Masoud Youssefi; Majid Eslami; Mohsen Karbalaei; Masoud Keikha; Kiarash Ghazvini
Abstract
Cancer is defined as uncontrolled cell division, which could spread or invade various tissues. There are more than 200 types of cancer, including breast, skin, lung, colon, and prostate cancer, and lymphoma, the symptoms and indications of which vary depending on the type of tissues. Cancer has several ...
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Cancer is defined as uncontrolled cell division, which could spread or invade various tissues. There are more than 200 types of cancer, including breast, skin, lung, colon, and prostate cancer, and lymphoma, the symptoms and indications of which vary depending on the type of tissues. Cancer has several treatments with different applications. For instance, chemotherapy, radiation therapy, surgery or their combination are common treatment modalities for cancer. However, a complete cure for cancer has not been achieved yet. On the other hand, novel drugs for cancer treatment are not efficient due to the ability of cancer cells to develop resistance against chemotherapeutic agents. Recently, natural compounds have been reported to improve the efficiency of cancer treatment. Polyunsaturated fatty acids (PUFAs) are natural compounds that could be used as dietary supplements in cancer patients. PUFAs are classified into two main categories, including n-3 and n-6 PUFAs. According to the literature, n-3 PUFAs exert protective effects against cancer through the induction of apoptotic pathways and suppressing cell proliferation, while n-6 PUFAs cause tumor formation by inducing cell growth and proliferation. Using PUFAs in combination with chemotherapeutic agents is considered to be an effective approach to the treatment of cancer patients through increasing cancer cell death. This review aimed to discuss the interactive effects of the structure and function of PUFAs on cancer and cell processes through various signaling pathways.
Zohre Najafi; Zahra Sadat Manzari
Abstract
Introduction: Nurses play a key role in the process of organ donation and transplantation, and previous studies have widely addressed the level of knowledge and attitude of intensive care unit (ICU) nurses in this regard. Considering the direct correlation between the positive attitude of the healthcare ...
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Introduction: Nurses play a key role in the process of organ donation and transplantation, and previous studies have widely addressed the level of knowledge and attitude of intensive care unit (ICU) nurses in this regard. Considering the direct correlation between the positive attitude of the healthcare team, especially nurses, and the level of consent on organ donation, knowledge and attitude of nurses are important factors that have been assessed in several studies. However, no definite conclusions have been drawn in this regard. The present study aimed to evaluate the knowledge and attitude of ICU nurses toward organ donation and the related factors.Methods: A systematic review was conducted via searching in databases such as ProQuest, Medscape, MedlinePlus, MagIran, PubMed, and ScienceDirect to identify the articles published during 1990-2015 using keywords such as knowledge, attitude, organ donation, and nurses.Result: Awareness and knowledge are the main determinants of attitude in nurses, which should be applied in order to foster positive attitudes in the process of organ donation. Furthermore, extensive clinical knowledge should be acquired on organ donation and communication skills by ICU nurses through proper training programs.Conclusion: According to the results, using standard guidelines or scheduled training programs in nursing schools could improve the level of knowledge in nurses, which in turn enhances nursing performance. In addition, our findings indicated that positive attitude and knowledge of nurses could largely infleunce the viewpoint of families toward organ donation.
Hedieh Nazarzadeh; Yavar Shams Hojati; Reza Nazarzadeh
Abstract
Introduction: Neuroblastoma is known as one of the most common solid tumors in children, which is recently under the investigation for the expression of CD133, a marker of cancer stem cells. Revealing the prognostic value of CD133 marker expression is important in predicting the outcome and survival ...
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Introduction: Neuroblastoma is known as one of the most common solid tumors in children, which is recently under the investigation for the expression of CD133, a marker of cancer stem cells. Revealing the prognostic value of CD133 marker expression is important in predicting the outcome and survival of neuroblastoma patients. In this systematic review, we aimed to review the studies on association between CD133 expression and other peripheral neuroblastic tumor prognostic factors.Methods: PubMed was searched for the relevant articles. No time and language limitation were included in our search strategy. Data regarding the patients’ number and age, tumor stage, histology and CD133 expression were extracted.Results: Overall, only 4 relevant articles were retrieved. One articles revealed the positive association between CD133 expression in neuroblastoma samples and its resistance to chemotherapy treatment. Three of the included articles showed the positive relation between CD133 expression rate and tumor stage progression. Two of the included studies revealed much worse survival of the neuroblastoma patients with more expression of CD133.Discussion: Based on included studies, CD133 expression is positively related with poor outcome prognosis in patients, more advanced tumor stage, shorter disease-free survival and overall survival. Conclusion: Although the expression of CD133 has shown increasing trend by advancing the neuroblastoma tumor stage, more studies with larger sample size are needed to accurately reveal the relation.
Leili Zarifmahmoudi; Maryam Khalesi; Ramin Sadeghi; Seyed Ali Jafari; Mohammad Ali Kiani; Hamidreza Kianifar
Abstract
Introduction: Hepatopulmonary syndrome (HPS) is known as a chronic liver disease associated with severe pulmonary deoxygenation due to intrapulmonary vascular vasodilation. Although liver transplantation is accepted as a main treatment of HPS, identifying effective drugs for recovery of HPS can be effective ...
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Introduction: Hepatopulmonary syndrome (HPS) is known as a chronic liver disease associated with severe pulmonary deoxygenation due to intrapulmonary vascular vasodilation. Although liver transplantation is accepted as a main treatment of HPS, identifying effective drugs for recovery of HPS can be effective in postponing the transplantation and decreasing the mortality rate of patients before the transplantation. In this study we briefly reviewed the pathogenesis of HPS and also systematically reviewed the current pharmacological treatment of HPS. Method: Pubmed, Scopus, and Google scholar were searched for the relevant English language clinical and experimental articles about the medications used in the treatment of HPS. Results: A total of 38 articles were included in this study which mostly resulted in decreasing NOS expression, NO production, endothelin-1 activation, intrapulmonary angiogenesis and increasing oxygenation.Conclusion: Various drugs have been proposed in treatment of HPS but more large controlled trial studies, is necessary to determine the exact efficacy of each drugs for HPS recovery.
Abdollah Banihashem; Ali Ghasemi; Lueisa Tavasolian
Abstract
Acute lymphoblastic leukemia (ALL) is the most common type of neoplastic disorder diagnosed in childhood. It is the cause of one third of all pediatric malignancies. ALL is characterized by the abnormal production and proliferation of immature lymphoblasts in bone marrow (BM). It seems that ALL occurs ...
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Acute lymphoblastic leukemia (ALL) is the most common type of neoplastic disorder diagnosed in childhood. It is the cause of one third of all pediatric malignancies. ALL is characterized by the abnormal production and proliferation of immature lymphoblasts in bone marrow (BM). It seems that ALL occurs due to a genetic mutation in DNA structure producing white blood cell (WBC) stem cells. Because ALL is a systemic disease, its primary management is based on chemotherapy.There are important risk factors responsible for the poor prognosis of ALL in children less than 1 year old and greater than 10 years old, such as: high WBC, mature T cell ,mature B cell, central nervous system (CNS) involvement, DNA index < 1 (hypodiploid), triploidy, tetraploidy, Mixed-Lineage Leukemia (MLL) gene re-arrangement on 11q23, the Philadelphia chromosome t(9;22), reduction in platelet count, hemoglobin>10 at diagnosis, no remission at the end of induction therapy and Minimal residual disease at the end of consolidation therapy. Complications might appear during the treatment including tumor lysis syndrome, bleeding, renal failure, sepsis, seizure, thrombosis, etc. Some consequences might identify after a long-term follow-up such as learning impairment, growth retardation, and secondary malignancies. It is estimated that up to 90% of pediatric ALL cases are curable.
Mehryar Taghavi Gilani; Mohammad Sharifi; Mona Najaf Najafi; Mohamad Ghasem Etemadi Mashhadi
Abstract
The activation of oculucardiac reflex (OCR) is common during the strabismus surgeries. OCR is known as a trigemino-vagal reflex, which leads to the various side effects including bradycardia, tachycardia, arrhythmia, or in some cases cardiac arrest. This reflex could be activated during intraorbital ...
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The activation of oculucardiac reflex (OCR) is common during the strabismus surgeries. OCR is known as a trigemino-vagal reflex, which leads to the various side effects including bradycardia, tachycardia, arrhythmia, or in some cases cardiac arrest. This reflex could be activated during intraorbital injections, hematomas, and mechanical stimulation of eyeball and extraocular muscles surgeries. The incidence of OCR varies in a wide range, from 14% to 90%, that depends on anesthetic strategy and drug used for the surgery. The efficacy of various anticholinergic and anesthetic agents on declining the OCR reflex has been evaluated in different studies, especially in children. Although the detection of OCR goes back to 1908, its exact effect is not well recognized during strabismus surgery. In this review, we aimed to summarize the studies investigated the efficacy and potential of various anesthetic medications on inhibiting the OCR in children undergoing strabismus surgery.
Reza Ghasemi; Mostafa Dastani; Alireza Abdolahi; Hamid Reza Rahimi
Abstract
Atherosclerosis is a chronic slow-developing condition affecting medium-size and large blood vessels. It is the principal underlying pathology of coronary heart disease and stroke. In some countries, coronary artery disease (CAD) is the cause of nearly half (48%) of the deaths and, loss of productivity ...
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Atherosclerosis is a chronic slow-developing condition affecting medium-size and large blood vessels. It is the principal underlying pathology of coronary heart disease and stroke. In some countries, coronary artery disease (CAD) is the cause of nearly half (48%) of the deaths and, loss of productivity life. Peripheral arterial disease (PAD) is defined as atherosclerosis in peripheral arteries instead of coronary arteries. CAD and PAD have same risk factors and underlying pathophysiological processes. Therefore, patient with CAD should be considered for PAD. Ankle brachial index (ABI), duplex sonography, and some other non-invasive techniques are recommended for PAD diagnosis in patients with the history of CAD. Pharmacotherapy, endovascular interventions, and surgical management could be chosen according to the patient’s situation. Cardiologists and general practitioners should consider PAD in a patient with CAD or DM as a strong correlated disease.
Farideh Akhlaghi; Elaham Rezaie Askarye; Mona Najaf Najafi; Zohre Khoee
Abstract
Introduction: Second-trimester pregnancy termination with live fetuses is an important issue in obstetric practice since it is more challenging than first- and third-trimester pregnancy termination. The present study aimed to compare the effectiveness of vaginal misoprostol moistened with normal saline ...
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Introduction: Second-trimester pregnancy termination with live fetuses is an important issue in obstetric practice since it is more challenging than first- and third-trimester pregnancy termination. The present study aimed to compare the effectiveness of vaginal misoprostol moistened with normal saline and acetic acid in second-trimester pregnancy termination.Methods: This clinical trial was conducted on 95 pregnant women with the gestational age of 14-26 weeks admitted for medical induced abortion. The subjects were randomly divided into two groups. The first group was administered with vaginal misoprostol moistened with acetic acid (n=47), and the second group received vaginal misoprostol moistened with normal saline (n=48). The abortion rate within the first 24 hours, induced abortion interval, length of hospital stay, and curettage and its complications were assessed in the study groups using statistical methods, and the P-value of less than 0.05 was considered significant.Results: Abortion within the first 24 hours occurred in 100% of the patients in the acetic acid group and 75% of the subjects in the normal saline group, and the difference was considered statistically significant (P<0.001). The mean time for fetal delivery was significantly lower in the acetic acid group (12.3±4.8) compared to the normal saline group (17.5±6.6) (P<0.001). In addition, the length of hospital stay was significantly lower in the acetic acid group compared to the normal saline group (P=0.008). The rate of abortion following the second dose of misoprostol was 46.8% in the acetic acid group and 20.8% in the normal saline group. However, no significant differences were observed in curettage and its complications between the groups.Conclusion: According to the results, high vaginal acidity was associated with the increased effectiveness of misoprostol in second-trimester pregnancy termination.
Maliheh Karimpour; Nasrin Moghadas Sharif; Naser Shoeibi; Negareh Yazdani; Asieh Ehsaei
Abstract
Introduction:The present study aimed to compare the anterior segment measurements between optical low-coherence reflectometry (LenStar LS900) and anterior segment optical coherence tomography (CASIA2 OCT). Methods:A total of 198 right eyes of 198 healthy participants were used for the current study, ...
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Introduction:The present study aimed to compare the anterior segment measurements between optical low-coherence reflectometry (LenStar LS900) and anterior segment optical coherence tomography (CASIA2 OCT). Methods:A total of 198 right eyes of 198 healthy participants were used for the current study, according to the inclusion and exclusion criteria. Ocular biometry parameters, such as central corneal thickness (CCT), anterior chamber depth (ACD), keratometry, and anterior chamber width (ACW), were measured usingLenStar LS 900 and CASIA2 OCT. The differences and correlations were assessed between these two instruments. The agreement was calculated as the 95% limits of agreement (LoA). Results: Among 198 subjects with a mean age of 29.39±7.88 years who enrolled in the study, 106 individuals (53.5%) were women. The mean CCT values were 531.7±35.25 and 527.3±37.82 µm for LenStar and OCT, respectively (P˂0.0001). The ACD measurements showed 2.92±0.40 and 2.95±0.43 mm for LenStar and OCT, respectively (P=0.0549). The ACW mean values were 12.04±0.52 and 11.79±0.49 mm by LenStar and OCT (P˂0.0001). The 95% LoA between the two instruments were within the ranges of -20.79 to 29.43 µm, -0.50 to -0.43 mm, -0.32 to 0.82 mm, and -0.70 to 0.87 D for CCT, ACD, ACW, and astigmatism, respectively. Conclusion: LenStar and OCT showed to have interchangeable ACD measurements; however, the results of CCT, ACW, and corneal astigmatism measured by these two instruments demonstrated clinically significant differences
Mitra Ahadi; Ali Beheshti Namdar; Samaneh Bakhshi; Elham Mokhtari Amirmajdi; Mohammad Derakhshan; Atieh Yaghoubi; kiarash Ghazvini
Abstract
Introduction: Based on serological studies, the prevalence of Helicobacter pylori infection in Iranian adults is up to 80%. Gastritis, peptic ulcer, and gastric adenocarcinoma are common clinical outcomes of this infection in Iran. Since antibiotic resistance patterns of Helicobacter pylori are geographically ...
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Introduction: Based on serological studies, the prevalence of Helicobacter pylori infection in Iranian adults is up to 80%. Gastritis, peptic ulcer, and gastric adenocarcinoma are common clinical outcomes of this infection in Iran. Since antibiotic resistance patterns of Helicobacter pylori are geographically different, local studies are highly required.Methods: Eighty isolates of Helicobacter pylori were obtained from patients referred to the endoscopy unit of Ghaem Hospital in Mashhad. Demographic features including age, gender, and symptoms were recorded before the sampling. The antibiotic susceptibility patterns of isolates were determined for the five common antibiotics used for the treatment of Helicobacter pylori infection. The agar dilution method was used to evaluate the antibiotic resistance patterns.Results: The patterns of antibiotic resistance were determined, and 41.2%, 13.7%, 8.7%, 6.6%, and 6.6% of isolates were resistant to metronidazole, clarithromycin, amoxicillin, tetracycline, and furazolidone, respectively.Conclusion: Our study demonstrates that the overall rate of antibiotic resistance of Helicobacter pylori especially in the case of metronidazole has increased over time. The resistance rates are generally higher in the age range of 30-60 years and in females for the case of metronidazole. This reminds us of the need for a continuous monitoring program of antibiotic susceptibility patterns.
Sona Sepahi; Bamdad Riahi-Zanjani; Adel Ghorani-Azam
Abstract
Introduction: Valproic acid (VPA) is an acidic compound that is commonly used as an anticonvulsant and mood-stabilizing agent in the treatment of epilepsy, mania and bipolar disorders as well as the prevention of migraine headaches. But, it can affect metabolic and endocrine system resulting in hormonal ...
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Introduction: Valproic acid (VPA) is an acidic compound that is commonly used as an anticonvulsant and mood-stabilizing agent in the treatment of epilepsy, mania and bipolar disorders as well as the prevention of migraine headaches. But, it can affect metabolic and endocrine system resulting in hormonal disturbances and incidence of some metabolic disease, especially in pediatric patients. In this study, we aimed to systematically review the literature wherein metabolic and endocrine effect of valproic acid has been studied in pediatric patients with epilepsy.Methods: To evaluate the relationship between VPA consumption and metabolic diseases, a systematic literature search was performed through searching for related documents in the PubMed and Scopus as two known databases using the following key terms “valproic acid”, “metabolic disease” and “pediatrics” in the title, keywords, and abstract of literatures. Data were then extracted and described.Result: Nearly 934 documents were collected and reviewed based on the main purpose of this study. Of the collected articles, 918 documents were excluded in several step by step processes of article selection, and only 16 relevant documents were included for further data assessment. The results showed that VPA can cause significant increase in plasma concentration of thyroid hormones and therefore increase the risk of metabolic disease in patients with epilepsy.Conclusion:The results of included documents in this review showed that VPA may induce metabolic and hormonal disturbances in pediatric patients, who were on treatment with VPA.
Mitra Ahadi; Negin Masoudifar
Abstract
Eosinophilic esophagitis (EoE) is a chronic immune condition affecting children and adults. Dysphagia and food impaction are the main symptoms; however, reflux-like symptoms may also be present. The diagnosis of EoE is made with endoscopic evaluation for dysphagia, and its definitive diagnosis requires ...
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Eosinophilic esophagitis (EoE) is a chronic immune condition affecting children and adults. Dysphagia and food impaction are the main symptoms; however, reflux-like symptoms may also be present. The diagnosis of EoE is made with endoscopic evaluation for dysphagia, and its definitive diagnosis requires biopsy confirmation. The criteria for active EoE are defined as the symptoms of esophageal dysfunction, eosinophilic tissue infiltration (eosinophil count of at least 15 eosinophils per high-power field), and exclusion of other possible causes of esophageal eosinophilia. EoE is more prevalent in patients suffering from atopic conditions; therefore, allergic conditions may play an important role in the development of the disease. However, the etiology and pathophysiology of the disease are not completely understood. Elimination diets are considered as the first-line therapy in children; nevertheless, this approach appears to be less effective in adults, who often require steroids. Despite medical treatments, EoE is complicated in some cases by esophageal stricture and stenosis that require additional endoscopic treatments.
Ali Akbar Momen; Reza Azizi Malamiri
Abstract
Epilepsies and epileptic syndromes are among the most common chronic neurological disorders in neonates, infants, and children. Remission occurs in 70% of epileptic children, while other cases experience frequent seizures and become refractory to various treatment modalities. Refractory seizures have ...
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Epilepsies and epileptic syndromes are among the most common chronic neurological disorders in neonates, infants, and children. Remission occurs in 70% of epileptic children, while other cases experience frequent seizures and become refractory to various treatment modalities. Refractory seizures have a significant adverse impact on the quality of life of epileptic children and their families. Prognosis of epilepsies is determined based on the risk of seizure or convulsion recurrence. Some of the most important risk factors for recurrence are the age at seizure presentation, neurodevelopment of the child, etiology of seizures, seizure frequency before anticonvulsant withdrawal, response to antiepileptic medications, type of epileptic syndromes, and electroencephalography of the patient. Recognition of the risk factors for seizure recurrence results in the optimal management of the treatment protocols, thereby reducing the adverse effects of epileptic seizures on patients and their families. The present study aimed to provide a narrative review of the most important risk factors for the recurrence of epilepsies in children by two child neurologists.
Mohammad Gharavi Fard; Alireza Sabzevari; Touka Banaee; Lida Parizad
Abstract
Introduction: Oxygen therapy used for preterm infant disease might be associated with oxygen toxicity or oxidative stress. The exact oxygen concentration to control and maintain the arterial oxygen saturation balance is not certainly clear. We aimed to compare the efficacy of higher or lower oxygen saturations ...
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Introduction: Oxygen therapy used for preterm infant disease might be associated with oxygen toxicity or oxidative stress. The exact oxygen concentration to control and maintain the arterial oxygen saturation balance is not certainly clear. We aimed to compare the efficacy of higher or lower oxygen saturations on the development of severe retinopathy of prematurity which is a major cause of blindness in preterm neonates. Methods: PubMed was searched for obtaining the relevant articles. A total of seven articles were included after studying the titles, abstracts, and the full text of retrieved articles at initial search. Inclusion criteria were all the English language human clinical randomized controlled trials with no time limitation, which studied the efficacy of low versus high oxygen saturation measured by pulse oximetry in preterm infants.Result: It can be suggested that lower limits of oxygen saturations have higher efficacy at postmesetural age of ≤28 weeks in preterm neonates. This relation has been demonstrated in five large clinical trials including three Boost trials, COT, and Support.Discussion: Applying higher concentrations of oxygen supplementations at mesentural age ≥32 weeks reduced the development of retinopathy of prematurity. Lower concentrations of oxygen saturation decreased the incidence and the development of retinopathy of prematurity in preterm neonates while applied soon after the birth.Conclusions: Targeting levels of oxygen saturation in the low or high range should be performed cautiously with attention to the postmesentural age in preterm infants at the time of starting the procedures.
Kazem Anvari; Azam Anvari; Mehdi Silanian Toosi
Abstract
Esophageal squamous cell carcinoma (ESCC) is one of the most frequent malignancies, worldwide. It is important to find out what prognostic factors can facilitate diagnosis, optimize therapeutic decisions, and improve the survival of these patients. Despite improvements in surgical techniques combined ...
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Esophageal squamous cell carcinoma (ESCC) is one of the most frequent malignancies, worldwide. It is important to find out what prognostic factors can facilitate diagnosis, optimize therapeutic decisions, and improve the survival of these patients. Despite improvements in surgical techniques combined with chemotherapy and/or radiotherapy, the novel therapies such as small molecule inhibitors of tyrosine kinases (TKIs) and humanized monoclonal antibodies (mAbs) are very much needed. On the other hand, neoadjuvant chemotherapy which may improve the outcome is accompanied by toxicity by destruction of normal cells. Side effects may be avoided by developing therapies that specifically target molecular characteristics of tumors. Epidermal growth factor receptor (EGFR) is one of tyrosine kinases receptors widely distributed in human epithelial cell membrane. Genetic polymorphisms in EGFR genes influence cell cycle progression, angiogenesis, apoptosis and metastasis. EGFR mutations are mostly observed in lung tumors; curiously they are more prevalent in Asian women diagnosed with adenocarcinoma. Also, esophageal SCC shows a relatively high incidence of EGFR (33%) and/or HER2 (31%) overexpression. Patients who carry these mutations in EGFR have been founded tending to have a better response to gefitinib, an EGFR-TKI, whereas patients with the wild-type genotype show a better response to conventional chemotherapy. Therefore, finding clinical characteristics and environmental interactions with EGFR can affect on investigations about novel anti-cancer therapies like monoclonal antibodies and gene therapy and studies which identify patients who may benefit from EGFR targeted therapies. Hence, it may be effective on the improvement of prognosis in these patients.
Mohsen Sabermoghaddam Ranjbar; Mojtaba Khezri; Majid Rajabian
Abstract
Introduction: The pain induced by propofol injection is a common adverse complications caused by propofol, which is ranked seventh among the 33 clinical symptoms of anesthesia. The present study aimed to investigate the effects of pre-treatment with ketamine and tourniquet inflation on the pain induced ...
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Introduction: The pain induced by propofol injection is a common adverse complications caused by propofol, which is ranked seventh among the 33 clinical symptoms of anesthesia. The present study aimed to investigate the effects of pre-treatment with ketamine and tourniquet inflation on the pain induced by propofol injection.Methods: This randomized controlled clinical trial was conducted on 120 patients with the American Society of Anesthesiologists (ASA) physical status classification I. The patients were assigned to six groups. In groups one and four, tourniquet was inflated above the angiocatheter. In groups two and five, ketamine was injected 30 seconds before propofol injection with no tourniquet. The patients in groups three and six were injected with propofol alone. To assess the severity of pain, verbal rating scores were used. Data analysis was performed in SPSS version 20.Results: In total, 74 male and 46 female patients were examined. In terms of pain severity, the lowest level of pain was experienced with the injection of ketamine before propofol with the use of a tourniquet (groups one and four). Based on the injection site, the total pain scores were higher with the injection of propofol into the veins on the dorsum of the hand. In addition, the mean pain score in groups one, two, four, and five was significantly lower compared to groups three and six (P< 0.05)Conclusion: According to the results, use of ketamine, especially with a tourniquet, could alleviate the pain induced by propofol injection.
Razieh Amirfakhrian; Atieh Yaghobi; Roya Saddat Ghaderi; Seyed Isaac Hashemy; Kiarash Ghazvini
Abstract
Introduction: In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity ...
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Introduction: In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity and mortality worldwide. The purpose of this study was the assessment of the prevalence and frequency of colistin resistance among gram-negative bacilli (Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp.) in Iran and around the world. Methods: For this systematic review and meta-analysis, we searched international and national databases, including PubMed, Google Scholar, SID, and Magiran, from 1998 to 2018 for articles and abstracts describing colistin resistance among gram-negative bacilli. We have included 92 studies that met our inclusion criteria, and the outcomes were combined using a random-effects model to derive the event rate of colistin resistance among gram-negative bacilli. Data were analyzed by the Comprehensive Meta-Analysis Software (V2), and the heterogeneity of the studies was assessed using the I2 index. Results: Out of the 11050 papers identified, 92 studies met the strict inclusion criteria and were finally included. The overall event rate of colistin resistance among gram-negative bacilli (GNB) was about 6.6%, while the event rate of colistin resistance among Acinetobacter spp. (n = 18504) was 2.8% (summary: 95% confidence interval (CI): [0.02, 0.041], P = 0.001, I2 = 70, df (Q) = 36, Q-value = 121.924). The colistin resistance among Pseudomonas spp. (n = 15094) was 3% (95% CI: [0.022, 0.041], P = 0.001, I2 = 68.3, df (Q) = 25, Q-value = 85.648), and the colistin resistance among Enterobacteriaceae spp. (n = 44772) was 0.8% (95% CI: [0.004, 0.014], P = 0.001, I2 = 87.6, df (Q) = 15, Q-value = 71.291). Therefore, the event rate of resistance to colistin among GNB was relatively low (6.6%). Conclusion: The event rate of resistance to colistin among GNB was low. Therefore, this antimicrobial agent can still be administered as a suitable option against GNB that are resistant to other antibiotics such as carbapenems.
Farzane Farzam; Masume Safaee; Mahsa Akbari Oryani; Hadi Razmara; Naveed Fathee; Vahide Farzam
Abstract
Introduction: Endothelial progenitor cells (EPCs) are known as putative cells in neovasculogenesis during pathological conditions, which are derived from bone marrow. This study was performed to systematically review the EPCs frequency in patients with non-small cell lung cancer (NSCLC) by evaluating ...
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Introduction: Endothelial progenitor cells (EPCs) are known as putative cells in neovasculogenesis during pathological conditions, which are derived from bone marrow. This study was performed to systematically review the EPCs frequency in patients with non-small cell lung cancer (NSCLC) by evaluating the expression of CD133 and vascular endothelial growth factor (VEGF) markers.Methods: We search the PubMed and Scopus databases for the following keywords; CD133 AND lung AND VEGF. Inclusion criteria were all the articles studied the expression of both CD133 and VEGF markers in patients with NSCLC. No language and date restrictions were imposed to the search strategy. All the articles that studied only one biomarker or those that investigated the markers expression and EPCs count in patients with other types of tumors except NSCLC were excluded from the study.Result: Totally 51 articles obtained following the primary search of both databases. Only 7 of them had the eligibility to be included in this systematic review. Six articles were case- control and one was a cohort type of investigation. Flowcytometry and immunohistochemistry were the most applied methods for estimating the EPCs count and evaluating the expression of markers in circulating peripheral blood and tumors tissue. The expression of EPCs markers was increased in patients with NSCLC compared to healthy control individuals; however, the frequency of EPCs was low in peripheral blood of patients.Conclusion: Although it is not clear that circulating EPC numbers are associated with lung cancer patients angiogenesis, EPCs and VEGF levels are elevated in patients with operable NSCLC. The ideal method for evaluating circulating endothelia cells (CECs) or EPCs levels in vivo is still a matter of debate and because of the low number of EPCs in peripheral blood, their detection is technically challenging.
Fatemeh Sadat Hashemi Javaheri; Hamidreza Kianifar; Pegah Rahbarinejad; Saeedeh Talebi
Abstract
Introduction:Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by difficulties with social interaction and communication, and by restricted and repetitive behavior. Children with ASD are at risk of nutritional problems that could impact growth and anthropometric indices over ...
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Introduction:Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by difficulties with social interaction and communication, and by restricted and repetitive behavior. Children with ASD are at risk of nutritional problems that could impact growth and anthropometric indices over both the short and long term. The aim of present study was to determine prevalence of malnutrition and other factors related to the malnutrition among children and adolescent with autism disorder.Material and method:To assess the prevalence of malnutrition indicators among preschool children with ASD, a cross-sectional study was conducted among 81 children and adolescents who referred to subspecialized and specialized Autism Akbar Children‘s Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Weight and height measurements were assessed based on standard protocols. The z-score of anthropometric indices was determined for all participants. Participants were asked about nutritional problems by the interview from their parents. Result:In the current study, the mean ± SD of age was 10.1±3.7 years old. Among participants 3.7% were with Diarrhea, 33.3% with Constipation, 4.9% with Reflux, 3.7% with Flatulence, and 1.2% with Steatorrhea. The prevalence of both of food neophobia and food Allergy was 16%. Furthermore, 18.5% had poor appetite, 23.5% had moderate and 58% had good appetite. Based on standardized z-scores, the overall prevalence of under-weight, risk of overweight, overweight, and obese was 1.2%, 22.2%, 12.3%, and 7.4%, respectively. Among participants 4.9% was stunting.Conclusion:Based on aforementioned prevalence, improving nutritional problems and anthropometric indices among ASD children and adolescents are crucial issue.
Gholamreza Khademi; Bahareh Imani
Abstract
Introduction: Noise pollution in hospital wards can arise from a wide range of sources including medical devices, air-conditioning systems and conversations among the staffs. Noise in intensive care units (ICUs) can disrupt patients’ sleep pattern and may have a negative impact on cognitive performance. ...
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Introduction: Noise pollution in hospital wards can arise from a wide range of sources including medical devices, air-conditioning systems and conversations among the staffs. Noise in intensive care units (ICUs) can disrupt patients’ sleep pattern and may have a negative impact on cognitive performance. Material and methods: In this review article, we searched through PubMed and Google Scholar, using [noise and (ICU or “intensive care unit”)] as keyword to find studies related to noise pollution in ICUs. In total, 250 studies were found among which 35 articles were included. Results: The majority of the reviewed studies showed that noise pollution levels were higher in ICUs than the level recommend by The United States Environmental Protection Agency and World Health Organization. Noise pollution was mostly caused by human activity and operating equipments in ICUs and other hospital wards. Conclusion: As the results indicated, identifying, monitoring and controlling noise sources, as well as educating the hospital staffs about the negative effects of noise on patients’ health, can be highly effective in reducing noise pollution.
Ahmad Reza Taheri; Sara Sabouri Rad; Sara Molkara
Abstract
Cutaneous leishmaniasis is a prevalent parasitic infection in humans. According to the reports published in several localities across the world, leishmaniasis is an endemic disease in certain regions in Iran. Leishmaniasis is transmitted through sandfly bites and is often diagnosed through the smear ...
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Cutaneous leishmaniasis is a prevalent parasitic infection in humans. According to the reports published in several localities across the world, leishmaniasis is an endemic disease in certain regions in Iran. Leishmaniasis is transmitted through sandfly bites and is often diagnosed through the smear examination of the affected area using a microscope. The treatments of choice for leishmaniasis involve the use of pentavalent antimony compounds, such as meglumine antimoniate and sodium stibogluconate. However, other medications have been proposed for the treatment of leishmaniasis, and there is ongoing research for effective, less harmful treatments. This narrative review aimed to summarize various systemic treatments for leishmaniasis.
Mortaza Talebi Doluee; hamidreza Reihani; Vahide Farzam
Abstract
Introduction:Resuscitation should be initiated immediately in shock. Early goal-directed therapy is an established algorithm for the resuscitation in septic shock. The first step is to maintain cardiac preload. Central venous pressure (CVP) plays an important role in goal-directed therapy. Central venous ...
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Introduction:Resuscitation should be initiated immediately in shock. Early goal-directed therapy is an established algorithm for the resuscitation in septic shock. The first step is to maintain cardiac preload. Central venous pressure (CVP) plays an important role in goal-directed therapy. Central venous catheterization is invasive and time-consuming in emergency conditions. There are some alternative and noninvasive methods for estimating the intravascular volume such as measuring the inferior vena cava (IVC) diameter by ultrasonography. Methods: We searched PubMed, Google scholar, and Scopus databases with keywords (central venous pressure OR venous pressure OR CVP) AND (ultrasonography OR sonography) AND (sepsis OR septic shock) AND (inferior vena cava OR IVC).Result: The search resulted in 2550 articles. The articles were appraised regarding the relevance, type of article, and statistical methods. Finally, 12 articles were selected. The number of patients was between 30 and 83 cases (mean age=57-67 years), intubated and non-intubated in each study. The IVC diameter was measured in respiratory cycle by bedside ultrasonography in longitudinal subxiphoid view and caval index was calculated, then they were compared with the CVP measured by central venous catheter.Discussion: CVP is an indicator of intravascular fluid status and right heart function. CVP measurement is an invasive method and of course with some complications. The IVC is the biggest vein of venous system with low-pressure; expansion of the vein reflects intravascular volume.Conclusion: It seems that IVC diameter measured by ultrasonography could be used as an alternative method for the determination of CVP in the emergency or critical patients.
Mohammad Hadi Sadeghian; Zahra Rezaei Dezaki; Seyyede Fatemeh Shams; Sepideh Shakeri
Abstract
Introduction: Plasma cell myeloma is the distortion of differentiated B lymphocytes which is associated with uncontrolled proliferation of plasma cells in bone marrow. Some studies propound a role for HHV-8 virus in pathogenesis of plasma cell myeloma. Yet the findings are inconsistent. In this article ...
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Introduction: Plasma cell myeloma is the distortion of differentiated B lymphocytes which is associated with uncontrolled proliferation of plasma cells in bone marrow. Some studies propound a role for HHV-8 virus in pathogenesis of plasma cell myeloma. Yet the findings are inconsistent. In this article we reviewed the literatures to determine the HHV-8 virus role in plasma cell myeloma pathogenesis.Methods: In this systematic review, scientific databanks including PubMed, Scopus, Embase, ISI, and Google scholar were searched. The search was based on the subsequent keywords and medical terms in title; different combinations of keywords were used, they were compatible with MeSH terms.Result: Four articles declared that there is no link between the HHV-8 and the pathogenesis of plasma cell myeloma; while five reported a connection between the virus and myeloma, arguing that virus infection will lead to disease progression.Conclusion: There are differences between the results of the studies. It is required to do further researches about the association of HHV-8 and plasma cell myeloma.
Jafar Malmir; Ehsan Bolvardi; Monavar Afzal Aghaee
Abstract
The severe sepsis and septic shock are as common and lethal that emergency physicians routinely confront. Actually, more than two thirds of sepsis patients present initially to the ED. Only a few laboratory tests for markers of sepsis are currently available. The serum lactate level can help in determining ...
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The severe sepsis and septic shock are as common and lethal that emergency physicians routinely confront. Actually, more than two thirds of sepsis patients present initially to the ED. Only a few laboratory tests for markers of sepsis are currently available. The serum lactate level can help in determining prognosis and to risk-stratify patients with severe sepsis. This independent review of the literature includes 83 studies published in all electronic-based database such as Elsevier, PubMed, and SID during the last 18 years (40–320 patients in each). Data gathered from English language articles and books published between 1995 and 2013. The serum lactate concentrations measured in almost all patients with severe sepsis raised at admission and were higher in patients who had the worst outcomes such as higher Apache-II and SOFA score. Serum lactate was associated with mortality independent of clinically apparent organ dysfunction and shock in patients with severe sepsis admitted to the emergency department and intensive care unit. This review focuses on the association between initial and serial serum lactate level and mortality in patients presenting to the emergency department with severe sepsis.
Ali Azari; leila Bigdelue; Afsoon Fazlinezhad; Marzye Farazandeh; Somaye Bakefayat
Abstract
Introduction: The pathophysiology of ischemia involves the cellular effect of myocardial ischemia, reactive oxygen species, and reactive inflammatory enzymes. Left atrial (LA) ischemia has been shown to have several mechanisms through which it can lead to abnormalities in left ventricular filling in ...
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Introduction: The pathophysiology of ischemia involves the cellular effect of myocardial ischemia, reactive oxygen species, and reactive inflammatory enzymes. Left atrial (LA) ischemia has been shown to have several mechanisms through which it can lead to abnormalities in left ventricular filling in early diastole and thus reduces LA passive functional reserve. In this review, we evaluated the physiological mechanisms of LA during myocardial ischemia, as previously demonstrated in experimental and clinical studies.Methods: Several databases were searched in order to find related articles. The outcome of interest included LA function measurements (measurement of LA volume) during ischemia. By applying a standardized protocol, reviewers independently extracted and assessed the studies.Results: The literature review indicated 50 publications, among which 15 studies were eligible for analysis. Assessment of LA dimension and function is essential for clinical evaluation and prognostic purposes. Conclusion: The present article revealed that LA passive emptying volume and LA emptying volume significantly increased in myocardial ischemia. Further researches could provide a better understanding of pathophysiological mechanisms behind LA enlargement and help to predict clinical outcomes in many cardiovascular disorders.