Medical Laboratory Journal

Breast Cancer: Risk Factors, Diagnosis and Management

Meghdad Abdollahpour-Alitappeh

ABSTRACT
Breast cancer remains the most common cancer of women and one of the most common causes of cancer-related deaths worldwide. In spite of major advances in breast cancer diagnosis and treatment, the incidence of breast cancer remains high and the treatment of metastatic breast cancer remains challenging. This review presents an overview of breast cancer with a particular focus on its clinical aspects and therapies.
Keywords: Breast Cancer, Risk Factors, Diagnosis, Treatment.

Detection of fim, pap, sfa and afa Adhesin-Encoding Operons in Escherichia coli Strains Isolated from Urinary Tract Infections

Majid Bouzari

ABSTRACT
             Background and objectives: Urinary tract infections (UTIs) are one of the most common infectious diseases caused by bacteria. The primary etiologic agent of UTIs is Escherichia coli. Uropathogenic E.coli (UPEC) strains have a number of specific virulence factors, which can worsen UTIs. This study was performed to detect fim, pap, sfa and afa genes among E.coli strains isolated from UTIs.
             Methods: A total of 100 E. coli isolates from patients with UTI was collected between June and December 2015 from Mosavi and Sayyad Shirazi hospitals in Gorgan, Iran. All bacterial isolates were identified via standard biochemical testing and Gram straining. Presence of the genes was assessed by polymerase chain reaction.
             Results: The frequency of the fim, pap, sfa and afa genes was 100%, 79%, 69% and 8%, respectively. All isolates contained at least one virulence gene. Prevalence of multiple adhesion genes was 6% for all genes and 65% for three genes (fim, pap and sfa) together. In addition, the frequency of the fim gene was significantly higher than that of the other genes (P<0.0001).
             Conclusion: The results of this study indicate the high prevalence of virulence factors that can enhance pathogenicity of E. coli. Therefore, these factors could be used as diagnostic markers or vaccine targets.
             Keywords: Virulence factors, Urinary tract infection, Uropathogenic Escherichia coli.

Diurnal Salivary Cortisol following Mindfulness-Based Cognitive Therapy (MBCT) in Women with Breast Cancer: A pilot Study

Robabeh Noori

ABSTRACT
             Background and Objectives: Cancer and its conventional treatments may bring about some psychological and health-related symptoms leading to unstable cortisol level. Since evidence has shown that mindfulness based approaches can be helpful to reduce cortisol level, we aimed at investigating the efficacy of   mindfulness-based cognitive therapy (MBCT) on decreasing salivary cortisol level in the women with breast cancer.
             Methods: in this one- group pretest posttest study, the women with early stage breast cancer were assessed to select eligible ones (N = 15). They were first trained for collecting salivary cortisol sample (before, after and follow-up)   and then were asked to participate in MBCT, an eight-week session approach. Participants provided salivary samples in the morning (7: 30- 8:30), afternoon (1-3) and night (9-11). To measure cortisol, Cortisol Enzyme Immunoassay Kit was used. Analysis was performed on the data of 12 participants remained, using repeated measurement.
              Results: the results of repeated measure ANOVA revealed that cortisol level of posttest (after 8-weeks of MBCT and follow-up period) in comparison with pretest was significantly reduced for morning and afternoon cortisol while it was not true for night cortisol. The post-treatment cortisol was not significantly correlated with age groups, education levels and socio-economic status using repeated measure ANCOVA.
             Conclusion: Given that the women with breast cancer are at the high risk of psychological distresses and unstable cortisol level, we recommend mindfulness-based approaches esp. MBCT to health providers specifically those working with breast cancer patients.
             Keywords: Mindfulness, MBCT, Cortisol , Salivary Cortisol, Breast cancer.

In Vitro Effect of Methanolic Extract of Quercus infectoria Galls on Promastigotes and Amastigotes of Leishmania major (MRHO/IR/75/ER)

Mansour Dabirzadeh

ABSTRACT
           Background and objectives: Leishmania major is a flagellated parasitic protozoan that causes cutaneous leishmaniasis. Pentavalent antimony compounds are considered the first-line drugs in the treatment of cutaneous leishmaniasis. However, the use of these drugs is associated with numerous limitations and side effects. Therefore, there is a need for herbal and natural alternatives for these compounds with fewer side effects. In this study, we evaluated the in vitro activity of methanol extract of Quercus infectoria (oak galls) against promastigotes and amastigotes of L. major.
           Methods: In this experimental study, the effect of 10, 100, 500 and 1000 µg/ml of methanolic extract of oak galls and 100, 500, 1000 and 10000 µg/ml of Glucantime was evaluated against L. major promastigotes using direct cell counting and MTT assay. Moreover, the effect of different concentrations of the extract and Glucantime was investigated on the mean number of amastigotes in macrophages after 24 and 48 hours. Data were analyzed using SPSS 16 and one- way analysis of variance.
           Results: The half-maximal inhibitory concentration of the oak gall extract and Glucantime was 75 µg/ml and 221 µg/ml after 24 hours, respectively. After 24 hours, the mean number of amastigotes per macrophage was lowest at concentrations of 1000 µg/ml of the extract (0.9) and 10000 µg/ml of Glucantime (0.85).
           Conclusion: Considering the inhibition of intracellular and extracellular growth of L. major, the oak gall extract might be used as an efficient and safe agent for treatment of cutaneous leishmaniasis.
           KEYWORDS: Leishmaniasis, Cutaneous, Quercus.

Prioritization of Deleterious Variations in the Human Hypoxanthine-Guanine Phosphoribosyltransferase Gene

Hoda Sohrabi

ABSTRACT
            Background and Objectives: Non-synonymous single nucleotide polymorphisms are typical genetic variations that may potentially affect the structure or function of expressed proteins, and therefore could be involved in complex disorders. A computational-based analysis has been done to evaluate the phenotypic effect of non-synonymous single nucleotide polymorphisms in the gene encoding the human hypoxanthine-guanine phosphoribosyltransferase (HGPRT-1). HGPRT-1 is an enzyme involved in purine recycling pathway and its deficiency is associated with several human genetic disorders.
            Methods: We provide a list of all amino acid replacements in the human HGPRT-1 from the dbSNP, Uniprot and dbEST databases. Sorting intolerant from tolerant (SIFT) and PolyPhen softwares were also used in our study.
            Results: Of 94 amino acid substitutions, rs 267606863 was predicted to be the most deleterious. Substitutions of S110L and S104A in flexible loop and D194N, D201Y, H204R, Y195C, F199V and H204D in hood domain were predicted as functionally damaging.
            Conclusion: It could be concluded that these intolerant changes may lie within a functional region of the protein and may affect the stability and folding of HGPRT-1. These variants could be used for future functional and molecular epidemiology studies of HGPRT-1-related disorders.
            Keywords: Polymorphism, Single Nucleotide, Amino acid substitution, Hypoxanthine Phosphoribosyltransferase.

Prevalence of Extended-Spectrum β-Lactamases Genes in Clinical Isolates of Pseudomonas aeruginosa

Majid Komijani

ABSTRACT
            Background and Objectives: Pseudomonas aeruginosa is an opportunistic pathogen resistant to various antibiotics. The aim of the present study was to study resistant patterns in clinical isolates of P. aeruginosa, classify them into pandrug resistance (PDR), extensive drug resistance (XDR) and multidrug resistance (MDR) groups, and identify extended-spectrum β-lactamase (ESBL)-positive isolates using the phenotypic and genotypic methods.
            Methods: This cross-sectional study was conducted on 161 P. aeruginosa isolates collected from the city of Isfahan, Iran. Antibiotic susceptibility tests were performed using 11 antimicrobial agents. ESBL-positive strains were identified using the phenotypic and genotypic methods.
            Results: The highest level of antibiotic resistance was observed against ceftazidime (77.64%). None of the isolates was resistant to polymyxin B. In the phenotypic method, 64 isolates (39.75%) were found as ESLB-positive, whereas 132 isolates (81.98%) were ESBL-positive in the genotypic method. The number of ESBL-positive isolates in the genotypic method was significantly higher than in the phenotypic method. The frequency of XDR and MDR isolates was 50.93% and 27.32%, respectively. None of the isolates was PDR. The frequency of the bla_TEM gene was significantly higher than other genes (P<0.0001).
            Conclusion: It was revealed that the genotypic method was much more accurate in identifying ESBL-positive strains than the phenotypic method. Therefore, use of the molecular method may increase the chance of successful treatment with antibiotics of the β-lactam family.
            Keywords: Drug Resistance, β-lactamases, Pseudomonas aeruginosa.

Multi-factorial Etiology of Bipolar Disorder and Schizophrenia in Iran: No Evidence of Borna Disease Virus Genome

Abdolvahab Moradi

ABSTRACT

            Background and Objectives: Psychiatric disorders such as schizophrenia and bipolar disorder pose a high burden among the general population. Etiological factor(s) of such disorders remain unknown. Borna disease virus (BDV) is a neurotropic virus that has been suggested as an etiological agent for psychiatric disorders. Therefore, we aimed to investigate the prevalence of BDV among patients with schizophrenia and bipolar disorder.
            Methods: Peripheral blood mononuclear cells (PBMCs) of schizophrenic (n=75) and bipolar (n=55) patients and healthy blood donors (n=125) were extracted form whole blood samples. RNA was extracted from PBMCs and the presence of BDV P40 RNA was assessed by reverse transcription-polymerase chain reaction.
            Results: The BDV genome was not detected in any of the subjects. Positive family history of disease was significantly more frequent among patients (P=0.0001). There was a significant association between contact with animals and psychiatric illnesses (P<0.05). Moreover, education level differed significantly between the two groups (P<0.05).
            Conclusion: The results indicate no evidence of BDV genome among patients with psychiatric disorders. Serological examination for BDV antigens or antibodies could provide further information in this regard. In addition, contact with cats is significantly more prevalent among patients with mental illnesses, which might be due to infection with Toxoplasma gondii.
            Keywords: Borna disease virus, Psychiatric disorder, Schizophrenia, Bipolar disorder, Risk factors.

Effect of Eight Weeks Aerobic and Combined Training on Serum Levels of Sirtuin 1 and PGC-1α in Coronary Artery Bypass Graft Patients

Amir Rashidlamir

ABSTRACT
           Background and objectives: Sirtuin-1 (SIRT1) is a conserved a NAD⁺-dependent protein deacetylase essential for cellular metabolism and defence against oxidative stress and endothelial dysfunction. This study aimed to compare effects of 8 weeks of aerobic and combined training on serum level of SIRT1 and PGC1-α in coronary artery bypass graft patients.
           Methods: In this semi-experimental study, 45 non-active men (mean age 47.4 ± 3.3 years) who had undergone coronary artery bypass graft surgery were randomly divided into three groups: aerobic training, combined resistance and aerobic training and control. Trainings were performed at 80% of maximum heart rate, three sessions a week for 8 weeks. Blood samples were collected 24 hours before the first exercise session and 48 hours after the last training session. T-test and one-way analysis of variance were used for assessment of within-group and between-group differences, respectively. P-values less than 0.05 were considered as statistically significant.
           Results: The 8-week aerobic and combined training increased serum levels of SIRT1 and PGC-1α compared with the control group, and significantly decreased the weight of subjects (p=0.001). There was no significant difference in serum levels of SIRT1 and PGC-1α between the two training groups (P≥0.05).
           Conclusion: Both combined and aerobic training significantly improve the SIRT1 and PGC-1α levels in coronary artery bypass graft patients.
           KEYWORDS: Combined training, Aerobic training, PGC-1α, SIRT1, CABG patient.