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Reza Malekzadeh

Publications and source records attributed to Reza Malekzadeh.

At least 19 recordsLinked to original sources
PubMed2005

Incidence and age distribution of colorectal cancer in Iran: results of a population-based cancer registry.

Epidemiologic patterns of colorectal cancer (CRC) in Iran have not been studied adequately. In a recent cancer registry and active cancer surveillance, we collected data on the incidence of colorectal tumors in five provinces of Iran from 1996 to 2000. In total, 2055 were registered in this study. Age-adjusted rates of CRC in Iranian males and females were 8.2 and 7.0/100,000, respectively. Seventeen percent of the cases were younger than 40 years of age at the time of diagnosis. This proportion was similar to proportions seen in many other Middle-Eastern countries, but much higher than those seen in Western countries. A comparison of age-specific rates between Iran and the US showed similar rates in young (<40 years) Iranians and Americans, but much lower rates in older (>/=40) Iranians. We conclude that Iran is still a country with low-risk of CRC, particularly for older individuals. The high proportions of young CRC cases seen in Iran, and probably many neighboring countries, are due to the young age-structure of these countries and relatively low rates of CRC in older individuals.

Adenocarcinoma↗
PubMed2005

Serum hyaluronate as a non-invasive marker of hepatic fibrosis and inflammation in HBeAg-negative chronic hepatitis B.

BACKGROUND: HBV infection is a serious global heath problem. It is crucial to monitor this disease more closely with a non-invasive marker in clinical trials. We aimed to evaluate the predictive value of serum hyaluronate for the presence of extensive liver fibrosis and inflammation. METHODS: 28 healthy volunteers and 65 patients with HBeAg negative chronic hepatitis B were enrolled. Liver biopsies scored according to Ishak system. Association of serum hyaloronate with liver fibrosis and inflammation were assessed, and cut off points for serum hyaluronate levels were identified by receiver operating characteristics (ROC) curves and their values for prediction of fibrosis and inflammation were assessed. RESULTS: In patients with CHB serum hyaluronate had the most significant correlation and predictive values for the liver fibrosis and inflammation comparing to the other variables. At the cut off point of 126.4 ngm/ml it could discriminate extensive fibrosis from milder ones with sensitivity of 90.9% and specificity of 98.1%. With the same value it could discriminate extensive inflammation from their milder counterparts with sensitivity of 63.6% and specificity of 92.6%. CONCLUSION: Serum hyaluronate was the best predictor of extensive liver fibrosis and inflammation and it could discriminate subgroups of patients with chronic hepatitis B. It could be used as a non-invasive test to monitor these patients more closely with developing anti viral agents in clinical trials.

Adult↗
PubMed2005

Family history of colorectal cancer in Iran.

BACKGROUND: Previous reports show a high proportion of young CRC patients in Iran. In this study we aim to look for the clustering of colorectal cancer in families of a series of CRC patients from Iran. METHODS: The family history of cancer is traced in 449 CRC patients of which 112 were 45 yrs or younger and 337 were older than 45 yrs at time of diagnosis. The patients were admitted in two hospitals in Tehran, during a 4-year period. RESULTS: Clinical diagnosis of HNPCC was established in 21 (4.7%) probands. Family history of CRC was more frequently reported by early-onset than by late-onset patients (29.5% vs. 12.8%, p < 0.001). Distribution of tumor site differed significantly between those with and without family history of CRC. Right colon cancer was the most frequent site (23/45, 35.4%) observed in patients with positive family history of colorectal cancer. CONCLUSION: The relatively high frequency of CRC clustering along with HNPCC in our patients should be further confirmed with larger sample size population-based and genetic studies to establish a cost effective molecular screening for the future.

Adult↗
PubMed2005

Human papillomavirus in squamous cell carcinoma of esophagus in a high-risk population.

AIM: To investigate the relation of human papillomavirus (HPV) and esophageal squamous cell carcinoma (ESCC) in Iranian patients as compared to normal controls. METHODS: Using MY09/MY11 consensus primers, we compared the prevalence of a HPV L1 gene in tumor tissues from 38 ESCC cases and biopsied tissues from 38 endoscopically normal Iranian individuals. We also compared the presence of HPV16 and HPV18 in the same samples using type-specific E6/E7 primers. RESULTS: Fourteen (36.8%) of the 38 ESCC samples but only 5 (13.2%) of the 38 control samples were positive for the HPV L1 gene (P = 0.02). Five (13.2%) of the ESCC samples but none of the control samples were positive for the HPV16 E6/E7 gene (P = 0.05). Three (7.9%) of the ESCC samples and 5 (13.2%) of the control samples were positive for the HPV18 E6/E7 gene (P = 0.71). CONCLUSION: Our data are consistent with HPV DNA studies conducted in other high-risk areas for ESCC. HPV should be considered as a potential factor contributing to the high incidence of ESCC in Iran and other high-incidence areas of the world.

Adult↗
PubMed2005

Impact of immunosuppressive treatment on liver fibrosis in autoimmune hepatitis.

The impact of treatment on progression of fibrosis in autoimmune hepatitis (AIH) is unknown. We assessed the changes in liver fibrosis before and after treatment among these patients. Nineteen AIH patients who had paired liver biopsies were studied. Of these, seven had been treated with 6 months of cyclosporine A and the rest with 6 months of prednisolone for induction of remission. Thereafter all had been maintained on azathioprine. Biopsy specimens before and after treatment were reviewed by one pathologist and scored by the Ishak method. Mean fibrosis stages before and after treatment were compared. Also, factors predicting significant fibrosis (stage > or =3) and cirrhosis (stage > or =5) at presentation were assessed. Mean interval between biopsies was 3.38 years. Mean fibrosis stage decreased from 4.53 to 2.16 following treatment (P < 0.001). Mean decrement in inflammatory grade was 8 scores (range, 4-10) in patients in whom fibrosis improved, and 2 scores (range, 0-4) in patients in whom fibrosis did not decrease after treatment (P < 0.001). ALT-to-platelet ratio was the best predictor of significant fibrosis and also cirrhosis. Fibrosis commonly improves after immunosuppressive treatment in AIH. ALT-to-platelet ratio can predict accurately the presence of significant fibrosis and cirrhosis in AIH.

Adolescent↗
PubMed2005

Helicobacter pylori endemic and gastric disease.

H. pylori infection of the stomach is widespread among human populations including Iranians and is considered to play a major role in the pathogenesis of gastric diseases such as peptic ulcer, adenocarcinoma, and MALT lymphoma. The association between H. pylorivirulence markers and disease has been studied in other populations around the world. The aim of this study was to investigate the distribution of H. pylori vacA and cagA genotypes and their association with clinical outcomes in Iran. H. pylori was cultured from gastric biopsy specimens obtained from 137 Iranian patients (58 with duodenal ulcer, 61 with nonulcer dyspeptic [NUD], and 18 with gastric adenocarcinoma). The vacA alleles and cagA genotypes were determined by PCR. The vacA sl allele was present in 107 of the 137 subjects (78%). Multiple strains (m1 and m2) were detected in H. pylori isolates from the patients. VacA s1 genotypes were more frequent in patients with peptic ulcer (46/58; 79%) than in NUD patients (47/61; 77%). CagA was present in 44% of the patients. NUD patients had a frequency of cagA positivity similar to that of the overall population (46%). CagA was present more frequently more than cagA-negative (20% vs. 8%, respectively) in patients with gastric carcinoma (20%) than cagA-negative in patients with gastric carcinoma (8%). This is the first comprehensive study to demonstrate the frequency of colonization with mixed strain, vacA s1, m1 and m2 as the dominant genotype in these Iranian patients, where a high rate of H. pylori infection exists and is similar to the region with a low rate of H. pylori infection. Therefore, host genetics, environmental factors, and the substantial genetic heterogeneity among different H. pylori strains may contribute to the different clinical outcomes.

Adolescent↗
PubMed2005

Coeliac disease in developing countries: Middle East, India and North Africa.

Following the application of simple serological tests for the diagnosis of coeliac disease (CD) in the 1980s, it gradually became clear that the prevalence of CD in different countries in the Middle East, North Africa and India is almost the same as that in Western countries. The prevalence of CD in at-risk populations in these regions is reported to range between 3 and 20% and the prevalence in people with type 1 diabetes is approximately 3-5%. Clinical manifestations of CD vary markedly with age, the duration and the extent of disease. Clinical studies showed that presentation with non-specific symptoms or no symptoms is as common in the Middle East as it is in Europe. Wheat has been the major staple food in these regions for many centuries and it is possible that the continuous and high level of exposure to wheat proteins has induced some degree of immune tolerance, leading to milder symptoms, which are misdiagnosed as irritable bowel syndrome or unexplained gastrointestinal disorders. A high index of suspicion for CD should be maintained in all developing countries for patients who present with chronic diarrhoea or iron deficiency anaemia. The best method for diagnosing CD in patients with diarrhoea is the panel of coeliac serological tests followed by small-bowel biopsy. In the absence of supplies for a gluten-free diet in Middle Eastern countries, maintaining this diet represents a real challenge to both patients and clinicians.

Africa, Northern↗
PubMed2005

Prevalence and etiology of persistently elevated alanine aminotransferase levels in healthy Iranian blood donors.

BACKGROUND AND AIM: Causes of elevated serum alanine aminotransferase (ALT) levels vary depending on the population under study. The aim of this study was to determine the prevalence and causes of elevated ALT levels among apparently healthy Iranian blood donors in Tehran. METHODS: A total of 1959 (1465 male) randomly selected blood donors were enrolled in the study. Body mass index (BMI), viral markers and ALT levels were measured. If ALT was elevated (> 40 U/L), it was rechecked twice within 6 months. Blood donors with > or =2 times elevated ALT levels (persistently elevated ALT) were invited for further evaluation. RESULTS: A total of 100 donors (5.1%) had elevated ALT levels at the first measurement. Fifty-two persons (2.65%) were found to have persistently elevated serum ALT. Among subjects with persistently elevated serum ALT, non-alcoholic steatohepatitis (NASH) was diagnosed in 46 (88.4%), chronic hepatitis C virus (HCV) infection in four (7.7%), alcoholic liver disease in one (1.92%), and drug-induced liver disease in one (1.92%). The prevalence of NASH and HCV infection in the studied population was 2.35% and 0.4%, respectively. The mean BMI of NASH subjects was 30.58 kg/m(2), compared with 27.28 kg/m(2) of those without NASH (P < 0.001). CONCLUSION: Non-alcoholic steatohepatitis is the most common cause of persistently elevated serum ALT in the asymptomatic Iranian blood donors in Tehran.

Adult↗
PubMed2005

Helicobacter pylori reinfection rate 3 years after successful eradication.

BACKGROUND AND AIM: Helicobacter pylori (HP) infection is one of the most prevalent human infections and has been implicated as a predisposing factor in gastric cancer, chronic active gastritis, duodenal ulcer, gastric ulcer and gastric lymphoma. Reinfection after successful eradication is quite uncommon in adults. In the only study carried out in Iran, a reinfection rate of 19.1% after 1 year has been reported. We studied the rate of reinfection 3 years after successful HP eradication. METHODS: All patients who had undergone HP eradication 3 years before the study and had successful eradication verified by a negative (14)C urea breath test (UBT) 1 year after eradication were invited to complete a questionnaire and undergo another UBT. In addition, spouses and the offspring of those testing positive were offered an UBT. RESULTS: Ninety-eight patients were enrolled (49% male). Mean age was 44 +/- 13 years (range: 18-75 years). Twenty patients (20.4%) had a positive UBT. Epigastric burning (25%vs 69%) and pyrosis (50%vs 67%) were seen less commonly in those who were HP free at 3 years compared to those who tested positive for HP. CONCLUSIONS: According to our data, in our region the HP reinfection rate is 20.4% 3 years after successful eradication.

Adolescent↗
PubMed2005

Detection of Helicobacter pylori-specific genes in the oral yeast.

BACKGROUND: Until today, human stomach is the only recognized habitat of Helicobacter pylori. However, recruitment of DNA-based methods has made possible the detection of H. pylori in water and oral cavity, thus suggesting fecal-oral and oral-oral routes for transmission of H. pylori, respectively. In this study, yeast has been proposed as a common vector for transmission of H. pylori. Thus designed primers were recruited to target 16S rDNA and cagA genes in the oral yeasts by PCR. MATERIALS AND METHODS: Eighteen yeasts were examined microscopically for the presence of bacterial-like bodies. DNAs were extracted from oral yeasts using phenol-chloroform method. Amplification conditions were optimized as 33 cycles and annealing temperatures of 63 degrees C for 16S rDNA and 51 degrees C and 52 degrees C for cagA gene which was targeted in two steps. DNAs of H. pylori and Saccharomyces cerevisiae were used as controls. Polymerase chain reaction (PCR) products of two genes from one yeast and from H. pylori were cloned in pCAP and subsequently subcloned in pSK+ and were sequenced. RESULTS: Bacterial-like bodies were observed in all oral yeasts. The amplified products of 16S rDNA from all oral yeasts were homologous in size with those of H. pylori. Fifteen out of eighteen (83%) yeasts contained cagA gene, homologous to H. pylori. CagA was not amplified from three yeasts and S. cerevisiae. Analysis of the sequenced products of 16S rDNA and cagA from one oral yeast showed 98% homology with those of H. pylori. CONCLUSIONS: The presence of H. pylori inside the yeast was indicated by light microscopy and PCR. It appears that yeasts, which are abundant in nature and thrive the mucosal surfaces of human, might serve as reservoirs and vehicles of H. pylori.

Antigens, Bacterial↗
PubMed2004

Hereditary risk factors for the development of gastric cancer in younger patients.

BACKGROUND: It is believed that the development of gastric cancer (GC) before the age of 50 has a hereditary basis. Blood group A and history of gastric cancer in first-degree relatives have been shown to be risk factors for GC. METHODS: In this case-control study, we enrolled patients with GC who were diagnosed before the age of 50. Patients who were diagnosed as having GC were selected. A total of 534 cases were found; of these, 44 diagnosed before the age of 50 were included in the case group. For the control group, 22 males and 22 females were randomly selected from the remaining subjects, who had diagnoses of GC after the age of 50. All the surviving patients and family members of the dead patients were interviewed about the history of cancer in the family and the age at which other family members developed cancer. The blood group of each subject was also obtained. RESULTS: forty-four cases under 50 years old (mean age: 36.2 years) and forty-four controls (mean age: 67.1 years) were enrolled in the study. At the time of the study, 59.1% of the study group and 50% of the control group were alive (P value = NS). In the study group, 68.1%, 13.6%, 13.6% and 4.5% had blood groups O, A, B and AB, respectively. In the control group the corresponding figures were 27.7%, 63.6%, 6.8% and 4.5%. First or second-degree relatives with cancer, including gastric (the most frequent), breast, lung, gynecological and hematological malignancies, were noted in 54.5% of the cases and 11.4% of the controls (p < 0.01). Family histories of cancer were accepted as valid provided that they were based on valid medical documents. CONCLUSIONS: It seems that the development of GC before the age of 50 is likely to be accompanied by familial susceptibility. Interestingly, our study showed a significant correlation between blood group O and the development of gastric cancer under the age of 50.

ABO Blood-Group System↗
PubMed2004

Genetic polymorphisms in three Iranian populations with different risks of esophageal cancer, an ecologic comparison.

The age-standardized incidence of esophageal cancer (EC) varies from 3 to >100/100,000 per year in different provinces of Iran. This striking variation of incidence is associated with differences in ethnic backgrounds, raising the possibility that genetic factors are involved in the pathogenesis of EC. We compared the frequencies of polymorphisms in ten genes that have been hypothesized to have a role in risk of EC (CYP1A1, CYP2A6, CYP2E1, GSTM1, GSTP1, GSTT1, ADH2, ADH3, ALDH2, and O6-MGMT) among three Iranian ethnic groups with highly varying rates of EC. These three groups included high-risk Turkomans, medium-risk Turks, and low-risk Zoroastrian Persians. Compared to Zoroastrians, Turkomans had higher frequency of four alleles that are speculated to favor carcinogenesis (CYP1A1 m1, CYP1A1 m2, CYP2A6*9, and ADH2*1); these results are consistent with an influence of these allele variants on the population risk of EC. However, none of these four alleles had a high enough prevalence in Turkomans to explain the high rates of EC in this group. Three of these four alleles (CYP1A1 m1, CYP1A1 m2, CYP2A6*9) were less frequent among Turkomans than in some Asian populations with lower risks of EC. We conclude that it is unlikely that variations in these polymorphic genes are major contributors to the high incidence of EC among Turkomans in Iran.

Asia↗
PubMed2004

Ecologic study of serum selenium and upper gastrointestinal cancers in Iran.

AIM: Both observational and experimental studies have shown that higher selenium status reduces the risk of upper gastrointestinal cancers in selenium deficient populations. Recent cancer registry data have shown very different rates of esophageal cancer (EC) and gastric cancer (GC) in four Provinces of Iran, namely Ardabil, Mazandaran, Golestan, and Kerman. The aim of this study was to have a preliminary assessment of the hypothesis that high rates of EC in Golestan and high rates of GC in Ardabil may be partly attributable to selenium deficiency. METHODS: We measured serum selenium in 300 healthy adults from Ardabil (n = 100), Mazandaran (n = 50), Golestan (n = 100), and Kerman (n = 50), using inductively coupled plasma, with dynamic reaction cell, mass spectrometry (ICP-DRC-MS) at the US Centers for Disease Control (Atlanta, Georgia). RESULTS: The median serum selenium concentrations were very different in the four Provinces. The medians (IQR) for selenium in Ardabil, Mazandarn, Golestan, and Kerman were 82 (75-94), 123 (111-132), 155 (141-173), and 119 (110-128) microg/L, respectively (P<0.001). The results of linear regression showed that the Province variable, by itself, explained 76% of the variance in log selenium (r2 = 0.76). The proportion of the populations with a serum selenium more than 90 microg/L (the concentration at which serum selenoproteins are saturated) was 100% in Golestan, Kerman, and Mazandaran but only 29% in Ardabil. CONCLUSION: Our findings suggest that selenium deficiency is not a major contributor to the high incidence of EC seen in northeastern Iran, but it may play a role in the high incidence of GC in Ardabil Province.

Adult↗
PubMed2004

Hepatitis B.

Explore the source record for details and available documents.

Alanine Transaminase↗
PubMed2004

Molecular epidemiology of hepatitis C virus in Iran as reflected by phylogenetic analysis of the NS5B region.

Hepatitis C virus (HCV) subtypes were determined in 125 Iranian patients by phylogenetic analysis within the NS5B or 5'-UTR/core regions. Subtypes 1a and 3a were predominant accounting for 47 and 36%, whereas 1b and 4 accounted for 8 and 7%. This subtype distribution differs from that of Turkey and Pakistan, where subtypes 1b and 3a dominate and also from neighbouring Arabic countries where subtype 4 is the prevalent genotype. The Iranian 1a and 3a strains formed subclusters in the dendrogram indicating that these subtypes are indigenous to Iran. In contrast, the 1b strains intermixed with strains derived worldwide. Subtype 1a was frequent in South Iran (70%), while 3a was more prevalent in North-West Iran (83%), a region with a high proportion of Turkish inhabitants. Patients infected by blood products had more frequently subtype 1a (57%), while younger drug users had more frequently subtype 3a (54%). Genotype 4 was over-represented among haemodialysis patients in Tehran. One strain, most similar to genotype 5, was highly divergent in the NS5B region and further analysis is needed to assess the systematic status of this strain. In half of the patients with unknown source of infection only the 5'-UTR could be amplified, most of which were from North-West Iran and from patients younger than those with unknown source of infection with typable strains, mean age 29 versus 43 years. In conclusion, the NS5B sequence data revealed population based subtype patterns in Iran, the further study of which may help to understand the molecular epidemiology of HCV in a low-endemic area.

5' Untranslated Regions↗
PubMed2004

Reversibility of cirrhosis in chronic hepatitis B.

BACKGROUND & AIMS: Hepatic fibrosis and cirrhosis are the consequences of many types of chronic liver disease, and, at its final stage when liver nodule and scarring develop, they are generally considered to be irreversible. METHODS: Here we describe 3 patients with chronic hepatitis B with clinical, biochemical, and histologic evidence of cirrhosis. They underwent treatment with interferon-alpha or lamivudine and had follow-up liver biopsy while in clinical, biochemical, and virologic remission. Biopsy specimens were randomly coded in unpaired manner according to patient, and they were read independently by 2 pathologists using the modified hepatitis activity index (with a maximum stage of 6). The mean interval between biopsies was 5.5 years. RESULTS: The mean ALT level decreased from 113.7 to 28.3 U/L. The mean bilirubin level decreased from 2.4 to 0.9 mg/dL, and the mean prothrombin time decreased from 16.3 to 12.3 seconds. The mean Child-Pugh score decreased from 8 to 5. The mean fibrosis score decreased from 5.8 to 0.5 (P = 0.004), and the mean grading score decreased from 10.8 to 3.2 (P = 0.017). CONCLUSIONS: Cirrhosis due to chronic hepatitis B might be reversible in some patients who respond to antiviral therapy.

Adult↗