Monitoring of serum total cortisol level in burned traumatic patients

Background: Systematic inflammatory syndrome causes death in many conditions. Inflammation and anti-inflammation parameters variation monitoring were done by different clinical and lab methods, however, determining the progression of inflammation is very important for on time interference, gaining best results, and cost controlling. In this condition, adrenal insufficiency's variation causes water and electrolyte disorders, circulatory failure, and uncontrolled progression of inflammatory response, which is very important. Routine serum total cortisol level monitoring for SIRS is not advised as yet, and corticosteroid was used blindly according to hemodynamic condition and physician diagnosis. Objectives: In this pilot study, the ability of first three days monitoring serum total cortisol level in SIRS of burned ICU traumatic patients was studied for outcoming improvement. Methods: A total of 60 patients, 15 - 70 years old, < 80 burn, with systemic inflammatory response syndrome, during first three days of admission in the ICU, that weren't included in the exclusion criteria (patients with history of clinical adrenal insufficiency or corton usage, or recent drug history of etomidate or ketoconazole), were divided randomly between two groups with 30 patients. The first group considered under the routine clinical treatment and in the second group, besides the routine methods cortisol daily measurement at 8 o'clock, was done during three days to find the cortisol level under 15 ug/dL, and replacement therapy with 50 mg hydrocortisone IV, four times a day. Results: None of the patients had a cortisol drop during their first three days. Among patients with cortisol more than normal, 20 (6 patients) died. Conclusions: Despite the fact that total serum cortisol drop during systemic inflammatory response syndrome may happen, it is not prevalent, however, it is wise to consider it as an effective parameter on monitoring of treatment measures. Copyright © 2018, Author(s)

Nanostructure of cellulose microfibrils in spruce wood

The structure of cellulose microfibrils in wood is not known in detail, despite the abundance of cellulose in woody biomass and its importance for biology, energy, and engineering. The structure of the microfibrils of spruce wood cellulose was investigated using a range of spectroscopic methods coupled to small-angle neutron and wide-angle X-ray scattering. The scattering data were consistent with 24-chain microfibrils and favored a “rectangular” model with both hydrophobic and hydrophilic surfaces exposed. Disorder in chain packing and hydrogen bonding was shown to increase outwards from the microfibril center. The extent of disorder blurred the distinction between the I alpha and I beta allomorphs. Chains at the surface were distinct in conformation, with high levels of conformational disorder at C-6, less intramolecular hydrogen bonding and more outward-directed hydrogen bonding. Axial disorder could be explained in terms of twisting of the microfibrils, with implications for their biosynthesis

Effect of modafinil administration on the level of consciousness in patients with brain injuries of moderate severity

Background: With regards to the importance of traumatic brain injury (TBI) and its high incidence rate in Iran as well as its severe consequences, it is important to determine the safety and efficiency of modafinil to increase the level of consciousness in hospitalized TBI patients. Methods: This double-blind randomized controlled trial was done during 2016. Sixty patients with TBI and moderate GCS score between 9 and 13 had the inclusion criteria and entered the study and were divided into two groups. Patients in the treatment group received 200 mg of modafinil once a day and the control group received the placebo. Overall, 24 hours after admission, defined as base day, modafinil was prescribed for 196 hours after admission and GCS scores were recorded: this period was defined as the last day. Level of consciousness in both treatment and control groups was assessed by the GCS score. Data were analyzed by SPSS version 21 software using the independent t-test with intention-to-treat approach. Results: Among 60 patients, there were 34 (56.66) males and 26 (43) females; 45 (75) survived. The ITT analysis was employed to assess changes in the level of consciousness (LOC) after prescribing modafinil and placebo. Based on the findings, modafinil prescription was not associated with significant differences in LoC in the first time period (24 hours after) and the last day (196 hours) (P > 0.05). Conclusions: Prescribing modafinil was not associated with significant changes in LoC in comparison with the placebo. Copyright © 2018, Author(s)

Influence of porosity and fibre diameter on the degradation of chitosan fibre-mesh scaffolds and cell adhesion

The state of the art approaches for tailoring the degradation of chitosan scaffolds are based on altering the chemical structure of the polymer. Nevertheless, such alterations may lead to changes in other properties of scaffolds, such as the ability to promote cell adhesion. The aim of this study was to investigate the influence of physical parameters such as porosity and fibre diameter on the degradation of chitosan fibre-mesh scaffolds, as a possible way of tailoring the degradation of such scaffolds. Four sets of scaffolds with distinct fibre diameter and porosity were produced and their response to degradation and cell adhesion was studied. The degradation study was carried out at 37"C in a lysozyme solution for five weeks. The extent of degradation was expressed as percentage of weight loss of the dried scaffolds after lysozyme treatment. Cell adhesion was assessed by Confocal Microscopy. The results have shown that the scaffolds with higher porosity degrade faster and that, within the same range of porosity, the fibres with smaller diameter degrade slightly faster. Furthermore, the morphological differences between the scaffolds did not affect the degree of cell adhesion, and the cells were observed throughout the thickness of all four types of scaffold

Iranian joint registry (iranian national hip and knee arthroplasty registry)

Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry (IJR) with a joint collaboration of the Social Security Organization (SSO) and academic research departments considering the requirements of the Iran's Ministry of Health and Education. ©BY THE ARCHIVES OF BONE AND JOINT SURGERY

Caracterização morfológica de nanocristais de celulose por microscopia de força atômica

RESUMO O isolamento de nanocristais de celulose (CNCs) de fibras vegetais é uma alternativa promissora para sua aplicação como reforço em matrizes poliméricas. A caracterização dos CNCs é fundamental para a confiabilidade da técnica, além de determinar as aplicações possíveis a partir de cada tipo de fibra. A partir da técnica de microscopia de força atômica, um estudo da morfologia e distribuição dos CNCs de semente de manga, vagem de algaroba, pseudocaule da bananeira e fibra do mesocarpo de dendê foi realizado neste trabalho. Os CNCs foram obtidos via reação hidrolítica com ácido sulfúrico em concentrações que variaram de acordo com a fonte da fibra. Os resultados obtidos revelaram dimensões variando de 300 a 500 nm em comprimento e 4 a 16 nm em diâmetro. A apresentação morfológica em forma de agulha demonstrou que o isolamento das fibras de celulose em CNCs foi efetiva. A razão de aspecto associada à formação cilíndrica em agulha dos CNCs isolados evidenciou o alto potencial das fontes de dendê e de vagem de algaroba para o reforço de bionanocompósitos

Toward osteogenic differentiation of marrow stromal cells and in vitro production of mineralized extracellular matrix onto natural scaffolds

Uncorrected proofTissue engineering has emerged as a new interdisciplinary field for the repair of various tissues, restoring their functions by using scaffolds, cells, and/or bioactive factors. A temporary scaffold acts as an extracellular matrix analog to culture cells and guide the development of new tissue. In this chapter, we discuss the preparation of naturally derived scaffolds of polysaccharide origin, the osteogenic differentiation of mesenchymal stem cells cultured on biomimetic calcium phosphate coatings, and the delivery of biomolecules associated with extracellular matrix mineralization

Iranian joint registry (iranian national hip and knee arthroplasty registry)

Periodic evaluation and monitoring the health and economic outcome of joint replacement surgery is a common and popular process under the territory of joint registries in many countries. In this article we introduce the methodology used for the foundation of the National Iranian Joint Registry (IJR) with a joint collaboration of the Social Security Organization (SSO) and academic research departments considering the requirements of the Iran's Ministry of Health and Education. ©BY THE ARCHIVES OF BONE AND JOINT SURGERY

Tension stimulation drives tissue formation in scaffold-free systems

Scaffold-free systems have emerged as viable approaches for engineering load-bearing tissues. However, the tensile properties of engineered tissues have remained far below the values for native tissue. Here, by using self-assembled articular cartilage as a model to examine the effects of intermittent and continuous tension stimulation on tissue formation, we show that the application of tension alone, or in combination with matrix remodelling and synthesis agents, leads to neocartilage with tensile properties approaching those of native tissue. Implantation of tension-stimulated tissues results in neotissues that are morphologically reminiscent of native cartilage. We also show that tension stimulation can be translated to a human cell source to generate anisotropic human neocartilage with enhanced tensile properties. Tension stimulation, which results in nearly sixfold improvements in tensile properties over unstimulated controls, may allow the engineering of mechanically robust biological replacements of native tissue