The potential impact of human leukocyte antigen (HLA) genotype variations on development of diabetic peripheral neuropathy (DPN) is not well determined. This study aimed to identify the association of HLA class II alleles with DPN in type 2 diabetes (T2D) patients. Totally 106 T2D patients, 49 with DPN and 57 without DPN, and 100 ethnic-matched healthy controls were analyzed. Both groups of the patients were matched based on sex, age, body mass index (BMI) and duration of T2D. Polyneuropathy was diagnosed using electrodiagnostic methods. HLA-DRB1 and DQB1 genotyping was performed in all subjects by the polymerase chain reaction with sequence-specific primers (PCR-SSP) method. T2D patients with DPN showed higher frequencies of HLA-DRB1*10 and DRB1*12 alleles compared to control group (P = 0.04). HLA-DQB1*02 allele and HLA-DRB1*07-DQB1*02 haplotype were associated with a decreased risk for developing DPN in T2D patients (P = 0.02 and P = 0.05 respectively). Also, patients with severe neuropathy showed higher frequencies of DRB1*07 (P = 0.003) and DQB1*02 (P = 0.02) alleles than those with mild-to-moderate form of neuropathy. The distribution of DRB1 and DQB1 alleles and haplotypes were not statistically different between all patients and healthy controls. Our findings implicate a possible protective role of HLA-DQB1*02 allele and HLA-DRB1*07-DQB1*02 haplotype against development of peripheral neuropathy in T2D patients. Therefore, variations in HLA genotypes might be used as genetic markers for prediction and potentially management of neuropathy in T2D patients.
Objective: Fatty liver causes progression in liver damage and accelerates liver fibrosis. Fatty liver may enhance AST and ALT enzymes in blood. Infiltration of lipid in liver is associated with an increasing in its echogenicity, depending on the severity of the lipid infiltration. Methods: This study is a randomized non-blind clinical trial in order to investigate the effect of Artichoke (Cynara Scolymus L.) herbal tea. The leaves of the plant were consumed twice a day (one tablespoon in a glass of boiling water for 20 minutes on indirect heat) for 45 days. Using Pokak analytical sampling formula, 70 patients (47 females and 23 males) aged 25 to 63 years were finally tested and the effect of this plant on parenchymal echogenic levels of liver, AST, and ALT of their liver was investigated. Liver enzymes and abdominal ultrasound were performed at the beginning and after treatment and studied people were grouped according to the ultrasound criteria for fatty liver disease after obtaining informed consent. The means were compared using paired t-test and data were analyzed by SPSS v.18 software. Results: Results showed that studied people, for fatty liver disease were grouped as follows: mild (23 patients, %32.86) as grade 1, moderate (38 patients, %54.28) as grade 2, and severe (9 patients, %12.86) as grade 3. At the end of this study, fatty liver grade was decreased in 51 patients (P≤0.05). However, 19 women didn’t show expected change in the grade of fatty liver. The Mean±SD of the enzymes measured in all patients before and after treatment were 5.49±26.76 and 36.96±13.01 for ALT, and 3641.20±14.46 and 31.76±12.26 for AST. Statistical analysis of the results by t-test showed significant decreasing for ALT and AST levels (P≤0.01). Conclusion: The results of this study showed that it seems this plant can be used to improve the laboratory symptoms of fatty liver.
Altered expression and dysregulation of microRNAs (miRNAs) have been reported in different samples of chronic obstructive pulmonary disease (COPD) patients. The present study attempted to evaluate the peripheral expressions of miR-146a and miR-218 in COPD patients and sex-matched healthy controls with/without cigarette smoke exposure (CSE). In this case-control study, blood samples were collected from 60 COPD patients (30 with CSE and 30 non-CSE in each group) and 60 healthy controls. Peripheral expressions of miRNA-146a and miR-218a were measured using qRT-PCR and results were compared between cases and controls as well as within the subgroups of patients. We found significantly decreased expressions for both miRNAs in the patients compared to healthy controls. Remarkable underexpression of miRNA-146a and miRNA-218 were found in the CSE and non-CSE patients compared to non-CSE healthy controls and even in the CSE versus non-CSE controls. Both groups of patients showed underexpression of two miRNAs in comparison with CSE healthy controls and interestingly, similar decrements were observed in the CSE versus non-CSE patients. Also, ROC curve analysis revealed the significantly diagnostic powers for both miRNAs in discrimination of patients from healthy individuals and CSE-COPD from non-CSE COPD patients. The underexpression of miR-146a and miR-218 in COPD patients and relation to CSE can be indicative of CSE-induced changes in miRNA expression profile and potential for these biomarkers in COPD risk assessment, particularly in those patients with CSE.
BACKGROUND:Obstructive sleep apnea (OSA) is characterised by recurrence in upper airway obstruction during sleep.AIM:This study aimed to compare the predictive values of the Epworth Sleepiness Scale (ESS) and STOP-BANG in the desaturation of patients with mild to moderate obstructive apnea based on the apnea-hypopnea index (AHI) scale.METHODS:A group of 79 patients (43 male and 36 female) were selected. The suspected patients were introduced to the sleep clinic, and the ESS and STOP-BANG questionnaires were filled up, then subjected to polysomnography test, and the scores of the disease were also determined based on an apnoea-hypopnoea index (AHI). Finally, the desaturation rate (SO2 < 3% based on the baseline) and desaturation index were determined in patients. Consequently, the finding was compared with the results of the questionnaires.RESULTS:Patients with STOP-BANG score above 3 had significantly higher weight, oxygen desaturation index (ODI) index and average desatu, while peripheral capillary oxygen saturation (SpO2) base and average SpO2 were lower than those with scores below 3 (P < 0.05). However, there was no significant difference between the patients with the ESS questionnaire score above 10 and below 10 (P > 0.05).CONCLUSION:The results of these two questionnaires reflect the unsaturated oxygen index in the blood, and can be considered for the evaluation of the severity of the disease.
Background: Neurofibromatosis type1 (NF-1) is a hereditary autosomal dominant disease that is accompanied by complications, such as benign and malignant tumors and vascular involvement, including pulmonary hypertension, artery stenosis, and pulmonary artery aneurysm. Spontaneous hemothorax is a rare and lethal complication of NF-1 due to vasculopathy as stenosis or aneurysmal modifications of large intrathoracic vessels, and dysplastic alterations of small vessels in highly vascularized mesenchymal tumors. Most commonly, tumor-related hemothorax is due to neurofibroma, and the most frequently involved artery is the intercostal artery. Case Presentation: A 48-year-old male referred to our hospital with a chief complaint of dyspnea from a week ago. His symptoms began with pleuritic chest pain followed by dyspnea. The physical examination showed many neurofibromatosis lesions and café-au-lait macules on the skin. Thoracotomy was performed during the hemothorax examination. Moreover, inflammation of the pleura and fibrothorax were reported without any site of bleeding. Conclusion: Vascular complications should be regarded in NF-1. Any patient presents with hemodynamic disorder or pleural effusion should be examined and treated promptly.
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