International journal of reproductive biomedicine (Yazd, Iran), 2017
Human and experimental studies suggest that the sympathetic regulatory drive in the ovary may be ... more Human and experimental studies suggest that the sympathetic regulatory drive in the ovary may be unbalanced (hyperactivity) in polycystic ovary syndrome (PCOS). Dysfunctional secretion of interleukin (IL) -1 (α & β) or related cytokines may thus be related to abnormal ovulation and luteinization. The aim of this study was the evaluation of cytokines' pattern in PCOS women and discussion about the explanation of cross-talk between two super systems: sympathetic and immune systems and explanation sympatho-excitation and relationship with interleukins. In this study, 171 PCOS women aged between 20-40 years were studied the. Their body mass index was <28. The patients were divided into two groups: study group (n=85, PCOS women) and control group (n=86 normal women). The blood sample was obtained on the 3 day of menstruation cycle. IL-17, IL-1α, IL-1β, and TNF-α concentrations were determined in both groups. The median serum level of IL-1α in the PCOS group was higher than the con...
Pruritus is the most frequent chronic dermal complication of sulfur mustard (SM), which negativel... more Pruritus is the most frequent chronic dermal complication of sulfur mustard (SM), which negatively influences the quality of life. Exact pathophysiology of SM-induced itching is unknown. The current study aimed at evaluating the possible association between SM-induced itching and the serum levels of matrix metalloproteinase (MMP)-9 and their endogenous inhibitors, and serum levels of soluble forms of selectins (sL-, sP-, and sE-selectins) as adhesion molecules involved in the development of different inflammatory reactions. Serum levels of MMP-9, MMP-9/ tissue inhibitors of metalloproteinases (TIMPs), and selectins were measured by the enzyme-linked immunosorbent assay (ELISA), and compared between the groups (n=368) with and without itching, and matched control groups (n=126). Serum levels of MMP-9 were significantly higher in the SM exposed group with itching, compared with that of the group without itching (medians: 894 and 624 pg/mL respectively; P-value =0.034). There was no re...
The International journal of biological markers, 2018
Epidemiological and experimental literature indicates that the risk of breast cancer incidence is... more Epidemiological and experimental literature indicates that the risk of breast cancer incidence is strongly linked to hormone-dependent factors, including reproductive history and obesity. However, the molecular mechanisms underlying the association between these factors and breast cancer risk are poorly understood. The aim of this study, therefore, was to determine whether obesity and reproductive history are associated with expression levels of two breast cancer-related long non-coding RNAs (lncRNAs), namely ZFAS1 and SRA1 in cancer-free breast tissues of women. In the current research, 145 healthy women were recruited, and the quantitative expression levels of the two lncRNAs were determined through qPCR assay after gathering the mammoplasty breast tissue samples. It was found that women with body mass index (BMI)≥30 kg/m and BMI 25-29 kg/m show a low expression of ZFAS1 compared to the BMI<25 kg/m ( P=0.031 and P=0.027, respectively). Then, the correlation analysis disclosed a...
Long noncoding RNAs (lncRNAs) constitute a major class of the human transcriptome which play cruc... more Long noncoding RNAs (lncRNAs) constitute a major class of the human transcriptome which play crucial roles in the key biological processes of both normal and malignant breast cells. Although the aberrant expression of lncRNAs has been well-documented in breast cancer (BC), little is currently known about the association between their expression levels in the breast tissue of healthy women and BC risk factors, especially the reproductive or demographic characteristics that are among the most well-known BC risk modifiers. This study was an attempt to investigate the correlation between the expression levels of 2 breast cancer-related lncRNAs, including GAS5 and LSINCT5, and reproductive and demographic characteristics in 145 normal breast tissues that were obtained from women without breast cancer undergoing cosmetic surgery. Total RNA was extracted from fresh normal breast tissues, and the expression level of target lncRNAs was quantified using real-time qPCR. Differences in the mean...
Among the most common metabolic disorders during pregnancy is gestational diabetes mellitus (GDM)... more Among the most common metabolic disorders during pregnancy is gestational diabetes mellitus (GDM). This research was conducted to examine the dietary pattern in women with GDM. In this case-study, 204 pregnant women (104 cases and 100 control women) were chosen through convenient sampling and random sampling. The subjects' food intakes were assessed using semi-quantitative food frequency questionnaire, while their activities evaluated by physical activity questionnaire. Anthropometric indices were measured based on standard instructions, and the body mass index was calculated. The dietary patterns were determined using principal component analysis and its relationship with preeclampsia was tested using logistic regression method. Unhealthy and healthy dietary patterns were found among the pregnant women. In the unhealthy group, after modifying the effect of confounding variables, a significant relationship was observed between dietary pattern and having gestational diabetes (OR ...
Although environmental factors play an important role in susceptibility to myocardial infarction ... more Although environmental factors play an important role in susceptibility to myocardial infarction (MI), genetic determinants also provide a significant contribution. This study aimed to determine whether or not MI susceptibility is influenced by the SDF1-rs1801157A/G and HHEX-rs1111875 A/G polymorphisms in an Iranian population. A total of 120 patients with MI and 120 healthy controls were enrolled. Blood samples were collected from all the participants for genomic DNA extraction and testing. Polymorphism genotyping was determined by the polymerase chain reaction-restriction fragment length polymorphism technique. Multiple logistic regression analysis revealed that the A allele and AA genotype of the SDF1-rs1111875 polymorphism produce a significant risk of MI both before (crude odds ratio [OR] = 8.83, 95% confidence interval [95% CI] = 1.05-73.76, p = 0.025) and after adjustment (adjusted OR = 8.12, 95% CI = 5.02-19.42, p = 0.04). In contrast, the GG genotype of the SDF1-rs1111875 polymorphism provides a protective effect on MI in a recessive model (GG vs. AA+AG) before (crude OR = 0.57, 95% CI = 0.34-0.97, p = 0.037) and after adjustment (adjusted OR = 0.53, 95% CI = 0.3-0.82, p = 0.021). No association was found between the HHEX-rs1111875 A/G polymorphism alleles and the susceptibility to MI. Taken together, the current findings suggest that the SDF1-rs1801157A/G gene variant may play an important role in relation to MI in this Iranian population. Nevertheless, more replication studies and meta-analyses should be carried out in this area.
Reproductive history and obesity are among the well-recognized risk factors in the development of... more Reproductive history and obesity are among the well-recognized risk factors in the development of breast cancer, which are partially mediated by the increased exposure of breast tissues to estrogens. However, only a few studies have investigated the link between these risk factors and the pattern of methylation signatures in the breast tissue of healthy women. The role of the estrogen receptor 1 (ESR1) gene hypermethylation is reportedly important in the development of breast cancer. Thus, it is speculated that such ESR1 epigenetic changes may be influenced or shaped by obesity and reproductive history-related factors before and during breast carcinogenesis. Breast samples were collected from 120 cancer-free women who had undergone cosmetic mammoplasty. DNA was extracted from the breast tissues and, then, the methylation levels at the promoter and exon 1 regions of the ESR1 gene CpG island were determined by using the methylated DNA immunoprecipitation-quantitative PCR assay. The me...
Measuring the quality of life (QOL) is a benchmark in today's world of medicine. The aim of t... more Measuring the quality of life (QOL) is a benchmark in today's world of medicine. The aim of the present study was to determine the general health and QOL of infertile women and certain affecting conditions. In a cross-sectional study, 161 infertile women referring to Dr. Rostami's Infertility Center of Shiraz, Southern Iran, in 2013 were enrolled by the convenience sampling method. Data were collected via a socio-demographic, general health (GHQ28), and the QOL Questionnaire of Infertile Couples and analyzed using descriptive and analytical statistics. According to 146 completely filled-out questionnaires, the mean age of the participants and their spouses were 29.4 ± 5.4 and 33.8 ± 5.8 years, respectively. Moreover, the general health of 57 (39%) patients was normal and that of 89 (61%) patients showed a degree of impairment. The scores for depression and physical symptoms were the highest and lowest, respectively. In addition, quite positive, positive, neutral, and negativ...
IL-1b-3953 C&gt;T and MMP-9-1562C&gt;T variants have been shown to be linked to the devel... more IL-1b-3953 C&gt;T and MMP-9-1562C&gt;T variants have been shown to be linked to the development of myocardial infarction (MI), although previous studies have reported inconsistent results. The aim of the present study was to determine whether these genetic variations are associated with MI susceptibility in an Iranian population. In the current study, 117 patients with MI and 120 control group members were selected as participants. Peripheral blood samples were taken from all the subjects for genomic DNA extraction. Single nucleotide polymorphism (SNP) genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assays. Multiple logistic regression analysis revealed that the TT genotype of the IL-1b-3953 C&gt;T polymorphism is associated with a significant MI protective effect in: the homozygote model after adjustment for MI risk factors (odds ratio [OR]: 0.18, confidence interval [95% CI] = 0.04-0.72; p = 0.01); and also in the recessive genetic model both before (OR: 0.39, 95% CI: 0.15-0.96, p = 0.04) and after (OR: 0.15, 95% CI: 0.04-0.58, p = 0.006) adjustment for MI risk factors. Furthermore, multiple logistic regression analysis indicated that the individuals with the TT genotype of the MMP-9-1562C&gt;T polymorphism were significantly protected against MI in comparison with the CC genotype (OR: 0.01, 95% CI: 0.002-0.68, p = 0.03). The findings suggest that the minor alleles of the two polymorphisms under study both have protective effects with respect to MI susceptibility in the Iranian population.
Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2016
The percent and distribution of body fat are important factors in the pathogenesis of numerous di... more The percent and distribution of body fat are important factors in the pathogenesis of numerous diseases. Our aim was to investigate common anthropometric indices in their relationship with body fat content. In a cross-sectional study 1360 healthy individuals (580 men and 780 women) in a cluster sampling, from Ahvaz, Iran, body fat content (using bioelectrical impedance) and anthropometric measurements [weight, waist circumference, a body shape index, abdominal volume index, body adiposity index, conicity, body mass index, hip circumference, waist to hip ratio and waist to height ratio] was obtained. The ROC curve analysis was used to compare each index with body fat percent. Significant difference was found between men and women in all anthropometric parameters (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Women displayed higher percentages in the overweight and obese categories (33.6% vs. 32.9% and 26.4% vs. 22.1%, respectively). In both men and women, the strongest correlations were seen between body fat percent and BMI, AVI and WHtR (r&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;7.9 and p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). BMI, WHtR and AVI in men and BAI, BMI and WHtR in women showed the most accuracy for estimating body fat percent, respectively. All anthropometric parameters could predict body fat percent with relatively good power, however BMI, WHtR and AVI are more powerful predictors. Based on our findings, we suggest using the AVI and WHtR instead of other indexes, as they are better able to assess the accumulation of fat in the abdominal area and are able to more accurately assess body fat percent, which are indicators of chronic disease.
Dyspnea is the hallmark symptom of some respiratory diseases such as chronic obstructive pulmonar... more Dyspnea is the hallmark symptom of some respiratory diseases such as chronic obstructive pulmonary disease and bronchiolitis and is a major reason for which these patients seek medical attention. We performed a randomized triple-blind controlled crossover clinical trial in which we compared the efficacy of inhaled furosemide (4 ml equal to 40 mg in 10 min) with placebo (4 ml of 0.9% saline solution) in 41 mustard gas-exposed patients. Dyspnea index, visual analog scale (VAS), and pulmonary function test results were obtained before and 4 h after treatments. Results showed that both furosemide and placebo significantly decreased VAS and dyspnea index and increased FEV(1), FVC, and FEV(1)/FVC, while there was no difference between the two drugs in these effects (p values .23, .61, .81, .36, and .27, respectively). Our results failed to address the previously reported effects of inhaled furosemide on dyspnea. In fact, we suggest that patients with a previous exposure to sulfur mustard, in which chronic bronchitis and bronchiolitis are the most suggested underlying mechanisms, may not benefit from furosemide to alleviate their dyspnea.
International journal of reproductive biomedicine (Yazd, Iran), 2017
Human and experimental studies suggest that the sympathetic regulatory drive in the ovary may be ... more Human and experimental studies suggest that the sympathetic regulatory drive in the ovary may be unbalanced (hyperactivity) in polycystic ovary syndrome (PCOS). Dysfunctional secretion of interleukin (IL) -1 (α & β) or related cytokines may thus be related to abnormal ovulation and luteinization. The aim of this study was the evaluation of cytokines' pattern in PCOS women and discussion about the explanation of cross-talk between two super systems: sympathetic and immune systems and explanation sympatho-excitation and relationship with interleukins. In this study, 171 PCOS women aged between 20-40 years were studied the. Their body mass index was <28. The patients were divided into two groups: study group (n=85, PCOS women) and control group (n=86 normal women). The blood sample was obtained on the 3 day of menstruation cycle. IL-17, IL-1α, IL-1β, and TNF-α concentrations were determined in both groups. The median serum level of IL-1α in the PCOS group was higher than the con...
Pruritus is the most frequent chronic dermal complication of sulfur mustard (SM), which negativel... more Pruritus is the most frequent chronic dermal complication of sulfur mustard (SM), which negatively influences the quality of life. Exact pathophysiology of SM-induced itching is unknown. The current study aimed at evaluating the possible association between SM-induced itching and the serum levels of matrix metalloproteinase (MMP)-9 and their endogenous inhibitors, and serum levels of soluble forms of selectins (sL-, sP-, and sE-selectins) as adhesion molecules involved in the development of different inflammatory reactions. Serum levels of MMP-9, MMP-9/ tissue inhibitors of metalloproteinases (TIMPs), and selectins were measured by the enzyme-linked immunosorbent assay (ELISA), and compared between the groups (n=368) with and without itching, and matched control groups (n=126). Serum levels of MMP-9 were significantly higher in the SM exposed group with itching, compared with that of the group without itching (medians: 894 and 624 pg/mL respectively; P-value =0.034). There was no re...
The International journal of biological markers, 2018
Epidemiological and experimental literature indicates that the risk of breast cancer incidence is... more Epidemiological and experimental literature indicates that the risk of breast cancer incidence is strongly linked to hormone-dependent factors, including reproductive history and obesity. However, the molecular mechanisms underlying the association between these factors and breast cancer risk are poorly understood. The aim of this study, therefore, was to determine whether obesity and reproductive history are associated with expression levels of two breast cancer-related long non-coding RNAs (lncRNAs), namely ZFAS1 and SRA1 in cancer-free breast tissues of women. In the current research, 145 healthy women were recruited, and the quantitative expression levels of the two lncRNAs were determined through qPCR assay after gathering the mammoplasty breast tissue samples. It was found that women with body mass index (BMI)≥30 kg/m and BMI 25-29 kg/m show a low expression of ZFAS1 compared to the BMI<25 kg/m ( P=0.031 and P=0.027, respectively). Then, the correlation analysis disclosed a...
Long noncoding RNAs (lncRNAs) constitute a major class of the human transcriptome which play cruc... more Long noncoding RNAs (lncRNAs) constitute a major class of the human transcriptome which play crucial roles in the key biological processes of both normal and malignant breast cells. Although the aberrant expression of lncRNAs has been well-documented in breast cancer (BC), little is currently known about the association between their expression levels in the breast tissue of healthy women and BC risk factors, especially the reproductive or demographic characteristics that are among the most well-known BC risk modifiers. This study was an attempt to investigate the correlation between the expression levels of 2 breast cancer-related lncRNAs, including GAS5 and LSINCT5, and reproductive and demographic characteristics in 145 normal breast tissues that were obtained from women without breast cancer undergoing cosmetic surgery. Total RNA was extracted from fresh normal breast tissues, and the expression level of target lncRNAs was quantified using real-time qPCR. Differences in the mean...
Among the most common metabolic disorders during pregnancy is gestational diabetes mellitus (GDM)... more Among the most common metabolic disorders during pregnancy is gestational diabetes mellitus (GDM). This research was conducted to examine the dietary pattern in women with GDM. In this case-study, 204 pregnant women (104 cases and 100 control women) were chosen through convenient sampling and random sampling. The subjects' food intakes were assessed using semi-quantitative food frequency questionnaire, while their activities evaluated by physical activity questionnaire. Anthropometric indices were measured based on standard instructions, and the body mass index was calculated. The dietary patterns were determined using principal component analysis and its relationship with preeclampsia was tested using logistic regression method. Unhealthy and healthy dietary patterns were found among the pregnant women. In the unhealthy group, after modifying the effect of confounding variables, a significant relationship was observed between dietary pattern and having gestational diabetes (OR ...
Although environmental factors play an important role in susceptibility to myocardial infarction ... more Although environmental factors play an important role in susceptibility to myocardial infarction (MI), genetic determinants also provide a significant contribution. This study aimed to determine whether or not MI susceptibility is influenced by the SDF1-rs1801157A/G and HHEX-rs1111875 A/G polymorphisms in an Iranian population. A total of 120 patients with MI and 120 healthy controls were enrolled. Blood samples were collected from all the participants for genomic DNA extraction and testing. Polymorphism genotyping was determined by the polymerase chain reaction-restriction fragment length polymorphism technique. Multiple logistic regression analysis revealed that the A allele and AA genotype of the SDF1-rs1111875 polymorphism produce a significant risk of MI both before (crude odds ratio [OR] = 8.83, 95% confidence interval [95% CI] = 1.05-73.76, p = 0.025) and after adjustment (adjusted OR = 8.12, 95% CI = 5.02-19.42, p = 0.04). In contrast, the GG genotype of the SDF1-rs1111875 polymorphism provides a protective effect on MI in a recessive model (GG vs. AA+AG) before (crude OR = 0.57, 95% CI = 0.34-0.97, p = 0.037) and after adjustment (adjusted OR = 0.53, 95% CI = 0.3-0.82, p = 0.021). No association was found between the HHEX-rs1111875 A/G polymorphism alleles and the susceptibility to MI. Taken together, the current findings suggest that the SDF1-rs1801157A/G gene variant may play an important role in relation to MI in this Iranian population. Nevertheless, more replication studies and meta-analyses should be carried out in this area.
Reproductive history and obesity are among the well-recognized risk factors in the development of... more Reproductive history and obesity are among the well-recognized risk factors in the development of breast cancer, which are partially mediated by the increased exposure of breast tissues to estrogens. However, only a few studies have investigated the link between these risk factors and the pattern of methylation signatures in the breast tissue of healthy women. The role of the estrogen receptor 1 (ESR1) gene hypermethylation is reportedly important in the development of breast cancer. Thus, it is speculated that such ESR1 epigenetic changes may be influenced or shaped by obesity and reproductive history-related factors before and during breast carcinogenesis. Breast samples were collected from 120 cancer-free women who had undergone cosmetic mammoplasty. DNA was extracted from the breast tissues and, then, the methylation levels at the promoter and exon 1 regions of the ESR1 gene CpG island were determined by using the methylated DNA immunoprecipitation-quantitative PCR assay. The me...
Measuring the quality of life (QOL) is a benchmark in today's world of medicine. The aim of t... more Measuring the quality of life (QOL) is a benchmark in today's world of medicine. The aim of the present study was to determine the general health and QOL of infertile women and certain affecting conditions. In a cross-sectional study, 161 infertile women referring to Dr. Rostami's Infertility Center of Shiraz, Southern Iran, in 2013 were enrolled by the convenience sampling method. Data were collected via a socio-demographic, general health (GHQ28), and the QOL Questionnaire of Infertile Couples and analyzed using descriptive and analytical statistics. According to 146 completely filled-out questionnaires, the mean age of the participants and their spouses were 29.4 ± 5.4 and 33.8 ± 5.8 years, respectively. Moreover, the general health of 57 (39%) patients was normal and that of 89 (61%) patients showed a degree of impairment. The scores for depression and physical symptoms were the highest and lowest, respectively. In addition, quite positive, positive, neutral, and negativ...
IL-1b-3953 C&gt;T and MMP-9-1562C&gt;T variants have been shown to be linked to the devel... more IL-1b-3953 C&gt;T and MMP-9-1562C&gt;T variants have been shown to be linked to the development of myocardial infarction (MI), although previous studies have reported inconsistent results. The aim of the present study was to determine whether these genetic variations are associated with MI susceptibility in an Iranian population. In the current study, 117 patients with MI and 120 control group members were selected as participants. Peripheral blood samples were taken from all the subjects for genomic DNA extraction. Single nucleotide polymorphism (SNP) genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assays. Multiple logistic regression analysis revealed that the TT genotype of the IL-1b-3953 C&gt;T polymorphism is associated with a significant MI protective effect in: the homozygote model after adjustment for MI risk factors (odds ratio [OR]: 0.18, confidence interval [95% CI] = 0.04-0.72; p = 0.01); and also in the recessive genetic model both before (OR: 0.39, 95% CI: 0.15-0.96, p = 0.04) and after (OR: 0.15, 95% CI: 0.04-0.58, p = 0.006) adjustment for MI risk factors. Furthermore, multiple logistic regression analysis indicated that the individuals with the TT genotype of the MMP-9-1562C&gt;T polymorphism were significantly protected against MI in comparison with the CC genotype (OR: 0.01, 95% CI: 0.002-0.68, p = 0.03). The findings suggest that the minor alleles of the two polymorphisms under study both have protective effects with respect to MI susceptibility in the Iranian population.
Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2016
The percent and distribution of body fat are important factors in the pathogenesis of numerous di... more The percent and distribution of body fat are important factors in the pathogenesis of numerous diseases. Our aim was to investigate common anthropometric indices in their relationship with body fat content. In a cross-sectional study 1360 healthy individuals (580 men and 780 women) in a cluster sampling, from Ahvaz, Iran, body fat content (using bioelectrical impedance) and anthropometric measurements [weight, waist circumference, a body shape index, abdominal volume index, body adiposity index, conicity, body mass index, hip circumference, waist to hip ratio and waist to height ratio] was obtained. The ROC curve analysis was used to compare each index with body fat percent. Significant difference was found between men and women in all anthropometric parameters (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Women displayed higher percentages in the overweight and obese categories (33.6% vs. 32.9% and 26.4% vs. 22.1%, respectively). In both men and women, the strongest correlations were seen between body fat percent and BMI, AVI and WHtR (r&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;7.9 and p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). BMI, WHtR and AVI in men and BAI, BMI and WHtR in women showed the most accuracy for estimating body fat percent, respectively. All anthropometric parameters could predict body fat percent with relatively good power, however BMI, WHtR and AVI are more powerful predictors. Based on our findings, we suggest using the AVI and WHtR instead of other indexes, as they are better able to assess the accumulation of fat in the abdominal area and are able to more accurately assess body fat percent, which are indicators of chronic disease.
Dyspnea is the hallmark symptom of some respiratory diseases such as chronic obstructive pulmonar... more Dyspnea is the hallmark symptom of some respiratory diseases such as chronic obstructive pulmonary disease and bronchiolitis and is a major reason for which these patients seek medical attention. We performed a randomized triple-blind controlled crossover clinical trial in which we compared the efficacy of inhaled furosemide (4 ml equal to 40 mg in 10 min) with placebo (4 ml of 0.9% saline solution) in 41 mustard gas-exposed patients. Dyspnea index, visual analog scale (VAS), and pulmonary function test results were obtained before and 4 h after treatments. Results showed that both furosemide and placebo significantly decreased VAS and dyspnea index and increased FEV(1), FVC, and FEV(1)/FVC, while there was no difference between the two drugs in these effects (p values .23, .61, .81, .36, and .27, respectively). Our results failed to address the previously reported effects of inhaled furosemide on dyspnea. In fact, we suggest that patients with a previous exposure to sulfur mustard, in which chronic bronchitis and bronchiolitis are the most suggested underlying mechanisms, may not benefit from furosemide to alleviate their dyspnea.
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Papers by Mohammad Naghizadeh