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Non-celiac gluten sensitivity (NCGS) and irritable bowel syndrome (IBS) frequently overlap. Although, gluten-free diet (GFD) and low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) improve the IBS clinical picture, many aspects remain unclear. Therefore, we designed a study to evaluate gluten tolerance, anxiety and quality of life in a specific study population. Fifty IBS patients were asked to follow a low FODMAP strict GFD for 6 weeks and were then randomly allocated to the following groups for a further 6 weeks: (A) receiving 8 g/day of gluten for 2 weeks; gluten-tolerating subjects received 16 g/day for 2 weeks and then 32 g/day for a further 2 weeks; (B) continuing to follow a low FODMAP strict GFD; and (C) receiving a gluten-containing diet. After the first 6 weeks, symptom scores significantly improved. Pain severity, bloating and total score were significantly decreased in the GFD and in the high-gluten groups, while the satiety score significantly increased in group C. Between-group analysis revealed significant differences for pain severity (p = 0.02), pain frequency (p = 0.04) and impact on community function (p = 0.02) at the end of the study. Our findings suggest that low FODMAP strict GFD could be prescribed in IBS patients and would reduce anxiety and improve the quality of life. [ABSTRACT FROM AUTHOR]

Helicobacter pylori as a class I carcinogen is correlated with a variety of severe gastroduodenal diseases; therefore, H. pylori eradication has become a priority to prevent gastric carcinogenesis. However, due to the emergence and spread of multidrug and single drug resistance mechanisms in H. pylori, as well as serious side effects of currently used antibiotic interventions, achieving successful H. pylori eradication has become exceedingly difficult. Recent studies expressed the intention of seeking novel strategies to improve H. pylori management and reduce the risk of H. pylori-associated intestinal and extragastrointestinal disorders. For which, vitamin supplementation has been demonstrated in many studies to have a tight interaction with H. pylori infection, either directly through the regulation of the host inflammatory pathways or indirectly by promoting the host immune response. On the other hand, H. pylori infection is reported to result in micronutrient malabsorption or deficiency. Furthermore, serum levels of particular micronutrients, especially vitamin D, are inversely correlated to the risk of H. pylori infection and eradication failure. Accordingly, vitamin supplementation might increase the efficiency of H. pylori eradication and reduce the risk of drug-related adverse effects. Therefore, this review aims at highlighting the regulatory role of micronutrients in H. pylori-induced host immune response and their potential capacity, as intrinsic antioxidants, for reducing oxidative stress and inflammation. We also discuss the uncovered mechanisms underlying the molecular and serological interactions between micronutrients and H. pylori infection to present a perspective for innovative in vitro investigations, as well as novel clinical implications. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the effects of factors like demographic items, comorbidities, and drug history on the inadequacy of colonic preparation before colonoscopy. Background: Inadequate bowel preparation can lead to lower polyp detection rates, longer procedure times, and lower cecal intubation rates. Methods: This population-based study was conducted on 2476 Iranian adults who were referred to two tertiary centers for elective colonoscopy between 2017 and 2018. Bowel preparation quality was scored by the Boston bowel preparation scale (BBPS). Univariate and multivariate logistic regressions were used to find the independent predictors of bowel preparation inadequacy. Results The results showed that 31.8% of patients had inadequate bowel preparation before their colonoscopy. Higher age, BMI>25, abdominal circumference>95 cm, low fruit consumption, and history of smoking were independently correlated with bowel preparation inadequacy. Additionally, using NSAIDs and SSRIs were correlated with bowel preparation adequacy in multivariate regression analysis. Finally, age, gender, ethnicity, BMI, abdominal circumference, fruit consumption, smoking, NSAIDs, SSRIs, education, constipation, physical activity, and diabetes entered the predictive model of this study. The area under the curve (AUC) reached 0.70 in the final step. Conclusion: The independent risk factors associated with colonic preparation inadequacy were identified, and herein, a predictive model is suggested for identifying patients with a high risk of bowel preparation inadequacy before a colonoscopy so that alternative preparation techniques can be employed among high-risk groups to yield optimal preparation quality. [ABSTRACT FROM AUTHOR]

Background: Since the relation between dietary total antioxidant capacity (DTAC) and the occurrence of gallstone disease (GSD) remains unclear, we conducted, for the first time, a case-control study to clarify this association in the Iranian population. Methods: In the present case-control study, convenience Sampling was performed. A total of 600 participants (300 case and 300 control) were included. Anthropometric, demographic, physical activity, and nutrient intakes data were obtained from each subject. DTAC was calculated using the US Department of Agriculture's database. The odds ratio (OR) and 95% confidence intervals were assessed using unconditional logistic regression. Results: The participants in the highest quartile of DTAC had a significantly lower OR for gallstone than the lowest quartile, which remained significant after further adjustment for age, sex, and education (model 2: OR, 0.34; 95% CI, 0.16-0.71). In addition, after adjustment for age, sex, education, BMI, physical activity, and energy, the results revealed that participants with the highest quartile of DTAC had 71% lower odds of gallstone than those with the lowest quartile (model 3: OR, 0.29; 95% CI, 0.11-0.78). Conclusions: The results of the present study demonstrated that the DTAC had an inverse association with GSD incident. However, interventional approaches are needed to confirm the relation between DTAC and GSD prevention. [ABSTRACT FROM AUTHOR]

The right ventricle has long been perceived as the "low pressure bystander" of the left ventricle. Although the structure consists of, at first glance, the same cardiomyocytes as the left ventricle, it is in fact derived from a different set of precursor cells and has a complex three-dimensional anatomy and a very distinct contraction pattern. Mechanisms of right ventricular failure, its detection and follow-up, and more specific different responses to pressure versus volume overload are still incompletely understood. In order to fully comprehend right ventricular form and function, evolutionary biological entities that have led to the specifics of right ventricular physiology and morphology need to be addressed. Processes responsible for cardiac formation are based on very ancient cardiac lineages and within the first few weeks of fetal life, the human heart seems to repeat cardiac evolution. Furthermore, it appears that most cardiogenic signal pathways (if not all) act in combination with tissue-specific transcriptional cofactors to exert inductive responses reflecting an important expansion of ancestral regulatory genes throughout evolution and eventually cardiac complexity. Such molecular entities result in specific biomechanics of the RV that differs from that of the left ventricle. It is clear that sole descriptions of right ventricular contraction patterns (and LV contraction patterns for that matter) are futile and need to be addressed into a bigger multilayer three-dimensional picture. Therefore, we aim to present a complete picture from evolution, formation, and clinical presentation of right ventricular (mal)adaptation and failure on a molecular, cellular, biomechanical, and (patho)anatomical basis. [ABSTRACT FROM AUTHOR]

Aim: The present study was performed on patients with large bile duct stones to compare clinical outcomes and complications of balloon dilatation treatment between two sizes of balloons, < 15 mm and ≥ 15 mm. Background: in 1982, the endoscopic papillary balloon dilatation (EPBD) method was presented by Staritz to reduce bleeding and perforation risk of large bile duct stones. Methods: Patients with large bile duct stones admitted to Taleghani hospital from December 2018 to December 2019 who were the candidates for balloon dilation with limited sphincterotomy. Patients were randomly divided into two groups. In group B, a ≥ 15 mm balloon was used, and in group A, a balloon <15 mm was used. The clinical results of balloon dilation and its complications were recorded and compared. Results: Most patients had 1 or 2 large bile duct stones, and there was no significant difference in the number of stones. Extraction was successful in 92.8% of group B and 85.7% of group A without significant differences (P = 0.8). Pancreatitis, hemorrhage, cholangitis, and perfusion occurred in 8%, 4.2%, 1.4%, and 2.8% of group B subjects and also in 10%, 2.8%, 0%, and 1.4% of group A subjects, respectively, and the difference between the two groups was not significant. Conclusion: Generally, this study results showed that balloon size did not have a significant effect on the success rate of bile duct stones. Moreover, considering the lack of significant association between balloon dilatation size and the occurrence of post-endoscopic complications such as pancreatitis, it seems that large-size dilatation has no serious clinical risk. [ABSTRACT FROM AUTHOR]

Objectives: Colorectal cancer (CRC) is the third and second most prevalent cancer in men and women, respectively. Various epidemiological studies indicated that dietary factors are implicated in the aetiology of CRC and its precursor, colorectal adenomas (CRA). Recently, much attention has been given to the role of acid-base balance in the development of chronic diseases including cancers. Therefore, the aim of the current study is to examine the association of diet-dependent acid load and the risk of CRC and CRA.Design: In this case-control study, potential renal acid load (PRAL) was computed based on dietary intake of participants assessed via a validated FFQ. Negative PRAL values indicated a base-forming potential, while positive values of PRAL implied acid-forming potential of diet. Logistic regression was used to derive OR and 95 % CI after adjusting for confounders.Setting: Tehran, Iran.Participants: A total of 499 participants aged 30-70 years were included in the study (240 hospital controls, 129 newly diagnosed CRC and 130 newly diagnosed CRA). The current study was conducted between December 2016 and September 2018.Results: After adjusting for potential confounders, a higher PRAL was associated with increased odds of CRC and CRA. The highest v. the lowest tertile of PRAL for CRC and CRA was OR 4·82 (95 % CI 2·51-9·25) and OR 2·47 (95 % CI 1·38-4·42), respectively.Conclusions: The findings of the current study suggested that higher diet-dependent acid load is associated with higher risk of CRC and CRA. [ABSTRACT FROM AUTHOR]

Designation of the local profile of Clarithromycin resistant (CAM-R) in Helicobacter pylori (H. pylori) positive patients with phenotypic testes consequently evaluation of probable agreement between resistance phenotypes to genotypes is the necessity of accessing rapid molecular noninvasive tests. So, we designed ASP-PCR and PCR-sequencing methods to evaluate infB (G160A), and 23S rRNA (A2142C/G, A2143C/G) and rpl22 (GTG deletion or TTCCATGTA insertion) nucleotide polymorphisms from stool of patients with symptoms of gastritis. Urea tubes were used to transport 96 gastric biopsies to the laboratory. Methods. Agar dilution method was performed to assess CAM-R strains. Besides the phenotypical identification, stool samples were collected and stored at -80° C. Molecular identity was characterized by amplification of 23S rRNA target gene. In evaluation of noninvasive genotypical molecular tests in detection of corresponded mutations, ASP-PCR was performed to isolate infB G160G wild-type strains and PCRsequencing in determining 23S rRNA and rpl22 polymorphisms. Results. Molecular isolation of H. pylori positive-patients was reported to be 34/54(62%). Among 35/96 (36%) phenotypically characterized H. pyloripositive infected patients,16/35(45%) were considered for CAM-R strains. Distribution of point mutations between resistant isolates have been revealed to be (1/16) for A2143C, (4/16) for infB G160A (PCR negative patients), (2/16) rpl22 for 3bp deletion, and (16/16) for rpl22 9bp insertion. Conclusion. We are honored to introduce rpl22-related point mutations as the potential marker in designing noninvasive molecular method in Clarithromycin resistant infected patients screening. [ABSTRACT FROM AUTHOR]

The pathogenesis of inflammatory bowel disease (IBD) is influenced by immune system malfunction, particularly innate immune receptors such as toll-like receptors. Furthermore, it is critical to investigate the extremely close association between viruses and IBD incidence .Toll-like receptors (TLRs) 3, 5, and 7 are involved in antiviral immune responses. Finding a relationship between TLR-related virus and IBD is important not only for understanding the disease pathogenesis, but also for developing effective therapies. It has been shown that influenza is expressed more severely in patients with IBD who use immune system inhibitors, and the influenza vaccine is less effective in these patients. In dendritic cells, TLR7 and TLR8 regulate the production of interferons (IFNs) and inflammatory mediators. COVID-19 causes the production of IL-6, possibly due to the induction of TLR pathways. TLR activation by SARS-CoV-2 causes inflammation and IL-1 production, which induces the production of IL-6. Understanding TLR-associated viruses' molecular mechanisms can greatly help improve the quality of life of people with IBD. Therefore, the present study reviewed the role of TLR7, 8, and 3 in inflammatory bowel disease as well as their association with viral infections and evaluated different antagonists for the treatment of IBD. [ABSTRACT FROM AUTHOR]

Aim: Search for SMAD4 mutations in Colorectal cancer (CRC) or polyp in Iran. Background: Colorectal cancer is one of the five prevalent cancers among the Iranian population; however, its molecular mechanisms are not fully understood. The vast majority of CRCs arise from neoplastic polyp Methods: Colorectal cancer and polyp lesions with matched normal tissues from patients who had undergone colonoscopy in Taleghani Hospital (January 2009 - November 2010) were included in the study. DNA extraction and PCR-sequencing for exons 511 of the SMAD-4 gene were carried out on 39 and 30 specimens of polyp and adenocarcinoma, respectively. Results Of cancer and polyp specimens, 33.3% and 28.2%, respectively, were mutated in the Smad-4 gene. The majority of SMAD4 mutations, especially in the MH2 domain were missense mutations (63.6% and 68.75, respectively). In cancer, codon 435 and in polyp, codons 435 and 399 were the most common alterations. Unlike cancer specimens, transversion was found frequently in the polyp (56.25% vs. 35.7%). CG>TA transition was about 18.75% and 14.3% in cancer and polyp samples, respectively. Mutations of codon 264 and C.483-4 were seen both in cancer and neoplastic polyps. Conclusion: As frequent alterations, missense mutations are presumably selected during tumorigenesis and polyposis due to their structural impacts on SMAD4 functions and TGF-β signaling pathway. The lower frequency of CG>TA can be attributed to global genome hypomethylation. Presumably, SMAD4 mutations had occurred in the primary polyps, and some of these mutated cells then developed into carcinoma. On the other hand, polyp-specific mutations may lower the risk of CRC. [ABSTRACT FROM AUTHOR]

Background: Nursing is one of the most important areas of medical sciences whose developments including its scientific publications can influence health care. Therefore, the aim of this study was to investigate nursing articles published from 2013 to 2018, and to provide a comprehensive view of common topical clusters in this research area. Materials and Methods: In this practical research, bibliometrics method and co-word analysis technique are used. The study population included all the articles in nursing area indexed in Web of Science from 2013 to 2018. The bibliometrics software, including BibExcel, UCINET, and SPSS was used to analyze the data. Results: Results indicated that the most frequently used nursing words in nursing research articles were "Quality of life," "Aged," "Education," and "Nursing." Moreover, the pairs such as "Anxiety"Depression", "Education, Nursing-Students, Nursing" and "Depression-Quality of life" were the most frequent co"occurrences. The use of hierarchical clustering led to the formation of seven topical clusters in Nursing: "Nursing care for the Aged," "Self-care," "Physical, emotional, and social support, "Mother and child health," "Preventing nursing care," "Nursing profession Research," and "Quality of nursing care." Conclusions: The growth of nursing scientific productions is an indicative of the importance of this subject area in healthcare services; however, there is no balanced growth in various subjects. [ABSTRACT FROM AUTHOR]