66 research outputs found

    The Prevalence of Needle sticks injuries among health care workers at a hospital in Tehran

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    ABSTRACT Needle stick injuries (NSIs) are one of the most significant and preventable hazards in relation to Healthcare workers (HCWs). Such injuries have been shown to be of high prevalence within developing countries. To determine the prevalence and circumstances pertaining to the occurrence of NSIs among HCWs employed at a special hospital. The study conducted was a cross-sectional study on HCWs and was carried out in one of Tehran's special hospitals in the year 2012. In this study, in order to identify and determine hazardous potential due to needle stick, HFMEA method was chosen. This resulted in the collection of 240 valid and reliable questionnaires. The validity and reliable nature of the questionnaires was confirmed by experts and by means of the test re-test method. The gathered data was analyzed with SPSS software, version 16.From the analysis of the data it was shown that, a total of 97 (40.42%) HCWs had suffered NSIs in the last year. The patient ward showed the highest prevalence of NSIs (47.42%) in the hospital. Nurses had the highest risk of suffering NSIs (56.7%) in comparison with the other occupational groups. All in all 175 NSIs occurred for the 240 HCWs trialed during the selected period of clinical practice. Of those that received injuries, only roughly 1 in 3 (38.14%) reported it to their infection control officer. Just over a quarter (26.80%) of the injured HCWs used post exposure prophylaxis (PEP) against HIV. Almost all (88.75%) of the HCWs had received a safe injection course. In general, NSIs and their subsequent underreporting are commonplace among hospital healthcare professionals. Significantly, more than two-thirds of the injured HCWs did not use post-exposure prophylaxis (PEP) against HIV. Improved prevention and reporting strategies are needed if the occupational health and safety of healthcare workers is to improve

    Determination of instantaneous interventricular septum wall thickness by processing sequential 2D echocardiographic images

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    Non-invasive quantitative analysis of the heart walls thickness is a fundamental step in diagnosis and discrimination of heart disease. Thickness measurements in 2D echocardiographic images have many applications in research and clinic for assessing of wall stress, wall thickening and viability parameters. Regarding to interventricular septum wall thickness measurement by conventional manual method is more dependent on sonographer experiment; this encouraged these researchers to develop a semi-automatic computer algorithm in accessing to interventricular septum segments thickness. We proposed and carried out a computerized algorithm for wall thickness measurements in 2D echocardiographic image frames. In this program, wall thickness measurement is based of intensity profile function and adaptive bilateral thresholding operation. For validation, thicknesses of septum base and mid segments were estimated in constituent image frames with use of proposed method and then were compared with conventional manual results at same images of the cardiac cycle by statistical methods. In our sample image frames (240 corresponding segments; with different rang of image quality), a bias of 0.10 and 0.12 mm with SD differences of ±0.81 and ±0.72 mm and correlation coefficients of 0.87 and 0.89 were found in base and mid segments, respectively. Interobserver variability using the Computer-Assisted Method (CAM) and Conventional Manual Method (CMM) were 4.0 and 4.7 for the basal and 2.8 and 3.9 for the middle segments. The method introduced in the present study permits precise thickness assessment of base and mid segments of the interventricular septum wall and has high concordance with CMM. © 2007 Asian Network for Scientific Information

    Diverging results of areal and volumetric bone mineral density in Down syndrome

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    Population with Down syndrome (DS) has lower areal BMD, in association with their smaller skeletal size. However, volumetric BMD and other indices of bone microarchitecture, such as trabecular bone score (TBS) and calcaneal ultrasound (QUS), were normal. INTRODUCTION: Patients with DS have a number of risk factors that could predispose them to osteoporosis. Several studies reported that people with DS also have lower areal bone mineral density, but differences in the skeletal size could bias the analysis. METHODS: Seventy-five patients with DS and 76 controls without intellectual disability were recruited. Controls were matched for age and sex. Bone mineral density (BMD) was measure by Dual-energy X-ray Absorptiometry (DXA), and volumetric bone mineral density (vBMD) was calculated by published formulas. Body composition was also measured by DXA. Microarchitecture was measured by TBS and QUS. Serum 25-hidroxyvitamin D (25OHD), parathyroid hormone (PTH), aminoterminal propeptide of type collagen (P1NP), and C-terminal telopeptide of type I collagen (CTX) were also determined. Physical activity was assessed by the International Physical Activity Questionnaires (IPAQ-short form). To evaluate nutritional intake, we recorded three consecutive days of food. RESULTS: DS individuals had lower height (151 ± 11 vs. 169 ± 9 cm). BMD was higher in the controls (lumbar spine (LS) 0.903 ± 0.124 g/cm2 in patients and 0.997 ± 0.115 g/cm2 in the controls; femoral neck (FN) 0.761 ± .126 g/cm2 and 0.838 ± 0.115 g/cm2, respectively). vBMD was similar in the DS group (LS 0.244 ± 0.124 g/cm3; FN 0.325 ± .0.073 g/cm3) and the controls (LS 0.255 ± 0.033 g/cm3; FN 0.309 ± 0.043 g/cm3). Microarchitecture measured by QUS was slightly better in DS, and TBS measures were similar in both groups. 25OHD, PTH, and CTX were similar in both groups. P1NP was higher in the DS group. Time spent on exercise was similar in both groups, but intensity was higher in the control group. Population with DS has correct nutrition. CONCLUSIONS: Areal BMD is reduced in DS, but it seems to be related to the smaller body and skeletal size. In fact, the estimated volumetric BMD is similar in patients with DS and in control individuals. Furthermore, people with DS have normal bone microarchitecture

    COMPARE CPM-RMI Trial: Intramyocardial transplantation of autologous bone marrow-derived CD133+ Cells and MNCs during CABG in patients with recent MI: A Phase II/III, multicenter, placebo-controlled, randomized, double-blind clinical trial

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    Objective: The regenerative potential of bone marrow-derived mononuclear cells (MNCs) and CD133+ stem cells in the heart varies in terms of their pro-angiogenic effects. This phase II/III, multicenter and double-blind trial is designed to compare the functional effects of intramyocardial autologous transplantation of both cell types and placebo in patients with recent myocardial infarction (RMI) post-coronary artery bypass graft. Materials and Methods: This was a phase II/III, randomized, double-blind, placebo-controlled trial COMPARE CPM-RMI (CD133, Placebo, MNCs - recent myocardial infarction) conducted in accordance with the Declaration of Helsinki that assessed the safety and efficacy of CD133 and MNCs compared to placebo in patients with RMI. We randomly assigned 77 eligible RMI patients selected from 5 hospitals to receive CD133+ cells, MNC, or a placebo. Patients underwent gated single photon emission computed tomography assessments at 6 and 18 months post-intramyocardial transplantation. We tested the normally distributed efficacy outcomes with a mixed analysis of variance model that used the entire data set of baseline and between-group comparisons as well as within subject (time) and group�time interaction terms. Results: There were no related serious adverse events reported. The intramyocardial transplantation of both cell types increased left ventricular ejection fraction by 9 95% confidence intervals (CI): 2.14% to 15.78%, P=0.01 and improved decreased systolic wall thickening by -3.7 (95% CI: -7.07 to -0.42, P=0.03). The CD133 group showed significantly decreased non-viable segments by 75% (P=0.001) compared to the placebo and 60% (P=0.01) compared to the MNC group. We observed this improvement at both the 6- and 18-month time points. Conclusion: Intramyocardial injections of CD133+ cells or MNCs appeared to be safe and efficient with superiority of CD133+ cells for patients with RMI. Although the sample size precluded a definitive statement about clinical outcomes, these results have provided the basis for larger studies to confirm definitive evidence about the efficacy of these cell types (Registration Number: NCT01167751). © 2018 Royan Institute (ACECR). All Rights Reserved

    Clinical, immunologic and molecular spectrum of patients with immunodeficiency, centromeric instability, and facial anomalies (ICF) syndrome: A systematic review

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    Background: Immunodeficiency, centromeric instability and facial dysmorphism (ICF) syndrome is a rare autosomal recessive immune disorder presenting with hypogammaglobulinemia, developmental delay, and facial anomalies. The ICF type 1, type 2, type 3 and type 4 are characterized by mutations in DNMT3B, ZBTB24, CDCA7 or HELLS gene, respectively. This study aimed to present a comprehensive description of the clinical, immunologic and genetic features of patients with ICF syndrome. Methods: PubMed, Web of Science, and Scopus were searched systemically to find eligible studies. Results: Forty-eight studies with 118 ICF patients who met the inclusion criteria were included in our study. Among these patients, 60% reported with ICF-1, 30% with ICF-2, 4% with ICF-3, and 6% with ICF-4. The four most common symptoms reported in patients with ICF syndrome were: delay in motor development, low birth weight, chronic infections, and diarrhea. Intellectual disability and preterm birth among patients with ICF-2 and failure to thrive, sepsis and fungal infections among patients with ICF-1 were also more frequent. Moreover, the median levels of all three immunoglobulins (IgA, IgG, IgM) were markedly reduced within four types of ICF syndrome. Conclusion: The frequency of diagnosed patients with ICF syndrome has increased. Early diagnosis of ICF is important since immunoglobulin supplementation or allogeneic stem cell transplantation can improve the disease-free survival rate

    Frame rate requirement for tissue Doppler imaging in different phases of cardiac cycle: Radial and longitudinal functions

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    Tissue Doppler imaging (TDI) has been suggested for quantitative analysis of regional myocardial function. Myocardial movement included different mechanical phases with different duration and tissue velocity profiles need to high sampling rate in the acquisition of tissue velocity imaging for phases with shorter duration. The aim of this study is determining of frame rate requirement for myocardial tissue velocity imaging for longitudinal and radial functions separately. Tissue velocity imaging recorded from 29 healthy volunteers by use of the apical and para-sternal views. Off-line analysis performed for extracting tissue velocity profiles of the myocardial longitudinal and radial functions. The frequency and subsequently the frame rate calculated separately for all LV segments during two consequent cardiac cycles. Segmental distribution of the time intervals measured in all cardiac phases and the minimum frame rate requirement calculated for each segment. We found significant differences between radial and longitudinal functions (P < 0.001) except early diastolic phases. The presented normal frame rate values for LV segments may useful for accurate studies of myocardial longitudinal and radial functions in different cardiac phases. We conclude that data sampling at a rate of at least 105 and 118 frames per second need for longitudinal and radial functions respectively. © Springer Science+Business Media B.V. 2007

    The role of PGC-1α and metabolic signaling pathway in kidney injury following chronic administration with 3-MCPD as a food processing contaminant

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    3-Monochloropropane-1,2-diol (3-MCPD) as a byproduct of food processing and a carcinogenic agent has attracted much attention in the last decades. Kidney is the main target organ that is sensitive to the toxicity of 3-MCPD. Due to limited evidence about possible 3-MCPD toxicity, we design an investigation to determine the role of mitochondrial biogenesis following chronic oral administration of 3-MCPD (2, 4, 8 and 32 mg/kg) for 2 months in male C57 mice. The present study evaluated the affects of 3-MCPD in modulating metabolic signalling which is associated with Il-18, PGC-1α, Nrf-2 and Sir3 which are the major transcription factors. Our data confirms controversial behaviors after chronic exposure with 3-MCPD. Over expression of the PGC-1α and Sir3 and IL-18 were observed after exposure with 2,4 &amp; 8 mg kg�1 day�1 of 3-MCPD. In front, PGC-1α down-regulation occurs at the highest dose (32 mg/kg) resulted in kidney injury. Based on the findings, PGC-1α plays an important role in the restoration of the mitochondrial function during the recovery from chronic kidney injury. We suggest that the PGC-1α can be consider as a therapeutic target in prevention and treatment of kidney injury after chronic exposure of 3-MCPD. Practical applications: 3-Monochloropropane-1, 2-diol (3-MCPD) existed in several foods, can induce nephrotoxicity, progressive nephropathy and renal tubule dilation following acute and chronic exposure. It revealed that 3-MCPD toxicity is related to metabolites which can cause oxidative stress and activation of cell death signaling. It seems that cytotoxicity of 3-MCPD has disruptive effect on kidney cells due to rise in ROS production and decrease in mitochondrial membrane permeability. These effects can lead to MPT pore opening, cytochrome c release and activation of programed cell death signaling pathway. Therefore, present study was investigated the role of PGC-1a and the metabolic signaling involved in 3-MCPD-induced nephrotoxicity for the first time. Our data revealed that up-regulation of mitochondrial biogenesis following chronic exposure with 3-MCPD accelerates recovery of mitochondrial and cellular function in kidney by deacetylation of histones, overexpression of transcription factors (PGC-1α, Nrf-2, and Sir3) and maintaining cellular homeostasis. © 2021 Wiley Periodicals LLC
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