovered and used for molecular identification and phylogenetic reconstruction. Results: Our molecular analyses inferred from both molecular markers revealed presence of two schistosome species, Ornithobilharzia canaliculata (Rudolphi, 1819) Odhner, 1912 and a putative new species of Austrobilharzia Johnston, 1917. Molecular elucidation of the life-cycle of O. canaliculata was achieved for the first time via matching novel and published sequence data from adult and larval stages. This is the first record of Ornithobilharzia from the Persian Gulf and globally the first record of this genus in a potamidid snail host.Conclusions: The present study provides new host and distribution records for major etiological agents of cercarial dermatitis and contributes important information on host-parasite relationships. Our study further highlights the importance of the molecular systematics in the assessment of schistosome diversity and calls for further surveys in order to reach a better understanding of the schistosome diversity and patterns of relationships among them, host associations, transmission strategies and distribution coverage.
Background: The evidence on the efficacy of adipose derived stem cells (ADSCs) in the treatment of stroke is controversial. Therefore, the aim of present systematic review and meta-analysis is to evaluate the efficacy of ADSCs administration in the treatment of animal models of ischemic stroke. Methods: An extensive search was performed on electronic databases of Medline, Embase, Scopus, CENTRAL and Web of Science until December 31, 2018. Animal studies that used ADSCs in treatment of ischemic stroke were included. The data were recorded as mean and standard deviation and then a pooled standardized mean difference (SMD) with 95% confidence interval (95% CI) was reported. Results: Twenty articles were included in the present meta-analysis. It was observed that administration of ADSCs improves motor function (SMD = 2.52, 95% CI: 1.67 to 3.37, p < 0.0001) and neurological status (SMD = 2.05, 95% CI: 1.33 to 2.78, p < 0.0001) in animals following an ischemic stroke. Multivariate meta-regression showed the model of stroke induction (p = 0.017) and the number of transplanted cells (p = 0.007) affect the efficacy of ADSCs administration on motor function improvement following the stroke. Conclusion: Moderate to high levels of evidence indicate a strong efficacy of ADSCs transplantation on motor function and neurological improvement following ischemic stroke in animal models. However, no reports regarding the dose-response effect of ADSCs administration on stroke exist in the literature. As a result, further pre-clinical studies are recommended to be conducted on the matter.
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