RESUMEN

Wound healing consists of a series of highly orderly overlapping processes characterized by hemostasis, inflammation, proliferation, and remodeling. Prolongation or interruption in each phase can lead to delayed wound healing or a non-healing chronic wound. Vitamin A is a crucial nutrient that is most beneficial for the health of the skin. The present study was undertaken to determine the effect of vitamin A on regeneration, angiogenesis, and inflammation characteristics in an in vitro model system during wound healing. For this purpose, mouse skin normal fibroblast (L929), human umbilical vein endothelial cell (HUVEC), and monocyte/macrophage-like cell line (RAW 264.7) were considered to evaluate proliferation, angiogenesis, and anti-inflammatory responses, respectively. Vitamin A (0.1-5 µM) increased cellular proliferation of L929 and HUVEC (p < 0.05). Similarly, it stimulated angiogenesis by promoting endothelial cell migration up to approximately 4 fold and interestingly tube formation up to 8.5 fold (p < 0.01). Furthermore, vitamin A treatment was shown to decrease the level of nitric oxide production in a dose-dependent effect (p < 0.05), exhibiting the anti-inflammatory property of vitamin A in accelerating wound healing. These results may reveal the therapeutic potential of vitamin A in diabetic wound healing by stimulating regeneration, angiogenesis, and anti-inflammation responses.

Asunto(s)

Neovascularización Fisiológica , Vitamina A , Animales , Células Endoteliales de la Vena Umbilical Humana , Humanos , Ratones , Piel , Cicatrización de Heridas

RESUMEN

OBJECTIVE: Diabetic foot ulcers (DFU) are often hard-to-heal, despite standard care. With such a complicated healing process, any advanced wound care to aid healing is recommended. Chitosan/collagen composite hydrogel materials have the potential to promote the regenerative process. In this study, the efficacy of a new collagen matrix dressing including chitosan/collagen hydrogel was compared with a standard dressing of saline-moistened gauze for wound healing in patients with a hard-to-heal neuropathic DFU. METHOD: This is an open labelled, randomised clinical trial. After conventional therapy consisting of debridement, infection control and offloading, patients were randomly allocated to receive either a collagen matrix dressing (the study group, receiving Tebaderm manufacturer) or a saline-moistened gauze dressing (control group) for wound care. The reduction in DFU size and the number of patients with complete healing were measured throughout the treatment and in follow-up. RESULTS: A total of 61 patients with a neuropathic DFU were recruited. Average percentage reduction in DFU size at four weeks was greater in the study group compared with the control group (54.5% versus 38.8%, respectively). Rate of complete healing rate at 20-weeks' follow-up was significantly better in the study group than the control group (60% versus 35.5%, respectively). CONCLUSION: The collagen matrix dressing used in this study accelerated the healing process of patients with a hard-to-heal DFU. Further research may suggest the used of this dressing to shorten the length of time to achieve complete healing.

Asunto(s)

Colágeno/administración & dosificación , Diabetes Mellitus Tipo 2 , Pie Diabético/terapia , Vendajes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento , Cicatrización de Heridas

RESUMEN

The radiomodulatory effect of photobiomodulation (PBM) has recently been studied in cancer cells. The aim of this study was to investigate cellular mechanisms involved in the X-ray radiosensitivity of HeLa cells pre-exposed to PBM. HeLa cells were irradiated with 685 nm laser at different energy densities prior to X-ray ionizing radiation. After irradiation, clonogenic cell survival, cell death due to apoptosis and autophagy were determined. Levels of intracellular reactive oxygen species (ROS), DNA damage and, cell cycle distribution after PBM were measured. PBM at different energy densities (5-20 J/cm2 ) was not cytotoxic. However, HeLa cells pre-exposed to 20 J/cm2 showed enhanced inhibition of colony formation following ionizing radiation. Enhanced radiosensitivity was due to increased oxidative stress, DNA damage, and radiation-induced apoptosis and autophagy. These results suggest that 685 nm PBM at a higher energy density could possibly be a promising radiosensitizing agent in cervical cancer, to decrease the radiation dose delivered, and therefore prevent the side-effects that are associated with cancer radiotherapy.

Asunto(s)

Apoptosis/efectos de la radiación , Autofagia/efectos de la radiación , Luz , Tolerancia a Radiación/efectos de la radiación , Neoplasias del Cuello Uterino/patología , Puntos de Control del Ciclo Celular/efectos de la radiación , Daño del ADN , Femenino , Células HeLa , Humanos , Estrés Oxidativo/efectos de la radiación

RESUMEN

OBJECTIVES: Regulation of pro-inflammatory factors such as TNF-α which are secreted by the immune cells through induction of their several receptors including dopamine receptors (especially DRD2 and DRD3) is one of the noticeable problems in diabetic severe foot ulcer healing. This study was conducted to evaluate the alteration of TNF-αin plasma as well as DRD2 and DRD3 changes in PBMCs of diabetics with severe foot ulcers. MATERIALS AND METHODS: Peripheral blood samples were collected from 31 subjects with ulcers, 29 without ulcers, and 25 healthy individuals. Total mRNA was extracted from PBMCs for the study of DRD2, DRD3, and TNF-α gene expression variations. Expression patterns of these genes were evaluated by real-time PCR. Consequently, concentration of TNF-α was investigated in plasma. RESULTS: Significant decrease in gene expression and plasma concentration of TNF-α in PBMCs was observed in both patient groups at P<0.05. These diminutions are correlated to the decrease in the expression of both DRD2 and DRD3 in PBMCs of both patient groups. Also, the same relationship is present between expressions of two new DRD3 transcripts with TNF-α downturn. CONCLUSION: We concluded that DRD2 and DRD3 expression alteration and presence of new DRD3 transcripts can be effective in reduction of TNF-α expression as a pro-inflammatory factor. Performing complementary studies, may explain that variations in DRD2 and DRD3 are prognostic and effective markers attributed to the development of diabetes severe foot ulcers.

RESUMEN

OBJECTIVE: The aim of this study was to investigate the radiomoulatory effects of low-level laser irradiation (LLLI) in normal and cancer cells exposed to ionizing X-ray radiation on clonogenic survival assay. BACKGROUND DATA: LLLI does have radioprotective effects on normal tissue. LLLI can reduce the incidence of mucocutaneous complications of ionizing radiation. Few in vitro studies reported adaptive responses for LLLI to ionizing radiation in normal and cancer cells, particularly with respect to clonogenic cell survival assay. METHODS: Normal NIH 3T3 cells and cancer HeLa cells were irradiated with 685 and 830 nm LLLI at different energy densities prior to ionizing X-ray radiation. The survival fraction was determined after ionizing radiation (0, 2, 4, and 6 Gy). The values of the linear (α) and quadratic (ß) parameters were calculated based on the clonogenic survival curves. RESULTS: Clonogenic radiation survival assay showed that the application of LLLI at 685 nm prior to ionizing radiation could significantly inhibit clonogenic growth of HeLa cells compared with unirradiated HeLa cells. LLLI could also significantly increase the α parameter of the linear quadratic (LQ) model. In contrast, application of LLLI at 830 nm could significantly protect NIH 3T3 cells against radiation and decreased α parameter. CONCLUSIONS: This study suggests that various physical parameters of LLLI can be diverse adaptive responses to ionizing radiation on normal and cancer cells.

Asunto(s)

Supervivencia Celular/efectos de la radiación , Radiación Ionizante , Línea Celular Tumoral , Relación Dosis-Respuesta en la Radiación , Humanos

RESUMEN

BACKGROUND: Resistance of bacteria against antibiotics and antimicrobials is arising worldwide and there is an urgent need for strategies that are capable of inactivating biofilm-state pathogens with less potential of developing resistance in pathogens. A promising approach could be photodynamic inactivation (PDI) which uses light in combination with a photosensitizer to induce a phototoxic reaction. In this study, we evaluated the in vitro phototoxic effect of hypericin (HYP) alone and in combination with acetylcysteine (AC) on Staphylococcus aureus biofilms. AC, a mucolytic agent, reduces the production of extracellular polysaccharide matrix while promoting the disruption of mature biofilm. METHODS: In vitro phototoxic effect of HYP alone (0.5 µg/ml, light dose: 16 J/cm(2)), and in combination with AC (10 mg/ml) on ten clinical S. aureus isolates and S. aureus (ATCC 25923) biofilms was studied. Effect of HYP concentration (0.5 µg/ml) and light dose (8 J/cm(2)) on PDI of all eleven S. aureus strains in planktonic forms was also investigated. RESULTS: HYP-PDI did not result in a reduction in viable count for each of the strains when grown in biofilms. However, HYP-PDI applied on biofilms treated with AC was able to disrupt pre-formed biofilms (viable count reduction ranging from 5.2 to 6.3 log10-unit in comparison to controls in all tested strains). A 6.5 log killing was obtained for S. aureus (ATCC 25923) planktonic cells treated with 0.5 µg/ml at 8 J/cm(2). For this set of PDI parameters, ten clinical S. aureus isolates showed 5.5-6.7 log killing. CONCLUSION: HYP-PDI in combination with AC had significant ability to eradicate the pre-formed mature biofilms of S. aureus strains.

Asunto(s)

Acetilcisteína/farmacología , Biopelículas/efectos de los fármacos , Perileno/análogos & derivados , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/farmacología , Staphylococcus aureus/efectos de los fármacos , Acetilcisteína/administración & dosificación , Antracenos , Quimioterapia Combinada , Perileno/administración & dosificación , Perileno/farmacología , Fármacos Fotosensibilizantes/administración & dosificación , Polisacáridos Bacterianos/metabolismo

RESUMEN

BACKGROUND: Photodynamic therapy (PDT) is a relatively novel modality for the treatment of cancer and some non-malignant lesions. PDT uses a photosensitive drug and light to destroy malignant cells. The aim of this study was to determine in vitro efficacy of Radachlorin-based PDT (Radachlorin-PDT) on human hepatocellular carcinoma (HCC). METHODS: The study used human liver cancer cells (HepG2) and normal liver cells (HFLF-PI4) to evaluate cell viability using the standard 2-(4, 5-dimethyl-2-thiazolyl)-3,5-diphenyl-2H-tetrazolium bromide (MTT) assay. The mechanism of cell death following Radachlorin-PDT was determined by DNA agarose gel electrophoresis and flow cytometry. RESULTS: Radachlorin without light irradiation had no toxic effect on HepG2 and HFLF-PI4 cells. Cell survival of HepG2 and HFLF-PI4 cells were decreased following PDT in a concentration-dependent manner. However, HepG2 cells were much more sensitive to Radachlorin-PDT than HFLF-PI4 cells. Radachlorin LD50 on HepG2 cells was 30µg/ml and 20µg/ml, 24h after exposure to doses of 5J/cm(2) and 15, or 25J/cm(2), respectively. Optimal Radachlorin and light dose to kill HepG2 cells with minimal effects on normal HFLF-PI4 cells were 100µg/ml and 15J/cm(2), respectively. Our results also showed that apoptosis is induced in HepG2 cells following Radachlorin-PDT. CONCLUSION: Our in vitro data suggest that the use of PDT with Radachlorin can be effective in the treatment of HCC.

Asunto(s)

Apoptosis/efectos de los fármacos , Fármacos Fotosensibilizantes/toxicidad , Porfirinas/toxicidad , Apoptosis/efectos de la radiación , Carcinoma Hepatocelular/tratamiento farmacológico , Línea Celular , Supervivencia Celular/efectos de los fármacos , Supervivencia Celular/efectos de la radiación , Combinación de Medicamentos , Células Hep G2 , Humanos , Luz , Neoplasias Hepáticas/tratamiento farmacológico , Fotoquimioterapia , Fármacos Fotosensibilizantes/química , Fármacos Fotosensibilizantes/uso terapéutico , Porfirinas/química , Porfirinas/uso terapéutico

RESUMEN

OBJECTIVE: The purpose of this study was to evaluate the effects of low-level laser irradiation (LLLI) on the in vitro growth characteristics and in vivo pathogenicity of Candida albicans in a murine model in the absence of a photosensitizer. BACKGROUND DATA: C. albicans is an opportunistic commensal organism that causes a wide variety of diseases in human beings, ranging from superficial infections to life-threatening invasive candidiasis. The incidence of C. albicans infection is increasing, because of the greater frequency of acquired immunodeficiency conditions. A high recurrence rate has been reported for vulvovaginal and oral candidiasis, despite the best available treatments. Therefore, the search for new treatment modalities seems quite rational. METHODS: Candida culture plates were exposed to common clinical energies of LLLI: 3, 5, 10, and 20 J at 685 nm (BTL Laser 5000, Medicinos Projektai, Czech Republic, Prague, max power output 50 mW) and 3, 5, 10, 30, and 50 J at 830 nm (BTL Laser 5000, Medicinos Projektai, Czech Republic, Prague, max power output 400 mW). RESULTS: Following LLLI with energies >10 J at both 685 and 830 nm wavelengths, statistically significant effects were observed in vitro on the turbidimetric growth kinetics of C. albicans and in vivo on the survival rate of infected mice (p value ≤ 0.05). Therefore, this energy could be considered a threshold for clinical investigation. CONCLUSIONS: Translating our data into the clinical setting, it can be proposed that a direct laser-based approach without using a photosensitizing dye can significantly reduce the pathogenicity of Candida albicans. It can also be concluded that laser light at specific wavelengths could be a possible promising novel treatment for superficial and mucocutaneous C. albicans infections.

Asunto(s)

Candida albicans/patogenicidad , Terapia por Luz de Baja Intensidad , Animales , Candida albicans/efectos de la radiación , Candidiasis/radioterapia , Femenino , Ratones Endogámicos BALB C , Dosis de Radiación

RESUMEN

BACKGROUND: Hypericin (HYP) is a natural photosensitizer considered for the new generation of photodynamic therapy (PDT) drugs. The aim of this study was to evaluate the in vitro bactericidal effect of HYP-PDT on four bacterial species, assessing its photocytotoxicity to primary human fibroblasts to determine possible side effects. METHODS: Effect of photosensitizer concentration (0.1, 0.3, 0.6, and 1 µg/ml) and light irradiation time (3, 5, 10 min) on photodynamic inactivation of microorganisms and primary human fibroblasts was investigated. RESULTS: A 6.3 log killing was obtained for Staphylococcus aureus (ATCC 25923) treated with 1 µg/ml at 48 J/cm². For this set of PDT parameters, Enterococcus faecalis (ATCC 11700) showed 6.5 log killing, Escherichia coli (ATCC 25922) 6.2 log killing, and Pseudomonas aeruginosa (ATCC 27853) 0.7 log killing. Fibroblasts can be preserved by keeping the HYP concentration below 0.6 µg/ml and the light dose below 48 J/cm². CONCLUSION: S. aureus, E. faecalis, and E. coli appear to be suitable for treatment with HYP-PDT without significant damage to fibroblasts.

Asunto(s)

Fenómenos Fisiológicos Bacterianos/efectos de los fármacos , Fenómenos Fisiológicos Bacterianos/efectos de la radiación , Fibroblastos/efectos de los fármacos , Iluminación/métodos , Perileno/análogos & derivados , Fotoquimioterapia/métodos , Antracenos , Células Cultivadas , Relación Dosis-Respuesta a Droga , Relación Dosis-Respuesta en la Radiación , Fibroblastos/citología , Fibroblastos/efectos de la radiación , Humanos , Viabilidad Microbiana/efectos de los fármacos , Viabilidad Microbiana/efectos de la radiación , Perileno/administración & dosificación , Fármacos Fotosensibilizantes/administración & dosificación

RESUMEN

BACKGROUND: An important determinant of the clinical applicability and value of antimicrobial photodynamic inactivation (PDI) is the cytotoxicity of the treatment to human cells. We evaluated the in vitro cytotoxicity of PDI to primary human fibroblasts using methylene blue (MB) and toluidine blue O (TBO) as the photosensitizers. METHODS: The primary human fibroblasts were exposed to PDI regimes that were used for the inactivation of methicillin-resistant Staphylococcus aureus (MRSA) and multi-drug resistant Escherichia coli (MDR E. coli). Mitochondrial activity subsequent to exposure was evaluated after 24h using the methylthiazoletetrazolium assay and compared to pretreatment values. RESULTS: Mitochondrial activity of primary human fibroblasts was reduced by 27% after exposure to light (163.8 J/cm(2)) and MB (50 µg/ml). At a TBO concentration previously demonstrated to induce 99.91% and 83.2% reduction in a viable count for MRSA and MDR E. coli, respectively, 39.6% of the fibroblasts were photo-inactivated. CONCLUSION: Our findings showed that MB/TBO-PDI did not induce significant cytotoxic effects on human fibroblasts in culture.

Asunto(s)

Escherichia coli/efectos de la radiación , Terapia por Luz de Baja Intensidad/métodos , Staphylococcus aureus Resistente a Meticilina/efectos de la radiación , Azul de Metileno/farmacología , Fármacos Fotosensibilizantes/farmacología , Cloruro de Tolonio/farmacología , Farmacorresistencia Bacteriana Múltiple , Fibroblastos , Humanos , Láseres de Semiconductores , Mitocondrias/efectos de la radiación

RESUMEN

BACKGROUND AND OBJECTIVE: This randomized controlled clinical trial (RCT) was designed to evaluate the effects of non-thermal, non-ablative CO(2) laser therapy (NACLT) to promote wound healing in minor recurrent aphthous stomatitis (miRAS). STUDY DESIGN/MATERIALS AND METHODS: Ten patients with 20 minor aphthous ulcers completed this study. Each patient had two discrete aphthous ulcers that had developed within 72 h before enrollment. One of the ulcers was randomly allocated to be treated with NACLT and the other one served as placebo. Before laser irradiation, a layer of transparent, non-anesthetic oral gel with high water content was placed on the laser and placebo lesions both. The CO(2) laser device was operated using 1 W power in defocused continuous mode, scanning rapidly over the lesion. The placebo lesion was irradiated with the same laser, but with an inactive probe. The healing times of the lesions were recorded by a blinded physician. RESULTS: The healing period was significantly shorter in ulcers treated by NACLT than in those treated with placebo (p=0.02). The process was not painful and anesthesia was not required. There were no visible side effects after NACLT and during follow-up periods. CONCLUSIONS: The results of this RCT suggest that single session of NACLT could be used to promote wound healing in minor aphthous ulcers, with no visible side effects.

Asunto(s)

Láseres de Gas/uso terapéutico , Terapia por Luz de Baja Intensidad/métodos , Estomatitis Aftosa/radioterapia , Cicatrización de Heridas/efectos de la radiación , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Valores de Referencia , Índice de Severidad de la Enfermedad , Estomatitis Aftosa/diagnóstico , Resultado del Tratamiento , Adulto Joven

RESUMEN

OBJECTIVE: To evaluate the immediate and long-term effectiveness of mindfulness-based stress reduction (MBSR) on biological and symptomatological markers of health among human immunodeficiency virus-positive (HIV+) patients in Tehran, Iran. METHODS: Using a randomized controlled trial design, data from 173 HIV+ patients (CD4 count > 250) not yet receiving antiretroviral therapy, who participated in either an 8-week MBSR (n = 87) or a brief education and support condition (n = 86) at the Imam Khomeini Hospital, were analyzed. Assessments included CD4 count, Symptom Checklist-90-Revised (SCL-90R), and Medical Symptom Checklist (MSCL) at baseline, immediate post-treatment, and at the 3-, 6-, 9-, and 12-month follow-up periods. RESULTS: The treatment-adherent sample had a mean (standard deviation) age of 35.1 (6.5) years and 69% were male. Linear mixed-model estimates indicated that, in the MBSR condition, the mean CD4 count increased from baseline up to 9 months after treatment and then returned to baseline level at 12 months. Improvements in mean SCL-90R (up to 6 months) and MSCL (up to 12 months) scores were observed for the MBSR condition, whereas education and support condition scores remained the same over time; however, only MSCL improvements significantly differed between groups and these changes lasted up to the final assessment. CONCLUSIONS: Findings suggest that among treatment-adherent Iranian HIV+ patients not yet receiving antiretroviral drug treatment, MBSR seems to have the strongest potential to improve self-reported medical symptoms. TRIAL REGISTRATION: Iranian Registry of Clinical Trials: IRCT201106084076N2.

Asunto(s)

Infecciones por VIH/inmunología , Infecciones por VIH/psicología , Meditación/métodos , Estrés Psicológico/prevención & control , Adaptación Psicológica , Adulto , Recuento de Linfocito CD4/estadística & datos numéricos , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Infecciones por VIH/fisiopatología , Humanos , Irán , Modelos Lineales , Masculino , Autoinforme , Estrés Psicológico/psicología , Resultado del Tratamiento

RESUMEN

BACKGROUND AND OBJECTIVE: It is important to prevent unwanted side effects of diode hair-removal lasers especially in dark skin tones. This study simulates the thermal damage patterns caused by diode hair-removal lasers in different skin types, hair colors, and hair densities. MATERIALS AND METHODS: LITCIT software has been used with the tissue modeled as two components, the skin and the hair. The absorption coefficients of various skin types (f(mel)=5%, 10%, 15%, and 20%), laser parameters, and optothermal properties of tissue were inputs. RESULTS: For all skin types there was a significant unwanted thermal damage to the epidermis as a result of fluence increase. Using longer pulse durations is accompanied by effective thermal damage to the hair follicle, while preserving the epidermis in skin types II and III, an effect not achieved in darker skins. Regardless of pulse duration, when the distance between hair follicles is ≤ 0.5 mm, there is a significant increase in thermal damage to interfollicular epidermis with high fluences compared with lower hair densities (interfollicular space ≥ 1 mm). In lighter hairs, while using longer pulse durations, higher fluences are needed in order to obtain the same level of thermal damage in the hair follicle as shorter pulse widths. CONCLUSIONS: In lighter skin types, lengthening the pulse duration of diode lasers (up to 400 ms) increases efficacy while preserving epidermis from unwanted thermal damage. However, it is necessary to use lower fluences while using longer pulse duration to avoid irreversible thermal damage to epidermis in darker tones, as is also true for locations with higher hair densities.

Asunto(s)

Quemaduras/patología , Color del Cabello , Remoción del Cabello/métodos , Láseres de Semiconductores/efectos adversos , Pigmentación de la Piel , Piel/lesiones , Quemaduras/etiología , Humanos , Láseres de Semiconductores/uso terapéutico , Modelos Biológicos

RESUMEN

BACKGROUND/PURPOSE: Acne vulgaris is a very prevalent skin disorder and remains a main problem in practice. Recently, phototherapy with various light spectrums for acne has been used. There are some evidences that low-level laser therapy (LLLT) has beneficial effect in the treatment of acne lesions. In this study, two different wavelengths of LLLT (630 and 890 nm) were evaluated in treatment of acne vulgaris. MATERIALS AND METHODS: This study was a single-blind randomized clinical trial. Patients with mild to moderate acne vulgaris and age above 18 years and included were treated with red LLLT (630 nm) and infrared LLLT (890 nm) on the right and left sides of the face respectively, twice in a week for 12 sessions, and clinically assessed at baseline and weeks 2, 4, 6, and 8. RESULTS: Twenty-eight patients were participated in this study. Ten weeks after treatment acne lesion were significantly decreased in the side treated by 630 nm LLLT (27.7±12.7 to 6.3±1.9) (P<0.001), but this decrease was not significant in the site treated by 890 nm LLLT (26.9±12.4 to 22.2±8.5) (P>0.05). CONCLUSION: Red wavelength is safe and effective to be used to treat acne vulgaris by LLLT compared to infrared wavelength.

RESUMEN

BACKGROUND: Photodynamic inactivation (PDI) has been investigated to cope with the increasing incidence of multidrug-resistant (MDR) pathogens. Here we studied the PDI mediated by methylene blue (MB) and toluidine blue O (TBO) in clinical methicillin-resistant Staphylococcus aureus and MDR Escherichia coli, together with their corresponding American Type Culture Collection (ATCC) strains. METHODS: Effect of photosensitizer concentration (12.5, 25, 50 µg/ml) and laser irradiation time (10, 20 and 30 min) on lethal photosensitization was investigated. RESULTS: TBO was more effective. TBO at 50 µg/ml, 46.8 J cm⁻², exhibited 0.7 log killing for MDR E. coli and 1.7 log killing for E. coli (ATCC 25922); 3.1 log killing for MRSA, and 4.2 log killing for S. aureus (ATCC 25923). MB at 50 µg/ml, 163.8 J cm⁻², only exhibited 2.2 log killing in MRSA and 3.1 log killing in S. aureus (ATCC 25923). MB (50 µg/ml, 163.8 J cm⁻²) induced 0.2 log killing for MDR E. coli and 0.3 log killing for E. coli (ATCC 25922). After TBO-PDI, MDR isolates were more susceptible to some antibiotics than control groups. CONCLUSION: Our studied clinical isolates were more resistant to PDI-mediated killing than their ATCC reference strains. Thus, TBO/MB-mediated PDI in other MDR isolates deserves further investigation.

Asunto(s)

Colorantes/farmacología , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Escherichia coli/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/farmacología , Antibacterianos/administración & dosificación , Antibacterianos/farmacología , Técnicas Bacteriológicas , Colorantes/administración & dosificación , Humanos , Azul de Metileno/administración & dosificación , Azul de Metileno/farmacología , Fármacos Fotosensibilizantes/administración & dosificación , Cloruro de Tolonio/administración & dosificación , Cloruro de Tolonio/farmacología

RESUMEN

Throughout the world, many migrant and mobile populations are at elevated risk for HIV. Iran has a large immigrant population from neighboring Afghanistan; however, few data exist on the prevalence of HIV in this community. In 2008, we conducted a study to assess the presence of HIV infection among 477 immigrants in a town to the northeast of Tehran using a rapid test in the field. HIV prevalence was 0.2% (95% CI 0.005-1.2) with one person HIV-positive. We recommend periodic HIV sero-surveillance with detailed behavioral measures for this population in the future.

Asunto(s)

Serodiagnóstico del SIDA/estadística & datos numéricos , Emigración e Inmigración , Infecciones por VIH/epidemiología , Adolescente , Adulto , Afganistán/etnología , Anciano , Anciano de 80 o más Años , Niño , Femenino , Infecciones por VIH/diagnóstico , Seroprevalencia de VIH , Humanos , Irán/epidemiología , Masculino , Persona de Mediana Edad , Adulto Joven

RESUMEN

BACKGROUND AND OBJECTIVES: Low-level laser therapy (LLLT) has been shown to promote chronic wound healing in conditions of reduced microcirculation. In this preliminary study, we report the results of using LLLT to heal foot ulcers in patients with diabetes mellitus. MATERIALS AND METHODS: Twenty-three patients with a diabetic foot wound for at least 3 months were included in this double-blind randomized clinical trial. Patients were randomized to receive placebo treatment (n = 10) or LLLT (n = 13) (685 nm, energy density 10 J/cm(2)) in addition to conventional therapy. Patients were followed for 20 weeks. Ulcer size reduction and the number of patients with complete healing were compared between the LLLT and placebo groups. RESULTS: There were no significant differences in baseline characteristics of patients and foot ulcers receiving LLLT and placebo treatment. At week 4, the size of ulcers decreased significantly in the LLLT group (p = 0.04). After 20 weeks, in the LLLT group, eight patients had complete healing and in the placebo group only three patients experienced complete wound healing. The mean time of complete healing in LLLT patients (11 weeks) was less than that in placebo patients (14 weeks) though the difference was not statistically significant. CONCLUSIONS: The study provides evidence that LLLT can accelerate the healing process of chronic diabetic foot ulcers, and it can be presumed that LLLT may shorten the time period needed to achieve complete healing.

Asunto(s)

Pie Diabético/radioterapia , Terapia por Luz de Baja Intensidad , Cicatrización de Heridas/efectos de la radiación , Anciano , Enfermedad Crónica , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad

RESUMEN

OBJECTIVE: The objective of our study was to show the impact of different chemotherapy regimens on the incidence of amenorrhea (chemotherapy-induced amenorrhea [CIA]) in premenopausal women of various ages with breast cancer. METHODS: This is a follow-up study of 226 premenopausal women with breast cancer who had received one of three chemotherapy regimens: conventional (cyclophosphamide/methotrexate/5-fluorouracil), anthracycline based, and anthracycline-taxane based. They were evaluated for the incidence of CIA in the follow-up clinic of the Iranian Center for Breast Cancer. A statistical analysis using SPSS software was performed, and logistic regression and Cox regression model were used to determine the risk factors for CIA. RESULTS: Of the 226 women with a median age of 40 years (range, 26-56 y) who participated in this study, 154 (68.1%) developed CIA. In 101 (65.6%) of these women, CIA was established. CIA was present in 52.5% of the women who had been treated with conventional regimens (cyclophosphamide/methotrexate/5-fluorouracil), 66.7% of the women who had been treated with anthracycline, and 78.7% of the women who had been treated with anthracycline-taxane. Therefore, the frequency of CIA was significantly higher in the taxane-based chemotherapy group than in the other groups (P = 0.015). Although a slightly higher incidence of CIA in women with hormone-insensitive tumors (estrogen receptor negative and progesterone receptor negative) versus hormone-sensitive tumors (estrogen receptor positive and progesterone receptor positive) who had been treated with combination regimens was observed, no statistically significant difference was found (P = 0.629). Of all of the risk factors that were evaluated in the study, anthracycline-taxane-based regimens (odds ratio, 4.059; 95% CI, 1.6-9.8) and age older than 40 years (odds ratio, 3.5; 95% CI, 1.9-6.6) were the most important factors in the development of CIA. CONCLUSIONS: The type of chemotherapy and the age of the woman at the onset of breast cancer are the most important risk factors in CIA. Taxane-based regimens induced more CIA than did other regimens.

Asunto(s)

Amenorrea/inducido químicamente , Antineoplásicos/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Mama/tratamiento farmacológico , Hidrocarburos Aromáticos con Puentes/efectos adversos , Taxoides/efectos adversos , Adulto , Antraciclinas/efectos adversos , Antraciclinas/uso terapéutico , Antineoplásicos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/cirugía , Hidrocarburos Aromáticos con Puentes/uso terapéutico , Ciclofosfamida/efectos adversos , Ciclofosfamida/uso terapéutico , Femenino , Fluorouracilo/efectos adversos , Fluorouracilo/uso terapéutico , Estudios de Seguimiento , Humanos , Metotrexato/efectos adversos , Metotrexato/uso terapéutico , Persona de Mediana Edad , Estadificación de Neoplasias , Receptores de Estrógenos/efectos de los fármacos , Receptores de Progesterona/efectos de los fármacos , Estudios Retrospectivos , Factores de Riesgo , Taxoides/uso terapéutico , Resultado del Tratamiento

RESUMEN

OBJECTIVE: The aim of this study was to evaluate the bilirubin albumin (B/A) ratio in comparison with total serum bilirubin (TSB) for predicting acute bilirubin-induced neurologic dysfunction (BIND). METHODS: Fifty two term and near term neonates requiring phototherapy and exchange transfusion for severe hyperbilirubinemia in Children's Medical Center, Tehran, Iran, during September 2007 to September 2008, were evaluated. Serum albumin and bilirubin were measured at admission. All neonates were evaluated for acute BIND based on clinical findings. FINDINGS: Acute BIND developed in 5 (3.8%) neonates. B/A ratio in patients with BIND was significantly higher than in patients without BIND (P<0.001). Receiver operation characteristics (ROC) analysis identified a TSB cut off value of 25 mg/dL [area under the curve (AUC) 0.945] with a sensitivity of 100% and specificity of 85%. Also, according to the ROC curve, B/A ratio cut off value for predicting acute BIND was 8 (bil mg/al g) (AUC 0.957) with sensitivity of 100% and specificity of 94%. CONCLUSION: Based on our results, we suggest using B/A ratio in conjunction with TSB. This can improve the specificity and prevent unnecessary invasive therapy such as exchange transfusion in icteric neonates.