Maryam Jessri

Macronutrients, vitamins and minerals intake and risk of esophageal squamous cell carcinoma: a case-control study in Iran

BackgroundAlthough Iran is a high-risk region for esophageal squamous cell carcinoma (ESCC), dietary factors that may contribute to this high incidence have not been thoroughly studied. The aim of this study was to evaluate the effect of macronutrients, vitamins and minerals on the risk of ESCC.MethodsIn this hospital-based case-control study, 47 cases with incident ESCC and 96 controls were interviewed and usual dietary intakes were collected using a validated food frequency questionnaire. Data were modeled through unconditional multiple logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), controlling for age, sex, gastrointestinal reflux, body mass index, smoking history (status, intensity and duration), physical activity, and education.ResultsESCC cases consumed significantly more hot foods and beverages and fried and barbecued meals, compared to the controls (p < 0.05). After adjusting for potential confounders, the risk of ESCC increased significantly in the highest tertiles of saturated fat [OR:2.88,95%CI:1.15-3.08], cholesterol [OR:1.53, 95%CI: 1.41-4.13], discretionary calorie [OR:1.51, 95%CI: 1.06-3.84], sodium [OR:1.49,95%CI:1.12-2.89] and total fat intakes [OR:1.48, 95%CI:1.09-3.04]. In contrast, being in the highest tertile of carbohydrate, dietary fiber and (n-3) fatty acid intake reduced the ESCC risk by 78%, 71% and 68%, respectively. The most cancer-protective effect was observed for the combination of high folate and vitamin E intakes (OR: 0.02, 95%CI: 0.00-0.87; p < 0.001). Controls consumed 623.5 times higher selenium, 5.48 times as much β-carotene and 1.98 times as much α-tocopherol as the amount ESCC cases consumed.ConclusionThis study suggests that high intake of nutrients primarily found in plant-based foods is associated with a reduced esophageal cancer risk. Some nutrients such as folate, vitamin E and selenium might play major roles in the etiology of ESCC and their status may eventually be used as an epidemiological marker for esophageal cancer in Iran, and perhaps other high-risk regions.

Next generation sequencing and its application in deciphering head and neck cancer

Head and neck squamous cell carcinoma (HNSCC) are a group of heterogeneous tumours mainly attributable to tobacco use, alcohol consumption and infection with human papillomavirus. Based on the stage of cancer at the time of diagnosis, patients are managed by surgery, radiotherapy, chemotherapy or a combination of these. Early diagnosis usually improves patient prognosis. Since their first commercial application in 2005, next generation sequencing (NGS) platforms are rapidly changing the face of basic science laboratories; however prior to progressing to clinical applications, clinicians should carefully examine currently available data and guidelines for technical and ethical matters concerning NGS. In this review, we compare various commercially available NGS platforms, with special consideration given to their clinical application in the management of HNSCC.

Measuring professionalism in residency training programs in Iran

Background and aim: To assess the Farsi (Persian) translated and modified version of the questionnaire of the American Board of Internal Medicine (ABIM) for measuring professionalism, and also, measuring the professional attitudes and behaviors associated with the medical residency training environment in Iran. Methods: After a pilot study, a 17-item questionnaire was distributed to 282 medical residents of two major universities of Iran, from December 2006 through February 2007. Results: Of the 282 distributed questionnaires, 259 (95.2%) were used in the analysis. Based on the analyses, two items were omitted and 15 items were retained for further analysis. The mean score was 106 (Standard Deviation (SD), 22.4) out of maximum 150, whereas the item mean was 6.12 (SD, 0.37) out of maximum 10. Corrected item-to-total correlations ranged from low to moderate. The internal reliability of the scale, based on Cronbachs alpha, meets Nunnallys minimal requirement. A factor analysis was performed, based on principal components and varimax rotation. The solution identified three factors (subscales) including excellence, honor/integrity and altruism/respect. Together these factors represented 58.8% of the common variance. Conclusion: This study showed the content validity and internal reliability of the Farsi version of the ABIM questionnaire. Therefore, it can be considered as an encouraging step toward developing a short, reliable and valid instrument for measuring professionalism in medical environments.

Adherence to dietary recommendations and risk of esophageal squamous cell carcinoma: A case-control study in Iran

Background/Aim: The Dietary Guidelines for Americans Adherence Index (DGAI) 2005 was developed to assess the contribution of dietary patterns to chronic disease risk. The objective of this study was to evaluate the association of dietary patterns as measured by the DGAI 2005 with the esophageal squamous cell carcinoma (ESCC) risk in Iran. Methods: This case-control study was conducted on 50 ESCC cases and 100 hospital controls aged 40–75 years. Participants were interviewed using validated food frequency questionnaires and the DGAI score was calculated subsequently. Results: Generally, the mean DGAI 2005 score for this population was low (9.54 ± 1.79) and the control group scored significantly higher compared to the ESCC cases (p < 0.001). Being in the highest tertile of DGAI scores reduced the risk of ESCC by 31%. Consumption of salty, peppery, and sour foods in combination increased the ESCC risk by 7.23%, followed by consumption of fried/barbecued meals (OR 3.79; 95% CI 1.10–5.44; p < 0.001) and high-temperature food/beverages (OR 3.68; 95% CI 1.20–8.99; p < 0.001). Conclusions: Consumption of a diet in accordance with dietary recommendations was associated with a lower risk of ESCC. Preventive strategies to reduce the ESCC risk in high-risk regions of the world should focus on overall dietary patterns and dietary habits in order to be effective.

Harnessing Massively Parallel Sequencing in Personalized Head and Neck Oncology

Advances in the management of patients with head and neck squamous cell carcinoma (HNSCC) have not significantly changed the prognosis of this tumor over the past five decades. Molecular heterogeneity of HNSCC and its association with HPV, in addition to the increase in the number of cancers arising in traditionally low-risk patients, are among some of the obstacles to the successful management of this group of tumors. Massively parallel sequencing, otherwise known as next-generation sequencing (NGS), is rapidly changing conventional patient management by providing detailed information about each patient’s genome and transcriptome. Despite major advances in technology and a significant reduction in the cost of sequencing, NGS remains mainly limited to research facilities. In addition, there are only a few published studies that have utilized this technology in HNSCC. This paper aims to report briefly on current commercially available NGS platforms and discuss their clinical applications, ethical considerations, and utilization in personalized patient care, particularly as this relates to head and neck cancer.

A case of primary diffuse large B‐cell non‐Hodgkin's lymphoma misdiagnosed as chronic periapical periodontitis

Lymphoma is a malignant neoplasm of component cells of the lymphoid system which is very rare in the jaws. Here we report a case of primary diffuse large B-cell lymphoma located in the periapical region of a mandibular molar which was misdiagnosed as chronic periapical periodontitis. The present case was diagnosed at an early stage and effectively managed by chemotherapy. Although lymphoma of the mandible is rare, it must be considered in the differential diagnosis of radiolucent lesions in this region. Lack of knowledge of this rare presentation may lead to delays in diagnosis and poor prognosis.

hMSH6: a potential diagnostic marker for oral carcinoma in situ

Oral medicine specialists rely upon accurate assessment of pathology to rationalise lesion management, especially for high-risk oral epithelial dysplasia, carcinoma in situ (CIS) and oral squamous cell carcinoma. Cross-discipline cancer research has highlighted the role of genetic instability in neoplasia. Improved diagnostic stringency from translation of immunostaining for DNA repair defects into current pathology practice has potential to benefit pathologists, clinicians and patients. The focus of this study was the obligatory and non-obligatory components of the MutLα and MutSα mismatch repair heterodimers, namely hMLH1, hMSH2, hPMS2 and hMSH6, which were studied in 274 formalin-fixed paraffin-embedded sections. A readily apparent inverse correlation between oral disease severity and both obligatory and non-obligatory components of MutLα and MutSα was observed (hMLH1, ρ=−0.715; hPMS2, ρ=−0.692; hMSH2, ρ=−0.728; and hMSH6, ρ=−0.702), with particularly conspicuous loss of hMSH6 expression from the stratum basale of CIS.

Next-Generation Sequencing Applications in Head and Neck Oncology

Head and neck cancer remains a major medical problem with significant morbidity, mortality and quality of life issues. Over the recent past there has been an increase in incidence, a shift in etiological factors, a growing proportion of tumours in younger cohorts, and a greater realisation of the heterogeneity of this group of tumours particularly within head and neck squamous cell carcinomas.

Prevalence of dental caries and its association with cariogenic foods and beverages

Adequate nutrition during toddlerhood is essential for optimal growth and development, yet biochemical data suggest that 12-24-month-old children are at risk of iron deficiency. Mathematical modelling combined with experimental interventions can provide strong evidence regarding the types of foods required to improve toddler iron status.Dietary pattern affects blood levels of environmental pollutants in elderly Swedish men and women

Does adherence to dietary recommendations reduce the risk of esophageal squamous cell carcinoma in a high-risk population?

Adequate nutrition during toddlerhood is essential for optimal growth and development, yet biochemical data suggest that 12-24-month-old children are at risk of iron deficiency. Mathematical modelling combined with experimental interventions can provide strong evidence regarding the types of foods required to improve toddler iron status.Dietary pattern affects blood levels of environmental pollutants in elderly Swedish men and women