Iranian Journal of Medical Sciences最新文献

{"title":"Differential Expression of Visfatin, Sirtuin-1, and Interleukin-18 in Ankylosing Spondylitis Patients: A Comparative Study of Etanercept-Treated versus Newly Diagnosed Patients.","authors":"Afrouz Asgarian, Zahra Hesari, Mehrdad Aghaei, Zahra Faghhian, Romina Malakouti, Sima Besharat, Koushan Sineh Sepehr","doi":"10.30476/ijms.2026.108802.4382","DOIUrl":"10.30476/ijms.2026.108802.4382","url":null,"abstract":"<p><strong>Background: </strong>Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the axial joints. In response to inflammation, sirtuin-1 (<i>SIRT-1</i>) plays a regulatory role by modulating inflammatory signaling pathways and protecting against further tissue damage. Interleukin-18 (IL-18) is a potent pro-inflammatory cytokine released predominantly by pyroptotic immune cells. Visfatin, an adipokine secreted by lymphocytes and other immune cells, is increasingly recognized as a pro-inflammatory mediator implicated in various rheumatologic disorders. This study aimed to evaluate the expression levels of <i>SIRT-1</i>, <i>IL-18</i>, and visfatin genes in immune cells of AS patients.</p><p><strong>Methods: </strong>In 2022, this cross-sectional study was conducted in Gorgan, Iran. Peripheral blood mononuclear cells (PBMCs) were isolated from a total of 49 AS patients, including patients undergoing treatment with three doses of etanercept and the newly diagnosed, treatment-naïve patients. Total RNA was extracted from PBMCs, and complementary DNA (cDNA) was synthesized. Gene expression levels of <i>SIRT-1</i>, <i>IL-18</i>, and visfatin were quantified using real-time PCR, and data were analyzed using SPSS v16 and GraphPad Prism 9 with Student's <i>t</i> test. A significant difference was considered as P<0.05.</p><p><strong>Results: </strong><i>SIRT-1</i> expression was significantly lower in newly diagnosed AS patients than in the etanercept-treated group (P=0.041). Visfatin expression was significantly higher in the new case group than in the treated group (P=0.021). Similarly, <i>IL-18</i> expression was significantly higher in new cases than in etanercept-treated patients (P=0.028).</p><p><strong>Conclusion: </strong>Etanercept significantly upregulates SIRT-1 expression while suppressing IL-18 and visfatin levels in AS patients, highlighting its pleiotropic anti-inflammatory mechanisms beyond TNF-α blockade. These findings provide novel insights into the molecular pathways modulated by anti-TNF therapy, particularly the interplay between <i>SIRT1</i>-mediated epigenetic regulation and adipokine-driven inflammation.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 8","pages":"554-560"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mulberrofuran G Induces Apoptosis and Cell Cycle Arrest Through Suppression of the JAK2/STAT3 Pathway by Direct JAK2 Inhibition and Reactive Oxygen Species Induction in the NCI-H460 Cell Line.","authors":"Zhong-Rui Li, Yu Zheng, Chao Han, Lei Wang","doi":"10.30476/ijms.2026.109449.4477","DOIUrl":"10.30476/ijms.2026.109449.4477","url":null,"abstract":"<p><strong>Background: </strong>Large cell lung carcinoma (LCLC) is an aggressive non-small cell lung cancer subtype. Mulberrofuran G (MG) from <i>Morus alba</i> L. possesses pharmacological properties, but its anticancer mechanisms in LCLC remain unexplored. This study aimed to validate the antitumor activity of MG against NCI-H460 cells and elucidate its dual mechanism involving Janus kinase 2 (JAK2) inhibition and reactive oxygen species (ROS) induction.</p><p><strong>Methods: </strong>This study was conducted at the Nanjing University of Chinese Medicine and China Pharmaceutical University, Nanjing, China, from 2023 to 2025. Cell viability was assessed via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT). Flow cytometry using annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI), 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA), and 5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolylcarbocyanine iodide (JC-1) measured apoptosis, cell cycle, ROS, and mitochondrial membrane potential (MMP). Western blot analyzed p21, cyclin B1, caspases3/7/9, cleaved caspases3/7/9, poly(ADP-ribose) polymerase (PARP), cleaved PARP, JAK2, p-JAK2, signal transducer and activator of transcription 3 (STAT3) and p-STAT3. Interactions were confirmed via docking, cellular thermal shift assay, and ADP-Glo. <i>In vivo</i> efficacy was evaluated in zebrafish. Data analysis was performed using GraphPad Prism 8.0. Statistical significance was determined using Student's t test or one-way/two-way ANOVA followed by Tukey's <i>post hoc</i> test (P<0.05).</p><p><strong>Results: </strong>MG suppressed proliferation (IC₅₀=9.90 μM), induced G2/M arrest, and triggered mitochondrial apoptosis. MG inhibited JAK2/STAT3 via direct kinase inhibition (IC₅₀=17.17 μM) and ROS-mediated suppression. N-acetylcysteine (NAC) reversed these effects. Zebrafish tumor growth decreased by 19.7% (P<0.05).</p><p><strong>Conclusion: </strong>MG exerts anticancer effects against LCLC by inducing ROS accumulation and dual suppression of the JAK2/STAT3 pathway, highlighting its potential as a therapeutic candidate.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 8","pages":"570-581"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Genetic Characterization of Gap Junction Protein β-6 Variants in Non-Syndromic Hearing Loss: A Case Report with Familial Evaluation and <i>In Silico</i> Analyses.","authors":"Fateme Zahedi Abghari, Marzieh Mohseni, Emran Esmaeilzadeh, Hossein Ghasemi, Hamid Reza Khorram Khorshid, Reza Najafipour","doi":"10.30476/ijms.2026.109418.4473","DOIUrl":"10.30476/ijms.2026.109418.4473","url":null,"abstract":"<p><p>Non-syndromic sensorineural hearing loss (NSHL) exhibits substantial genetic heterogeneity, and the identification of its causative variants remains an important challenge. The gap junction protein β-6 (<i>GJB6</i>), expressed in multiple tissues including the sensory epithelium of the inner ear, is essential for auditory function. Although large <i>GJB6</i> deletions are well characterized, single-nucleotide variants (SNVs) have been reported infrequently, and their pathogenic significance remains insufficiently defined. In this study, we identified a novel homozygous missense variant in GJB6, NM_001110219.3:c.446C>T (p.Ala149Val), through whole-exome sequencing and confirmed it by Sanger sequencing in a 32-year-old Iranian female from a consanguineous family, presenting with prelingual bilateral sensorineural hearing loss without any additional phenotypes or syndromic features. She was referred to the Medical Genetics Laboratory in Tehran, Iran, in March 2025. <i>In silico</i> predictions, mammalian conservation, and structural modeling suggest that this substitution may disrupt normal <i>GJB6</i> function. To contextualize this finding, we reviewed all reported SNVs in <i>GJB6</i>, identifying 20 distinct variants in 47 patients, with most mutations clustering in the extracellular loop 1, cytoplasmic loop, transmembrane domain 3, and extracellular loop 2. These results expand the mutational spectrum of <i>GJB6</i> and highlight its critical role in NSHL pathogenesis. Collectively, this study presents the first comprehensive report of SNVs in <i>GJB6</i> and supports their further investigation in the genetic architecture of hereditary hearing loss.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 8","pages":"592-602"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Family with Sequence Similarity 19, Member A5 as a Potential Indicator of Atherogenic Risk: Correlations with Low-Density Lipoprotein/Apolipoprotein B Ratio, Atherogenic Index, and Castelli Indices in Diet-Induced Obesity.","authors":"Efrida Efrida, Prima Adelin, Eka Fithra Elfi, Rismawati Yaswir","doi":"10.30476/ijms.2026.109872.4530","DOIUrl":"10.30476/ijms.2026.109872.4530","url":null,"abstract":"<p><strong>Background: </strong>Family with sequence similarity 19, member A5 (FAM19A5) is a secreted protein initially proposed as an adipokine with anti-inflammatory and anti-atherogenic properties. However, recent evidence has challenged this view by demonstrating minimal adipose expression and suggesting that circulating FAM19A5 may instead increase in response to vascular stress and atherogenic progression. To clarify its relevance in obesity-related dyslipidemia, this study examined the association between circulating FAM19A5 and established lipid-based atherogenic indices in a diet-induced obesity model.</p><p><strong>Methods: </strong>This <i>in vivo</i> correlational study involved 14 male Sprague-Dawley rats (n=7 per group) conducted in Padang, Indonesia, in 2024. Rats were assigned to a control group (American Institute of Nutrition-93 diet) or an obesity group (high-fat and high-fructose diet) for 12 weeks. Serum FAM19A5 levels were measured by ELISA. Derived indices included the LDL/ApoB ratio, Castelli Risk Index I and II, and the HDL-based atherogenic index. Spearman's correlation analysis was used to assess the correlation (P<0.05), and all analyses were performed using SPSS version 25 (IBM Corp., USA).</p><p><strong>Results: </strong>FAM19A5 showed a strong positive correlation with the LDL/ApoB ratio (r=0.734, P<0.050), indicating that higher FAM19A5 levels coincide with more atherogenic ApoB-containing lipoprotein patterns. Correlations with Castelli Risk Index I (r=0.127, P>0.05), Castelli Risk Index II (r=0.369, P=0.195), and the HDL-based atherogenic index (r=0.127, P=0.666) were weak and not statistically significant.</p><p><strong>Conclusion: </strong>Elevated circulating FAM19A5 may serve as a potential biomarker reflecting ApoB-related lipid alterations during obesity progression.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 8","pages":"561-569"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammasome Suppression via Combined Training Modulates Downstream Cytokines (Interleukin-1β/Caspase-1) and Improves Insulin Resistance in Diabetic Rats.","authors":"Kambiz Pourfarzad, Rahman Soori, Nader Hamedchaman, Simin Riahy","doi":"10.30476/ijms.2026.107912.4254","DOIUrl":"10.30476/ijms.2026.107912.4254","url":null,"abstract":"<p><strong>Background: </strong>Diabetic Cardiomyopathy (DCM) is connected to prolonged systemic glucose metabolism and/or hyperinsulinemia-induced cardiac metaflammation. This study aims to investigate the effects of combined endurance and resistance training on the protein levels of nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP3), caspase-1, and interleukin -1β (IL-1β) in the myocardium of male rats with type 2 diabetes.</p><p><strong>Methods: </strong>In this experimental study, 24 male Wistar rats (8 weeks old, 260±20 g) were randomly divided into three groups: (n=8/groups): Normal Control (NC), Diabetes Control (DC), and Diabetes+Combined Training (DCT). After type 2 diabetes induction, the training group performed the combined training for 8 weeks, five sessions/week, in spring 2024 at AJA University of Medical Sciences. Approximately 48 hours following the end of the training protocol, blood samples and myocardium tissue were taken for subsequent assessment of inflammatory and biochemical markers. Group comparisons were achieved using one-way ANOVA, followed by the Tukey <i>post hoc</i> test using SPSS (version 22).</p><p><strong>Results: </strong>Chronic implementation of combined training significantly downregulated final weight (P=0.033), protein levels of NLRP3, Caspase-1, and IL-1β (P=0.03, 0.001 and 0.019, respectively) in the cardiac tissue as well as modulation the homeostatic model assessment for insulin resistance (HOMA-IR: P=0.039) via attenuation of serum glucose and insulin levels (P=0.032 and 0.07) of the training group compared to the diabetic group.</p><p><strong>Conclusion: </strong>The modality of combined training (endurance+resistance) can reduce the risk factors associated with DCM in the myocardium of type 2 diabetic rats.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 8","pages":"582-591"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Period-Cohort Analysis of Marriage Survival and Divorce Indicators in Iran, Fars Province, and Shiraz County (2013-2022): A Letter to the Editor.","authors":"Seyedeh Zohreh Balaghi, Ali Pezhhan, Kamal Javanmard","doi":"10.30476/ijms.2026.108936.4411","DOIUrl":"10.30476/ijms.2026.108936.4411","url":null,"abstract":"","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 8","pages":"603-605"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Serum Monounsaturated Fatty Acids Levels May Increase Risk of Cardiovascular Disease: A Mendelian Randomization Study.","authors":"Danial Habibi, Farshad Teymoori, Fahimeh Haghighatdoost, Sahand Tehrani Fateh, Sajedeh Masjoudi, Amir Hossein Saeidian, Alireza Soleymani Taloubaghi, Taha Rafiei, Soheil Rahmati, Mohammad Rafiei, Hossein Farhadnejad, Hanifeh Mirtavoos-Mahyari, Hakon Hakonarson, Fereidoun Azizi, Mehdi Hedayati, Maryam Sadat Daneshpour, Marjan Mansourian, Mahdi Akbarzadeh","doi":"10.30476/ijms.2026.107801.4239","DOIUrl":"10.30476/ijms.2026.107801.4239","url":null,"abstract":"<p><strong>Background: </strong>Monounsaturated fatty acids (MUFAs) are dietary and circulating fats that may influence cardiovascular health. However, their causal role in cardiovascular diseases (CVDs) remains unclear due to conflicting observational evidence. This study aimed to determine the causal relationship of high serum MUFAs with the risk of various CVDs using the Mendelian randomization (MR) design.</p><p><strong>Methods: </strong>The summary statistics dataset related to serum MUFAs was used from the published genome-wide association study (GWAS) of European descent in UK Biobank participants (n=114,999). Genetic variants underlying angina, atherosclerotic, ischemic heart disease (IHD), myocardial infarction (MI), and hypertension events were ascertained using a GWAS dataset of 461,880 (case=14,828, control=447,052), 463,010 (case=12,171, control=450,839), 361,194 (case=20,857, control=340,337), 462,933 (case=10,616, control=452,317), and 461,880 (case=124,227, control=337,653) European descent participants from the UK Biobank, respectively. We investigated potential association relationships between MUFAs and these outcomes using generalized summary Mendelian randomization (GSMR) and two-sample Mendelian randomization (TSMR). TSMR was employed to validate associations identified by GSMR. The results were reported as odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>GSMR results showed that MUFAs were associated with angina (OR=1.007, 95%CI:1.005-1.009; P<0.001), atherosclerotic (OR=1.006, 95%CI:1.004-1.008; P<0.001), IHD (OR=1.006, 95%CI:1.003-1.009; P<0.001), MI (OR=1.003, 95%CI:1.001-1.005; P<0.001), and hypertension (OR=1.003, 95%CI:0.998-1.008; P<0.001). Besides, TSMR results indicated that MUFAs were associated with angina (OR=1.012, 95%CI:1.010-1.015), atherosclerotic (OR=1.009, 95%CI:1.006-1.011; P<0.001), IHD (OR=1.015, 95%CI:1.010-1.019; P<0.001), MI (OR=1.007, 95%CI:1.004-1.009; P<0.001), and hypertension (OR=1.021, 95%CI:1.011-1.031; P<0.001). These findings remained consistent when utilizing different MR methods and sensitivity analyses.</p><p><strong>Conclusion: </strong>The current MR study indicated that higher levels of MUFAs might be associated with an increased risk of CVD events.<b>Preprint Declaration:</b> A preprint version of this manuscript is available at https://www.medrxiv.org/content/10.1101/2023.09.06.23295142v1.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 8","pages":"543-553"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of Persian Speech Test Signal (PerSTS).","authors":"Sasan Etezadi, Nariman Rahbar, Seyyed Jalal Sameni, Farhad Torabinezhad, Behrooz Mahmoodi-Bakhtiari","doi":"10.30476/ijms.2026.109949.4539","DOIUrl":"10.30476/ijms.2026.109949.4539","url":null,"abstract":"<p><strong>Background: </strong>Digital hearing aids require precise fitting to enable realistic speech processing. The international speech test signal (ISTS) provides a standard reference, yet does not fully capture the phonetic and prosodic features of Persian. This study aimed to create and acoustically verify a Persian version of the ISTS-termed the Persian speech test signal (PerSTS)-to enhance verification accuracy for Persian-speaking users.</p><p><strong>Methods: </strong>The North Wind and the Sun (NWS) passage was translated into Persian with careful phoneme distribution and natural syntax. Six native female speakers recorded the passage at 44.1 kHz and 24-bit resolution. These recordings were segmented, enhanced, and stitched into 10-15 second sequences that adhered to pitch and spectral criteria. Sequences that closely matched the Byrne female long-term average speech spectrum (LTASS; ±1 dB) and were rated as most natural by linguists were assembled into a 60-second PerSTS. The final audio was calibrated to 65 dB sound pressure level (SPL) and analyzed for its spectral, temporal, and amplitude characteristics in Tehran, Iran (2025).</p><p><strong>Results: </strong>The PerSTS exhibited spectral peaks between 200-400 Hz and 3-4 kHz, characteristic of female Persian speech. Its LTASS closely matches the Byrne LTASS and ISTS, with minor deviations below 500 Hz and above 8 kHz. The crest factor (16.7 dB) and dynamic range (27.1 dB) were consistent with those of natural speech. Experts rated its naturalness as 4.35±0.28 on a five-point scale.</p><p><strong>Conclusion: </strong>The PerSTS mimics the acoustic and temporal features of natural Persian speech within International Electrotechnical Commission (IEC) standards, providing a standardized tool for hearing aid verification and audiology.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 7","pages":"505-511"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empagliflozin's Effects on Carotid Ultrasound Parameters in Type 2 Diabetes Patients Post-ST-Elevation Myocardial Infarction: A Randomized Controlled Trial.","authors":"Hadi Sabat Sani, Shalaleh Aghaei, Soroor Kalantari, Reza Madadi, Zahra Kalantari, Alireza Amir Maafi","doi":"10.30476/ijms.2026.109620.4497","DOIUrl":"10.30476/ijms.2026.109620.4497","url":null,"abstract":"<p><strong>Background: </strong>Patients with type 2 diabetes (T2D) and recent ST-elevation myocardial infarction (STEMI) face accelerated atherosclerosis and a high risk of recurrent cardiovascular events. Sodium-glucose cotransporter-2 inhibitors (SGLT2i), particularly empagliflozin, offer proven cardioprotection in T2D. This study investigated the 3-month effects of empagliflozin on carotid intima-media thickness (CIMT) and Doppler hemodynamic parameters (resistive index [RI] and pulsatility index [PI]) in T2D patients post-STEMI.</p><p><strong>Methods: </strong>In this randomized clinical trial, 80 patients with T2D and a recent STEMI from Ayatollah Mousavi Hospital, Zanjan, Iran (from July to December 2025), were randomized in a 1:1 ratio to empagliflozin 10 mg daily or an identical placebo, in addition to standard therapy. The primary endpoint was the change in CIMT at 3 months, assessed using B-mode ultrasound. Secondary endpoints included changes in RI and PI, measured via Doppler ultrasound.</p><p><strong>Results: </strong>Follow-up data were available for 78 patients (two deaths in the intervention arm, both unrelated to the study drug). In the primary intention-to-treat analysis (n=80), empagliflozin was associated with a significant reduction in left CIMT compared with controls (median change=-0.13 mm vs. -0.01; within-group P=0.002; between-group ΔCIMT P=0.004; ANCOVA-adjusted P<0.001) versus controls (-0.01 mm). A smaller though statistically significant difference was also observed for right CIMT (ΔCIMT, P=0.021; ANCOVA-adjusted P=0.006). These findings remained consistent in the per-protocol analysis. After Bonferroni correction, the reduction in left CIMT remained significant, whereas the effect on right CIMT became more modest. No significant changes were observed in RI or PI.</p><p><strong>Conclusion: </strong>Short-term empagliflozin suggested favorable changes in CIMT in high-risk T2D patients post-STEMI, without detectable effects on RI or PI.<b>Iranian Registry of Clinical Trials:</b> IRCT20230727058945N1.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 7","pages":"481-491"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral Pedicular Puncture with Lateral Injection for Osteoporotic Vertebral Compression Fractures in the Upper and Middle Thoracic Vertebrae: A Technical Report and Efficacy Comparison.","authors":"Feng Huang, Yi Hang He, Lu Lin, Yun Cheng, Yang Wang, Xiao Lin Chen, Zhen Yong Ke","doi":"10.30476/ijms.2026.106836.4149","DOIUrl":"10.30476/ijms.2026.106836.4149","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous vertebroplasty (PVP) for upper and middle thoracic osteoporotic vertebral compression fractures (OVCFs) is challenged by technical difficulties and safety concerns, which drive the need for innovative techniques to optimize its efficacy. The purpose of this study was to delineate the technical characteristics of a novel methodology and to conduct a comparative analysis of its efficacy against bilateral transpedicular puncture PVP.</p><p><strong>Methods: </strong>A retrospective study was conducted on consecutive patients undergoing PVP for upper/middle thoracic OVCFs at the Second Affiliated Hospital of Chongqing Medical University (Chongqing, China) between January 2019 and December 2024. Patients were allocated to either the unilateral transpedicular puncture lateral injection (UTPLI) or the conventional bilateral transpedicular puncture (BTP) group based on the surgical timeline, with earlier cases undergoing BTP and later ones UTPLI. Baseline characteristics, operative time, estimated blood loss, cement volume, visual analogue scale (VAS), Oswestry disability index (ODI), vertebral and segmental kyphosis angles, anterior/middle/posterior vertebral heights, and postoperative cement distribution indices were recorded and compared between the two groups. Data were analyzed with SPSS software (version 26.0) using Chi square, <i>t</i> tests, and non-parametric tests.</p><p><strong>Results: </strong>A total of 57 patients were enrolled (UTPLI group=21, BTP group=36). The UTPLI group had a shorter operation time (18.00±9.00 min vs. 25.00±9.00 min, P=0.002) and less estimated blood loss (3.93±1.22 mL vs. 5.13±1.37 mL, P=0.002). No significant intergroup differences were found in VAS, ODI, kyphosis angles (vertebral, segmental, thoracic), vertebral heights (anterior, middle, posterior), baseline data, bone cement leakage, cement dispersion index, or spatial distribution scores, either preoperatively or postoperatively (P>0.05).</p><p><strong>Conclusion: </strong>The UTPLI technique is a viable alternative to BTP PVP for upper and middle thoracic OVCFs. It reduced operative time and blood loss while achieving comparable outcomes.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"51 7","pages":"512-522"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}