Translational Health Reports

Abstract Background: In the context of modern healthcare, surgical interventions are essential yet pose inherent risks, including postoperative infections. Antibiotic prophylaxis plays a pivotal role in mitigating these risks, aiming to prevent surgical site infections (SSIs) and associated complications. This study focuses on the consumption patterns of antibiotic prophylaxis regimens among patients admitted to the surgical wards at Bu Ali Sina Medical and Educational Services Center in Sari, Iran.
Methods: This retrospective cross-sectional study involved 970 participants undergoing clean or clean-contaminated surgical procedures. The research employed a researcher-made questionnaire covering demographic information, antibiotic details, side effects, duration of administration post-operation, adherence to guidelines, and compliance with ASHP 2013 antibiotic prophylaxis guidelines. Statistical analyses included central tendency and dispersion indicators, Chi-squared test, Fisher's exact test, one-sample Kolmogorov-Smirnov, Mann-Whitney U test, and T-test.
Results: The predominant antibiotic categories were cephalosporins, with ceftriaxone and cefazolin accounting for 65.2% and 61.8% of prescriptions, respectively. Comparison between orthopedic and ENT surgery groups did not reveal significant differences in antibiotic regimens (P=0.085). However, a noteworthy difference emerged in the duration of antibiotic prophylaxis, with a significant distinction between orthopedic and ENT surgery groups (P=0.650). Compliance with ASHP 2013 guidelines was observed in 84% of cases regarding the timing and type of prescribed antibiotic prophylaxis regimen.
Conclusion: This study provides crucial insights into the consumption patterns of antibiotic prophylaxis among surgical patients, emphasizing the prevalence of cephalosporins and revealing distinctions in duration between orthopedic and ENT surgery groups. The findings contribute to optimizing patient outcomes and addressing antimicrobial resistance challenges. As the healthcare community navigates the delicate balance between prophylactic benefits and resistance concerns, these results offer valuable information for policy-making and clinical practices.

Abstract Introduction: Osteoporosis is a widespread bone disease characterized by low bone mineral density (BMD), structural bone deterioration, and an increased risk of fractures. It primarily affects postmenopausal women and the elderly, representing a significant global health burden. The management of osteoporosis involves pharmacological treatments aimed at preventing fractures, alleviating symptoms, and improving overall quality of life.
Methods: This review analyzes the pharmacology of current osteoporosis treatments, including bisphosphonates, selective estrogen receptor modulators (SERMs), monoclonal antibodies, and newer agents such as sclerostin inhibitors. It also examines pain management strategies, particularly those targeting fracture-related pain, and explores the intersection between bone therapies and analgesia.
Results: The current pharmacological treatments for osteoporosis have shown significant efficacy in reducing fracture risk. However, managing pain in osteoporosis, particularly post-fracture pain, remains a complex challenge. This review highlights the need for a multidimensional approach that integrates both bone-targeted therapies and effective pain management strategies.
Conclusion: While osteoporosis therapies have greatly reduced fracture risk, pain management in osteoporosis patients remains an area requiring further research. This review synthesizes current literature on osteoporosis treatments and pain management, offering insights into best practices and identifying future research directions to improve patient outcomes.

Abstract Background: Coronary Heart Disease (CHD) is a widespread health challenge characterized by intricate pathophysiological mechanisms such as chronic inflammation, endothelial impairment, and metabolic irregularities. Exercise-focused Cardiac Rehabilitation (CR) is a key element of secondary prevention, known to decrease mortality and improve health outcomes. Examining its impact on a diverse range of biomarkers offers deeper insight into the biological mechanisms behind these benefits.
Objective: This systematic review consolidates current research on the effects of structured exercise training within CR on biomarkers related to critical pathological areas in CHD patients, including inflammation, lipid metabolism, vascular function, myocardial stress, and metabolic health.
Methods: A systematic search of PubMed, Scopus, and the Cochrane Central Register of Controlled Trials was conducted from January 2000 to May 2024. Randomized controlled trials, meta-analyses, and prospective cohort studies evaluating the impact of exercise-based CR on biomarkers in adults with confirmed CHD were included.
Results: Analysis of 40 high-quality studies shows that exercise-based CR consistently produces beneficial changes across multiple biomarker pathways. Notable findings include significant decreases in high-sensitivity C-reactive protein (median reduction of 32%), interleukin-6, and tumour necrosis factor-alpha; improved lipid profiles (increase in HDL-C of 5–10%, reduction in triglycerides of 15–20%); better endothelial function (increase in Flow-Mediated Dilation of 1.5–3.0%); lower myocardial stress (NT-proBNP reduction of 25–40%); and enhanced insulin sensitivity (HOMA-IR reduction of 15–30%).
Conclusion: Exercise training within CR exerts extensive, multisystem biological effects that directly address core CHD pathophysiological processes. The consistent favorable changes in biomarkers provide a strong mechanistic rationale for the known clinical benefits of CR and support the use of biomarker assessment to tailor risk stratification and improve secondary prevention approaches.

Abstract Background: Neoadjuvant chemotherapy is a common treatment approach for breast cancer, but its impact on disease-free survival, quality of life, and recurrence rates is not well understood.

Objectives: To evaluate the association between neoadjuvant chemotherapy and disease-free survival, quality of life, and recurrence rates in patients with breast cancer.

Methods: This retrospective cohort study included 350 patients with breast cancer who underwent surgery at a university clinic between 2015 and 2022. Patients were divided into two groups: those who received neoadjuvant chemotherapy (n=105) and those who did not (n=245). Demographic, tumor, and treatment characteristics were compared between groups. Disease-free survival, quality of life, and recurrence rates were analyzed using Cox proportional hazards models, multivariate analysis of variance, and logistic regression models. 1 year follow ups were made.

Results: Patients who received neoadjuvant chemotherapy had a significant reduction in the risk of disease recurrence (HR=0.65, p=0.02) and local recurrence (OR=0.42, p=0.01). However, they had lower physical and social functioning scores compared to those who did not receive neoadjuvant chemotherapy (p=0.04 and p=0.02, respectively). Neoadjuvant chemotherapy was also associated with a higher survival rate at 12 months (92.5% vs. 85.1%, p=0.03).

Conclusions: Neoadjuvant chemotherapy is associated with improved disease-free survival and reduced local recurrence rates in patients with breast cancer. However, it may have a negative impact on quality of life, particularly physical and social functioning. These findings have implications for the management of breast cancer and highlight the need for further research on the optimal use of neoadjuvant chemotherapy.

Abstract Background: Nosocomial infections remain a significant challenge in intensive care units (ICUs), contributing to increased morbidity, mortality, and healthcare costs. Emerging evidence suggests that structured risk assessment strategies may not only improve infection control but also modulate inflammatory and immune responses.
Methods: A comprehensive literature review was conducted, querying PubMed, Cochrane Library, EMBASE, and Web of Science for studies published through 2025. Eligible studies evaluated risk assessment tools or protocols in ICU settings and reported on outcomes including infection incidence, clinical parameters, and biomarker levels (e.g., inflammatory cytokines).
Results: The integration of structured risk assessment frameworks into ICU infection prevention protocols is associated with substantial benefits. These include reduced infection rates, improved clinical outcomes, and favorable alterations in key biomarker profiles, indicating a potential systemic immunomodulatory effect.
Conclusion: Implementing risk assessment in ICU infection control is advantageous for both clinical outcomes and biomarker patterns. Future research should focus on longitudinal biomarker monitoring and the development of personalized, dynamic risk assessment models to further optimize prevention strategies.




 
 
 
 
 

Abstract This forward-looking clinical investigation explored the prognostic utility of four distinct 
biomarkers—high-sensitivity cardiac troponin T (hs-cTnT), N-terminal pro b-type 
natriuretic peptide (NT-proBNP), Copeptin, and Mid-regional pro-Adrenomedullin (MR
proADM)—in forecasting significant cardiovascular complications among 120 individuals 
presenting with symptoms suggestive of acute coronary syndrome (ACS) in an emergency 
care setting. Across a 12-month observation window, occurrences of major adverse 
cardiovascular events (MACE)—encompassing myocardial infarction, stroke, and 
cardiovascular mortality—were systematically tracked and correlated with both initial and 
serial biomarker measurements. 
Multivariate analysis using Cox proportional hazards modeling, adjusted for demographic 
and behavioral risk factors such as age, sex, and smoking, revealed a robust association 
between elevated biomarker levels and MACE incidence. Diagnostic accuracy for each 
marker—individually and collectively—was assessed through ROC curve analysis, 
demonstrating favorable area under the curve (AUC) values indicative of strong predictive 
performance. Survival outcomes stratified by median biomarker thresholds were estimated 
using Kaplan-Meier methodology, showing pronounced differences in MACE-free survival 
between high- and low-risk groups. 
The findings affirm the clinical value of hs-cTnT, NT-proBNP, Copeptin, and MR-proADM in 
early cardiovascular risk stratification. Moreover, the integrative use of these markers was 
shown to outperform any single biomarker alone, emphasizing their combined role in 
refining diagnostic precision and guiding therapeutic decisions. These results support 
incorporating such biomarker panels into routine evaluation protocols for patients 
undergoing assessment for suspected ACS.

Abstract Background: Esophageal cancer (EC) is a highly aggressive malignancy with increasing global prevalence, especially esophageal adenocarcinoma (EAC). Late-stage detection significantly contributes to its unfavorable outcomes, highlighting an urgent demand for non-invasive early diagnostic approaches. Metabolomics, the comprehensive study of small-molecule metabolites, provides a valuable strategy for discovering biomarker patterns that mirror the pathophysiological condition of cancer.
Objective: This review seeks to consolidate and critically assess existing research on the utility of plasma metabolites as diagnostic, prognostic, and predictive biomarkers in EC.
Methods: A systematic search of PubMed, Scopus, and Web of Science was performed for literature published between January 2000 and March 2024. Keywords such as "esophageal cancer," "metabolomics," "plasma," "serum," "biomarkers," "mass spectrometry," and "NMR" were employed. Studies were chosen based on their focus on plasma or serum metabolomic analysis in human EC patients.
Results: EC patients exhibit consistent changes in plasma metabolomic profiles compared to healthy individuals. Major disrupted pathways involve amino acid metabolism (e.g., increased branched-chain amino acids, reduced glutamine), energy metabolism (including the Warburg effect and disturbances in the TCA cycle), and lipid metabolism (alterations in phospholipid and sphingolipid concentrations). Panels comprising multiple metabolites show strong diagnostic performance, often with area under the curve (AUC) values above 0.90. Additionally, certain metabolic patterns may be useful for predicting patient outcomes and evaluating responses to neoadjuvant treatments.
Conclusion: Plasma metabolomics offers considerable potential to transform the clinical approach to EC through non-invasive methods for early diagnosis, risk assessment, and therapy evaluation. Validation through extensive, multi-center prospective studies is needed to implement these advances in clinical settings.

Abstract Background: Glioblastoma multiforme (GBM) is a highly aggressive brain tumor with a poor prognosis. Radiation therapy (RT) and temozolomide (TMZ) are standard treatments, but their impact on cognitive function is not well understood.

Objective: To investigate the effects of radiation dose and TMZ dose on cognitive function in patients with GBM treated with RT and TMZ.

Methods: This retrospective study included 162 patients with GBM treated with RT and TMZ between 2018 and 2023. Cognitive function was assessed using a comprehensive battery of neuropsychological tests, and MRI-based measures of cognitive function were obtained. Patients were categorized into three groups based on radiation dose received: low dose (< 50 Gy), moderate dose (50-60 Gy), and high dose (> 60 Gy). Follow ups were made up to 8 to 12 months after chemoradiotherapy.

Results: Patients in the high dose group performed significantly worse on executive function and memory tests, and had reduced white matter integrity and increased white matter hyperintensity volume compared to the low dose group. Higher TMZ doses were associated with poorer cognitive outcomes in executive function, memory, and reduced hippocampal volume. Linear regression analysis showed that higher radiation doses were associated with poorer cognitive outcomes in memory, and higher TMZ doses were associated with poorer cognitive outcomes in executive function, memory, and reduced hippocampal volume.

Conclusion: This study suggests that higher radiation doses and TMZ doses are associated with poorer cognitive outcomes in patients with GBM. These findings have important implications for the management of GBM, highlighting the need to minimize radiation dose and TMZ dose to prevent cognitive decline. Future studies are needed to confirm these findings and to explore strategies to mitigate the cognitive effects of RT and TMZ in patients with GBM.

Abstract Background: The established first-line treatment for newly diagnosed Glioblastoma Multiforme (GBM) involves maximal surgical removal of the tumor, followed by a regimen of radiotherapy (RT) together with concurrent and maintenance temozolomide (TMZ) chemotherapy. Patient response to this combined approach varies widely and is closely associated with the tumor's molecular characteristics.
Objective: This analysis compiles current research on how the RT/TMZ combination modifies crucial GBM biomarkers over time, focusing on therapy-induced alterations rather than their initial prognostic significance.
Methods: A systematic review of literature from January 2000 to July 2024 was performed using PubMed, Scopus, and Web of Science. Search keywords included "glioblastoma," "radiotherapy," "temozolomide," "MGMT," "IDH," "biomarker," and related terms. Emphasis was placed on clinical trials and key preclinical studies.
Results: The RT/TMZ protocol imposes significant selective pressure, dynamically influencing GBM biomarkers. MGMT promoter methylation is the primary predictor of TMZ efficacy, but treatment often leads to the expansion of MGMT-active, resistant tumor clones at recurrence. IDH1/2 mutations are strong prognostic indicators, and their associated metabolic changes may increase tumor sensitivity to DNA-damaging therapies. Treatment substantially reshapes the tumor immune microenvironment; RT can stimulate anti-tumor immune responses but also increase PD-L1 expression, while TMZ often causes severe lymphocyte depletion. Additionally, therapy promotes the selection of cells with enhanced DNA damage repair mechanisms and activates survival pathways such as EGFR, fostering treatment resistance.
Conclusion: RT and TMZ induce continuous, adaptive changes in GBM biomarkers. Recognizing this dynamic process is essential for personalizing treatment, assessing response, and developing new combination therapies to combat resistance.

Abstract Urosepsis is a severe, life-threatening condition caused by the rapid dissemination of urinary-tract pathogens into the bloodstream and an uncontrolled host inflammatory response. The emergence of multidrug-resistant organisms and the variability of immune activation in critically ill patients have made its management increasingly complex. Targeted antimicrobial therapy (TAT)—defined as the selection of antibiotics based on microbiological identification and susceptibility testing—embodies the principles of precision medicine, aiming to optimize treatment effectiveness while minimizing broad-spectrum exposure and the spread of resistance.

This review synthesizes the current evidence regarding the role of TAT in urosepsis, highlighting its effects on systemic inflammation, organ function, and clinical outcomes. Special attention is given to novel biomarkers such as Presepsin, neutrophil CD64 index, and Copeptin, examined alongside classical inflammatory mediators including tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP). Collectively, these markers provide valuable insights into the interplay between pathogen control and immune modulation. The review also discusses diagnostic and operational barriers to implementing TAT, the variability of antimicrobial stewardship across institutions, and future research directions aimed at integrating biomarker-guided targeted therapy into individualized sepsis management.

Abstract Background: Acute pain is one of the most frequent presenting complaints in emergency departments (EDs). In the context of the global opioid crisis, there is increasing interest in effective non-opioid and opioid-sparing analgesic strategies. Ketamine, at subanesthetic doses, has emerged as a valuable option for acute pain management due to its unique pharmacologic profile.
Objectives: This narrative review aims to synthesize current evidence on the mechanisms of analgesia, clinical efficacy, dosing protocols, and safety considerations of ketamine for acute pain management in adult ED patients.
Methods: A comprehensive narrative review of the literature was conducted using recent randomized controlled trials, systematic reviews, meta-analyses, and international guidelines focusing on ketamine use for acute pain in emergency settings. Studies from diverse geographic regions and healthcare systems were included to provide a global perspective.
Results: Evidence consistently demonstrates that subdissociative-dose ketamine provides analgesia comparable to opioids for acute pain in the ED. Typical intravenous doses of 0.1–0.35 mg/kg, administered as a bolus or infusion, achieve rapid pain relief while preserving respiratory drive and airway reflexes. Ketamine is associated with higher rates of transient neuropsychiatric effects, such as dizziness and emergence reactions, but lower risks of respiratory depression compared with opioids. Alternative routes of administration, including intranasal and subcutaneous, offer additional flexibility in selected patients.
Conclusion: Ketamine is a safe and effective alternative or adjunct to opioids for acute pain management in the emergency department when used at appropriate subanesthetic doses. With proper patient selection, monitoring, and adherence to established protocols, ketamine can play a central role in multimodal ED analgesia strategies aimed at improving pain control while reducing opioid exposure.

Abstract Background: Chemoradiation therapy (CRT) is fundamental for treating locally advanced and high-risk breast cancer. Although effective, it significantly impacts systemic physiology, which can be tracked through fluctuations in serum biomarkers. This review consolidates existing research on how CRT affects circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), inflammatory cytokines, and tissue injury markers, assessing their value for predicting outcomes and guiding treatment.
Methods: A systematic search of PubMed, Embase, Scopus, and Web of Science was conducted for studies to 2025. Keywords included "breast cancer," "chemoradiation," "serum biomarker," "ctDNA," "CTC," and related terms. Eligible studies reported serum biomarker levels in breast cancer patients before, during, or after CRT and linked them to clinical results.
Results: Analysis of studies indicates that CRT causes a predictable but individualized alteration in serum biomarkers. A swift decrease in CTCs and ctDNA levels during neoadjuvant or definitive CRT strongly correlates with pathological complete response (pCR) and better survival. In contrast, detectable ctDNA after treatment is a powerful indicator of minimal residual disease (MRD) and impending relapse. Inflammatory markers such as IL-6 and CRP generally increase during therapy; prolonged elevation is linked to poorer prognosis and greater toxicity. Additionally, biomarkers like high-sensitivity Troponin I and TGF-β1 enable early identification of subclinical cardiotoxicity and radiation-induced skin damage, respectively.
Conclusion: Serum biomarkers offer a real-time, dynamic reflection of tumor response and host toxicity during CRT. Incorporating liquid biopsy components (CTCs, ctDNA) and host-response markers into clinical practice shows great potential for personalizing treatment, facilitating early intervention, and enhancing long-term results. Prospective studies are urgently required to standardize testing methods and confirm their clinical utility in guiding treatment strategies.

Abstract Background: Pediatric kidney transplantation is the optimal therapy for end-stage kidney disease in children, yet long-term allograft survival remains inferior to adults due to heightened immunological reactivity, subclinical inflammation, and progressive fibrosis. Conventional monitoring with serum creatinine and protocol biopsies is limited by poor sensitivity and invasiveness.
Methods: This comprehensive narrative review synthesizes evidence on native T1-mapping MRI—a non-contrast technique quantifying renal parenchymal microstructure via elevated cortical T1 and reduced corticomedullary differentiation, reflecting inflammation, oedema, and interstitial fibrosis/tubular atrophy (IFTA)—and its mechanistic interplay with serum cytokine/chemokine profiles capturing alloimmune response phenotypes.
Results: Emerging data show strong pathophysiological/statistical correlations between pro-inflammatory cytokines (especially IL-6, TNF-α, CXCL10) and T1 prolongation, as cytokine-driven inflammation alters tissue relaxation properties detectable by MRI. Native T1-mapping demonstrates high diagnostic performance for IFTA (sensitivity 81-89%, specificity 78-85%), predicts graft dysfunction (HR 3.8 per 100 ms T1 increase), and tracks treatment response. Combined with cytokines, it identifies subclinical rejection with 94% specificity, outperforming eGFR/creatinine.
Conclusions: Native T1-mapping offers robust prognostic value in pediatric renal allografts. Integrated with targeted cytokine panels, it enables biopsy-sparing monitoring, early injury detection, and personalized strategies to improve outcomes. Multicenter trials with standardized protocols are needed.

Abstract Post-stroke upper limb spasticity (PULS) is a disabling condition that severely limits motor function and quality of life. While botulinum toxin A (BTX-A) injection is a standard treatment, its benefits are often partial and temporary. Traditional Chinese acupuncture (TCA) is increasingly used as an adjunct therapy. Concurrently, there is growing interest in identifying objective biomarkers to monitor recovery and elucidate treatment mechanisms.Combining acupuncture with BTX-A is more effective than BTX-A monotherapy for PULS rehabilitation. The therapy induces favorable changes in biomarkers related to muscle repair, neural plasticity, and neuroendocrine adaptation, providing a molecular basis for the observed clinical synergy. This integrated, biomarker-informed approach offers a promising direction for personalized neurorehabilitation in stroke survivors.

Abstract Backgrounds: Hyperlipidemic acute pancreatitis (HLAP) is a growing and serious subtype of acute pancreatitis, involving a complicated interaction of metabolic imbalance, widespread inflammation, and clotting irregularities. The potential of low molecular weight heparin (LMWH) and early enteral nutrition (EEN) as supplementary treatments has attracted considerable attention for their ability to influence central disease mechanisms.
Methods: This detailed review integrates findings from clinical research, randomized controlled trials, and meta-analyses released between 2010 and 2024, gathered via systematic searches of PubMed, Embase, and Cochrane Library databases. Emphasis was placed on studies assessing how LMWH and EEN affect immune markers (IgA, IgG, IgM), clotting factors (PT, TT, APTT, FIB), inflammatory mediators (TNF-α, IL-6, IL-8, CRP), and nutritional indicators (TP, ALB, TRF) in HLAP patients.
Results: Current data suggest that using LMWH together with EEN produces better patient results than traditional care alone. Notable outcomes involve a marked decrease in inflammatory markers, better clotting function, higher antibody levels, and improved nutritional measures. This combined method is linked to reduced hospitalization time, quicker return of digestive function, and fewer complications like multiple organ failure.
Conclusion: The complementary actions of LMWH and EEN tackle the diverse causes of HLAP. LMWH enhances blood flow in the pancreas while lowering excessive clotting and inflammation, whereas EEN protects intestinal lining and helps regulate immunity. Subsequent studies should aim to establish consistent treatment guidelines and determine which patients would gain the most from this dual therapy.

Abstract Background: Renal colic is a common and severely painful emergency condition often caused by ureteral stones. Rapid pain management is critical. This study evaluates the efficacy of inhaled salbutamol, a β2-agonist with smooth muscle relaxant properties, as an adjunct therapy in reducing pain severity in patients with acute renal colic.

Methods: In this double-blind randomized controlled trial, 204 patients with moderate renal colic pain (based on the Visual Analog Scale, VAS) referred to the emergency department of Imam Khomeini Hospital in Sari, Iran, were randomly assigned to two groups. The intervention group received 30 mg intravenous ketorolac and inhaled salbutamol (5 puffs), while the control group received ketorolac and a placebo inhalation. Pain intensity, vital signs, and symptoms such as nausea and vomiting were recorded at baseline and at intervals of 10, 20, 30, 45, 60, and 120 minutes after treatment.

Results: Pain intensity significantly decreased over time in both groups (p

Abstract Brain tumor-related epilepsy (BTRE) is a prevalent complication, affecting 25-60% of patients with primary or metastatic brain tumors, significantly impacting quality of life and complicating oncologic management. This narrative review examines factors influencing the effectiveness of levetiracetam (LEV), lamotrigine (LTG), and lacosamide (LCS) in BTRE. By analyzing epidemiological data, pathophysiological mechanisms, pharmacological profiles, and clinical evidence, we study how tumor characteristics (type, location, molecular profile), patient-specific factors (age, comorbidities), drug interactions, and pharmacodynamic properties modulate seizure control. LEV is often the first-line choice due to its favorable tolerability and minimal drug interactions, achieving seizure freedom in 65-80% of patients in some studies. LTG and LCS, effective as monotherapy or add-on therapies with response rates of 50-70%, vary in efficacy based on tumor histology and peritumoral microenvironment. Challenges include drug resistance linked to glutamate excitotoxicity, sodium channel dysregulation, and tumor-driven molecular changes. Research gaps, such as long-term comparative trials and personalized dosing strategies, highlight the need for further investigation. Optimizing AED selection in BTRE requires a multidisciplinary approach to balance seizure control, antitumor therapy efficacy, and adverse effect minimization, emphasizing personalized medicine.

Abstract Background: Spinal injuries are a significant cause of morbidity and mortality globally. Trauma-related spinal fractures contribute to the burden on healthcare systems and significantly affect the quality of life. Although substantial progress has been made in trauma care, spinal fractures, particularly those associated with spinal cord injuries (SCI), remain a leading cause of long-term disability. The epidemiology of spinal fractures varies regionally due to demographic, trauma mechanisms, and healthcare factors. In Iran, motor vehicle accidents and falls from heights are prominent causes of spinal injuries, but regional data on the epidemiology of these injuries, particularly from smaller cities, is scarce.


Materials and Methods: This retrospective cohort study was conducted at Imam Khomeini Hospital in Sari, Mazandaran province, Iran, reviewing the records of 288 patients with spinal fractures treated between March 2014 and March 2018. Data collected included demographic characteristics (age and gender), injury mechanisms, fracture locations, fracture types, presence of spinal cord injuries, and clinical outcomes. The analysis also included the association between injury mechanisms and fracture types using statistical tests.


Results: The study included 288 patients, with 75% being male and a mean age of 39.21 years. The most common mechanisms of injury were motor vehicle accidents (47.2%) and falls from height (35.4%). Cervical spine fractures were the most common, accounting for 49% of cases. Burst fractures were the most prevalent type of fracture (40.5%). Spinal cord injuries were present in 21.2% of the patients, with a higher incidence in those injured by vehicle accidents. The mortality rate was 3.1%, and 42.4% of patients underwent surgical intervention. The average hospital stay was 7.53 days.


Conclusion: This study provides a comprehensive epidemiological profile of spinal fractures in a regional Iranian hospital. It highlights the high incidence of spinal fractures due to motor vehicle accidents and falls from height, with cervical spine fractures and burst fractures being the most common. The presence of spinal cord injury is significant and underscores the need for early diagnosis and effective treatment. . Further studies, particularly prospective ones, are needed to better understand the long-term outcomes of spinal injuries and SCI in Iran.

Abstract Objective To integrate the latest evidence regarding inherited genetic risk factors for esophageal cancer while emphasizing contrasting susceptibility profiles between esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC)/Barrett’s esophagus as this integration also allows assessment of how genome-wide association studies (GWAS) together with new trans-ancestry genomic methods have advanced the discovery of risk loci and their potential clinical application.

Results More than 30 reliable risk loci are now recognized for ESCC mostly identified in East Asian populations with major signals located in PLCE1 alcohol/aldehyde metabolism genes ADH/ALDH2 (showing strong interaction with alcohol consumption) CHEK2 and HLA-region immune pathways whereas recent trans-ancestry studies have validated shared loci such as PLCE1 while uncovering novel African-enriched variants that highlight population-specific genetic architecture. By comparison EAC and Barrett’s esophagus present a separate genetic profile shaped largely by European-ancestry consortia featuring risk loci near BARX1 FOXP1 CRTC1 (involved in mucosal development) as well as CFTR MSRA BLK (linked to barrier function and oxidative stress) and although fewer loci have been found overall EAC exhibits considerable shared heritability with Barrett’s esophagus which supports the value of genetically guided surveillance.

Conclusion ESCC and EAC display strikingly different inherited risk patterns that closely reflect their distinct environmental risk factors as this difference now permits the construction of polygenic risk scores that incorporate subtype-specific GWAS findings together with emerging rare-variant and functional genomic information thereby enabling personalized risk assessment and more targeted screening in high-risk families and populations.

Abstract Background: Physical inactivity is a key risk factor for coronary heart disease (CHD). This systematic review explores the role of exercise in cardiac rehabilitation for CHD patients, emphasizing the integration of nuclear stress tests and tumor imaging techniques to assess heart function.

Materials and Methods: A systematic review was conducted, analyzing randomized controlled trials (RCTs) indexed in the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and EMBASE. Studies were selected based on criteria related to exercise-based cardiac rehabilitation, including outcomes such as cardiovascular mortality, hospitalization, and quality of life. Imaging methods, such as nuclear stress tests and tumor imaging, were also considered. The quality of the studies was assessed using the Cochrane Risk of Bias tool.

Results: Five RCTs were included in the final analysis. The reviewed literature consistently reported that exercise-based cardiac rehabilitation led to reductions in cardiovascular mortality and hospital admissions, alongside notable improvements in patient quality of life. The inclusion of nuclear stress tests was found to improve diagnostic accuracy for identifying myocardial ischemia and assessing heart function during exercise. Tumor imaging techniques were successfully used to identify cardiac tumors and monitor post-surgical heart function.

Conclusion: This systematic review supports the integration of exercise as a core component of cardiac rehabilitation programs for CHD patients. The findings indicate significant benefits in reducing cardiovascular mortality and improving quality of life. The use of nuclear stress tests and tumor imaging techniques enhances the precision of rehabilitation strategies, offering a more personalized approach to care.

Abstract Introduction: The global prevalence of obesity has spurred interest in alternative therapies beyond conventional diet, exercise, and pharmacotherapy. Acupuncture, a staple of Traditional Chinese Medicine, is one such intervention, though its efficacy and mechanisms of action, particularly on fat distribution, warrant further synthesis of existing evidence.



Objective: This review aims to critically appraise and summarize the current literature on the efficacy and safety of acupuncture for weight loss, with a special focus on insights provided by MRI and CT scan imaging regarding its impact on visceral and subcutaneous fat distribution.



Methods: A narrative review of scientific literature was conducted. Key databases, including PubMed, Google Scholar, and ISI Web of Science, were searched for relevant clinical trials, reviews, and meta-analyses published up to September 2024. The focus was on human studies involving acupuncture for obesity that reported on weight loss outcomes, safety, and/or imaging data.



Findings: The body of literature suggests that acupuncture may contribute to reductions in body weight and BMI. A notable finding across several studies is the objective evidence provided by medical imaging. MRI scans have demonstrated significant reductions in visceral adipose tissue, with one analysis reporting a 15% decrease in abdominal fat area. Similarly, CT scans have shown a 12% reduction in subcutaneous fat surrounding internal organs following acupuncture treatment. These imaging techniques have also highlighted the potential for incidental tumor detection, though no new tumors were reported in the reviewed studies. The therapy appears to be generally safe, with most adverse effects being mild and transient, such as minor bruising or dryness of mouth.



Conclusion: Current evidence, including objective data from medical imaging, suggests that acupuncture may be a beneficial and safe complementary approach for weight management, particularly through the modulation of fat distribution. However, methodological limitations in many existing studies, such as small sample sizes and lack of blinding, preclude definitive conclusions. More rigorous, large-scale, and long-term studies are recommended to confirm these findings and elucidate the underlying mechanisms.