Background Different techniques in neuroimaging have been proposed for assessment of olfactory dysfunction but they are not without limitations. Recently, some studies showed the usefulness of single photon emission–computed tomography (SPECT) in evaluation of patients with posttraumatic anosmia. This study was designed to assess the possible diagnostic value of SPECT findings in patients with posttraumatic anosmia in comparison with magnetic resonance imaging (MRI)/CT imaging. Methods Sixteen patients who had head trauma and consequently anosmia, which was defined according to Cain's identification test, were included in this study. Two nonanosmic groups, traumatic patients and nontraumatic healthy individuals, were selected as control groups for this study. Qualitative and semiquantitative brain perfusion SPECT was performed by measuring the uptake ratio of the orbital frontal cortex to occipital pole in the sagittal projections (uptake index). All 16 target patients had a previous CT scan and/or MRI. Semiquantitative and qualitative brain perfusion SPECT were compared with radiological imaging. Results Semiquantitative assessment of brain perfusion SPECT revealed remarkable orbital frontal hypoperfusion as compared with two control groups. 87.5% of anosmic patients showed orbital frontal hypoperfusion (≥2 SD below the lowest level in healthy controls). In addition, the semiquantitative SPECT method detected more orbitofrontal abnormality than the qualitative method or radiological imaging (MRI and/or CT). Conclusion Findings suggest that by using SPECT, posttraumatic anosmia corresponds to the hypoperfusion in the orbital frontal cortex in a great number of patients. Because of its availability, rather low cost, technical ease, and possibility to obtain objective quantitative information, brain perfusion SPECT can be complementary to other diagnostic techniques in the evaluation of olfactory function, although additional neurophysiological and imaging studies are needed.
Insulin resistance is a measure of metabolic stress in the perioperative period. Before now, no clinical trial has determined the summative effects of glutamine, L-carnitine, and antioxidants as metabolic conditioning supplements in the perioperative period.The purpose of this study was to determine the effects of a new conditioning supplement on perioperative metabolic stress and clinical outcomes in non-diabetic patients.In this randomized controlled trial, 89 non-diabetic patients scheduled for coronary artery bypass grafting, with ejection fractions above 30%, were selected. Using the balanced block randomization method, the patients were allocated to one of four study arms: 1) SP (supplement/placebo): supplement seven days before and placebo 30 days after the surgery; 2) PS: placebo before and supplement after the surgery; 3) SS: supplement before and after the surgery; and 4) PP: placebo before and after the surgery. The supplement was composed of glutamine, L-carnitine, vitamin C, vitamin E, and selenium, which was manufactured for the first time by this research team. Five blood samples were drawn: seven days preoperatively, at the entrance to the operating room, while leaving the operating room, seven days postoperatively, and 30 days postoperatively. Levels of glucose, insulin, and HbA1c were measured in blood samples. Insulin resistance and sensitivity were calculated using a formula. Surgical complications were assessed 30 days postoperatively. Data analysis was done using one-way ANOVA, the Chi-square test, and a general linear model repeated-measures analysis with Bonferroni adjustment.Blood glucose levels were increased postoperatively in the four groups (< 0.001), but a significantly higher increase occurred in the PP group compared to the SP (0.027), PS (0.026), and SS (0.004) groups. The superficial wound infection rate was significantly different between the four groups (0.021): 26.08% in PP, 9.09% in SP, 4.54% in PS, and 0% in SS.Our new metabolic conditioning supplement, whether given pre- or postoperatively, led to better perioperative glycemic control and decreased postsurgical wound infections in non-diabetic patients.
Adrenal lesions are commonly observed during 18F-FDG PET/CT studies. Although, most of these lesions are considered benign, an important consideration in oncologic patients is metastasis. Benign lesions, such as adenomas usually present with low 18F-FDG uptake, although overlap with malignant lesions exist and clear SUV cut-off for distinguishing adrenal adenomas has not been established. Different criteria have been proposed to further characterize adrenal lesions, as benign or metastatic. Conventional imaging modalities have additional value when the degree of uptake is equivocal. In this review, we go through some of the common adrenal lesions, as well as discerning features that favor either benign or malignant etiology.
The aim of this study was to evaluate the relationship between breakfast pattern and short-term memory in guidance-school students. Memory improves for subjects who have eaten breakfast. It appears that breakfast consumption influences cognition via several mechanisms. What children eat for breakfast before going to school is very important. A total of 150 junior high school girls were taken from a subject pool in four schools in Shiraz (capital of the Fars Province in Iran). They filled out the socio-economic questionnaires as well as food frequency questionnaires for breakfast and provided two-three day breakfast records in two different seasons and their short-term memories were evaluated by Weksler test socio-economic conditions and dietary intakes were analyzed. The results of the study showed that there was no correlation between parents job, students mean age and their school grades with their memory scores. Dietary analysis demonstrated a negative correlation between local soup consumption in breakfast and memory scores. Food record analysis showed no correlation between fat, cholesterol, protein, vitamin B6, B12, calorie and iodine intake in breakfast and memory scores, but there was a positive correlation between carbohydrate, iron and vitamin B3 intake in breakfast and memory scores, similarly there was a positive correlation between B12 intake in the breakfast and students' average school grades during the year.
Background: Whey protein can improve quality of life and vitamin E can reduce oxidative stress. Due to the reduced quality of life in hemodialysis patients, this study was conducted to evaluate the effect of whey beverage fortified with vitamin E on quality of lifein hemodialysis patients.
Methods: Ninety two 17 to 65 years old patients who were on hemodialysis were randomly assigned to four groups of (i) 1 receiving whey beverage fortified with vitamin E, (ii) 2 receiving whey beverage, (iii) 3 receiving vitamin E, and (iv) 4 as the control group receiving no intervention. SF-12 questionnaire was used for assessing quality of life in the participants.
Results:Bodily pain score improved significantly in group 3 while, a significant decline was seen for bodily pain in control group. An improvement was seen in groups 1 and 2. Physical health showed a significant improvement in group 1. Considering social functioning scores, improvement in whey beverage and vitamin E groups was seen. An improvement of quality of life in whey beverage fortified with vitamin E was noticed.
Conclusion: Whey protein and vitamin E were shown to reduce oxidative stress and their effect on neurotransmitters in brain such as serotonin and dopamine leads to improvement in quality of life in hemodialysis patients. Doing longer studies with questionnaires such as SF-36, may help precise investigation of whey protein and vitamin E effects on quality of life of hemodialysis patients.
To date a few studies have focused on the possible effects of subclinical hyperthyroidism on bone metabolism, showing conflicting results. This study was designed to evaluate this possibility. Sixty-six patients, 22 pre-menopausal women, 33 post-menopausal women and 11 men, who had received iodine-131 ((131)I) ablation postoperatively for well differentiated thyroid carcinoma (WDTC) and were treated for a long term with levothyroxine (T(4)), entered the study and were compared with sixty-six healthy controls individually matched to the patients for age, gender and menopausal status. The bone mineral density (BMD) of lumbar and hip regions of the patients was measured, while on the T(4) suppressive treatment, with average duration of 14.93+/-2.17 months after initiation of the T(4) suppressive treatment and was compared with the BMD of healthy controls. All patients were in the subclinical hyperthyroid state, while all controls were serologically and clinically euthyroid. Our results show that there was no significant difference in BMD measured at the lumbar spine of patients and controls in any subgroup (P>0.05). Analysis of the data of BMD from the hips in men, premenopausal women and controls, also revealed no difference. It was noted that the mean BMD of the femur in the postmenopausal women were at the statistical limit of significance as compared to the control group (P=0.05). In conclusion, our findings indicate that the replacement dose of T(4) in WDTC patients after (131)I ablation, does not have a significant effect on BMD in men, in pre and post-menopausal women and hence on the risk of osteoporosis. In post-menopausal women, the mean femoral BMD was at the limit of statistical significance.
Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide. This underlies the need to evaluate different targets, such as diet quality. In this regard, we conducted the present study to find whether the healthy eating index-2015 (HEI-2015) score is associated with a 10-year risk of CVDs based on Framingham Risk Score (FRS) and QRISK3 in different body mass index (BMI) groups.This cross-sectional study was performed based on Shiraz University of Medical Sciences Employees Health Cohort Study (SUMS EHCS) data in April 2020. A total of 764 participants met the inclusion criteria. An expert performed demographic, anthropometric, and dietary evaluations. A semi-quantitative food frequency questionnaire (FFQ) was applied to assess the diet quality, and FRS and QRISK3 were used to evaluate the 10-year risk of CVDs.Based on the results, many components of HEI-2015 indicated an increasing trend through quartiles (p < 0.001). However, the consumption of refined grains in higher quartiles showed a decreasing trend (p < 0.001). The consumption of added sugar and saturated fatty acids (SFAs) in higher quartiles revealed an increasing trend (p < 0.001). In addition, lower HEI-2015 scores and lower whole grain consumption were significantly associated with higher BMI (p < 0.05). Also, lower consumption of fruits showed a significant relationship with higher risk scores of Framingham and QRISK3 (p < 0.05). Higher added sugar and SFAs intake was significantly related to lower FRS (p < 0.05). A significant reverse association between HEI-2015 and QRISK3 and Framingham risk scores was seen (p < 0.05).Our findings support dietary recommendations to increase fruit and whole grains intake to prevent CVD and obesity. Moreover, a significant inverse association between HEI-2015 and QRISK3 and Framingham risk scores was observed. Since the results for added sugars and SFA intakes were controversial, further studies are needed.
Background: Normal-weight obesity (NWO), defined as normal body mass index (BMI) but high body fat, is related to chronic health conditions. This study aims to assess the prevalence of NWO and some possible relationships with dietary factors in an Iranian population. Methods: A cross-sectional study was conducted on the participants of the Employees Health Cohort Study, Shiraz, Iran. Based on the anthropometric assessments, participants were categorized into three groups: Normal-weight non-obese, NWO, and Overweight/Obese. NWO was defined as having a normal BMI but high body fat. Body fat was assessed by bioelectrical impedance analysis. Then, a 116-item semi-quantitative Food Frequency Questionnaire (FFQ) was used to obtain food intake. Dietary factors included energy intake, macro-nutrients intake, frequency of meals, fried and grilled foods’ consumption, and salt intake. Results: Overall, 1038 participants (513 men and 525 women) were studied with a mean age of 41.04±6.98. 35.9% had normal weight and 63.0% were overweight or obese according to BMI criteria. Based on WHO criteria, the prevalence of NWO was 21.68% and 26.63% among men and women, respectively. Women were more likely to have excess body fat compared with men (P<0.001). Moreover, no significant relationship was observed between any dietary factor and NWO. Conclusions: NWO was prevalent among university employees, and no relationship was observed between dietary factors and NWO. Considering the high cardio-metabolic risk of this condition, it needs further attention.
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