Journal of Research in Medical Sciences最新文献

{"title":"Using the power of artificial intelligence to improve the diagnosis and management of nonmelanoma skin cancer.","authors":"Fahimeh Abdollahimajd, Fatemeh Abbasi, Alireza Motamedi, Narges Koohi, Reza Mohamoud Robati, Mona Gorji","doi":"10.4103/jrms.jrms_607_24","DOIUrl":"10.4103/jrms.jrms_607_24","url":null,"abstract":"<p><p>Nonmelanoma skin cancer (NMSC), including basal cell carcinoma and squamous cell carcinoma, is the most prevalent type of skin cancer. While generally less aggressive than melanoma, early detection and treatment are crucial to prevent the complications. Artificial intelligence (AI) systems show promise in enhancing the accuracy, efficiency, and accessibility of NMSC diagnosis and management. These systems can facilitate early interventions, reduce unnecessary procedures, and promote collaboration among healthcare providers. Despite AI algorithms demonstrating moderate-to-high performance in diagnosing NMSC, several challenges remain. Ensuring the robustness, explainability, and generalizability of these models is vital. Collaborative efforts focusing on data diversity, image quality standards, and ethical considerations are necessary to address these issues. Building patient trust is also essential for the successful implementation of AI in the clinical settings. AI algorithms may outperform experts in controlled environments but can fall short in the real-world clinical applications, indicating a need for more prospective studies to evaluate their effectiveness in the practical scenarios. Continued research and development are essential to fully realize AI's potential in improving NMSC diagnosis and management by overcoming the existing challenges and conducting comprehensive studies.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"25"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the potential of diffusion tensor imaging biomarkers in prediction of white matter changes after brain radiation therapy: A systematic review.","authors":"Baranoosh Rahmani, Abdurrahim Rahimian, Mahsa Mansourian, Iraj Abedi","doi":"10.4103/jrms.jrms_234_24","DOIUrl":"10.4103/jrms.jrms_234_24","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to systematically review the use of diffusion tensor imaging (DTI) biomarkers in the early detection of radiation-induced white matter (WM) changes.</p><p><strong>Materials and methods: </strong>The PubMed and Scopus databases were searched for peer-reviewed articles published in English up to November 28, 2022, according to the PRISMA guidelines to identify studies that related to changes in DTI parameters after radiotherapy.</p><p><strong>Results: </strong>After reviewing the literature, eight studies met the inclusion criteria. The results indicated that changes in the late delay phase were completely related to changes in the acute phase. There was a difference in the sensitivity of the biomarkers between studies. Still, there was substantial evidence for the early detection of changes by axial diffusivity (AD), radial diffusivity (RD), and fractional anisotropy (FA). However, further research is still necessary on the potential of mean diffusivity (MD) sensitivity for detecting early changes. The majority of the included studies demonstrated progressive changes in DTI parameters over time and with dose.</p><p><strong>Conclusion: </strong>There is significant potential for DTI biomarkers to predict WM changes caused by radiation after brain radiation therapy by having significant predictive power.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"20"},"PeriodicalIF":1.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Iranian clinical practice guidelines: An experience in cardiovascular diseases-A policy brief.","authors":"Nizal Sarrafzadegan, Shahla Shahidi, Fahimeh Bagherikholenjani","doi":"10.4103/jrms.jrms_617_24","DOIUrl":"https://doi.org/10.4103/jrms.jrms_617_24","url":null,"abstract":"<p><p>In the wake of the dominance of evidence-based thinking, clinical practice guidelines (CPGs) within the country's health system have gained a key position in recent years and playing an important role in enhancing all functions of this system. However, the absence of a standard model, the inadequacy of existing documentation for designing clinical guidelines, data obtained from the national self-care project (IMPROVE-CARE), the Persian Registry of Cardiovascular Disease, the national priorities declared by the Iranian Network of Cardiovascular Research, and most importantly, the order from the Ministry of Health, all highlight the necessity of establishing a structure followed by the creating of a standard model for the development of guidelines, and subsequently, the creation of Iranian clinical guidelines. This policy brief article discusses the process of establishing the structure and the produced content and presents the necessary policies for the development of national clinical guidelines.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"16"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing risk models for predicting incidence of diabetes and prediabetes in the first-degree relatives of Iranian patients with type 2 diabetes and comparison with the finnish diabetes risk score.","authors":"Parisa Khodabandeh Shahraki, Awat Feizi, Sima Aminorroaya, Heshmatollah Ghanbari, Majid Abyar, Massoud Amini, Ashraf Aminorroaya","doi":"10.4103/jrms.jrms_139_23","DOIUrl":"https://doi.org/10.4103/jrms.jrms_139_23","url":null,"abstract":"<p><strong>Background: </strong>We aimed to develop risk models for predicting the onset of developing diabetes and prediabetes in the first-degree relatives (FDRs) of patients with type 2 diabetes, who have normal glucose tolerance (NGT).</p><p><strong>Materials and methods: </strong>In this study, 1765 FDRs of patients with type 2 diabetes mellitus, who had NGT, were subjected to the statistical analysis. Diabetes risk factors, including anthropometric indices, physical activity, fast plasma glucose, plasma glucose concentrations 2-h after oral glucose administration, glycosylated hemoglobin (HbA1c), blood pressure, and lipid profile at the baseline were considered as independent variables. Kaplan-Meier, log-rank test, univariate, and multivariable proportional hazard Cox regression were used for the data analysis. The optimal cutoff value for risk score was created according to the receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>The best diabetes predictability was achieved by a model in which waist-to-hip ratio, HbA1c, oral glucose tolerance test-area under the curve (OGTT-AUC), and the lipid profile were included. The best prediabetes risk model included HbA1c, OGTT-AUC, systolic blood pressure, and the lipid profile. The predictive ability of multivariable risk models was compared with fasting plasma glucose (FPG), HbA1c, and OGTT. The predictive ability of developed models was higher than FPG and HbA1c; however, it was comparable with OGTT-AUC alone. In addition, our study showed that the developed models predicted diabetes and OGTT-AUC better than the Finnish Diabetes Risk Score (FINDRISC).</p><p><strong>Conclusion: </strong>We recommend regular monitoring of risk factors for the FDRs of patients with type 2 diabetes as an efficient approach for predicting and prevention of the occurrence of diabetes and prediabetes in future. Our developed diabetes risk score models showed precise prediction ability compared to the FINDRISC in Iranian population.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"17"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic effect of memantine on patients with posttraumatic headache: A randomized double-blinded clinical trial.","authors":"Fariborz Khorvash, Elham Bani, Rasool Soltani, Majid Rezvani, Mohammad Saadatnia, Noushin Maktoobian, Mohsen Kheradmand","doi":"10.4103/jrms.jrms_542_24","DOIUrl":"https://doi.org/10.4103/jrms.jrms_542_24","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) can result in different complications. Posttraumatic headache (PTH) is a disabling complication of TBI. We investigated the therapeutic effect of memantine on patients with PTH.</p><p><strong>Materials and methods: </strong>This randomized and double-blinded clinical trial was performed in 2020 in a hospital on 90 patients with head trauma. Patients were divided into two groups. The active group received 5 mg memantine tablet for 2 weeks followed by 10 mg tablet daily for up to 6 months. The control arm received identical placebo tablets. Patients were evaluated at 3 months and 6 months. Headache severity was measured with a Visual Analog Scale for Pain. Headache frequency (per week) and duration were also recorded.</p><p><strong>Results: </strong>After 3 months, the patients in the memantine group had significantly lower headache severity (<i>P</i> = 001) and frequency (<i>P</i> = 0.008) in comparison to baseline of the study. However, in the placebo group, there was only significant reduction in the headache duration (<i>P</i> = 0.001), and there was no significant reduction in headache intensity and frequency. After 6 months, there was a significant reduction in headache intensity and duration in both groups (<i>P</i> < 0.05), but only in the memantine group, headache frequency was significantly reduced (<i>P</i> < 0.001). Finally, patients in the memantine group had less headache intensity, frequency, and duration after 6 months of taking memantin than the placebo group.(<i>P</i> < 0.05 for all).</p><p><strong>Conclusion: </strong>The administration of memantine for 6 months could significantly lower the severity, duration, and frequency of PTHs.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"15"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microenvironment of diabetic foot ulcers: Implications for healing and therapeutic strategies.","authors":"Jixue Wang, Xirui Yang, Tao Zhou, Haitao Ma, Xingxing Yuan, Shuxun Yan, Siqi Wang","doi":"10.4103/jrms.jrms_573_24","DOIUrl":"https://doi.org/10.4103/jrms.jrms_573_24","url":null,"abstract":"<p><p>Diabetic foot ulcers (DFUs) are a common yet serious complication in individuals with diabetes, often presenting as chronic, nonhealing wounds that significantly impair quality of life. The healing process of DFUs is largely influenced by the local microenvironment, which encompasses factors such as hypoxia, inflammation, and the involvement of various cell types. Poor blood circulation in the affected area results in hypoxia, compromising cellular function and restricting nutrient supply, thereby delaying wound healing. In addition, chronic inflammation disrupts immune system balance, with excessive pro-inflammatory cytokines not only failing to facilitate tissue repair but also exacerbating tissue damage. Moreover, key cell types, including fibroblasts, keratinocytes, and macrophages, play crucial roles at different stages of the healing process, contributing to collagen production and skin regeneration. A comprehensive understanding of the complex dynamics within the DFU microenvironment is essential for developing more precise therapeutic approaches, such as advanced drug delivery systems and bioactive materials, aimed at promoting wound healing and reducing the risk of recurrence.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"19"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccination versus natural infection: A review of antibody differentiation techniques.","authors":"Vaishnavi H Mishra, Pratham Gupta, Nandkishor J Bankar, Obaid Noman","doi":"10.4103/jrms.jrms_550_24","DOIUrl":"https://doi.org/10.4103/jrms.jrms_550_24","url":null,"abstract":"<p><p>The production of specific antibodies occurs in response to pathogens, whether encountered naturally or introduced through vaccination, serving as markers of immunity. As novel vaccines are developed and deployed, especially in response to emerging infectious diseases, the ability to distinguish between vaccine-induced and infection-induced antibodies becomes increasingly important. Vaccines are designed to mimic this natural infection process without causing the disease itself. Serological assays are critical tools in immunology, enabling researchers and clinicians to differentiate between antibodies produced by vaccination and those generated by natural infection. By understanding whether an individual's antibodies are the result of previous infection or vaccination, healthcare providers can modify booster recommendations more effectively. It also plays an important role in identifying people with hybrid immunity and in assessing the effectiveness of vaccination campaigns.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"18"},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-reactive protein and digestive pathologies: A narrative review for daily clinical use.","authors":"Reza Kianmanesh, Koceila Lamine Amroun, Rami Rhaiem, Amir Hossein Davarpanah Jazi, Hashem Moazenzadeh, Linda Rached, Perrine Zimmermann, Adrien Durame, Yohann Renard, Ambroise Ravenet, Olivier Bouche, Sophie Deguelte","doi":"10.4103/jrms.jrms_537_23","DOIUrl":"10.4103/jrms.jrms_537_23","url":null,"abstract":"<p><p>The aim of this narrative review is to familiarize clinicians, especially digestive surgeons, to adequately use of serum C-reactive protein as a reliable noninvasive biomarker in diverse practical clinical situations. We hope that the review will help clinicians for their decision-making when facing various digestive diseases including operative and nonoperative pathologies such as anastomotic leakage, pancreatitis, emergency situation, and digestive cancer management and prognosis.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"10"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment-resistant inflammatory demyelinating pseudotumor with Marburg-like features: A narrative review-based treatment approach.","authors":"Mohammad Amin Najafi, Shakiba Houshi, Payam Riahi, Salar Nasr, Mohammad Reza Najafi","doi":"10.4103/jrms.jrms_477_24","DOIUrl":"10.4103/jrms.jrms_477_24","url":null,"abstract":"<p><p>Inflammatory demyelinating pseudotumor (IDP) mimics intracranial neoplasms in terms of both clinical presentation and imaging features. IDP with Marburg-like features represents a severe form of inflammatory demyelinating encephalomyelitis, marked by a dramatic onset, aggressive course, absence of remission, and the presence of tumor-like central nervous system demyelinating lesions. Key features of IDP in brain magnetic resonance imaging include open or incomplete ring enhancement, low T2 rim, peripheral diffusion restriction, absent or mild mass effect, and perilesional edema. In brain magnetic resonance spectroscopy (MRS), elevated glutamate, choline, and lactate peaks are observed; however, brain MRS findings can be nonspecific and nondifferentiating. Pathologic findings show prominent perivascular lymphoid infiltrates consisting predominantly of leukocyte common antigen (LCA)+ and PAX5+ B lymphocytes in immunohistochemistry staining, parenchymal and perivascular macrophages (CD68+), some with visible myelin globules on Luxol Fast Blue staining, preferential loss of myelin with relative axonal preservation and the formation of axonal spheroids (swellings), reactive astrocytosis (GFAP+ and ATRX-), and remyelination with thinner myelin sheaths than background axons at the periphery of the plaque. A review of previous case reports revealed that prompt aggressive immunosuppression therapy in the IDP with Marburg-like features may lead to a favorable response. Initiating treatment with a cycle of high-dose corticosteroids followed by rescue immunosuppressive therapy using cyclophosphamide, mitoxantrone, rituximab, or alemtuzumab demonstrated positive outcomes. In addition, maintenance immunosuppressive therapy with B-cell-depleting agents, such as rituximab and ocrelizumab, showed potential for controlling disease activity and improving long-term prognosis.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"9"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of survival outcomes in preemptive versus non-preemptive kidney transplant recipients.","authors":"Firouzeh Moeinzadeh, Shahrzad Shahidi, Raheleh Heidari, Mojgan Mortazavi, Marjan Mansourian, Bahareh Botlani Yadegar","doi":"10.4103/jrms.jrms_122_24","DOIUrl":"10.4103/jrms.jrms_122_24","url":null,"abstract":"<p><strong>Background: </strong>There are conflicting results regarding survival in preemptive versus non-preemptive kidney transplant recipients. The present study aimed to estimate the risk of death in preemptive versus non-preemptive kidney transplant recipients.</p><p><strong>Materials and methods: </strong>In the present retrospective cohort study, all end-stage renal disease (ESRD) patients who underwent kidney transplantation between 1996 and 2021 in referral kidney transplantation centers in Isfahan province were investigated. In total, 499 patients who received dialysis before kidney transplantation (non-preemptive) and 168 patients who received no dialysis before kidney transplantation (preemptive) were included in the final analysis. Data regarding demographic and clinical variables including sex, age, body mass index (BMI), follow-up duration, immunosuppressive regimen change, kidney donor type, underlying causes of ESRD, and comorbidities before and after kidney transplantation were collected.</p><p><strong>Results: </strong>The mean age was 55.47 ± 15.53 years in preemptive and 54.87 ± 14.69 years in non-preemptive patients (<i>P</i> = 0.65). Mortality rates were 24.44/1000 person-years of follow-up for preemptive and 18.25/1000 person-years of follow-up for non-preemptive patients (<i>P</i> = 0.013). In the crude model of Cox regression analysis, preemptive kidney transplant recipients had a significantly higher risk of mortality compared to non-preemptive kidney transplant recipients (hazard ratio [HR] = 1.59; 95% confidence interval [CI]: 1.09-2.33; <i>P</i> = 0.015). However, the association attenuated and became insignificant after adjustment for confounders, including age, BMI, immunosuppressive regimen change, kidney donor type, and comorbidities (HR = 1.35; 95% CI: 0.92-1.99; <i>P</i> = 0.12).</p><p><strong>Conclusion: </strong>The results of the present study indicated that there is no independent association between preemptive kidney transplantation and increased risk of mortality.</p>","PeriodicalId":50062,"journal":{"name":"Journal of Research in Medical Sciences","volume":"30 ","pages":"11"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}