Usefulness of Cardiac Index to Predict Early and 30-Day Mortality in Non-Cardiac Patients Being Admitted to Intensive Care Units

Introduction: Cardiac index is a hemodynamic parameter defined as the ratio of the cardiac output, i.e., the volume of blood ejected from the left ventricle in 1 min, to the body surface area. This study aimed to assess the cardiac index to predict early and 30-day outcomes of non-cardiac patients being admitted to intensive care units using a non-invasive approach. Materials and Methods: This prospective cohort study included 31 non-cardiac patients who were consecutively admitted to the intensive care units of Rasoul-e-Akram Hospital, Tehran, Iran, in 2016. On admission, the simplified acute physiology score II to predict mortality and the cardiac output (by two-dimensional echocardiography) of each patient were determined. The cardiac index was calculated by dividing the cardiac output by the body surface area. In-hospital mortality and complications were assessed, and the association between simplified acute physiology score II and cardiac index was determined. The patients were followed-up 30 days after discharge by telephone to determine late death, occurrence of myocardial infarction, readmission, or re-hospitalization. Results: The mean cardiac index was significantly lower among the patients who died in intensive care units than in those who survived (2.86 ± 0.63 versus 3.70 ± 0.49, p = 0.006). A significant inverse association was found between Simplified Acute Physiology Score II and cardiac index (r = −0.539, p = 0.002). The length of hospital and intensive care units stay was not associated with Simplified Acute Physiology Score -II or cardiac index. The receiver operating characteristic curve analysis revealed that the cardiac index was effective in predicting in intensive care units mortality (area under curve = 0.857, p = 0.007). The best cut-off value for the cardiac index to predict in intensive care units mortality was 3.35, yielding a sensitivity of 83.3% and a specificity of 80.0%. Conclusion: Measuring the cardiac index during intensive care units admission using a noninvasive approach even in non-cardiac patients can predict in intensive care units mortality with high sensitivity and specificity

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

The Effects of Vitamin D Supplementation on Pulmonary Function of Chronic Obstructive Pulmonary Disease Patients, before and after Clinical Trial

Vitamin D has several extra calcemic effects. Vitamin D deficiency is highly prevalent in chronic obstructive pulmonary disease (COPD) patients but little is known about it’s association with lung function. Objective: To investigate whether supplementation with vitamin D could improve pulmonary function in COPD patients. Design: Before and after, double center, clinical trial. Setting: Hazrat Rasoul University Hospital, Tehran, and Imam Khomaini University Hospital, Ahvaz, Iran. Participants: 24 patients with mild to very severe COPD. Intervention: Loading dose of 300,000–600,000 International Units (IU) of vitamin D, then 50000 IU weekly for 12 weeks. Measurements: The outcomes included forced expiratory volume in one second (FEV1), forced vital capacity (FVC), vital capacity (VC), forced expiratory flow between 25%–75% of forced vital capacity (FEF 25%–75%), exercise capacity according to the six minute walk test(6MWT) and the saturation of oxygen during exercise. Results: The mean FEV1 (p-value = 0.866), FVC (p-value = 0.475) and VC (p-value = 0.425) were not significantly different before and after intervention. FEF 25%–75% did not improve with this intervention (p-value = 0.555). The vitamin D supplementation did not have any significant effect on the exercise capacity (p-value=0.175) or the saturation of oxygen (p-value = 0.635). Conclusion: Pulmonary function and exercise capacity did not improve with vitamin D supplementation in COPD patients

Energy and Protein Intake and Its Relationship with Pulmonary Function in Chronic Obstructive Pulmonary Disease (COPD) Patients

Chronic Obstructive Pulmonary Disease (COPD) is a public health problem worldwide. Increased energy and protein needs, decreased energy and protein intake are common in COPD patients. Adequate intake is essential to improve pulmonary function and immune system, prevention of weight loss and maintaining muscle mass and strength. Assessment of energy and protein intake and its relationship with pulmonary function in COPD patients was performed in this study. The study group included 63 COPD patients. For all subjects, evaluation of energy and protein intake by Food Frequency Questionnaire (FFQ) and 24-hour recall, spirometry for measuring pulmonary function and determining disease severity were performed. The subjects were divided into three groups based on disease severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages. Relationship between energy and protein intake with pulmonary function was assessed. Energy and protein intake were lower than the calculated energy and protein demand for all groups. Significant relationship was found between the amount of protein intake extrapolated from food frequency questionnaire with Forced Vital Capacity (FVC) (r=0.2, P=0.02) and Vital Capacity (VC) (r=0.3, P=0.008). The results of the study suggest that accurate evaluation of protein and energy intake and requirements should be included in the goals of medical treatment of COPD patients

Comparing the performance of QuantiFERON-TB Gold and Mantoux test in detecting latent tuberculosis infection among Iranian health care workers

Objectives: The risk of transmission of Mycobacterium tuberculosis from patients with tuberculosis to health care workers (HCWs) has been well documented but little is known about the prevalence of latent tuberculosis infection (LTBI) in Iranian HCWs. The aim of this study was to determine the prevalence of LTBI among HCWs by using IFNgamma-release assay and compare the results with those of tuberculin skin test (TST). Methods: Two hundred HCWs were evaluated with both TST and QuantiFERON-TB Gold In Tube test (QFT-GIT). The obtained data were analyzed by SPSS v.16 Software. Results: The participants were 73 males and 127 females with the mean age of 34.36±8.26 years. TST was positive in 105 cases (52.5%) and the QFT results were positive in 17 cases (8.5%). There was poor agreement between the two tests (53%, к = 0.115). Induration diameter of TST ≥ 10 mm and working duration ≥ 10 years were independent predictors for positive QFT (p = 0.004). Conclusions: Due to the fact that BCG vaccination has been administered routinely to all HCWs in Iran, specifi c tests should be introduced for high risk groups. QFT thus seems to be more effective for LTBI diagnosis than TST among HCWs with BCG immunization history

Evaluation of Desmin, α-SMA and hTERT expression in pulmonary fibrosis and lung cancer

Background: Pulmonary fibrosis is a clinical problem with an enigmatic etiology with no effective therapy. Current therapies for lung fibrosis are ineffective for progression of lung fibrosis and preventing respiratory failure. Objectives: The aim of this study is to explore the expression of Desmin, α-smooth muscle actin (α-SMA) and the telomerase subunit: human telomerase reverse transcriptase (h-TERT) in a spectrum of lung tissue samples consist of lung fibrosis, lung cancer, and healthy controls. Materials and Methods: The expression of Desmin, α-SMA and hTERT were studied in samples of 15 pulmonary fibrosis samples, 16 samples of lung cancer and 14 healthy controls investigated. We evaluated Desmin, α-SMA as well as the expression of components of telomerase (TERT), by methods: RNA Extraction and cDNA synthesis, Real-Time quantitative PCR, Immunohistochemistry, all prepared from lung tissue paraffin blocked. Results: α-SMA marker detected 1(8.3%) of healthy control and 11(91.7%) of lung fibrosis samples. The difference between groups was significant (p<0.001). Also the difference between healthy control 1(6.7%) and lung cancer 14 (93.3%) for α-SMA marker was a significant (P<0.001). It was a significant difference between healthy control and lung cancer for TERT expression (P=.005). TERT was not positive in any sample of neither healthy control nor lung fibrosis. For TERT, it was a significant difference between lung fibrosis and lung cancer by Fisher’s Exact Test (P=.004). Expression of TERT and α-SMA between small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) was not statistically significant (P=.700, P=0758), respectively. Conclusions: We recommend more investigation to regard α-SMA, Desmin in patients with lung fibrosis and follow them for possible cancer risk. Also, more study is needed to regard TERT as a marker in lung cancer. Assessment of these markers may have future implication to explain the same way of pathogenesis and carcinogenesis of fibrosis and cancer and for prevention or treatmen

Synergistic Effects of Conductive PVA/PEDOT Electrospun Scaffolds and Electrical Stimulation for More Effective Neural Tissue Engineering

Fabrication and optimization of conductive scaffolds capable of inducing proper intercellular connections through electrical signals is critical for neural tissue engineering. In this research, electrospun conductive PVA (Polyvinyl alcohol)/PEDOT(poly(3,4-ethylenedioxythiophene)) scaffolds were fabricated in different compositions. Conductivity of electrospinning solutions and electrospun scaffolds were measured. Morphology and topography, mechanical properties and water contact angle of scaffolds were analyzed. Chemistry of scaffolds were studied using FTIR analysis, while biocompatibility and cellular interactions with scaffolds were tested using MTT assay and cellular attachment and spreading testing. Our results show improvements in PEDOT-containing scaffolds, in terms of physiochemical properties, and cell viability compared to pure PVA scaffolds. After optimization of scaffolds, real-time PCR analysis was used to study neural differentiation of rat mesenchymal stem cells (MSCs). Scaffold samples with and without induction of electrical stimulation are shown to upregulate β-tubulin, nestin and enolase as compared to TCP samples. Additionally, expression of nestin gene in scaffold samples with electrical stimulation was 1.5 times more significant than scaffold sample. Overall, this study shows that using PVA/PEDOT conductive scaffolds with electrical stimulation can improve cellular response and neural differentiation through mimicking the properties of native neural tissue

A Convenient Catalytic Method for the Synthesis of Pyridines with Henna and Pyrazole Moieties using Cooperative Vinylogous Anomeric-Based Oxidation

In this work, [Fe3O4@SiO2(CH2)3][DABCO-H][C(CN)3]2 was prepared, identified by various analyses such as FT-IR, EDX, SEM coupled EDX (SEM mapping), XRD, FE-SEM, TEM, TGA, DTG, ICP and VSM and used as a nanomagnetic catalyst for the synthesis of henna-based benzopyrazolo[3,4-b]quinolindiones via cooperative vinylogous anomeric based oxidation under solvent-free condition. Some of these products are new and reported for the first time.We thank the Bu-Ali Sina University, the Hamedan University of Technology, and Iran National Science Foundation [(INSF), Grant Number: 98001912) for financial support to our research group

Correlation of EGFR Expression with Survival Rate in Patients with Oral Squamous Cell Carcinoma

Background and Aim: This study aimed to indicate the role of epidermal growth factor (EGF) in proliferation and growth of epithelial tissue and to determine the correlation be-tween the frequency of expression of EGF receptor (EGFR) by means of immunohistochemistry with survival rate in oral squamous cell carcinoma (OSCC). Materials and Methods: Thirty-eight cases of OSCC diagnosed by hematoxylin and eo-sin (H&E) staining were included in this prospective study, and immunohistochemistry for EGFR was applied using antibodies against EGFR. The total score of stained cells and the correlation between the total score and survival rate of patients were recorded. The data were analyzed by Kaplan-Meier, Spearman and the log rank tests using SPSS software version 20. Results: The mean age of patients was 71.8±1.09 years. The follow up range was 25-86 months. The mean survival time for EGFR score 3 (51±9.32 months) was significantly higher than that for score 4, (28.64±4.1 months) (P=0.002) and overexpression of EGFR was correlated with poor prognosis. A significant correlation was found between the grade of tumor and EGFR scale (P=0.049, R=0.318). There was no significant correlation between EGFR overexpression and OSCC stage (P>0.05). Conclusion: EGFR is probably an independent prognostic factor for assessment of survival rate. A correlation also exists between the grade of tumor and expression of EGFR