Impact of endoscopic versus open saphenous vein harvest technique on late coronary artery bypass grafting patient outcomes in the ROOBY (Randomized On/Off Bypass) Trial

ObjectiveIn the Randomized On/Off Bypass (ROOBY) Trial, the efficacy of on-pump versus off-pump coronary artery bypass grafting was evaluated. This ROOBY Trial planned subanalysis compared the effects on postbypass patient clinical outcomes and graft patency of endoscopic vein harvesting and open vein harvesting.MethodsFrom April 2003 to April 2007, the technique used for saphenous vein graft harvesting was recorded in 1471 cases. Of these, 894 patients (341 endoscopic harvest and 553 open harvest) also underwent coronary angiography 1 year after coronary artery bypass grafting. Univariate and multivariable analyses were used to compare patient outcomes in the endoscopic and open groups.ResultsPreoperative patient characteristics were statistically similar between the endoscopic and open groups. Endoscopic vein harvest was used in 38% of the cases. There were no significant differences in both short-term and 1-year composite outcomes between the endoscopic and open groups. For patients with 1-year catheterization follow-up (n = 894), the saphenous vein graft patency rate for the endoscopic group was lower than that in the open harvest group (74.5% vs 85.2%, P < .0001), and the repeat revascularization rate was significantly higher (6.7% vs 3.4%, P < .05). Multivariable regression documented no interaction effect between endoscopic approach and off-pump treatment.ConclusionsIn the ROOBY Trial, endoscopic vein harvest was associated with lower 1-year saphenous vein graft patency and higher 1-year revascularization rates, independent of the use of off-pump or on-pump cardiac surgical approach

Self-efficacy Among Older Adults in Fereydunshahr City

Objectives Self-efficacy is a very important factor as far as old age is concerned. Because of the numerous physical and physiological changes occurring in elder&rsquo;s bodies, self-efficacy has &nbsp;initiated a broad discussion among experts. Numerous studies have revealed that self-efficacy is one of the most important predictors of health behaviors among the elderly and adults in general. Keeping these facts in mind, this study was conducted to evaluate the self-efficacy among the elderly in Fereydunshahr City.&nbsp; Methods & Materials The present study was a descriptive-analytical one and was conducted by means of a cross-sectional survey. Two hundred elderly people in Fereydunshahr City were selected by the systematic randomly sampling method. The average (SD) age of the elderly was 68.02 (3.7) years, and 101 (50.5%) of them were women, and 99 (49.5%) were men. The data were collected with a couple of questionnaires. The first questionnaire included demographic characteristics of the elderly, and the second was the Scherer self-efficacy questionnaire. Data were analyzed by SPSS (ver. 20) through descriptive statistics, Pearson correlation, Spearman test, and Independent t test. Results The mean (SD) score of self-efficacy among elderly was 26.6 (6.8); the independent t test showed that the self-efficacy score in those with chronic diseases was significantly lower than healthy elders. The average score of self-efficacy in the elderly who lived with family was significantly higher than those who lived alone, and the average self-efficacy score in the elderly people with jobs was significantly higher than those who were unemployed.&nbsp; Conclusion Given that self-efficacy is an important component of lifestyle changes, it can be effective in changing behaviors or help in the initiating of healthy behaviors. In this study, self-efficacy of the elderly was moderate. Therefore, designing and implementing educational interventions and promoting healthy practices are recommended

In vitro complete differentiation of human spermatogonial stem cells to morphologic spermatozoa using a hybrid hydrogel of agarose and laminin

Spermatogenesis refers to the differentiation of the spermatogonial stem cells (SSCs) located in the base seminiferous tubules into haploid spermatozoa. Prerequisites for in vitro spermatogenesis include an extracellular matrix (ECM), paracrine factors, and testicular somatic cells which play a supporting role for SSCs. Thus, the present study evaluated the potential of co-culturing Sertoli cells and SSCs embedded in a hybrid hydrogel of agarose and laminin, the main components of the ECM. Following the three–week conventional culture of human testicular cells, the cells were cultured in agarose hydrogel or agarose/laminin one (hybrid) for 74 days. Then, immunocytochemistry, real-time PCR, electron microscopy, and morphological staining methods were applied to analyze the presence of SSCs, as well as the other cells of the different stages of spermatogenesis. Based on the results, the colonies with positive spermatogenesis markers were observed in both culture systems. The existence of the cells of all three phases of spermatogenesis (spermatogonia, meiosis, and spermiogenesis) was confirmed in the two groups, while morphological spermatozoa were detected only in the hybrid hydrogel group. Finally, a biologically improved 3D matrix can support all the physiological activities of SSCs such as survival, proliferation, and differentiation