Archives of Iranian Medicine最新文献

{"title":"Lactating Adenoma in Pregnancy: Report of Three Cases.","authors":"Julija Cvetković, Maja Jovičić Milentijević, Nikola Živković, Miodrag Đorđević, Jelena Grujović, Goran Radenković","doi":"10.34172/aim.28751","DOIUrl":"10.34172/aim.28751","url":null,"abstract":"<p><strong>Background: </strong>Lactating adenoma is an infrequent benign stromal breast tumor mostly seen during pregnancy and lactation. This report seeks to enhance the literature by presenting three cases diagnosed with this condition, while also highlighting its histological subtypes, immunohistochemical characteristics, and differential diagnoses. <b>Case Presentation:</b> In all three patients, a circumscribed, painless, and mobile mass was found in the breast in the third trimester of pregnancy. Pathohistological examination revealed hyperplastic lobules with glandular formations in back-to-back arrangements showing more or less abundant hobnailing phenomena with intraluminal eosinophilic secretions and inconspicuous myoepithelial cell layer separated by fibrovascular stroma. The immune profile showed positive reaction for cytokeratin 14 and p40 markers, indicating the presence of myoepithelial cells and distinguishing these cases from other breast lesions.</p><p><strong>Conclusion: </strong>Pathohistological and immunohistochemical analysis should be performed to differentiate these lesions from other benign lesions and malignant tumors.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 2","pages":"124-128"},"PeriodicalIF":1.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588285","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":"A Novel Candidate Gene <i>MACF1</i> is Associated with Autosomal Dominant Non-syndromic Hearing Loss in an Iranian Family.","authors":"Niloofar Bazazzadegan, Mojgan Babanejad, Susan Banihashemi, Sanaz Arzhangi, Kimia Kahrizi, Kevin Ta Booth, Hossein Najmabadi","doi":"10.34172/aim.31746","DOIUrl":"10.34172/aim.31746","url":null,"abstract":"<p><p>Cytoskeletal dynamics, the interplay of actin, microtubules, and septins, is a highly coordinated and tightly regulated process. Defects in the proteins involved can result in a wide range of cellular consequences. Hearing loss is the most common sensory defect and exhibits extraordinary genetic and phenotypic heterogeneity. Currently, there are more than 170 genes casually linked to non-syndromic hearing loss (NSHL), of which more than 60 are associated with autosomal dominant inheritance. Here, we add to this growing number by implicating <i>MACF1</i> (OMIM # 608271), as a novel candidate gene for autosomal dominant non-syndromic hearing loss (ADNSHL). MACF1's cytoskeleton integrator function and hair cell expression pattern lead one to believe that it is a necessary protein for hair cells. Many protein domains in MACF1 allow for dynamic interaction with the cytoskeleton. A large Iranian family segregating progressive ADNSHL was recruited for this study. The proband had bilateral mild-moderate sensorineural hearing loss and was negative for <i>GJB2</i> mutations. After applying exome sequencing on the proband, a missense mutation c.1378C>T (p.His460Tyr) was found in <i>MACF1</i> and co-segregated with the hearing loss in the extended family. We speculated that <i>MACF1</i> mutations probably cause non-syndromic hearing loss inherited in an autosomal dominant manner. The potential functional impact of the identified variant will be investigated through further analysis.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 1","pages":"63-66"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506000","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":"Gastroenteropancreatic Neuroendocrine Tumors: Does Tumor Location Affect Prognosis?","authors":"Mehmet Sait Ozsoy, Cem Ilgin Erol, Muhammet Ali Aydemir, Hakan Baysal, Fatih Buyuker, Hatice Seneldir, Ozgur Ekinci, Tunc Eren, Orhan Alimoglu","doi":"10.34172/aim.33366","DOIUrl":"10.34172/aim.33366","url":null,"abstract":"<p><strong>Background: </strong>Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare entities. Generally, they can be localized anywhere in the gastrointestinal or hepatobiliary tract. The purpose of our study is to evaluate the effect of tumor location on prognosis in patients with GEP-NET undergoing surgery. Our secondary objective is to examine other factors affecting the prognosis of patients with GEP-NET.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 30 patients with GEP-NET who underwent surgery in the General Surgery Clinic between 2012 and 2022. The gNET group (n=18) included tumors located in the gastrointestinal tract, while the pNET group (n=12) included tumors located in the hepatopancreatobiliary system. Surgical, laboratory, radiological, and pathological findings of the patients, as well as follow-up outcomes were recorded and statistically analyzed.</p><p><strong>Results: </strong>In subgroup comparison, tumor size was found to be larger in the pNET group (<i>P</i>=0.002). The statistical analysis of recurrence (16.7% versus 33.3%) and mortality rates (16.7% versus 41.7%) between the subgroups (<i>P</i>=0.329 and <i>P</i>=0.210, respectively) did not reveal a significant difference. When all patients were evaluated, it was observed that advanced age, presence of carcinoma diagnosis, higher tumor grade, advanced TNM stage, larger tumor size, presence of lymphovascular or perineural invasion, elevated mitotic index, higher Ki-67 index, and having received adjuvant therapy increased the rates of recurrence and mortality.</p><p><strong>Conclusion: </strong>There was no statistically significant difference in survival outcomes between the GEP-NET groups located in the gastrointestinal tract and the hepatopancreatobiliary system.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 1","pages":"29-39"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506093","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":"Prognostic Features for Overall Survival in Male Diabetic Patients Undergoing Hemodialysis Using Elastic Net Penalized Cox Regression; A Machine Learning Approach.","authors":"Mehrdad Sharifi, Razieh Sadat Mousavi-Roknabadi, Vahid Ebrahimi, Robab Sadegh, Afsaneh Dehbozorgi, Seyed Rouhollah Hosseini-Marvast, Mojtaba Mokdad","doi":"10.34172/aim.27746","DOIUrl":"10.34172/aim.27746","url":null,"abstract":"<p><strong>Background: </strong>Diabetics constitute a significant percentage of hemodialysis (HD) patients with higher mortality, especially among male patients. A machine learning algorithm was used to optimize the prediction of time to death in male diabetic hemodialysis (MDHD) patients.</p><p><strong>Methods: </strong>This multicenter retrospective study was conducted on adult MDHD patients (2011-2019) from 34 HD centers affiliated with Shiraz University of Medical Sciences. As a special type of machine learning approach, an elastic net penalized Cox proportional hazards (EN-Cox) regression was used to optimize a predictive regression model of time to death. To maximize the generalizability and simplicity of the final model, the backward elimination method was used to reduce the estimated predictive model to its core covariates.</p><p><strong>Results: </strong>Out of 442 patients, 308 eligible cases were used in the final analysis. Their death proportion was estimated to be 28.2%. The estimated overall one-, two-, three-, and eight-year survival rates were 87.6%, 74.4%, 67.2%, and 53.9%, respectively. The EN-Cox regression model retained 14 (out of 35) candidate predictors of death. Five variables were excluded through backward elimination technique in the next step. Only 6 of the remaining 9 variables were statistically significant at the level of 5%. Body mass index (BMI)<25 kg/m² (HR=2.75, <i>P</i><0.001), vascular access type (HR=2.60, <i>P</i><0.001), systolic blood pressure (1.02, <i>P</i>=0.003), hemoglobin (11≤Hb≤12.5 g/dL: HR=3.00, <i>P</i>=0.028 and Hb<11 g/dL: HR=2.95, <i>P</i>=0.021), dialysis duration in each session≥4hour (HR=2.95, <i>P</i><0.001), and serum high-density lipoprotein cholesterol (HDL-C) (HR=1.02, <i>P</i>=0.022) had significant effects on the overall survival (OS) time.</p><p><strong>Conclusion: </strong>Anemia, hypotension, hyperkalemia, having central venous catheter (CVC) as vascular access, a longer dialysis duration in each session, lower BMI and HDL-C were associated with lower mortality in MDHD patients.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 1","pages":"9-17"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506099","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":"Prognostic Impact of Right Ventricular Diastolic Dysfunction in Patients Undergoing Isolated Coronary Artery Bypass Grafting.","authors":"Tahereh Davarpasand, Arezoo Zoroufian, Rezvan Ahmadi Roknabadi, Mohammad Sadeq Najafi, Zahra Karimi, Soheil Mansourian, Amirhossein Poopak, Roozbeh Narimani-Javid","doi":"10.34172/aim.28830","DOIUrl":"10.34172/aim.28830","url":null,"abstract":"<p><strong>Background: </strong>Right ventricular diastolic dysfunction (RVDD) increases the volume load on the right ventricle. We aimed to evaluate the association of RVDD with perioperative outcomes in patients undergoing isolated coronary artery bypass graft surgery (CABG).</p><p><strong>Methods: </strong>This single-center observational study included all consecutive isolated CABG patients with a left ventricular ejection fraction (LVEF)>40% from May 2022 to May 2023 who were evaluated for RV diastolic function by transthoracic echocardiography. We divided patients into two groups, with and without RVDD, and then compared the two groups in terms of the primary outcomes of the duration of hospitalization, intensive care unit (ICU) stay, and intubation time, and the secondary outcome composed of postoperative in-hospital complications.</p><p><strong>Results: </strong>Our study found that 49.1% of patients suffered from RVDD, and patients with RVDD had significantly lower systolic blood pressure and were more likely to take angiotensin-converting enzyme inhibitors than those without RVDD. There was no association between RVDD and primary outcomes of hospitalization time (β=-0.01; 95% CI -0.05, 0.04; <i>P</i> value=0.717), ICU stay (β=0.01; 95% CI -0.18, 0.17; <i>P</i> value=0.984) and intubation time ([β=0.06; 95% CI -0.05, 0.17; <i>P</i> value=0.309). However, more postoperative complications occurred in patients with RVDD (90% vs. 85%). After adjustment for confounding factors, RVDD was not independently associated with primary and secondary outcomes.</p><p><strong>Conclusion: </strong>Preexisting RVDD in CABG patients with LVEF>40% increased postoperative complications but not significantly. More extensive studies are needed to evaluate RV diastolic function before cardiac surgery to identify high-risk patients and optimize their perioperative management.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 1","pages":"18-23"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506115","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":"Efficacy and Safety of Tofacitinib in Lichen Planopilaris: A Retrospective Series of 74 Patients.","authors":"Mehdi Goodarzi, Sahar Dadkhahfar, Faranak Yahyaei, Zahra Razzaghi, Hamideh Moravvej","doi":"10.34172/aim.33237","DOIUrl":"10.34172/aim.33237","url":null,"abstract":"<p><strong>Background: </strong>Lichen planopilaris (LPP) is a rare, inflammatory condition leading to scarring alopecia, predominantly affecting middle-aged women. Traditional treatments have shown limited efficacy, highlighting the need for novel therapeutic approaches. Tofacitinib, a Janus kinase (JAK) inhibitor, has shown promise in treating various autoimmune diseases, including autoimmune dermatological disorders. This study aims to evaluate the efficacy of tofacitinib in treating patients with LPP.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center observational study at Shohadaye Tajrish Hospital, reviewing records of 74 patients with biopsy-confirmed LPP who had extensive and treatment-resistant disease. Patients were treated with tofacitinib 5 mg twice daily for at least 16 weeks. Efficacy was assessed using the LPP Activity Index (LPPAI), and adverse events were monitored.</p><p><strong>Results: </strong>This study evaluated 74 patients with LPP, predominantly female (83.3%), with a mean age of 46.64±8.05 years. The mean LPPAI score significantly decreased from 4.61±1.26 before treatment to 1.73±1.68 after six months (<i>P</i><0.0001). Response rates varied: 21.62% within 1‒3 months, 24.32% within 3‒6 months, 33.78% within 6‒12 months, and 8.10% within 12‒24 months, with 6.75% showing no response. Adverse effects included headache (8.10%), hyperlipidemia (2.70%), elevated liver enzymes (5.40%), nausea (6.75%), and high blood pressure (4.15%).</p><p><strong>Conclusion: </strong>Tofacitinib represents a promising treatment for LPP, providing significant improvement in disease activity for most patients. Further research is needed to refine treatment protocols, understand predictors of response, and address gender-specific adverse effects.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 1","pages":"24-28"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506151","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":"Serum Uric Acid Level and Intraventricular Hemorrhage in Patients with Acute Hemorrhagic Stroke: A Retrospective Observational Study.","authors":"Su Jin Choi, Min Wook So, Sunggun Lee, Seung Won Choi, Doo-Ho Lim","doi":"10.34172/aim.31804","DOIUrl":"10.34172/aim.31804","url":null,"abstract":"<p><p>In contrast to experimental studies indicating the neuroprotective role of uric acid (UA), recent clinical studies have shown that increased UA is associated with a risk of acute hemorrhagic stroke. However, the association of UA with intraventricular hemorrhage (IVH) has not been adequately evaluated. In this study, we determined the relationship between UA and IVH in patients with intracerebral hemorrhage (ICH). We included 721 patients with ICH who were admitted to a tertiary hospital in South Korea. The patients were stratified into quartiles based on their UA levels. IVH decreased continuously across all quartiles of UA. After adjusting for confounding factors, the odds ratio (OR) for IVH was significantly lower in the fourth quartile compared with that in the first quartile (OR: 0.713; 95% CI: 0.546-0.934; <i>P</i>=0.045). In conclusion, UA is independently associated with IVH, suggesting its protective role against IVH in patients with ICH.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 1","pages":"40-43"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506168","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":"Correction: Effects of World War II on Infectious Diseases in the Persian Gulf.","authors":"Mohammad Jafar Chamankar","doi":"10.34172/aim.33705","DOIUrl":"10.34172/aim.33705","url":null,"abstract":"","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 1","pages":"72"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506145","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":"Correction: Breast Cancer Sentinel Lymph Node Detection Rate: First Large Scale Multi-Centric Data for Technetium Phytate.","authors":"Ramesh Omranipour, Mehrshad Abbasi, Newsha Nazarian, Bardia Gholami, Samareh Heydari, Bita Eslami, Alireza Abdollahi, Sadaf Alipour","doi":"10.34172/aim.33700","DOIUrl":"10.34172/aim.33700","url":null,"abstract":"","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 1","pages":"71"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506141","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":"Epstein-Barr Virus Encephalitis as a Cause of Status Epilepticus - A Rare Encounter.","authors":"Ayisha Farooq Khan, Tooba Arshad, Faryal Abdy, Mohammad Wasay","doi":"10.34172/aim.28844","DOIUrl":"10.34172/aim.28844","url":null,"abstract":"<p><p>Epstein-Barr virus (EBV) is associated with infectious mononucleosis and is known to cause various neurological complications, albeit rarely. EBV encephalitis is a rare manifestation, and even rarer is its presentation as status epilepticus. To date, fewer than ten cases of EBV encephalitis presenting as status epilepticus have been reported globally. We report a case of an 18-year-old girl who presented with fever followed by seizures. She went into status epilepticus the next day. Cerebrospinal fluid (CSF) analysis showed lymphocytic predominance. Brain imaging showed bilateral symmetric hyperintense lesions in the caudate and the putamen. EBV IgG and IgM were found to be positive. The patient was treated with ganciclovir and anti-epileptics and she improved gradually. Our case emphasizes the importance of considering EBV encephalitis as a potential cause of status epilepticus, even in individuals without immunodeficiency. Recognizing atypical presentations and appropriate diagnostic investigations can facilitate early diagnosis and treatment initiation.</p>","PeriodicalId":55469,"journal":{"name":"Archives of Iranian Medicine","volume":"28 1","pages":"67-70"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506173","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}