Summary Background Microvascular free tissue transfers play an important role in the reconstruction of body defects. Various aetiologies lead to vascular thrombosis and free-flap failure. In this ...study, the effects of botulinum toxin A on vessel diameters and prevention of anastomotic thrombosis were studied in a blinded vasospasm model in rabbits. Methods One side of 16 adult rabbit ears was pre-treated with botulinum toxin type A, and normal saline injections were performed as control in the contralateral side. Seven days later, vessel diameters were measured in both the groups; the vessels were then cut and reanastomosed after vasospastic challenge and vessel patencies were evaluated. Results Both artery and vein diameters were significantly larger in the botulinum toxin A group ( P = 0.002 and < 0.001, respectively). The patency rate of arterial and venous anastomosis was significantly higher in the neurotoxin pre-treated group ( P = 0.038 and 0.003, respectively). Conclusion This study shows that pre-treatment with botulinum toxin type A is associated with a lower rate of arterial and venous thrombosis in rabbit-model microanastomosis. Further studies are necessary to evaluate its ability to decrease vasospasm and thrombosis in free-flap survival of humans.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Buerger's disease or thromboangiitis obliterans (TAO) seems to be common in IR Iran, The present study aimed to evaluate an Iranian population with Buerger's disease in order to suggest a diagnostic ...criterion for Buerger's disease based on the most frequent findings and to compare it with Papa diagnostic criteria. In a cross-sectional study, all patients with resting limb pain, limb ischemic ulcers, intermittent claudication and limb ischemia who referred to the Vascular Clinic of Sina Hospital during 2009-2011 were evaluated. The patients were allocated to Buerger's and non-Buerger's groups; Evaluating 122 patients (61 in each group), according to the model each clinical manifestations and risk factors in the patients with Buerger's disease obtained a score. Absent pulsation, abnormal distal Doppler sonography and ischemic ulcer were respectively present in 58 (95.1%), 58 (95.1%) and 49 (80.3%) individuals with Buerger's disease. Multivariate linear regression analysis and multivariate logistic regression analysis were used for modeling. Considering the model finding findings, diagnostic criteria including age, sex, smoking, Raynaud's phenomenon, abnormal proximal Doppler, diabetes mellitus and hyperlipidemia were suggested (R2=0.582); the sensitivity and specificity of the criteria was respectively 95.1% and 78.7%. Compared with Papa criteria, Kappa coefficient was measured at 0.66 with a P-value<0.001. It seems that the recommended criteria have an acceptable accuracy in diagnosing Buerger's disease, especially in the Iranian population; however, it is necessary to conduct more studies with larger sample sizes to evaluate the criteria, especially in other populations.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
This study was aimed at determining intra and inter-observer concordance rates in the Gleason scoring of prostatic adenocarcinoma, before and after a web-based educational course. In this ...self-controlled study, 150 tissue samples of prostatic adenocarcinoma are re-examined to be scored according to the Gleason scoring system. Then all pathologists attend a free web-based course. Afterwards, the same 150 samples with different codes compared to the previous ones are distributed differently among the pathologists to be assigned Gleason scores. After gathering the data, the concordance rate in the first and second reports of pathologists is determined. In the pre web-education, the mean kappa value of Interobserver agreement was 0.25 fair agreement. Post web-education significantly improved with the mean kappa value of 0.52 moderate agreement. Using weighted kappa values, significant improvement was observed in inter-observer agreement in higher scores of Gleason grade; Score 10 was achieved for the mean kappa value in post web-education was 0.68 substantial agreement compared to 0.25 (fair agreement) in pre web-education. Web-based training courses are attractive to pathologists as they do not need to spend much time and money. Therefore, such training courses are strongly recommended for significant pathological issues including the grading of the prostate adenocarcinoma. Through web-based education, pathologists can exchange views and contribute to the rise in the level of reproducibility. Such programs need to be included in post-graduation programs.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Pantoprazole, is a proton pump inhibitor (PPI) prescribed for the treatment of upper gastrointestinal disorders, which in high doses has been suggested to decrease calcium absorption leading to ...hypocalcaemia and therefore osteoporosis. The aim of this study was to assess whether pantoprazol, could alter the rate of orthodontic tooth movement (OTM) in rats.
A time course study was established using 72 rats which were divided into six groups of 12 samples each (four: vehicle; eight: pantoprazole + vehicle). Pantoprazole at a dose of 200 mg/kg suspended in carboxymethyl cellulose (0.25 percent) was administered by a gastric tube. The upper incisors and first molars were ligated by a 5 mm nickel-titanium closed-coil spring to deliver an initial force of 60 g. Animals were euthanized two weeks after orthodontic treatment followed by assessment of tooth movement and histomorphometric evaluation of the detached maxillae. Lateral skull radiographs were obtained once a week, starting from the first day to the 6(th) week of the study. OTM and bone density data were analyzed using independent sample t-test and repeated measures ANOVA.
No significant changes in OTM measurements and optical density were observed in vehicle-receiving animals during the study (P=0.994). OTM was significantly increased after six weeks pantoprazole therapy which continued until the 7(th) week of the experiment (P=0.007). Optical density significantly increased in the pantoprazole-treated rats after six weeks.
Long term PPI therapy at high doses could lead to osteoporosis and enhanced OTM.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background & ObjectiveThe most frequent type of cancer found in the endocrine system is thyroid carcinoma. Among well-differentiated thyroid malignancies, the most commonly occurring type is ...identified as papillary thyroid carcinoma (PTC), which makes up 70-90% of the cases. A subtype of PTC is papillary thyroid microcarcinoma (PTMC), which includes tumors smaller than 10 mm in diameter. Due to the advancements in diagnostic techniques, the incidence of this type of cancer is on the rise. In this study, we aimed to analyze the factors worsening the PTMC prognosis.MethodsIn the first step, we searched various databases for the factors affecting this tumor. The relevant articles were collected and different outcomes of this tumor and its associated factors which were studied in more than one article, were classified. Finally, we conducted a meta-analysis of these outcomes and their related factors.ResultsIn the meta-analysis, a significantly association was found between the following factors: recurrence with gender (P<0.001) lymph node metastasis (LNM) (P= 0.003), and extrathyroidal invasion (P<0.001); lymph node metastasis with extrathyroidal invasion (P<0.001), and multifocality (P<0.001); central lymph node metastasis (CLNM) with gender (P=0.001), tumor size (P<0.001), extracapsular invasion (P<0.001), lateral cervical lymph node metastasis (P<0.001), and extrathyroidal invasion (P<0.001); lymph node metastasis resulted in poor outcomes (P<0.001); and finally tumor size with BRAFV600E mutation (P<0.001).ConclusionIn conclusion, it is essential to note that greater awareness and understanding of this tumor characteristics and special and separate attention to PTMC can significantly improve the society overall health.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Various questionnaires are used in patients who undergo rhinologic surgeries but a unique comprehensive questionnaire is needed to evaluate quality of life (QOL) in rhinologic surgeries. The purpose ...of this study was to prepare a comprehensive questionnaire and compare QOL among four common rhinologic surgeries including functional endoscopic sinus surgery, septoplasty, septorhinoplasty, and septoplasty with turbinoplasty preoperatively and 6 months postoperatively. This was a prospective interventional before-and-after study. Preoperative and 6 months postoperative evaluations were performed with a Modified Health-Related Quality of Life (HRQL) questionnaire designed to cover all needed QOL aspects and the 22-item Sino-nasal Outcome Test questionnaire to cover all needed QOL aspects. The Modified HRQL included 33 items in six subgroups (nasal symptoms, sleep problems, headache, nonnasal symptoms, and practical and emotional problems) and general feeling. From 202 patients who completed the questionnaire before the procedures, 146 (72% of all patients) who were interviewed 6 months postoperatively were included in this study. Comparing preoperative data between followed up patients and missed patients showed no statistical difference among surgeries (p = 0.90). Comparison of patient's pre- and postoperative QOL showed a significant improvement in global QOL and in all questionnaire items (p < 0.0001 in all comparisons). Comparison of QOL changes before and after surgery among different surgeries revealed no statistical difference (p = 0.282). Our data showed a significant improvement in each surgery but the amount of improvement in different surgeries was almost constant.
Abstract Aims To estimate the prevalence and trends of diabetes mellitus (DM) and impaired fasting glucose (IFG), 2005–2011, and to determine the contribution of obesity to DM prevalence. Patients ...and methods Data from Surveillance of Risk Factors of Non-communicable Diseases (SuRFNCD) conducted in 2005, 2007, and 2011 were gathered. DM was defined as presence of self-reported previous diagnosis or a fasting plasma glucose (FPG) ≥ 7 mmol/L. IFG was diagnosed with FPG levels between 5.6 and 6.9 mmol/L. Prevalence rates for 2011 and trends for 2005–2011 were determined by extrapolating survey results to Iran's adult population. Population attributable fraction (PAF) of obesity was also calculated. Results In 2011, IFG and total DM prevalence rates were 14.60% (95%CI: 12.41–16.78) and 11.37% (95%CI: 9.86–12.89) among 25–70 years, respectively. DM was more common in older age ( p < 0.0001), in women ( p = 0.0216), and in urban-dwellers ( p = 0.0001). In 2005–2011, trend analysis revealed a 35.1% increase in DM prevalence (OR: 1.04, 95%CI: 1.01–1.07, p = 0.011); albeit, IFG prevalence remained relatively unchanged (OR: 0.98, 95%CI: 0.95–1.00, p = 0.167). In this period, DM awareness improved; undiagnosed DM prevalence decreased from 45.7% to 24.7% ( p < 0.001). PAF analysis demonstrated that 33.78%, 10.25%, and 30.56% of the prevalent DM can be attributed to overweight (BMI ≥ 25 kg/m2 ), general obesity (BMI ≥ 30 kg/m2 ), and central obesity (waist circumference ≥ 90 cm), respectively. Additionally, the DM increase rate in 2005–2011, was 20 times higher in morbidly obese compared with lean individuals. Conclusion More than four million Iranian adults have DM which has increased by 35% over the past seven years, owing in large part, to expanding obesity epidemic.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
One of the identified risk factors for anxiety disorders in adolescence and adulthood is inhibited behaviors in childhood. The present study sought to examine the relationship between behavioral ...inhibition with some of the internal (personal) and external (family environment) factors in a sample of preschool children in kindergartens. In a cross sectional study in 2009, data was collected trough a structured questionnaire completed by parents and teachers in day-care centers. A total of 1403 children were assessed. Analysis was performed through complex sample analysis. The results showed that 7.4% (CI95%= 6.1%-9.1%) of children according to parents' and 8.1% (CI95%= 6%- 10.7%) according to teachers' evaluation classified as behaviorally inhibited. The higher levels of behavioral inhibition were shown by girls, first children, single parent families and older children. Birth year before 2004, birth rank, living in a single parent family and maternal level of education were independent predictors for behavioral inhibition in logistic regression modeling. There is relatively high prevalence of inhibited behaviors among Iranian children. Further examination of diagnosed children with behavioral inhibition by experienced psychiatrists is needed. Also establishing consultation centers for behaviorally inhibited children and instructing their parents and teachers are recommended.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Seizures are among the most common causes of apparent life-threatening events. There are discrepancies among the published reports on the correlation between epilepsy/febrile seizures and deficiency ...or overload of trace elements. The objective of this review and meta-analysis was to examine the present knowledge on the concentrations of the most investigated trace metals, including zinc, copper, selenium, and magnesium, in patients with epilepsy and febrile seizures. The PubMed and Scopus databases were searched to identify case–control studies that compared the concentration of zinc, copper, magnesium, and selenium in serum, hair, or cerebrospinal fluid between patients with epilepsy/febrile seizures and controls. A total of 60 articles were included in the present study (40 pertaining to epilepsy and 25 pertaining to febrile seizures). The serum concentration of zinc in nontreated patients with epilepsy was significantly higher than in controls (P = 0.034). There were significantly reduced serum concentrations of zinc (P = 0.018) and selenium (P = 0.012) in patients with febrile seizures compared with controls. The concentrations of copper, magnesium, and zinc were all significantly altered in patients with epilepsy who received antiepileptic drugs compared with untreated patients with epilepsy. Designing treatments to selectively restore zinc levels may be a strategy for treating patients with epilepsy. It is still unclear whether these ions are causal to, or a cofactor in, the development of epilepsy. Knowledge of the effects of various antiepileptic drugs on trace element homeostasis could potentially be used to effectively guide appropriate therapeutic strategies in the future.
Health Care Associated Infection (HCAI), especially nosocomial infection (NCI) in intensive care units (ICUs), has remained a major cause of mortality and morbidity. In this study, the rate of HCAI ...and the factors associated with both NCIs and deaths in ICUs were assessed in a large teaching hospital complex in Tehran, IR Iran.
In this cross sectional study, 300 patients hospitalized in six different ICUs of a large teaching hospital located in Tehran were assessed from January to March 2013. Nosocomial infection was defined as the presence of clinical signs and symptoms of infection in patients at least 48h after their hospitalization, confirmed by positive cultures of specimens taken from the patients’ blood, urine, wounds, respiratory secretions and other body fluids. The risk factors of NCIs were assessed by a researcher – produced checklist consisting of 109 questions.
According to the findings, NCIs were observed in 59 (19.7%) (CI 95%=15.2–24.2%) patients and the overall mortality rate was 23 (7.7%) (CI 95%=4.7–10.7%), and the highest infection rate belonged to general ICU-1. The factors associated with the higher rate of NCI and/or mortality were as follows: lower education levels, increased length of stay in ICU, increased duration of antibiotic use, combined antibiotic therapy, long time inserted catheters, anemia, and immunosuppression or chronic diseases. Multivariate analysis showed an independent statistically significant association between prolonged urinary catheterization and both NCIs and deaths.
It seems that patients with prolonged catheterization are prone to NCIs and deaths, so they should be treated intensively.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
PDF
